Learning for life: Work-related upper limb disorders

Life Long Learning and Continuing Professional Development (CPD) are the
processes by which professionals, such as nurses, develop and improve their practice.

There are many ways to address CPD: formally, through attending courses,
study days and workshops; or informally, through private study and reflection.
Reading articles in professional journals is a good way of keeping up-to-date
with what is going on in the field of practice, but reflecting and identifying
what you have learnt is not always easy. These questions are designed to help
you to identify what you have learnt from studying the article. They will also
help you to clarify what you can apply to practice, what you did not understand
and what you need to explore further.

1. Which of the following structures are at risk during the development

a) Muscles, tendons, bones
b) Muscles, bones, ligaments
c) Tendons, bones, ligaments
d) Muscles, tendons, ligaments

2. Who was Ramazzini?

a) The father of industrial hygiene

b) The first factory inspector
c) A professor of medicine at Oxford University
d) An Italian artist

3. Which of the following was not one of Ramazzini’s risk factors for
developing WRULD?

a) Single overload
b) Violent motions
c) Irregular motions
d) Unnatural posture

4. Which adverse environmental factors have been shown to increase risk

a) Humidity, increased noise and cold
b) Poor lighting, increased noise and cold
c) Poor lighting, humidity and cold
d) Poor lighting, noise and increased humidity

5. Regarding the risk of developing Carpel Tunnel Syndrome, which of the
following statements is true?

a) Obesity has been shown to decrease the risk
b) Being underweight has been shown to increase the risk
c) Weight has not been found to be a factor
d) Obesity has been found to increase the risk

6. Which nerve is affected in CTS?

a) Brachial
b) Median
c) Vagus
d) Olecrannon

7. Which of the following is a good preventative strategy?

a) Regular physiotherapy and comfortable clothing
b) Regular physiotherapy with frequent exercise
c) Stretching exercises and comfortable clothing
d) Regular changes of clothing and stretching exercises

8. Which is NOT a preventative measure?

a) Increased task rotation
b) Extended sick leave
c) Ergonomic interventions
d) Work strengthening programmes

9. What is the best preventative strategy? A good policy on…

a) Sickness absence
b) Accident reporting
c) Treatment
d) Rehabilitation

10. Who is most likely to develop WRULD?

a) A well off female in good health
b) A less well off female in goodhealth
c) A well off male in good health
d) A less well off male in good health


1. d) WRULD is a term used to describe disorders of the soft tissues.
2. a) I am sure everyone has heard of Bernardo Ramazzini (1633-1714) who
wrote the first ever treatise on occupational diseases and for those of you
would like a copy of his original book there is one for sale on the internet at
£6,850! 3. a) It is interesting to note that WRULD was identified so
long ago and we are still having to deal with it today. 4. b) Consider
your own place of work and whether there are environmental conditions that
could lead to WRULD and whether any (simple) improvements can be made to prevent
this happening. 5. d) Undertake a search and refresh your memory of
Carpel Tunnel Syndrome. 6. b) Refresh your memory of the structures in
the arm. 7. c) Consider how you have dealt with information on
stretching exercises and regular breaks in your workplace where WRULD could be
a problem. Have effective have your strategies been, what improvements could
you make? Discuss this with your colleagues. 8. b). 9. d) With regard to
the answers to both 8 and 9 update your knowledge on rehabilitation, sickness
absence and work. If necessary carry out a literature search. 10. b)
Several personal risk factors are given in the text. Consider whether this
applies in your professional experience.

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