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The natural course of carpal tunnel syndrome in a working population.

Silverstein BA; Fan ZJ; Bonauto DK; Bao S; Smith CK; Howard N; Viikari-Juntura E
Scand J Work Environ Health 2010 Sep; 36(5):384-393
OBJECTIVE: The aim of this study was to assess prevalence, incidence, and persistence of carpal tunnel syndrome (CTS) and associated symptoms over a one-year period in a working population. METHODS: We conducted a one-year prospective study of 418 active workers in 12 worksites. Detailed health interviews, psychosocial questionnaires, and electrophysiological studies [ie, nerve conduction velocity (NCV) tests] were conducted at baseline and one-year follow-up. Individual-observed exposure assessments of wrist posture, hand activity, and hand forces were conducted. RESULTS: Prevalence of CTS cases at baseline was 10.8% [95% confidence interval (95% CI) 7.8-13.7%] on the dominant side and 6.0% (95% CI 3.7-87.3%) on the non-dominant side; CTS symptoms were 14.1% (95% CI 10.8-17.5%) and 11.0% (95% CI 8.0-14.0%), respectively. Incidence of CTS cases were 7.5% (95% CI 4.8-10.2%) and 5.6% (95% CI 3.3-7.9%), respectively. Higher proportions of subjects with current symptoms or positive electrophysiological test findings at baseline became CTS cases at one year compared to those with neither (28.6% and 13.9%, respectively, versus 0.5%). One-year persistence of CTS case status was 44.4% (95% CI 29.9-59.0%) for the dominant hand and 52.0% (95% CI 32.4-71.6) for non-dominant hand. There were significant differences at baseline between asymptomatic subjects and CTS cases with respect to higher job demands (P=0.027), lower job satisfaction (P=0.036), lower general health (P=0.0009), higher exposure to vibrating hand tool use (P=0.039), and greater time using a forceful power grip (P=0.035) among cases. CONCLUSIONS: CTS symptoms more than positive NCV test results alone appear to predict CTS at one year. Persistence of CTS at one year is high.
Arm-injuries; Carpal-tunnel-syndrome; Electrophysiological-effects; Electrophysiological-examinations; Electrophysiological-measurements; Electrophysiology; Ergonomics; Exposure-assessment; Injuries; Physiological-measurements; Physiological-response; Posture; Questionnaires; Risk-analysis; Statistical-analysis; Work-analysis; Worker-health; Work-performance
B. Silverstein, Safety and Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor and Industries, PO Box 44330, Olympia, WA 98504-4330, USA
Publication Date
Document Type
Journal Article
Email Address
Funding Amount
Funding Type
Cooperative Agreement; Grant
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U01-OH-007316; Grant-Number-T42-OH-008433
Issue of Publication
Priority Area
Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
Source Name
Scandinavian Journal of Work, Environment & Health
Performing Organization
Washington State Department of Labor and Industries
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division