Serum creatine kinase as an indicator of local muscular strain in experimental and occupational work.

Serum creatine kinase (SCK) was measured in ten subjects in the laboratory before and after the performance of bicycle ergometry and a lifting task. SCK was significantly increased 24 h and 48 h after the lifting work but not after the bicycle ergometry, although the work performed on the latter was four-times as great as on the former. The lifting work resulted in muscle pain and tenderness and, for six subjects, in clinical signs of shoulder tendinitis. In a field study, an increase in SCK was noted among assemblers/welders and cash-register operators, but not among controllers and forklift-truck drivers. A health interview revealed that musculo-skeletal complaints were most often located in the upper extremity in the cases of the assemblers/welders and the cash-register operators. It is proposed that the SCK increase during work is a result of a high local muscular load due to fatigue and energy depletion of muscle cells producing a greater efflux of muscle enzymes. The evaluation of SCK changes during work may be an important tool in occupational health for early detection of work tasks producing local muscular strain.