Elsevier

Applied Ergonomics

Volume 40, Issue 1, January 2009, Pages 15-22
Applied Ergonomics

National occupational research agenda (NORA) future directions in occupational musculoskeletal disorder health research

https://doi.org/10.1016/j.apergo.2008.01.018Get rights and content

Abstract

Musculoskeletal disorders are among the most costly health care problems facing society today. The scientific literature has indicated that psychosocial factors, individual factors, workplace physical requirements, and workplace organizational factors have been associated with risk. Since musculoskeletal risk is multi-dimensional, the magnitude of risk attributable to various factors can be of importance to scientists and policy makers in designing countermeasures to reduce injury incidence. Traditionally, the disciplines of biomechanics, physiology, and psychophysics have dominated the body of knowledge that has defined exposure limitations to work. However, recent research has explored the association of psychosocial and work organization factors with musculoskeletal problems. Advances have been made to better quantify the levels of occupational exposure by improved exposure metrics, quantification of three-dimensional loads experienced by certain joints (e.g. the spine), identification of tissue tolerance limits and tissue response to mechanical stresses, and the impact of psychosocial stresses. However, efforts to quantitatively link epidemiological, biomechanical loading, soft tissue tolerance, and psychosocial studies should be pursued to establish a better understanding of the pathways of injury and resultant preventive strategies. Although we are beginning to understand how the major risk factors influence the load–tolerance relationship of human tissue, how these risk factors interact is virtually unexplored. Since the impact of the interactions may be far greater than that of any individual factor, the impact of the interactions between risk factors must be delineated so that work-related risk can be better quantified. Efforts to quantitatively link epidemiological, biomechanical loading, soft tissue tolerance, and psychosocial studies should be pursued to establish a better understanding of the pathways of injury and resultant preventive strategies.

Section snippets

National perspective

The National Institute for Occupational Safety and Health (NIOSH) recognizes that addressing the high incidence rate of work-related musculoskeletal disorders (MSDs) requires coordination and cooperation among its many external partners. This philosophy underpins NIOSH's National Occupational Research Agenda (NORA), a collaborative effort between NIOSH and its partners to guide occupational safety and health research into the 21st century. In the first decade of NORA, which began in 1996, 20

Recent studies for identification of risk factors

Review of the literature and economic data by the NORA MSD team indicated that musculoskeletal disorders (MSD) related to the workplace are among the most costly health problems facing society today (N.R.C., 1999, N.R.C., 2001a). Currently, the low back and the upper extremities are the parts of the body most subject to risk associated with work (Andersson, 1997; Bongers, 2001; Dennerlein et al., 1999; Ferguson and Marras, 1997; Katz et al., 2000; Marras et al., 2000a, Marras et al., 2001;

Recent advances

Over the past decade, several significant advances have improved our understanding of MSD causality. First, improved exposure metrics have made it possible to more accurately quantify the physical characteristics of the environment to which workers are exposed and to specify the levels of exposure that significantly increase workplace musculoskeletal risk (Deyo et al., 1998; Fathallah et al., 1998; Ferguson and Marras, 1997; Granata and Marras, 1995; Lavender et al., 1989, Lavender et al., 1999a

Future research directions

Traditionally, high force, highly repetitive loading of the musculoskeletal system has been the hallmark of work. However, the workplace and the nature of the work are changing rapidly. Manufacturing, where employees work on a traditional assembly line is decreasing. However, those that remain employed in these environments are increasingly exposed to more frequent but less forceful motions (Punnett et al., 1991, Punnett et al., 2000). More assembly is occurring in work cells where employees

Disclaimer

The findings and conclusions in this report are those of the author(s) and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

Acknowledgments

The authors would like to acknowledge the efforts of the NORA Musculoskeletal Disorders Team for their contributions in generating this manuscript. The members were Lida Orta-Anes, Jim Panagis, Barbara Silverstein, Tom Slavin, Larry Fine, Vern Anderson, Stephen Hudock, and Cheryl Estill.

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