Documents Patry, Louis 2 results

A validation study of a questionnaire on occupational risk factors for carpal tunnel syndrome (CTS) was performed. A questionnaire designed for interviewing CTS patients to identify possible risk factors for CTS was developed based on a systematic review of published studies examining work practices and exposures implicated as causing CTS. The questionnaire consisted of eight questions designed to enable scores for five potential risk factors for CTS to be computed: use of force by hands and wrists, awkward wrist motions, duration of tasks requiring forceful or awkward wrist movements, exposure to cold, and exposure to vibrations. The questionnaire was evaluated using 238 residents of Montreal, Canada, who were being surgically treated for CTS. They had been employed in occupations such as cleaner or housekeeper, material handler, food and beverage processor, electronic data processing equipment operator, food and beverage server, and motor transport operator. Associations between the questionnaire scores for the five potential risk factors and the risk of CTS in the patients' occupations were examined by computing the standardized incidence ratios (SIRs) for CTS in these occupations. The SIRs were calculated using the background CTS rate in the general Montreal population as the reference. The CTS SIRs varied from 2.7 for employment as a motor transport operator to 10.6 for employment in cleaning and housekeeping. Use of force by the hands and wrists was the only potential risk factor associated with an increased risk for CTS. The mean scores increased significantly with increasing CTS SIRs. The authors conclude that questioning workers on the amount of force they have applied to perform tasks that are especially demanding for the wrists or hands is useful both clinically and for deciding whether an individual CTS case is occupationally related.

"OBJECTIVE: To estimate the fraction of carpal tunnel syndrome (CTS) that is attributable to work in the total adult population of the island of Montreal. METHODS: The population consisted of 1.1 million people 20-64 years of age, with 73.2% of men and 60.6% of women employed. The rates of first surgery for CTS were compared between occupational groups and the total adult population with the standardised incidence ratio (SIR) method. Rates of surgery for the island of Montreal were obtained from the provincial data base of payments. The occupational history was obtained from telephone interviews of a sample of surgical cases. The attributable fractions in exposed people were calculated with odds ratios (ORs) obtained from logistic regressions with non-manual workers as the control group.RESULTS: The surgical incidence of CTS was 0.9/1000 adults. SIRs for all manual workers were 1.9 (95% confidence interval (95% CI) 1.4-2.5) in men and 1.8 (95% CI 1.4-2.2) in women, and the fractions attributable to work were 76% (95% CI 47-88) and 55% (95% CI 33-69), respectively. Seven occupational groups were identified as having excess risk of surgical CTS, with fractions attributable to occupation ranging from 75% to 99%.CONCLUSION: Among manual workers on the island of Montreal, 55% of surgical CTS in women and 76% in men was attributable to work. Increased risk of surgical CTS was found in seven occupational groups."