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Work Related Upper Limb

What is a work related upper limb disorder?

Work related upper limb disorder (WRULD) is an umbrella term used to describe a variety of related injuries to the muscles, nerves, tendons and other soft body tissues of the shoulder and arm, including the forearm, elbow, wrist, hands and fingers. Neck pain can also arise. Other terms in general use include repetitive strain injury (RSI) and cumulative trauma disorder (CTD).

What are the causes?

A variety of work tasks may be responsible for causing WRULD's including :-
• highly repetitive movements
• movements requiring forceful activity
• maintaining the same posture for a long time with little or no movement
• over work
• work at a fast pace
• inadequate breaks
• poorly designed equipment
• vibration

What are the symptoms?

A wide range of symptoms may exist and which tend to progress (if unchecked) from mild through to moderate and finally severe and possibly irreversible. Symptoms may include :-

• tenderness in the muscles or joints
• aches and pains
• weakness
• numbness or tingling
• loss of strength and grip
• cramp or swelling

Pain is generally the main symptom and occurs especially when carrying out the activity that caused it, although the pain may progress, and be present even when inactive. Non-specific pain may begin around the wrist, forearm or elbow and may spread into the upper arm, shoulder and neck.

In the early stages of development pain may improve when the activity is not being pursued, over the weekend or when absent from work but as symptoms worsen it may be present even at rest.

What medical conditions can arise?

• Tenosynovitis
• Tendonitis
• Carpal Tunnel Syndrome
• Epicondylitis
• Trigger finger/thumb
• Tennis elbow
• Rotator cuff injury
• Peritendonitis
• De Quervains Syndrome
• Bursitis
• Ganglions

What Occupations are at risk?

A variety of industries and jobs are affected and specifically any which involve workers using their arms to carry out tasks. Those most at risk include :-

• Keyboard operators
• Supermarket checkout operators
• Assembly workers
• Hand insertion workers e.g. of leaflets into newspapers
• Packers
• Cleaners
• Counting, sorting and checking workers
• Any workers involved in hand feeding tasks

The frequency of movement involved in the task is usually an important factor in placing the individual worker at risk.

The Law

An employer has a legal obligation to ensure the health and safety at work of its workers and to provide safe work procedures and equipment and a safe work place. Employees should be provided with health and safety information and training. A number of Acts and other statutory provisions exist requiring employers to take care for the health and safety of their workers. If a breach of these Acts or provisions can be clearly established an injured employee may succeed with a claim against his/her employer. A claim may also exist in negligence and in order to establish negligence on the part of the employer the following must be proved :-

• that there was a breach of the duty of care owed by employer to employee;
• that the employer should reasonably have foreseen the risk of injury from the breach of the duty of care;
• that the breach caused the injury.
In a WRULD case it is likely that expert opinion will be required from an Ergonomist or a Consulting Engineer in order to deal, to the satisfaction of a court, with the issue of foreseeable risk of injury.

Steps to take

An employee who considers that he may have suffered a WRULD should consider the following action :-

• report any signs and symptoms of injury before they become too serious to management and safety representatives.
• keep a note of all reported problems made to management;
• record any injury in the accident book even if not serious;
• seek medical help if thought necessary;
• if a specific task is causing or contributing to the WRULD ask management to remove you from the task.

Please contact us for further information.