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

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.

Download Full-text

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

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105619 ◽

2019 ◽

Vol 76 (8) ◽

pp. 519-526 ◽

Cited By ~ 7

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.

Download Full-text

The COL5A1 gene is associated with increased risk of carpal tunnel syndrome

Clinical Rheumatology ◽

10.1007/s10067-014-2727-7 ◽

2014 ◽

Vol 34 (4) ◽

pp. 767-774 ◽

Cited By ~ 13

Author(s):

Marilize Burger ◽

Hanli de Wet ◽

Malcolm Collins

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Increased Risk ◽

Tunnel Syndrome

Download Full-text

Prevalence of carpal tunnel syndrome and wrist osteoarthritis in long-term paraplegic patients compared with controls

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413478550 ◽

2013 ◽

Vol 39 (2) ◽

pp. 132-138 ◽

Cited By ~ 5

Author(s):

M. Akbar ◽

S. Penzkofer ◽

M. A. Weber ◽

T. Bruckner ◽

M. Winterstein ◽

...

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Structural Changes ◽

Hand Function ◽

Trapeziometacarpal Osteoarthritis ◽

Gender And Age ◽

Tunnel Syndrome ◽

The Right ◽

Matching Criteria

We compared functional and structural changes in the hands, in particular the prevalence of carpal tunnel syndrome, in 56 paraplegic patients who had been wheelchair dependent for over 25 years with a group of able-bodied volunteers (with matching criteria for gender and age). The hands were assessed by clinical examination, electrophysiology, disabilities of the arm shoulder and hand score and magnetic resonance imaging. Hand function was worse and wrist pain was experienced more often in the paraplegic patients, and they also had a significantly higher prevalence of carpal tunnel syndrome both clinically and electrophysiologically. The prevalence of wrist and trapeziometacarpal osteoarthritis was significantly higher in the right hand.

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

Factors Associated with Increased Risk of Recurrence following Treatment of Trigger Finger with Corticosteroid Injection

Journal of Hand and Microsurgery ◽

10.1055/s-0040-1719228 ◽

2020 ◽

Author(s):

Frederik Flensted ◽

Claus Hjorth Jensen ◽

Henrik Daugaard ◽

Jens-Christian Vedel ◽

Rasmus Wejnold Jørgensen

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Thyroid Disease ◽

Primary Treatment ◽

Trigger Finger ◽

Recurrence Time ◽

Risk Of Recurrence ◽

Time To Recurrence ◽

Increased Risk ◽

Tunnel Syndrome

Abstract Introduction The aim of the study was to estimate recurrence rates, time to recurrence, and predisposing factors for recurrence of trigger finger when treated with corticosteroid (CS) injection as primary treatment. Materials and Methods In a retrospective chart review, we identified primary trigger fingers treated with CS injection as primary treatment. Affected hand and finger, recurrence, time to recurrence, duration of symptoms, secondary treatment type, and comorbidities were recorded. A total of 539 patients were included with a mean follow-up of 47.6 months Results In total, 330/539 (61%) recurrences were registered. Mean time to recurrence was 312 days. Increased risk of recurrence was seen after treatment of the third finger (relative risk [RR]: 1.22; 95% confidence interval [CI]: 1.06–1.39). Several comorbidities were associated with increased risk of recurrence: carpal tunnel syndrome (RR: 1.27; 95% CI: 1.07–1.52), thyroid disease (RR: 1.45; 95% CI: 1.15–1.83), or shoulder diseases (RR: 1.58; 95% CI: 1.36–1.83). Conclusion We found a recurrence rate after primary treatment of CS injection for trigger finger of 61%. Most recurrences happened within 2 years and we found treatment of third finger, carpal tunnel syndrome, shoulder, or thyroid disease to be associated with an increased risk of recurrence of symptoms.

Download Full-text

Aromatase Inhibitors and Risk of Arthritis and Carpal Tunnel Syndrome among Taiwanese Women with Breast Cancer: A Nationwide Claims Data Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9020566 ◽

2020 ◽

Vol 9 (2) ◽

pp. 566 ◽

Cited By ~ 2

Author(s):

Hsu-Chih Chien ◽

Yea-Huei Kao Yang ◽

C. Kent Kwoh ◽

Pavani Chalasani ◽

Debbie L. Wilson ◽

...

Keyword(s):

Breast Cancer ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Cancer Recurrence ◽

Research Database ◽

Taiwanese Women ◽

Increased Risk ◽

Significant Difference ◽

Tunnel Syndrome ◽

Claims Data Analysis

Tamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007–2012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 ± 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, p < 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, p = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09–1.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22–2.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81–1.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67–1.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.

Download Full-text