Page 75 - Occupational Health & Safety, June 2018

There are many approaches to managing CTS following diagno- sis. Most are considered con- servative approaches, and their effectiveness varies greatly.
studied, including computer use, awkward postures, forceful exertion, repetition, vi- bration, and various combinations of these factors. However, the risk factors most strongly associated with CTS include time- weighted average peak hand force; forcce- ful hand exertion repetition rate; percent time of forceful hand exertion; and hand- arm vibration.
What’s the Best Way to Manage Occupational Risk Factors for CTS? The most effective way to reduce or man- age CTS in the workplace is to design the workplace and work tasks to be within worker capabilities. This means providing engineering controls to reduce worker ex- posure to the known risk factors of force, repetition, duration, and vibration. This approach starts with completing a quanti- tative MSD risk assessment of the job to de- termine which tasks involve risk and what the magnitude of that risk is.
The ACGIH hand activity level (HAL) is an excellent risk assessment tool to as- sess hand, wrist, and forearm biomechani- cal overload based on exertions, frequency, and force use. The ACGIH threshold limit value (TLV) method can be used to pre- dict CTS. A study of 4,097 workers found a dose-response relationship between the ACGIH HAL TLV classification and risk for CTS; higher risk scores are linked to higher rates of CTS (Bonfiglioli et al., 2013).
Once the magnitude of MSD risk is determined, the next step is to identify the root cause(s) of the risk. Controls are iden- tified, prioritized, and then implemented to address the root cause(s). Effective controls either eliminate exposure or reduce the lev- el of exposure to the risk factors. Controls that reduce time of exposure or rely on the worker to change behavior are less effective.
Blake McGowan is Managing Consultant and Research Specialist for Humantech Inc. References for this article are included in the online version of the article at www. ohsonline.com.
www.ohsonline.com
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