ORIGINAL ARTICLES

Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy

S Mattioli¹, A Baldasseroni², S Curti¹, R M T Cooke¹, A Mandes¹, F Zanardi¹, A Farioli¹, E Buiatti³, G Campo⁴, F S Violante¹

¹ Occupational Medicine Unit, Dipartimento di Medicina Interna, dell’Invecchiamento e Malattie Nefrologiche, University of Bologna, Bologna, Italy
² Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), Florence, Italy
³ Tuscany Regional Health Care Agency, Florence, Italy
⁴ Dipartimento Processi Organizzativi, National Institute of Occupational Safety and Prevention (ISPESL), Rome, Italy

Dr Stefano Mattioli, Occupational Medicine Unit, Policlinico S. Orsola-Malpighi, Dipartimento di Medicina Interna, dell’Invecchiamento e Malattie Nefrologiche, Università di Bologna, via Pelagio Palagi 9, I-40138 Bologna, Italy; s.mattioli{at}unibo.it

Objectives: Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared.

Methods: Surgically treated cases of idiopathic CTS were investigated among 25–59-year-old residents of Tuscany, Italy, during 1997–2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany’s regional database. Population data were extracted from the 2001 census.

Results: After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives’ rates were similar to those of blue-collar female workers up to 40–44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives’ rates were much higher (p<0.001) than those of white-collar women.

Conclusions: Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.

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