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1 Introduction
Background
In May 1998 the National Institutes of Health asked the National Academy of Sciences/National Research Council to assemble a group of experts to examine the scientific literature relevant to work-related musculoskeletal disorders of the lower back, neck, and upper extremities. A steering committee was convened to design a workshop, to identify leading researchers on the topic to participate, and to prepare a report based on the workshop discussions and their own expertise. In addition, the steering committee was asked to address, to the extent possible, a set of seven questions posed by Congressman Robert Livingston on the topic of work-related musculoskeletal disorders. The steering committee includes experts in orthopedic surgery, occupational medicine, epidemiology, ergonomics, human factors, statistics, and risk analysis.
This document is based on the evidence presented and discussed at the 2-day Workshop on Work-Related Musculoskeletal Injuries: Examining the Research Base, which was held on August 21 and 22, 1998, and on follow-up deliberations of the steering committee, reflecting its own expertise. We note the limitations of the project, both in terms of time constraints and sources of evidence.
Although reports on the number of work-related musculoskeletal disorders vary from one data system to another, it is clear that a sizable number of individuals report disorders and lost time from work as a result of them.1 For example, the Bureau of
1
We use the World Health Organization's definition of work-related disorders (World Health Organization, 1985). It characterizes work-related disorders as multifactorial to indicate the inclusion of physical, organizational, psychosocial, and sociological risk factors. A disorder is work related when work procedures, equipment, or environment contribute significantly to the cause of the disorder. There is great variation in the diagnostic criteria for musculoskeletal disorders, ranging from clinical diagnoses based on symptoms and signs for some, to diagnoses based on structural and functional criteria for others. We note that ''disorder" is a broader category than "injury" and better captures the range of phenomena being considered.
