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This paper presents the results obtained in job evaluation of an organization working in the airport logistics. The sector is characterized by different activities that determine many types of musculoskeletal disorder and is marked by lack of knowledge of the accident prevention and health conditions at work. To analyze the workstations we have used video recordings, photographs and test through a dynamometer to determine the force applied during the pushing and pulling phase. In a lot of workstations were unacceptable NIOSH index due to a range of factors such as incorrect conformation of the workstations, the frequency and weight of loads handled, the heights of picking and unloading. Design solution have been studied and verified to reduce or eliminate the problems.

The authors have gone through the complaints concerning all the cases of shoulder accidents at work filed by the Genoa office of the Italian Workers' National compensation Agency (INAIL) during the two years' period 2006-2007, reviewing in particular those somehow affecting rotator components. The aim of this paper is to assess the real role played by the occupational trauma in the rotator cuff tear. The data gathered so far have shown, on the one hand, a high prevalence of pre-existing inflammatory and degenerative diseases and, on the other, a rather modest influence of the trauma which, for this reason, has usually borne, as an immediate medico-legal consequence, the rejection of a cause-effect relationship between the accident and the rotator cuff lesion, without taking into any account whether the worker was likely to be affected by an occupational disease (ex table Ministerial Decree n. 81 April 9th 2008- item 78). In such cases a systematic and in-depth investigation of the occupational case history is suggested, in order to highlight the possible pre-existence of a former biomechanical overload of the upper limbs, so as to allow the physician to detect a pathology often misdiagnosed.

In this paper the result of application of SIMLII guide lines on upper extremity work related musuloskeletal disorders in different work conditions are presented and discussed. We applied the following risk assessment methods: Washington State Standard, HAL, OCRA, RULA, Strain Index, OREGE. The evaluations were subdivided in 3 class: acceptable risk, intermediate risk, high risk. It is confirmed that the application of more than one method for risk assessment, enable to better measure the risk and to focus the specific risk factors (frequency, posture, force, complementary factors).

Background: The industrial production of upholstered furniture exposes workers to significant risk of occupational disorders due to ergonomics-related problems, such as repetitive strain and movements of the upper limb, manual load lifting, prolonged static postures., Objective: This paper describes the main measures taken by the biggest company in the "sofa sector" in southern Italy in order to solve such problems in the years 1996-2004., Methods: the classic instruments of ergonomics were used such as risk assessment, medical surveillance, training and information programmes, technological reorganization of the manufacturing process and of single working tasks., Results: The accident rate (number of accidents per million working hours) which showed an increasing trend in the previous years, rose from a value of 31 in 1996 to 51 in the years 1999-2000 (with a percentage of accidents related to load lifting in the range 25-35%). At the same time the incidence rate of work-related upper limb musculoskeletal disorders (UL-WMSDs) in the population of workers (which had increased in the meantime from 2500 to 3500 employees) reached nearly 5% in 2001, with peaks of 8-9% in the work tasks with higher exposure. Accident rates progressively fell in the following three years until a value of 20 was reached in 2004 and 2005, while the mean incidence rate of WMSDs reached a value of nearly 1%. The data need to be compared with the trends in the other companies of the sector in the same period, with an average incidence rate of WMSDs around 2% and a generally increasing trend., Conclusions: Ergonomic interventions not only concur in the management and control of negative events for workers health but also in achieving advantages in terms of lower costs and greater productivity.

Among work-related diseases, musculoskeletal disorders of the upper extremities have obtained increasing attention in last decades. In this paper we present and discuss the results of a work place ergonomic survey in a complex manufactory industry (Indesit S.p.A.), considering upper limbs disorders for biomechanical work-load risk. Ergonomic analysis has been performed using OCRA check-list, ORAGE method and Strain Index (S.I.). Results highlight the effectiveness use of the three arranged methods to assess risk situations and improve work places ergonomics conditions.

The existence of a risk of musculoskeletal disorders work-related of the upper extremity (UEWMSDs) in the textile industry, specifically in particular working phases as spinning, appears today controversial. The upper limb disorders, sometimes described, have not a location ever plausible with the level of the biomechanical overload, as when carpal tunnel syndromes are signalled during activities in which the shoulder is the only segment eventually interested. Moreover these findings are shown in workers appointed at tasks or actions not clearly identified at risk. For example the spinning activity, that requires the movement of shuttles of modest weight, sometimes on levels above the shoulder line, is organized with cyclical cadences sometimes as repetitive tasks concentrated in a short period, sometimes in longer during the entire shift. Distribution and number of the actions, would however allow a sufficient biomechanical recovery. The identification of the single technical action may result difficult, due to interindividual variability of actions, of their speed and complexity. Furthermore the other possible activities, alternate with specific spinning activities, can require strength or not correct posture even if they may have short duration. In this paper we present and discuss the results of the ergonomic survey for risk assessment of musculoskeletal disorders work-related of the upper limb. These analysis have been carried out in two textile plants, in which some cases of disorders of the upper limb in workers employed in spinning activities have been described by occupational health physicians. In addition to assessment of possible risk for UEWMSDs in spinning activities, we founded the capability of usual methods for ergonomic analysis to adequately examine work situations like spinning, in which the hazardous actions are diluted over the entire shift or concentrate in a short period and in which there is a specific biomechanically overloaded segment i.e. the shoulder. Finally attention was paid to evaluate psychosocial factors which appear to be important when biomechanical factors are low-lying.

Among work-related diseases, musculoskeletal disorders of the upper extremities have obtained increasing attention in recent last decades. Because of their relevance, the Italian Society of Occupational Medicine and Industrial Hygiene has decided to draw up a set of National Guidelines on the subject. This paper discusses their production and contents, including definitions, rationale, physiopathogenesis, occupational physician's contribution to biomechanical overload risk evaluation, medical surveillance of exposed workers.

Background: The paper considers a database of old (already published) and new data concerning 23 groups of workers (Total number of subjects examined=5373) with different levels of exposure to repetitive movements of the upper limbs: for all these groups data were available regarding exposure indexes (OCRA index and Checklist "OCRA" score) and clinically determined UL-WMSD outcomes (PA=Prevalence of workers Affected by one or more UL- WMSDs; PC=Prevalence of single diagnosed Cases of an UL- WMSDs)., Objectives: Using these data, the paper aimed at presenting and discussing the results obtained in order to estimate: new critical values of OCRA index for discriminating different exposure levels (green, yellow, red areas); new prediction models of expected PA and PC in exposed populations based on exposure indexes., Methods: New critical values of the OCRA index (and, consequently, of the checklist score) were estimated by an original approach in which data of the effect variable PA in a reference population not exposed to the specific risks were combined with the regression function between OCRA and PA, as resulting from the 23 available groups., Results: The resulting critical values and the consequent classification system of the OCRA index and of the checklist score are synthetically reported in the following table: [table: see text]. The best simple regression functions between exposure indexes (OCRA; checklist) and health outcome variables (PA; PC) were then sought, in order to obtain prediction models of effects starting from exposure. The following were the main prediction models derived from the available set of data (standard error of b in brackets): [formula: see text]. Finally, a multiple regression model was computed for estimating PA (Y) based on OCRA index and gender structure of the group (SEXRATIO=n. females x 100/n. total) with its 5 degrees and 95 degrees percentiles (in brackets); the resulting model was. Y = 2.02 (1.72-2.32) x OCRA + 0.075 (0.035-0.115) x SEXRATIO. This model showed a very high association between the two independent variables and the effect variable (PA) (R2=0.96)., Discussion: Discussion of the results obtained considers their intrinsic limits, as they are based on prevalence studies, and also suggests due recommendations and caution in the use of the proposed classification system and prediction models when the OCRA methods are applied for the evaluation of occupational risk associated with repetitive movements of the upper limbs.

The aim of the present paper was to evaluate the effectiveness of a sitting system based on the application of magnetic fields in the prevention of posture-related musculoskeletal disorders. We studied 5 healthy male volunteers during laboratory simulation tests including 60-minute sessions of "driving" and computer-work. Two subjects performed a 60-minute driving test on an isotonic dynamometer with a steering wheel, in which they had to steer for 2 min and drive normally for 3 min, alternatively. They repeated the test with and without the magnet-based sitting system. Three subjects performed a 60-minute computer-work test in a seated position with and without the magnet-based sitting system. EMG activity was registered in the trapezius muscles and at L1 and L5 lumbar level bilaterally with surface electrodes. The EMG trapezius activity continuously recorded was analysed with the APDF method, as proposed by Jonsson. Before and after the tests, the subjects performed a 60-sec isometric back extension at 60% MVC with a specific back dynamometer, while paraspinal EMG was recorded. The slope of decay of the median frequency of the EMG power spectrum was then calculated as an index of localised muscle fatigue. The results showed a decreased myoelectric activity both at shoulder and lumbar level by using the magnet-based sitting system for prolonged seated work tasks. Thus, the system appears to be an effective tool in preventing muscle contractures secondary to prolonged, constrained positions.

This paper reviews the impact of ageing on physical work capacity in the elderly worker and the benefits of exercise programmes designed for the prevention of musculo-skeletal complaints. Physical work capacity generally declines significantly after 50 years of age as a consequence of a reduction in aerobic capacity and muscle strength. The latter is accompanied by a decline in the fatigue threshold. This, in combination with a reduced recovery capacity after exercise, may lead to chronic overload of muscles and tendons in the elderly worker. Thus, it has been proposed that physical exercise programmes may prevent the onset of musculo-skeletal disorders. The effectiveness of different physical exercise programmes proposed in the literature for the prevention of musculo-skeletal disorders is reviewed here. The adoption of an active life-style and the rational use of ergonomic interventions, such as automatization of certain work processes, also appear to be crucial in minimizing the impact of ageing on work ability and capacity in the elderly worker.

In the light of the experiences and guidelines developed by other countries and of Italian legislative and operational conditions, the authors outline a strategy for a health surveillance programme for work-related musculo-skeletal disorders of the upper limbs. In particular, the paper defines the various aims of the health surveillance programme and identifies significant relevant criteria for its implementation (i.e. existence of risks or effects). A screening schedule is presented based on successive investigations (1st and 2nd level surveillance); the authors discuss the principal methods used for processing the results of the health surveillance programme, in collective (i.e. statistical comparisons; planning of periodical investigations) and individual terms (job fitness judgements; reporting of suspected occupational diseases.

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