Numerous epidemiologic studies have examined musculoskeletal disorders (MSDs) that affect the cervical spine and analyzed their relationship to physical workplace factors [1-5]. However, due to the various definitions and methods of data reporting, the nature of MSDs remains controversial. Disparities arise not only with respect to which causative factor relates to neck injury but also to the relative importance assigned to each factor. Nonetheless, strong evidence exists for the predominance of four risk factors: static contraction, forceful exertion, prolonged static loads, and extreme working posture [6]. Repetitive work was considered a secondary factor. Age and gender were considered confounding factors and are not consistent with work-related factors [6].

Adding to the controversy is the limited amount of information regarding occupational injuries of U.S. workers. Since 1972, the only routinely published, national source of information is the Annual Survey of Occupational Injuries and Illnesses (ASOII). This survey, conducted by the Bureau of Labor Statistics (BLS) within the U.S. Department of Labor, is a random sample of approximately 250,000 private-sector establishments. According to the BLS, approximately 349,000 musculoskeletal disorders (MSDs) occurred in 2016. Of these, sprains, strains, and tears accounted for 244,000, approximately 70% of all MSDs, and soreness/pain accounted for another 67,500, approximately 19% of all MSDs [7]. The BLS data also indicated that neck involvement was present in approximately 5,100 MSDs.

Unfortunately, the BLS data excludes self-employed workers, farms with fewer than 11 employees, private households, and all government agencies [7]. Even more importantly, multiple occupational sectors were not accounted for in the BLS data. The potential impact of such omissions was indicated in a more targeted study within the single state of Washington (whose population represents only 2.27% of the U.S. population). During the 1994-2002 study interval, Washington’s workers compensation program (operated by the state’s Department of Labor and Industries) annually accepted 4,752 work-related MSD claims involving the neck (out of a total of 40,640 work-related MSD claims) – nearly as many as accounted for nationally by the BLS. The Washington study further reported that annual direct costs associated with neck-related MSDs exceeded $14.2 million. A simple projection of similar neck-related MSD rates and costs would lead to estimates of approximately 209,000 occurrences and $626 million in costs for the nation as a whole.

Although the costs estimated from the study in Washington state are based on assumptions of similarity across states, they are consistent with an overall occupational MSD cost estimate reported by the National Institute for Occupational Safety and Health (NIOSH): $13 billion annually [8]. To validate this consistency, we note that Washington’s neck related MSD costs represented approximately 4.57% of all MSD costs [10]. Projecting these costs nationally, the total MSD cost estimate would be $626 million/0.0457 = $13.7 billion, which is very close to the NIOSH estimate.

The problem of work-related neck pain is a global one. As an example, the direct costs of neck pain in the Netherlands were estimated at $160 million in 1996, with indirect costs of $527 million [9]. The total cost of neck pain represented 0.1% of the gross domestic product in 1996 [9], although the share of these costs that were specifically attributable to work related neck pain were not indicated. Although MSD definitions and methods of reporting within the European Union are not standardized, the data from the Netherlands, along with that in America, suggest that the problem is significant in both health and economic terms.

To address this problem, Psyche Comfort Products, LLC has designed and developed the next generation Neck Guard, intended for any occupational trade in which overhead work is performed. It is designed to reduce loading of internal musculoskeletal structures during maintenance of extended neck postures that individuals experience during overhead occupational tasks. Neck Guard was developed to reduce the pain associated with muscle fatigue and improve worker endurance while performing overheard work. As a step toward this vision, we have conducted initial cervical muscle activation assessments and engineering interface load computations in order to establish proof-of-concept, which was reduction of cervical muscle activation and more uniform dispersion of interface loading in the head/neck region.