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Little systematic research on musculoskeletal disorders has been conducted in this occupational group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 3995 active members of the Brotherhood of Maintenance of Way Employes Division (BMWED) completed a standardized survey focusing on disorders caused by hand\u2010transmitted vibration. We computed adjusted prevalence ratios (aPRs) using Poisson regression for shoulder, elbow, carpal tunnel syndrome, and vibration white finger musculoskeletal symptoms by work exposures, adjusted for age, region, race\/ethnicity, smoking, potential second job, and spare time vehicle vibration exposure, and other work exposures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among active male BMWED members, we found associations between &gt;5.2 years (vs. 0.0\u20130.7 years) duration of full\u2010time equivalent power tool use and shoulder pain (aPR\u2009=\u20092.01; 95% confidence interval [CI], 1.43\u20132.85), elbow pain (aPR\u2009=\u20092.88; 95% CI, 1.86\u20134.46), vibration white finger symptoms (aPR\u2009=\u20092.49; 95% CI, 1.06\u20135.85), hand\/wrist pain (aPR\u2009=\u20092.40; 95% CI, 1.74\u20133.32), finger numbness or tingling (aPR\u2009=\u20091.86; 95% CI, 1.38\u20132.50) and self\u2010reported carpal tunnel syndrome diagnosis (aPR\u2009=\u20092.16; 95% CI, 1.24\u20133.77). Associations were not consistent across outcomes for the duration of non\u2010powered hand tool use and \u201crepeated lifting, pushing, pulling, or bending.\u201d Positive gradients were observed for most outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hand\u2010arm vibration and some other biomechanical exposures were associated with shoulder, elbow, wrist, hand, and finger symptoms. Prevention programs should address occupational risk factors for upper extremity musculoskeletal disorders among MOW workers.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajim.23259","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T02:05:48Z","timestamp":1623722748000},"page":"744-757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Upper extremity musculoskeletal disorders and work exposures among railroad maintenance\u2010of\u2010way workers"],"prefix":"10.1002","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4066-566X","authenticated-orcid":false,"given":"Paul","family":"Landsbergis","sequence":"first","affiliation":[{"name":"Downstate School of Public Health State University of New York (SUNY)  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7066-5241","authenticated-orcid":false,"given":"Eckardt","family":"Johanning","sequence":"additional","affiliation":[{"name":"Department of Medicine, Center for Family and Community Medicine Columbia University  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8426-9677","authenticated-orcid":false,"given":"Marco","family":"Stillo","sequence":"additional","affiliation":[{"name":"Downstate School of Public Health State University of New York (SUNY)  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Jain","sequence":"additional","affiliation":[{"name":"Downstate School of Public Health State University of New York (SUNY)  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Davis","sequence":"additional","affiliation":[{"name":"Downstate School of Public Health State University of New York (SUNY)  Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0000000000001614"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.23099"},{"volume-title":"The Railroad. 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