Exposure–response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal 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.

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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

10.1136/oemed-2016-103951.69 ◽

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

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The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnelsyndrome (CTS) in a prospective cohort

Ergonomics ◽

10.1080/00140139.2011.644328 ◽

2012 ◽

Vol 55 (4) ◽

pp. 396-414 ◽

Cited By ~ 57

Author(s):

A. Garg ◽

J. Kapellusch ◽

K. Hegmann ◽

J. Wertsch ◽

A. Merryweather ◽

...

Keyword(s):

Prospective Cohort ◽

Threshold Limit Value ◽

Activity Level ◽

Strain Index ◽

Limit Value ◽

Threshold Limit

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

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181321651238 ◽

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.

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