Article Figures & Data
Tables
- Table 1.
Cross-Sectional Studies That Found No Association between Occupational Exposure and CTS
Study No. of Patients Setting of Study Measurement of Occupational Exposure CTS Diagnostic Criteria Controlling of Confounding Factors Findings Comment Chiang et al22 207 Fish processing workers Observation and EMG force recording S, PE Age, gender No association with repetition on the exposure group Excluded the subjects with medical condition that can cause CTS English et al., 199524 1167 Orthopedic clinic Self-report Not specified Gender, height, weight No association with wrist ergonomics Moore et al23 230 Pork processing plant Observation S, PE, NCV No No association Based on the medical records review Nathan et al17 471 Employees from 27 occupations in 4 industries Observation by investigators NCV Age, gender No association between occupational hand activity and NCV finding Case definition does not include symptom, physical examination Schottland et al19 178 Poultry-processing plant Employment status, not observation NCV Age, gender No association between employment experience and the NCV finding Case definition does not include symptom, physical examination Steven et al27 257 Orthopedic clinic Not specified S, PE, NCV No No association CTS, carpal tunnel syndrome; EMG, electromyelogram; S, self-report; PE, physical examination; NCV, nerve conduction velocity.
- Table 2.
Cross-Sectional Studies That Found an Association between Occupational Exposure and CTS
Author No. of Patients. Setting Measurement of Occupational Exposure CTS Diagnostic Criteria Controlling of confounding factors Result Comment Chiang et al 21 207 Two frozen food plants Observation S, PE, NCV Age, gender, length of employment Strongly positive association between repetition and CTS (OR = 7.40) Excluded the subjects with medical condition that can cause CTS Latko et al26 352 Three companies Observation S, PE, NCV Age, gender Positive association with repetition (OR = 3.1) Osorio et al20 56 Grocery store Observation S, PE, NCV Age, gender, alcohol assumption and high-risk medical history Strongly positive association (OR = 6.7) Silverstein et al14 652 Active workers in 39 jobs from 7 different industrial sites Observation, (EMG) recordings S, PE Demographic information including age, gender, years on the job, etc Strongly positive association between high force-high repetitive job and CTS prevalence (OR = 15) CTS diagnosis was not confirmed by NCV Stetson et al16 345 Industrial workers Observation and workers interview S, NCV Age, height, skin temperature and finger circumference Positive association between ergonomic factors and NCV finding Werner et al25 184 Six work sites Observation S, NCV Demographic, anthropometric, history of diabetes and psychosocial factors Positive association CTS, carpal tunnel syndrome; EMG, electromyelogram; S, self-report; PE, physical examination; NCV, nerve conduction velocity.
Ask the patient, “In your current occupation . . . ” Is this the hand you primarily use to perform your current job?
Do you bend the wrist up and down or from side to side repeatedly more than twice a minute (wrist flexion/extension, ulnar/radial deviation) or twist/rotate the wrist with palm facing up and then down more than twice a minute (wrist rotation)?
Do you have repeated finger-tapping movement more than twice a minute?
Do you spend more than 4 hours per day moving your hand/wrist in the same fashion?
Do you grip or hold any object in the palm with a force greater than 12 lb while performing the activities listed in questions 2, 3, or 4?
Do you hold tools that vibrate during most of your workday?
Scoring: the number of “Yes” answers is directly proportional to the degree of risk: 0 to 2, low risk for occupational CTS; 3 to 4, moderate risk; 5 to 6, high risk.
