A Longitudinal Study of Predictors of Research-Defined Carpal Tunnel Syndrome in Industrial Workers: Findings at 17 Years

In 1984, we initiated a prospective study of factors associated with research-defined carpal tunnel syndrome (CTS) in 471 industrial workers. Medical history, lifestyle factors and job tasks were assessed by questionnaire and CTS case status was based on both symptoms and electrophysiologic findings. Participants were re-examined in 1989, 1994 to 1995 and 2001 to 2002. This study reports both baseline and aggregated risk factors associated with increased risk of CTS by 2001 to 2002 for 166 participants successfully re-examined after 17 years. In analyses of baseline risk factors, fewer repetitive tasks at work, female gender and greater relative weight were associated with any occurrence of CTS during follow-up. In analyses of aggregate risk factor scores through 1994 to 1995, only greater relative weight and female gender were associated with CTS in 2001 to 2002. Although obesity and gender are consistent predictors of CTS, workplace demands appear to bear an uncertain relationship to CTS. These findings are also discussed in relation to the possible differences between research-defined CTS and medically referred CTS.

Download Full-text

Anastrozole-Induced Carpal Tunnel Syndrome: Results From the International Breast Cancer Intervention Study II Prevention Trial

Journal of Clinical Oncology ◽

10.1200/jco.2015.63.4972 ◽

2016 ◽

Vol 34 (2) ◽

pp. 139-143 ◽

Cited By ~ 17

Author(s):

Francesco Spagnolo ◽

Ivana Sestak ◽

Anthony Howell ◽

John F. Forbes ◽

Jack Cuzick

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Odds Ratio ◽

Intervention Study ◽

Musculoskeletal Symptoms ◽

Increased Risk ◽

Tunnel Syndrome ◽

Cancer Intervention

Purpose Carpal tunnel syndrome (CTS) occurs when the median nerve is compressed at the wrist in the carpal tunnel. It has been suggested that hormonal risk factors may be involved in the pathogenesis of CTS, and a higher incidence of CTS has been reported in randomized clinical trials with aromatase inhibitors (AIs) compared with tamoxifen. Patients and Methods This was an exploratory analysis of the International Breast Cancer Intervention Study II, a double-blind randomized clinical trial in which women at increased risk of breast cancer were randomly assigned to receive anastrozole or placebo. This is the first report of risk factors for and characteristics of CTS in women taking an AI in a placebo-controlled trial. Results Overall, 96 participants with CTS were observed: 65 (3.4%) in the anastrozole arm and 31 (1.6%) in the placebo arm (odds ratio, 2.16 [1.40 to 3.33]; P < .001). Ten participants were reported as having severe CTS, of which eight were taking anastrozole (P = .08). Eighteen women (0.9%) in the anastrozole arm and six women (0.3%) in the placebo arm reported surgical intervention, which was significantly different (odds ratio, 3.06 [1.21 to 7.72], P = .018). Six women discontinued with the allocated treatment because of the onset of CTS. Apart from treatment allocation, a high body mass index and an a prior report of musculoskeletal symptoms after trial entry were the only other risk factors for CTS identified in these postmenopausal women. Conclusions The use of anastrozole was associated with a higher incidence of CTS but few participants required surgery. Further investigations are warranted into the risk factors and treatment of AI-induced CTS.

Download Full-text

Carpal Tunnel Syndrome in Military Aviators

Military Medicine ◽

10.1093/milmed/usaa077 ◽

2020 ◽

Vol 185 (9-10) ◽

pp. e1506-e1509

Author(s):

J Banks Deal ◽

Anthony J Magee

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Protective Factor ◽

Female Gender ◽

Age Group ◽

White Race ◽

Helicopter Pilots ◽

Tunnel Syndrome ◽

The Military

Abstract Introduction The incidence of carpal tunnel syndrome (CTS) is increased in occupations exposed to repetitive motion, poor wrist posture, and vibration exposure. While all pilots are exposed to these factors, helicopter pilots are especially exposed to vibration. The study is to identify the incidence and risk factors for CTS in military aviators. Materials and Methods Clearance was obtained from Tripler Army Medical Center IRB. The Defense Medical Epidemiological Database was queried for all new cases of CTS from 2006 to 2015. Incidence rates (IRs) were determined for helicopter pilots, fixed-wing pilots, and nonpilot officers. Poisson regression analysis was used to calculate adjusted IR in order to control for demographic factors. Race was also taken into account, where pilots would classify themselves into a white or non-white race, defined by each individual. Race was assessed in the study to see if there were any differences in IR of CTS between white and non-white pilots. Results We identified 7,398 new cases of CTS among 2,319,352 person-years within the study period. Increasing age, female gender, and non-white race were significantly correlated with higher IR. Fixed-wing pilots demonstrated significantly lower adjusted IR than nonpilot officers in each age group. Helicopter pilots demonstrated higher IR than fixed-wing pilots in each age group. Helicopter pilots had lower incidence of CTS early in their career compared to nonpilot officers, but by age 40+, their IR ratio was significantly higher (1.21). Conclusion Analysis of the database indicates that fixed-wing pilot status is a protective factor against development of CTS among U.S. military officers. In contrast, helicopter pilots were found to be at an increased rate of CTS than their fixed-wing counterparts. Their incidence is comparable to their nonpilot officer peers early in their career, but is significantly increased at the senior level. Increasing age and female gender are risk factors in the military officer population as expected. Non-white race was found to increase risk in the military population, in contrast to reports of the civilian population.

Download Full-text

Prevalence and risk factors associated with self-reported carpal tunnel syndrome (CTS) among office workers in Kuwait

BMC Research Notes ◽

10.1186/1756-0500-5-289 ◽

2012 ◽

Vol 5 (1) ◽

pp. 289 ◽

Cited By ~ 5

Author(s):

Sudha R Raman ◽

Becher Al-Halabi ◽

Elham Hamdan ◽

Michel D Landry

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Office Workers ◽

Factors Associated ◽

Tunnel Syndrome

Download Full-text

Risk Factors of Carpal Tunnel Syndrome for Male Patient Undergoing Carpal Tunnel Release

Handchirurgie · Mikrochirurgie · Plastische Chirurgie ◽

10.1055/a-0747-5982 ◽

2018 ◽

Vol 50 (05) ◽

pp. 335-340

Author(s):

Jun-Ku Lee ◽

Soo-Hyun Lee ◽

Banghyun Kim ◽

Kyunghun Jung ◽

Inkeun Park ◽

...

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Fluid Balance ◽

Occupational Risk ◽

Occupational Risk Factors ◽

Factors Associated ◽

Female Patients ◽

Tunnel Syndrome ◽

Male Patients

Abstract Introduction Although the major cause of carpal tunnel syndrome (CTS) remains idiopathic, many male CTS patients are clinically different from female patients and often have specific risk factors associated with their conditions. An accurate analysis of such propensity has yet to be established. The purpose of this study is to compare male and female patients by analyzing the risk factors associated with CTS patients who underwent surgical treatment, with focus on their occupation. Patients/Material and Methods retrospective chart review of 818 patients with CTS was performed to identify the associated risk factors. Patients were stratified by gender: female (n = 707, 86.4 %) and male (n = 111, 13.6 %). The mean patient age was 54.5 (range: 16–85 yr.) for all groups. The medical history and risk factors of each patient was thoroughly reviewed by medical charts and telephone survey. We categorized the risk factors of CTS into 7 categories: anatomic, neuropathic, inflammatory, alteration of fluid balance, distal radius fracture associated, occupational risk factor related, and idiopathic. Occupations of CTS patients were divided into high risk occupations (vibratory tools, assembly jobs, and food processing and packaging jobs, and other occupations of repetitive wrist motion and forceful gripping) and nonrisk occupations. All variables were analyzed with chi-square or Fisher’s exact test for differences between men and women. Results The number of individuals with known risk factors of CTS was greater in male, compared to that of female patients; 97 (87.4 %) male patients had the risk factors of CTS, while 361 (51.1 %) female patients (p < 0.001) did. In subgroup analysis of risk factors, male patients had frequent risk factors in neuropathic, inflammatory, and alteration of fluid balance (p < 0.001). Occupational risk was strongly associated with male gender (p < 0.001). Conclusion Male CTS patients who underwent surgery are more likely to have a reason and have many occupational risk factors than women.

Download Full-text

Symptoms and risk factors associated with carpal tunnel syndrome in east of Turkey: Evaluation /INS;of 767 cases

Journal of the Neurological Sciences ◽

10.1016/j.jns.2013.07.2467 ◽

2013 ◽

Vol 333 ◽

pp. e715

Author(s):

R. Alp ◽

S. Ilhan Alp ◽

G. Bulut ◽

Y. Palanci ◽

U. Turk Boru

Keyword(s):

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Factors Associated ◽

Tunnel Syndrome

Download Full-text

Identification of Common Risk Factors Associated with Carpal Tunnel Syndrome

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v29i2.56175 ◽

2013 ◽

Vol 29 (2) ◽

pp. 70-78

Author(s):

MD Nahidul Islam ◽

Mohammad Shah Jahirul Hoque Chowdhury ◽

MD Tauhidul Islam Chowdhury ◽

Ahmed Hossain Chowdhury ◽

Mahmudul Islam ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Diabetes Mellitus ◽

Risk Factors ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Factors Associated ◽

Group I ◽

Tunnel Syndrome ◽

Common Risk Factors ◽

Group Ii

Objective: To identify the common risk factors associated with carpal tunnel syndrome. Methodology:This case-control observational study was conducted in the department of neurology and medicine, DMCH from May 2010 to April 2011 for a duration of 1 year. The study included purposively selected 80 persons. Patients attending the outdoor and admitted in indoor of department of neurology and medicine, DMCH with a clinically suspected CTS and established by electrophysiological parameters selected as cases (group –I) . Healthy volunteers and subjects who were devoid of any features of CTS but having history with isolated injury to the lower limb nerve and isolated facial nerve palsy with normal electrophysiological parameters selected as control (group –II). Data were collected by interview of the patients, clinical examination and laboratory investigations using the research instrument. Result: The mean age was 42.7±9.8 years with range from 24 to 64 years and 41.1±9.1 years with range from 26 to 61 years in group-I and group-II respectively. The proportion of male and female patients was similar in both the study groups. Male Female ratio was 1: 7 in both groups. In this study it was observed that hypothyroidism was found 25.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in carpal tunnel syndrome patients. Diabetes mellitus was significantly higher in carpal tunnel syndrome patients, which was 22.5% in group I and 7.5% in group II. Rheumatoid arthritis was found 20.0% in group I and 5.0% in group II, which was significantly (p<0.05) higher in patients with carpal tunnel syndrome. Pregnancy was found 11.4% in group I and 2.9% in group II. CKD with hemodialysis was found 17.5% and 7.5% in group I and group II respectively. In pregnancy and CKD with hemodialysis difference was not statistically significant (p>0.05) among the two groups. Regarding obesity it was found in this present series that 42.5% and 17.5% patients were obese in group I and group II respectively. Obesity was significantly (p<0.05) higher in patients with carpal tunnel syndrome. In this study it was found in multivariate analysis that patients with hypothyroidism 1.28 times, DM 2.20 times, RA disease 3.84 times, obesity 5.9 times more likely to be associated with carpal tunnel syndrome but CKD with hemodialysis patients and pregnancy were not significantly associated in multivariate analysis. In this study it was also found that almost a half (47.5%) of the patients was housewives followed by garment workers (27.5%) and clerical workers (22.5%) in group I, which indicates that carpal tunnel syndrome was more common among housewives. Conclusion: A conclusion can be made from the above mentioned result that CTS is multifactorial. Obesity, diabetes mellitus, hypothyroidism and rheumatoid arthritis are commonly associated with carpal tunnel syndrome. Moreover female sex and age were also associated with CTS. This study also found that patients diagnosed as having work-related CTS have a high prevalence of concurrent medical conditions capable of causing CTS without respect to any particular occupation. Bangladesh Journal of Neuroscience 2013; Vol. 29 (2) : 70-78

Download Full-text