Up-to-date epidemiological results for carpal tunnel syndrome in connection with occupation

Status:

completed 08/2005

Aims:

Carpal tunnel syndrome (CTS) is a disease of the wrists caused by a number of factors. Differentiated assessment of the occupational and non-occupational risk factors has been possible to date only on a limited scale as a differentiated analysis of the available results of scientific studies was not available. A survey was produced by the BG Institute for Occupational Safety and Health (BGIA) involving a summary and critical analysis of the latest epidemiological results on the subject. The objective was to identify influencing factors at the workplace which can cause CTS, and to differentiate them from other possible influencing factors. The definition of suitable prevention measures is to follow.

Activities/Methods:

The literature up to 1997 is already available carefully summarized by the National Institute for Occupational Safety and Health (NIOSH). Therefore the epidemiological literature on carpal tunnel syndrome published since then was systematically searched and evaluated. The publications satisfying certain quality criteria and permitting conclusions on possible occupational risk factors were analysed.

Results:

The results indicate a weak correlation between repetitive work and a risk of carpal tunnel syndrome. Three studies named work involving force as a factor influencing the risk of CTS. Since the definitions of exposure and effect were not comparable, no validated evidence for this correlation could be derived from these indications. Epidemiological studies have produced no validated evidence pointing conclusively to a correlation between other working tasks and CTS. Altogether, the quality of the research conducted since 1997 into the correlation between occupational activity and CTS has improved. A "gold standard" for medical diagnosis is still lacking, however. Future studies and literature surveys should take into account the fact that the prevalence and incidence of CTS and the risk factors associated with it are strongly dependent upon the case definition used. In 1997, highly repetitive work, forceful work, vibration, or one of these in combination with extreme wrist postures were regarded as risk factors for occupationally induced CTS. The analysis presented here of the epidemiological literature published in English and German between 1997 and 2003 permits the conclusion that consistent indicators exist of a minor positive correlation between repetitive work and CTS. The evidence for a relationship between CTS and work involving exertion is weak and of dubious validity. Owing to the inadequate evidence, conclusions cannot be drawn concerning a correlation between CTS and occupational exposure to vibration, work involving extreme wrist postures, or combinations of exposure.

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