Musculoskeletal Disorders and the Workplace

510 Pages·2001·1.61 MB·English

by  National Research Council

MUSCULOSKELETAL
DISORDERS
AND THE WORKPLACE
Low Back and Upper Extremities
Panel on Musculoskeletal Disorders and the Workplace
Commission on Behavioral and Social Sciences and Education
National Research Council
and
Institute of Medicine
NATIONAL ACADEMY PRESS
Washington, D.C.
NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418
NOTICE: The project that is the subject of this report was approved by the Governing Board
of the National Research Council, whose members are drawn from the councils of the
National Academy of Sciences, the National Academy of Engineering, and the Institute of
Medicine. The members of the committee responsible for the report were chosen for their
special competences and with regard for appropriate balance.
The study was supported by Contract No. HHS-100-99-0001 between the National Academy
of Sciences and the U.S. Department of Health and Human Services. Any opinions, findings,
conclusions, or recommendations expressed in this publication are those of the author(s)
and do not necessarily reflect the view of the organizations or agencies that provided sup-
port for this project.
Suggested citation: National Research Council and the Institute of Medicine (2001) Muscu-
loskeletal Disorders and the Workplace: Low Back and Upper Extremities. Panel on Musculoskel-
etal Disorders and the Workplace. Commission on Behavioral and Social Sciences and
Education. Washington, DC: National Academy Press.
Library of Congress Cataloging-in-Publication Data
Musculoskeletal disorders and the workplace : low back and upper
extremities / Panel on Musculoskeletal Disorders and the Workplace,
Commission on Behavioral and Social Sciences and Education, National
Research Council and Institute of Medicine.
p. ; cm.
Includes bibliographical references and index.
ISBN 0-309-07284-0 (hardcover)
1. Backache. 2. Industrial accidents. 3. Arm--Wounds and injuries.
4. Back--Wounds and injuries. I. National Research Council (U.S.).
Panel on Musculoskeletal Disorders and the Workplace. II. Institute of
Medicine (U.S.)
[DNLM: 1. Musculoskeletal Diseases--epidemiology. 2. Arm Injuries
--epidemiology. 3. Back Injuries--epidemiology. 4. Low Back Pain
--epidemiology. 5. Occupational Diseases--epidemiology. WE 140
M98515 2001]
RD771.B217 M875 2001
617.4′7044--dc21
2001000906
Additional copies of this report are available from National Academy Press, 2101 Constitu-
tion Avenue, N.W., Washington, D.C. 20418
Call [phone] or [phone] (in the Washington metropolitan area)
This report is also available online at http://www.nap.edu
Printed in the United States of America
Copyright 2001 by the National Academy of Sciences. All rights reserved.
Cover photographs: Background figure: © Charles Gupton/Stock, Boston/PictureQuest. Inset:
© PhotoDisc.
National Academy of Sciences
National Academy of Engineering
Institute of Medicine
National Research Council
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chairman, respectively, of the National Research Council.
PANEL ON MUSCULOSKELETAL DISORDERS
AND THE WORKPLACE
JEREMIAH A. BARONDESS (Chair), New York Academy of Medicine
MARK R. CULLEN, Occupational and Environmental Medicine
Program, School of Medicine, Yale University
BARBARA de LATEUR, Department of Physical Medicine and
Rehabilitation, School of Medicine, Johns Hopkins University
RICHARD A. DEYO, Department of Medicine, Division of General
Internal Medicine, University of Washington, Seattle
SUE K. DONALDSON, School of Nursing and School of Medicine,
Johns Hopkins University
COLIN G. DRURY, Department of Industrial Engineering, State
University of New York, Buffalo
MICHAEL FEUERSTEIN, Departments of Medical/Clinical Psychology
and Preventive Medicine/Biometrics, Uniformed Services
University of the Health Sciences, Bethesda, Maryland, and Division
of Behavioral Medicine, Georgetown University Medical Center
BARUCH FISCHHOFF, Department of Social and Decision Sciences and
Department of Engineering and Public Policy, Carnegie Mellon
University
JOHN W. FRYMOYER (retired), McClure Musculoskeletal Research
Center, Department of Orthopaedics and Rehabilitation, University
of Vermont, Burlington
JEFFREY N. KATZ, Division of Rheumatology, Immunology, and
Allergy, Brigham and Women’s Hospital, Harvard University
Medical School
KURT KROENKE, Regenstrief Institute for Health Care and School of
Medicine, Indiana University, Indianapolis
JEFFREY C. LOTZ, Orthopaedic Bioengineering Laboratory and
Department of Orthopaedic Surgery, University of California, San
Francisco
SUSAN E. MACKINNON, Division of Plastic and Reconstructive
Surgery, School of Medicine, Washington University, St. Louis
WILLIAM S. MARRAS, Institute for Ergonomics and Department of
Industrial, Welding, and Systems Engineering, Ohio State
University, Columbus
ROBERT G. RADWIN, Department of Biomedical Engineering,
University of Wisconsin, Madison
DAVID M. REMPEL, School of Medicine, University of California, San
Francisco
ROBERT M. SZABO, Department of Orthopaedic Surgery, School of
Medicine, University of California, Davis
v
DAVID VLAHOV, Center for Urban Epidemiologic Studies, New York
Academy of Medicine, and Johns Hopkins University School of
Public Health
DAVID H. WEGMAN, Department of Work Environment, University of
Massachusetts, Lowell
ANNE S. MAVOR, Study Director
JAMES P. McGEE, Senior Research Associate
SUSAN R. McCUTCHEN, Senior Project Assistant
ALEXANDRA K. WIGDOR, Deputy Director, Commission on Behavioral
and Social Sciences and Education
ANDREW M. POPE, Director, Division of Health Sciences Policy, Institute
of Medicine
FREDERICK J. MANNING, Senior Program Officer, Division of Health
Sciences Policy, Institute of Medicine
vi
COMMITTEE ON HUMAN FACTORS
WILLIAM C. HOWELL, Department of Psychology, Arizona State
University, Tempe
JOHN M. CARROLL, Center for Human-Computer Interaction, Virginia
Polytechnic Institute and State University, Blacksburg
COLIN G. DRURY, Department of Industrial Engineering, State
University of New York, Buffalo
MARTHA GRABOWSKI, Rensselaer Polytechnic and LeMoyne College,
Cazenovia, New York
DANIEL R. ILGEN, Department of Psychology and Department of
Management, Michigan State University, East Lansing
RICHARD J. JAGACINSKI, Department of Psychology, Ohio State
University, Columbus
LAWRENCE R. JAMES, Department of Management, University of
Tennessee, Knoxville
BONNIE E. JOHN, Human-Computer Interaction Institute, School of
Computer Science, Carnegie Mellon University
KURT KRAIGER, Department of Psychology, University of Colorado,
Denver
WILLIAM S. MARRAS, Institute for Ergonomics and Department of
Industrial, Welding, and Systems Engineering, Ohio State
University, Columbus
RAJA PARASURAMAN, Department of Psychology, Catholic
University
KARLENE ROBERTS, Haas School of Business, University of California,
Berkeley
KIM J. VICENTE, Cognitive Engineering Laboratory and Department of
Mechanical and Industrial Engineering, University of Toronto
GREG L. ZACHARIAS, Charles River Analytics, Cambridge,
Massachusetts
ANNE S. MAVOR, Director
SUSAN R. McCUTCHEN, Senior Project Assistant
vii
Contents
PREFACE xiii
EXECUTIVE SUMMARY 1
PART I: INTRODUCTION
1 INTRODUCTION 17
Charge to the Panel, 18
Background, 20
Approach to the Problem, 21
The Whole Person: Injury, Illness, and Disease, 23
Levels of Analysis: Individuals and Populations, 27
Contextual Factors, 28
Mechanical, Physiological, and Psychological Factors, 31
Guide to the Report, 35
2 DIMENSIONS OF THE PROBLEM 38
Musculoskeletal Disorders in the General Population, 38
Work-Related Musculoskeletal Disorders, 44
Data on Economic Costs, 57
Limitations of the Data, 59
Summary, 64
ix
x CONTENTS
3 METHODOLOGICAL ISSUES AND APPROACHES 65
Research Perspectives, 66
Determining Causality Within Studies, 71
Criteria for Causality Across Studies, 77
Study Designs, 79
Pattern of Evidence Comparisons, 81
PART II: REVIEW OF THE EVIDENCE
4 EPIDEMIOLOGIC EVIDENCE 85
Methods, 85
Results, 98
Conclusion, 113
Appendix, 117
5 TISSUE MECHANOBIOLOGY 184
Pain Pathways from Peripheral Tissues, 185
Literature Review, 187
Vertebral Bone and Spinal Disc, 187
Tendons and Ligaments, 194
Skeletal Muscle, 199
Peripheral Nerve, 210
Spinal Nerve Roots, 213
Summary, 216
6 BIOMECHANICS 219
Concepts of Load Tolerance, 219
Low Back Mechanics, 235
Upper Body Biomechanics, 253
7 OCCUPATIONAL STRESS 287
General Models of Occupational Stress, 288
Biological Response, 289
Occupational Stress and Work-Related Musculoskeletal
Disorders: Some Working Hypotheses, 291
Summary, 300