Quantitative and ratings-based job exposure measures were each associated with CTS. Obesity increased the association between frequency of exertion and CTS.

Workplace and individual risk factors both contribute to the risk for CTS. Time spent in forceful exertion can be a greater risk for CTS than obesity if the job exposure is high. Preventive workplace efforts should target forceful exertions.

This article compares several methods that were used for determining hand activity level and force in a large prospective ergonomics study. The first goal of this analysis was to determine the degree of correlation between hand activity/ force ratings using different assessment methods. The second goal was to determine if the hand activity/force methods were functionally equivalent for the purpose of calculating the ACGIH(R) hand activity level (HAL) threshold limit value (TLV(R)). A final goal was to investigate reasons for potential differences between methods. More than 700 task analyses were conducted on 484 workers at three study locations. Hand activity was assessed by two methods, including a trained observer on site using a 10-point visual analog scale for hand activity level and by offsite video analysis of the same task to calculate the frequency of exertions and the work/recovery ratio. Hand force was assessed by two on-site methods: ratings of perceived exertion (RPE) using a modified Borg CR-10 scale by a trained observer and RPE by the worker performing the task. The two methods for assessing hand activity level were correlated (Spearman rank = 0.49) and produced main TLV result categories (below Action Limit, Action Limit, TLV) with percent of exact agreement ranging from 71 to 91% and weighted Kappa ranging from 0.61 to 0.75. The two RPE methods for assessing hand force were correlated (Spearman rank ranging from 0.47 to 0.69) and produced TLVs with percent of exact agreement ranging from 64 to 83% and weighted Kappa ranging from 0.52 to 0.62. Differences between methods may be explained by a number of task and subject variables that were significantly associated with higher levels of hand activity and force. In summary, this study found substantial agreement between two methods for assessing hand activity level and moderate agreement between two methods for assessing hand force.