Schweizerische Tagung der
personalärztlichen Dienste
im Gesundheitsdienst

Die Hand an der Arbeit
Lausanne - CHUV
18-19 november 2004

Wissenschaftliche Tagung der
Schweizerischen Gesellschaft
für Arbeitsmedizin

Karpaltunnelsyndrom, Epicondylitis: Prävention am Arbeitsplatz

Thomas Läubli, Institut für Hygiene und Arbeitsphysiologie, Eidgenössische Technische Hochschule Zürich

Epidemiological studies describing the relationship between epicondylitis and work showed evidence for a strong association between forceful work (and a combination of repetition and forceful work) and development of elbow pain (and epicondylitis). Repetitive arm movements were often found to be correlated with a risk for epicondylitis, but these risks being rather small. Results for work at visual display units are not conclusive.

From EMG studies it can be concluded that many hand movements, including forearm rotations, against resistance increase stress on the lateral epicondyle. Any forceful hand-movements lead to high forces at the forearm tendon insertions, so that from a biomechanical point of view a causal relationship between high work forces and an increased risk of epicondylitis is well founded.

From these results it becomes clear that long work periods involving high forces of the hand, either with repetitive movements or not, must be avoided and required forces must be reduced. The forces required depend on work organization, on the weight of handled objects, but also on the design of handles or the gripping surface, which need to be optimized. There seems to be mounting evidence that sufficient rest time might be crucial for the prevention of any work-related musculoskeletal pain. A good social support has proven to be a protective factor in work-related musculoskeletal disorders.