Abstract
ObjectivesThe Dictionary of Occupational Titles (DOT) is used in vocational rehabilitation to guide decisions about the ability of a person with activity limitations to perform activities at work. The DOT has categorized physical work demands in five categories. The validity of this categorization is unknown. Aim of this study was to investigate whether the DOT could be used validly to guide decisions for patients with injuries to the upper extremities. Four hypotheses were tested.MethodsA database including 701 healthy workers was used. All subjects filled out the Dutch Musculoskeletal Questionnaire, from which an Upper Extremity Work Demands score (UEWD) was derived. First, relation between the DOT-categories and UEWD-score was analysed using Spearman correlations. Second, variance of the UEWD-score in occupational groups was tested by visually inspecting boxplots and assessing kurtosis of the distribution. Third, it was investigated whether occupations classified in one DOT-category, could significantly differ on UEWD-scores. Fourth, it was investigated whether occupations in different DOT-categories could have similar UEWD-scores using Mann Whitney U-tests (MWU).ResultsRelation between the DOT-categories and the UEWD-score was weak (rsp = 0.40; p<.01). Overlap between categories was found. Kurtosis exceeded ±1.0 in 3 occupational groups, indicating large variance. UEWD-scores were significantly different within one DOT-category (MWU = 1.500; p<.001). UEWD scores between DOT-categories were not significantly different (MWU = 203.000; p = .49).ConclusionAll four hypotheses could not be rejected. The DOT appears to be invalid for assessing upper extremity work demands.
Highlights
Hand injuries may severely influence a person’s work capacity, frequently resulting in long periods of absence from work [1,2,3,4]
The Dictionary of Occupational Titles (DOT) appears to be invalid for assessing upper extremity work demands
Twenty-five subjects were excluded from the database because the Upper Extremity Work Demands score (UEWD)-score could not be calculated, leaving 677 subjects to Driving Instructors (n = 14) Teacher (n = 34) Job Consultant (n = 10) Secretary (n = 21) Physical Therapist (n = 22) Nurse (n = 16) Analysts (n = 11) Home Attendant (n = 17) Production Workers (n = 24) Surgery Assistant (n = 16)
Summary
Hand injuries may severely influence a person’s work capacity, frequently resulting in long periods of absence from work [1,2,3,4]. Hand performance in subjects with simulated finger disabilities has been investigated previously and it was found that strength was not influenced by the fictitious injury. Dexterity, lifting and some torque exertion tasks (e.g.: screwdriver handling) were negatively influenced by the diminished hand function [5]. The type of control to be handled during work might determine whether the worker can perform the tasks at the required pace for the job [6]. Both aforementioned studies suggest that strength is not the only key factor determining whether a person can resume his job after a hand injury, but that other factors may be or even more important
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