Occupational upper extremity symptoms in sign language interpreters: prevalence and correlates of pain, function, and work disability
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Detalles
The interactive role of work demands, occupational stressors, and ergonomic risk factors in work-related upper extremity (UE) disorders remains unclear. Professional sign language interpreting, which involves exposure of the upper limbs to a combination of potential ergonomic and psychosocial stressors represents a unique occupational group to investigate the multivariate nature of UE disorders. The present study reports data on the prevalence, patterns of symptoms, associated medical problems, and health care related to upper extremity disorders in sign language interpreters. The contribution of work demands, work style, and psychosocial stressors to the occurrence of self-reported function, pain, muscle tension, and work disability was also studied. A group of 1398 sign language interpreters completed an 83-item national survey on occupational musculoskeletal health (response rate of 58%). Interpreters were asked a series of demographic, workstyle, work environment, medical care, and symptom-related questions. Logistic regression, multivariate regression, and discriminant function analyses were used to examine the data. A large percentage of interpreters reported symptoms in the neck region (73.6%) followed by the hand/wrist (69.6%). Using a NIOSH case definition for work-relatedness, prevalence rates varied from 16% to 32% depending upon the anatomic location. Medical care was primarily sought within the first month of symptoms (21.9%) and nonsteroidal antiinflammatory drugs were the most frequently used treatment (70.3%). A multivariate logistic regression indicated that female gender, number of years worked, pressure at work, fear of developing pain, tendency to work in pain to insure work quality, and increased wrist deviations from neutral were associated with case status. Impact on function, pain, and perceived muscle tension at work were all primarily associated with tendency to work in a painful way to insure work quality and fear of developing a pain problem. Time off work was also associated with these variables as well as with the lack of an opportunity to use one's initiative. Results indicate that upper extremity symptoms are prevalent in this work group and that a combination of work demands, workstyle, and psychosocial stressors are associated with case status and the exacerbation of pain, muscular tension, functional limitations, and work disability.