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MS CUPID – Cultural and Psychosocial Influences on Disability
Differences in prevalence of wrist/hand pain by country and occupation: findings from the CUPID study
  1. David Coggon,
  2. E Clare Harris,
  3. Georgia Ntani,
  4. Keith Palmer on behalf of the CUPID collaboration
  1. University of Southampton, Southampton, UK


Objectives Musculoskeletal disorders of the wrist and hand have been linked with various occupational activities, including use of computer keyboards and other repetitive manual tasks. They are also influenced by psychological risk factors. To explore a hypothesised role of culturally determined health beliefs and expectations, we compared rates of wrist/hand pain in workers carrying out similar occupational tasks in culturally diverse settings.

Methods As part of the CUPID study, a standardised questionnaire was used to collect baseline data on musculoskeletal symptoms and their risk factors from samples of nurses (12 countries), office workers (10 countries) and manual workers carrying out repetitive tasks with their hands (nine countries). Analysis focused on 9347 workers aged 20–59 years. Simple descriptive statistics were used to compare the prevalence of wrist/hand pain by occupational group and country.

Results Among the office workers, almost all of whom used a computer keyboard for ≥4 h/day, the 1-month prevalence of wrist/hand pain varied from 3% in Pakistan and 6% in Japan to 37% in Brazil and 38% in Nicaragua. Within countries, prevalence rates in nurses were generally similar to those in office workers. Pakistani and Japanese manual workers also had low rates of wrist/hand pain, but the lowest prevalence was in Brazilian cane cutters (2%), and the highest in Italian workers at a toy factory (43%).

Conclusions Country of residence appears to be a much more important determinant of wrist/hand pain than workplace physical activity. Possible reasons for the major differences in prevalence between countries will be discussed.

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