Objective A longitudinal cohort of automobile manufacturing workers (n = 1,214) was examined for: (1) prevalence and persistence of specific upper extremity musculoskeletal disorders (UEMSDs) such as lateral epicondylitis and de Quervain’s disease, and non-specific disorders (NSDs) defined in symptomatic individuals without any specific disorder, and (2) disorder prognoses based on symptom characteristics and other factors. Methods Eight specific disorders were identified through case definitions based on upper extremity physical examinations and symptom surveys administered on three occasions over 6 years. Results At baseline, 41% of the cohort reported upper extremity symptoms; 18% (n = 214) of these had NSDs. In each survey, tendon-related conditions accounted for over half of the specific morbidity. Twenty-five percent had UEMSDs in multiple anatomical sites, and most with hand/wrist disorders had two or more hand/wrist UEMSDs. Persistence for all specific disorders decreased with length of follow-up. Specific UEMSDs were characterized by greater pain severity and functional impairment, and more lost work days than NSDs. Conclusions Upper extremity symptoms and diagnoses vary over time. NSDs may be the early stages of conditions that will eventually become more specific. NSDs and overlapping specific UEMSDs should be taken into account in UEMSD classification. Am. J. Ind. Med. 52:124-132, 2009.
Judith E. Gold ScD1 2 * Angelo d’Errico MD3 Jeffrey N. Katz MD4 Rebecca Gore PhD2 Laura Punnett ScD2
Department of Public Health, Temple University, Philadelphia, Pennsylvania;Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts;Epidemiologic Unit, Piedmont Region, Grugliasco (TO), Italy;Division of Rheumatology, Immunology and Allergy and Department of Orthopaedic Surgery Brigham and Women’s Hospital, Boston, Massachusetts