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The evolution and developments in modern industry have resulted a wide range of
occupational activities, some of which can lead to industrial injuries. Due to the activities of
occupational medicine, much progress has been made in transforming the way that operatives
perform their tasks. However there are still many occupations where manual tasks have become
more repetitive, contributing to the development of conditions that affect the upper limbs.
Repetitive Strain Injury is one classification of those conditions which is related to overuse of
repetitive movement. Hand Arm Vibration Syndrome is a subtype of this classification directly
related to the operation of instruments and machinery which involves vibration.
These conditions affect a large number of individuals, and are costly in terms of work
absence, loss of income and compensation. While such conditions can be difficult to avoid, they can
be monitored and controlled, with prevention usually the least expensive solution. In medico-legal
situations it may be difficult to determine the location or the degree of injury, and therefore
determining the relevant compensation due is complicated by the absence of objective and
quantifiable methods.
This research is an investigation into the development of an objective, quantitative and
reproducible diagnostic procedure for work related upper limb disorders. A set of objective
mechanical provocation tests for the hands have been developed that are associated with vascular
challenge. Infrared thermal imaging was used to monitor the temperature changes using a well
defined capture protocol. Normal reference values have been measured and a computational tool
used to facilitate the process and standardise image processing.
These objective tests have demonstrated good discrimination between groups of healthy
controls and subjects with work related injuries but not individuals, p<0.05, and are reproducible. A
maximum value for thermal symmetry of 0.5±0.3ºC for the whole upper limbs has been established
for use as a reference.
The tests can be used to monitor occupations at risk, aiming to reduce the impact of these
conditions, reducing work related injury costs, and providing early detection. In a medico-legal
setting this can also provide important objective information in proof of injury and ultimately in
objectively establishing whether or not there is a case for compensation
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