A comparison was made of occupational and personal, nonoccupational risk factors for carpal tunnel syndrome (CTS). Data from the 1988 National Health Interview Survey, Occupational Health Supplement were analyzed. A total of 441 of the 30,074 recent workers surveyed met the definition of self reported (SR) CTS for a prevalence of 1.5%. A total of 145 met the definitions of both self reported and medically called (MC) CTS. A significantly higher prevalence of both SR and MC CTS was seen in subjects exposed to bending/twisting of the hands/wrists or use of vibrating hand tools. Other risk factors including being female, white, and 35 to 54 years of age. The prevalence of both SR and MC CTS was also significantly higher in people with a body mass index of 25 or more and in those with higher levels of education and income. Among smokers, the highest prevalence of CTS was seen in past smokers. Logistic regression demonstrated that bend/twisting of the hands/wrists and white race had the highest adjusted odds ratios followed by gender, body mass index, and exposure to vibration. The authors conclude that, although both occupational and nonoccupational factors are associated with self reported CTS, hand/wrist positions and the use of vibrating tools are important risk factors for work related CTS.