Carpal tunnel syndrome and computer exposure at work in two large complementary cohorts.
OBJECTIVE
The boom in computer use and concurrent high rates in musculoskeletal complaints and carpal tunnel syndrome (CTS) among users have led to a controversy about a possible link. Most studies have used cross-sectional designs and shown no association. The present study used longitudinal data from two large complementary cohorts to evaluate a possible relationship between CTS and the performance of computer work.


METHODS
The Cosali cohort is a representative sample of a French working population that evaluated CTS using standardised clinical examinations and assessed self-reported computer use. The PrediCTS cohort study enrolled newly hired clerical, service and construction workers in several industries in the USA, evaluated CTS using symptoms and nerve conduction studies (NCS), and estimated exposures to computer work using a job exposure matrix.


METHODS
During a follow-up of 3-5 years, the association between new cases of CTS and computer work was calculated using logistic regression models adjusting for sex, age, obesity and relevant associated disorders.


RESULTS
In the Cosali study, 1551 workers (41.8%) completed follow-up physical examinations; 36 (2.3%) participants were diagnosed with CTS. In the PrediCTS study, 711 workers (64.2%) completed follow-up evaluations, whereas 31 (4.3%) had new cases of CTS. The adjusted OR for the group with the highest exposure to computer use was 0.39 (0.17; 0.89) in the Cosali cohort and 0.16 (0.05; 0.59) in the PrediCTS cohort.


CONCLUSIONS
Data from two large cohorts in two different countries showed no association between computer work and new cases of CTS among workers in diverse jobs with varying job exposures. CTS is far more common among workers in non-computer related jobs; prevention efforts and work-related compensation programmes should focus on workers performing forceful hand exertion.
Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France Versailles St-Quentin University, UMS 011, Villejuif, France AP-HP, Occupational Health Unit/EMS (Samu92), University hospital of West suburb of Paris, Poincaré site, Garches, France.
Z
Z
Mediouni
Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France.
J
J
Bodin
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.
A M
AM
Dale
Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France Versailles St-Quentin University, UMS 011, Villejuif, France.
E
E
Herquelot
Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France Versailles St-Quentin University, UMS 011, Villejuif, France.
M
M
Carton
Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France Versailles St-Quentin University, UMS 011, Villejuif, France Inserm, UMR-S VIMA, Villejuif, France.
A
A
Leclerc
Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France Department of Occupational Health, French Institute for Public Health Surveillance, Saint-Maurice, France.
N
N
Fouquet
Hand Center, Clinique les eaux claires, ZAC Moudong Sud, Baie Mahault, France.
C
C
Dumontier
Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France CHU Angers, Angers, France.
Y
Y
Roquelaure
Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA.
B A
BA
Evanoff
Inserm, UMR-S VIMA, Villejuif, France Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France Versailles St-Quentin University, UMS 011, Villejuif, France AP-HP, Occupational Health Unit/EMS (Samu92), University hospital of West suburb of Paris, Poincaré site, Garches, France.
A
A
Descatha
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D015331:Cohort Studies; D003201:Computers; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D015994:Incidence; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D011187:Posture; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
EPIDEMIOLOGY; OCCUPATIONAL & INDUSTRIAL MEDICINE; PUBLIC HEALTH; RHEUMATOLOGY