RELATIONS BETWEEN UPPER-LIMB SOFT-TISSUE DISORDERS AND REPETITIVE MOVEMENTS AT WORK

To make a preliminary assessment of whether upper limb soft tissue dis orders might be associated with activities at work, we have conducted a case-control study of subjects attending orthopedic clinics in three cities. All subjects between the ages of 16 and 65 years, in whom def ined soft tissue conditions of the upper limb were diagnosed by the pa rticipating orthopedic surgeons, were invited to take part. Controls w ere subjects attending the same clinics within the same age range whos e clinical diagnosis did not include disease of the upper limb, cervic al or thoracic spine. Information concerning repetitive movements of t he upper limbs at work was elicited by questionnaire. Five hundred eig hty cases and 996 controls were studied, representing 96% and 93%, res pectively, of those invited to participate. The diagnoses of the cases included soft tissue conditions affecting the shoulder, elbow, forear m, wrist, thumb, hand, and fingers. The diagnoses of the controls incl uded traumatic, degenerative, and inflammatory conditions, mostly of t he legs and lower back. Women predominated among the cases (70%) and m en among the controls (56%). Of 221 female cases with injury to the wr ist and forearm, 32 were cleaner/domestics (14.5%) compared to 35 of 4 39 controls (8%), a difference statistically significant at the 21/2% level. Other jobs significantly overrepresented (5% level) among femal e cases with injuries at various anatomical sites included hairdresser s, secretary/temps, assembly line workers, and machine operators (type unspecified). Among male cases, electricians were significantly overr epresented (5% level). Jobs for which there was a suggestion (p < 0.1) of overrepresentation among cases included butchers and teacher/lectu rers (both males only) and the combined job groups (chosen a priori fo r analysis) of keyboard operators, machine operators, and music teache rs (all three jobs, females only).