Carpal tunnel syndrome and manual work: a longitudinal study.
OBJECTIVE
To assess risks associated with work-related biomechanical overloads in onset/course of carpal tunnel syndrome.


METHODS
Work-groups with job tasks spanning different biomechanical exposures were evaluated at baseline in terms of American Conference of Governmental Industrial Hygienists hand-activity/peak force action limit and threshold limit values (TLV). Exposures of interest were "unacceptable" (hand-activity above TLV) and "borderline" (between action limit and TLV) overloads. Clinical/individual data were collected at baseline and 12 months.


RESULTS
One-year incidence of "classic/possible" carpal tunnel syndrome symptoms as defined by consensus criteria was 7.3% (153 of 2092). "Unacceptable" overload was associated with a 3-fold increased risk of onset with respect to "acceptable" load. At ordered logistic regression analysis of symptom-status variations, increased risks were recorded for "unacceptable" and "borderline" overloads.


CONCLUSIONS
Effectiveness of encouraging workplace adherence to the American Conference of Governmental Industrial Hygienists recommendations deserves investigation as a possible key to wide-scale prevention.
Violante
Francesco S
FS
Occupational Medicine Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Armstrong
Thomas J
TJ
Fiorentini
Cristiana
C
Graziosi
Francesca
F
Risi
Alessandro
A
Venturi
Silvia
S
Curti
Stefania
S
Zanardi
Francesca
F
Cooke
Robin M T
RM
Bonfiglioli
Roberta
R
Mattioli
Stefano
S
D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002349:Carpal Tunnel Syndrome / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D015995:Prevalence; D011795:Surveys and Questionnaires; D014937:Work