Repetitive Strain Injury (RSI)Repetitive Strain Injury (RSI)

Professor T.C. AwMBBS, PhD, FRCP, FRCPC, FFOM, FFPHM

Head, Division of Occupational Health

University of Kent

RSI Settlement 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):416-419IntMedJ 2004;34(7):416-419

‘Repetitive strain injuries: has the Australian epidemic burnt out?”

Awerbuch (2004)

CommHlthStud 1988;12(3):348-CommHlthStud 1988;12(3):348-358358

‘The arguments about RSI: an examination’

Brammer G, Martin B (1988)

Extent of problem (UK) Extent of problem (UK)

Musculo-skeletal problems:0.5 million workers affected in the UKIncrease of >50,000 affected since 2001/022nd most common cause of sickness absence in

many industries in the UK

HSE: Self-reported work-related illness survey

Extent of problem (UK) Extent of problem (UK)

For upper limb (and neck)5 million working days lostaverage of 3 weeks lost time per person

HSE: Self-reported work-related illness survey

TerminologyTerminology

Repetitive Strain Injury (RSI)Cumulative trauma disorder (CTD)Occupational overuse syndrome (OOS)Work-related repetitive movement injury

(WRMI)Work-related upper limb disorder (WRULD)

DefinitionDefinition

Pain and/or discomfort in the limbs due toRepetitive movements (dynamic stress), orConstrained postures (static stress)

ClassificationClassification

Specific entities:

Carpal tunnel syndrome

De Quervain’s syndrome

Tendonitis/Tenosynovitis

Peritendinitis crepitans

Epicondylitis

Tennis elbow Non-specific diffuse arm pain

ExposureExposureRepetitive movements

- within normal range e.g.

flexion & extension;

pronation & supination;

abduction & adduction

- extremes of rangeConstrained postures

+/- FORCE

Courtesy of Dr. Syed Ahmed

EffectEffect

SymptomsDiscomfortPainNumbnessTingling

SignsLocalised swellingWarmth & rednessLoss of function Crepitus

Contributory factorsContributory factors

Non-occupational factorsIndividual susceptibilityErgonomicsPsychological overlayTrauma – previous or recentCompensation?

Laboratory investigationsLaboratory investigations

Tendon acoustic monitoringCAT scanNuclear magnetic resonanceThermographyElectromyographyNerve conduction studies

TreatmentTreatmentAnalgesics – NSAIDs, IbuprofenRest/ExerciseLocal injectionSurgeryPhysiotherapy UltrasoundInfra-red

PreventionPrevention

Frequent rest breaksPostureWorkstation design[T’ai Chi, yoga, Alexander technique,

communicating with the subconscious?]

Ref: RSI Association

Threshold limit value (TLV)Threshold limit value (TLV)

Hand activity level (HAL) [0-10] e.g. 2 : Consistent, conspicuous long pauses; or very slow motions6 : Steady motion/exertion; infrequent pause10 : Rapid, steady motion/ difficulty keeping up or continuous exertion

Peak hand force

NIOSH, 2006

ConclusionsConclusions

Getting the right person &/or tools for the job

Information, instruction & training

 

t.c.aw@kent.ac.uk