Carpal tunnel syndrome: What is attributable to work? The Montreal Study

Montreal Department of Public Health, Canada.
Occupational and Environmental Medicine (Impact Factor: 3.27). 08/1997; 54(7):519-23. DOI: 10.1136/oem.54.7.519
Source: PubMed


To estimate the fraction of carpal tunnel syndrome (CTS) that is attributable to work in the total adult population of the island of Montreal.
The population consisted of 1.1 million people 20-64 years of age, with 73.2% of men and 60.6% of women employed. The rates of first surgery for CTS were compared between occupational groups and the total adult population with the standardised incidence ratio (SIR) method. Rates of surgery for the island of Montreal were obtained from the provincial data base of payments. The occupational history was obtained from telephone interviews of a sample of surgical cases. The attributable fractions in exposed people were calculated with odds ratios (ORs) obtained from logistic regressions with non-manual workers as the control group.
The surgical incidence of CTS was 0.9/1000 adults. SIRs for all manual workers were 1.9 (95% confidence interval (95% CI) 1.4-2.5) in men and 1.8 (95% CI 1.4-2.2) in women, and the fractions attributable to work were 76% (95% CI 47-88) and 55% (95% CI 33-69), respectively. Seven occupational groups were identified as having excess risk of surgical CTS, with fractions attributable to occupation ranging from 75% to 99%.
Among manual workers on the island of Montreal, 55% of surgical CTS in women and 76% in men was attributable to work. Increased risk of surgical CTS was found in seven occupational groups.

Download full-text


Available from: Susan R Stock
  • Source
    • "Combining electro diagnostic and clinical criteria for CTS classification in blue collar workers had a significant relative risk (RR) of 3 for women and a RR of 4.2 for men[37]. And in a Montreal Study of patients undergoing CTS surgery, 76% of CTS in male manual workers was judged attributable to work[38]. Similar conclusions of CTS work-relatedness were reached in several other studies394041. "

    Preview · Article · Jan 2016
  • Source
    • "Las compensaciones económicas demandadas a las empresas y las aseguradoras con respecto a los días de ausentismo laboral, asociados a los costos indirectos, que se asumen por esta patología se promedian en 30 días en los Estados Unidos y en Inglaterra en 27 días [7] [8]. La Tabla 1 muestra los Odds Ratio y Fracción Atribuible de acuerdo con la exposición laboral [9], esto con el fin de evidenciar que grupo de trabajadores tienen un mayor chance de desarrollar esta patología. 2212-1099/$36.00 – see front matter Copyright & 2013, International Society for Pharmacoeconomics and Outcomes Research (ISPOR). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Knowing the burden of disease related to carpal tunnel syndrome in the Colombian working population and the importance of assessing the indirect costs against the total costs of the disease. Methods We reviewed the literature on the prevalence and incidence of carpal tunnel syndrome in the Colombian population, disability days caused by this disease and methods for the assessment of indirect costs, such as the human capital approach and the friction costs. From the databases provided by the Ministry of Social Protection of Colombia and two from General System insurers Colombian Social Security, assessing the importance of the consideration of indirect costs in relation to the total costs of the disease. Results We developed a regression model that shows the relationship between costs (total) of disease and disability days. Indirect costs represented by disability days have a higher correlation with the total cost with the time of treatment of disease. Conclusions Carpal tunnel syndrome is a common condition in the working population; which may affect the frequency of increased absenteeism. Consequently, this could lead to increased overhead costs and therefore total costs associated with a disease.
    Full-text · Article · Dec 2013
  • Source
    • "Moreover, many industrial job titles were poorly represented due to regional employment characteristics (the 95% CI for specific job titles and other occupational subgroups tended to be wide due to limited absolute numbers). Although most studies of occupational risk of CTS have focused on industrial settings [17], some at-risk "non-industrial" occupational job titles have also been reported, including housekeepers/cleaners, food/beverage service workers, grocery store workers, postal workers, health workers, lorry/bus drivers, and child care workers [14,30,32]. In the present work, raised risks of surgically treated CTS were recorded in several clearly non-industrial blue-collar categories: food retail workers, waiters/bartenders, cooks, agricultural/horticultural workers (including many in the fruit-growing sector), cleaners/domestic helpers, and nursing/paramedical workers (with point estimates between about 8 and 30, albeit with wide 95% CI). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Carpal tunnel syndrome (CTS) is a socially and economically relevant disease caused by compression or entrapment of the median nerve within the carpal tunnel. This population-based case-control study aims to investigate occupational/non-occupational risk factors for surgically treated CTS. Cases (n = 220) aged 18-65 years were randomly drawn from 13 administrative databases of citizens who were surgically treated with carpal tunnel release during 2001. Controls (n = 356) were randomly sampled from National Health Service registry records and were frequency matched by age-gender-specific CTS hospitalization rates. At multivariate analysis, risk factors were blue-collar/housewife status, BMI > or = 30 kg/m2, sibling history of CTS and coexistence of trigger finger. Being relatively tall (cut-offs based on tertiles: women > or =165 cm; men > or =175 cm) was associated with lower risk. Blue-collar work was a moderate/strong risk factor in both sexes. Raised risks were apparent for combinations of biomechanical risk factors that included frequent repetitivity and sustained force. This study strongly underlines the relevance of biomechanical exposures in both non-industrial and industrial work as risk factors for surgically treated CTS.
    Full-text · Article · Sep 2009 · BMC Public Health
Show more