Risk factors for carpal tunnel syndrome in a general population.
Nordstrom-DL; Vierkant-RA; DeStefano-F; Layde-PM
Occup Environ Med 1997 Oct; 54(10):734-740
A case control study of carpal tunnel syndrome (CTS) in a community population was presented in which both work exposure and nonexposure were assessed. The Marshfield Epidemiological Study Area is a catchment with about 55,000 residents in 14 contiguous US postal ZIP codes in Wisconsin, USA. Study cases included men and women aged 18 to 69 with newly diagnosed CTS, accounting for 206 persons out of 248 eligible to be included in the study. Telephone interviews and reviews of medical records obtained height and weight, medical history, average daily hours of exposure to selected physical and organizational work factors, and self ratings based on psychosocial work scales. The relation between body mass index (BMI) and CTS was very strong. For each increase of one unit of BMI, which for an average sized adult is about 6 pounds, risk of CTS increased by 8%. In the current study 40% of those using power tools or machinery at work reported the tool to be a drill or saw, but there was no clear difference between controls and study cases with regard to tool use and CTS. The opportunity to find a dose response effect of self reported hours of hand bending in this study occurred as well. The results indicate that either hand motion alone is not sufficient as a cause of CTS or the induction period of the disease exceeds 12 months. High repetition was more of a risk factor for CTS than high force. The association between keyboard use and musculoskeletal disorders reported in other studies was not confirmed in these findings. This is the first reported finding of an association between job control and CTS. Of the eight risk factors identified, those which seem to have a causal relation to CTS based on statistical and biological evidence are body mass index, use of power tools or machinery, and repetitive hand bending.
NIOSH-Publication; NIOSH-Cooperative-Agreement; Musculoskeletal-system-disorders; Occupational-exposure; Epidemiology; Posture; Repetitive-work; Carpal-tunnel-syndrome; Skeletal-system; Equipment-operators; Power-tools; Office-workers
Occupational and Environmental Medicine
Marshfield Medical Research & Education Foundation