Efficacy of text messaging apprentices to reinforce ergonomics and safety voice training.

INTRODUCTION: Injuries and work-related musculoskeletal disorders (MSDs) are common among masons. SAfety Voice for Ergonomics (SAVE) integrates training in ergonomic and safety problem-solving skills into masonry apprenticeship training. The purpose of this study was to assess the efficacy of text messaging to reinforce SAVE program content. METHOD: SAVE effectiveness was evaluated at masonry apprenticeship training centers across the United States by comparing three experimental groups: (1) Ergonomics training, (2) Ergonomics and Safety Voice training, and a (3) Control. Apprentices received SAVE training with their standard instruction. To reinforce classroom training, refresher training was implemented by sending weekly text messages for six months. Half of the text messages required a response, which tested knowledge or assessed behavior, while the remaining reiterated knowledge. Apprentices (n = 119) received SAVE text messages. Response rates and percentage of correct responses were compared with chi-square tests and independent group t-tests. Multivariable logistic regression analysis predicted apprentice response with selected demographic and work experience variables. Finally, feedback on of the use of text messaging was obtained. RESULT: Of 119 participants, 61% (n = 72) responded to at least one text message. Logistic regression revealed that being a high school graduate and a brick and block mason significantly affected the odds of responding. Sixty-nine percent of apprentices agreed that text messages reinforced SAVE content. CONCLUSION: Even though there was no training center requirement to respond, the high response rate suggests that text messaging can effectively be used to reinforce ergonomics and safety voice training for both knowledge and behavior. Practical Application: The prevalent use of text messaging creates opportunities to reinforce health and safety training and engage workers, especially for populations that may be at various locations over time such as construction sites. Instructors and practitioners should consider the utility of text messaging for supporting their training and safety programs.

Prevalence of work-related musculoskeletal pain in masonry apprentices.

The construction industry, specifically masonry, reports more work-related musculoskeletal disorders (WMSD) rates than the general industry. Masonry apprentices are assumed to be healthy, yet may have WMSDs. The purpose of this study was to evaluate the prevalence of musculoskeletal symptoms (MSS), time loss, and healthcare use among apprentices. 183 brick and block masonry apprentices completed surveys on demographics, work history, MSS, and functional well-being. The prevalence of MSS was calculated by body region, time loss, and healthcare use. The relationship between MSS, and perceived global physical and mental health was assessed. Approximately 78% of apprentices reported MSS, most in several body regions. Low back and wrists/hands were most prevalent, although few missed work or sought healthcare. Lower functional health and well-being was reported. Apprentices reported MSS comparable to previous studies of journey-level masons. Apprenticeship programmes could integrate ergonomics education to help apprentices develop safety culture early in their careers. Practitioner Summary: New masonry workers (apprentices) are assumed to be healthy yet work-related musculoskeletal symptoms (MSS) may be common early in their career. The prevalence of MSS was assessed among apprentices. Approximately 78% of apprentices reported MSS, most in several body regions, comparable to journey-level masons. Abbreviations: WMSD: work-related musculoskeletal disorders; MSS: musculoskeletal symptoms; SAVE: SAfety voice for ergonomics; MNQ: modified nordic questionnaire; FTE: full-time equivalent; SF-12: short from-12v2.

Safety Voice for Ergonomics (SAVE): Evaluation of a masonry apprenticeship training program.

BACKGROUND: Masons have a high rate of musculoskeletal disorders among construction workers and greater than all other industries. Viable solutions to musculoskeletal hazards have been identified by industry stakeholders, yet masons receive minimal ergonomics training. Apprentices, as the next generation of masons, need training and strategies to identify and speak up about ergonomic and safety issues on job sites. To fill this gap, our team developed the Safety Voice for Ergonomics (SAVE) training program. METHODS: The interactive, 7-unit SAVE program was developed specifically for masonry brick and block apprentices. This innovative training contains detailed ergonomics lessons focusing on risk factors and solutions specific to this masonry craft. It also contains lessons that provide communication and problem solving strategies. Evaluation of SAVE employed a randomized control trial designed to assess the effectiveness of SAVE for apprentices over a six-month period. RESULTS: Our findings demonstrated that compared to controls, SAVE trained apprentices used their safety voice more (P = .049) and had greater safety participation (P = .028). They adopted more ergonomic practices such as adjusting scaffolding (P = .016) and using better body postures (P = 042). Apprentices liked SAVE and indicated that it prompted them to change workplace safety behaviors. CONCLUSIONS: SAVE is an effective program, providing needed ergonomic and safety communication training for workers as they begin their trade. The broad adoption of SAVE training by the masonry industry has the potential to empower apprentices, elevate the trade's safety culture, and ultimately reduce musculoskeletal disorders.

Safety voice for ergonomics (SAVE) project: protocol for a workplace cluster-randomized controlled trial to reduce musculoskeletal disorders in masonry apprentices.

BACKGROUND: Masons have the highest rate of overexertion injuries among all construction trades and rank second for occupational back injuries in the United States. Identified ergonomic solutions are the primary method of reducing exposure to risk factors associated with musculoskeletal disorders. However, many construction workers lack knowledge about these solutions, as well as basic ergonomic principles. Construction apprentices, as they embark on their careers, are greatly in need of ergonomics training to minimize the cumulative exposure that leads to musculoskeletal disorders. Apprentices receive safety training; however, ergonomics training is often limited or non-existent. In addition, apprenticeship programs often lack "soft skills" training on how to appropriately respond to work environments and practices that are unsafe. The SAVE program - SAfety Voice for Ergonomics - strives to integrate evidence-based health and safety training strategies into masonry apprenticeship skills training to teach ergonomics, problem solving, and speaking up to communicate solutions that reduce musculoskeletal injury risk. The central hypothesis is that the combination of ergonomics training and safety voice promotion will be more effective than no training or either ergonomics training alone or safety voice training alone. METHODS/DESIGN: Following the development and pilot testing of the SAVE intervention, SAVE will be evaluated in a cluster-randomized controlled trial at 12 masonry training centers across the U.S. Clusters of apprentices within centers will be assigned at random to one of four intervention groups (n = 24 per group): (1) ergonomics training only, (2) safety voice training only, (3) combined ergonomics and safety voice training, or (4) control group with no additional training intervention. Outcomes assessed at baseline, at the conclusion of training, and then at six and 12 months post training will include: musculoskeletal symptoms, general health perceptions, knowledge of ergonomic and safety voice principles, and perception and attitudes about ergonomic and safety voice issues. DISCUSSION: Masons continue to have a high rate of musculoskeletal disorders. The trade has an expected increase of 40 % in the number of workers by 2020. Therefore, a vetted intervention for apprentices entering the trade, such as SAVE, could reduce the burden of musculoskeletal disorders currently plaguing the trade. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02676635 , 2 February 2016.

Upper trapezius muscle activity in healthy office workers: reliability and sensitivity of occupational exposure measures to differences in sex and hand dominance.

Patterns of cervical muscle activity may contribute to overuse injuries in office workers. The purpose of this investigation was to characterise patterns of upper trapezius muscle activity in pain-free office workers using traditional occupational exposure measures and a modified Active Amplitude Probability Distribution Function (APDF), which considers only periods of active muscle contraction. Bilateral trapezius muscle activity was recorded in 77 pain-free office workers for 1-2 full days in their natural work environment. Mean amplitude, gap frequency, muscular rest and Traditional and Active APDF amplitudes were calculated. All measures demonstrated fair to substantial reliability. Dominant muscles demonstrated higher amplitudes of activity and less muscular rest compared to non-dominant, and women demonstrated less muscular rest with no significant difference in amplitude assessed by Active APDF compared to men. These findings provide normative data to identify atypical motor patterns that may contribute to persistence or recurrence of neck pain in office workers. Practitioner Summary: Upper trapezius muscle activity was characterised in a large cohort of pain-free workers using electromyographic recordings from office environments. Dominant muscles demonstrated higher activity and less rest than non-dominant, and women demonstrated less rest than men. Results may be used to identify atypical trapezius muscle activity in office workers.

A prospective study of musculoskeletal outcomes among manufacturing workers: I. Effects of physical risk factors.

OBJECTIVE: To better characterize associations between physical risk factors and upper-extremity musculoskeletal symptoms and disorders, a prospective epidemiologic study of 386 manufacturing workers was performed. BACKGROUND: Methodological limitations of previous studies have resulted in inconsistent associations. METHOD: An individual, task-based exposure assessment strategy was used to assess upper-extremity exertion intensity, repetition, and time-in-posture categories. Participants recorded time spent performing daily work tasks on a preprinted log, which was then used to calculate time-weighted-average exposures across each week of follow-up. In addition, a weekly Strain Index (SI) risk category was assigned to each participant. Incident musculoskeletal symptoms and disorders were assessed weekly. Proportional hazards analyses were used to examine associations between exposure measures and incident hand/arm and neck/shoulder symptoms and disorders. RESULTS: Incident symptoms and disorders were common (incident hand/arm symptoms = 58/100 person-years (PY), incident hand/arm disorders = 19/100 PY, incident neck/shoulder symptoms = 54/100 PY, incident neck/shoulder disorders = 14/100 PY). Few associations between separate estimates of physical exposure and hand/arm and neck/shoulder outcomes were observed. However, associations were observed between dichotomized SI risk category and incident hand/arm symptoms (hazard ratio [HR] = 1.73, 95% confidence interval [CI] = [0.99, 3.04]) and disorders (HR = 1.93,95% CI = [0.85,4.40]). CONCLUSION: Evidence of associations between physical risk factors and musculoskeletal outcome was strongest when exposure was estimated with the SI, in comparison to other metrics of exposure. APPLICATION: The results of this study provide evidence that physical exposures in the workplace contribute to musculoskeletal disorder incidence. Musculoskeletal disorder prevention efforts should include mitigation of these occupational risk factors.

A prospective study of musculoskeletal outcomes among manufacturing workers: II. Effects of psychosocial stress and work organization factors.

OBJECTIVE: The aim of this study was to characterize associations between psychosocial and work organizational risk factors and upper-extremity musculoskeletal symptoms and disorders. BACKGROUND: Methodological limitations of previous studies of psychosocial and work organizational risk factors and musculoskeletal outcomes have produced inconsistent associations. METHOD: In this prospective epidemiologic study of 386 workers, questionnaires to assess decision latitude ("control") and psychological job demands ("demand") were administered to study participants and were used to classify them into job strain "quadrants". Measures of job stress and job change were collected during each week of follow-up. Incident hand/arm and neck/shoulder symptoms and disorders were ascertained weekly. Associations between exposure measures and musculoskeletal outcomes were estimated with proportional hazard methods. RESULTS: When compared to the low-demand/high-control job strain referent category, large increases in risk of hand/arm disorders were observed for both high-demand/high-control (hazard ratio [HR] = 4.49, 95% confidence interval [CI] = [1.23, 16.4]) and high-demand/low-control job strain categories (HR = 5.18,95% CI = [1.39, 19.4]). Similar associations were observed for hand/arm symptoms. A strong association was also observed between the low-demand/low-control job strain category and neck/shoulder disorders (HR = 6.46, 95% CI = [1.46, 28.6]). Statistically significant associations were also observed between weekly stress level and weekly job change and several musculoskeletal outcomes. CONCLUSION: Associations between psychosocial risk factors and work organizational factors and musculoskeletal outcomes were large and in the hypothesized direction. APPLICATION: Prevention of occupational musculoskeletal disorders may require attention to psychosocial and work organizational factors in addition to physical factors. Methods to control adverse effects of psychosocial and work organizational risk factors should be explored.

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.

Normative median and ulnar nerve conduction values among a rural aged population.

BACKGROUND: Carpal tunnel syndrome (CTS) is commonly diagnosed with a combination of characteristic symptoms and nerve conduction studies (NCS) across the wrist. Normative NCS values exist, but there is minimal data among older individuals or among rural populations. OBJECTIVE: To estimate distal median and ulnar sensory, and median motor latencies across the wrist in an older, rural population. METHODS: Hand symptom questionnaires and three standard NCS were obtained from 1085 participants. Univariate and multiple linear regression analyses were conducted. RESULTS: Normative NCS values are presented from participants (mean age 57 years) who reported either no CTS symptoms or possible CTS symptoms. Covariates associated with NCS included age, hand temperature, body mass index, and height. CONCLUSIONS: This large normative NCS data set can be generalized to an older and rural population. Nerve conduction latencies were generally longer in this population than those reported in previous studies.

The effect of lift teams on kinematics and muscle activity of the upper extremity and trunk in bricklayers.

STUDY DESIGN: Workplace-simulation study using a crossover design. OBJECTIVES: To evaluate the effect of lift teams on trunk and upper extremity kinematics and muscle activity among bricklayers. BACKGROUND: Healthcare practitioners often instruct individuals with work-related musculoskeletal disorders in proper lifting techniques. Bricklayers are especially affected by lifting-related musculoskeletal disorders. Lift teams are a possible intervention for reducing exposure to heavy lifting. METHODS: Eighteen apprentice bricklayers constructed walls with concrete blocks alone (1 person) and in 2-person lift teams. Peak shoulder and trunk kinematics and normalized mean surface electromyography of the upper trapezius, lumbar paraspinals, and flexor forearm muscles were collected bilaterally. Differences between construction methods and rows 1, 3, and 6 of the wall were calculated with repeated-measures analyses of variance. RESULTS: Working in lift teams required less trunk flexion (P = .008) at row 1 but more sidebending at row 6 (P<.001) than working alone. Dominant-side lumbar paraspinal activity was lower at row 3 (P = .008) among lift-team workers. Lift-team peak shoulder flexion was lower at row 3 (P = .002), whereas abduction was higher at rows 1 (P = .007) and 6 (P<.001). Concomitantly, nondominant upper trapezius activity and flexor forearm activity were significantly higher for lift teams at row 6 (P<.001 and P = .007). Block moment arm was significantly greater for lift teams at all rows (P≤.002). CONCLUSION: Working in lift teams may be a beneficial intervention for reducing trunk flexion and lumbar paraspinal activity when bricklayers work at heights between the knees and waist, but lift teams are not recommended at higher working heights.

Variability in muscle activity and wrist motion measurements among workers performing non-cyclic work.

Appropriate sampling strategies for estimation of exposure to physical risk factors require knowledge of exposure variability over time. Limited information is available about the variability of exposure to physical risk factors for upper extremity musculoskeletal disorders, especially during non-cyclic work activities. We investigated the magnitude and relative contributions of several sources of variance to the total exposure variance among office, custodial, or maintenance workers (N = 5 per group). In addition, we examined the homogeneity of exposure within each group of workers and exposure contrast between groups of workers. Activation of the flexor carpi radialis and upper trapezius muscle groups was assessed with surface electromyography (EMG) and wrist motion was assessed with electrogoniometry. Exposure information was collected continuously over a complete work shift on two occasions. We observed a substantial contribution of the within-day-within-subject variance component to the total exposure variance for all EMG and electrogoniometer summary measures. We also observed limited exposure contrast between the occupational groups in summary measures of upper trapezius EMG and most electrogoniometry summary measures. The large within-day-within-subject variance suggests the need for prolonged measurement durations (e.g., more than 1 hr) in future epidemiologic investigations of associations between exposure to physical risk factors and upper extremity musculoskeletal disorders.

Reliability of assessing upper limb postures among workers performing manufacturing tasks.

The purpose of this study was to determine the inter- and intra-rater reliability of assessing upper limb postures of workers performing manufacturing tasks. Assessment of neck, shoulder, and wrist postures of 20 manufacturing employees was conducted by two raters observing digital video files using Multimedia Video Task Analysis (MVTA). Generalizability theory was used to estimate the inter- and intra-rater reliability. The results demonstrated good to excellent inter-rater reliability for neck and shoulder postures and fair to excellent inter-rater reliability for wrist postures. Intra-rater posture assessment demonstrated good to excellent reliability for both raters in all postures of the neck, shoulder, and wrist. This study demonstrated that posture assessment of manufacturing workers using MVTA is a reliable method.

Musculoskeletal symptoms of the neck and upper extremities among Iowa dairy farmers.

BACKGROUND: The prevalence of musculoskeletal symptoms (MSS) among U.S. dairy farmers is relatively unknown. The purpose of this study was to assess the prevalence of neck and upper extremity MSS, and to examine associations between symptoms and dairy operation activities among dairy farmers. METHODS: Questionnaires were mailed to randomly selected dairy farmers in the State of Iowa, USA. Demographic, site specific MSS, and dairy operation activity information was obtained. Odds ratios and 95% confidence intervals were estimated with logistic regression adjusting for potential confounders. RESULTS: Among the participants (N = 341), shoulder MSS were reported most frequently (54%). Neck MSS were significantly associated with manually feeding (OR(adj) = 2.29; 95% CI = 1.09-4.80) and tractors use (OR(adj) = 2.17; 95% CI = 1.05-4.50). Also, wrist/hand MSS were associated with manually cleaning animal stalls (OR(adj) = 1.96; 95% CI = 1.06-3.63). CONCLUSIONS: Neck and upper extremity MSS were common and associated with common dairy farming practices. Future studies need to more accurately assess exposures to physical risk factors for MSS so ergonomic interventions can be developed.

Bootstrap exploration of the duration of surface electromyography sampling in relation to the precision of exposure estimation.

OBJECTIVES: This study examined the effect of sampling duration, in units of work cycles, on the precision of estimates of exposure to forceful exertion obtained with surface electromyography (EMG). METHODS: Recordings of the activity of the flexor digitorum superficialis, extensor digitorum, and upper trapezius muscles over 30 consecutive work cycles were obtained for a random sample of 25 manufacturing workers, each of whom was performing a unique production task representing a portion of the whole job. The mean root-mean-square amplitude and the 10th, 50th, and 90th percentiles of the distribution function of the amplitude probability were calculated for each cycle. Bootstrap analyses were used to examine the precision of the summary measures as the sampling duration increased incrementally from 1 to 30 work cycles. Precision was estimated by calculating the coefficient of variation (CV) of the bootstrap distributions at each sampling duration increment. RESULTS: The average minimum sampling duration for a bootstrap distribution CV of 15% ranged from 2.0 (SD 1.5) cycles to 7.5 (SD 9.6) cycles, depending on muscle and summary measure. For a 5% CV, the average minimum sampling duration ranged from 11.9 (SD 9.0) to 20.9 (SD 10.5) cycles. CONCLUSIONS: The results suggest that sampling as few as three work cycles was sufficient to obtain a bootstrap distribution CV of 15% for some of the muscles and summary measures examined in this study. While limited to machine-paced, cyclic manufacturing work, these results will assist the development of exposure assessment strategies in future epidemiologic studies of physical risk factors and musculoskeletal disorders.

Effect of aviation snip design and task height on upper extremity muscular activity and wrist posture.

Hand tools described as ergonomic in design are intended to reduce exposure to physical risk factors associated with work-related musculoskeletal disorders. Additionally, using the right tool for the job is believed to reduce exposure and, consequently, risk of disease. Sheet metal workers frequently use a cutting tool called aviation snips when fabricating and installing ductwork. The purpose of this laboratory simulation study was to determine the effect of (1) aviation snip design; and (2) work height on muscle activity, wrist posture, and user satisfaction among sheet metal workers. We hypothesized that specific aviation snips designs would be most appropriate for use at specific heights. Twenty-three sheet metal workers used three different designs of aviation snips to make curved cuts in sheet metal placed both at waist height and shoulder height. Conventional circular snips, straight snips, and an alternate design of offset snips were used. Upper extremity muscle activity was measured with surface electromyography, wrist posture was measured with electrogoniometry, and user satisfaction was rated by the participants on a survey. Statistically significant effects of snip design and task height on muscle activity, wrist posture, and user satisfaction were observed. However, no snip was preferable for all dependent variables. Work height had a greater effect on muscle activity and wrist posture than snip design. Field studies are indicated to determine the long-term effect of snip design on physical risk factors and risk of musculoskeletal disorders.

Method for quantitatively assessing physical risk factors during variable noncyclic work.

OBJECTIVES: Assessing exposure to physical risk factors during variable noncyclic work can be problematic. The purpose of this study was to modify an existing data reduction method for directly quantifying physical exposures during variable noncyclic work. METHODS: Myoelectric activity of the finger flexors of two groups of workers, heavy equipment operators (N=25) and mechanics (N=25), was sampled to determine the intensity and duration of forceful exertions during normal tasks. Data were reduced with a modification of the exposure variation analysis (EVA), called clustered EVA (CEVA), using three intensity and two duration categories. A two-way, mixed-effects, repeated-measures analysis of variance evaluated the percentage of sampled work time in each CEVA category. RESULTS: CEVA was able to quantify variable noncyclic work, and it contrasted the work of the two groups, with simple effects significantly different for all the exposure categories. The mechanics performed high-intensity short-duration contractions 9.1% of the time, whereas the operators had similar contractions only 1.8% of the time. Conversely, the operators used low-intensity contractions of prolonged duration over 81% of the time, compared with only 43% for the mechanics. CONCLUSIONS: CEVA is a useful modification of EVA for contrasting the noncyclic work typical of understudied industries like construction. A simplification of electromyography with summary measures such as CEVA provides a comprehensible, yet accurate measure of forceful exertions during worktasks.

Symptoms of musculoskeletal disorders among apprentice construction workers.

Musculoskeletal disorders (MSDs) are a major cause of work-related disability and lost-time illnesses for many occupational groups. This study determined the prevalence of musculoskeletal symptoms among young construction workers. A symptom and job factors survey was self-administered to 996 construction apprentices. Prevalence was determined by the percent of positive responses to musculoskeletal symptom questions. Odds ratios and 95 percent confidence intervals were the measures of association between prevalent musculoskeletal symptoms and demographic, leisure, and job factors and were determined by logistic regression. The low back was the site most commonly reported for job-related musculoskeletal symptoms (54.4%), which was also the most common reason for seeking care from a physician (16.8%) and missing work (7.3%). Number of years worked in the construction trade was significantly associated with knee (p-trend = 0.0009) and wrist/hand (p-trend < 0.04) MSD symptoms and was suggestive of an association with low back pain (p-trend = 0.05). "Working in the same position for long periods" was the job factor identified as most problematic, with 49.7 percent of all construction apprentices rating it as a moderate/major problem contributing to musculoskeletal symptoms. Musculoskeletal symptoms are a significant problem among young construction workers at the beginning of their careers. Prevention strategies are needed early in the apprentice training program to reduce the potential disability associated with work-related musculoskeletal symptom disorders.

Prevalence of musculoskeletal symptoms and carpal tunnel syndrome among dental hygienists.

BACKGROUND: Carpal tunnel syndrome (CTS) and other work-related musculoskeletal disorders (MSDs) are common problems in general industry as well as dental hygiene. The purpose of this study is to determine the prevalence of CTS and other MSDs among dental hygienists. No previous studies involving dental hygienists have combined nerve conduction studies (NCS) and symptoms in their CTS case definitions. METHODS: Dental hygienists (N = 95) completed a symptom and job factors survey, hand symptom diagram, and underwent NCS across the wrist. RESULTS: At least one MSD was reported by 93%. Prevalence of CTS was 8.4% utilizing a case definition of symptoms and NCS, but 42% if defined by symptoms alone. Age, BMI, and the number of patients treated per day were significant factors associated with CTS. CONCLUSIONS: Dental hygienists are exposed to occupational factors that increase the risk of CTS. A case definition that does not include NCS overestimates CTS prevalence.

Test-retest reliability of a self-administered musculoskeletal symptoms and job factors questionnaire used in ergonomics research.

The purpose of this study was to investigate the test-retest reliability of questionnaire items related to musculoskeletal symptoms and the reliability of specific job factors. The type of questionnaire items described in the present study have been used by several investigators to assess symptoms of musculoskeletal disorders and problematic job factors among workers from a variety of occupations. Employees at a plastics molding facility were asked to complete an initial symptom and jobs factors questionnaire and then complete an identical questionnaire either two or four weeks later. Of the 216 employees participating in the initial round, 99 (45.8%) agreed to participate in the retest portion of the study. The kappa coefficient was used to determine repeatability for categorical outcomes. The majority of the kappa coefficients for the 58 questionnaire items were above 0.50 but ranged between 0.13 and 1.00. The section of the questionnaire having the highest kappa coefficients was the section related to hand symptoms. Interval lengths of two and four weeks between the initial test and retest were found to be equally sufficient in terms of reliability. The results indicated that the symptom and job factors questionnaire is reliable for use in epidemiologic studies. Like all measurement instruments, the reliability of musculoskeletal questionnaires must be established before drawing conclusions from studies that employ the instrument.

Carpal tunnel syndrome among apprentice construction workers.

BACKGROUND: In terms of lost-work time and restricted workdays, surgery, and rehabilitation, one of the most costly occupational musculoskeletal disorders is carpal tunnel syndrome (CTS). The purpose of this study was to determine the prevalence of CTS among apprentice construction workers. METHODS: This cross-sectional study included apprentices from four construction trades. Apprentices completed a self-administered questionnaire and received electrophysiologic studies assessing median nerve function across the carpal tunnel. A surveillance case definition for CTS was based on characteristic hand symptoms and the presence of median mononeuropathy across the carpal tunnel. RESULTS: Of the 1,325 eligible apprentices, 1,142 (86.2%) participated in the study. The prevalence of CTS among apprentices was 8.2%; sheet metal workers had the highest rate (9.2%). In operating engineers, the prevalence of CTS was significantly higher (OR = 6.9; 95% CI = 2.6-18.2) among the heavy equipment mechanics than the drivers of those vehicles. Body mass index, age, and self-reports of working overhead were associated with prevalent CTS. Less than 15% of the apprentices with CTS sought medical attention for their disorder. CONCLUSIONS: Many construction workers begin developing CTS before or during their apprenticeship. Few apprentices seek medical attention for hand symptoms characteristic of CTS. The results of this study indicate a public health need for the implementation of prevention strategies for CTS in the construction industry.