A novel approach to preemployment worker fitness evaluations in a material-handling industry.

STUDY DESIGN: Effectiveness of a pre-employment worker fitness evaluation in a sample of grocery warehouse order selectors was studied retrospectively. Implementation of the program began in March 1990 and as of September 10, 1993, 1100 prospective employees have been tested. OBJECTIVES: Identification of prospective employees with the necessary job specific physical requirements was conducted with a standardized test protocol based on job analysis and normative data. Follow-up injury rates and costs for this department were supplied by the company for statistical analysis. SUMMARY OF BACKGROUND DATA: To establish normative data for minimum standards of job performance, a control group of current, uninjured and experienced order selectors was evaluated in respect to job requirements and isokinetic variables. In the control group, 17 variables were identified including one each from two 5-minute repetitive lifting tasks with weighted crates and 15 isokinetic trunk function and lifting variables. Prospective employees were required to successfully complete at least 15 variables for hire as an order selector. METHODS: The t-test for significance of difference between two proportions was used to compare injury rates in 1989 to those reported in 1990, 1991, 1992, and 1993. RESULTS: Statistically significant differences were found between the unimplemented comparison year of 1989 and the 4 years post-implementation. CONCLUSIONS: Preliminary data suggests that a worker fitness evaluation using the above methodology may be an effective method of reducing injuries and subsequent costs.

Thoracic zygapophyseal joint pain patterns. A study in normal volunteers.

STUDY DESIGN: Nine asymptomatic volunteers underwent 40 provocative intra-articular injections of the thoracic zygapophyseal joints. OBJECTIVE: The purpose of the study was to isolate and stimulate the thoracic zygapophyseal joints via fluoroscopically guided intra-articular injections to determine whether they are potential pain generators. SUMMARY OF BACKGROUND DATA: Experimentally, the cervical and lumbar zygapophyseal joints have been shown to produce pain, and tentative referral patterns have been established. Referral patterns based on stimulation of the thoracic zygapophyseal joints have not been previously reported. METHODS: Four subjects underwent right-sided T3-T4, T5-T6, T7-T8, and T9-T10 joint injections, and four subjects underwent left-sided T4-T5, T6-T7, T8-T9, and T10-T11 joint injections. One subject underwent both the right- and left-sided joint injections. The zygapophyseal joints were injected with contrast medium only, and the quality, intensity, and distribution of evoked pain was recorded. RESULTS: In this asymptomatic population, 72.5% of joints injected produced a sensation/pain that was different from the sensation of needle advancement through the soft tissues. In 27.5% of joints injected, there was no evoked pain despite adequate capsular distension. Evoked referral patterns were consistent in all subjects. Significant overlap occurred in the referral patterns, with most thoracic regions sharing 3-5 different joint referral zones. CONCLUSIONS: This study provides preliminary confirmation that the thoracic zygapophyseal joints can cause both local and referred pain. A referral pain diagram has been constructed.