Affiliations: [a] Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy
| [b] San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy
| [c] Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA
Correspondence:
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Address for correspondence: Federica Masci, Department of Health Sciences of the University of Milan and International Center of Rural Health of San Paolo Hospital, Via San Viglio 43, 20142 Milan, Italy. Tel.: +39 0281843465; Mobile: +39 320 0668906; Fax: +39 02 89180221; E-mail: [email protected].
Abstract: BACKGROUND: Dairy milking is a demanding work task that has been associated with hand and wrist musculoskeletal disorders. Clinical approaches to identify the early effects of musculoskeletal disorders among dairy parlor workers’ wrist have not been well defined. OBJECTIVES: The purpose of this pilot study was to develop a study protocol that would assist in the identification and quantification of hand and wrist disorders among dairy workers that perform tasks in the dairy parlor. Additionally, such a study protocol was needed to perform relatively rapid assessments of the wrist/hand on large samples of dairy workers. METHODS: Fourteen dairy parlor workers were assessed for i) upper limb symptoms and work history through questionnaire, ii) a physical examination of the upper limb and in particular wrists and iii) wrist ultrasonography. An additional 21 unexposed paired participants (the control group) also participated in the data collection. RESULTS: The study results identified two ultrasound acoustic windows characterized by the highest predictive value for alteration of the wrist’s structure. Study results indicated an impairment of the distal median nerve in structure and mobility and impairment of the distal tendon of the muscle extensor carpi ulnaris that included dislocation and frank damage. CONCLUSIONS: This study identified at least two acoustic windows that should be assessed with ultrasound studies on larger groups and in prospective periodical health surveillance of dairy workers. The study confirmed the wrist was at risk for biomechanical stress among workers conducting milking tasks in the dairy parlors.
Keywords: Milkers, wrists overload, ultrasonography, study protocol
