Consistency between the ACGIH TLV for hand activity and proposed action levels for wrist velocity and forearm muscular load based on objective measurements: an example from the assembly industry.

Objectives. This study aimed to investigate the consistency between results of the American Conference for Governmental Occupational Hygienists (ACGIH) threshold limit value (TLV) for hand activity and proposed action levels of objective measurements in risk assessments of work-related musculoskeletal disorders. Methods. Wrist velocities and forearm muscular load were measured for 11 assemblers during one working day. Simultaneously, each assembler's hand activity level (HAL) during three sub-cycles was rated twice on two separate occasions by two experts, using a HAL scale. Arm/hand exertion was also rated by the assemblers themselves using a Borg scale. In total, 66 sub-cycles were assessed and assigned to three exposure categories: A) below ACGIH action limit (AL) (green); B) between AL and TLV (yellow); and C) above TLV (red). The median wrist velocity and the 90th percentile of forearm muscular load obtained from the objective measurements corresponding to the sub-cycles were calculated and assigned to two exposure categories: A) below or C) above the proposed action level. Results. The agreement between ACGIH TLV for hand activity and the proposed action level for wrist velocity was 87%. Conclusions. The proposed action level for wrist velocity is highly consistent with the TLV. Additional studies are needed to confirm the results.

Adverse health manifestations in the hands of vibration exposed carpenters - a cross sectional study.

BACKGROUND: Despite EU regulatory standards, many workers suffer injury as a result of working with hand-held vibrating tools. Our aim of this study was to confirm whether carpenters, a highly exposed group, suffer more injuries to their hands than painters, a group assumed to be less exposed to vibration. METHODS: 193 carpenters (participation rate 100%) and 72 painters (participation rate 67%), all men, answered a questionnaire and underwent a clinical examination to identify manifestations of neural and vascular origin in the hands. Neurosensory affection was defined as having at least one symptom in the fingers/hands (impaired perception of touch, warmth, or cold, impaired dexterity, increased sensation of cold, numbness or tingling, or pain in the fingers/hands when cold) and at least one clinical finding (impaired perception of touch, warmth, cold, vibration, or two-point discrimination). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Neurosensory affection was fulfilled for 31% of the carpenters and 17% of the painters, age-adjusted OR 3.3 (CI 1.6-7.0). Among carpenters with neurosensory affection 18% reported interference with daily life activities, the most common symptoms being increased sensation of cold, numbness and pain in the fingers/hands when cold, the most common clinical findings were impaired perception of touch and vibration. Neurosensory affection was found in 12% of young carpenters (≤ 30 years old). No difference was found in the prevalence of white fingers between carpenters and painters. CONCLUSIONS: Carpenters showed more symptoms and clinical findings of neurosensory affection than painters, probably due to vibration exposure. Also young carpenters showed signs of neurosensory affection, which indicates that under current conditions workers at these companies are not protected against injury. This underlines the importance of reducing exposure to vibration and conducting regular medical check-ups to detect early signs of neural and vascular manifestations indicating hand-arm vibration injuries. Special attention should be given to symptoms of increased sensation of cold, pain in the fingers when cold, and numbness, as these were the most common initiating ones, and should be addressed as early as possible in the preventive sentinel process. It is also important to test clinically for small- and large-fibre neuropathy, as the individual may be unaware of any pathology.

The effect of two types of maximal voluntary contraction and two electrode positions in field recordings of forearm extensor muscle activity during hotel room cleaning.

Purpose. This study aimed to investigate the effects of using hand grip or resisted wrist extension as the reference contraction, and two electrode positions, on field recordings of forearm extensor muscle activity. Materials and methods. Right forearm extensor muscle activity was recorded using two electrode pairs (over the most prominent part (position 2) and proximal to that (position 1)) during one working day in 13 female hotel housekeepers. Each subject performed the two maximal voluntary contractions (MVCs), and the electrical activity obtained during these (maximal voluntary electrical activity (MVE)) was used for normalization. Each set of recordings was analysed twice, once using hand grip as the MVC and once using resisted wrist extension. Results. Resisted wrist extension showed a higher group mean MVE than hand grip. Position 2 had higher correlation between MVE and force during the MVCs. The workload during cleaning was lower when using resisted wrist extension as reference than when using hand grip (24%MVE vs 46%MVE; p = 0.002 at position 2) for the 90th percentile. The workload (99th percentile) was overestimated in two subjects when using hand grip as reference. Conclusions. Problems associated with poorly activated forearm extensors can be overcome by using resisted wrist extension as reference.

An analytical ergonomic risk evaluation of body postures during daily cleaning tasks in horse stables.

BACKGROUND: Musculoskeletal disorders (MSDs) are a common reason for health problems and sick leave in many professions. A work arena where MSDs have not been sufficiently studied is stable work. Here many heavy and repetitive work tasks are performed manually with old-fashioned working tools. OBJECTIVE: The aim of this study was to use an analytical approach to identify, evaluate and grade ergonomic problems in physical work performed during daily activities in horse stables and relate these to MSDs among the workers and to the design of the tools. METHODS: Three common work tasks were studied to identify, evaluate and grade ergonomic problems; mucking out, sweeping and bedding replacement. Used methods were Hierarchical Task Analysis, Heuristic Evaluation and Rapid Entire Body Assessment. RESULTS: Several high-risk operations were found in mucking out boxes and disposal of bedding material. The problems consisted of awkward working postures such as a twisted and bent back, arms in an elevated position, wrists in extreme joint positions and handling of heavy loads. CONCLUSIONS: By using an analytical approach it is possible to identify presumptive ergonomic problems without extensive empirical research. In most high-risk operations, long-shafted tools or a wheelbarrow were used, which emphasize a need to develop tools with better ergonomic design to improve the working situation. The limitation is that the ergonomics problems found are not finally validated. The results show where deeper empirical research is needed, both regarding how MSDs occur and how tools and environment contribute to physical problems.

The farrier's work environment.

The horse industry in Sweden has rapidly expanded in recent years. This increasing number of horses implies a greater need for more farriers. Shoeing a horse is hard physical work, and includes awkward work postures and repetitive movements. It is well known that hard physical work increases the risk of injuries and musculoskeletal problems. The risk is especially high for musculoskeletal disorders when certain movements are constantly repeated. Heavy or repeated unilateral loads lead to considerable stress on the muscles, which can lead to rupture and fatigue that can cause long term problems. A case study showed that farriers worked 75% of their work time with their backs in bent positions (often more than 70 degrees). Farriers are also exposed to risk factors in their physical environment like dust, noise and poor lighting. Risk of kicks and bites, eye injuries and burns are other factors that make their work environment hazardous. There are only a few studies available that have documented the farriers' working environment and these are not of recent date. A US study from 1984 described kicks and bites from horses, metal splinters in the eyes, heat exhaustion and problematic postures to be perceived as the greatest risks in their work. The back, knees and wrists were the most exposed body regions. There is a need for more current and in-depth studies investigating the farriers' working conditions in order to gain more knowledge of their health and work environment. The aim of the present study is to investigate the physical health and work environment of farriers. The investigation will use questionnaires, work load measurements and workplace analysis. The results will serve as a base for improvements concerning the design of the workplace, equipment, tools and aids as well as supplying recommendations about physical exercise and the correct work technique, etc. The results are planned to be incorporated in the education of farriers.