Upper extremity musculoskeletal disorders (UE MSDs) are a major public health concern resulting in disabling injuries among the working population. Previous studies have shown that workplace physical exposures are associated with MSDs, though the strength of the relationships has varied between studies. In 2001, the National Academy of Sciences put forth recommendations for research on MSDs and highlighted the need for accurate and consistent measures of disease outcomes and work exposures to enable future research. There are a limited number of methods available for measuring exposures and disease status, and the reliability and validity of these methods has not been fully explored. The purpose of this dissertation was to describe the performance of three commonly used tools for UE MSD research.

These studies assessed the reliability and inter-method agreement and the random and non-random error of self-reported measures of disease outcomes and exposure. The first study evaluated the hand diagram, a method for determining a characteristic pattern of symptoms for carpal tunnel syndrome (CTS). Although past studies have shown good reliability between raters, differences in agreement among raters have not been assessed for factors that may lead to systematic differences. The second and third studies examined commonly used self-reported methods for assessing physical exposures for epidemiological studies. A self-administered survey of exposures for CTS and a hand force estimation procedure were analyzed for agreement with referent methods. In all of these studies, assessment of misclassification used statistical, graphical, and computational methods. Exploratory analyses showed possible causes of the misclassification.

Misclassification was modest for the hand diagram tool and hand force estimation methods, but larger for some of the self-reported upper extremity exposure measures. The studies found that the presence of hand and wrist symptoms and job type systematically affected results in some of the measures. The dissertation concludes with suggestions for future studies to develop new items for a self-reported exposure survey and further refinement of rules and procedures for using the hand diagram. Findings from this dissertation allow refinement of exposure and outcome measures used to study this prevalent and disabling health condition.