Today's News

Saturday, March 3, 2001

Hard to focus attention of public on occupational health issues

By Laird Harrison

Changes in the way people work could reduce their musculoskeletal disorders, but it's hard to focus public attention on the problem, panelists said at a Friday morning press conference on occupational health.

Though 14 percent of Americans suffer some sort of workplace disorder, and in 1997 such injuries cost $418 billion, workplace illness has yet to find a poster child. "I could bring Mary Tyler Moore up here and she would tell you how to prevent diabetes," said University of Kansas, Wichita Assistant Professor of Orthopaedic Surgery J. Mark Melborn, MD. "I wish we had a spokesperson for musculoskeletal pain."

But it's harder to publicize ways of preventing work-related illness in part because the causes are harder to pin down, said Dr. Melborn. And even some seemingly obvious preventative measures don't work.

For example, many people suffer repetitive stress injury (RSI) from using keyboards. But when the Japanese government limited keyboard use to six hours a day, the rate of RSI went up. That's because people who use keyboards a lot are sometimes less vulnerable than people who use them only a little.

In general, Dr. Melborn said, workplace injuries result from the complex interaction of a worker's age, gender, genetics, biosocial factors and nonwork experiences with the repetition, force, vibration, temperature, posture, contact stress and unaccustomed activities involved in the work.

The risk of injury can be reduced by adjusting the pace of the work, providing sufficient breaks and rotating tasks, he said. "Most studies show that doing those things improve productivity. And they improve the quality of life in the patient."

The same points apply to activities outside the workplace, Dr. Melborn added. For example, when you're cleaning house, "instead of dusting, then vacuuming, then mopping the whole house, dust, vacuum and mop each room before going on to the next one. That way, you rotate tasks, limit exposure and allow the body to respond."

As an example of how complex a work-related illness can be, internist Alvin Markovitz, MD, a University of Southern California associate professor, described the controversy around fibromyalgia. "A lot of orthopaedic surgeons don't believe it exists," he said, because it involves no pathophysiologic abnormalities.

The primary symptom is diffuse muscle pain. Biopsies of patients' muscles appear normal. No controlled studies show that any treatment works. And yet the disease was first described in 1700 and as many as 6 percent of all women fit the criteria.

Researchers have been able to measure some biochemical abnormalities in fibromyalgia patients, such as an increase in some hormones and a decrease in seratonin. Dr. Markovitz believes that the disease is brought on by severe stress, such as sexual harassment or an infection.

He treats it with a lot of encouragement, exercise and antidepressants. "Yes, there is something called fibromyalgia," he concluded. "It really, really, really does exist."

The final speaker in the press conference, Ronald M. Selby, MD, a clinical assistant professor of orthopaedic surgery at New York Medical College, described new arthroscopic surgery for treating rotator cuff injuries. He, too, emphasized that these injuries could be reduced if workers took the time to stretch and exercise before doing jobs that put stress on their joints.

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Last modified 03/March/2001 by IS