Incident CTS in a large pooled cohort study: Associations obtained by a job exposure matrix versus associations obtained from observed exposures

Ann Marie Dale, Christine C. Ekenga, Skye Buckner-Petty, Linda Merlino, Matthew S. Thiese, Stephen Bao, Alysha Rose Meyers, Carisa Harris-Adamson, Jay Kapellusch, Ellen A. Eisen, Fred Gerr, Kurt T. Hegmann, Barbara Silverstein, Arun Garg, David Rempel, Angelique Zeringue, Bradley A. Evanoff

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19 Scopus citations


Background There is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures. Objective T his study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study. Methods 2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O NET. Results Both exposure methods found associations between incident CT S and exposures of force and repetition, with evidence of dose-response. Observed associations were similar across the two methods, with somewhat wider CI s for HRs calculated using the JEM method. Conclusion E xposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the 'gold standard' method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures.

Original languageEnglish
Pages (from-to)501-506
Number of pages6
JournalOccupational and Environmental Medicine
Issue number7
StatePublished - 2018


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