Slide 1

WORK-RELATED
MUSCULO-SKELETAL DISORDERS
(WRMSD):
 
Overview & Epidemiology
Clinical & Compensation aspects

Overview

OVERVIEW & EPIDEMIOLOGY

The most important skill you need…

Slide 6

Case study:
Clinical signs

Case study:
Progression of disease I

Case study:
Progression of disease II

Case study:
State progression of disease III

So what….

Stupid…

WHO Definition of work-related musculoskeletal disorders 1:

WHO Definition of work-related musculoskeletal disorders 2:

WHO Definition of work-related musculoskeletal disorders 3:

WHO Definition of work-related musculoskeletal disorders 4:

Draft amendment of Schedule 3 of COID Act (130 0f 1993) – 7 Nov 2003

Definition: Work-related Upper Limb Disorder (WRULDs) (CI 180)

Historical Perspective
Alternative Names

Historical Perspective I

Historical Perspective II

Historical Perspective III

Historical Perspective IV
OCD Epidemic (Japan) 1960 - 1980

Historical Perspective V
1964 Ministry of Labour Guidelines (Japan)

Historical Perspective VI
Mid 1980’s – Australian RSI Epidemic

Historical Perspective VII
Telecom Australia 1981 - 1985

Historical Perspective VIII
RSI Definition

Historical Perspective IX
Who developed RSI?

Historical Perspective XI
RSI controversy

Historical Perspective XIII
Supreme Court of Australia

Historical Perspective XIV
Australian Hand Surgery Society Resolution (1985)

WRULDs – Historical Perspective XV
Medical Journal of Australia (1986)

Historical Perspective XVI
CTD Epidemic in USA (1990s)

Historical Perspective XVII
WRULD – UK & Europe

Slide 35

Cost of WRULDs II
European Union

Cost of WRULDs III
South Africa

Cost of WRULDs IV
Direct & indirect costs

WRMSD - Models of causation 1

WRMSD - Models of causation 2

WRULDs - Risk Factors 1

WRULDs - Risk Factors 2

WRULDs - Risk Factors 3
Psychosocial factors 1

WRULDs - Risk Factors 4
Psychosocial factors 2

WRULDs - Risk Factors 5

WRULDs - Risk Factors 6
Individual differences cont…

LOWER BACK PAIN -RISK FACTORS Occupational

LOWER BACK PAIN -RISK FACTORS Non-occupational

Work-relatedness of MSD:
Physical work risk factors 1

Work-relatedness of MSD:
Physical work risk factors 2

Work-relatedness of MSD:
Physical work risk factors 3

Work-relatedness of MSD:
Physical work risk factors 4

Work-relatedness of MSD:
Physical work risk factors 5

Work-relatedness of MSD:
Physical work risk factors 6

Slide 55

CLINICAL &
COMPENSATION ASPECTS

Classification
Types of WRULDS 1

Classification
Types of WRULDS 2

Classification
According to affect on specific tissue

Classification
Tendon-related disorders I

Classification
Tendon-related disorders II

Classification
Tendon-related disorders III

Classification
Tendon-related disorders IV

Classification
Nerve-Related Disorders I

Classification
Nerve-Related Disorders II

Classification
Nerve-Related Disorders III

Classification
Bursa-related disorders

Classification
Blood-vessel disorders

Classification
Other Disorders

Shoulder
Rotator Cuff Syndrome I

Shoulder
Rotator Cuff Syndrome II

Shoulder
Rotator Cuff Syndrome III

Shoulder
Job activities and tasks typically associated with rotator cuff syndrome

Shoulder
Other work-related shoulder conditions

Elbow
Lateral Epicondylitis I

Elbow
Lateral Epicondylitis II

Elbow
Medial Epicondylitis (“Golfer’s Elbow”)

Elbow
Cubital Tunnel Syndrome

Forearm, Wrist & Fingers
 De Quervain’s Tenosynovitis I

Forearm, Wrist & Fingers
De Quervain’s Tenosynovitis II

Forearm, Wrist & Fingers
De Quervain’s Tenosynovitis III

Forearm, Wrist & Fingers
De Quervain’s Tenosynovitis IV

Forearm, Wrist & Fingers
De Quervain’s Tenosynovitis V

Forearm, Wrist & Fingers
De Quervain’s Tenosynovitis VI

Forearm, Wrist & Fingers
Trigger Finger / Thumb I

Forearm, Wrist & Fingers
Trigger Finger / Thumb II

Forearm, Wrist & Fingers
Carpal Tunnel Syndrome I

Forearm, Wrist & Fingers
Carpal Tunnel Syndrome II

Forearm, Wrist & Fingers
Carpal Tunnel Syndrome III

Forearm, Wrist & Fingers
Carpal Tunnel Syndrome IV

Forearm, Wrist & Fingers
Carpal Tunnel Syndrome V

Forearm, Wrist & Fingers
Flexor/Extensor
tendinosis/tenosynovitis

Forearm, Wrist & Fingers
Other work-related hand and wrist conditions

Diagnosis
Principles of diagnosis I

Diagnosis
Principles of diagnosis II

Slide 96

Diagnosis
Symptoms

Diagnosis
Clinical signs

Diagnosis
PLEASE NOTE THAT…

Diagnosis
State progression of disease I

Diagnosis
State progression of disease II

Diagnosis
State progression of disease III

Diagnosis
History of occupational exposure I

Diagnosis
History of occupational exposure I

Diagnosis
History of occupational exposure II

Diagnosis
Special investigations

Treatment
Employee Education

Treatment
Anti-inflammatory Strategies

Treatment
Biokinetic and ergonomic strategies I

Treatment
Biokinetic and ergonomic strategies II

Treatment
Biokinetic and ergonomic strategies III

Treatment
Biokinetic and ergonomic strategies IV

Treatment
Psychology & Surgery

Treatment
Coordinated effort

Treatment
 Algorithms

Compensation of WRULDs

Circular Instruction 180
Occupational Disease
vs. Occupational Injury

Circular Instruction 180
Compensation & Prevention
(COIDA & OHSA/MHSA)

Reporting to the Compensation Commissioner 1

Reporting to the Compensation Commissioner 2

Reporting to the Compensation Commissioner 3

Evaluation of Impairment

Permanent impairment will be assessed after (I):

Permanent impairment will be assessed after (II):

Reporting to Labour / DME

Reporting to Labour / DME

Reporting to Labour / DME

Slide 128