Associate Professor Identification of Research Needs for Epidemiology of Work-Related Musculoskeletal Disorders

JACQUELINE AGNEW, MPH, PhD

Johns Hopkins University
School of Public Health
615 North Wolfe Street
Baltimore, MD 21205
Phone: (410) 955-4082

A workshop was convened by the Johns Hopkins University, Center for VDT and Health Research in conjunction with the International Conference on Occupational Disorders of the Upper Extremity. The primary objective of the workshop was to review research methodology applicable to epidemiologic studies of musculoskeletal disorders of the upper limb among office workers using VDT work stations (with key boards or other devices), so as to identify research needs and priorities. Workshop participants were asked to asses the "state of the art" with respect to definitions of musculoskeletal disorders appropriate to epidemiologic studies (health endpoints), methods for assessment of physical ergonomic stressors among VDT users in the office setting (ergonomic exposures), and methods for assessment of psychosocial and job organizational factors related to stress in a work environment (psychosocial stress measures). Attention was also given to design of epidemiologic studies of musculoskeletal disorders of the upper limb in office workers. Research needs identified in the above areas included the following.

Health End Points Research Needs:

• Review of studies of the reliability and validity of symptomatic questionnaires and functional status assessment instruments;
• Laboratory studies of pathophysiologic mechanisms to assess potential predictors of chronic musculoskeletal disorders;
• Epidemiologic surveillance and improved etiologic or preventive studies; and
• Studies of symptomatic disorders in relation to productivity and cost-effectiveness of treatment and prevention.
  

Exposure Assessment Research Needs:

• Determination of the importance, validity, and predictive value of assessment metrics;
• Estimates of inter- and intra-subject variability with respect to the range of risk factors potentially associated with VDT office work ;
• Assessment metrics need to be better developed and explicitly defined in terms of standardized protocols with respect to specific assessment tools;
• Examination of the relationship between exposure related risk factors and physiologic measures of disease;
• Develop and validate new and improved tools for assessing risk factors in terms of assessment metric and physiologic measures of dose; and
• Develop a taxonomy of VDT office work job tasks to standardize reporting.
  

Psychosocial and Work Organization Research Needs:

• Identification of additional relevant psychosocial variables;
• Identification of valid, reliable, and standardized methods for measuring psychosocial variables;
• Develop a better understanding of potential confounding variables and sources of bias;
• Further exploration of models to explain the relationship between these factors and work-related musculoskeletal disorders;
• Examine the effects of worker participation; and
• Identify biobehavioral interventions for preventing work related musculoskeletal disorders.
  

In addition, two consensus conferences were proposed: one on the definition of health endpoints and another on exposure assessment.