O13-4 Exposure-response relationships between movements and postures of the wrist and carpal tunnel syndrome among male and female house painters: a retrospective cohorts study

2016 ◽  
Author(s):  
Jane Froelund Thomsen ◽  
Sigurd Mikkelsen ◽  
Susanne Wulff Svendsen ◽  
Lau Caspar Thygesen ◽  
Gert-Åke Hansson ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Male And Female ◽  
Exposure Response ◽  
Tunnel Syndrome ◽  
House Painters

Differences in characteristics of carpal tunnel syndrome between male and female patients

2020 ◽  
Vol 25 (5) ◽  
pp. 843-846 ◽  
Author(s):  
Tatsunori Mitake ◽  
Katsuyuki Iwatsuki ◽  
Hitoshi Hirata
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Male And Female ◽  
Female Patients ◽  
Tunnel Syndrome

scholarly journals Movements of the wrist and the risk of carpal tunnel syndrome: a nationwide cohort study using objective exposure measurements

2019 ◽  
Vol 76 (8) ◽  
pp. 519-526 ◽  
Author(s):  
Christina Bach Lund ◽  
Sigurd Mikkelsen ◽  
Lau Caspar Thygesen ◽  
Gert-Åke Hansson ◽  
Jane Frølund Thomsen
Keyword(s):  
Cohort Study ◽  
Carpal Tunnel Syndrome ◽  
Angular Velocity ◽  
Carpal Tunnel ◽  
Exposure Level ◽  
Office Work ◽  
Mean Power ◽  
Exposure Response ◽  
Increased Risk ◽  
Tunnel Syndrome

ObjectivesWe conducted a large cohort study to investigate the association between work-related wrist movements and carpal tunnel syndrome (CTS).MethodsElectro-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 (IRRadj) using Poisson regression models.ResultsWe found a clear exposure–response association between wrist angular velocity and CTS with an IRRadj 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 IRRadj 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.ConclusionsHigh 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.

Differences in the association between the 2018 ACGIH TLV for Hand Activity and carpal tunnel syndrome by gender and age

2021 ◽  
Vol 65 (1) ◽  
pp. 708-709
Author(s):  
C Harris-Adamson ◽  
A Meyers ◽  
R Bonfiglioli ◽  
J Kapellusch ◽  
AM Dale ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Older Workers ◽  
Response Models ◽  
Exposure Response ◽  
Younger Workers ◽  
Increased Risk ◽  
Gender And Age ◽  
Tunnel Syndrome ◽  
Working Populations

The recently revised ACGIH TLV for Hand Activity (TLV2018) is a widely used tool for assessing risk for upper limb musculoskeletal disorders. The purpose of this analysis was to compare the strength of the exposure-response relationships between the TLV2018 and carpal tunnel syndrome (CTS) between men and women and across age strata. Heterogeneity of the effect size by sex or age would be important to specialists using the method for prevention of CTS among working populations. Data from two large prospective studies were combined to allow for stratification of exposure-response models assessing the association between the TLV2018 and CTS by gender and age. Results show greater risk for women than men and for younger workers than older workers for TLV2018 values above the action limit. Although the TLV2018 is an effective surveillance tool for estimating increased risk of CTS with increasing exposure, these analyses show that such increase are not homogeneous across sex and age.

Clinical Update: Assessing Maximum Medical Improvement in Carpal Tunnel Syndrome

2003 ◽  
Vol 8 (4) ◽  
pp. 4-5
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Proper Time ◽  
Carpal Tunnel Release ◽  
Hand Function ◽  
Factors Affecting ◽  
Early Results ◽  
Medical Evaluation ◽  
Nerve Recovery ◽  
Tunnel Syndrome

Abstract Permanent impairment cannot be assessed until the patient is at maximum medical improvement (MMI), but the proper time to test following carpal tunnel release often is not clear. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) states: “Factors affecting nerve recovery in compression lesions include nerve fiber pathology, level of injury, duration of injury, and status of end organs,” but age is not prognostic. The AMA Guides clarifies: “High axonotmesis lesions may take 1 to 2 years for maximum recovery, whereas even lesions at the wrist may take 6 to 9 months for maximal recovery of nerve function.” The authors review 3 studies that followed patients’ long-term recovery of hand function after open carpal tunnel release surgery and found that estimates of MMI ranged from 25 weeks to 24 months (for “significant improvement”) to 18 to 24 months. The authors suggest that if the early results of surgery suggest a patient's improvement in the activities of daily living (ADL) and an examination shows few or no symptoms, the result can be assessed early. If major symptoms and ADL problems persist, the examiner should wait at least 6 to 12 months, until symptoms appear to stop improving. A patient with carpal tunnel syndrome who declines a release can be rated for impairment, and, as appropriate, the physician may wish to make a written note of this in the medical evaluation report.

Clinical Update: Understanding Causation: An Example Using Carpal Tunnel Syndrome

2007 ◽  
Vol 12 (6) ◽  
pp. 5-8 ◽  
Author(s):  
J. Mark Melhorn
Keyword(s):  
Risk Factors ◽  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Legal Responsibility ◽  
Medical Evidence ◽  
Anatomic Structure ◽  
Legal Professionals ◽  
Compensation Systems ◽  
Tunnel Syndrome ◽  
Four Levels

Abstract Medical evidence is drawn from observation, is multifactorial, and relies on the laws of probability rather than a single cause, but, in law, finding causation between a wrongful act and harm is essential to the attribution of legal responsibility. These different perspectives often result in dissatisfaction for litigants, uncertainty for judges, and friction between health care and legal professionals. Carpal tunnel syndrome (CTS) provides an example: Popular notions suggest that CTS results from occupational arm or hand use, but medical factors range from congenital or acquired anatomic structure, age, sex, and body mass index, and perhaps also involving hormonal disorders, diabetes, pregnancy, and others. The law separately considers two separate components of causation: cause in fact (a cause-and-effect relationship exists) and proximate or legal cause (two events are so closely related that liability can be attached to the first event). Workers’ compensation systems are a genuine, no-fault form of insurance, and evaluators should be aware of the relevant thresholds and legal definitions for the jurisdiction in which they provide an opinion. The AMA Guides to the Evaluation of Permanent Impairment contains a large number of specific references and outlines the methodology to evaluate CTS, including both occupational and nonoccupational risk factors and assigning one of four levels of evidence that supports the conclusion.

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