Self-reported pain and physical signs for musculoskeletal disorders in the upper body region among Los Angeles garment workers

Article type: Research Article

Authors: Wang, Pin-Chieh^; | Rempel, David M. | Hurwitz, Eric L. | Harrison, Robert J. | Janowitz, Ira | Ritz, Beate R.

Affiliations: Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA, USA | Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA | Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, CA, USA | Occupational Health Branch, California Department of Health Services, Oakland, CA, USA | Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawai'i at Mānoa, HI, USA

Note: [] Address for correspondence: Beate Ritz, M.D., Ph.D., Vice Chair, Department of Epidemiology, Professor of Epidemiology, Environmental Health Sciences, and Neurology, UCLA, Schools of Public Health and Medicine, BOX 951772, 650 Charles E. Young Drive, Los Angeles, CA 90095-1772, USA. Tel.: +1 310 206 7458; Fax: +1 310 206 6039; E-mail: britz@ucla.edu

Abstract: Reports of pain and physical exam findings for musculoskeletal disorders (MSDs) are two common outcome measures independently used to assess work-related MSDs in the scientific literature. How these measures correlate with each other, however, is largely unknown. We recruited 520 sewing machine operators to describe the correlation between subjective self-reported pain and physical findings of MSDs in three upper body regions including the neck/shoulder, elbow/forearm, and hand/wrist. Self-reports of pain and physical findings resulted in different and partly non-overlapping classifications of subjects as MSD cases in our study. Both outcome measures were found to be consistently associated with 'having a medical history of MSDs', 'perceived physical exertion', 'perceived job insecurity' (neck/shoulder), being of older age (arm/forearm), and female gender (arm/forearm and hand/wrist); however, we observed inconsistency for the measures for a number of other job related factors such as 'operating a single machine' and 'number of work hours per week'. Because to date no agreed upon "gold standard" for diagnosing MSDs exists, our findings suggest that research results can be very different when using self-reported measures versus physical exam findings. Also, in order to evaluate the success of an intervention, screening, or surveillance program for work related MSDs, it is important to define clearly which outcome measure best to employ.

Keywords: Agreement, correlation, physical sign, physical examination, work organization

DOI: 10.3233/WOR-2009-0904

Journal: Work, vol. 34, no. 1, pp. 79-87, 2009