Transcript English

Repetitive Strain Injury (RSI)
Professor T.C. Aw
MBBS, PhD, FRCP, FRCPC, FFOM, FFPHM
Head, Division of Occupational Health
University of Kent
RSI Settlement
Compensation totalling £10,000 is to be paid to
30 poultry production workers at Beatrice
International Foods of Lincoln who suffer from
repetitive strain injury caused by handling
birds. Out of court settlements from £2,000 to
£8,500 were agreed
IntMedJ 2004;34(7):416-419
‘Repetitive strain injuries: has the
Australian epidemic burnt out?”
Awerbuch (2004)
CommHlthStud 1988;12(3):348358
‘The arguments about RSI: an
examination’
Brammer G, Martin B (1988)
Extent of problem (UK)
Musculo-skeletal problems:
 0.5 million workers affected in the UK
 Increase of >50,000 affected since 2001/02
 2nd most common cause of sickness absence in
many industries in the UK
HSE: Self-reported work-related illness survey
Extent of problem (UK)
For upper limb (and neck)
 5 million working days lost
 average of 3 weeks lost time per person
HSE: Self-reported work-related illness survey
Terminology

Repetitive Strain Injury (RSI)
 Cumulative trauma disorder (CTD)
 Occupational overuse syndrome (OOS)
 Work-related repetitive movement injury
(WRMI)
 Work-related upper limb disorder (WRULD)
Definition

Pain and/or discomfort in the limbs due to
 Repetitive movements (dynamic stress), or
 Constrained postures (static stress)
Classification

Specific entities:
Carpal tunnel syndrome
De Quervain’s syndrome
Tendonitis/Tenosynovitis
Peritendinitis crepitans
Epicondylitis
Tennis elbow
 Non-specific diffuse arm pain
Exposure

Repetitive movements
- within normal range e.g.
flexion & extension;
pronation & supination;
abduction & adduction
- extremes of range
 Constrained postures
+/- FORCE
Courtesy of Dr. Syed Ahmed
Effect


Symptoms
Discomfort
Pain
Numbness
Tingling
Signs
Localised swelling
Warmth & redness
Loss of function
Crepitus
Contributory factors

Non-occupational factors
 Individual susceptibility
 Ergonomics
 Psychological overlay
 Trauma – previous or recent
 Compensation?
Laboratory investigations

Tendon acoustic monitoring
 CAT scan
 Nuclear magnetic resonance
 Thermography
 Electromyography
 Nerve conduction studies
Treatment
Analgesics – NSAIDs, Ibuprofen
 Rest/Exercise
 Local injection
 Surgery
 Physiotherapy
 Ultrasound
 Infra-red

Prevention

Frequent rest breaks
 Posture
 Workstation design
 [T’ai Chi, yoga, Alexander technique,
communicating with the subconscious?]
Ref: RSI
Association
Threshold limit value (TLV)

Hand activity level (HAL) [0-10] e.g.
2 : Consistent, conspicuous long pauses; or very
slow motions
6 : Steady motion/exertion; infrequent
pause
10 : Rapid, steady motion/ difficulty
keeping up or continuous exertion
 Peak hand force
NIOSH, 2006
Conclusions
 Getting
the right person &/or tools for
the job
 Information, instruction & training
[email protected]