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Prevalence and work-relatedness of self-reported carpal tunnel syndrome (CTS) among U.S. workers - an analysis of 1988 National Health Interviews Survey, Occupational Health Supplement.

Tanaka-S; Wild-DK; Seligman-P; Behrens-V; Putz-Anderson-V
Proceedings of the 9th international symposium on epidemiology in occupational health. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 94-112, 1994 Jan; :463-464
Since the mid-1980's the Bureau of Labor Statistics has reported a sharp increase in incidence of repetitive trauma injuries or cumulative trauma disorders (CTDs) among U.S. workers. To estimate the magnitude of self-reported carpal tunnel syndrome (CTS) nationally, data from the Occupational Health supplement of 1988 National Health Interview Survey (NHIS) were analyzed. Among 127 million "current workers" (those who worked during the 12 months prior to the survey), the prevalence rate for self-reported CTS was 1.47% {95% C.I. 1.30 - 1.65}. The demographics and work-relatedness of self-reported CTS are described for this subset of 1.62 million "current workers" who reported CTS and experienced hand discomfort for one or more days. The prevalence rate of CTS was 1.63% for female {95% C.I. 1.39% - 1.87%} and 0.97% for male {95% C.I. 0.77% - 1.18%}. The female/male rate ratio for CTS was 1.7. The median age among those reporting CTS was 40 for female and 38 for male, while among those not reporting CTS, it was 39 and 37 respectively. Occupational categories with the highest prevalence rates of self-reported CTS were: 1) mail and message distributing (3.24%), 2) health assessment and treatment (2.74%), 3) construction and extractive trades (2.49%), and 4) fabricators, assemblers, and inspectors (2.44%). Industrial categories with the highest prevalence rates were: 1) manufacturing of food and kindred products (2.46%), 2) repair services (2.40%), 3) transportation industry (excluding railroad and trucking) (2.34%), 4) construction (2.1%), and 5) manufacturing of transportation equipment (mostly automobile) (2.08%). Among individuals who report repetitive bending or twisting of the hand and wrists at work, 2.01 % {95% C.I.1.72-2.30} reported CTS, compared to 0.55% {95% C.I. 0.42 - 0.68} of those without such exposure (rate ratio: 3.7). Among those who used vibrating tools, 2.03% {95% C.I. 1.50-2.56) reported CTS, while 1.11 % {95% C.I. 0.95 - 1.27} of those who did not use Vibrating tools reported CTS (rate ratio: 1.8). When the combined effects of these two stressors were examined, 2.36% {95% C.I. 0.72 - 2.99} of those who were exposed to both reported CTS, while 1.74% {95% C.I. 1.45 - 2.03} of those exposed to neither stressor self-reported CTS (rate ratios: 4.2, 3.1, 1.0). Although there was a suggestion of an additive effect of these two types of stressors, the difference between ''both stressors" and "either stressor" was not statistically significant. The NHIS identified occupations and industries with high risk of CTS and supports the relationship between ergonomic stressors and development of this condition. Periodic surveys can be used to monitor trends in disease, identify, responsible risk factors and high risk industries and occupations toward which prevention efforts should be directed.
Statistical-analysis; Epidemiology; Risk-analysis; Risk-factors; Carpal-tunnel-syndrome; Cumulative-trauma; Cumulative-trauma-disorders; Traumatic-injuries; Hand-injuries
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Proceedings of the 9th international symposium on epidemiology in occupational health