Epidemiologic concerns for ergonomists: illustrations from the musculoskeletal disorder literature

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Abstract
Ergonomics and epidemiology are unique fields that share some common interests. Epidemiologic methods are increasingly being utilized in ergonomic studies of the work-related risk factors of musculoskeletal disorders. This multidisciplinary approach requires a shared knowledge base and understanding of the methodology of both disciplines. In this paper, basic epidemiologic concepts are introduced. Examples from the upper extremity musculoskeletal disorder literature are used to illustrate study design issues and to suggest improved study methods. Epidemiologic design problems including selection bias (healthy worker survivor effect), misclassification, and confounding are discussed. Prospective research designs are described as a feasible approach for the study of these disorders. Increased collaboration between ergonomists and epidemiologists is encouraged to improve progress towards the reduction of workplace injuries and illnesses.