Interpreter's Wrist: Repetitive Stress Injury and Carpal Tunnel Syndrome in Sign Language Interpreters Joe D. Stedt American Annals of the Deaf, Volume 137, Number 1, March 1992, pp. 40-43 (Article) Published by Gallaudet University Press DOI: https://doi.org/10.1353/aad.2012.0428
For additional information about this article https://muse.jhu.edu/article/385097/summary
Access provided by University of South Dakota (17 Dec 2018 21:24 GMT)
Interpreter's Wrist Repetitive Stress Injury and Carpal Tunnel Syndrome in Sign Language Interpreters Joe D. Stedt
Forty interpreters attending a regional Registry of Interpreters for the Deaf conference completed a questionnaire regarding symptoms related to repetitive stress injury (RSI), a generic classification of problems that occur after extensive, repetitive motion. RSIs, including the most prevalent form, Carpal Tunnel Syndrome (CTS), were surveyed. The vast majority (87.5%) of the interpreters in the sample reported that they had at sometime experienced at least two symptoms associated with RSI. Some (12.5%) who had CTS reported that they had been misdiagnosed. When asked how many other interpreters they knew with RSI problems, they reported, on average, that they knew more than four others. The data indicate that RSI is a severe problem among sign language interpreters and warrants immediate action. The term interpreter's wrist may best describe the malady.
Carpal Tunnel Syndrome (CTS) has only recently been associated with sign language interpreters (Stedt, 1989). Described briefly, CTS is a problem that occurs within the space where the wrist bones narrow, the carpal tunnel. It was first described in the 1940s (Feingold, Hiduegi, & Horwitz, 1980) as a problem of abnormal sensations in the portions of the hand innervated by the medial nerve due to compression of the
the wrist, tenosynovitis, obesity, small wrist size, oral contraceptives, degenerative arthritis, rheumatoid arthritis, hypothyroidism, sarcoidosis, congenital defects, Paget's disease, pregnancy, diabetes mellitus, and water retention
nerve. The sensations include, but are not limited to,
numbness, tickling, pins and needles feelings, burning,
Perhaps the greatest cause of CTS, however, is occupations requiring consistent and repetitive wrist movements
waking numbness (when the hand wakes the afflicted
(Masear, Hayes, & Hyde, 1986). Recently, medical authori-
patient during sleep), and a feeling that the hand has fallen asleep for no apparent reason. Additionally, though less commonly, symptoms include pain in the elbow and/or wrist, weakened thumb and/or wrist movements, and finally, swelling in the volar section of the wrist. CTS has many suspected causes. Among them are previous wrist injuries, rubella, gout, calcium deposits in The author is an assistant professor of education and psychol-
ties and professionals concerned about the health of people in the work place have extended the scope of physical problems causedby excessive motion and grouped them into a generic category called repetitive stress injury (RSI). This category includes CTS, as well as several problems related to CTS such as tenosynovitis (inflamma-
due to the menstrual cycle.
Repetitive Stress Injuries
tion of affected tendons), DeQuewain's Syndrome (an inflammation of the thumb tendon), epicondylitis (tennis elbow), and sprains.
ogy at Cameron University in Lawton, Oklahoma. Previously,
RSI goes by many names including repetitive motion
he ivas a teacher at the Texas and California Schools for the deaf.
40
trauma injury, repetitive motion injury, repetitive stress
AAD
Vol. 137, No. 1
Interpreter's Wrist
illness, repetitive stress syndrome, cumulative trauma injury, and cumulative trauma disorder. Stix (1991) has pointed out that names for RSI have been created to
Table 1. Background Information on Interpreters
indicate their etiology. A worker ata supermarket may have
Λ/=40
pricer's palsy. A person working in a pickle factory who manually inserts the last pickle into the jar may have picklepusher's thumb. A child who has played video games too
Sex: 36 Females, 4 Males
Average Age = 35.26 years
long may encounter Nintendonitis (Stix, 1991). People
Average Signing Experience = 17.36 years
encountering problems from sign language interpreting are referred to as having interpreter's wrist.
Average Interpreting Experience = 10.51 years
These are not all new conditions; some have been diagnosed since as early as 1700 (Stix, 1991). However, a Procedure
Department of Labor report on occupational injuries and illnesses stated that they increased excessively over the last decade (Kilborn, 1989). Whereas such injuries now
The interpreters were asked to respond to questions about pain and symptoms that would indicate RSI due to sign language interpreting. The questionnaire was designed to ferret out some of the physical problems that could be produced by excessive interpreting. The text of the questionnaire appears in Table 2.
account for almost half (48%) of all work place injuries, they only accounted for 18% of work place injuries in 1981 and 38% in 1987. It has been estimated that the number
of RSIs jumped 700% during the 1980s (Baker, 1991), with approximately one U.S. worker in 500 experiencing the disability (Hamilton, 1991). CTS is the most common complaint of people suffering from RSI; thus, many experts think that the increase was caused by automation, which requires the use of computers, and therefore, repetitive keyboard use and wrist movements. It has been
Results
The results are presented in Table 2. When asked if they had any of the symptoms of CTS or RSI such as numbness, tickling, pin & needles sensation, burning feeling, waking numbness during sleep, pain in elbow, pain in wrist, loss of dexterity or weak grip, 35 of the 40 (87.5%) interpreters said that they had experienced two or more symptoms at sometime (Question 1). When asked to rate the severity of the problem, more than one third 07.5%) stated that they had either moderate, bothersome, or severe problems (Question 2). Question 3, asking if the problem was prone to one's
estimated that 50% to 75% of all cases of RSI are CTS
(Squires, 1991). The 240,900 occupational illnesses reported in 1988 included 115,400 problems with RSIs, such as CTS (the most prevalent RSI), arthritis, tendinitis, and sprains (Kilborn, 1989). In groups who actively use repetitive wrist movements, the general population incidence of CTS of 1% can soar to 15%; the female/male ratio decreases from 3:1 to
dominant hand, produced data indicating that 65% of the
1.38:1; and average age decreases by 20 years, from 55 to 35 (Masear et al., 1986).
interpreters having problems had dominant hand problems. In contrast, only 5% had problems in the nondominant hand, and 25% had problems in both hands. When asked if the hand problems disappeared or subsided after resting
Method
Subjects We gathered information from 40 interpreters attending a regional Registry of Interpreters conference during August of 1990. Participation in the survey was voluntary. The respondents came from states in the Southeast. The sample cannot be construed as being randomly drawn or representative of any larger group. It can be maintained, however, that the sample is not homogeneous and does represent a variety of interpreters who translate in different circumstances. Some of the respondents were educational interpreters, some were legal interpreters, and some were freelance interpreters. The mean age of the group was 35.26 years, the mean number of years of signing experience was 17.36, and the mean number of years of interpreting experience was 10.51 years (Table 1). As might be expected, 90% of the sample
from interpreting, 67.5% said "yes" (Question 4). As might be expected, more than 77% said the problems returned after they resumed interpreting (Question 5).
The majority of interpreters in this sample (60%), had hobbies that require repetitive wrist movements (knitting,
needlepoint, sewing, etc) (Question 6). Several (12.5%) had missed worked due to repetitive motion problems (Question 7). More than one fourth (27.5%) had seen a doctor for
problems (Question 8), and 15% had received medical treatment (Question 9). Interestingly, 12.5% had CTS and had been misdiagnosed (Question 10). Half of the interpreters (50%) noticed problems most often when they did more fingerspelling than signing (Question 11). Slightly more of them reported problems when interpreting only (42.5%) than whenboth interpreting and signing (32.5%) (Question 12).
(36) was female and 10% was male.
Vol. 137, No. 1
AAD
41
Interpreter's Wrist
Table 2. Interpreters' Responses to Subjective Self-evaluation of Repetitive Stress Injuries
7. Have you ever missed work because of CTS
1. Which of these symptoms of CTS/RSI have you had?— numbness, tickling, "pin & needles" sensation, burning feeling, "sleeping" hand, waking numbness during sleep, pan in elbow, pain in wrist, loss of dexterity, weak grip.
symptoms? a) yes 5(12.5%) b) no 35 (87.5%)
35 of 40 (87.5%) people responded that they had two or more of these symptoms at some time.
8. Have you ever seen a doctor for CTS symptoms? a) yes 11 (27.5%) b) no 29 (72.5%)
2. How would you rate this problem? insignificant mild moderate bothersome severe 6(15%) 19(47.5%) 4(10%) 6(15%) 5(12.5%)
9. Have you ever received medical treatment for CTS? a) yes 6(15%) b) no 34 (85%)
3. Do you have these symptom(s) in— a) dominant hand? 26 (65%) b) nondominant? 2 (5%) c) both hands? 10(25%) d) not applicable/no response 2 (5%)
10. Have you ever been diagnosed for something else when you in fact had CTS? a) yes 5(12.5%) b) no 35 (87.5%)
4. Do the symptoms disappear/subside when you "rest" from Interpreting?
11. When do you notice the problem the most?
a) yes 27(67.5%) b)no 10(25%) c) not applicable/no response 3 (7.5%)
a) when doing proportionately more signing? 4 (10%) b) when doing proportionately more fingerspelling? 20 (50%) c) both 4(10%) d) not applicable/no response 12 (30%)
5. Do the symptoms reappear when resuming interpreting?
12. Do you have CTS problems when—
a) yes 31 (77.5%) b)no 4(10%) c) not applicable/no response 5 (12.5%)
a) signing? 2 (5%) b) Interpreting? 17(42.5%) c)both? 13(32.5%) d) not applicable/no response 8 (20%)
6. Do you have hobbies that use repetitive wrist movement?
a) yes 24(63.16%) b)no 16(36.84%)
13. How many interpreters do you know with CTS problems? Average (Mean) = 4.49
(average age of about 35) to encounter the problems associated with CTS, unless they were in occupationally atrisk groups for RSI. The number of respondents who had problems in their dominant hand was more than twice as high as the number who had problems in both hands. This pattern has been noted in other occupational groups prone to RSI (Masear et al., 1986). Similarly, a pattern in which the RSI symptom goes away (or diminishes) during inactivity (see Question 4) is common with other occupational workers (Masear et al, 1986).
The final question asked how many other interpreters they knew who seemed to have problems with CTS or RIS. On the average, they knew more than four other interpreters with such problems. Discussion
The data gathered and presented here indicate that RSI is a problem among sign language interpreters. CTS is most common in people in their 50s. However, the youth of interpreters indicates that the problems found in this sample were due to motion injury. It would be unusual for
Interestingly, 15% of the interpreters in my sample had been given medical treatment for CTS (Question 9). Masear
a group of people as young as the subjects in this study 42
AAD
Vol. 137, No. 1
Interpreter's Wrist
et al. (1986) also cited a figure of 15% when describing the incidence of medical treatment for a group of industrial workers at-risk for CTS. Sadly, some members of the group in my study (12.5%) had been misdiagnosed as not having should be. It must be pointed out here, however, that such injuries have only recently received attention, and some
creating technical signs (Caccamise et al., 1977); this knowledge should be employed rather than perpetuate risky conditions with constant fingerspelling. Perhaps the best solutions rest with the interpreters themselves. They must be able to refuse to work when they begin to manifest occupationally related problems. Employers need to realize that adequate rest periods are necessary even when there is a shortage of interpreters to
physicians are just becoming aware of them.
meet the need in a given area.
CTS when, in fact, they did have it. This may indicate that
some doctors are not as aware of CTS and RSI as they
Another problem is with fingerspelling. It seems that
The last problem that needs to be addressed here is that of health insurance. Often, interpreters do not qualify for the health insurance provided by their employers. In many situations, the interpreter is employed on a part-time basis (sometimes by more than one employer) and does not qualify for benefits. Even for those with health insurance, collecting compensation can be difficult (Hembree & Sandoval, 1991), because the damage caused by RSI is often hard to identify.
fingerspelling would put more stress on interpreters than would pure signing, because more wrist movement is involved in making a combination fingerspelled letters than is involved with making signs, which is comparatively slower (Stedt, 1989). Up-and-down movement of the wrist during repetitive activity increases the pressure within the wrist and increases CTS (Sebright, 1986). This movement is related to that of the wrist during fingerspelling. One-half of the my group reported that problems were more noticeable during fingerspelling, compared to only 10% who said they noticed the problem more when signing.
References
Baker, B. (1991, March 29). Repetitive motion injury on the rise experts say. Los Angeles Times, p. A-3. Caccamise, F., Bradley, C, Battison, R., Blasdell, R., Warren, K. N., & Hurwitz, T. (1977). A project for standardization and development of technical signs. American Annals oftheDeaf,
The last item on the survey asked the subjects how many other interpreters they knew with such motion problems. On average, they knew more than four. As pointed out earlier, the incidence of CTS can be as great as 15% in populations that are at high risk. Working backward from the information given, if the average interpreter in this study knew 30 interpreters, and 15% of them had motion injury problems, that interpreter would know 4.5 other interpreters with the problem. Logically, these figures for the incidence of RSI in sign language interpreters seem plausible; perhaps they are even conservative.
122, 44-49.
Feingold, M. H., Hiduegi, E., &Horwitz, S.J. 1980. Bilateral carpal
tunnel syndrome in an adolescent. 134, 394-396. Hamilton, M. M. (1991, July 3D. Thirty-one unions seek OSHA action on repetitive motion injuries. Washington Post, pp. Fl, F4. Hembree, D., & Sandoval, R. (1991, July-August). RSI has become the nation's leading work-related illness: How are reporters and editors coping with it? Columbia Journalism Review, pp. 41-46.
Conclusions
Kilborn, P. T. (1989, November 16). Workplace injury is rising, and the computer is blamed. The New York Times, p. 26. Masear, V. R, Hayes, J. M., & Hyde, A. G. (1986). An industrial
Based on the information given here, RSI deserves serious attention in the community of sign language users. No doubt, the incidence of RSI is gaining more attention in all industrial settings. In fact, CTS has been called the new "Industrial Epidemic" (Schenck, 1989). A variety of suggestions have been made to help reduce RSI, many of which are not applicable to sign language
cause of carpal tunnel syndrome. The Journal of Hand Surgery, 11, 222-227.
Schenck, R. R. (1989). Carpal tunnel syndrome: The new "Industrial Epidemic." American Association of Occupational Health Nurses Journal, 6, 226-231·
Sebright, J. A. (1986). Gloves, behavior changes can reduce carpal tunnel syndrome. Occupational Health and Safety, 55, (9),
interpreters. Sebright (1986) has suggested the use of
18- 21.
gloves or restraints that limit movement but at the same
Squires, S. (1991, July 9). The alarming rise in RSI. Washington Post Health Magazine, p.7. Stedt, J.D. (1989). Carpal Tunnel Syndrome: The risk to educa-
time allow "adequate dexterity." This is an interesting idea and could be the basis of future research. Several types of restraints are already available for people working in situations that can cause RSI. Currently, it is unknown whether any of the available restraints could be used during interpreting. Another idea is to reduce fingerspelling and
tional interpreters. American Annals oftheDeaf 134,223-226. Stix, G. (1991). Handful of pain: Pressure mounts to alleviate repetitive-motion injuries. Scientific American, 264, (5), 118-120.
use more signs (Stedt, 1989). Information is available for
Vol. 137, No. 1
AAD
43
For additional information about this article https://muse.jhu.edu/article/385097/summary
Access provided by University of South Dakota (17 Dec 2018 21:24 GMT)
Interpreter's Wrist Repetitive Stress Injury and Carpal Tunnel Syndrome in Sign Language Interpreters Joe D. Stedt
Forty interpreters attending a regional Registry of Interpreters for the Deaf conference completed a questionnaire regarding symptoms related to repetitive stress injury (RSI), a generic classification of problems that occur after extensive, repetitive motion. RSIs, including the most prevalent form, Carpal Tunnel Syndrome (CTS), were surveyed. The vast majority (87.5%) of the interpreters in the sample reported that they had at sometime experienced at least two symptoms associated with RSI. Some (12.5%) who had CTS reported that they had been misdiagnosed. When asked how many other interpreters they knew with RSI problems, they reported, on average, that they knew more than four others. The data indicate that RSI is a severe problem among sign language interpreters and warrants immediate action. The term interpreter's wrist may best describe the malady.
Carpal Tunnel Syndrome (CTS) has only recently been associated with sign language interpreters (Stedt, 1989). Described briefly, CTS is a problem that occurs within the space where the wrist bones narrow, the carpal tunnel. It was first described in the 1940s (Feingold, Hiduegi, & Horwitz, 1980) as a problem of abnormal sensations in the portions of the hand innervated by the medial nerve due to compression of the
the wrist, tenosynovitis, obesity, small wrist size, oral contraceptives, degenerative arthritis, rheumatoid arthritis, hypothyroidism, sarcoidosis, congenital defects, Paget's disease, pregnancy, diabetes mellitus, and water retention
nerve. The sensations include, but are not limited to,
numbness, tickling, pins and needles feelings, burning,
Perhaps the greatest cause of CTS, however, is occupations requiring consistent and repetitive wrist movements
waking numbness (when the hand wakes the afflicted
(Masear, Hayes, & Hyde, 1986). Recently, medical authori-
patient during sleep), and a feeling that the hand has fallen asleep for no apparent reason. Additionally, though less commonly, symptoms include pain in the elbow and/or wrist, weakened thumb and/or wrist movements, and finally, swelling in the volar section of the wrist. CTS has many suspected causes. Among them are previous wrist injuries, rubella, gout, calcium deposits in The author is an assistant professor of education and psychol-
ties and professionals concerned about the health of people in the work place have extended the scope of physical problems causedby excessive motion and grouped them into a generic category called repetitive stress injury (RSI). This category includes CTS, as well as several problems related to CTS such as tenosynovitis (inflamma-
due to the menstrual cycle.
Repetitive Stress Injuries
tion of affected tendons), DeQuewain's Syndrome (an inflammation of the thumb tendon), epicondylitis (tennis elbow), and sprains.
ogy at Cameron University in Lawton, Oklahoma. Previously,
RSI goes by many names including repetitive motion
he ivas a teacher at the Texas and California Schools for the deaf.
40
trauma injury, repetitive motion injury, repetitive stress
AAD
Vol. 137, No. 1
Interpreter's Wrist
illness, repetitive stress syndrome, cumulative trauma injury, and cumulative trauma disorder. Stix (1991) has pointed out that names for RSI have been created to
Table 1. Background Information on Interpreters
indicate their etiology. A worker ata supermarket may have
Λ/=40
pricer's palsy. A person working in a pickle factory who manually inserts the last pickle into the jar may have picklepusher's thumb. A child who has played video games too
Sex: 36 Females, 4 Males
Average Age = 35.26 years
long may encounter Nintendonitis (Stix, 1991). People
Average Signing Experience = 17.36 years
encountering problems from sign language interpreting are referred to as having interpreter's wrist.
Average Interpreting Experience = 10.51 years
These are not all new conditions; some have been diagnosed since as early as 1700 (Stix, 1991). However, a Procedure
Department of Labor report on occupational injuries and illnesses stated that they increased excessively over the last decade (Kilborn, 1989). Whereas such injuries now
The interpreters were asked to respond to questions about pain and symptoms that would indicate RSI due to sign language interpreting. The questionnaire was designed to ferret out some of the physical problems that could be produced by excessive interpreting. The text of the questionnaire appears in Table 2.
account for almost half (48%) of all work place injuries, they only accounted for 18% of work place injuries in 1981 and 38% in 1987. It has been estimated that the number
of RSIs jumped 700% during the 1980s (Baker, 1991), with approximately one U.S. worker in 500 experiencing the disability (Hamilton, 1991). CTS is the most common complaint of people suffering from RSI; thus, many experts think that the increase was caused by automation, which requires the use of computers, and therefore, repetitive keyboard use and wrist movements. It has been
Results
The results are presented in Table 2. When asked if they had any of the symptoms of CTS or RSI such as numbness, tickling, pin & needles sensation, burning feeling, waking numbness during sleep, pain in elbow, pain in wrist, loss of dexterity or weak grip, 35 of the 40 (87.5%) interpreters said that they had experienced two or more symptoms at sometime (Question 1). When asked to rate the severity of the problem, more than one third 07.5%) stated that they had either moderate, bothersome, or severe problems (Question 2). Question 3, asking if the problem was prone to one's
estimated that 50% to 75% of all cases of RSI are CTS
(Squires, 1991). The 240,900 occupational illnesses reported in 1988 included 115,400 problems with RSIs, such as CTS (the most prevalent RSI), arthritis, tendinitis, and sprains (Kilborn, 1989). In groups who actively use repetitive wrist movements, the general population incidence of CTS of 1% can soar to 15%; the female/male ratio decreases from 3:1 to
dominant hand, produced data indicating that 65% of the
1.38:1; and average age decreases by 20 years, from 55 to 35 (Masear et al., 1986).
interpreters having problems had dominant hand problems. In contrast, only 5% had problems in the nondominant hand, and 25% had problems in both hands. When asked if the hand problems disappeared or subsided after resting
Method
Subjects We gathered information from 40 interpreters attending a regional Registry of Interpreters conference during August of 1990. Participation in the survey was voluntary. The respondents came from states in the Southeast. The sample cannot be construed as being randomly drawn or representative of any larger group. It can be maintained, however, that the sample is not homogeneous and does represent a variety of interpreters who translate in different circumstances. Some of the respondents were educational interpreters, some were legal interpreters, and some were freelance interpreters. The mean age of the group was 35.26 years, the mean number of years of signing experience was 17.36, and the mean number of years of interpreting experience was 10.51 years (Table 1). As might be expected, 90% of the sample
from interpreting, 67.5% said "yes" (Question 4). As might be expected, more than 77% said the problems returned after they resumed interpreting (Question 5).
The majority of interpreters in this sample (60%), had hobbies that require repetitive wrist movements (knitting,
needlepoint, sewing, etc) (Question 6). Several (12.5%) had missed worked due to repetitive motion problems (Question 7). More than one fourth (27.5%) had seen a doctor for
problems (Question 8), and 15% had received medical treatment (Question 9). Interestingly, 12.5% had CTS and had been misdiagnosed (Question 10). Half of the interpreters (50%) noticed problems most often when they did more fingerspelling than signing (Question 11). Slightly more of them reported problems when interpreting only (42.5%) than whenboth interpreting and signing (32.5%) (Question 12).
(36) was female and 10% was male.
Vol. 137, No. 1
AAD
41
Interpreter's Wrist
Table 2. Interpreters' Responses to Subjective Self-evaluation of Repetitive Stress Injuries
7. Have you ever missed work because of CTS
1. Which of these symptoms of CTS/RSI have you had?— numbness, tickling, "pin & needles" sensation, burning feeling, "sleeping" hand, waking numbness during sleep, pan in elbow, pain in wrist, loss of dexterity, weak grip.
symptoms? a) yes 5(12.5%) b) no 35 (87.5%)
35 of 40 (87.5%) people responded that they had two or more of these symptoms at some time.
8. Have you ever seen a doctor for CTS symptoms? a) yes 11 (27.5%) b) no 29 (72.5%)
2. How would you rate this problem? insignificant mild moderate bothersome severe 6(15%) 19(47.5%) 4(10%) 6(15%) 5(12.5%)
9. Have you ever received medical treatment for CTS? a) yes 6(15%) b) no 34 (85%)
3. Do you have these symptom(s) in— a) dominant hand? 26 (65%) b) nondominant? 2 (5%) c) both hands? 10(25%) d) not applicable/no response 2 (5%)
10. Have you ever been diagnosed for something else when you in fact had CTS? a) yes 5(12.5%) b) no 35 (87.5%)
4. Do the symptoms disappear/subside when you "rest" from Interpreting?
11. When do you notice the problem the most?
a) yes 27(67.5%) b)no 10(25%) c) not applicable/no response 3 (7.5%)
a) when doing proportionately more signing? 4 (10%) b) when doing proportionately more fingerspelling? 20 (50%) c) both 4(10%) d) not applicable/no response 12 (30%)
5. Do the symptoms reappear when resuming interpreting?
12. Do you have CTS problems when—
a) yes 31 (77.5%) b)no 4(10%) c) not applicable/no response 5 (12.5%)
a) signing? 2 (5%) b) Interpreting? 17(42.5%) c)both? 13(32.5%) d) not applicable/no response 8 (20%)
6. Do you have hobbies that use repetitive wrist movement?
a) yes 24(63.16%) b)no 16(36.84%)
13. How many interpreters do you know with CTS problems? Average (Mean) = 4.49
(average age of about 35) to encounter the problems associated with CTS, unless they were in occupationally atrisk groups for RSI. The number of respondents who had problems in their dominant hand was more than twice as high as the number who had problems in both hands. This pattern has been noted in other occupational groups prone to RSI (Masear et al., 1986). Similarly, a pattern in which the RSI symptom goes away (or diminishes) during inactivity (see Question 4) is common with other occupational workers (Masear et al, 1986).
The final question asked how many other interpreters they knew who seemed to have problems with CTS or RIS. On the average, they knew more than four other interpreters with such problems. Discussion
The data gathered and presented here indicate that RSI is a problem among sign language interpreters. CTS is most common in people in their 50s. However, the youth of interpreters indicates that the problems found in this sample were due to motion injury. It would be unusual for
Interestingly, 15% of the interpreters in my sample had been given medical treatment for CTS (Question 9). Masear
a group of people as young as the subjects in this study 42
AAD
Vol. 137, No. 1
Interpreter's Wrist
et al. (1986) also cited a figure of 15% when describing the incidence of medical treatment for a group of industrial workers at-risk for CTS. Sadly, some members of the group in my study (12.5%) had been misdiagnosed as not having should be. It must be pointed out here, however, that such injuries have only recently received attention, and some
creating technical signs (Caccamise et al., 1977); this knowledge should be employed rather than perpetuate risky conditions with constant fingerspelling. Perhaps the best solutions rest with the interpreters themselves. They must be able to refuse to work when they begin to manifest occupationally related problems. Employers need to realize that adequate rest periods are necessary even when there is a shortage of interpreters to
physicians are just becoming aware of them.
meet the need in a given area.
CTS when, in fact, they did have it. This may indicate that
some doctors are not as aware of CTS and RSI as they
Another problem is with fingerspelling. It seems that
The last problem that needs to be addressed here is that of health insurance. Often, interpreters do not qualify for the health insurance provided by their employers. In many situations, the interpreter is employed on a part-time basis (sometimes by more than one employer) and does not qualify for benefits. Even for those with health insurance, collecting compensation can be difficult (Hembree & Sandoval, 1991), because the damage caused by RSI is often hard to identify.
fingerspelling would put more stress on interpreters than would pure signing, because more wrist movement is involved in making a combination fingerspelled letters than is involved with making signs, which is comparatively slower (Stedt, 1989). Up-and-down movement of the wrist during repetitive activity increases the pressure within the wrist and increases CTS (Sebright, 1986). This movement is related to that of the wrist during fingerspelling. One-half of the my group reported that problems were more noticeable during fingerspelling, compared to only 10% who said they noticed the problem more when signing.
References
Baker, B. (1991, March 29). Repetitive motion injury on the rise experts say. Los Angeles Times, p. A-3. Caccamise, F., Bradley, C, Battison, R., Blasdell, R., Warren, K. N., & Hurwitz, T. (1977). A project for standardization and development of technical signs. American Annals oftheDeaf,
The last item on the survey asked the subjects how many other interpreters they knew with such motion problems. On average, they knew more than four. As pointed out earlier, the incidence of CTS can be as great as 15% in populations that are at high risk. Working backward from the information given, if the average interpreter in this study knew 30 interpreters, and 15% of them had motion injury problems, that interpreter would know 4.5 other interpreters with the problem. Logically, these figures for the incidence of RSI in sign language interpreters seem plausible; perhaps they are even conservative.
122, 44-49.
Feingold, M. H., Hiduegi, E., &Horwitz, S.J. 1980. Bilateral carpal
tunnel syndrome in an adolescent. 134, 394-396. Hamilton, M. M. (1991, July 3D. Thirty-one unions seek OSHA action on repetitive motion injuries. Washington Post, pp. Fl, F4. Hembree, D., & Sandoval, R. (1991, July-August). RSI has become the nation's leading work-related illness: How are reporters and editors coping with it? Columbia Journalism Review, pp. 41-46.
Conclusions
Kilborn, P. T. (1989, November 16). Workplace injury is rising, and the computer is blamed. The New York Times, p. 26. Masear, V. R, Hayes, J. M., & Hyde, A. G. (1986). An industrial
Based on the information given here, RSI deserves serious attention in the community of sign language users. No doubt, the incidence of RSI is gaining more attention in all industrial settings. In fact, CTS has been called the new "Industrial Epidemic" (Schenck, 1989). A variety of suggestions have been made to help reduce RSI, many of which are not applicable to sign language
cause of carpal tunnel syndrome. The Journal of Hand Surgery, 11, 222-227.
Schenck, R. R. (1989). Carpal tunnel syndrome: The new "Industrial Epidemic." American Association of Occupational Health Nurses Journal, 6, 226-231·
Sebright, J. A. (1986). Gloves, behavior changes can reduce carpal tunnel syndrome. Occupational Health and Safety, 55, (9),
interpreters. Sebright (1986) has suggested the use of
18- 21.
gloves or restraints that limit movement but at the same
Squires, S. (1991, July 9). The alarming rise in RSI. Washington Post Health Magazine, p.7. Stedt, J.D. (1989). Carpal Tunnel Syndrome: The risk to educa-
time allow "adequate dexterity." This is an interesting idea and could be the basis of future research. Several types of restraints are already available for people working in situations that can cause RSI. Currently, it is unknown whether any of the available restraints could be used during interpreting. Another idea is to reduce fingerspelling and
tional interpreters. American Annals oftheDeaf 134,223-226. Stix, G. (1991). Handful of pain: Pressure mounts to alleviate repetitive-motion injuries. Scientific American, 264, (5), 118-120.
use more signs (Stedt, 1989). Information is available for
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