[Epidemics of musculotendinous pathologies of the upper limbs (cumulative trauma disorders) in a group of assembly line workers].Med Lav. 1993 Nov-Dec; 84(6):487-500.ML
The study was prompted by a report concerning a group of assembly line workers in a factory producing prams who had developed various muscular and tendinous disorders of the upper limbs that can be classified under the larger category of Cumulative Trauma Disorders (CTD). The study first concentrated on the working conditions with analysis of the main factors responsible for overloading of the upper limbs during work. This analysis revealed high frequency and repetitiveness of upper limb movements together with a marked inadequacy of the length and distribution of pauses. In a significant part of the operations the workers also performed movements in positions that over loaded the wrist and hand. A parallel clinical and instrumental study carried out in collaboration with specialists in orthopedics, brain surgery and neurophysiology on all 40 workers in the shop showed that 90% of the subjects suffered from a form of CTD of the upper limbs: in particular, 40% were affected with carpal tunnel syndrome (12.5% bilateral), and there were high prevalence of tenosynovitis (32% Trigger Finger, 17% De Quervain's syndrome) and epicondylitis (20% medial or lateral). The results of the study once again emphasize the need for greater attention of occupational health practitioners in Italy for muscular and tendinous disorders of the upper limbs due to repeated strain, which Italian law defines, albeit controversially, as occupational.