Mark Your Calendars for RSI Awareness Day

February 28^th, 2009 is International RSI Awareness Day.  The intent of this day is to bring awareness to the various Repetitive Strain Injuries, the amount of people affected by RSIs, and the need for prevention. The first RSI Awareness Day began on February 29^th, 2000, as it was the only non-repetitive day of that year. 

The term "Repetitive Strain Injury" (RSI) encompasses various individual conditions that affect specific parts of the body.  Other terms have been developed which can be used synonymously with RSI such as:

·         Musculoskeletal disorders (MSD),

·         Work-related musculoskeletal disorders (WRMSD),

·         Musculoskeletal disorders of the upper extremity (MSD-UE),

·         Occupational overuse syndrome (OOS), or

·         Repetitive motion injuries (RMI).

Specific body parts that are affected by RSIs include:

·         Muscles,

·         Nerves,

·         Connective tissues, and

·         Tendons. 

Typical diagnoses include:

·         Carpal tunnel syndrome,

·         DeQuervain's syndrome,

·         thoracic outlet syndrome,

·         Tendonitis,

·         Rotator cuff syndrome,

·         Trigger finger/thumb, and

·         Reflex sympathetic dystrophy syndrome (RSDS).

According to Statistics Canada, in 2000/2001, approximately 2.3 million Canadians aged 20 years and older, reported having had a repetitive strain injury in the past 12 months.   They went on to report the cause to be most often work-related activities (Tjepkema, 2003). The United States Bureau of Labor Statistics (2008) reports MSDs accounted for 29 percent of all workplace injuries requiring time away from work in 2007. 

Nursing aides, orderlies, and attendants had the highest rate of 252 cases per 10,000 workers, with emergency medical technicians and paramedics coming second with a rate of 179.  Flight attendants recorded a rate of 178 cases per 10,000 workers, with aircraft structure, surfaces, rigging, and systems assemblers recording a rate of 177 cases, and laborers and freight, stock, material movers with a rate of 149 cases.

According to research conducted by Liberty Mutual Research Institute for Safety (2008), "repetitive motion" injuries cost employers $2.1 billion in 2005.

With employer commitment and support to reduce and prevent RSIs in the workplace, it is necessary to understand and identify what the risk factors, or hazards, are for developing these types of injuries. 

Known risk factors include:

• Excessive force,
• Awkward posture,
• High repetition,
• Vibration,
• Contact stress, and
• Temperature.

Identifying the risk factor(s) is a first step, but how do you know if the exposure level is high enough for employees to develop a RSI?  There are a variety of assessment tools available to quantify the level of risk, and to prioritize the high-risk areas/jobs/tasks.  Typical screening tools include Rapid Upper Limb Assessment (RULA), or a Rodgers Muscle Fatigue Assessment.  More quantitative assessment tools include the ACGIH TLV for Hand Activity Level, Moore-Garg Strain Index, Liberty Mutual Manual Materials Handling Tables, and the NIOSH lifting equations. 

Knowing which tool (or tools) is most appropriate to use for a particular assessment can be challenging at times and attention must be paid to understanding the uses and limitations of each assessment tool before use*. Quantifying the risk will identify which RSI risk factor(s) needs to be controlled in order to reduce the risk of an RSI.  Typical controls for RSI risk factors can be broken up into 1) Engineering controls and 2) Administrative controls:

Engineering controls focus on modifications to the work or workplace. Examples include: modifying the work area, modifying the work process, and/or providing new tools or changing the tools currently being used. 

Administrative controls do not change the physical workspace, but rather the process in which the work is done.  For example: changing work schedules to reduce exposure, implementing specific work policies and procedures, and/or making modifications to staffing levels.

The United States Bureau of Labor Statistics (2008) reports the rate of MSD injuries declined by 9% in 2007, as compared to 2006.  Perhaps part of this reduction can be attributed to days such as RSI Awareness day which strives, through education and awareness, to make RSIs a statistic of the past. 

*Knowing when to use the most appropriate ergonomic assessment tool(s) can present a challenge at times. Sandalwood has developed Ergonomic Path Finder (EPF) to provide a tool to assist with this process. EPF is a software system that leads the user through a quantitative analysis using the most appropriate assessment tool (For further information, please feel free to contact pdwyer@sandalwood.com).

References

Liberty Mutual Research Institute for Safety, 2008. The most disabling workplace injuries cost industry an estimated $48.3 Billion.  From Research to Reality 11, 3-6.  Available at: http://www.libertymutualgroup.com/omapps/ContentServer?cid=1138355661160&pagename=LMGroup%2Fcms_document%2FShowDoc&c=cms_document.

Tjepkema, M., 2003. Repetitive strain injury. Statistics Canada Health Reports 14, 11-30.

United States Bureau of Labor Statstics, 2008.  Nonfatal occupational injuries and illnesses requiring days away from work, 2007.  Available at: http://www.bls.gov/news.release/osh2.nr0.htm.