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Month 2003
Tendinitis: An Often Painful Occupational Additional Resources for Ergonomic
Information Particularly Relevant to
Condition for Laboratorians Laboratory Practice:
http://www.niehs.nih.gov/odhsb/ergoguid/home.htm
NIEHS Health and Safety Guide to Laboratory Ergonomics.
The National Institute of Environmental Health Sciences
• Kevin J. Costello (NIEHS) is one of 25 Institutes and Centers of the National
Institutes of Health (NIH)
http://odp.od.nih.gov/whpp/ergonomics/
T
he U.S. Bureau of Labor Statistics prone to further injury, potentially continuing sheath) during movement. (Figure 2) are observed below the threshold of ergonomics.html
M
(BLS) monitors occupational illnesses the damage beyond the effectiveness of • DeQuervain’s tendinitis - caused by irrita- 15% MVC (maximum voluntary contraction). US Department of Health and Human Services. The
and injuries that occur in private indus- treatments such as anti-inflammatory drugs, tion or swelling of the tendons at the base of MVC is a guideline supported in published lit- National Institutes of Health is the steward of medical and
behavioral research for the Nation.
try each year. Separating the various cate- immobilization, slings and sprints, or steroid the thumb. Pain near the thumb side of the erature as an exertion level indicative of mus-
gories can often be difficult because some injections. Surgery and long-term cessation of wrist occurs as well as an occasional “catch- cle fatigue. Arm flexion and extension during http://www.osha.gov/ergonomics/
overlap exists among certain injuries like in the occupational activity may then be required. ing or snapping” when the thumb is moved. plunger operation remains within recom- U.S. Department of Labor - Occupational Safety & Health
Administration
repetitive motion injury category, which in- While women incurred only 33% of the to- Government and industry have attempted to mended limits for maintaining effective arm
cludes tendinitis and carpal tunnel syndrome. tal number of injuries reported by private in- reduce exposure to some of the pipetting risk strength (Figure 3). Wrist deviation when ap- http://www.cdc.gov/od/ohs/Ergonomics/labergo.htm
However, these injuries account for tens of dustry in 1999, the incidence rate for over-us- factors and resultant injuries by recommending plying tips also remains near the neutral posi- Centers for Disease Control - Laboratory Ergonomics. The
Centers for Disease Control and Prevention (CDC) is recog-
thousands of reported incidents each year. In age injuries in women is 61%. This notable modifications to certain laboratory practices tion so there is no strength degradation as a nized as the lead federal agency for protecting the health
fact, the BLS has cited that these injuries were difference may be due to a higher percentage and the creation of more ergonomically favor- result of poor hand posture (Figure 4). and safety of people.
sustained by at least 1 out of every 1250 full- of women in jobs that involve repetitive mo- able work environments. Additionally, pipette Many pipetting products have been intro-
http://www.isber.org/pdfs/barr.pdf
time workers in the United States in 1999. tion, coupled with use of equipment that may manufacturers have reduced spring forces and duced to the market in recent years boasting Preventing repetitive stress injuries (RSI’s). Presentation by
They also acknowledged that the rate of inci- not be as ergonomically favorable to women. added electronics to some of their products in ergonomic features such as plungers or but- Jason Barr, Division of Safety, National Institutes of Health
dence is most likely higher because under-re- The more common forms of tendon injury an effort to lower operating forces. However, tons that require less force due to electronics
http://www.d.umn.edu/ehso/ergonomics/labergo.htm
porting often takes place, and the reported experienced by laboratory workers using because of the strong interrelationship be- or reduced spring forces, or soft grip handles Laboratory Ergonomics. University of Minnesota
cases only include injuries that resulted in pipettes include: tween force and posture, simple reductions in and hand hooks. However, these feature en-
days away from work. • Medial epicondylitis - caused by wrist mechanical force requirements alone are not hancements fail to address or correct the pri- http://ergo.human.cornell.edu/
Human Factors and Ergonomics. Cornell University. This
flexion and pronation that injures the tendons sufficient to reduce the physical exertion and mary causative factor of strain and injury in site links to several ergonomic sites that focus on safety
A potential epidemic in the laboratory attached to the medial epicondyle of the muscle fatigue that leads to injury. the upper arm extremity (neck, shoulder, el- issues, such as: carpal tunnel syndrome, back injuries, air
While the risk of developing tendinitis or humerus. Pain occurs in the flexor tendons and bow, wrist and hand), specifically the awk- quality, sick building syndrome, and lighting.
other forms of overuse strain injuries is not medial aspect of the elbow when the wrist is An opportunity to reduce occupational ward posture that takes place during use with http://www-ehs.ucsd.edu/ergo/training/labergo/
confined to people in a single industry or job, flexed or rotated outward. risk the device. When magnified with sufficient ErgoLabSlide1.htm
laboratory workers using pipettes may experi- • Lateral epicondylitis (tennis elbow) - Recent evaluations of user exertion levels repetition, even minimal stress and force lev- Practical approach for improving comfort in research envi-
ronments Daphne A. Thaung, certified Industrial Hygienist.
ence a higher risk of these injuries. Tendon or caused by continued stress on grasping mus- required while pipetting shows considerable els can become formidable. Unfortunately, the University of California, San Diego - Environmnent, Health
muscle overuse in the hand, wrist, arm or cles of the hand on rotation when the forearm differences when the upper arm posture re- force/exertion threshold associated with over- and Safety Department
shoulder occurs from any combination of faces upward or forward. Pain occurs over the mains in ergonomically-favorable positions. use strain injuries varies greatly among indi-
http://www.stanford.edu/dept/EHS/prod/
repetitive, unaccustomed, forceful, or awk- lateral side (outside) of the elbow when the The Ovation® BioNatural Pipette, by allowing viduals and effects from injury accumulate researchlab/lab/laboratory_ergonomics.html
ward positions due to bad ergonomics. The wrist is extended. the forearm, wrist, and shoulder to remain in over long periods, often going unnoticed until Laboratory Ergonomics. Stanford University -
resulting micro injuries gradually accumulate • Rotator cuff tendinitis - involves a group neutral positions, demonstrates favorable mus- they are severe. However, laboratory workers Environmental Health & Safety Department
faster than they can heal and the area even- of muscles that control shoulder rotation. Pain cle and joint measurements during all pipetting may consider reducing their occupational risk http://www.interface-analysis.com/ergoworld/
tually becomes painful. Because of the poor occurs when bringing the arm across the chest. functions (acquiring tips, aspirating & dispens- factors now by using pipettes designed specif- ErgoWorld has planets specifically focused on Office
intrinsic healing capability of tendons, even • Trigger finger/thumb - caused by a nodule ing, discarding of tips) in comparison to tradi- ically to operate with neutral alignments of Ergonomics and Injury Prevention/Treatment. This site also
has links to other topics in the field (industrial ergonomics,
with treatment and rest, a degradation of (knot) or swelling in the lining of a tendon. tional, axial-designed pipettes. Ovation’s detip- the upper arm extremities, and in all likelihood HCI/usability, transportation HF, HF in design), and provides
strength by as much as 30% is common for Pain, popping or a catching feeling in the fin- ping effort levels required by the flexor muscle reduce overuse strain injuries like tendinitis information on employment opportunities, university pro-
months or years following an acute injury. In ger or thumb occurs as the tendon squeezes in all individuals (Figure 1), and in the forearm, that continue to aggravate the health of many grams, consultants, products, and events.
The Ovation pipette design
this weakened condition, the tendons are through the opening of the tunnel (flexor hand and thumb specifically among women with increased frequency. Write In xxx - Or Reply Online keeps the entire upper arm in
neutral positions, permitting
• Awkward postures and working positions during pipetting are leading contributors to tendon injuries muscles and joints to operate
efficiently with minimum effort
levels as shown in Figures 1-4.
Action: elevated, extended arm reaches Action: wrist ulnar deviation, tight hand grip, Action: elevated arm, forearm supination, Action: forearm supination, wrist flexion and Action: tight hand grip, wrist ulnar deviation,
Potential Consequence: strain and inflam- extended thumb reach wrist extension and radial deviation ulnar deviation thumb strain
mation to shoulder muscles Potential Consequence: swelling within ten- Potential Consequence: shoulder and upper Potential Consequence: strain to medial Potential Consequence: strain to medial
Leads to: Rotator cuff tendonitis don linings arm injuries, elbow problems, swelling within area of elbow, swelling within tendon linings area of elbow and base of thumb, swelling
Leads to: Trigger finger/thumb, Carpal Tunnel tendon linings Leads to: Medial epicondylitis within tendon linings
Syndrome Leads to: Lateral epicondylitis Leads to: DeQuervain’s tendonitis