Karpaltunnelsyndrom als Berufskrankheit: Zeitliche Zusammenhänge zwischen Exposition und Auftreten der Erkrankung

Abstract

Carpal tunnel syndrome as an occupational disease: temporal relationship between exposure and onset of the disease Objective: It is sometimes difficult to assess carpal tunnel syndrome (CTS) as an occupational disease (OD) due to the lack of clear statements in the scientific argumentation on the duration of exposure prior to the onset of CTS. We therefore conducted a review of the literature on the duration of exposure in the case of CTS. In addition, we analysed OD files on the duration of exposure for insured persons suspected of having CTS. Methods: The literature search was conducted in the PubMed, Cinahl and Web of Science databases for the period from 2014 to 2019. Information on the duration of exposure was taken from the OD files of the Occupational Accident Insurance for Healthcare and Welfare Services (BGW) for the purpose of explorative data analysis. Results: Nine studies were included in the review. The findings on the association between duration of exposure and CTS risk were inconsistent. In six studies, exposure periods of at least nine years were associated with an increased risk of CTS. Shorter exposure times were associated with an insignificant increase in CTS risk in only one study. In two studies, there was no association between duration of exposure and the development of CTS. In the BGW claims data, the median duration of exposure until the diagnosis of CTS was 24 years. Only a small number of insured persons (8 %) had a period of exposure of less than five years before the development of CTS. Conclusion: No reliable conclusion can be drawn on the association between duration of exposure and CTS on the basis of the nine included studies. The duration of exposure in the claims data was mostly long. There were a few cases in which CTS developed after less than five years of exposure. There is no justification for rejecting CTS as an OD if the duration of exposure is long. Keywords: carpal tunnel syndrome – occupational disease – latency period – accident insurance – claims data