Objectives Carpal tunnel syndrome (CTS) is a socially relevant condition that often involves disability. Few large analytical studies have been published considering occupational/non-occupational risk factors. This population-based case-control study aims at investigating both occupational and non-occupational risk factors for surgically treated CTS.
Methods Sixteen centres participated in the study. Each centre identified 200 subjects (aged 25–59 yr): 100 cases (50 women and 50 men) and 100 controls (50 women and 50 men). Cases were randomly drawn from administrative databases of all citizens submitted during 2001 to carpal tunnel release in any public/private hospital with a principal diagnosis of CTS. Controls were randomly sampled from official national health service registry records and were frequency matched by age and gender with cases. Participants were invited by mail (and phone when necessary) to respond to a structured questionnaire regarding occupational (including previous and current job titles along with biomechanical risk factors) and non-occupational risk factors.
Results The sixteen centres overall identified 3,052 subjects (1,458 cases and 1,594 controls) on the base of the study protocol criteria. A total number of 2,294 subjects responded to the questionnaire (1,182 cases and 1,112 controls) corresponding to a response rate of 81% and 70% respectively. After exclusion of non-eligible subjects, 1,018 cases and 959 controls entered the main analysis. After adjusting for non-occupational risk factors, manual workers of both sexes appeared to have at least 4-fold risk of surgical treatment of CTS, as compared with non-manual counterparts (women: OR 4.57, 95% CI 3.07–6.81; men: OR 4.44; 95% CI 2.96–6.67).
Conclusions This multicentre population-based case-control study strongly underscores the relevance of manual work as an important risk factor for surgically treated CTS, irrespectively of gender. Further analyses will contribute to provide conclusive evidence on the relationship between biomechanical overload and CTS, considering non-occupational risk factors as well.
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