Occupational injuries are one of the most important and preventable health problems that occur daily throughout the world. While preventable, they are a human capital issue to business and a disabling socio-economic factor to the injured worker. The concurrent impact reaches far beyond lost time, missed schedules and production delays. In years past, scores of today's aging workforce labored in non-ergonomic jobs, never to be inoculated to improved ergonomics as part of today's assessment of human capital costs. Improper height of work stations, non-electric hand tools and warehouse staging areas account for a multitude of simply avoidable musculoskeletal disorders (MSD's) the aging workforce faces today.
According to the Bureau of Labor Statistics, Editor's Desk 2005 Report, of the 1.3 million sprains and strains reported, often involving the back, 43 percent of these injuries required more than one day recuperation from work beyond the day of the incident. When you combine the simple sprain and soft tissue damage with bruises and contusions, lacerations and fractures, approximately two thirds of all these cases resulted in cumulative lost work time, not counting the day of the injury.
The National Electronic Injury Surveillance System (NEISS) of the Journal of American Medical Association's occupational supplement records and reports non-fatal work related injuries from U.S. hospital Emergency Rooms across the U.S. NEISS uses a stratified sampling of 67-70 hospitals' emergency rooms that monitor injury trends 24/7 to aid in prevention activities correlating monthly reviews out of 5300 hospitals to separate work related and non-work related injuries.
The U.S. Dept of Labor Bureau of Labor Statistics (BLS) December 4, 2009 Report, where lower trunk (back) injuries being the most prominent, discloses a common denominator among other reporting agencies with like data - BLS, OSHA, CDC, to name a few. The underlying factor stated that resulted in the highest number of absences that directly correlates to the list below was overuse/overexertion (hyperextension) of muscles due to: (1) heavy lifting, (2) pushing, pulling or carrying heavy objects; (3) falls on the same level, (4) bodily reaction to avoid obstacle; (5) contact with object or equipment; (6) repetitive motion (tendonitis); (7) extremity or joint stress fractures; (8) carpal tunnel syndrome; (9) complex regional pain syndrome; and (10) fall to lower level. In a 2008 BLS Survey of Occupational Injuries, of the nearly 19 million state and local government workers with reported MSD injuries, firefighters and law enforcement personnel remain the highest among all workers with a 14.8 per 100 cases. Yet, this same report reflects that these state and local government workers ranked 1.5 times higher for the same injury than that of the private sector. While these statistics reflect high human capital costs for lost work time, medical costs and their ensuing socio-economic impact on the injured, OSHA and other organizations only collects data from a small portion of the private sector establishments within the U.S. or approximately 80,000 out of 7.5 million. Therefore the data does not effectively represent the majority of business, especially small business, where enumerating the data is impossible. Even state workman's compensation boards do not account for establishments with less than 15 employees so conclusions should not be drawn on this data alone.
The small business or self-employed injury affects the economic and social impact to a much greater extent where loss of time translates to loss of income for the self-employed. Numerous self-employed individuals interviewed stated they couldn't justify the cost-benefit ratio of workman's compensation insurance and choose to work 'at risk'. Drawing a parallel with a JAMA 2007 injury report and an Indiana Workers' Compensation report for that year, back injury accounted for more than 53% of all work-related injuries exacerbated by improper or repetitive motion-bending, twisting or lifting.
Succeeding to lower back injury, further data cites Carpal Tunnel Syndrome (CTS) as one of the highest maladies for absenteeism. A 1998 human capital cost reported three out of every 10,000 workers missed upwards of ten days at an aggregate cost of $30,000 per individual over a long time span. Surprised that CTS reported such high human capital cost, I decided to research this subject to clarify the misconception that CTS was a computer operator's nightmare. Carpal Tunnel Syndrome is a neuropathic malady in which the body's peripheral nerves become compressed or traumatized by injury within the carpal tunnel, a rigid passageway containing ligaments and bones surrounding the median nerve, usually at the wrist. This nerve controls sensations to the palm side of the thumb and fingers, sans the little finger, as well as impulses to small muscles that allow the fingers and thumb to move.
Who is at risk for CTS? According to the National Institute of Health (NIH), women are three times as likely to develop carpal tunnel syndrome. Another misconception, I assumed this was due to a higher percentage of workforce women in administrative jobs involving computer activity. Not true. In fact, a 2001 Mayo Clinic report found that heavy computer use (averaging 7 hours per day) did not increase a person's chances of developing CTS.
Dispelling the myth. According to Dr. Mark Souder, Family Practice Physician in Auburn, Indiana with an active patient roster of over 8,500 and voted Indiana Doctor of the Year 2010, states "Women may appear more prone to this ailment because their carpal tunnel is simply smaller in size. By no means is this a woman's disorder. I see plenty of assembly line personnel with neuropathic and tendon disorders caused by a host of underlying circumstances. Sometimes it's simply defined as new job misery having little time to adjust to motor function change. Many times it is short-lived and classified as repetitive motion disorder such as bursitis or tendonitis. First I rule out congenital disorders such as rheumatoid arthritis, overactive glandular activity, cysts and tumors. Then I determine if excessive repetition, vibration or mechanical problems of the wrist itself exist. Last year, under co-sponsorship by InMed, a company that evaluates new technologies, I trialed a new therapeutic modality-RiteTemp Medical on workers experiencing work-related musculoskeletal disorders. RiteTemp employs anatomically correct optimum temperature cool therapeutic devices that are not cold like ice or gel. These devices effectively deliver continuous cooling in the mid 50's Fahrenheit so individuals can wear any of the RiteTemp devices without worrying about frostbite and its complications. It's a truly effective treatment coupled with conditioning and flexing the tendons and ligaments to accelerate healing and return to function of the affected area. What I discovered in my trial that's ideal about RiteTemp as a modality is higher patient compliance and a reduction of the need for pain medication."
The occupations at the highest risk for carpal tunnel were sewing machine operators and manufacturing assembly personnel requiring repetitive hand motion with intricate movements. Asking around I actually located a large U.S. based sewing operation, whose owner is proactive in thwarting workplace injuries. Hentz Manufacturing and Markfore's owner, Bob Hinty of Fort Wayne, Indiana is an advocate of preventative medicine and conditioning therapy for his workers. Hinty's facilities, one of the largest sewing, silk-screening and embroidery operations in the U.S. that offers exceptional quality, quick turn-around, specialized and custom sewing that from the high-end line of ladies handbags and computer cases to Disco Bed for mobile transport of military personnel in the field. Hinty, in his facilities, takes a personal approach daily to involve job conditioning, safety compliance and goes so far as customizing work stations to account for petite to the exceedingly tall worker, especially when workers rotate to different jobs.
"Human ergonomics has many facets and they all must co-exist harmoniously in a high volume production facility," states Hinty. "When cross-training is required, which involves atypical motor skill or non-ergonomic functions, my supervisors regularly employ the use of RiteTemp Medical therapeutic devices as part of body conditioning and training." His recipe for success is a mix of mechanical science and human ergonomics that produces a "work of art" in the high-end fashionable Cinda B line of specialized handbags and totes. Hinty is in the forefront overseeing implementation of a new production project on the Gerber Cutter with one of his employees wearing the RiteTemp Wrist-Forearm to thwart overexertion of using new muscles until the muscles become conditioned to atypical movement.
When it comes to addressing the baby boomer population that have been working for at least 3 decades, I was fortunate to have an orthopedic surgeon that is one of several doctors participating in a pain study involving the RiteTemp Medical cool therapy devices as pre- and post-surgical recuperative treatment. The perfect example below was echoed by Dr. Richard Steinfeld, Orthopedic Surgeon of Vero Beach, Florida who recently conducted arthroscopic surgery on a business owner, who is active on his feet daily, to clean out the torn ACL (acruciate ligament) and meniscus in his right knee joint. Removing the badly torn meniscus during the arthroscopy revealed the looming problem that faces this baby boomer and our aging workforce - arthritis and other degenerative joint diseases.
Presumed from excessive rotation or torsion of the knee joint during high energy exercise, in this case, the patient experienced prolonged aggravation of the knee joint due to the repeated pounding pressure on the joint. Upon completion of the arthroscopy, I was privileged to have the opportunity to view the patient's injury and post-surgical outcome with Dr. Steinfeld. While the operation was successful, what was not initially revealed by the patient's pre-op X-Rays was degenerative arthritis, diagnosed as common among the baby boomer population from trying to be 'too healthy'. According to Dr. Steinfeld, former Navy flight surgeon who operates a private practice in Vero Beach, Florida, "The patient described herein who now has arthritis reported to Dr. Steinfeld and thereafter to me in his pre-operative interview that in his more youthful days he regularly ran five or more miles a day in hilly country, played racquetball twice weekly and actively pursued baseball as often as possible. We're invincible in our twenties and thirties. We're not invincible in our fifties. We ply tremendous torque on our joints by running. This patient is like many I see who has finally succumbed to arthritis.... He will need a total joint replacement in the very near future as he has bone on bone rubbing together, creating friction and discomfort. It's like having a flat tire."
As a participant in the pain study, the treatment prescribed by Dr. Steinfeld for this patient recuperating after arthroscopy outpatient surgery was to utilize the RiteTemp Active Knee as a regimen at first opportunity and continue wearing the cooling device as much as possible over the upcoming weeks. Different than all ice or gel cold therapy devices, this medical device can be worn without interruption as it does not get cold like ice or gel. It is a two-piece device with a live-hinge to flex appropriately on all body types as the knee bends during normal ambulation. While I was not privy to obtain a picture of this new active knee cool therapy device being used by this patient, an informational video describing this new "active modality" for physical therapy can be viewed at the YouTube site and refer to RiteTemp Medical Active Knee.
After a 30 day follow up with Dr. Steinfeld about this patient, Dr. Steinfeld reported that this patient was religious in utilizing the cooling device as often as possible and that pre-cooling of this patient's knee for one hour with the RiteTemp device prior to surgery in his opinion aided in reducing the typical post-surgical pain and swelling. He noted the patient reported only using Ibuprofen occasionally and did not take the prescribed pain medication reaffirming a higher patient compliance throughout the recuperation period and faster healing attributable to utilizing the RiteTemp as a better modality.
For more information on this "active medicine" technology visit the ritetempmedical.com website or email me at kathryndoh99@gmail.com and I'll gladly share worthy health information.
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