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      Characteristics of Work-related Musculoskeletal Disorders in Korea and Their Work-relatedness Evaluation

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          Work-related musculoskeletal disorders (WMSDs) can be compensated through the Industrial Accident Compensation Insurance Act. We looked at the characteristics of WMSDs in worker's compensation records and the epidemiological investigation reports from the Occupational Safety and Health Research Institute (OSHRI). Based on the records of compensation, the number of cases for WMSDs decreased from 4,532 in 2003 to 1,954 in 2007. However the proportion of WMSDs among the total approved occupational diseases increased from 49.6% in 2003 to 76.5% in 2007, and the total cost of WMSDs increased from 105.3 billion won in 2004 to 163.3 billion won in 2007. The approval rate of WMSDs by the OSHRI accounted for 65.6%. Ergonomic and clinical characteristics were associated with the approval rate; however, the degenerative changes had a minimal affect. This result was in discordance between OSHRI and the Korea Workers' Compensation & Welfare Service. We presumed that there were perceptional gaps in work-relatedness interpretation that resulted from the inequality of information in ergonomic analyses. We propose to introduce ergonomic analysis to unapproved WMSDs cases and discuss those results among experts that will be helpful to form a consensus among diverse groups.

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          Most cited references 32

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          Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation.

           D Boden,  T S Dina,  S Wiesel (1990)
          We performed magnetic resonance imaging on sixty-seven individuals who had never had low-back pain, sciatica, or neurogenic claudication. The scans were interpreted independently by three neuro-radiologists who had no knowledge about the presence or absence of clinical symptoms in the subjects. About one-third of the subjects were found to have a substantial abnormality. Of those who were less than sixty years old, 20 per cent had a herniated nucleus pulposus and one had spinal stenosis. In the group that was sixty years old or older, the findings were abnormal on about 57 per cent of the scans: 36 per cent of the subjects had a herniated nucleus pulposus and 21 per cent had spinal stenosis. There was degeneration or bulging of a disc at at least one lumbar level in 35 per cent of the subjects between twenty and thirty-nine years old and in all but one of the sixty to eighty-year-old subjects. In view of these findings in asymptomatic subjects, we concluded that abnormalities on magnetic resonance images must be strictly correlated with age and any clinical signs and symptoms before operative treatment is contemplated.
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            Abnormal findings on magnetic resonance images of asymptomatic shoulders.

            Magnetic resonance images of the shoulders of ninety-six asymptomatic individuals were evaluated to determine the prevalence of findings consistent with a tear of the rotator cuff. The scans were reviewed independently by two diagnostic radiologists who are experienced in the interpretation of magnetic resonance images of the shoulder. The over-all prevalence of tears of the rotator cuff in all age-groups was 34 per cent (thirty-three). There were fourteen full-thickness tears (15 per cent) and nineteen partial-thickness tears (20 per cent). The frequency of full-thickness and partial-thickness tears increased significantly with age (p < 0.001 and 0.05, respectively). Twenty-five (54 per cent) of the forty-six individuals who were more than sixty years old had a tear of the rotator cuff: thirteen (28 per cent) had a full-thickness tear and twelve (26 per cent) had a partial-thickness tear. Of the twenty-five individuals who were forty to sixty years old, one (4 per cent) had a full-thickness tear and six (24 per cent) had a partial-thickness tear. Of the twenty-five individuals who were nineteen to thirty-nine years old, none had a full-thickness tear and one (4 per cent) had a partial-thickness tear. Magnetic resonance imaging identified a high prevalence of tears of the rotator cuff in asymptomatic individuals. These tears were increasingly frequent with advancing age and were compatible with normal, painless, functional activity. The results of the present study emphasize the potential hazards of the use of magnetic resonance imaging scans alone as a basis for the determination of operative intervention in the absence of associated clinical findings.
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              The Strain Index: a proposed method to analyze jobs for risk of distal upper extremity disorders.

               Sarah J Moore,  A Garg (1995)
              Based on existing knowledge and theory of the physiology, biomechanics, and epidemiology of distal upper extremity disorders, a semiquantitative job analysis methodology was developed. The methodology involves the measurement or estimation of six task variables (intensity of exertion, duration of exertion per cycle, efforts per minute, wrist posture, speed of exertion, and duration of task per day); assignment of an ordinal rating for each variable according to exposure data; then assignment of a multiplier value for each variable. The Strain Index is the product of these six multipliers. Preliminary testing suggests that the methodology accurately identifies jobs associated with distal upper extremity disorders versus jobs that are not; however, large-scale studies are needed to validate and update the proposed methodology.

                Author and article information

                J Korean Med Sci
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                December 2010
                15 December 2010
                : 25
                : Suppl
                : S77-S86
                Occupational Safety and Health Research Institute, KOSHA, Incheon, Korea.
                Author notes
                Address for Correspondence: Kyoo Sang Kim, M.D. Occupational Safety and Health Research Institute, 478 Munemiro, Bupyeong-gu, Incheon 403-711, Korea. Tel: +82.32-510-0823, Fax: +82.32-518-0862, kobawoo@
                © 2010 The Korean Academy of Medical Sciences.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Occupation & Environmental Medicine


                upper extremity, low back pain, musculoskeletal diseases, workplace, risk factors


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