Trauma Disorders

Cumulative trauma disorders (CTDs), also referred to as repetitive-motion injuries, result from excessive use of the hand, wrist, or forearm. As with overexertion injuries, the frequency and costs of CTDs are growing to epidemic proportions. Some of the most common cumulative trauma disorders are carpal tunnel syndrome, cubital tunnel syndrome, tendinitis, and tenosynovitis. 

Cumulative Trauma Disorders (CTDs) occur when stresses build up over time in a part of the body and cause pain or other discomfort. CTDs are often difficult to identity, classify, and manage because employees respond differently to stress, and they can be aggravated by activities outside the warehouse. Causes are sometimes difficult to isolate and control. 

Raynaud s phenomenon Tendinitis Tenosynovitis Carpal tunnel syndrome DeQuerians disease Trigger finger 

Internal derangement of the knee Patellar bursitis Tarsal tunnel syndrome Plantar fascitis. 

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Smith M and Carayon P (1996). Work organization, stress and cumulative trauma disorders. In Beyond Biomechanics Psychosocial Aspects of Musculoskeletal Disorders in Office Work (S Moon and S Sauter eds), pp. 23-44. London, UK Taylor Francis. 

Disorders due to repeated trauma Disorders due to physical agents All other illnesses... 

As discussed in ANSI Z-365 (1999), surveillance is defined as the ongoing systematic collection, analysis, and interpretation of health ruid exposure data in the process of describing and monitoring work-related cumulative trauma disorders. Surveillance is used to determine when and where job analysis is needed and where ergonomic interventions may be warranted. 

Analysis of existing records and surveys consists of reviewing existing databases, principally collected for other purposes, to identify incidents and patterns of work-related cumulative trauma disorders. It can help determine and prioritize the jobs to be further analyzed using job analysis. There are three types of existing records and survey analyses ... 

This is equivalent to the number of new cases per 100 worker years. Workplace-wide incidence rates (IRs) wiU be calculated for all cumulative trauma disorders and by body location for each department, process, or type of job. (If specific work hours are not readily available, the number of full-time equivalent employees in each area multiplied by 2000 hours will be used to obtain the denominator.) Severity rates (SRs) traditionally use the number of lost workdays rather than the number of cases in the numerator. Prevalence rates (PRs) are the number of existing cases per 200,000 hours or the percentage of workers with the condition (new cases plus old cases that are still active). 

ANSI Z-365 Draft (1995), Control of Work-Related Cumulative Trauma Disorders, Part I Upper... 

Armstrong, T. (1986), Ergonomics and Cumulative Trauma Disorders, Hand Clinics, Vol. 2, pp. 553-565. 

Armstrong, T. J., and Lifshitz, Y. (1987), Evaluation and Design of Jobs for Control of Cumulative Trauma Disorders, in Ergonomic Interventions to Prevent Musculoskeletal Injuries in Industry, American Conference of Governmental Industried Hygienists, Lewis, Chelsea, MI. 

Karwowski, W., and Marras, W. S. (1997), Cumulative Trauma Disorders, in Handbook of Human Factors and Ergonomics, 2nd Ed., G. Salvendy, Ed., John Wiley Sons, New York, pp. 1124-1173. 

Keyserling, W. M., Stetson, D. S., SUverstein, B. A., and Brouver, M. L. (1993), A Checklist for Evaluating Risk Factors Associated with Upper Extremity Cumulative Trauma Disorders, Ergonomics, Vol. 36, No. 7, pp. 807-831. 

Putz-Anderson, V., Ed. (1988), Cumulative Trauma Disorders A Marmal for Musculoskeletal Diseases for the Upper Limbs, Taylor Francis, London. 

Other task considerations dealing with the content of the task that ate related to the physical requirements include the pace or rate of work, the amount of repetition in task activities, and work pressure due to production demands. Task activities that are highly repetitive and paced by machinety rather than by the employee tend to be stressful. Such conditions also diminish an employee s attention to hazards and the capability to respond to a hazard due to boredom. These conditions may produce cumulative trauma disorders to the musculoskeletal system when the task activity cycle time is short and constant. Tasks with relatively low workload and energy expenditure can be very hazardous due to the high frequency of muscle and joint motions and boredom, which leads to employee inattention to hazards. 

Smith, M. J., and Carayon, P. (1995), Work Organization, Stress and Cumulative Trauma Disorders, in Beyond Biomechanics Psychosocial Aspects of Cumulative Trauma Disorders, S. Moon and S. Sauter, Eds., Taylor Francis, London. 

Eigure 5 Approximate Reach Distances for Average U.S. Male and Female Workers. (From V. Putz-Anderson, Ed., Cumulative Trauma Disorders, copyright 1988 Taylor Francis Books Ltd., by permission)... 

TABLE 7 Sample Checklist for Upper-Extremity Cumulative Trauma Disorders... 

Lifshitz, Y., and Armstrong, T. J. (1986), A Design Checklist for Control and Prediction of Cumulative Trauma Disorder in Hand Intensive Manual Jobs, in Proceedings of the Human Factors Society 30th Annual Meeting. 

CSGs (Constructive Solid Models), 182 C/S systems, see Client/server systems CTA, see Cognitive task analysis CTDs, see Cumulative trauma disorders CTP (capable-to-promise), 2046 CTS, see Ctupal tunnel syndrome Cuban Missile Crisis, 139 Culture. See also National culture Oigemizational culture and eilignment of technology/oiganizational structure, 956-961 safety, 959-961 Culture shift, 14, 16 Culture systems, 15-16, 1798 Cumulative distribution function (CDF), 2385-2386... 

University of Saarland (Germany), 290-291 University of Southern CaMfomia Information Sciences Institute, 1112 University of St. Gallen, 217-218 University of Utah, 238 Uimecessary work, 1459 Unpaced fines models of, 1639 Umelated events, 2147 Unstable processes, 1830 Unsupervised neural networks, 1779-1780 UnsustainabiMty, 997 Upper-Extremity CheckHst, 1143-1144 Upper-extremity cumulative trauma disorders, 1365... 

The system of just-in-time production, in which inventory buffers are kept to a minimum, does, in fact, increase the cost of aeddents to the firm. This logic does not apply to chronic health problems, however, and Wokutch documents the reluctance of Japanese firms to address the long-term consequences of its high-paced, high-stress production system - particularly cumulative trauma disorders. 

Technological advances have made unintended consequences almost inevitable. Like a phantom in a bag that pops out in every direction that isn t held, secondary effects that are masked by primary effects assume much more importance when the primary effects are conquered (Tenner, 1996). Chronic illnesses such as cancer, silicosis, and cumulative trauma disorder probably were not recognized as important because acute illnesses such as typhoid, plague, and pneumonia killed so many. After anesthetics allowed painless surgery, the number of surgical procedures skyrocketed and the total amount of pain experienced by the total human population is higher because of it. 

Human factors are also important in rehabilitation, where various aids for the disabled must be sized correctly, be versatile enough to accommodate special needs, be acceptable to the human user, and be socially acceptable to others. Without proper incorporation of human factors, health problems such as eyestrain, mental stress, and physical injury can result. Cumulative trauma disorder (work-related musculoskeletal disorder) comes about when working repetitively with tools under awkward conditions. Carpel tunnel syndrome is one form of this. 

Cumulative trauma The accumulation of repeated insults to body structures over a period of time (usually months or years) often leading to cumulative trauma disorders. ... 

For many incidents resulting in back injuries, strains and sprains, cumulative trauma disorders, and others, employees were adhering to the prescribed work procedure when the incident occurred. Typically, an incident investigation report would show that an unsafe act, a human error, was the principal incident cause. 

Unfortunately, ergonomics has been narrowly and inappropriately perceived by some to include only cumulative trauma disorders. Opportunities for risk reduction and improving productivity and cost efficiency are lost if ergonomics concepts are not applied to all aspects of workplace and work methods design presenting excessive biomechanical stresses—cumulative or instantaneous. 

Cumulative Trauma Disorders A Manual for Musculoskeletal Diseases of the Upper Limbs, Vem Putz-Anderson, ed. 

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