Bonfiglioli Roberta, Mattioli Stefano, Fiorentini Cristiana, Graziosi Francesca, Curti Stefania, Violante Francesco S
Occupational Health Unit, Policlinico Sant'Orsola-Malpighi, Alma Mater Studiorum, University of Bologna, Via Palagi 9, Bologna, Italy.
Int Arch Occup Environ Health. 2007 Jan;80(3):248-53. doi: 10.1007/s00420-006-0129-0. Epub 2006 Jul 25.
To investigate the prevalence of Carpal Tunnel Syndrome (CTS) in full-time and part-time supermarket cashiers exposed to a different weekly duration of biomechanical load.
All the 269 cashiers and 127 office workers were asked to participate. The protocol included ergonomic risk assessment, collection of personal and clinical data and bilateral electrodiagnostic study of the median nerve. CTS symptoms were defined as past and/or current nocturnal and/or diurnal numbness, tingling, burning or pain involving at least one of the first three fingers. Results were evaluated according to two case definitions based on current symptoms and on the combination of current symptoms and slowing of sensory conduction velocity from wrist to palm, respectively. Difference in proportions of CTS symptoms and cases was evaluated by the Pearson's chi-square (chi(2)) test, univariate and multivariate logistic regression analyses were performed to determine the impact of weekly exposure.
The final female study population included 71 full-time cashiers, 155 part-time cashiers and 98 office workers. Ergonomic risk level was rated 5 for hand activity level and 4 for peak of force according to ACGIH. The intersection of the two values fell on the threshold limit value line, confirming the possible exposure to biomechanical risk factors for CTS. The prevalence of current CTS symptoms was higher among full-time (31.0%) than in part-time cashiers (19.3%) or controls (16.3%) (p = 0.055). A similar pattern was found for CTS past symptoms and cases. Univariate analysis showed that full-time cashiers had a 2.3 fold increased risk for CTS specific current symptoms than control subjects. A similar trend also emerged for CTS cases but was not significant (Odds ratios 1.23). Multivariate logistic regression analysis confirmed the increased risk for CTS current symptoms in full-time cashiers.
Intensive manual work associated with inadequate recovery time might have generated an impairment of the median nerve at the wrist level proportionally increasing with duration of hand use. Our study can provide useful information both for ergonomic risk assessment and work organization.
调查每周承受不同时长生物力学负荷的全职和兼职超市收银员腕管综合征（CTS）的患病率。
邀请了269名收银员和127名办公室职员参与。研究方案包括人体工程学风险评估、收集个人和临床数据以及对正中神经进行双侧电诊断研究。CTS症状定义为过去和/或当前出现的夜间和/或日间麻木、刺痛、灼痛或疼痛，累及至少前三根手指中的一根。分别根据基于当前症状以及当前症状与从手腕到手掌感觉传导速度减慢相结合的两种病例定义对结果进行评估。通过Pearson卡方（χ²）检验评估CTS症状和病例比例的差异，进行单因素和多因素逻辑回归分析以确定每周暴露的影响。
最终的女性研究人群包括71名全职收银员、155名兼职收银员和98名办公室职员。根据美国政府工业卫生学家会议（ACGIH）的标准，手部活动水平的人体工程学风险等级为5级，力量峰值为4级。这两个值的交叉点落在阈限值线上，证实了可能暴露于CTS的生物力学风险因素。全职收银员中当前CTS症状的患病率（31.0%）高于兼职收银员（19.3%）或对照组（16.3%）（p = 0.055）。CTS过去症状和病例也发现了类似模式。单因素分析显示，全职收银员出现CTS特定当前症状的风险比对照组高2.3倍。CTS病例也出现了类似趋势，但不显著（优势比为1.23）。多因素逻辑回归分析证实了全职收银员出现CTS当前症状的风险增加。
与恢复时间不足相关的高强度体力劳动可能导致手腕水平的正中神经受损，且随着手部使用时间的延长成比例增加。我们的研究可为人体工程学风险评估和工作组织提供有用信息。
