The occupational history is used to both ascertain the potential work-relatedness of the patient's condition and to investigate whether workplace interventions are necessary. It should focus on the patient’s exposure to workplace factors which may be associated with the development of CTS, including rapid work pace, repetitive motion, forceful exertions, static loads, non-neutral body postures, and hand-arm vibration. Specific diagnoses, such as localized nerve entrapment (CTS), tendinitis (de Quervain's tendinitis) and muscle strains have been associated with jobs in all sectors of the economy.
Aestheticians frequently engage in hand intensive work. Here, the aesthetician is painting a client's toenails. Note also the non-neutral posture: her right shoulder is hiked up and her body weight is supported by her left elbow that is propped on her left knee, as well as the rounded shoulder and forward head posture.
Image Source: Victoria Squissato
Repetition, force, non-neutral or static postures, vibration, work speed and low task variation are job factors that may contribute to the development of these ailments. However, much is still unknown about the health effects of most workplace exposures. That is why it is necessary to take a thorough occupational history, since your history taking skills will be the key to recognition of occupational illness.
1Newman LS. Occupational Illness. New England Journal of Medicine. 1995;333:1126-1134.
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