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Journal of Occupational Rehabilitation

, Volume 10, Issue 1, pp 39–53 | Cite as

Describing the Burden of Upper-Extremity Musculoskeletal Disorders in Newspaper Workers: What Difference do Case Definitions Make?

  • Dorcas E. Beaton
  • Donald C. Cole
  • Michael Manno
  • Claire Bombardier
  • Sheilah Hogg-Johnson
  • Harry S. Shannon
Article

Abstract

Musculoskeletal disorders (MSD) of the upper limb are of growing concern, although there is no consensus on how to define a “case” of MSD. Varying the case definition has been shown to alter the description of the prevalence of the disorder. The purpose of this study was to compare the symptom description as well as the burden (disability costs, time off work) of MSD across four different published case definitions. A survey was conducted at a large urban newspaper, and 1003 (84% response rate) people responded. The questionnaire included measures of pain (intensity, frequency, duration), disability, work disability, and absence. Case definitions permitted creation of four overlapping samples, which were compared descriptively on the various measures of burden of MSD. The case definitions led to different descriptions of burden associated with MSD. Contrasting between the two extremes (Hunting and NIOSH), differences were found in prevalence (55% vs. 20%), overall disability (14.6 vs. 23.2/100, 100 = more disability) and difficulty at work (8 vs. 15.5/100), and proportion reporting pain interfering with work (27.3 vs. 16.2%). The various case definitions drew samples that were described by different experiences in terms of burden. Studies using different case definitions therefore lack comparability. The definition to use may depend on the study goals (primary or secondary prevention for example). However, consensus on a common definition would allow comparability across studies.

repetition strain injury classification burden disability survey questionnaire 

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REFERENCES

  1. 1.
    Hagberg M, Silverstein B, Wells R, Smith MJ, Hendrick HW, Carayon P, Perusse, M. Work related musculoskeletal disorders (WMSDs): A reference book for prevention. London Taylor & Francis, 1995.Google Scholar
  2. 2.
    Ranney D. Work-related chronic injuries of the forearm and hand: Their specific diagnosis and management. Ergonomics 1993; 36(8): 871–880.Google Scholar
  3. 3.
    Hales TR, Bernard BP. Epidemiology ofwork-related musculoskeletal disorders. Orthop Clin North Am 1996; 27(4): 679–709.Google Scholar
  4. 4.
    Buchbinder R, Goel V, Bombardier C, Hogg-Johnson S. Classification systems of soft tissue disorders of the neck and upper limb: Do they satisfy methodological guidelines? J Clin Epidemiol 1996; 49(2): 141–149.Google Scholar
  5. 5.
    Buchbinder R. The classification of soft tissue disorders of the neck and upper limb for epidemiological research. University of Toronto, 1993.Google Scholar
  6. 6.
    Pransky G, Benjamin K, Himmelstein J, Mundt K, Morgan W, Feuerstein M, Koyamatsu K, Hill-Fotouchi C. Work-related upper-extremity disorders: Prospective evaluation of clinical and functional outcomes. JOEM 1999; 41(10).Google Scholar
  7. 7.
    Beaton DE. Examining the clinical course of work-related musculoskeletal disorders of the upper extremity using the Ontario Workers' Compensation Board administrative database. University of Toronto, Toronto, 1995.Google Scholar
  8. 8.
    Hunting KL, Welch LS, Cuccherini BA, Seiger LA. Musculoskeletal symptoms among electricians. Am J Ind Med 1994; 25(2): 149–163.Google Scholar
  9. 9.
    Bernard B, Sauter S, Fine L, Petersen M, Hales T. Job task and psychological risk factors for work-related musculoskeletal disorders among newspaper employees. Scand J Work Environ Health 1994; 20: 417–426.Google Scholar
  10. 10.
    Silverstein BA. The prevalence of upper cumulative trauma disorders in industry. Unpublished Ph.D. dissertation, University of Michigan, 1985.Google Scholar
  11. 11.
    Waris P, Kuorinka I, Kurppa K, Luopajarvi T, Virolainen M, Personen K, et al. Epidemiologic screening of occupational neck and upper limb disorders. Scand J Work Environ Health 1979; 5(suppl. 3): 25–38.Google Scholar
  12. 12.
    National Institute for Occupational Safety and Health. Musculoskeletal disorders and workplace factors. A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back. U.S. Department of Health and Human Services, Baltimore, 1997.Google Scholar
  13. 13.
    Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G, Jorgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergo 1987; 18(3): 233–237.Google Scholar
  14. 14.
    Polanyi M, Cole DC, Beaton DE, Chung J, Wells R, Abdolell M, Beech-Hawley L, Ferrier, SE, Mondloch, MV, Shields, SA, Smith, JM, Shannon, HS. Upper limb work-related musculoskeletal disorders among newspaper employees: Cross-sectional survey results. Am J Ind Med 1997; 32: 620–628.Google Scholar
  15. 15.
    Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life: A conceptual model of patient outcomes. JAMA 1995; 273(1): 59–65.Google Scholar
  16. 16.
    Verbrugge LM, Jette AM. The disablement process. Soc Sci Med 1994; 38(1): 1–14.Google Scholar
  17. 17.
    World Health Organization. International classification of impairment, disability and handicap–2 (beta version). WHO Website, 1999.Google Scholar
  18. 18.
    Von Korff M, Dworkin SF, Le Resche L. Graded chronic pain status: An epidemiologic evaluation. Pain 1990; 40: 279–291.Google Scholar
  19. 19.
    VonKorff M, Ormel J, Keefe FJ, Dworkin SF. Grading the severity of chronic pain. Pain 1992; 50(2): 133–149.Google Scholar
  20. 20.
    Von Korff M. Epidemiological and survey methods: chronic pain assessment. In: Turk DC, Melzack R, eds. Handbook of pain assessment. New York: The Guilford Press, 1992, pp. 391–408.Google Scholar
  21. 21.
    Verbrugge LM. The iceberg of disability. In: Stahl SM, ed. The legacy of longevity. Newbury Park, CA: Sage Publications, 1990, pp. 55–75.Google Scholar
  22. 22.
    Verbrugge LM, Jette AM. The disablement process. Soc Sci Med 1994; 38(1): 1–14.Google Scholar
  23. 23.
    Hudak PL, Amadio PC, Bombardier C. The Upper Extremity Collaborative Group (UECG). Development of an upper extremity outcome measure: The DASH (Disabilities of the Arm, Shoulder and Head). Am J Ind Med 1996; 29(6): 602–608.Google Scholar
  24. 24.
    Kirkley A, Griffith S, McLintock H, Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability: The Western Ontario Shoulder Instability Index (WOSI). Am J Sports Med 1998; 26(6): 764–772.Google Scholar
  25. 25.
    Turchin DC, Beaton DE, Richards RR. Validity of observer-based aggregate scoring systems as descriptors of elbow pain, function, and disability. J Bone Joint Surg 1998; 80-A(2): 154–162.Google Scholar
  26. 26.
    McConnell S, Beaton DE, Bombardier C. The DASH outcome measure: A user's manual. (1st Ed.). Toronto: Institute for Work & Health, 1999.Google Scholar
  27. 27.
    Lohr KN, Aaronson NK, Alonso J, Burnam MA, Patrick DL, Perrin EB, Roberts S. Evaluating quality-of-life and health status instruments: Development of scientific review criteria. Clin Therap 1996; 18(5): 979–992.Google Scholar
  28. 28.
    McDowell I, Jenkinson C. Development standards for health measures. J Health Serv Res Policy 1996; 1(4): 238–246.Google Scholar
  29. 29.
    McHorney CA, Tarlov AR. Individual patient monitoring in clinical practice: Are available health status surveys adequate? qolr 1995; 4: 293.Google Scholar
  30. 30.
    Nunnally JC, Bernstein IH. Psychometric theory. (3rd Ed.). New York: McGraw-Hill, 1994.Google Scholar
  31. 31.
    Ware JE, Jr., Kosinski M, Keller SD. SF-12: How to score the SF-12 physical and mental health summary scales (2nd Ed.). Boston, MA: The Health Institute, New England Medical Center, 1995.Google Scholar
  32. 32.
    SF-12 Health Survey. Scoring algorithms & test dataset for physical (PCS) & Mental (MCS) summary measures. New England Medical Center, USA, 1996.Google Scholar
  33. 33.
    Baron S, Hales T, Hurrell J. Evaluation of symptom surveys for occupational musculoskeletal disorders. Am J Ind Med 1996; 29(6): 609–617.Google Scholar
  34. 34.
    Croft P. Soft tissue rheumatism. In: Silman AJ, Hochberg MC, eds. Epidemiology of the rheumatic diseases. New York: Oxford University Press, 1993: 375–421.Google Scholar
  35. 35.
    Katz JN, Liang MH. Classification criteria revisited. Arthrit Rheum 1991; 34(10): 1228–1230.Google Scholar
  36. 36.
    Feinstein AR. Clinical epidemiology. Part 2: The identification rates of disease. Ann Intern Med 1968; 69(5): 1037–1061.Google Scholar
  37. 37.
    Armstrong TJ, Buckle P, Fine LJ, Hagberg M, Jonsson B, Kilbom A, Kuorinka I, Silverstein BA, Sjogaard G, Viikari-Juntura E. A conceptual model for work-related neck and upper-limb musculoskeletal disorders. Scand J Work Environ Health 1993; 19(2): 73–84.Google Scholar
  38. 38.
    Rempel D, Evanoff B, Amadio P, de Krom M, Franklin G, Franzblau A, Gray R, Gerr F, Hagberg M, Hales T, Katz JN, Pransky G. Consensus criteria for the classification of carpal tunnel syndrome in epidemiological studies. AJPH 1998; 88(10): 1447–1451.Google Scholar
  39. 39.
    Harrington JM, Carter JT, Birrell L, Gompertz D. Surveillance case definitions for work related upper limb pain syndromes. Occ Environ Med 1998; 55: 264–271.Google Scholar
  40. 40.
    Sinclair SJ, Hogg-Johnson SA, Mondloch MV, Shields SA. The effectiveness of an early active intervention program for workers with soft tissue injuries: The Early Claimant Cohort study. Spine 1997; 22(24): 2919–2931.Google Scholar
  41. 41.
    Faucett J, Rempel D. VDT-related musculoskeletal symptoms: Interactions between work posture and psychosocial work factors. Am J Ind Med 1994; 26: 597–612.Google Scholar
  42. 42.
    Badley E. The impact of musculoskeletal disorders on the Canadian population. J Rheumatol 1992; 19(3): 337–340.Google Scholar
  43. 43.
    Badley EM, Yoshida K, Webster G, Stephens M. Disablement and long term health problems in Ontario: A report on the 1990 Ontario Health Survey. The Arthritis Community Research and Evaluation Unit, The Wellesley Hospital Research Unit, Toronto, 1992.Google Scholar
  44. 44.
    Badley EM, Rasooly I, Webster GK. Relative importance of musculoskeletal disorders as a cause of chronic health problems, disability, and health care utilization: Findings from the 1990 Ontario Health Survey. J Rheumatol 1994; 21(3): 505–514.Google Scholar
  45. 45.
    van der Heijden GJMG. Introduction. In: van der Heijden GJMG, ed. Shoulder disorder treatment: Efficacy of ultrasoundtherapy and electrotherapy. Maastricht: University Press Maastricht, 1996: 7–10.Google Scholar

Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • Dorcas E. Beaton
    • 1
    • 2
    • 3
  • Donald C. Cole
    • 1
    • 4
  • Michael Manno
    • 1
  • Claire Bombardier
    • 1
    • 2
  • Sheilah Hogg-Johnson
    • 1
    • 2
  • Harry S. Shannon
    • 1
    • 4
  1. 1.Institute for Work and HealthTorontoCanada
  2. 2.University of TorontoTorontoCanada
  3. 3.Institute for Work and HealthTorontoCanada
  4. 4.Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada

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