Male and female rate differences in carpal tunnel syndrome injuries: personal attributes or job tasks?

Carpal tunnel syndrome (CTS) exacts a significant toll on the health and productivity of American workers. In 1996, 29,937 workers lost time from work due to CTS. Half of these were out for more than 25 days, compared to a median of 5 days for all injuries/illnesses. There are striking gender disparities in CTS rates. Overall, three times more women suffer from CTS than men. While some authors have emphasized the role of gender attributes in this risk disparity, the multifactoral causes of CTS, and the sex segregation of women into jobs with high-risk tasks, may be obscuring the work-related contributions to CTS risk. We argue here that men and women doing the same work tasks will have similar rates of CTS. To examine this premise, we used Bureau of Labor Statistics injury counts (numerator) and census data from the Current Population Survey (denominator) to determine injury rates of CTS for both men and women in six high-risk occupations: (1) assembler, (2) laborer-nonconstruction, (3) packaging and filling machine operators, (4) janitors and cleaners, (5) butchers and meat cutters, and (6) data entry keyers. Variable job tasks exist within five of the six high-risk occupational titles. Among those five, the male to female (M:F) risk rate ratio ranged from 0.29 to 0.50. However, the sixth occupational title, data entry keyers, which requires a single physical task, had a risk rate ratio of 1.06. This suggests that an equal risk between genders exists when the occupational tasks (exposure) are truly similar. Job task analysis unmasks potential biases that may wrongly attribute disproportionate CTS rates to gender attributes. This focus on gender attributes fails all workers because preventive interventions in the workplace are deferred. It fails women disproportionately because they are overrepresented in jobs at high risk for CTS.