title: Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort.
abstract: BACKGROUND
  Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes.
  
  
  OBJECTIVE
  This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors.
  
  
  METHODS
  3515 participants, without baseline CTS, were followed-up to 7 years. Case criteria included symptoms and an electrodiagnostic study consistent with CTS. Adjusted HRs were estimated in Cox proportional hazard models. Workplace biomechanical factors were collected but not evaluated in this analysis.
  
  
  RESULTS
  Women were at elevated risk for CTS (HR=1.30; 95% CI 0.98 to 1.72), and the incidence of CTS increased linearly with both age and body mass index (BMI) over most of the observed range. High job strain increased risk (HR=1.86; 95% CI 1.11 to 3.14), and social support was protective (HR=0.54; 95% CI 0.31 to 0.95). There was an inverse relationship with years worked among recent hires with the highest incidence in the first 3.5 years of work (HR=3.08; 95% CI 1.55 to 6.12).
  
  
  CONCLUSIONS
  Personal factors associated with an increased risk of developing CTS were BMI, age and being a woman. Workplace risk factors were high job strain, while social support was protective. The inverse relationship between CTS incidence and years worked among recent hires suggests the presence of a healthy worker survivor effect in the cohort.
authors: Department of Environmental Health Sciences, School of Public Health, University of California Berkeley, Berkeley, California 94609, USA. charrisadamson@samuelmerritt.edu
authors: Carisa
authors: C
authors: Harris-Adamson
authors: Ellen A
authors: EA
authors: Eisen
authors: Ann Marie
authors: AM
authors: Dale
authors: Bradley
authors: B
authors: Evanoff
authors: Kurt T
authors: KT
authors: Hegmann
authors: Matthew S
authors: MS
authors: Thiese
authors: Jay M
authors: JM
authors: Kapellusch
authors: Arun
authors: A
authors: Garg
authors: Susan
authors: S
authors: Burt
authors: Stephen
authors: S
authors: Bao
authors: Barbara
authors: B
authors: Silverstein
authors: Fred
authors: F
authors: Gerr
authors: Linda
authors: L
authors: Merlino
authors: David
authors: D
authors: Rempel
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D002349:Carpal Tunnel Syndrome / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D009784:Occupational Diseases / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012944:Social Support; D013315:Stress, Psychological / Q000150:complications*; D017132:Workplace
references: Am J Ind Med. 2007 Mar;50(3):155-72
references: 17216630
references: Occup Environ Med. 1999 Jun;56(6):417-22
references: 10474539
references: Acta Neurol Scand. 1993 Aug;88(2):149-52
references: 8213060
references: Scand J Work Environ Health. 2010 Sep;36(5):384-93
references: 20352175
references: Epidemiology. 2011 Jul;22(4):599-606
references: 21543985
references: J Occup Rehabil. 2005 Mar;15(1):47-55
references: 15794496
references: JAMA. 1999 Jul 14;282(2):153-8
references: 10411196
references: J Occup Environ Med. 2007 Nov;49(11):1189-96
references: 17993922
references: J Occup Rehabil. 2006 Jun;16(2):207-22
references: 16705490
references: Scand J Work Environ Health. 1997 Aug;23(4):299-307
references: 9322821
references: J Gen Intern Med. 1999 May;14(5):310-4
references: 10337041
references: J Occup Environ Med. 1996 Mar;38(3):290-8
references: 8882102
references: Am J Public Health. 1998 Oct;88(10):1447-51
references: 9772842
references: Am J Public Health. 1991 Jun;81(6):741-6
references: 1827570
references: Scand J Work Environ Health. 2001 Aug;27(4):268-78
references: 11560341
references: Br J Gen Pract. 2007 Jan;57(534):36-9
references: 17244422
references: Mayo Clin Proc. 1992 Jun;67(6):541-8
references: 1434881
references: J Occup Health Psychol. 1998 Oct;3(4):322-55
references: 9805280
references: Muscle Nerve. 1998 Jun;21(6):711-21
references: 9585324
references: J Hand Surg Br. 1998 Apr;23(2):151-5
references: 9607648
references: J Hand Surg Eur Vol. 2013 Jan;38(1):67-72
references: 22832982
references: Am J Ind Med. 2002 May;41(5):315-42
references: 12071487
references: Arch Intern Med. 2011 May 23;171(10):943-4
references: 21606100
references: Scand J Work Environ Health. 2009 Mar;35(2):113-26
references: 19294319
references: Am J Public Health. 1994 Nov;84(11):1846-8
references: 7977933
references: Neurology. 2009 Jan 6;72(1):33-41
references: 19122028
references: Am J Ind Med. 2001 Dec;40(6):655-66
references: 11757042
references: Am J Ind Med. 1997 Jun;31(6):671-7
references: 9131220
references: Arch Intern Med. 1998 Jul 27;158(14):1506-12
references: 9679791
references: Muscle Nerve. 2008 Apr;37(4):477-82
references: 18236454
references: Scand J Work Environ Health. 2013 Sep 1;39(5):495-505
references: 23423472
references: J Hand Surg Am. 1995 Jan;20(1):109-14
references: 7722249
references: Neurology. 1988 Jan;38(1):134-8
references: 3336444
references: ANZ J Surg. 2006 Jun;76(6):494-6
references: 16768777
references: Am J Ind Med. 1998 Apr;33(4):374-8
references: 9513644
references: Scand J Work Environ Health. 2013 Mar 1;39(2):155-63
references: 22752342
references: J Hand Surg Br. 2004 Aug;29(4):315-20
references: 15234492
references: Int J Occup Med Environ Health. 2001;14(4):357-67
references: 11885919
references: Occup Environ Med. 2009 Jun;66(6):368-73
references: 19451144
references: Clin Neurol Neurosurg. 2004 Sep;106(4):294-9
references: 15297003
references: Muscle Nerve. 1994 Jun;17(6):632-6
references: 8196706
references: Epidemiology. 1998 May;9(3):342-5
references: 9583428
references: Neurology. 2002 Jan 22;58(2):289-94
references: 11805259
references: Occup Environ Med. 2004 Oct;61(10):854-60
references: 15377772