European Stars and Stripes (Newspaper) - June 16, 1992, Darmstadt, Hesse                                Coping with the a occupational disease of the �?T90s�?T continued from Page 15 to recover in a few months Quot said or. Emil a scarch director of ambulatory care at the Hospital. Quot but workers with severe injuries can take a year or More to get  in some parts of the country workers diagnosed with carpal Tunnel syndrome Are often treated with surgery to reduce pressure on the nerve that is compressed by swollen or enlarged tissue passing through the wrist. While some surgeons say the procedure is remarkably helpful to 60 to 80 percent of patients other experts say it is abused by doctors who do not try More conservative remedies first. Carpal Tunnel surgery is now the second most common operation performed in this country. The problem of work related Tuscul skeletal disorders is not new. In 1717 the father of occupational Medicine an italian doctor named Bernardino Ramazini first described cumulative Micro trauma As a main cause of occupational disease. But repetitive motion disorders received Only a Flicker of expert attention until they began striking White Collar workers and especially newspaper reporters who had been All but immune to the Job related injuries that other labourers have endured for centuries. Some of the Rise in cases is widely attributed to increased recognition of the problem and a new willingness to report it. Or. Laura Punnett an ergonomist and epidemiologist at the University of Massachusetts at Lowell said Quot historically there s been lots of under reporting Quot of these disorders. As she explained Quot Many workers did not recognize the problem As being Job related others who did worried about losing their jobs if they reported their  the occupational safety and health administration is Only beginning to formulate regulations to curb these disorders which continue to plague huge numbers of workers who process meat poultry and fish and operate machinery As Well As those who use computers. Or Barbara Silverstein an epidemiologist with the department of labor and industries in Washington state noted that the United states is a Johnny come lately in trying to curb problems caused by repetitive motion in the workplace. In Japan she said a longstanding National commission has limited the time workers can spend at keyboards and set mandatory rest periods. The result she said has been lower repetitive stress injuries among keyboard operators in Japan. A common experience of workers in America who report hand and wrist injuries to their employers is to find themselves suspected of malingering. Lamp Foyers doubts Are bolstered by the fact that victims of repetitive stress injury take longer to recover and Are less Likely to i mum to work if they have filed worker s compensation claims according to a study of 28,000 wot Ken conducted by or. Gary Franklin a neurologist who selves is medical director for Washington state s  a labor and industries. Franklin also noted that the disabilities suffered by Many workers were Quot out of proportion Quot to measurable at 111011 10111103 in their wrists a widely acknowledged finding that has pump cd North m. Hadler a Rheum apologist at the t Niv r by of North Carolina to dispute whether the problem i. Heat i Badiei Monit Ains that Tuscul skeletal activity that is Quot reason. Ine comfortable and customary and which can be Lopo aled without undue distress Quot such As typing on a computes is unlikely to result in tissue damage Thois. Like Silverstein report that although dissatisfied workers ate none to exaggerate their injuries or Discon ifsits she found in her study at the newspaper in new York that the most devoted and talented reporters typically suffered the most. Quot these Are High production people who Don t listen to therr bodies a Silverstein said. Quot they Don t Stop working when they Start hurting. The same with musicians. It is the High performance people who Are at highest risk of Tuscul skeletal disorders. And one could hardly accuse musicians of seeking to gel paid without working since they Don  in a seven Industry study of factory workers she also found no differences in Overall Job satisfaction and in views about work in general among employees afflicted with hand wrist disorders and those who were not. Still she and Franklin agreed that psychological and social factors can make work related muscular stress worse by increasing muscular tension. One complicating Factor is being unable to modify the work schedule and Pace of work to an individual s need. Another is receiving too Little support from one s supervisor. A third is having an uncomfortable work environment. Among the physical factors Dainoff lists As raising a workers risk of hand wrist disorders Are these a High rates of repetition of the same action. A awkward or unnatural posture while working. The Ideal position of the wrist is Flat and straight which positions the hand level with the Arm and extended in a straight line from it. Those who work with hands Bent up Down or to the Side risk damage to the tissues in the wrist. Use of excessive Force while working. In Silverstein s factory study workers who had to use High Force and a High rate of repetition had 29 times the rate of hand wrist disorders As workers using Low Force and a Low rate of repetition. A Lack of adequate rest periods or recovery time. Experts estimate that hands should be relieved of repetitive motion for at least 15 minutes every 2 hours to reduce the risk of injury. Quot try telling that to a reporter writing against a deadline a Silverstein remarked. People who work on computers which do not require much Force to operate May nonetheless fall victim to repetitive stress injuries Dainoff explained that in Many computer reliant offices almost every activity is done with the keyboard. In addition there is no break to change paper or push a Carriage return and no machine imposed limit on How fast one can Type. Some computer based jobs Are Quot the sweatshops of the 90s,&Quot said or. John Kella a musician and biomechanics who directs a rehabilitation and retraining program for injured workers at the Miller Institute in new York. He pointed out that computer keyboards Are unforgiving and Many operators press the keys too hard causing an almost imperceptible Kickback As the fingertips hit the keyboard s Rock hard Bottom. His colleague Pascarelli likened it to dancers performing Day after Day on a Concrete floor. Quot eventually they Are going to get injured a he said. The injuries that he treats Are often not Quot classical Quot syndromes with readily identifiable pathological changes in structures of the hands and wrists. Some perhaps a Quarter of those complaining of symptoms have Clear cases of carpal Tunnel syndrome. Some have tendinitis an inflammation of the Tendon that passes through the wrist and others have ten synovitis an inflammation of the Sheath around the Tendon. But Many fit no recognized classification. Or. Lawrence Fine an occupational Medicine specialist for the National Institute of occupational safety and health in Cincinnati said Quot yet these people Are in a lot of pain and Are forced to take time off from work. Its hard for me As a physician to say it s All in people s Heads especially when the frequency and severity of the disorders abates when the risk factors Are  even when a rational remedy is applied the workplace setting can sometimes cause it to backfire. Silverstein gave on the Job exercises to workers in a dental floss manufacturing Plant. A year into the program she found no improvement in the rate of repetitive stress injuries because the workers forced to meet production quotas had worked harder to make up for the time lost during their exercise sessions. Choosing the right angles to prevent keyboard injury posture Beck angled backward a few degrees to Widen Angle Between Torso and thighs increase blood flow and reduce compression of spine. Arms relaxed and Loose at sides forearms and hands parallel to floor. Thighs at right Angle to Torso. Knee at night Angle to thighs chair Back real tits curve of lower Back. Seal inclines Forward sightly to Transfer pressure from spine to thighs and feet. A Cushion curves downward at front to ease pressure on thighs. Lumbering up exar Elsaa Lor tha hands wrists and Flat Gers Monitor top of screen at Eye level Canter viewed a Ruth slight downward gaze. Correct wrist and hand position  / a t. \ j / r / 4-, to i i Ltd. V.  a it Vogt i f / y Massage inside and outside of hand with thumb and fingers grasp fingers and gently Bend Back wrist. Hold for five seconds. Sau cer Jim pttd., Amer hmm cat to Shuw Tot the me Obj a Imma gently pull thumb Down and Back until you feel the stretch. Hold for five seconds. Clench fist tightly then release fanning out fingers. Repeat five times. Not Page 16 a the stars and stripes tuesday june 16, 1992