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Personal and Workplace Factors and Median Nerve Function in a Pooled Study of 2396 US Workers

Rempel, David MD, MPH; Gerr, Fred MD; Harris-Adamson, Carisa PhD; Hegmann, Kurt T. MD; Thiese, Matthew S. PhD; Kapellusch, Jay PhD; Garg, Arun PhD; Burt, Susan ScD; Bao, Stephen PhD; Silverstein, Barbara PhD; Merlino, Linda MS; Dale, Ann Marie PhD; Evanoff, Bradley MD

Journal of Occupational and Environmental Medicine: January 2015 - Volume 57 - Issue 1 - p 98–104
doi: 10.1097/JOM.0000000000000312
Original Articles

Objective: Evaluate associations between personal and workplace factors and median nerve conduction latency at the wrist.

Methods: Baseline data on workplace psychosocial and physical exposures were pooled from four prospective studies of production and service workers (N = 2396). During the follow-up period, electrophysiologic measures of median nerve function were collected at regular intervals.

Results: Significant adjusted associations were observed between age, body mass index, sex, peak hand force, duration of forceful hand exertions, Threshold Limit Value for Hand Activity Limit, forceful repetition rate, wrist extension, and decision latitude on median nerve latencies.

Conclusions: Occupational and nonoccupational factors have adverse effects on median nerve function. Measuring median nerve function eliminates possible reporting bias that may affect symptom-based carpal tunnel syndrome case definitions. These results suggest that previously observed associations between carpal tunnel syndrome and occupational factors are not the result of such reporting bias.

From the Division of Occupational and Environmental Medicine (Drs Rempel and Harris-Adamson), University of California at San Francisco; Department of Occupational and Environmental Health (Dr Gerr and Ms Merlino), College of Public Health, University of Iowa; the Rocky Mountain Center for Occupational and Environmental Health (Drs Hegmann and Thiese), University of Utah, Salt Lake City; Department of Occupational Science and Technology (Drs Kapellusch and Garg), University of Wisconsin–Milwaukee; the National Institute for Occupational Safety and Health (Dr Burt), Cincinnati, Ohio; the Safety and Health Assessment and Research for Prevention Program (Drs Bao and Silverstein), Washington State Department of Labor and Industries, Olympia; and the Division of General Medical Science (Drs Dale and Evanoff), Washington University School of Medicine, Saint Louis.

Address correspondence to: David Rempel, MD, MPH, Division of Occupational and Environmental Medicine, University of California at San Francisco, 1301 South 46th St Bldg 163, Richmond, CA 94804 (

This study was supported in part by research funding from the Center for Disease Control/National Institute for Occupational Safety and Health (R01OH009712) and the Washington University Institute of Clinical and Translational Sciences Award (UL1 TR000448) from the National Center for Advancing Translational Sciences of the National Institutes of Health. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.

The authors declare no conflicts of interest.

Copyright © 2015 by the American College of Occupational and Environmental Medicine