Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers

Abstract

Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes. Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors. Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models. Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS. Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.

Personal risk factors for carpal tunnel syndrome in female visual display unit workers

“…As CTS has become one of the most frequent causes of work compensation, both in Europe and in the United States, and due to the large and still increasing number of people working with computers, also a feeble excess of risk means that a high number of workers may then experience upper extremities [4,5]. Occupational (i.e., repetitive and forceful work such as gripping, vibrations) and non-occupational risk factors (i.e., female sex, age, obesity, diabetes, gynaecological surgery, menstrual problems/disorders and exercise levels) have been associated with CTS, suggesting a multifactorial aetiology [6][7][8][9][10][11][12][13][14][15]. The controversial association between CTS and visual display unit (VDU) use, suggested since the seventies of the last century, still remains an unsolved issue [16,17].…”

“…Finally, studies on CTS in occupational medicine and, in particular, in VDU workers often lack an accurate evaluation of personal medical history. As CTS is a very frequent condition in adult females [3][4][5], for both anatomical and physiological reasons [1][2][3][4][5], with a very large array of well-established occupational and non-occupational risk factors [6][7][8][9][10][11][12][13][14][15], it should be interpreted as a "work related musculoskeletal disorder," i.e., an impairment of body structures associated with, rather than simply caused by, cumulative exposure to work and working environment over a long period of time [25]. In other words, not only occupational but also personal history influence in probabilistic terms natural history of CTS, both inducing and anticipating its clinical presentation [1,2,16].…”

Influence of Smartphone Addiction on Grip and Pinch Strength in Collegiate Population – An Observational Study.

“…However, we found no tendon or joint pathologiesTo explain these relationships in the groups, unlike findings from another recent study. 16 the underlying Pathogenetic mechanisms of increased pain in high smartphone users are not clear. In addition, we found increased pinch strength and grip strength increased with the duration and time of smartphone use, and this may have been due to enlargement of tendons such as The fpl tendon as suggested in another study.…”

“…8,9 the human hand has unique features and functions like any other organ of the body in everyday life, and the functional impairment of the hand can affect everyday life and ultimately the quality of life.…”

D6-2 The Effect of Keyboard Typing on the Median Nerve at the Proximal Carpal Tunnel

“…Repetitive joint movements and joint position are the main biomechanical factors that may influence CTS. Moreover, studies suggested occupational biomechanical factors may contribute to workplace CTS incidents (Bao et al, 2015;Dias et al, 2004;Harris-Adamson et al, 2015).…”