Inclusivity

We ask all those who work or have worked in a wet lab; what would your life look like if something happened to your hands?

Purpose

We ask all those who work or have worked in a wet lab; what would your life look like if something happened to your hands?

Synthetic biology was created and is continuously explored through the hands of wet lab members. Their contributions of spending long hours working with their hands push forward innovation in this field.

For many, working in a wet lab is a source of community, fulfillment, passion, opportunity, as well as a source of income and livelihood. Without the use of their hands, wet lab members may be at risk of losing their community and livelihood. A career they built up for many years can be taken from them in a moment. They can now no longer participate in the same manner in projects that they are incredibly passionate in, and lose the community that they found within their labs. Wet lab work ultimately was what started iGEM, and brought our global community together.

As well, entry level opportunities become harder to come by for new members of the life science community. Most peoples’ first opportunities to gain work experience in life science are lab opportunities where one mainly does repetitive manual labor for another person’s project. The inability to use your hands would block one from building experiences, preventing a person from building up their resume.

Fundamentally, the use of your hands is a requirement for working in the vast majority of wet labs. A single accident, injury or disease could lead to someone being unable to work in a wet lab, which can be a huge loss in their life.

Unfortunately, working in a wet lab, performing those repetitive, straining procedures, can be what leads to the development of musculoskeletal disorders, also known as MSK disorders. Many people experience wrist, hand or arm pain, which can later develop into these disorders. Our aim with the Inclusive Lab Space aim is to design a tool that can be attached onto a pipette, which would ensure easier use for those who have MSK disorders. This project then will not only allow people who never had the chance of working in wet labs due to their MSK disorders to be able to participate, but also ensure that wet lab members in our global iGEM community who develop MSK disorders are able to stay in the lab, working on their passions with their community.

What are MSK disorders?

Across many occupations, musculoskeletal (MSK) disorders of the hand and wrist cause limiting pain and stress for individuals with conditions such as arise osteoarthritis, carpal tunnel syndrome, and repetitive injury ([1]). In the healthcare sector, 90% of physiotherapists and 78% of nurses experience MSK disorders in the lower back, neck and shoulders, respectively. But this is ubiquitous among a diverse set of careers: 38.5-100% of handicraft workers, 77% of farmers and up to 86% of catering staff are subject to having and/or developing some sort of musculoskeletal disorder, raising significant economic and health challenges for these individuals, making it important to evaluate what causes WMSDs and thereby, how they can be mitigated ([1]). According to a systematic review of the current epidemiological causes of work-related MSK disorders, there are multiple independent lines of evidence suggesting a causality between work-related MSK disorders and the following: disorders of the hand/wrist, repetitive and/or prolonged and forceful use of hands in demanding tasks, nerve and/or muscle damage ([2]).

Studies looking at hand/wrist stressors have observed pathophysiological and anatomical changes that highlight the roots of the MSK disorders discomfort. A study analyzing the ECRB tendon of patients with lateral epicondylitis, the painful swelling of arm tendons, found that there was a significantly higher amount of glutamate in their tendon compared to those without this disorder, by 32% (p<0.001) ([3]). Being a mediator of pain, glutamate up-regulation along with other pathophysiological factors such as increased fibroblast concentration (mediating pain), collagen disruption (excess friction between joints), and vascular hyperplasia (the thickening of blood vessel walls as a response to inflammation) are the aftermath of hand/wrist strain ([4]).

More specifically, repetitive use and/or overuse of hands, prolonged wrist extension, and extensive gripping are risk factors for these disorders as they cause deterioration of the lubricating sheath in the ECRB tendon (synovial tendon sheaths) ([5]). This is consistent with a study that observed the effect of repetitive tasks on rats and found increasing muscle inflammation and strain after three weeks of repetition ([6]). As for glutamate up-regulation in tendons, it is also seen across other WMSDs such as osteoarthritis with the PTT tendon (p=0.03) ([7]). Stimulating work-related factors pain-inducing disorders such as tendonitis, epicondylitis, CTS and De Quervain’s disease have been amalgamated by the Canadian Centre for Occupational Health and Safety (CCOHS) to be the following: repetitive wrist motion, prolonged arm extension, repetitive/forceful forearm rotation and wrist bending (epicondylitis), strong gripping and mechanical stress on the palm (CTS). Within the workplace, individuals may experience these symptoms and recover through rest and other forms of therapies, but repeated exposure to straining tasks that caused the onset of their symptoms can lead to chronic WMSD which is common in occupational settings ([5]). A study that investigated the effect of repeated strain on rats over a six-week period found a 62% decrease in muscle mass, an expansion of noncractile tissue by 87% which speaks to the stiffening of muscles and an 87% reduction in myofiber areas that are involved with tissue flexibility ([8]). This, along with aforementioned lines of evidence further exemplify the importance of reducing forceful and repetitive movements in occupational settings when it may be unrealistic to temporarily dismiss someone from their work.

Moreover, musculoskeletal pain can also caused by nerve damage, with one of the most common disorders of which being carpal tunnel syndrome (CTS). Carpel Tunnel Syndrome is when the tendons surrounding the median nerve swell, causing pressure to the nerve which leads to the symptoms of pain, numbness, tingling, and burning sensations ([5]). There are many candidates for causing Carpal tunnel syndrome, and although there is no uniform consensus in the literature regarding its cause, the compression of the median nerve due to mechanical forces in the carpal tunnel content is widely accepted as being a risk factor ([9]). Bending the wrist in light of median nerve strain can disable the thumb and first two fingers from freely moving and cause numbness and pain in the hand ([10]). Such forces lead to tendonitis (tendon swelling) in the carpal tunnel, as a study has found a significant increase in the thickness of synovial sheaths that encompass flexer tendons inside this tunnel, suggesting inflammation ([5]).

This shows that work-related MSK disorders can also be linked, with the onset of symptoms for one disorder trickling into another and eventually amplifying the discomfort felt by the individual. From a biomechanical standpoint, the American Association of Neurological Surgeons adds that the painful, tingling sensations associated with CTS are exaggerated when the wrist is bent forward which is important in the design of work tools accessible to these individuals in addition to the aforementioned stimulants ([11]).

In addition, musculoskeletal strain can also caused by nerve and muscle damage, including but not limited to upper-limb osteoarthritis and rheumatory arthritis ([5]). According to the Arthritis Society of Canada, 20% of the Canadian population over the age of 15 has some form of arthritis ([12]) and out of this population, around 40% of them experience a pain severe enough to limit their daily activities ([13]). Osteoarthritis, specifically, is a limiting disorder that causes stiffness, swelling and pain in the joints because of the cartilage inside the joints breaking down ([14]). Individuals with osteoarthritis face mobility issues and reduced gripping force which greatly affect their day-to-day lives ([15]). Rheumatory arthritis is an autoimmune disorder in which the joints are spontaneously attacked by the immune system, causing swelling, numbing and pain. Similar to other WMSDs, it is important to consider these limitations in the design of workplace tools and equipment, advocated for by the Canadian Centre for Occupational Health and Safety ([5]). Repetitive tasks, overuse of joints and awkward posture worsens arthritis symptoms, making the development of ergonomics that immobilize involved joints and encourage good posture important ([16]).

Despite there being a modest array of research regarding generic work-related arm/hand strains, there is a gap regarding researchers’ experience with such strains in the lab space as well as adaptations of heavily-used lab tools that meet the needs of individuals with WMSDs ([5]). Past research has suggested a correlation between pipette handling and work-related MSK disorders. As supported by worked performed by the University of Pittsburgh, handling a micropipette for at least two hours per day for a 50-week work year, could cause discomfort in musculoskeletal areas ([17]). This link is supported by a seperate study that found undergoing repetitive movements for minimum two hours on a daily basis could cause lateral epicondylitis, placing even more restrain on the ECRB tendon fundamental to wrist movement and extension([4]).

Understanding the specific ways in which this discomfort is exemplified by pipettes specifically paves the way for targeted ergonomics in a fundamental aspect of lab work, making this the primary objective of this study. And even further, designing a micropipette add-on to minimize those risks is crucial in reducing the potential arm/hand restraints caused by repetitive pipette handling.

How do MSK disorders relate to inclusivity?

Some of you might be thinking to yourself, “I also get wrist pain which impacts my ability to perform wet lab tasks, but I’m not disabled.” There is a common misunderstanding that comes with inclusive designs; inclusive designs are only built for those who identify as disabled, which is not at always the case. Everyone has differing degrees of ability, and there are individuals who aren’t defined by society as disabled or they themselves don’t label themselves as disabled, however certain aspects regarding the way things operate in society would cause barriers. This is the social model of disability. The way in which disability is defined has recently shifted from the biomedical to a social model. No longer is disability defined as a personal health condition, but rather there is now more recognition that disability is a mismatch in how a person is able to interact with society. What we mean by that is designs in society are made for the consideration of the majority. However it won’t work for everyone, and it might not work for some people one day when the other day it worked fine. Although some people may not consider themselves disabled, struggling with pain and discomfort due to the design of the pipette impacts the way they can interact in society and affects their ability to perform wet lab tasks. By understanding this broader definition of inclusivity, we can better understand the broad directions one can take when improving inclusivity.

Because disability isn’t what you see but how a person interacts with the world, there are many ways that a person gets excluded without the immediate awareness of others. Chronic, pain related disabilities have a massive impact on how a person is able to interact with society, often having varying abilities day by day, or hour by hour. However other’s might not always think about the other person, making assumptions about a person’s character when a person’s disability prevents them from performing specific tasks. This problem is worsened by the fact that many hide their condition due to the fear of it affecting employment. By creating a tool that is meant for those with an invisible condition, we hope to also raise awareness and teach the iGEM community about different ways people can be excluded, while also tackling a potential solution.

Our efforts in making the invisible MSK disorders, visible

Many wet lab members may not be aware of all the risk factors of overworking their wrists. Therefore, knowing that our Instagram is followed by many that are interested in wet lab, we posted the following posts to bring educate and bring awareness to different MSK disorders. Working with the design team, they drew the medical figures found in the posts, and created the Instagram posts.

Inclusivity Page Order:

Understanding our User’s Needs

Fine-tuning our Understanding

Iterative DBTL Cycles

Project Outcomes

Alternative Inclusive design projects

Best Practices for Inclusive Design Project

Additional Inclusivity Page:

Inclusive Perspective