ABSTRACT
Low-level static exertions have been identified as a risk factor for the development of cumulative trauma
disorders or repetitive strain injuries from epidemiological studies. The exposure in terms of static exer-
tions in the workplace has been assessed for different jobs and tasks based on electromyographic record-
ings from specific muscle groups (Table 14.1). Jobs characterized by relatively high static levels in neck
and shoulder showed health outcomes in terms of musculoskeletal disorders in these body regions
(Table 14.2). In the 1970s, static contractions of 15% MVC (maximum voluntary contraction) were con-
sidered to be tolerated for an “unlimited” period of time for a muscle.1 However, later studies showed
that if a contraction is to be maintained for just 1 h, it may have to be as low as 8% MVC.2 A permissible
level of static muscle load of 2 to 5% MVC was then suggested.3 However, it was observed that muscu-
loskeletal disorders were frequent even in jobs with static levels of this magnitude, and it was suggested to
reduce the acceptable static level, for example, by job rotation.4 Static levels as low as 0.5 to 1% MVC may
relate to troubles in the shoulder region,5,6 and most recently, statements have been brought forward that
static loads are not acceptable at all if sustained frequently or over a long period of time. Actually,
“working hours as a risk factor in the development of musculoskeletal complaints” has been proposed.7
Such continuous revision of recommendations can be foreseen if we do not understand why low-level
static exertions cause disorders. The acceptable limits or interventions recommended in the workplace
will only reduce cumulative trauma disorders if the true risk factors that elicit adverse health outcome
are eliminated or minimized. Therefore, it is important to identify which aspect of these so-called
low-level static exertions may be the risk factors. In this context, plausibility also plays an important
role in risk identification, that is, possible physiological mechanisms of tissue degradation, which may
be causally related to the identified risk aspect. The term “low-level static exertions” will be discussed, fol-
lowed by a presentation of possible short-and long-term physiological responses. Based on this, preven-
tive strategies are presented.
