TY - JOUR

T1 - Movements of the wrist and the risk of carpal tunnel syndrome

T2 - a nationwide cohort study using objective exposure measurements

AU - Lund, Christina Bach

AU - Mikkelsen, Sigurd

AU - Thygesen, Lau Caspar

AU - Hansson, Gert Åke

AU - Thomsen, Jane Frølund

PY - 2019

Y1 - 2019

N2 - Objectives We conducted a large cohort study to investigate the association between work-related wrist movements and carpal tunnel syndrome (CTS). Methods Electro-goniometric measurements of wrist movements were performed for 30 jobs (eg, office work, child care, laundry work and slaughterhouse work). We measured wrist angular velocity, mean power frequency (MPF) and range of motion (ROM). We established a cohort of Danish citizens born 1940-1979 who held one of these jobs from age 18-80 years, using Danish national registers with annual employment information from 1992 to 2014. We updated the cohort by calendar year with job-specific and sex-specific means of measured exposures. Dates of a first diagnosis or operation because of CTS were retrieved from the Danish National Patient Register. The risk of CTS by quintiles of preceding exposure levels was assessed by adjusted incidence rate ratios (IRR adj) using Poisson regression models. Results We found a clear exposure-response association between wrist angular velocity and CTS with an IRR adj of 2.31 (95% CI 2.09 to 2.56) when exposed to the highest level compared with the lowest. MPF also showed an exposure-response pattern, although less clear, with an IRR adj of 1.83 (1.68 to 1.98) for the highest compared with the lowest exposure level. ROM showed no clear pattern. Exposure-response patterns were different for men and women. Conclusions High levels of wrist movement were associated with an increased risk of CTS. Preventive strategies should be aimed at jobs with high levels of wrist movements such as cleaning, laundry work and slaughterhouse work.

AB - Objectives We conducted a large cohort study to investigate the association between work-related wrist movements and carpal tunnel syndrome (CTS). Methods Electro-goniometric measurements of wrist movements were performed for 30 jobs (eg, office work, child care, laundry work and slaughterhouse work). We measured wrist angular velocity, mean power frequency (MPF) and range of motion (ROM). We established a cohort of Danish citizens born 1940-1979 who held one of these jobs from age 18-80 years, using Danish national registers with annual employment information from 1992 to 2014. We updated the cohort by calendar year with job-specific and sex-specific means of measured exposures. Dates of a first diagnosis or operation because of CTS were retrieved from the Danish National Patient Register. The risk of CTS by quintiles of preceding exposure levels was assessed by adjusted incidence rate ratios (IRR adj) using Poisson regression models. Results We found a clear exposure-response association between wrist angular velocity and CTS with an IRR adj of 2.31 (95% CI 2.09 to 2.56) when exposed to the highest level compared with the lowest. MPF also showed an exposure-response pattern, although less clear, with an IRR adj of 1.83 (1.68 to 1.98) for the highest compared with the lowest exposure level. ROM showed no clear pattern. Exposure-response patterns were different for men and women. Conclusions High levels of wrist movement were associated with an increased risk of CTS. Preventive strategies should be aimed at jobs with high levels of wrist movements such as cleaning, laundry work and slaughterhouse work.

KW - carpal tunnel syndrome

KW - electro-goniometry

KW - work-related carpal tunnel syndrome

KW - work-related disorders of the upper limb

KW - wrist movement

U2 - 10.1136/oemed-2018-105619

DO - 10.1136/oemed-2018-105619

M3 - Journal article

C2 - 31189693

AN - SCOPUS:85067287402

VL - 76

SP - 519

EP - 526

JO - Occupational and Environmental Medicine

JF - Occupational and Environmental Medicine

SN - 1351-0711

IS - 8

ER -