A cross-sectional assessment of the ACGIH TLV for hand activity level

The ACGIH Worldwide Threshold Limit Value (TLV) for hand activity "considers average hand activity level or "HAL" and peak hand force." We report cross-sectional data that assess the validity of the TLV with respect to symptoms and selected upper extremity musculoskeletal disorders among workers. The prevalence of symptoms and specific disorders were examined among 908 workers from 7 different job sites in relation to the TLV. Worker exposures were categorized as above the TLV, above the TLV Action Limit but below the TLV, or below the TLV Action Limit. Symptoms in the distal upper extremities did not vary by TLV category. Tendonitis in the wrist/hands/fingers did not vary by TLV category, but elbow/forearm tendonitis was significantly associated with TLV category. All measures of carpal tunnel syndrome were associated with TLV category. In all instances, prevalence of symptoms and specific disorders were substantial in jobs that were below the TLV action limit, suggesting that even at "acceptable" levels of hand activity, many workers will still experience symptoms and/or upper extremity musculoskeletal disorders, which may be important in the rehabilitation and return to work of injured workers. Future analyses need to examine the incidence of symptoms and upper extremity musculoskeletal disorders prospectively among workers in relation to the TLV for hand activity.