Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers

Carisa Harris-Adamson; Ellen A. Eisen; Jay Kapellusch; Arun Garg; Kurt T. Hegmann; Matthew S. Thiese; Ann Marie Dale; Bradley Evanoff; Susan Burt; Stephen Bao; Barbara Silverstein; Linda Merlino; Fred Gerr; David Rempel

doi:10.1136/oemed-2014-102378

Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers

Carisa Harris-Adamson, Ellen A. Eisen, Jay Kapellusch, Arun Garg, Kurt T. Hegmann, Matthew S. Thiese, Ann Marie Dale, Bradley Evanoff, Susan Burt, Stephen Bao, Barbara Silverstein, Linda Merlino, Fred Gerr, David Rempel

Research output: Contribution to journal › Article › peer-review

97 Scopus citations

Abstract

Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes.

Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors.

Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models.

Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.

Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS.

Original language	English
Pages (from-to)	33-41
Number of pages	9
Journal	Occupational and Environmental Medicine
Volume	72
Issue number	1
DOIs	https://doi.org/10.1136/oemed-2014-102378
State	Published - Jan 1 2015

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Harris-Adamson, C., Eisen, E. A., Kapellusch, J., Garg, A., Hegmann, K. T., Thiese, M. S., Dale, A. M., Evanoff, B., Burt, S., Bao, S., Silverstein, B., Merlino, L., Gerr, F., & Rempel, D. (2015). Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers. Occupational and Environmental Medicine, 72(1), 33-41. https://doi.org/10.1136/oemed-2014-102378

Harris-Adamson, Carisa ; Eisen, Ellen A. ; Kapellusch, Jay ; Garg, Arun ; Hegmann, Kurt T. ; Thiese, Matthew S. ; Dale, Ann Marie ; Evanoff, Bradley ; Burt, Susan ; Bao, Stephen ; Silverstein, Barbara ; Merlino, Linda ; Gerr, Fred ; Rempel, David. / Biomechanical risk factors for carpal tunnel syndrome : A pooled study of 2474 workers. In: Occupational and Environmental Medicine. 2015 ; Vol. 72, No. 1. pp. 33-41.

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title = "Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers",

abstract = "Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes.Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors.Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models.Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS.",

author = "Carisa Harris-Adamson and Eisen, {Ellen A.} and Jay Kapellusch and Arun Garg and Hegmann, {Kurt T.} and Thiese, {Matthew S.} and Dale, {Ann Marie} and Bradley Evanoff and Susan Burt and Stephen Bao and Barbara Silverstein and Linda Merlino and Fred Gerr and David Rempel",

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doi = "10.1136/oemed-2014-102378",

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Harris-Adamson, C, Eisen, EA, Kapellusch, J, Garg, A, Hegmann, KT, Thiese, MS, Dale, AM , Evanoff, B, Burt, S, Bao, S, Silverstein, B, Merlino, L, Gerr, F & Rempel, D 2015, 'Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers', Occupational and Environmental Medicine, vol. 72, no. 1, pp. 33-41. https://doi.org/10.1136/oemed-2014-102378

Biomechanical risk factors for carpal tunnel syndrome : A pooled study of 2474 workers. / Harris-Adamson, Carisa; Eisen, Ellen A.; Kapellusch, Jay; Garg, Arun; Hegmann, Kurt T.; Thiese, Matthew S.; Dale, Ann Marie ; Evanoff, Bradley; Burt, Susan; Bao, Stephen; Silverstein, Barbara; Merlino, Linda; Gerr, Fred; Rempel, David.

In: Occupational and Environmental Medicine, Vol. 72, No. 1, 01.01.2015, p. 33-41.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Biomechanical risk factors for carpal tunnel syndrome

T2 - A pooled study of 2474 workers

AU - Harris-Adamson, Carisa

AU - Eisen, Ellen A.

AU - Kapellusch, Jay

AU - Garg, Arun

AU - Hegmann, Kurt T.

AU - Thiese, Matthew S.

AU - Dale, Ann Marie

AU - Evanoff, Bradley

AU - Burt, Susan

AU - Bao, Stephen

AU - Silverstein, Barbara

AU - Merlino, Linda

AU - Gerr, Fred

AU - Rempel, David

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes.Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors.Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models.Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS.

AB - Background Between 2001 and 2010, five research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries and collected detailed subject-level exposure information with follow-up of symptoms, electrophysiological measures and job changes.Objective This analysis examined the associations between workplace biomechanical factors and incidence of dominant-hand CTS, adjusting for personal risk factors.Methods 2474 participants, without CTS or possible polyneuropathy at enrolment, were followed up to 6.5 years (5102 person-years). Individual workplace exposure measures of the dominant hand were collected for each task and included force, repetition, duty cycle and posture. Task exposures were combined across the workweek using time-weighted averaging to estimate job-level exposures. CTS case-criteria were based on symptoms and results of electrophysiological testing. HRs were estimated using Cox proportional hazard models.Conclusions In this prospective multicentre study of production and service workers, measures of exposure to forceful hand exertion were associated with incident CTS after controlling for important covariates. These findings may influence the design of workplace safety programmes for preventing work-related CTS.Results After adjustment for covariates, analyst (HR=2.17; 95% CI 1.38 to 3.43) and worker (HR=2.08; 95% CI 1.31 to 3.39) estimated peak hand force, forceful repetition rate (HR=1.84; 95% CI 1.19 to 2.86) and per cent time spent (eg, duty cycle) in forceful hand exertions (HR=2.05; 95% CI 1.34 to 3.15) were associated with increased risk of incident CTS. Associations were not observed between total hand repetition rate, per cent duration of all hand exertions, or wrist posture and incident CTS.

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U2 - 10.1136/oemed-2014-102378

DO - 10.1136/oemed-2014-102378

M3 - Article

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AN - SCOPUS:84919460362

VL - 72

SP - 33

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JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

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Biomechanical risk factors for carpal tunnel syndrome: A pooled study of 2474 workers

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