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Risk Factors for Carpal Tunnel Syndrome and Median Neuropathy in a Working Population

Armstrong, Theodore BS; Dale, Ann Marie MS OTR/L; Franzblau, Alfred MD; Evanoff, Bradley A. MD, MPH

Journal of Occupational and Environmental Medicine: December 2008 - Volume 50 - Issue 12 - p 1355-1364
doi: 10.1097/JOM.0b013e3181845fb1
Original Articles

Objective: To assess whether work-related physical activities are associated with Carpal tunnel syndrome (CTS), even when controlling for personal risk factors.

Methods: A cross-sectional assessment of 1108 workers from eight employers and three unions completed nerve conduction testing, physical examination, and questionnaires. CTS was defined by median neuropathy and associated symptoms.

Results: Eighteen workers had CTS and 131 had evidence of median neuropathy. CTS was highest among construction workers (3.0%) compared to other subjects (<1%). Logistic regression models for median neuropathy both personal and work-related risk factors. Work-related exposures were estimated by two methods: self-report and job title based ratings.

Conclusions: Both work and personal factors mediated median nerve impairment. Construction workers are at an increased risk of CTS so awareness should be raised and interventions should specifically target this risk group.

From the Division of General Medical Sciences (Mr Armstrong, Ms Dale, Dr Evanoff), Washington University School of Medicine, St. Louis, Mo.; and the Department of Environmental Health Sciences (Dr Franzblau), University of Michigan School of Public Health, Ann Arbor, Mich.

No authors in this study are affiliated with any organization that to any author’s knowledge have direct interests, including financial interest, in the subject matter or materials discussed.

Bradley A. Evanoff has the right to grant on behalf of all authors and does grant on behalf of all authors, an exclusive license (or nonexclusive for government employees) on a worldwide basis to the BMJ Publishing group Ltd and its Licensees to permit this article (if accepted) to be published in OEM and any other BMJPGL products to exploit all subsidiary rights, as set out in our license.

This study was presented at the Sixth International Scientific Conference on Prevention of Work-Related Musculoskeletal Disorders, August 2007.

Dr Evanoff had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Address correspondence to: Bradley A. Evanoff, Washington University in St. Louis School of Medicine, Division of General Medical Sciences, Campus Box 8005, 660 S Euclid Ave, St. Louis, MO 63110; E-mail:

Copyright © 2008 by the American College of Occupational and Environmental Medicine