Occupational factors and carpal tunnel syndrome.
Silverstein BA; Fine LJ; Armstrong TJ
Am J Ind Med 1987 Mar; 11(3):343-358
A cross sectional investigation was performed to determine if forceful and repetitive job attributes were positively associated with symptoms and physical signs of carpal tunnel syndrome (CTS). The prevalence of CTS was estimated among 652 active workers in 39 jobs from seven industrial sites whose jobs were categorized according to specific hand force and repetitiveness characteristics: low force/low repetitive (LOF/LOR); high force/low repetitive (HIF/LOR); low force/high repetitive (LOF/HIR); high force/high repetitive (HIF/HIR). Fourteen cases of CTS were identified on physical examination and interview; these were distributed over 11 of the 39 jobs. On interview the prevalence of CTS varied from 1.3 percent in the LOF/LOR category to 9.6 percent in the HIF/HIR category. On physical examination and interview, prevalence ranged from 0.6 percent in the LOF/LOR category to 5.6 percent in the HIF/HIR category. Logistic regression analysis suggested that CTS was not significantly associated with gender or facility on physical examination and interview. In the HIF/HIR group, the risk of CTS on physical examination and interview was more than 15 times that of the LOF/LOR group. Force seemed to be a less important risk factor than repetitiveness. There was confounding between HIF/HIR and vibration. When postural variables were entered into the logistic regression models, they were not significant predictors. The authors conclude that HIF/HIR and to a lesser extent high repetitiveness alone are strongly associated with CTS.
NIOSH-Publication; NIOSH-Contract; Contract-200-82-2507; Nervous-system-disorders; Occupational-exposure; Extremities; Posture; Vibration-exposure; Clinical-symptoms; Electrical-measurement; Medical-examinations; Carpal-tunnel-syndrome; Cumulative-trauma-disorders;
Author Keywords: repetitive trauma; Carpel tunnel syndrome; nerve entrapment
Barbara A. Silverstein, PhD, Department of Environmental and Industrial Health, University of Michigan, Ann Arbor, MI 48109
Musculoskeletal System Disorders
American Journal of Industrial Medicine
The University of Michigan, Ann Arbor, Michigan