Robert A Werner1. 1. Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor, USA. rawerner@umich.edu
Abstract
OBJECTIVES: Carpal tunnel syndrome (CTS) is common in the industrial setting but there are still some advocates who argue that CTS is not a work related problem. There are also controversies about the proper way to establish the diagnosis and whether screening for CTS in the industrial setting is warranted. METHODS: A comprehensive literature review. RESULTS: The literature does demonstrate that the prevalence of CTS in the industrial setting is significantly higher than in the general population. Numerous epidemiologic studies have identified independent risk factors, which include repetitiveness of work, forceful exertions, mechanical stress, posture, and vibration as well as several personal co-factors. The strength of these associations are discussed. The diagnostic criteria for establishing work-related CTS are discussed as well as the effectiveness of various screening methods that are commonly used in the workplace. The sensitivity and specificity of nerve conduction studies to establish or confirm the diagnosis of CTS is presented along with normative data for the industrial worker. CONCLUSIONS: CTS has both work-related and personal risk factors. The diagnosis is best established using a combination of history, symptom distribution and confirmation using the relative latency of median sensory testing using normative data. Screening for CTS in the industrial setting has questionable benefit.
OBJECTIVES:Carpal tunnel syndrome (CTS) is common in the industrial setting but there are still some advocates who argue that CTS is not a work related problem. There are also controversies about the proper way to establish the diagnosis and whether screening for CTS in the industrial setting is warranted. METHODS: A comprehensive literature review. RESULTS: The literature does demonstrate that the prevalence of CTS in the industrial setting is significantly higher than in the general population. Numerous epidemiologic studies have identified independent risk factors, which include repetitiveness of work, forceful exertions, mechanical stress, posture, and vibration as well as several personal co-factors. The strength of these associations are discussed. The diagnostic criteria for establishing work-related CTS are discussed as well as the effectiveness of various screening methods that are commonly used in the workplace. The sensitivity and specificity of nerve conduction studies to establish or confirm the diagnosis of CTS is presented along with normative data for the industrial worker. CONCLUSIONS:CTS has both work-related and personal risk factors. The diagnosis is best established using a combination of history, symptom distribution and confirmation using the relative latency of median sensory testing using normative data. Screening for CTS in the industrial setting has questionable benefit.
Authors: Yi Wang; Jaclyn M Goodrich; Robert Werner; Brenda Gillespie; Niladri Basu; Alfred Franzblau Journal: Sci Total Environ Date: 2012-01-10 Impact factor: 7.963
Authors: Ann Marie Dale; Bethany T Gardner; Angelique Zeringue; Robert Werner; Alfred Franzblau; Bradley Evanoff Journal: J Occup Environ Med Date: 2014-08 Impact factor: 2.162
Authors: Yi Wang; Jaclyn M Goodrich; Robert Werner; Brenda Gillespie; Niladri Basu; Alfred Franzblau Journal: Sci Total Environ Date: 2013-03-26 Impact factor: 7.963
Authors: Michael S Cartwright; Francis O Walker; Jill N Blocker; Mark R Schulz; Thomas A Arcury; Joseph G Grzywacz; Dana Mora; Haiying Chen; Antonio J Marín; Sara A Quandt Journal: Muscle Nerve Date: 2013-05-06 Impact factor: 3.217
Authors: Z Joyce Fan; Carisa Harris-Adamson; Fred Gerr; Ellen A Eisen; Kurt T Hegmann; Stephen Bao; Barbara Silverstein; Bradley Evanoff; Ann Marie Dale; Matthew S Thiese; Arun Garg; Jay Kapellusch; Susan Burt; Linda Merlino; David Rempel Journal: Am J Ind Med Date: 2015-03-16 Impact factor: 2.214
Authors: Carisa Harris-Adamson; Ellen A Eisen; Ann Marie Dale; Bradley Evanoff; Kurt T Hegmann; Matthew S Thiese; Jay M Kapellusch; Arun Garg; Susan Burt; Stephen Bao; Barbara Silverstein; Fred Gerr; Linda Merlino; David Rempel Journal: Occup Environ Med Date: 2013-05-03 Impact factor: 4.402