Musculoskeletal disorders among visual display terminal users in a telecommunications company.

The relationship between workplace factors and work-related upper extremity musculoskeletal disorders (UE disorders) was assessed in a cross-sectional study of 533 telecommunication employees utilizing video display terminals (VDTs). Cases of UE disorders were defined using symptom questionnaires and physical examinations. Data on demographics, individual factors (medical conditions and recreational activities), work organization and practices, and psychosocial aspects of work, including electronic performance monitoring (EPM), were obtained by questionnaire. Associations between workplace factors and UE disorders were assessed by multiple logistic models generated for each of the four UE areas (neck, shoulder, elbow, hand/wrists). One-hundred and eleven (22%) participants met our case definition for UE disorders. Probable tendon-related disorders were the most common (15% of participants). Probable nerve entrapment syndromes were found in 4% of participants. The hand/wrist was the area most affected, 12% of participants. The following variables had associations in the final models (p < 0.05) with at least one of the four UE disorders, although the strength of these associations were modest. Non-white race, a diagnosis of a thyroid condition (self-reported) use of bifocals at work, and seven psychosocial variables (fear of being replaced by computers, increasing work pressure, surges in workload, routine work lacking decision-making opportunities, high information processing demands, jobs which required a variety of tasks and lack of a production standard) were associated with UE disorders. This study indicates that work-related UE musculoskeletal disorders are relatively common among telecommunication workers who use VDTs, and adds to the evidence that the psychosocial work environment is related to the occurrence of these disorders.

Relative osmotic effects of raffinose, KCl, and NaCl across basolateral cell membrane.

Lumen-collapsed segments of rabbit S2 proximal tubule were bathed in isotonic medium and then exposed acutely to a medium made hypertonic by the addition of raffinose, NaCl, KCl, Na gluconate, K gluconate, or choline Cl. The result was a rapid efflux of water and a shrinking of the tubule, which could be measured by video techniques within the first 0.1 s. After reequilibration in isotonic medium, each tubule was then exposed to a second hypertonic medium to provide a direct comparison between two different solutes, either NaCl vs. KCl or raffinose vs. any one of the other solutes. Because raffinose is impermeant across the basolateral cell membrane, the ratio of its effect to that of another solute is a measure of the reflection coefficient (sigma) of that other solute. The following results were obtained: sigma KCl = 0.70 +/- 0.02, sigma K gluconate = 0.97 +/- 0.07, sigma Na gluconate = 0.84 +/- 0.06, and sigma choline Cl = 0.75 +/- 0.06. We previously have reported sigma NaCl = 0.56 +/- 0.07. If sigma of each salt is considered to be the arithmetic average of its component parts, and if gluconate and choline are considered to be impermeant, we also obtain sigma Na+ = 0.68, sigma K+ = 0.94, and sigma Cl- = 0.50.

Video measurement of basolateral NaCl reflection coefficient in proximal tubule.

Isolated, lumen-collapsed, proximal and distally occluded segments of rabbit S1 and S2 proximal tubule were equilibrated in isotonic NaCl or isosmotic raffinose medium and then exposed acutely to hypotonic or hypertonic raffinose or NaCl solution. The result was a water flux per millimeter tubule length, JVo, across the basolateral cell membranes and a consequent cell swelling or shrinkage that could be measured by a video technique in the initial 0.1 s or less after a change from steady state. The cell volume change was proportional to the applied osmolality difference, delta pi, and differed consistently with the solute employed. From the equation JVo/delta pi = sigma LpA, where sigma is the basolateral membrane reflection coefficient for the osmotic solute used and LpA is the membrane hydraulic conductivity per millimeter tubule length, and from the assumption that sigma raffinose = 1, sigma NaCl was obtained by dividing the JVo/delta pi values from the NaCl studies by those from the raffinose studies. For both S1 and S2 segments, sigma NaCl was found to be approximately 0.5. A similar value was obtained from the rate of cell shrinkage immediately after isosmolar exchange of raffinose for NaCl medium.

Video measurement of basolateral membrane hydraulic conductivity in the proximal tubule.

Isolated, lumen-collapsed S1, S2, and S3 proximal tubule segments from the rabbit were exposed acutely to media made hypotonic or hypertonic by adjusting the concentration of the impermeant solute raffinose. The result was a water flux into or out of the cells across their basolateral cell membranes and a consequent swelling or shrinking of the cells. From tubule volume changes measured at 1/60-s intervals during the first 0.03-0.2 s of video recordings, the earliest water fluxes were found to be 0.76 +/- 0.04 nl X min-1 X mm-1 X mosM-1 in S1, 0.53 +/- 0.03 in S2, and 0.35 +/- 0.04 in S3. When normalized to outer tubule surface areas, these fluxes yield statistically different hydraulic conductivities of about 5,500, 4,000, and 3,000 microns X s-1 in the three segments. However, when normalized to the basolateral membrane surface areas, the basolateral membrane hydraulic conductivities are all approximately 300 microns X s-1 and not statistically different. If one assumes that the hydraulic conductivities of the basolateral and apical cell membranes are equal, the latter value agrees with reported transtubular measurements and is sufficient to allow nearly isotonic transcellular absorption to occur with driving forces of 2-3 mosM.