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Nested case-control study of hand and wrist work-related musculoskeletal disorders in carpenters.

Atterbury-MR; Limke-JC; Lemasters-GK; Li-Y; Forrester-C; Stinson-R; Applegate-H
Am J Ind Med 1996 Dec; 30(6):695-701
The results of a work related musculoskeletal injury (WMI) symptom questionnaire, administered to unionized carpenters, were compared with symptomatic carpenters who met a hand and/or wrist work related WMI case definition identified through physical examination and electrodiagnostic findings, to determine if questionnaire symptom data could be used to estimate the prevalence of hand or wrist WMIs. A total of 522 unionized carpenters were randomly selected to be interviewed by telephone. Question topics included work history, psychosocial factors, medical conditions prior to the WMI, and pain or other symptoms in their neck, shoulders, hand, wrists, back, and legs. Hand and/or wrist problems were classified as WMIs if they occurred during the past year, started while working as a carpenter, occurred once a month or lasted at least one week, the carpenter had no history of injury, and the pain was moderate to severe. Of the carpenters with symptoms, 25 underwent physical examination and nerve conduction testing by physicians. A previous history of carpal tunnel syndrome (CTS) was significantly increased among symptomatic cases (36%) compared with controls. Symptoms reported by 25 carpenters included bilateral symptoms (72%), numbness or tingling (92%), pain/aching (56%), burning (24%), and fingers turning white or blue (8%). Physical examination found that five (20%) symptomatic cases and four (11.4%) control carpenters had wrist tendinitis; Phalen's test was positive in nine (36%) cases and two (6%) controls; Tinel's test was positive in seven (28%) cases and three (9%) controls; and CTS was significantly increased in cases compared with controls. Mean median sensory and motor distal latencies were significantly longer and median sensory amplitude significantly smaller in cases compared to controls. The prevalence of mononeuropathy among cases was 78%, and 34% among controls. The authors conclude that because 78% of the carpenters with hand or wrist WMI defined by symptom questionnaire showed nerve conduction studies consistent with CTS, telephone interviews are useful in estimating the prevalence of CTS among carpenters.
NIOSH-Publication; NIOSH-Cooperative-Agreement; Musculoskeletal-system; Woodworkers; Carpal-tunnel-syndrome; Musculoskeletal-system-disorders; Questionnaires; Construction-workers; Hand-injuries; Occupational-hazards; Humans; Woodworking-industry
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Journal Article
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American Journal of Industrial Medicine