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Natural History of Upper Extremity Musculoskeletal Symptoms and Resulting Work Limitations Over 3 Years in a Newly Hired Working Population

Gardner, Bethany T. OTD, OTR/L; Dale, Ann Marie PhD, OTR/L; Descatha, Alexis MD; Evanoff, Bradley MD, MPH

Journal of Occupational and Environmental Medicine: June 2014 - Volume 56 - Issue 6 - p 588–594
doi: 10.1097/JOM.0000000000000179
Original Articles

Objective: To describe the proportions of workers with upper extremity (UE) symptoms and work limitations because of symptoms in a newly hired working population over a 3-year study period and to describe transitions between various outcome states.

Methods: A total of 827 subjects completed repeat self-reported questionnaires including demographics, medical and work history, symptoms, and work status. Outcomes of interest were UE symptoms and work limitations because of symptoms.

Results: Up to 72% of workers reported symptoms at least once during the study, with 12% reporting persistent symptoms and 27% reporting fluctuating symptoms; 31% reported work limitations at least once, with 3% reporting consistent work limitations and 8% reporting fluctuating limitations.

Conclusions: UE symptoms and work limitations are common among workers and dynamic in their course. A better understanding of the natural course of symptoms is necessary for targeted interventions.

From the Department of General Medical Sciences (Drs Gardner, Dale, and Evanoff), Washington University School of Medicine, St Louis, Mo; and Occupational Health Unit (Dr Descatha), the Inserm U1018-AP-HP, Garches, France.

Address correspondence to: Bethany T. Gardner, OTD, OTR/L, Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Ave, Saint Louis, MO 63110 (

This study was supported by CDC/NIOSH (grant number R01OH008017-01) and by the Washington University Institute of Clinical and Translational Sciences Award (CTSA) (grant # UL1 TR000448) from the National Center for Advancing Translational Sciences (NCATS) of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NIOSH, NCATS, or NIH.

Authors Gardner, Dale, Descatha, and Evanoff have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

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Copyright © 2014 by the American College of Occupational and Environmental Medicine