Post-Offer Screening and Risk Factors for CTS

Details

• Personal Author:
  Evanoff B ; Franzblau, Alfred
• Description:
  Our study addresses two controversies concerning carpal tunnel syndrome (CTS), a common and costly disorder in working populations. One controversy concerns the relative contributions of work exposures and personal characteristics in the multi-factorial etiology of carpal tunnel syndrome. The second controversy concerns effective preventive strategies for CTS. Some have advocated pre-employment screening nerve conduction studies, with the rationale that these studies can predict future risk of developing carpal tunnel syndrome. Workers at higher risk for CTS can then be kept from jobs requiring intensive hand activity. Though screening for CTS is common, its effectiveness and the role of placement strategies in preventing carpal tunnel syndrome have not previously been studied in a prospective study. We conducted a prospective, longitudinal study of 1100 newly hired workers in a mixture of industries at increased risk for CTS. Baseline data included nerve conduction studies, a medical history, symptoms, physical examination, and job exposures. Workers were followed for 3 years through repeated questionnaires; a subcohort of more than 450 workers received more detailed followup, including repeat nerve conduction testing and observation of job exposures. Preliminary analyses from our study found that personal characteristics of obesity and age affected the risk of CTS. Past work exposures to force, vibration, and repetition also conferred a higher risk of CTS, even when controlled for age, obesity, and gender. While baseline nerve conduction studies did predict a higher rate of future CTS, the cost of screening all prospective employees outweighed likely costs savings that would result from not hiring workers with nerve conduction abnormalities. Most workers with abnormal baseline testing would not develop CTS, and most workers who developed CTS had normal baseline findings. Our study suggests that reducing workplace physical exposures is likely to reduce future risk of CTS, and that addressing other aspects of worker health such as reducing obesity may also prevent future cases of CTS. Preemployment screening of workers with nerve conduction testing is unlikely to be a cost effective preventive measure in most industries. Our study data are undergoing further analysis, and will be pooled with data from five other studies in a future study that will allow more precise exposure response measures meant to provide specific guidance to workplace safety professionals on levels of exposure related to increased risks of CTS. [Description provided by NIOSH]
• Subjects:
  Age Factors Cumulative Trauma Disorders Musculoskeletal Diseases Musculoskeletal System Occupational Exposure Occupational Health Protective Clothing Risk Assessment Risk Factors Safety Surveys And Questionnaires Vibration

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• Keywords:
  Activity Levels Age Factors Carpal Tunnel Syndrome Clinical Tests Costs CTS Employee Exposure Etiology Force Hand Injuries Hand Protection Health Surveys Injury Prevention Longitudinal Study Medical Screening Musculoskeletal System Disorders Nerve Function Obesity Physical Stress Physiological Testing Preemployment Examinations Questionnaires Repetitive Stress Risk Assessment Risk Factors Work Performance

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Missouri ; OSHA Region 7
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-21
• NIOSHTIC Number:
  nn:20050274
• NTIS Accession Number:
  PB2018-100232
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-008017, 2013 Feb; :1-21
• Contact Point Address:
  Bradley Evanoff, MD, MPH, Washington University School of Medicine, 660 South Euclid Ave., Box 8005, St. Louis, MO 63110
• Email:
  bevanoff@dom.wustl.edu
• Federal Fiscal Year:
  2013
• NORA Priority Area:
  Construction ; Manufacturing
• Performing Organization:
  Washington University - St. Louis, Missouri
• Peer Reviewed:
  False
• Start Date:
  20040601
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20151231
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5bc26424e4a31370b0f367117ca1047c76ebcd43f2f38e5db6783dc1291df60fb19d67bbb6d97bc0714030440ef5972c5e2f3571f58db9fb950ff8cfa3513a75
• Download URL:
  https://stacks.cdc.gov/view/cdc/218667/cdc_218667_DS1.pdf
• File Type:
  [PDF - 606.98 KB ]