Abstract
The ACGIH Worldwide Threshold Limit Value (TLV) for hand activity “considers average hand activity level or “HAL” and peak hand force.” We report cross-sectional data that assess the validity of the TLV with respect to symptoms and selected upper extremity musculoskeletal disorders among workers. The prevalence of symptoms and specific disorders were examined among 908 workers from 7 different job sites in relation to the TLV. Worker exposures were categorized as above the TLV, above the TLV Action Limit but below the TLV, or below the TLV Action Limit. Symptoms in the distal upper extremities did not vary by TLV category. Tendonitis in the wrist/hands/fingers did not vary by TLV category, but elbow/forearm tendonitis was significantly associated with TLV category. All measures of carpal tunnel syndrome were associated with TLV category. In all instances, prevalence of symptoms and specific disorders were substantial in jobs that were below the TLV action limit, suggesting that even at “acceptable” levels of hand activity, many workers will still experience symptoms and/or upper extremity musculoskeletal disorders, which may be important in the rehabilitation and return to work of injured workers. Future analyses need to examine the incidence of symptoms and upper extremity musculoskeletal disorders prospectively among workers in relation to the TLV for hand activity.
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References
Bernard BP, ed. Musculoskeletal disorders and workplace factors: A critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity and low back. Cincinnati: Department of Health and Human Services, National Institute for Occupational Safety and Health, 1997.
National Research Council (NRC). Work-related musculoskeletal disorders. Report, Workshop Summary, and Workshop Papers. Washington, DC: National Academy Press, 1999.
National Research Council (NRC). Musculoskeletal disorders and the workplace. Low back and upper extremities. Washington, DC: National Academy Press, 2001.
Foley M, Silverstein B. Musculoskeletal disorders, risk factors, prevention steps: A survey of employers in Washington State. Technical Report 53-1-1999. Olympia, Washington: SHARP, Washington State Department of Labor & Industries, 1999.
ACGIH Worldwide. Hand Activity Level TLV, 2001.
Franzblau A, Werner RA, Albers JW, Grant CL, Olinski D, Johnston E. Workplace surveillance for carpal tunnel syndrome using hand diagrams. J Occup Rehab 1994; 4(4): 185–198.
Franzblau A, Salerno DF, Armstrong TJ, Werner RA. Test–retest reliability of an upper extremity discomfort questionnaire in an industrial population. Scand J Work Environ Health 1997; 23: 299–307.
Homan MM, Franzblau A, Werner RA, Albers JW, Armstrong TJ, Bromberg MB. Agreement between symptom surveys, physical examination findings and electrodiagnostic testing for carpal tunnel syndrome. Scand J Work Environ Health 1999; 25(2): 115–124.
Latko WA, Armstrong TJ, Franzblau A, Ulin SS, Werner RA, Albers JW. A cross-sectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders. Am J Ind Med 1999; 36(2): 248–259.
Salerno DF, Franzblau A, Werner RA, Bromberg MB, Armstrong TJ, Albers JW. Median and ulnar nerve conduction studies among workers: Normative values. Muscle Nerve 1998; 21(8): 999–1005.
Salerno DF, Werner RA, Albers JW, Becker MP, Armstrong TJ, Franzblau A. Reliability of nerve conduction studies among active workers. Muscle Nerve 1999; 22(10): 1372–1379.
Rempel D, Evanoff B, Amadio PC, 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 epidemiologic studies. Am J Public Health 1998; 88(10): 1447–1451.
Latko W. Development and evaluation of an observational method for quantifying exposure to hand activity and other physical stressors in manual work. Doctoral Dissertation, The University of Michigan, 1997.
Latko WA, Armstrong TJ, Foulke JA, Herrin GD, Rabourn RA, Ulin SS. Development and evaluation of an observational method for assessing repetition in hand tasks. Am Ind Hyg Assoc J 1997; 58(4): 278–285.
STATA for Windows (version 7.0). College Station, TX: Stata Corporation, 2002.
Everitt BS. The analysis of contingency tables. New York: John Wiley & Sons, 1979.
McAtamney L, Corlett E. RULA: A survey method for the investigation of work-related upper limb disorders. Appl Ergonom 1993; 24(2): 91–99.
Hignett S, McAtamney L. Rapid entire body assessment (REBA). Appl Ergonom 2000; 31(2): 201–205.
Moore JS, Garg A. The Strain Index: A proposed method to analyze jobs for risk of distal upper extremity disorders. Am Ind Hyg Assoc J 1995; 56(5): 443–458.
Colombini D. An observational method for classifying exposure to repetitive movements of the upper limbs. Ergonomics 1998; 41(9): 1261–1289.
Armstrong TJ, Fine LJ, Radwin RG, Silverstein BS. Ergonomics and the effects of vibration in hand-intensive work. Scand J Work Environ Health1987; 13(4): 286–289.
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Franzblau, A., Armstrong, T.J., Werner, R.A. et al. A Cross-Sectional Assessment of the ACGIH TLV for Hand Activity Level. J Occup Rehabil 15, 57–67 (2005). https://doi.org/10.1007/s10926-005-0874-z
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DOI: https://doi.org/10.1007/s10926-005-0874-z