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JPE was individually measured and quantified using the Strain Index (SI) and TLV for HAL. Worker demographics, medical history, psychosocial factors, and current musculoskeletal disorders were obtained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010six workers developed LE. In multivariate models JPE, age, family problems, and swimming were associated with increased risk of LE. SI showed an exposure\u2010response relationship with maximum hazard ratio (HR) of 4.5(<jats:italic>P<\/jats:italic>\u2009=\u20090.04). TLV for HAL showed a non\u2010statistically significant trend for increased risk of LE (<jats:italic>P<\/jats:italic>\u2009=\u20090.19).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>JPE is associated with increased risk of LE. The SI and TLV for HAL are useful metrics for estimating JPE. Am. J. Ind. 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