Journal of occupational and environmental medicine
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J. Occup. Environ. Med. · Jun 1998
Occupational upper extremity disorders in the federal workforce. Prevalence, health care expenditures, and patterns of work disability.
Upper extremity disorders (UEDs) account for a significant number of work-related illnesses in the US workforce. Little information exists on the distribution of UEDs, their associated health care and indemnity costs, or patterns of work disability. The study presented is an analysis of upper extremity claims within the federal workforce. ⋯ Also mean duration and pattern of work disability revealed that these disorders can result in chronic work disability similar to that observed in low back pain. The results highlight the need to determine whether interventions that account for the majority of costs significantly impact long-term outcomes. There is also a need to identify risk factors for prolonged disability in those who experience problems with delayed recovery.
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J. Occup. Environ. Med. · Oct 1997
ReviewDe Quervain's tenosynovitis. Stenosing tenosynovitis of the first dorsal compartment.
De Quervain's tenosynovitis is a disorder characterized by pain on the radial (thumb) side of the wrist, impairment of thumb function, and thickening of the ligamentous structure covering the tendons in the first dorsal compartment of the wrist. It is precisely defined as stenosing tenosynovitis of the first dorsal compartment. ⋯ The topics covered include normal anatomy and kinesiology; history; clinical observations related to diagnosis; pathology; pathophysiology; clinical observations on etiology; descriptive epidemiology; epidemiological studies; and case management. Models for the pathogenesis of De Quervain's tenosynovitis are proposed and opportunities for future research presented.
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J. Occup. Environ. Med. · Dec 1996
Evaluation of the utility of spirometry in a regional public health screening program for workers exposed to welding fumes.
The objective of this study was to determine the usefulness of spirometry in the screening of chronic pulmonary problems related to exposure to welding fumes, in a regional public health-based screening program. Pulmonary questionnaires and spirometric tests were administered twice at 5-year intervals on 229 welders/cutters (mean age, 39.9 years from 31 metal manufacturing plants. The baseline mean value at the first test for the forced expiratory volume in one second (FEV1) was 102% of predicted, the forced vital capacity (FVC) was 107%, and the FEV1/FVC ratio was 79%. ⋯ A high lifetime exposure to welding fumes was associated with better lung functions in the cross-sectional approach (healthy worker effect) but not in the longitudinal approach, where no association was found. We concluded that the public health regional application of this screening program generated too many sources of variation for spirometry to fulfill the objective of early detection of pulmonary function decline related to exposure to welding fumes. Based on these observations, we recommend that maintaining questionnaire screening, with spirometry reserved as a second-line diagnostic intervention.