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There are several questionnaires and observational measurement tools to quantify distal upper limb (DUL) physical exposures. Perhaps the most commonly used observational methods are the Strain Index (SI) and the ACGIH TLV for HAL. However, there is currently no ”gold standard” observational tool.Data from recently conducted prospective cohort studies of DUL musculoskeletal disorders (MSDs) were used to compare the SI, TLV for HAL, and the newly developed Revised Strain Index (RSI). A total of 3647 tasks performed by 710 workers were evaluated. When a tool lacked specific guidance, generally accepted techniques (e.g., time-weighted-averaging) were used to handle task complexity and multi-task jobs.the SI, RSI, and TLV for HAL provide inconsistent estimates of physical exposure and predicted risk of DUL MSDs. Correlations and weighted kappa scores between the model’s ranged from poor to good (e.g., weighted-kappa range: 0.16 to 0.82).Neither the TLV for HAL nor the SI were designed to assess multi-task jobs with complex tasks; whereas the RSI was. Assumptions made in order to use the SI and TLV for HAL for complex and multi-task analysis may contribute to the large differences between their physical exposure estimates. In this regard the RSI would appear to be a superior tool and one that has promising utility, at least for design and ergonomics intervention of complex and multi-task jobs. However, more research is needed to establish a ”gold standard” DUL observational measurement tool.