Objectives: We compared rates of surgically treated CTS among blue-/white-collar workers and housewives in the general population.
Methods: We estimated numbers of surgically-treated cases of idiopathic CTS among 25–59-year-old residents of Tuscany, Italy, during 1997–2000 (when out-of-hospital CTS surgery was extremely rare), 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, we identified 8,801 eligible cases. Age-standardized 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; “white-collar men”, 15.3. Compared with reference categories (same-sex white-collar workers), women blue-collar workers experienced a 4.2-fold higher standardized rate; housewives, 3.8-fold excess; men blue-collar workers, 4.8-fold excess (all P<0.001). Men and women blue-collar workers showed about 3- to 7-fold higher age-specific rates with respect to white-collar counterparts (all P<0.001).Housewives’ rates appeared superimposable with those of blue-collar women 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 appeared 3 to 7 times more common (depending on age/gender) in blue-collar than in white-collar workers—magnitudes difficult to attribute only to differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates recorded for full-time housewives suggest that domestic chores deserve more investigation as a possible risk factor for CTS.
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