Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospectiv... more Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors.
Journal of Occupational and Environmental Medicine, 2015
Objective: Evaluate associations between personal and workplace factors and median nerve conducti... more Objective: Evaluate associations between personal and workplace factors and median nerve conduction latency at the wrist. Methods: Baseline data on workplace psychosocial and physical exposures were pooled from four prospective studies of production and service workers (N = 2396). During the follow-up period, electrophysiologic measures of median nerve function were collected at regular intervals. Results: Significant adjusted associations were observed between age, body mass index, sex, peak hand force, duration of forceful hand exertions, Threshold Limit Value for Hand Activity Limit, forceful repetition rate, wrist extension, and decision latitude on median nerve latencies. Conclusions: Occupational and nonoccupational factors have adverse effects on median nerve function. Measuring median nerve function eliminates possible reporting bias that may affect symptom-based carpal tunnel syndrome case definitions. These results suggest that previously observed associations between carpal tunnel syndrome and occupational factors are not the result of such reporting bias.
A job exposure matrix may be useful for the study of biomechanical workplace risk factors when in... more A job exposure matrix may be useful for the study of biomechanical workplace risk factors when individual-level exposure data are unavailable. We used job title-based exposure data from a public data source to construct a job exposure matrix and test exposure-response relationships with prevalent carpal tunnel syndrome (CTS). Exposures of repetitive motion and force from the Occupational Information Network were assigned to 3,452 active workers from several industries, enrolled between 2001 and 2008 from 6 studies. Repetitive motion and force exposures were combined into high/high, high/low, and low/low exposure groupings in each of 4 multivariable logistic regression models, adjusted for personal factors. Although force measures alone were not independent predictors of CTS in these data, strong associations between combined physical exposures of force and repetition and CTS were observed in all models. Consistent with previous literature, this report shows that workers with high fo...
Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tu... more Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure-response relationships. This analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS. 1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude. There were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10-14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions. Although attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS.
Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal t... more Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. After adjustment fo...
Objective: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination ... more Objective: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both !1 and !2 median nerveeserved digits. Design: Pooled data from 5 prospective cohorts. Setting: Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care. Participants: Employed, working-age participants who are able to provide consent and undergo EDS testing (NZ3130). Interventions: None. Main Outcome Measures: CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in !1 or !2 median nerveeserved digits. EDS criteria from other published studies were applied to allow for comparison. Results: CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of 1. Conclusions: There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence. Archives of Physical Medicine and Rehabilitation 2014;-:------ª 2014 by the American Congress of Rehabilitation Medicine
American journal of industrial medicine, Jan 16, 2015
Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measu... more Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measurements, and appropriate control for confounders to examine associations between workplace psychosocial and biomechanical factors and carpal tunnel syndrome (CTS). Pooling data from five independent research studies, we assessed associations between prevalent CTS and personal, work psychosocial, and biomechanical factors while adjusting for confounders using multivariable logistic regression. Prevalent CTS was associated with personal factors of older age, obesity, female sex, medical conditions, previous distal upper extremity disorders, workplace measures of peak forceful hand activity, a composite measure of force and repetition (ACGIH Threshold Limit Value for Hand Activity Level), and hand vibration. In this cross-sectional analysis of production and service workers, CTS prevalence was associated with workplace and biomechanical factors. The findings were similar to those from a pro...
Six research groups independently conducted prospective studies of carpal tunnel syndrome (CTS) i... more Six research groups independently conducted prospective studies of carpal tunnel syndrome (CTS) incidence in 54 US workplaces in 10 US States. Physical exposure variables were collected by all research groups at the individual worker level. Data from these research groups were pooled to increase the exposure spectrum and statistical power. This paper provides a detailed description of the characteristics of the pooled physical exposure variables and the source data information from the individual research studies. Physical exposure data were inspected and prepared by each of the individual research studies according to detailed instructions provided by an exposure subcommittee of the research consortium. Descriptive analyses were performed on the pooled physical exposure data set. Correlation analyses were performed among exposure variables estimating similar exposure aspects. At baseline, there were a total of 3010 participants in the pooled physical exposure data set. Overall, the...
Detailed, exposureâ€"response relationships for: (i) the ACGIH TLV for HAL, (ii) peak force, and ... more Detailed, exposureâ€"response relationships for: (i) the ACGIH TLV for HAL, (ii) peak force, and (iii) HAL, and CTS are provided. Contour plots provide visualizations of how CTS risk is affected by the mathematical relationship between PF and HAL. Equations are provided that can be used by practitioners and future researchers to quantify physical exposure and predict risk of CTS.
To determine if job title based physical exposure measures predicted prevalent carpal tunnel synd... more To determine if job title based physical exposure measures predicted prevalent carpal tunnel syndrome (CTS) in a large pooled cohort of workers. We pooled baseline examination data from six prospective cohort studies, restricting analyses to those employed at least 1 year. CTS was defined as median neuropathy plus typical symptoms. Physical exposure estimates for static strength, dynamic strength, time spent making repetitive motions, and time handling objects were extracted from the Occupational Network (O*NET) database using Standard Occupational Classification codes based on reported job title. Three exposure categories of high force/ high repetition, low force/ low repetition, and mixed high and low exposures were entered into logistic regression models adjusting for age, gender, body mass index (BMI), diabetes, rheumatoid arthritis, employed time and study site. Of 3562 in the pooled cohort, 7.6% met a prevalent CTS definition with mean employed time of 7.9 years (SD 8.2). Compared to subjects with low job requirements for dynamic strength and repetitive motion, those with mixed exposures or high exposures showed increased prevalence of CTS (OR 1.46; 95% CI: 1.01-2.11 and OR 2.32; 95% CI: 1.15-4.67, respectively). Similar dose dependent associations of combined exposures were shown for all exposure combinations tested, with high/high combinations having the largest effect sizes (OR range 2.32-3.17) relative to the low force/low repetition exposure combinations. Use of job-title based exposures was useful for demonstrating associations with prevalent CTS. Jobs with combined high exposures of force and repetition showed consistently greater risk of CTS compared to jobs with lower exposure levels.
Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospectiv... more Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors.
Journal of occupational and environmental medicine, Jan 20, 2016
Recent evidence has found potential associations between cardiovascular disease (CVD) risk factor... more Recent evidence has found potential associations between cardiovascular disease (CVD) risk factors and common musculoskeletal disorders. We evaluated possible associations between risk factors and both glenohumeral joint pain and rotator cuff tendinopathy. Data from WISTAH hand study participants (n = 1226) were assessed for associations between Framingham Heart Study CVD risk factors and both health outcomes. A strong association was observed between CVD risk scores and both glenohumeral joint pain and rotator cuff tendinopathy. Peak odds ratios (ORs) of the adjusted models were 4.55 [95% confidence interval (95% CI) 1.97 to 10.31] and 5.97 (95% CI 2.12 to 16.83), respectively. The results show a dose-response trend of increasing risk. Individual risk factors were associated with both outcomes. Combined, CVD risk factors demonstrated a strong correlation with glenohumeral joint pain and an even stronger correlation with rotator cuff tendinopathy. Results suggest a potentially modif...
The Revised Strain Index (RSI) is a distal upper extremity (DUE) physical exposure assessment mod... more The Revised Strain Index (RSI) is a distal upper extremity (DUE) physical exposure assessment model based on: intensity of exertion, frequency of exertion, duration per exertion, hand/wrist posture and duration of task per day. The RSI improves upon the 1995 Strain Index (SI) by using continuous rather than categorical multipliers, and replacing duty cycle with duration per exertion. In a simulation of 13,944 tasks, the RSI and 1995 SI showed good agreement in risk predictions for 1995 SI scores ≤3 (safe) and >13.5 (hazardous). For tasks with 1995 SI scores of >3 and ≤13.5, the two models showed marked disagreement, with the RSI providing much greater discriminations between 'safe' and 'hazardous' tasks for various combinations of force, repetition and duty cycle. We believe the RSI is a substantially improved model that will be useful for DUE task analysis, intervention and design. Practitioner Summary: RSI is a substantial improvement over the 1995 SI. It sho...
The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting... more The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting of exertions at different force levels and/or with different exertion times. The Cumulative Strain Index (CUSI) further integrates biomechanical stressors from different tasks to quantify exposure for the entire work shift. The paper provides methodologies to compute COSI and CUSI along with examples. Complex task simulation produced 169,214 distinct tasks. Use of average, time-weighted-average (TWA) and peak force, and COSI classified 66.9%, 28.2%%, 100% and 38.9% of tasks as hazardous, respectively. For job rotation the simulation produced 10,920 distinct jobs. TWA COSI, Peak task COSI, and CUSI classified 36.5%, 78.1%, and 66.6% jobs as hazardous, respectively. The results suggest that the TWA approach systematically underestimates the biomechanical stressors and peak approach overestimates biomechanical stressors, both at the task and job level. It is believed that the COSI and CUSI...
Journal of Occupational and Environmental Medicine, 2016
This study assesses relationships between the Framingham cardiovascular disease risk (CVD risk) s... more This study assesses relationships between the Framingham cardiovascular disease risk (CVD risk) score and prevalence of US Department of Transportation (DOT)-reportable crashes in commercial motor vehicle (CMV) drivers, after controlling for potential confounders. Data were analyzed from CMV drivers (N = 797) in a large cross-sectional study. CVD risk was calculated for each driver. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) between CVD risk and DOT-reportable crashes were calculated. Drivers in the two highest CVD risk groups had significantly higher likelihood of crash (OR = 2.08, 95% CI = 1.20 to 3.63 and OR = 1.99, 95% CI = 1.05 to 3.77, respectively) after adjusting for confounders. There was a significant trend of increasing prevalence of crashes with an increasing CVD risk score (P = 0.0298). Drivers with a high CVD risk had a higher likelihood of a crash after controlling for confounders.
Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustab... more Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustable desks are being used to decrease worksite based sitting time (ST). Single-desk sit-to-stand workplaces exhibit small ST reduction potential and short-term loss in performance. The aim of this paper is to report the study design and methodology of an ACTIVE OFFICE trial. The study was a 1-year three-arm, randomized controlled trial in 18 healthy Austrian office workers. Allocation was done via a regional health insurance, with data collection during Jan 2014 - March 2015. Participants were allocated to either an intervention or control group. Intervention group subjects were provided with traditional or two-desk sit-to-stand workstations in either the first or the second half of the study, while control subjects did not experience any changes during the whole study duration. Sitting time and physical activity (IPAQ-long), cognitive performance (text editing task, Stroop-test, d2R test ...
Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospectiv... more Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors.
Journal of Occupational and Environmental Medicine, 2015
Objective: Evaluate associations between personal and workplace factors and median nerve conducti... more Objective: Evaluate associations between personal and workplace factors and median nerve conduction latency at the wrist. Methods: Baseline data on workplace psychosocial and physical exposures were pooled from four prospective studies of production and service workers (N = 2396). During the follow-up period, electrophysiologic measures of median nerve function were collected at regular intervals. Results: Significant adjusted associations were observed between age, body mass index, sex, peak hand force, duration of forceful hand exertions, Threshold Limit Value for Hand Activity Limit, forceful repetition rate, wrist extension, and decision latitude on median nerve latencies. Conclusions: Occupational and nonoccupational factors have adverse effects on median nerve function. Measuring median nerve function eliminates possible reporting bias that may affect symptom-based carpal tunnel syndrome case definitions. These results suggest that previously observed associations between carpal tunnel syndrome and occupational factors are not the result of such reporting bias.
A job exposure matrix may be useful for the study of biomechanical workplace risk factors when in... more A job exposure matrix may be useful for the study of biomechanical workplace risk factors when individual-level exposure data are unavailable. We used job title-based exposure data from a public data source to construct a job exposure matrix and test exposure-response relationships with prevalent carpal tunnel syndrome (CTS). Exposures of repetitive motion and force from the Occupational Information Network were assigned to 3,452 active workers from several industries, enrolled between 2001 and 2008 from 6 studies. Repetitive motion and force exposures were combined into high/high, high/low, and low/low exposure groupings in each of 4 multivariable logistic regression models, adjusted for personal factors. Although force measures alone were not independent predictors of CTS in these data, strong associations between combined physical exposures of force and repetition and CTS were observed in all models. Consistent with previous literature, this report shows that workers with high fo...
Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tu... more Between 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure-response relationships. This analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS. 1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude. There were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10-14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions. Although attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS.
Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal t... more Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. After adjustment fo...
Objective: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination ... more Objective: To analyze differences in carpal tunnel syndrome (CTS) prevalence using a combination of electrodiagnostic studies (EDSs) and symptoms using EDS criteria varied across a range of cutpoints and compared with symptoms in both !1 and !2 median nerveeserved digits. Design: Pooled data from 5 prospective cohorts. Setting: Hand-intensive industrial settings, including manufacturing, assembly, production, service, construction, and health care. Participants: Employed, working-age participants who are able to provide consent and undergo EDS testing (NZ3130). Interventions: None. Main Outcome Measures: CTS prevalence was estimated while varying the thresholds for median sensory latency, median motor latency, and transcarpal delta latency difference. EDS criteria examined included the following: median sensory latency of 3.3 to 4.1 milliseconds, median motor latency of 4.1 to 4.9 milliseconds, and median-ulnar sensory difference of 0.4 to 1.2 milliseconds. EDS criteria were combined with symptoms in !1 or !2 median nerveeserved digits. EDS criteria from other published studies were applied to allow for comparison. Results: CTS prevalence ranged from 6.3% to 11.7%. CTS prevalence estimates changed most per millisecond of sensory latency compared with motor latency or transcarpal delta. CTS prevalence decreased by 0.9% to 2.0% if the criteria required symptoms in 2 digits instead of 1. Conclusions: There are meaningful differences in CTS prevalence when different EDS criteria are applied. The digital sensory latency criteria result in the largest variance in prevalence. Archives of Physical Medicine and Rehabilitation 2014;-:------ª 2014 by the American Congress of Rehabilitation Medicine
American journal of industrial medicine, Jan 16, 2015
Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measu... more Few large epidemiologic studies have used rigorous case criteria, individual-level exposure measurements, and appropriate control for confounders to examine associations between workplace psychosocial and biomechanical factors and carpal tunnel syndrome (CTS). Pooling data from five independent research studies, we assessed associations between prevalent CTS and personal, work psychosocial, and biomechanical factors while adjusting for confounders using multivariable logistic regression. Prevalent CTS was associated with personal factors of older age, obesity, female sex, medical conditions, previous distal upper extremity disorders, workplace measures of peak forceful hand activity, a composite measure of force and repetition (ACGIH Threshold Limit Value for Hand Activity Level), and hand vibration. In this cross-sectional analysis of production and service workers, CTS prevalence was associated with workplace and biomechanical factors. The findings were similar to those from a pro...
Six research groups independently conducted prospective studies of carpal tunnel syndrome (CTS) i... more Six research groups independently conducted prospective studies of carpal tunnel syndrome (CTS) incidence in 54 US workplaces in 10 US States. Physical exposure variables were collected by all research groups at the individual worker level. Data from these research groups were pooled to increase the exposure spectrum and statistical power. This paper provides a detailed description of the characteristics of the pooled physical exposure variables and the source data information from the individual research studies. Physical exposure data were inspected and prepared by each of the individual research studies according to detailed instructions provided by an exposure subcommittee of the research consortium. Descriptive analyses were performed on the pooled physical exposure data set. Correlation analyses were performed among exposure variables estimating similar exposure aspects. At baseline, there were a total of 3010 participants in the pooled physical exposure data set. Overall, the...
Detailed, exposureâ€"response relationships for: (i) the ACGIH TLV for HAL, (ii) peak force, and ... more Detailed, exposureâ€"response relationships for: (i) the ACGIH TLV for HAL, (ii) peak force, and (iii) HAL, and CTS are provided. Contour plots provide visualizations of how CTS risk is affected by the mathematical relationship between PF and HAL. Equations are provided that can be used by practitioners and future researchers to quantify physical exposure and predict risk of CTS.
To determine if job title based physical exposure measures predicted prevalent carpal tunnel synd... more To determine if job title based physical exposure measures predicted prevalent carpal tunnel syndrome (CTS) in a large pooled cohort of workers. We pooled baseline examination data from six prospective cohort studies, restricting analyses to those employed at least 1 year. CTS was defined as median neuropathy plus typical symptoms. Physical exposure estimates for static strength, dynamic strength, time spent making repetitive motions, and time handling objects were extracted from the Occupational Network (O*NET) database using Standard Occupational Classification codes based on reported job title. Three exposure categories of high force/ high repetition, low force/ low repetition, and mixed high and low exposures were entered into logistic regression models adjusting for age, gender, body mass index (BMI), diabetes, rheumatoid arthritis, employed time and study site. Of 3562 in the pooled cohort, 7.6% met a prevalent CTS definition with mean employed time of 7.9 years (SD 8.2). Compared to subjects with low job requirements for dynamic strength and repetitive motion, those with mixed exposures or high exposures showed increased prevalence of CTS (OR 1.46; 95% CI: 1.01-2.11 and OR 2.32; 95% CI: 1.15-4.67, respectively). Similar dose dependent associations of combined exposures were shown for all exposure combinations tested, with high/high combinations having the largest effect sizes (OR range 2.32-3.17) relative to the low force/low repetition exposure combinations. Use of job-title based exposures was useful for demonstrating associations with prevalent CTS. Jobs with combined high exposures of force and repetition showed consistently greater risk of CTS compared to jobs with lower exposure levels.
Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospectiv... more Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors.
Journal of occupational and environmental medicine, Jan 20, 2016
Recent evidence has found potential associations between cardiovascular disease (CVD) risk factor... more Recent evidence has found potential associations between cardiovascular disease (CVD) risk factors and common musculoskeletal disorders. We evaluated possible associations between risk factors and both glenohumeral joint pain and rotator cuff tendinopathy. Data from WISTAH hand study participants (n = 1226) were assessed for associations between Framingham Heart Study CVD risk factors and both health outcomes. A strong association was observed between CVD risk scores and both glenohumeral joint pain and rotator cuff tendinopathy. Peak odds ratios (ORs) of the adjusted models were 4.55 [95% confidence interval (95% CI) 1.97 to 10.31] and 5.97 (95% CI 2.12 to 16.83), respectively. The results show a dose-response trend of increasing risk. Individual risk factors were associated with both outcomes. Combined, CVD risk factors demonstrated a strong correlation with glenohumeral joint pain and an even stronger correlation with rotator cuff tendinopathy. Results suggest a potentially modif...
The Revised Strain Index (RSI) is a distal upper extremity (DUE) physical exposure assessment mod... more The Revised Strain Index (RSI) is a distal upper extremity (DUE) physical exposure assessment model based on: intensity of exertion, frequency of exertion, duration per exertion, hand/wrist posture and duration of task per day. The RSI improves upon the 1995 Strain Index (SI) by using continuous rather than categorical multipliers, and replacing duty cycle with duration per exertion. In a simulation of 13,944 tasks, the RSI and 1995 SI showed good agreement in risk predictions for 1995 SI scores ≤3 (safe) and >13.5 (hazardous). For tasks with 1995 SI scores of >3 and ≤13.5, the two models showed marked disagreement, with the RSI providing much greater discriminations between 'safe' and 'hazardous' tasks for various combinations of force, repetition and duty cycle. We believe the RSI is a substantially improved model that will be useful for DUE task analysis, intervention and design. Practitioner Summary: RSI is a substantial improvement over the 1995 SI. It sho...
The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting... more The Composite Strain Index (COSI) quantifies biomechanical stressors for complex tasks consisting of exertions at different force levels and/or with different exertion times. The Cumulative Strain Index (CUSI) further integrates biomechanical stressors from different tasks to quantify exposure for the entire work shift. The paper provides methodologies to compute COSI and CUSI along with examples. Complex task simulation produced 169,214 distinct tasks. Use of average, time-weighted-average (TWA) and peak force, and COSI classified 66.9%, 28.2%%, 100% and 38.9% of tasks as hazardous, respectively. For job rotation the simulation produced 10,920 distinct jobs. TWA COSI, Peak task COSI, and CUSI classified 36.5%, 78.1%, and 66.6% jobs as hazardous, respectively. The results suggest that the TWA approach systematically underestimates the biomechanical stressors and peak approach overestimates biomechanical stressors, both at the task and job level. It is believed that the COSI and CUSI...
Journal of Occupational and Environmental Medicine, 2016
This study assesses relationships between the Framingham cardiovascular disease risk (CVD risk) s... more This study assesses relationships between the Framingham cardiovascular disease risk (CVD risk) score and prevalence of US Department of Transportation (DOT)-reportable crashes in commercial motor vehicle (CMV) drivers, after controlling for potential confounders. Data were analyzed from CMV drivers (N = 797) in a large cross-sectional study. CVD risk was calculated for each driver. Adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) between CVD risk and DOT-reportable crashes were calculated. Drivers in the two highest CVD risk groups had significantly higher likelihood of crash (OR = 2.08, 95% CI = 1.20 to 3.63 and OR = 1.99, 95% CI = 1.05 to 3.77, respectively) after adjusting for confounders. There was a significant trend of increasing prevalence of crashes with an increasing CVD risk score (P = 0.0298). Drivers with a high CVD risk had a higher likelihood of a crash after controlling for confounders.
Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustab... more Prolonged sitting is ubiquitous in modern society and linked to several diseases. Height-adjustable desks are being used to decrease worksite based sitting time (ST). Single-desk sit-to-stand workplaces exhibit small ST reduction potential and short-term loss in performance. The aim of this paper is to report the study design and methodology of an ACTIVE OFFICE trial. The study was a 1-year three-arm, randomized controlled trial in 18 healthy Austrian office workers. Allocation was done via a regional health insurance, with data collection during Jan 2014 - March 2015. Participants were allocated to either an intervention or control group. Intervention group subjects were provided with traditional or two-desk sit-to-stand workstations in either the first or the second half of the study, while control subjects did not experience any changes during the whole study duration. Sitting time and physical activity (IPAQ-long), cognitive performance (text editing task, Stroop-test, d2R test ...
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Papers by Jay Kapellusch