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Workplace
Original research
Carpal tunnel syndrome and occupational hand exposures: a Danish nationwide cohort study
  1. Sorosh Tabatabaeifar1,2,
  2. Annett Dalbøge1,3
  1. 1 Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
  2. 2 Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark
  3. 3 Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
  1. Correspondence to Dr Sorosh Tabatabaeifar, Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus 8200, Denmark; sortab{at}rm.dk

Abstract

Objectives The aim was to examine exposure–response relations between occupational hand exposures and carpal tunnel syndrome (CTS) and to compare the relation between surgery-treated and non-surgery-treated CTS. The secondary aim was to study sex-specific differences in exposure–response relations.

Methods We conducted a nationwide register-based cohort study of all persons born in Denmark (1945–1994). During follow-up (2010–2013), we identified first-time events of CTS. Occupational hand exposure estimates the year before each follow-up year were obtained by linking individual occupational codes with a job exposure matrix. We used multivariable logistic regression equivalent to discrete survival analysis based on sex and surgery. The excess fraction of cases was calculated.

Results For both sexes, exposure–response relations were found for all occupational hand exposures. Among men, we found ORadj of 3.6 (95% CI 3.2 to 3.8) for hand-related force, 2.9 (95% CI 2.5 to 3.2) for repetitive hand movements, 3.8 (95% CI 2.7 to 5.2) for non-neutral hand posture and 2.5 (95% CI 2.2 to 2.7) for hand-arm vibration in the highest exposure groups. For combined exposure (hand load), ORadj was 3.5 (95% CI 3.1 to 4.0). Slightly higher ORsadj were generally found for surgery-treated CTS compared with non-surgery-treated CTS for both sexes. When comparing sex, somewhat higher ORsadj were found among men. The excess fraction was 42%.

Conclusions Occupational hand exposures carried a 3-5-fold increased risk of CTS with slightly higher risks for surgery-treated compared with non-surgery-treated CTS. Even though CTS occurs more frequently among women, somewhat higher exposure–response relations were found for men compared with women. In the general working population, a substantial fraction of first-time CTS could be related to occupational hand exposures.

  • Epidemiology
  • Ergonomics
  • Occupational Health

Data availability statement

No data are available.

https://doi.org/10.1136/oemed-2024-109568

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    Data availability statement

    No data are available.

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    Footnotes

    • Contributors Both authors contributed to the conception and design of the study. ST performed the statistical analyses and drafted the manuscript in collaboration AD. Both authors interpreted the findings and revised the manuscript critically. ST is the guarantor of this study. Both authors approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.