Workplace and individual risk factors for carpal tunnel syndrome.
Burt-S; Crombie-K; Jin-Y; Wurzelbacher-S; Ramsey-J; Deddens-J
Occup Environ Med 2011 Dec; 68(12):928-933
Objectives: To quantify the relationship between workplace physical factors, particularly hand activity level (HAL) and forceful exertion and carpal tunnel syndrome (CTS), while taking into account individual factors. To compare quantitative exposure assessment measures with more practical ratings-based measures. Methods: In a group of healthcare and manufacturing workers, each study participant's job tasks were evaluated for HAL, forceful exertion and other physical stressors and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Electrodiagnostic testing of median and ulnar nerves and questionnaires were administered to all participants. A CTS case required median mononeuropathy and symptoms on hand diagrams in fingers 1e3. Multiple logistic regression models were used to analyse associations between job and individual factors and CTS. Results: Of 477 workers studied, 57 (11.9%) were dominant hand CTS cases. Peak force greater tjam or equal to 70% maximum voluntary contraction versus <20% maximum voluntary contraction resulted in an OR of 2.74 (1.32-5.68) for CTS. Among those with a body mass index greater than or equal to 30, the OR for greater than or equal to 15 exertions per minute was 3.35 (1.14-9.87). Peak worker ratings of perceived exertion increased the odds for CTS by 1.14 (1.01-1.29) for each unit increase on the 10-point scale. The odds for CTS increased by 1.38 (1.05-1.81) for each unit increase on the HAL 10-point scale among men, but not women. Combined force and HAL values above the ACGIH TLV for HAL resulted in an OR of 2.96 (1.51-5.80) for CTS. Discussion/Conclusions: Quantitative and ratingsbased job exposure measures were each associated with CTS. Obesity increased the association between frequency of exertion and CTS.
Carpal-tunnel-syndrome; Ergonomics; Exposure-assessment; Hand-injuries; Health-care-personnel; Injury-prevention; Manual-lifting; Physical-reactions; Physical-stress; Physiological-effects; Physiological-factors; Posture; Quantitative-analysis; Questionnaires; Repetitive-work; Risk-analysis; Risk-factors; Statistical-analysis; Work-analysis; Work-environment; Worker-health; Work-operations; Workplace-studies; Work-practices
Susan Burt, Industrywide Studies Branch, Division of Surveillance Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, 4676 Columbia Pkwy, Mail Stop R-15, Cincinnati, OH 45226, USA
Occupational and Environmental Medicine