Lacey R J, Lewis M, Sim J
Primary Care Sciences Research Centre, Keele University, Staffordshire ST5 5BG, UK.
Rheumatology (Oxford). 2005 Oct;44(10):1287-93. doi: 10.1093/rheumatology/kei007. Epub 2005 Jul 5.
To investigate the association of occupational factors, both physical and psychosocial, with hand paraesthesia, and whether any such associations differ according to the concurrent presence of neck and upper limb pain (NULP).
A questionnaire was mailed to an age-stratified random sample of 9596 adults. All subjects were asked about hand paraesthesia in the past 4 weeks. Information was obtained on respondents' main job (the job held for the longest time), whether this job involved any of six neck or upper limb activities on most or all days of the working week, and questions on the psychosocial aspects of the work environment. The questionnaire also asked about NULP according to a preshaded manikin.
A total of 5133 people replied to the survey (adjusted response 53.5%). Of these, 1592 reported abnormal feelings in the hands (prevalence of 31.9%). Prolonged gripping, prolonged bending of the neck forwards, working with arms at/above shoulder height, low job control, many changes in tasks and low job support were independently associated with hand paraesthesia. Among responders also reporting NULP, working with arms at/above shoulder height and many changes in tasks were independently associated with hand paraesthesia; prolonged gripping was linked to hand paraesthesia in the absence of NULP.
Hand paraesthesia is associated with physical and psychosocial workplace factors, although different work-related factors were associated with hand paraesthesia according to the concurrent presence of NULP, suggesting that these symptoms may not always be mediated in the same way.