title: Assessing the effects of biomechanical overload on dairy parlor workers' wrist: Definition of a study approach and preliminary results.
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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Masci
authors.affiliation: San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Tassoni
authors.affiliation: Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bossi
authors.affiliation: San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Magenta Biasina
authors.affiliation: San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Serrao
authors.affiliation: Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO, USA.
authors.forename: J
authors.initials: J
authors.lastname: Rosecrance
authors.affiliation: Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Colosio
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000473:pathology; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000175:diagnosis* / Q000453:epidemiology; D003612:Dairying / Q000379:methods*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D014463:Ultrasonography / Q000379:methods; D014954:Wrist Injuries / Q000175:diagnosis*
keywords: Milkers; ultrasonography, study protocol; wrists overload