McMaster University, Hamilton, Ontario, Canada.
Hum Factors. 2021 Feb;63(1):5-31. doi: 10.1177/0018720819860683. Epub 2019 Jul 17.
The relationships between workplace risk factors and upper extremity injuries from epidemiological and laboratory studies were examined.
Epidemiological studies are associated with several limitations, affecting the strength of association between risk factors and the development of injuries.
In this narrative review, we identified epidemiological and laboratory studies (published primarily since 1997) investigating exposure to workplace risk factors (force, repetition, posture, vibration) and risk of hand/wrist tendon-related disorders, epicondylitis, and carpal tunnel syndrome (CTS).
Forceful exertions are strongly associated with hand/wrist tendon-related disorders, epicondylitis, and CTS. Dose-response relationships were found for epicondylitis (repetition) and CTS (posture). Interactions demonstrate multiplicative effects of risk factors for injury risk. Laboratory studies display clear associations between task demands and biomechanical measures linked to mechanisms for upper extremity injuries with animal models providing further evidence of a dose-response between risk factors and injury.
Forceful, repetitive work requiring non-neutral postures are associated with increasing risk of hand/wrist tendon-related disorders, epicondylitis, and CTS as evidenced by epidemiology studies and laboratory-based investigations of humans and animals.
Understanding the relationship between exposure levels of workplace risk factors and upper extremity disorders can improve injury prevention and rehabilitation strategies.
从流行病学和实验室研究两个方面，研究工作场所危险因素与上肢损伤之间的关系。
流行病学研究存在一些局限性，影响到危险因素与损伤发生之间关联的强度。
在这篇综述中，我们确定了自 1997 年以来发表的流行病学和实验室研究（主要发表于此之后），这些研究调查了工作场所危险因素（力、重复、姿势、振动）暴露与手部/腕部肌腱相关疾病、肘突炎和腕管综合征（CTS）的风险之间的关系。
剧烈用力与手部/腕部肌腱相关疾病、肘突炎和 CTS 密切相关。对于肘突炎（重复）和 CTS（姿势），发现了剂量-反应关系。交互作用显示了危险因素对损伤风险的乘法效应。实验室研究显示了任务需求与与上肢损伤机制相关的生物力学测量之间的明确关联，动物模型进一步提供了危险因素与损伤之间存在剂量-反应关系的证据。
需要进行非中立姿势的剧烈重复工作与手部/腕部肌腱相关疾病、肘突炎和 CTS 的风险增加有关，这一点可以通过流行病学研究以及对人类和动物进行的基于实验室的研究得到证实。
了解工作场所危险因素暴露水平与上肢疾病之间的关系可以改善损伤预防和康复策略。
