ABSTRACT
As early as 1700, Bernardino Ramazzini, one of the founders of occupational medicine, had associated certain physical activities with musculoskeletal disorders (MSD). He postulated that certain violent and irregular motions and unnatural postures of the body impair the internal structure [Snook et al., 1988]. Presently, much effort is directed toward a better understanding of work-related musculoskeletal disorders involving the back, cervical spine, and upper extremities. The World Health Organization (WHO) has defined occupational diseases as those work-related diseases where the relationship to specific causative factors at work has been fully established [WHO, 1985]. Other work-related diseases may have a weaker or unclear association to working conditions. They may be aggravated, accelerated, or exacerbated by workplace factors and lead to impairment of workers’ performance. Hence obtaining the occupational history
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is crucial to proper diagnosis and appropriate treatment of work-related disorders. The occupational physician must consider the conditions of both the workplace and the worker in evaluation of injured workers. Biomechanical and ergonomic evaluators have developed a series of techniques for quantification of the task demands and evaluation of the stresses in the workplace. Functional capacity evaluation also has been advanced to quantify the maximum performance capability of workers. The motto of ergonomics is to avoid the mismatch between the task demand and functional capacity of individuals. A multidisciplinary group of physicians and engineers constitutes the rehabilitation team that will work together to implement the prevention measures. Through proper workplace design, workplace stressors could be minimized. It is expected that one-third of the compensatable low back pain in industry could be prevented by proper ergonomic workplace or task design. In addition to reducing the probability of both the initial and recurring episodes, proper ergonomic design allows earlier return to work of injured workers by keeping the task demands at a lower level. Unfortunately, ergonomists are often asked to redesign the task or the workplace after a high incidence of injuries has already been experienced. The next preventive measure that has been suggested is preplacement of workers based on the medical history, strength, and physical examinations [Snook et al., 1988]. Training and education have been the third prevention strategy in the reduction of musculoskeletal disorders. Some components of these educational packages such as “back schools” and the teaching of “proper body mechanics” have been used in the rehabilitation phase of injured workers as well.
