On prevention and rehabilitation of work related musculoskeletal disorders from upper extremitis

Abstract: Neck pain and shoulder impairment are the most common causes of disability pension among workers in Sweden. Women are affected to a greater extent than men. Such complaints are also costly in terms of national economy by affecting health care and social insurance. The situation is much the same in all industrialized countries. Efforts aiming at prevention and rehabilitation seem so far to have had relatively smalleffects. The number of people affected has increased over the last few years.A series of studies have been countered in a manufacturing industry with high degree of assembly work. Jobs with large contents of repetitive, monotonous arm movements in fixed postures were highly overrepresented in workers with complaints. Exposure to such tasks plays an important role for the emergance of symptoms.Those studies also showed that shoulder-neck complaints are still the overriding cause of long term sickleave in the manufacturing industry. They accounted for 45 days on an annual basis; 60 percent of long term sickleave and 30 percent of short term absence were caused by shoulder and neck disorders.On-the-job training, aiming at an ergonomically adequate working technique, decreases musculoskeletal complaints among newly employed assembly workers.Carpal tunnel syndrome can be treated surgically with success. However, if workers return to monotonous and repetitive work tasks after surgery the long run rehabilitation outcome will be poor.An outpatient rehabilitation programme performed in team work including work pace efforts can reduce the number of relapses due to shoulder-neck symptoms.Ergonomic implementations in a wider sense including organizational factors may reduce sickleave and labour turnover among assembly workers. Sickleave decreased by 5 percentage points and personnel turnover dropped by 25 per cent in the factory at study. Production costs were reduced by 10 per cent. Thus, ergonomical changes are no contradiction to productivity.