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A total of 574 active workers from six different industrial sites were categorised into four force repetitive exposure groups. Workers in low force-low repetitive jobs served as an internal comparison population for the three other groups. Videotapes and surface electromyography were used to estimate hand force and repetitiveness. The presence of cumulative trauma disorders (CTD) was determined by structured interview and standardised non-invasive physical examination. Only workers who had been working on the study jobs for at least one year at the time of evaluation were eligible for selection. Categorisation of jobs and identification of CTDs were carried out independently by investigators who were appropriately blinded to exposure and outcome. The analysis of associations between CTDs and exposure categories were performed using Mantel-Haenszel plant adjusted odds ratios and unconditional multiple logistic regression. Significant positive associations were observed between hand wrist CTDs and high force-high repetitive jobs. These associations were independent of age, sex, years on the specific job, and plant.