Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region

Abstract

BackgroundCarpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy in the working-age population. The reduction of CTS incidence in the workforce is a priority for policy makers due to the human, social and economic costs.To assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or work-related risk factors for CTS.MethodsSurgical CTS were assessed using regional hospital discharge records for persons aged 20–59 in 2009. Using work-related attributable fractions (AFEs), we estimated the number of work-related CTS (WR-CTS) in high-risk jobs. We simulated three theoretical scenarios of workplace-based primary prevention for jobs at risk: a mono-component work-centered intervention reducing the incidence of WR-CTS arbitrarily by 10% (10%-WI), and multicomponent global interventions reducing the incidence of all surgical CTS by 5% and 10% by targeting personal and work risk factors.ResultsA limited proportion of CTS were work-related in the region’s population. WR-CTS were concentrated in nine jobs at high risk of CTS, amounting to 1603 [1137–2212] CTS, of which 906 [450–1522] were WR-CTS. The 10%-WI, 5%-GI and 10%-GI hypothetically prevented 90 [46–153], 81 [58–111] and 159 [114–223] CTS, respectively. The 10%-GI had the greatest impact regardless of the job. The impact of the 10%-WI interventions was high only in jobs at highest risk and AFEs (e.g. food industry jobs). The 10%-WI and 5%-GI had a similar impact for moderate-risk jobs (e.g. healthcare jobs).ConclusionThe impact of simulated workplace-based interventions suggests that prevention efforts to reduce exposure to work-related risk factors should focus on high-risk jobs. Reducing CTS rates will also require integrated strategies to reduce personal risk factors, particularly in jobs with low levels of work-related risk of CTS.

Theoretical impact of workplace-based primary prevention of lumbar disc surgery in a French region: A pilot study

“…interventions (10%-GI scenarios) [26]. Combining interventions on personal and work-related factors was assumed to have a higher impact than interventions targeting only on personal or work-related factors [16].…”

“…As in a previous study of carpal tunnel syndrome [26], in absence of precise data in the literature, we arbitrarily hypothesized that interventions could reduce the incidence of LDS by 10% in high-risk jobs, and simulated three scenarios of workplace-based primary prevention, differing by their main target: These indicators were computed for each sector when (i) more than 10 men or women were employed and (ii)…”

“…Based on a similar approach in a recent article about carpal tunnel syndrome [26], the aim of this study was to assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or work-related risk factors for LDS.…”

“…industry sectors were at high risk of LDS in the region, amounting to 277 [216-352] LDS cases, of which 98 [37-175] were WR-LDS (Table 1): construction and information & communication for men; wholesale & retail trade and accommodation & food service activities for women. AFE was limited for each industry sector, varying between 30% for men construction and 55% for women of accommodation & food service activities.As shown inTable 2, the number of avoidable LDS varied between the different preventive scenarios and sectors.The 10%-WI, 5%-GI and 10%-GI scenarios hypothetically prevented 10[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], 13[11][12][13][14][15][16][17] and 28[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] LDS cases among sectors at risk, respectively. For each sector at risk, the hypothetical preventive efficiency was lower for the 10%-WI scenario compared to the 10%-GI and even the 5%-GI scenarios.…”

Proportion of upper extremity musculoskeletal disorders attributable to personal and occupational factors: results from the French Pays de la Loire study

“…Identifying the modifiable risk factors for UEMSD in the workplace with the highest impact can help public health practitioners and policy makers to better target interventions at the working population level [24]. In this context, the effect of a particular risk factor depends not only on the strength of the association between the risk factor and the disease, but also on the prevalence of the risk factor.…”