Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research

Abstract

BackgroundOccupational risks for carpal tunnel syndrome (CTS) have been examined in various occupations, and several systematic reviews (SRs) have been published on this topic. There has been no critical appraisal or synthesis of the evidence in the SRs. The aims of this study are (1) to synthesise the observational evidence and evaluate the methodological quality of SRs that assess the effect of biomechanical risk factors on the development of CTS in workers, (2) to provide an update of current primary research on this association, (3) to assess a potential dose-response relationship.MethodsWe searched MEDLINE, EMBASE, CINAHL, the Cochrane Library and the reference lists of articles. The first step covered SRs (1998–2014), and the second step covered current primary studies (2011–2014). The methodological quality of the SRs was evaluated by using the AMSTAR-R tool; primary studies were assessed using a list of 20 items. A qualitative approach was used for synthesising evidence. In addition, we undertook a meta-analysis of the primary studies to determine risk ratios in the dose-response relationship.ResultsWe identified ten SRs that covered a total of 143 original studies. Seven primary studies met the criteria for inclusion, of which four provided longitudinal data. We found high quality of evidence for risk factors such as repetition, force and combined exposures. Moderate quality of evidence was observed for vibration, and low quality of evidence was found for wrist postures. An association between computer use and CTS could not be established. Recent primary studies supported the existence of a significant relationship between CTS and repetition, force and combined exposure. The meta-analysis of current research revealed a dose-response relationship between CTS and the American Conference of Governmental Industrial Hygienists’ (ACGIH) threshold limit value (TLV) for hand-activity level (HAL). Those between the action limit and TLV and above TLV had RR of 1.5 (95 % CI 1.02–2.31) and RR 2.0 (95 % CI 1.46–2.82), respectively.ConclusionsOccupational biomechanical factors play a substantial role in the causation of CTS. Data from current primary studies on dose-response suggest that the risk of CTS increases with the ACGIH TLV levels.Electronic supplementary materialThe online version of this article (doi:10.1186/s12891-015-0685-0) contains supplementary material, which is available to authorized users.

Carpal tunnel syndrome and manual work: the OCTOPUS cohort, results of a ten-year longitudinal study

“…A recent overview of systematic reviews and a metaanalysis of current research concluded that there is high evidence for an increased risk of CTS in activities requiring a high degree of repetition and forceful exertion while the evidence for vibration and non-neutral wrist postures appears moderate and low respectively (33).…”

Median and common peroneal neuropathy in coir workers of Alappuzha district, Kerala

“…[12] Magnetic resonance imaging has revolutionized the assessment of entrapment neuropathies. [13] Sangwan et al .…”

Descripción electrofisiològica del síndrome de túnel carpiano según edad en pacientes adultos

“…Además, pueden optar a un tratamiento médico temprano disminuyendo el compromiso de la patología en algunos casos. Por otro lado, los pacientes que acuden a CAS, en general, no realizan actividades laborales que requieran de trabajo manual extremo o muy repetitivo, minimizando a este grupo de la población con mayor riesgo de desarrollar STC 34 . Destaca el bajo número de pacientes excluidos por cirugía previa de STC, esto pudiese ser explicado por las características de la población estudiada, o bien por falta de información en el diagnóstico de derivación.…”