Thermology and Ergonomics - thermal imaging of work related injuries

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Infrared Thermal Evaluations Provide a responsive ergonomics program for workers & corporations Establish baselines Assess workers at risk Non-invasive Objective A preventive measure Efficient	Ergonomics - Worker Evaluations Adult male hands/those on right are cooler Thermal imaging establishes a baseline measurement. Observes the effectiveness of a company's ergonomics program Assist with the assessment of employees at risk for work-related injuries. Help determine the physical capacity of the worker in relation to the physical requirements of the job Identify WMSDs (work-related musculoskeletal disorders) more efficiently Help to reduce workers' compensation costs Help to reduce indirect costs such as time off and false claims Provide objective findings Facilitate better medical management and control Simple non-invasive infrared scans provide pictures similar to the following images: Example of inflammation in cervical region along with extremely poor circulation in arms (blue colors). An employee involved with heavy lifting may be predisposed to injury with poor circulatory activity in the upper extremities along with cervical irritation. Muscle tear in the upper leg. Asymmetrical lower extremities. Increased neuro-vascular activity in this region - note the hot pink region in the upper thigh area. Example of low back asymmetry with abnormal thermal projections extending from midline, particularly in lumbar region. Good symmetry in upper extremities and hands. However, note area of increased activity in the region of the thumbs of both hands BMJ 1997;314:118 (11 January) Thermographic changes in keyboard operators with chronic forearm pain. S D Sharma, Research Fellow, E M Smith, Research Nurse, B L Hazleman, Consultant Rheumatologist,J R Jenner, Consultant Rheumatologist Rheumatology Research Unit, Box 194, Cambridge CB2 2QQ, b Addenbrookes NHS Trust, Cambridge CB2 2QQ Chronic incapacitating forearm pain and disability in the context of repetitive action has caused much debate. Lack of objective measurements in a condition with diverse symptoms, few physical signs, and uncertain pathology is a major problem. Clinical observations have suggested the presence of vasomotor changes in repetitive strain injury, so we used computer assisted thermography to assess this. We conclude that thermography needs further evaluation as a diagnostic tool in evaluating repetitive strain injury. It may prove more useful in follow up, particularly in measuring response to treatment, some of which has been prescribed at enormous cost and with little evidence of benefit. J Hand Surg [Am] 1987 Sep;12(5 Pt 2):943-9 Thermography in the detection of carpal tunnel syndrome and other compressive neuropathies. Herrick RT, Herrick SK School of Industrial Engineering, Auburn University, Ala. Studies were conducted using liquid crystal thermography (FlexiTherm) and electronic thermography for the diagnosis of carpal tunnel syndrome. Studies were also conducted to differentiate carpal tunnel syndrome from peripheral neurovascular injuries. Ninety patients were included in the study, with an average follow-up time of 24 months. Fifty patients also had electric studies for comparison and contrast. Thermal patterns of carpal tunnel syndrome showed a decreased vascular heat emission pattern over the median nerve distribution. The procedures using thermography consisted of imaging of the cervical spine, shoulders, forearms, and hands. Results of the studies showed that thermographic studies were efficacious and sensitive for the differential diagnosis of carpal tunnel syndrome from other peripheral compressive neuropathies, including cervical radiculitis, thoracic outlet syndrome, cubital tunnel syndrome, and Guyon's canal syndrome. Biomechanic and etiologic factors indict carpal tunnel syndrome to be an occupational disease. Thermographic technique use may lead to the early diagnosis, treatment, and preventative measures that could eliminate the high cost of manpower loss and of medical care often concomitant with carpal tunnel syndrome. J Hand Surg [Am] 1992 Jul;17(4):631-7 Thermographic observations in unilateral carpal tunnel syndrome: report of 61 cases. Tchou S, Costich JF, Burgess RC, Wexler CE Department of Rehabilitation Medicine, University of Kentucky, Lexington. This study was undertaken to assess the sensitivity and specificity of thermographic diagnosis of unilateral carpal tunnel syndrome in a patient population large enough to permit meaningful statistical analysis. Sixty-one persons with clinical diagnoses of unilateral carpal tunnel syndrome confirmed by electrodiagnostic examination and 40 symptom-free volunteers underwent standard thermographic examinations. The thermographic images were then randomly sorted and interpreted by an experienced physician thermographer. Fifty-seven of the 61 patients with carpal tunnel syndrome were found to have thermographic abnormalities, while only one of the control group was found to have such an abnormality. Individual area sensitivity was highest in the dorsal area, but addition of other regions increased this measure; specificity ranged between 98% and 100%. These findings would appear to confirm the value of thermography in the diagnosis of unilateral carpal tunnel syndrome. Med Tr Prom Ekol 1995;(9):37-9 [Thermographic signs of forearm myopathies in industrial workers]. [Article in Russian] Rastopina EI, Arshin VV The authors described thermographic sign of forearm myopathy similar to RSI in industrial workers. The sign is that upper third of the forearm has skin temperature higher by over 0.3 degree C (for associated cervical osteochondrosis--by over 0.5 degree C) as lower third of the forearm. The temperature gradient (up to 2.5 degrees C) appeared to correlate with more marked myopathy. Zh Nevropatol Psikhiatr Im S S Korsakova 1991;91(10):17-20 [Automated diagnosis of vibration disease]. [Article in Russian] Kolesov VG, Il'in VP Based on a multidimensional discriminant analysis of the clinical and physiological characteristics derived as a result of examination of 593 miners, classification functions were plotted, allowing the diagnosis of vibratory disease in the automatic mode by means of mathematic computations. Functional indicators of skin sensitivity, particularly vibratory, dynamometry, rheovasography and thermography of the hand and fingers, a "white spot" symptom, and characteristics derived on a mathematic analysis of heart rhythm were established to be informative for automated diagnosis. The diagnosis was found to be more accurate in case of using a two-stage variant of the discriminant analysis where the differentiation is first made between healthy workers and workers with a pathology, followed by the discrimination of the preclinical and clinical phase of the disease. The automated diagnostic system is demonstrated to compare very favourably with the conventional method of diagnosis. Med Pr 1985;36(3):173-8 [Usefulness of thermal tests for evaluating vascular changes in persons exposed to vibration]. Tutak T The investigations have been carried out on 40 workers of an industrial factory. Twenty workers used vibration tools, the others, having no contact with vibration, constituted the control group. Each subject had his skin temperature measured at 19 points of the left and right hands at ambient temperature of 22 degrees C and after cooling at 15 degrees C and 8 degrees C. The results have demonstrated that early vasomotor changes are best identified by the thermal test with cooling at 8 degrees C. Furthermore, this method enables a topographic estimation of the hand areas for special risk of the disturbances in blood vessels of workers using vibration tools. Skeletal Radiol 1984;12(4):235-49 Normal thermographic standards for the cervical spine and upper extremities. Feldman F, Nickoloff EL Although thermography has been used for a variety of abnormal conditions, extensive data on large, relatively asymptomatic populations has heretofore not been available. More specifically, no data deal with the upper extremities and, more particularly, no analyses are based on simultaneous thermograms of the posterior neck and shoulders. The current study undertook this task. The results confirm the existence of thermal symmetry in the overwhelming majority of 100 normal relatively asymptomatic, actively employed factory workers. Conversely,if persistent, statistically significant thermal asymmetry exists, as outlined and correlates with patient symptomatology, an organic basis for it should be sought. Vrach Delo 1989 Aug;(8):108-10 [Thermography in the diagnosis of respiratory organ diseases in coal miners]. Shelygin SI A thermographic study of the chest was of importance in the diagnosis and differential diagnosis of pneumoconiosis, chronic dust-induced bronchitis, unspecific pulmonary diseases. This could substitute traditional methods of examination. Results make it possible to recommend the method of thermography in the diagnosis of professional diseases as well as in periodic prophylactic screenings of coal miners.

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