Workplace and individual risk factors for carpal tunnel syndrome
Workplace and individual risk factors for carpal tunnel syndrome
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DOI：
10.1136/oem.2010.063677
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发表时间：
2011-12-01
影响因子：
4.9
通讯作者：
Deddens, James
中科院分区：
文献类型：
--
作者：
Burt, Susan;Crombie, Ken;Deddens, James
目的量化工作场所物理因素，特别是手部活动水平（HAL）和用力与腕管综合征（CTS）之间的关系，同时考虑到个人因素。为了比较定量暴露评估措施与更实际的ratings-based measures.Methods在一组医疗保健和制造业workers. Every研究参与者的工作任务进行了评估HAL，用力和其他身体压力和录像作进一步分析，包括频率和持续时间的努力和姿势偏差。对所有参与者进行正中神经和尺神经的电诊断测试和问卷调查。CTS病例需要1-3指的中位单神经病变和手图症状。结果在477名工人中，57例（11.9%）为优势手CTS病例。峰值力量>= 70%最大自主收缩与= 30，OR为>= 15用力每分钟为3.35（1.14-9.87）。在10分的量表上，每增加一个单位，员工感知劳累的峰值评级就会使CTS的几率增加1.14（1.01-1.29）。在男性中，HAL 10分量表每增加一个单位，CTS的几率就增加1.38（1.05-1.81），但女性没有。综合力和HAL值以上的ACGIH TLV HAL导致的OR为2.96（1.51-5.80）为CTS.Discussion/Conclusions定量和评级为基础的工作暴露的措施都与CTS。肥胖增加了运动频率和CTS之间的关联。
Objectives To quantify the relationship between workplace physical factors, particularly hand activity level (HAL) and forceful exertion and carpal tunnel syndrome (CTS), while taking into account individual factors. To compare quantitative exposure assessment measures with more practical ratings-based measures.Methods In a group of healthcare and manufacturing workers, each study participant's job tasks were evaluated for HAL, forceful exertion and other physical stressors and videotaped for further analysis, including frequency and duration of exertion and postural deviation. Electrodiagnostic testing of median and ulnar nerves and questionnaires were administered to all participants. A CTS case required median mononeuropathy and symptoms on hand diagrams in fingers 1-3. Multiple logistic regression models were used to analyse associations between job and individual factors and CTS.Results Of 477 workers studied, 57 (11.9%) were dominant hand CTS cases. Peak force >= 70% maximum voluntary contraction versus = 30, the OR for >= 15 exertions per minute was 3.35 (1.14-9.87). Peak worker ratings of perceived exertion increased the odds for CTS by 1.14 (1.01-1.29) for each unit increase on the 10-point scale. The odds for CTS increased by 1.38 (1.05-1.81) for each unit increase on the HAL 10-point scale among men, but not women. Combined force and HAL values above the ACGIH TLV for HAL resulted in an OR of 2.96 (1.51-5.80) for CTS.Discussion/Conclusions Quantitative and ratings-based job exposure measures were each associated with CTS. Obesity increased the association between frequency of exertion and CTS.