Article Text
Abstract
Objectives The aim was to assess the association between occupational biomechanical exposure and the occurrence of radial nerve entrapment (RNE) in construction workers over a 13-year follow-up period.
Methods A cohort of 229 707 male construction workers who participated in a national occupational health surveillance programme (1971–1993) was examined prospectively (2001–2013) for RNE. Height, weight, age, smoking status and job title (construction trade) were obtained on health examination. RNE case status was defined by surgical release of RNE, with data from the Swedish national registry for out-patient surgery records. A job exposure matrix was developed, and biomechanical exposure estimates were assigned according to job title. Highly correlated exposures were summed into biomechanical exposure scores. Negative binomial models were used to estimate the relative risks (RR) (incidence rate ratios) of RNE surgical release for the biomechanical factors and exposure sum scores. Predicted incidence was assessed for each exposure score modelled as a continuous variable to assess exposure–response relationships.
Results The total incidence rate of surgically treated RNE over the 13-year observation period was 3.53 cases per 100 000 person-years. There were 92 cases with occupational information. Increased risk for RNE was seen in workers with elevated hand-grip forces (RR=1.79, 95% CI 0.97 to 3.28) and exposure to hand-arm vibration (RR=1.47, 95% CI 1.08 to 2.00).
Conclusions Occupational exposure to forceful handgrip work and vibration increased the risk for surgical treatment of RNE.
- nerve entrapment
- upper extremity load
- neuropathy
- job exposure matrix
- elbow flexion/extension
- hand-arm vibration
- hand tools
- static work
- repetitive
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Footnotes
Contributors JJ: worked on study design, data analysis, manuscript preparation, revision and submission. DO: worked on data extraction and analysis. AB: worked on study design, and manuscript preparation and revision. LP and JW: worked on study design and manuscript revision. BJ: worked on study design, data analysis and manuscript revision.
Funding This study was funded by Forskningsrådet om Hälsa, Arbetsliv och Välfärd (FORTE 2016-01016).
Competing interests None declared.
Ethics approval The study was approved by the Regional Ethical Review Board in Umeå (2017/16-31).
Provenance and peer review Not commissioned; externally peer reviewed.