A Pooled Longitudinal Analysis of Workplace Carpal Tunnel Syndrome

描述(申请人提供)：工作场所腕管综合征的综合纵向分析腕管综合征仍然是工作人员残疾的一个主要来源，也是雇主和保险公司的一项主要费用。不幸的是，由于设计、暴露和结果确定以及统计能力的限制，关于工作场所暴露于生物力学因素和腕管综合征之间的相关性的研究一直没有定论。2001至2008年间，七个研究小组对美国生产工人进行了协调、多年的前瞻性研究，并收集了详细的受试者水平的上肢生物力学暴露信息，并进行了后续症状评估、体检和神经传导测量。拟议的研究将汇集这些前瞻性研究的数据，以创建一个大型数据库(N=3573)，其中包括一系列职业和行业的职业暴露、人口统计、协变量和结果衡量标准。除了能够准确估计不同工作人群中CTS的发病率外，拟议的研究还将精确量化生物力学风险因素(例如，力、重复、劳损指数、手活动水平)与腕管综合征发病率之间的暴露-反应关系，同时控制重要的协变量(例如，年龄、性别、心理社会因素、体重指数)。这项研究还将评估在基线水平上患有腕管综合征的患者中，工作场所和个人因素之间的关系，以及随后手残疾的变化。拟议的分析结果将为雇主、雇员、公共卫生机构和职业健康调查人员提供CTS与职业生物力学因素之间的关联的定量估计，以便更有效地指导工作场所的健康和安全预防计划。 公共卫生相关性：叙述性腕管综合征是蓝领工人手部残疾的重要原因。这项研究的目的是通过合并来自七项前瞻性研究的数据，创建迄今为止关于工作场所腕管综合征的最大数据库。所有七项研究都已经收集了详细的工作场所活动信息。这个大型数据库将使我们能够详细地检查特定类型的手活动与发生腕管综合征的几率之间的关系。这项研究可以回答这样一个问题：对于腕管综合症的发生，手的移动速度是更重要还是更不重要，而不是工作任务中施加的握力。雇主、雇员以及健康和安全人员需要这些信息来设计更安全的工作场所，以减少患上腕管综合症的机会。

DESCRIPTION (provided by applicant): A Pooled Longitudinal Analysis of Workplace Carpal Tunnel Syndrome Carpal tunnel syndrome continues to be a major source of disability among working persons and a major expense to employers and insurers. Unfortunately, studies of associations between workplace exposures to biomechanical factors and carpal tunnel syndrome have been inconclusive as a result of limitations in design, exposure and outcome ascertainment, and statistical power. Between 2001 and 2008, seven research groups conducted coordinated, multi-year, prospective studies of US production workers and collected detailed subject-level upper-extremity biomechanical exposure information with follow-up symptom assessment, physical examination, and nerve conduction measures. The proposed study will pool the data from these prospective studies to create a large database (N = 3573) of occupational exposure, demographic, covariate and outcome measures across a range of occupations and industries. In addition to allowing for precise estimates of the incidence of CTS among members of a diverse working population, the proposed study will quantify with precision exposure-response relationships between biomechanical risk factors (e.g., force, repetition, Strain Index, Hand Activity Level) and incidence of carpal tunnel syndrome while controlling for important covariates (e.g., age, gender, psychosocial factors, BMI). The study will also evaluate, among those with carpal tunnel syndrome at baseline, the relationship between workplace and personal factors and subsequent changes in hand disability. The results of the proposed analyses will provide employers, employees, public-health agencies and occupational health investigators with quantitative estimates of the associations between CTS and occupational biomechanical factors in order to more effectively guide workplace health and safety prevention programs. PUBLIC HEALTH RELEVANCE: Narrative Carpal tunnel syndrome is an important cause of hand disability among blue collar workers. The purpose of this study is to create the largest database to-date on workplace carpal tunnel syndrome by merging together data from seven prospective studies. Detailed workplace activity information has already been collected by all seven studies. This large database will allow us to examine, in detail, the relationships between specific types of hand activity and the chance for developing carpal tunnel syndrome. The study can answer the question of whether how fast the hand moves is more or less important for the development of carpal tunnel syndrome than the amount of grip force applied during a work task. This information is needed by employers, employees, and health and safety personnel to design safer workplaces in order to reduce the chance of developing carpal tunnel syndrome.