Repetitive industrial work and neck and upper limb disorders in females.

A cross-sectional study was performed in which physical examinations of the neck and upper limbs were conducted on 82 currently working female industrial workers with exposure to repetitive work tasks and on 64 currently working referent subjects without exposure to repetitive work tasks. Associations between results of symptom questions and physical examination were sought with variables related to the work environment and to the individuals. In a multivariate model, there were statistically significant associations between exposure to repetitive work and diagnoses in both the neck/shoulders (prevalence odds ratio, POR = 4.6) and elbows/hands (POR = 3.5). In addition, age (POR = 1.9, 75th vs. 25th percentiles), tendencies towards subjective muscular tension (POR = 2.3), and stress/worry (POR = 1.9) were also associated with diagnoses in the neck/shoulders; however, there was not an association between these variables and the prevalence of diagnoses in elbows/hands. Standardized evaluation of videotape recordings in 74 of the industrial workers revealed significant associations between neck flexion, and elevation and abduction of the arm and the prevalence of neck/shoulder diagnoses. In the multivariate model, neck flexion was significantly associated with diagnoses in the neck/shoulders (p = 0.005). In addition, low muscle strength, lack of emotional well-being at work, and a variety of psychosomatic symptoms were associated with diagnoses in the neck/shoulders (all p < 0.001). Lack of strength was also associated with disorders of elbows/hands (p = 0.007). This study demonstrated a substantial prevalence of neck and upper limb disorders associated with repetitive work performed with a flexed neck and elevated and abducted arms, as well as a possible potentiation of these ergonomic factors by certain personal traits in some workers.

An assessment of neck and upper extremity disorders by questionnaire and clinical examination.

To study the usefulness of a screening questionnaire for neck/upper extremity complaints, 165 women in either repetitive industrial, or mobile and varied work, were studied by the questionnaire and by a detailed clinical physical examination. A total of 94 subjects recorded complaints in the questionnaire. In 140 subjects findings were recorded at the examination. Most subjects with findings at the clinical examination of shoulders reported complaints in the questionnaire (sensitivity 80%). For the other anatomical regions, the sensitivity was rather low (42-65%). For all regions, most subjects without findings reported no complaints (specificity 77-97%). A total of 75 subjects were given clinical diagnoses according to a set of predetermined diagnostic criteria. The capacity of the questionnaire to identify diagnoses of shoulders was higher (sensitivity 92%) than for the other regions (66-79%). Of subjects who did not qualify for diagnosis, a majority (specificity 71-81%) did not report complaints in the questionnaire. We conclude that the questionnaire approach gives a fairly good picture of the neck/upper extremity status of a working female population. However, a clear view of the size of a problem is obtained only by a detailed clinical examination, particularly as regards the neck, elbows and hands, for which the questionnaire gave an underestimate.