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Workplace
Original article
Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers
  1. Carisa Harris-Adamson1,2,
  2. Ellen A Eisen1,
  3. Jay Kapellusch3,
  4. Arun Garg3,
  5. Kurt T Hegmann4,
  6. Matthew S Thiese4,
  7. Ann Marie Dale5,
  8. Bradley Evanoff5,
  9. Susan Burt6,
  10. Stephen Bao7,
  11. Barbara Silverstein7,
  12. Linda Merlino8,
  13. Fred Gerr8,
  14. David Rempel9,10
  1. 1Department of Environmental Health Sciences, University of California Berkeley, Berkeley, California, USA
  2. 2Department of Physical Therapy, Samuel Merritt University, Oakland, California, USA
  3. 3Center for Ergonomics, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
  4. 4Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), University of Utah, Salt Lake City, Utah, USA
  5. 5Division of General Medical Science, Washington University School of Medicine, Saint Louis, Missouri, USA
  6. 6Previously with the National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
  7. 7Safety and Health Assessment and Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Olympia, Washington, USA
  8. 8Department of Occupational and Environmental Health, University of Iowa, College of Public Health, Iowa City, Iowa, USA
  9. 9Division of Occupational and Environmental Medicine, University of California at San Francisco, San Francisco, California, USA
  10. 10Department of Bioengineering, University of California Berkeley, Berkeley, California, USA
  1. Correspondence to Prof. David Rempel, 1301 South 46th Street Bldg 163 Richmond, CA 94804, USA; david.rempel{at}ucsf.edu

Abstract

Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes.

Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors.

Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models.

Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS.

Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.

  • entrapment neuropathy
  • prospective
  • upper extremity
  • physical exposure

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/oemed-2014-102378

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