Carpal tunnel syndrome among milking parlor workers in Northern Italy: a comparison of screening approaches.

BACKGROUND: Occupational tasks characterized by repetitive, awkward and forceful movements of the hand and wrist may heighten the risk of carpal tunnel syndrome (CTS) among dairy parlor workers. Median nerve impairment can be investigated with ultrasonography (US) and nerve conduction studies (NCS) but a structured questionnaire may help identify early symptoms. OBJECTIVES: Our objectives were to: a) compare the sensitivity of US investigations and NCS to detect early signs of CTS; b) explore the correlation of the results of these two tests with CTS symptoms obtained from the administration of a targeted questionnaire. METHODS: Forty male milking parlor workers were recruited. The study protocol included: 1) the identification of characteristic CTS symptoms through a targeted questionnaire; 2) US imaging of the carpal tunnel inlet (using a portable ultrasound device; 3) NCS of the distal median nerve. RESULTS: The symptom questionnaire was considered positive if at least one CTS symptom was present within two weeks prior to the examination. The symptom questionnaire showed a high level of specificity (92,6%) and sensitivity (61%) when compared with NCS results. Ultrasound results revealed a prevalence of median neuropathy of 55%, but when compared to NCS, the ultrasound showed quite low predictive values (NPV of 37% and PPV of 38%). DISCUSSION: The symptom questionnaire was associated with the median nerve pathology often seen in CTS. Moreover, the study results have shown the questionnaire to be the most effective screening method when compared to ultrasound.

Occupational physical activity in brewery and office workers.

Active lifestyles are beneficial to health and well-being but our workplaces may not be inherently supportive of physical activity at work. With the increasing use of technology in the workplace, many jobs are becoming more sedentary. The purpose of this study was to characterize levels of occupational physical activity (OPA) among active and sedentary workers. Two types of activity trackers (Fitbit Charge HR and Hexoskin) were used to assess activity measures (steps, heart rate, and energy expenditure) among workers during one full work shift. The first objective of the study was to assess the agreement between two types of accelerometer-based activity trackers as measures of occupational physical activity. The second objective of this study was to assess differences in measures of OPA among workers in generally physically active (brewery) and sedentary (office) work environments. Occupational physical activity data were collected from 50 workers in beer-brewing tasks and 51 workers in office work tasks. The 101 subjects were from the brewing service sector, a call center, and an engineering office within a manufacturing facility. A two-factor repeated measures analysis of variance (ANOVA) was used to assess the two activity tracking devices while two-sample t-tests were used to compare the two worker groups. There were statistically significant differences in total steps and mean heart rate between the two devices. When comparing the two groups of workers there were statistically significant differences in measures of steps, mean heart rate, and energy expenditure. The results of the present study provide quantitative evidence that levels of OPA should be identified for different work groups.

A mixed-methods analysis of logging injuries in Montana and Idaho.

BACKGROUND: Despite advances in mechanization, logging continues to be one of the most dangerous occupations in the United States. Logging in the Intermountain West region (Montana and Idaho) is especially hazardous due to steep terrain, extreme weather, and remote work locations. METHODS: We implemented a mixed-methods approach combining analyses of workers' compensation claims and focus groups to identify factors associated with injuries and fatalities in the logging industry. RESULTS: Inexperienced workers (>6 months experience) accounted for over 25% of claims. Sprain/strain injuries were the most common, accounting for 36% of claims, while fatalities had the highest median claim cost ($274 411). Focus groups identified job tasks involving felling trees, skidding, and truck driving as having highest risk. CONCLUSIONS: Injury prevention efforts should focus on training related to safe work methods (especially for inexperienced workers), the development of a safety culture and safety leadership, as well as implementation of engineering controls.

Risk assessment of cheese processing tasks using the Strain Index and OCRA Checklist.

The purpose of this study was to conduct and compare two ergonomic risk assessment methods often used in occupational health research and practice: the Strain Index (SI) and Occupational Repetitive Actions (OCRA) Checklist. Seven raters used the SI and OCRA Checklist to assess task-level physical exposures to the upper extremity of workers performing 21 cheese-manufacturing tasks. Of the total task exposures assessed with both methods, nearly half (49.1%) were classified as hazardous using the OCRA Checklist while 60.2% were classified as hazardous using the SI. Although the underlying injury risk characterization constructs of the SI and OCRA Checklist differ, the results indicated that the SI and OCRA Checklist often classified job tasks into similar risk categories. The differences in risk classifications determined by the SI and OCRA Checklist for job tasks were likely related to the definition of variables measured by these assessment methods as well as the complexity of tasks evaluated. By design, the SI is specific to the distal upper extremity while the OCRA Checklist accounts for the entire upper extremity including the shoulder. When conducting risk assessments of industrial work tasks, the choice of analysis tools should be based on the purpose of the assessment and the complexity of task functions. Both the SI and OCRA Checklist yield risk assessment ratings that are similar for cheese processing tasks.

Prevalence of work-related musculoskeletal symptoms among US large-herd dairy parlor workers.

BACKGROUND: Dairy production in the US is moving towards large-herd milking operations resulting in an increase in task specialization and work demands. METHODS: A modified version of the Standardized Nordic Questionnaire was administered to assess MSS prevalence among 452 US large-herd parlor workers. Worker demographics and MSS prevalences were assessed, and differences based on parlor configuration (i.e., herringbone, parallel, rotary) were computed. RESULTS: Three-fourths (76.4%) of parlor workers reported work-related MSS in at least one body part. Highest prevalences were reported in the upper extremity (55%). Herringbone workers reported a higher prevalence of MSS in the wrist/hand, and rotary workers reported higher prevalences of MSS in the neck, upper back, and shoulders. CONCLUSIONS: Our findings draw attention to higher work-related MSS in the upper extremity among dairy parlor workers. As the trend toward larger herd sizes on US dairy farms continues, the need for further health and safety research will increase.

Inter-rater reliability of cyclic and non-cyclic task assessment using the hand activity level in appliance manufacturing.

This study evaluated the inter-rater reliability of the American Conference of Governmental Industrial Hygienists (ACGIH®) hand activity level (HAL), an observational ergonomic assessment method used to estimate physical exposure to repetitive exertions during task performance. Video recordings of 858 cyclic and non-cyclic appliance manufacturing tasks were assessed by sixteen pairs of raters using the HAL visual-analog scale. A weighted Pearson Product Moment-Correlation Coefficient was used to evaluate the agreement between the HAL scores recorded by each rater pair, and the mean weighted correlation coefficients for cyclic and non-cyclic tasks were calculated. Results indicated that the HAL is a reliable exposure assessment method for cyclic (r̄-bar w = 0.69) and non-cyclic work tasks (r̄-bar w = 0.68). When the two reliability scores were compared using a two-sample Student's t-test, no significant difference in reliability (p = 0.63) between these work task categories was found. This study demonstrated that the HAL may be a useful measure of exposure to repetitive exertions during cyclic and non-cyclic tasks. RELEVANCE TO INDUSTRY: Exposure to hazardous levels of repetitive action during non-cyclic task completion has traditionally been difficult to assess using simple observational techniques. The present study suggests that ergonomists could use the HAL to reliably and easily evaluate exposures associated with some non-cyclic work tasks.

Intra-rater and inter-rater reliability of 3D facial measurements.

Three-dimensional (3D) body scanning technology has applications for obtaining anthropometric data in human-centered and product development fields. The reliability of 3D measurements gathered from 3D scans must be assessed to understand the degree to which this technology is appropriate for use in place of manual anthropometric methods. The intra- and inter-rater reliabilities of 3D facial measurements were assessed among four novice raters using 3D landmarking. Intraclass correlation coefficient (ICC) statistics were calculated for the 3D measurement data collected in three phases to assess baseline reliabilities and improvements in reliabilities as the result of additional training and experience. Based on the results of this study, the researchers found that the collection of 3D measurement data, by multiple raters and using 3D landmarking methods, yielded a high percentage of ICC statistics in the good to excellent (>0.75 ICC) reliability range. Rater training and experience were important considerations in improving intra- and inter-rater reliabilities.

Age in relation to worker compensation costs in the construction industry.

BACKGROUND: A better understanding of how workers' compensation (WC) costs are affected by an aging US workforce is needed, especially for physically demanding industries, such as construction. METHODS: The relationship between age and injury type on claim costs was evaluated using a database of 107,064 Colorado WC claims filed between 1998 and 2008 among construction workers. RESULTS: Mean WC costs increased with increasing age for total cost (P < 0.0001), medical costs (P < 0.0001), and indemnity costs (P < 0.0001). For each one-year increase in age, indemnity, and medical costs increased by 3.5% and 1.1%, respectively. For specific injury types, such as strains and contusions, the association between age and indemnity costs was higher among claimants aged ≥65 compared to claimants aged 18-24. CONCLUSIONS: Our findings suggest that specific injury types may be partially responsible for the higher indemnity costs among older construction workers, compared with their younger coworkers.

Carpal tunnel syndrome among ewe dairy farmers in Sardinia, Italy.

BACKGROUND: The region of Sardinia, Italy is known internationally for the production of cheeses made from ewe's milk. Although the use of automated milking equipment is available in ewe dairy operations, traditional hand milking is still performed on many ewe farms. The purpose of this study was to evaluate the prevalence of carpal tunnel syndrome (CTS) among farmers that manually milk ewes. METHODS: Worker demographics, upper limb symptoms, and electrophysiologic studies were obtained on 76 ewe farmers recruited from a random sample of 109 in northern Sardinia. Characteristic hand symptoms and electrophysiologic studies were used in the case definition of CTS. RESULTS: Of the 76 farmers evaluated, 42 (55.3%) fit the case definition of CTS in at least one hand. Assuming that all non-respondents did not have CTS, the CTS prevalence ratio would have been 38.5% (42/109) among the randomized sample of ewe farmers. CONCLUSIONS: These findings suggest that CTS is a significant occupational health issue for ewe farmers that continue the traditional methods of manual milking. The recent trend in automated ewe milking machines may help reduce the prevalence of CTS among the next generation of Italian ewe farmers.

Construction workers' reasons for not reporting work-related injuries: an exploratory study.

Although under-reporting of work-related injuries by workers is recognized as a significant problem in construction and other industries, little is known about the specific reasons for such occurrences. Qualitative and quantitative methods were used in this study to (a) identify reasons why construction workers may choose not to report work-related injuries, and (b) to investigate the frequency of the identified reasons. Twenty-seven percent of a sample of construction workers (N = 135) indicated that they had failed to report a work-related injury. The most frequent reasons given were related to perceptions of injuries as "small" and "part of the job" as well as fear of negative consequences, which may follow injury reporting. These findings are discussed in terms of practical implications. Strategies to overcome these reasons are suggested to decrease the under-reporting of injuries in the construction industry.

An aging workforce and injury in the construction industry.

The relatively large birth cohort between 1946 and 1964, combined with the economic recession in the first decade of the 21st century, have led to an increase in the proportion of older workers in the US workplace. Understanding the health and safety needs of an aging workforce will be critical, especially in the construction industry, where physical job demands are high. This paper reviews the epidemiologic literature on the impact of age on injury among workers in the construction industry in terms of cause, type, and cost. PubMed was searched by using the following terms: older workers, construction, construction industry, injury, and age. The available studies reported that, among the construction industry workforce, older age at injury was related to higher injury costs but not to number of injuries. The higher injury costs associated with worker age are likely due in part to the severity of the injuries sustained by older workers. Identification of injury trends and subsequent analytical research efforts designed to ascertain factors associated with injury among older construction workers are needed for employers to effectively manage a health and safety program that addresses the needs of the aging worker.

Prevalence of carpal tunnel syndrome among dairy workers.

BACKGROUND: The purpose of this study was to determine the prevalence of carpal tunnel syndrome (CTS) among dairy workers. METHODS: Sixty-six dairy parlor workers and 58 non-parlor workers at dairies in Texas, New Mexico, and Colorado participated in structured interviews regarding demographics, work history, and hand symptoms. All participants had nerve conduction studies performed on both hands across the carpal tunnel. A CTS case definition was based on the presence of characteristic CTS symptoms and an abnormal median mononeuropathy across the carpal tunnel. RESULTS: The prevalence of CTS among the dairy parlor workers was 16.6% and 3.6% among non-parlor workers. The difference was found to be statistically significant (P < 0.05) with an odds ratio of 5.3, CI (1.1-25.5). CONCLUSIONS: The results of this study indicate that CTS is a significant challenge for dairy parlor workers. The prevalence of CTS was found to be significantly higher among dairy workers performing tasks in the milking parlor as opposed to workers performing tasks in other areas of the dairy farm. The results emphasize the need for administrative and engineering controls to limit the exposure to physical risk factors that are associated with upper limb disorders such as CTS.

Validity and reliability of a job factors questionnaire related to the work tasks of physical therapists.

Physical therapists engage in work tasks that expose them to occupational risk factors related to musculoskeletal disorders. Due to the gap in the literature on instruments focused on those workers, this study adapted a job factors questionnaire to physical therapists, and assessed its psychometric properties. The questionnaire was adapted and its content validity was established. The psychometric properties were evaluated among 142 physical therapists. Reliability was verified using the temporal-stability design and internal consistency. Construct validity was assessed with the known-groups technique. Test-retest results demonstrated intraclass correlation coefficients between .82 and .90 (p < .001). Cronbach's α of .91 verified the reliability of the questionnaire. The known-groups technique demonstrated a statistically significant difference on the scores of the items when physical therapists were compared to office workers. The results indicated that the adapted questionnaire had acceptable psychometric properties for assessing problematic job factors among physical therapists working in hospitals.

Assessing the Impact of Work Activities on the Physiological Load in a Sample of Loggers in Sicily (Italy).

Occupational logging activities expose workers to a wide range of risk factors, such as lifting heavy loads, prolonged, awkward positioning of the lower back, repetitive movements, and insufficient work pauses. Body posture has an important impact on the level of physiological load. The present study involved a group of 40 loggers in the province of Enna (Sicily, Italy) with the aim of defining the impact of logging activities on the workers' physiological strain during the three primary work tasks of felling, delimbing, and bucking. The Zephyr Bioharness measurement system was used to record trunk posture and heart rate data during work tasks. The NASA TLX questionnaire was used to explore workers' effort perception of the work tasks. Based on our results, the most demanding work task was tree felling, which requires a higher level of cardiac cost and longer periods spent in awkward trunk postures. The perceived physiological workload was consistently underestimated, especially by the more experienced loggers. Lastly, as the weight of the chainsaw increased, the cardiac load increased.

Trunk Posture during Manual Materials Handling of Beer Kegs.

Craft brewing is a rapidly growing industry in the U.S. Most craft breweries are small businesses with few resources for robotic or other mechanical-assisted equipment, requiring work to be performed manually by employees. Craft brewery workers frequently handle stainless steel half-barrel kegs, which weigh between 13.5 kg (29.7 lbs.) empty and 72.8 kg (161.5 lbs.) full. Moving kegs may be associated with low back pain and even injury. In the present study, researchers performed a quantitative assessment of trunk postures using an inertial measurement unit (IMU)-based kinematic measurement system while workers lifted kegs at a craft brewery. Results of this field-based study indicated that during keg handling, craft brewery workers exhibited awkward and non-neutral trunk postures. Based on the results of the posture data, design recommendations were identified to reduce the hazardous exposure for musculoskeletal disorders among craft brewery workers.

An Assessment of Ergonomics Climate and Its Association with Self-Reported Pain, Organizational Performance and Employee Well-Being.

Previous studies have demonstrated that a positive ergonomics climate with an equal focus on improving operational performance and employee well-being is beneficial to both employee health and organizational performance. This study aimed to assess the ergonomics climate at two power plants and examine its association with self-reported pain, performance, and well-being. At two power plants in Iran, survey responses from 109 and 110 employees were obtained. The questionnaires contained data on ergonomics climate, organizational performance, employee health, and self-reported pain. Results showed that the mean ergonomics climate scores between the Besat and Rey power plants were significantly different (p < 0.001). The overall ergonomics climate score, and all subscales scores, were positively associated with organizational performance (p < 0.001). The overall ergonomics climate score, and some of its subscales, were significantly associated with employees' general health (p < 0.001). The ergonomics climate score was significantly higher in the group of employees who reported musculoskeletal pain than those who did not report musculoskeletal pain (p < 0.05). Investigation of ergonomics climate can provide organizations with a baseline for prioritizing their values and finding areas for improving organizational performance and employee health.

Livestock-handling injuries in agriculture: an analysis of Colorado workers' compensation data.

BACKGROUND: Previous studies have reported that livestock-handling injuries are among the most severe of agricultural injuries. This study identifies the costs, characteristics, and contributing factors associated with livestock-handling injuries among Colorado dairy farmers, cattle/livestock raisers, and cattle dealers. METHODS: A 10-year (1997-2006) history of Colorado's workers' compensation claims data was used for analysis. Descriptive analyses of livestock-handling injury claims were performed. Claim cost analysis was also conducted. The agent-host-environment epidemiological model was used to analyze injury event descriptions. RESULTS: A total of 1,114 livestock-handling claims were analyzed. Claims associated with milking parlor tasks represented nearly 50% of injuries among dairy workers. Claims associated with riding horseback, sorting/penning cattle, and livestock-handling equipment represented high proportions of livestock-handling injuries among cattle/livestock raisers and cattle dealers. Claims associated with livestock-handling represented the highest percentage of high-cost and high-severity injuries in all three sectors. CONCLUSIONS: Livestock-handling injuries are a significant problem, more costly, and result in more time off work than other causes of agricultural injuries. There is a strong and compelling need to develop cost-effective interventions to reduce the number of livestock-handling injuries in agriculture.

Determinants of Safety Climate in the Professional Logging Industry.

Work involving forest logging is considered one of the most dangerous occupations in the world. In the intermountain region of Montana and Idaho in the United States, the extreme terrain, remote location and severe weather conditions escalate risk. Although safety has improved through the development of mechanized equipment, logging tasks continue to be very hazardous. Thus, as with leading companies in other occupational sectors, logging enterprises are beginning to consider safety climate as a useful measure in their safety systems. The purpose of this study was to quantify safety climate within the logging industry of Montana, USA and to identify specific determinants of safety climate. A demographic, musculoskeletal symptom (MSS), and safety climate survey (NOSACQ-50) was administered to 743 professional loggers. Analyses were conducted to determine the association between demographic characteristics, MSS, workplace variables and the scores on five safety climate dimensions (management safety priority and ability, workers' safety commitment, workers' safety priority and risk non-acceptance, peer safety communication, learning and trust in safety ability, and workers' trust in efficacy of safety systems). Variables identified as predictors of safety climate included logging system type, supervisory status, age, years of experience and reported MSS. As safety climate is a leading indicator of workplace safety, if work groups with the lowest safety climate scores can be identified, they could receive targeted safety intervention programs or resources; thereby directing resources to the groups who need it the most, without relying on lagging indicators such as injury and fatality rates.

Active Surveillance of Musculoskeletal Disorder Symptoms in the Development of Safety Interventions for Professional Loggers.

Logging is one of the most dangerous occupations in the world. Logging tasks, whether they consist of operating a chainsaw, operating a mechanized harvester, or driving logging trucks, have an influence on the types of hazards and injuries among professional loggers. Using the Standardized Nordic Questionnaire, we investigated the 12-month period prevalence of musculoskeletal disorder symptoms (MSS) among professional loggers in the mountainous region of Montana. We also differentiated the prevalence of MSS based on logging system-type accounting for demographic and workplace covariates. Based on data from 743 professional loggers in Montana, loggers using conventional felling practices with chainsaws were more than twice as likely to report MSS (Odds Ratio (OR): 2.24 (1.07-4.69)) than those using mechanized logging equipment. In addition, increased MSS scores were associated with conventional harvesting systems, increased years of experience, and increased BMI. The active surveillance of MSS among professional loggers in Montana resulted in recommendations for safety interventions. The safety interventions included a greater mechanization of logging tasks and early career training on the heavy equipment used in logging operations.

A Case Study in the Application of the Systematic Approach to Training in the Logging Industry.

The purpose of this research was to develop and assess a targeted emergency first-aid and safety training program for professional loggers in Montana. There were two key objectives for the program: (1) participant demonstration of recall and retention of key concepts and (2) improved participant reception in comparison to the previous year's training program. The Systematic Approach to Training provided the overall model for the development and conduct of the training program. Qualitative and quantitative analyses were used to assess the effectiveness of the training program. The training program was administered to 873 loggers. Pre-, post-, and follow-up examinations were used to assess recall and retention of key learning objectives, while surveys were used to assess learner reception of the updated training program. Post-training survey data indicated increases in training applicability, understanding of learning objectives, and overall course enjoyment of the updated program in comparison to the previous year's training program. Participants scored significantly higher on the post-training exams, which demonstrated recall of key training objectives. The results obtained by the training evaluation will guide future research and the continued development of the training program to align with ongoing analysis activities and participant suggestions.