Mamo C, Bena Antonella, Argentero O, Baratti A, Bruno Santina, Ferraris F
Servizio Regionale di Epidemiologia, ASL 5, Grugliasco.
Med Lav. 2007 Jul-Aug;98(4):331-42.
The prevalence of surgical cases of carpal tunnel syndrome (CTS) tends to increase in the general population in Italy. Nevertheless, it is still unclear what percentage of CTS is attributable to occupational exposure, to ergonomic or psychosocial factors. Moreover, the problem of obtaining a reliable definition of occupational exposure in the absence of direct observation and measurement in the workplace remains unsolved. Piedmont (north-western Italy) is one of the Italian regions with the highest number of musculoskeletal disorders recognized and compensated as work-related. The aim of this study was to estimate the proportion of work-related CTS surgical cases, based on self-reported exposure data.
An interview-based questionnaire included items on medical history, workplace exposures and non-occupational risk factors for CTS. The study was carried out between June 2003 and November 2004. A total of 260 adult patients (aged 18-65 years) were interviewed. An evaluation of the questionnaires was made by 3 occupational physicians, assigning every patient a probability score of occupational aetiology. Seventy-four per cent of the sample were female; the mean age was 48.4 years.
Seventy-one percent of the patients reported bilateral CTS. Occupational exposure preceded the onset of CTS symptoms for 184 patients. The probability that CTS was work-related was estimated as high for 66 patients (26% of the sample). Agreement among examiners, evaluated using the kappa statistic, was good.
Despite the limitations of the study, the number of cases attributable to occupation was much higher than the number of diseases reported to INAIL (National Institute for the Insurance of Industrial Accidents), which suggests that there is substantial under-notification in Italy.
在意大利普通人群中，腕管综合征（CTS）手术病例的患病率呈上升趋势。然而，仍不清楚CTS中有多大比例可归因于职业暴露、工效学或社会心理因素。此外，在缺乏对工作场所直接观察和测量的情况下，获得职业暴露可靠定义的问题仍未解决。皮埃蒙特（意大利西北部）是意大利公认并认定为与工作相关的肌肉骨骼疾病数量最多的地区之一。本研究的目的是根据自我报告的暴露数据，估算与工作相关的CTS手术病例的比例。
基于访谈的问卷包括有关病史、工作场所暴露和CTS的非职业风险因素的项目。该研究于2003年6月至2004年11月进行。共对260名成年患者（年龄在18 - 65岁之间）进行了访谈。由3名职业医生对问卷进行评估，为每位患者分配职业病因的概率评分。样本中74%为女性；平均年龄为48.4岁。
71%的患者报告患有双侧CTS。184名患者的职业暴露先于CTS症状出现。66名患者（占样本的26%）的CTS与工作相关的可能性被估计为高。使用kappa统计量评估，检查者之间的一致性良好。
尽管本研究存在局限性，但可归因于职业的病例数远高于向意大利国家工伤事故保险协会（INAIL）报告的疾病数，这表明在意大利存在大量漏报情况。
