Cumulative Trauma Disorders

Topics: Loss Control

Summary: Cumulative trauma disorders (CTDs) are long-term musculoskeletal injuries caused by repeated work-related activities. CTDs are a major occupational issue in the United States, affecting at least 3% of the adult population. These conditions can be painful for workers and sometimes cause irreversible damage. The good news is many CTDs are preventable by making a proactive change in work habits.

Workplace injuries are not always simply the result of one-time accidents. Falling off a ladder, slipping on a wet floor, getting hit on the head by an object falling off a shelf, or slicing a hand on a sharp tool are common ways workers injure themselves while performing their daily job duties. However, long-term injuries that develop caused by repetitive, daily work activities are also common workers’ compensation claims.

What are Cumulative Trauma Disorders?

Cumulative trauma disorders (CTDs) are long-term musculoskeletal injuries caused by repeated work-related activities. CTDs develop from repetitive motions that cause excessive wear and tear on the muscles, tendons and sensitive nerve tissues, or from improper positioning and unnatural postures, rapid movements, vibration and idleness. Coupled with a lack of adequate recovery time, the symptoms can become quite severe.

Employees in many different industry types can be at risk for cumulative trauma disorders. Office workers who sit typing at a desk throughout the day, assembly line workers in a factory, housekeepers and construction workers may all be susceptible to CTDs. Additionally, repetitive motion injuries are among the top injury types with the highest number of reported workers’ compensation claims for retail workers, with the second-highest average payout at $14,000 per claim, according to AmTrust’s Retail Risk Report.

CTDs are a major occupational issue in the United States, affecting at least 3% of the adult population. A few common examples of CTDs are:
  • Tendonitis: Tendons are fibrous tissues that connect muscles and bones together. When these tendons are used too long or too vigorously, they can become inflamed and painful, a condition known as tendonitis.
  • DeQuervain’s Disease: This disease is similar to other tendon CTDs in that it is caused by repetitive hand and/or wrist motion causing inflammation to tendons, specifically the tendons around the thumb and traveling up the forearm. It’s also sometimes referred to as tennis elbow.
  • Carpal Tunnel Syndrome: This CTD is a nerve disorder that affects feeling and movement in the thumb and first three fingers of the hand. Caused by pressure on a nerve in the wrist, symptoms include pain, numbness or tingling in the hand and difficulty holding objects.
  • Raynaud’s Syndrome: This is another nerve disorder, which is also known as “vibration white finger” or “hand-arm vibration syndrome.” When employees consistently use tools that vibrate, numbness in the fingers can occur, which can ultimately lead to a loss of muscle control in the hands.
  • Radial Tunnel Syndrome: Also known as resistant tennis elbow, this condition is similar to DeQuervain’s Disease in that the nerve operating the muscles around the wrist and hand becomes compressed, causing the muscles to weaken and leading to pain in the elbow.
  • Trigger finger: The thumb and forefinger are most often affected by this condition. One of the fingers will often get stuck in a bent position, or it may bend or straighten with an audible snap – like a trigger being pulled and released.
  • Lower back pain: Minor stresses that accumulate over a long period of time can lead to a variety of problems in the lower back. Sitting without adequate support or improperly lifting, carrying or lowering objects can all put unnecessary stress on the lower back.

Cumulative Trauma Disorders and COVID-19

Businesses that shut down in the early days of the COVID-19 pandemic, such as restaurants, bars and retail stores, have reopened over the last several months, often with the need to hire new employees to replace those who were furloughed or let go to save on payroll costs. Historically, new workers are frequently more at risk for injuries. Also, many companies are facing a shortage of employees, leading to those currently on staff taking on extra shifts.

According to Matt Zender, SVP Worker’s Compensation Strategy at AmTrust, “Many businesses are struggling to find employees, so the employees who are left are working longer hours to make up for the shortage. We might also see an increase in cumulative trauma claims in certain states and an increase in claims as employees are working harder and fatigue continues to be a significant factor for these claims.”

Main Risk Factors for Cumulative Trauma Disorders in the Workplace – and How to Prevent Them

cumulative trauma disorders in the workplace
It’s impossible to predict exactly who might develop a cumulative trauma disorder, but symptoms should be taken seriously as soon as they are noticed. These conditions can be painful for workers and sometimes cause irreversible damage. The good news is many CTDs are preventable by making a proactive change in work habits.

Here are the top five risk factors that can contribute to the development of CTDs in retail workers, as well as how to prevent them:
  1. Body position: Unnatural or awkward body positions can easily lead to CTDs. Workers should pay attention to their posture, keeping shoulders relaxed and the spine in its natural “S” curve. This can help alleviate the strain placed on muscles, tendons, discs and ligaments. Workers should also understand how to rotate positions and change how muscles are used over a work shift.
  2. Force: The more force required to perform a particular task or the longer that force must be applied, the greater the risk of developing a CTD. Make sure workers are using the proper tools for their job duties to avoid overexertion.
  3. Repetition: Tasks that repeatedly use the same muscles and tendons require more muscle effort and less recovery time. Often jobs that require high repetition rates can lead to fatigue and injury. Allow workers to take rest breaks and encourage them to stretch tired or overworked muscles regularly.
  4. Vibration: The use of vibrating or impact tools or equipment for hours at a time can put stress on the hands and arms, the lower back and the neck. Workers should be provided with personal protective equipment like anti-shock or anti-vibration gloves to help reduce the impact.
  5. Lifting: Unassisted, frequent or heavy lifting, especially when performed improperly, can stretch the ligaments of the back and cause the vertebrae to become misaligned. As lower back pain is one of the most common cumulative trauma disorders in the workplace, it’s vital that employees understand safe lifting techniques.
Other factors such as extreme temperatures, poor lighting, general health, age and gender can also cause cumulative trauma disorders in workers. It’s important to keep in mind that not all muscle aches and pains are CTDs, as everyone experiences occasional discomfort from certain work activities. Simply allowing the body time to recover and heal from overuse can be key in reducing injuries like CTDs.

Loss Control Services from AmTrust Financial

AmTrust Financial’s Loss Control department can help your retail operation assess the conditions, practices and processes of the workplace to help identify common hazards facing workers. It’s our goal to provide the right safety resources and commercial property safeguards to ensure your small business thrives. Contact us today to learn more.

This material is for informational purposes only and is not legal or business advice. Neither AmTrust Financial Services, Inc. nor any of its subsidiaries or affiliates represents or warrants that the information contained herein is appropriate or suitable for any specific business or legal purpose. Readers seeking resolution of specific questions should consult their business and/or legal advisors. Coverages may vary by location. Contact your local RSM for more information.

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