Violante Francesco S, Armstrong Thomas J, Fiorentini Cristiana, Graziosi Francesca, Risi Alessandro, Venturi Silvia, Curti Stefania, Zanardi Francesca, Cooke Robin M T, Bonfiglioli Roberta, Mattioli Stefano
Occupational Medicine Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
J Occup Environ Med. 2007 Nov;49(11):1189-96. doi: 10.1097/JOM.0b013e3181594873.
To assess risks associated with work-related biomechanical overloads in onset/course of carpal tunnel syndrome.
Work-groups with job tasks spanning different biomechanical exposures were evaluated at baseline in terms of American Conference of Governmental Industrial Hygienists hand-activity/peak force action limit and threshold limit values (TLV). Exposures of interest were "unacceptable" (hand-activity above TLV) and "borderline" (between action limit and TLV) overloads. Clinical/individual data were collected at baseline and 12 months.
One-year incidence of "classic/possible" carpal tunnel syndrome symptoms as defined by consensus criteria was 7.3% (153 of 2092). "Unacceptable" overload was associated with a 3-fold increased risk of onset with respect to "acceptable" load. At ordered logistic regression analysis of symptom-status variations, increased risks were recorded for "unacceptable" and "borderline" overloads.
Effectiveness of encouraging workplace adherence to the American Conference of Governmental Industrial Hygienists recommendations deserves investigation as a possible key to wide-scale prevention.
评估与工作相关的生物力学过载在腕管综合征发病/病程中的风险。
对从事不同生物力学暴露工作任务的工作小组在基线时按照美国政府工业卫生学家会议的手部活动/峰值力作用限值和阈限值(TLV)进行评估。感兴趣的暴露为“不可接受的”(手部活动高于TLV)和“临界的”(在作用限值和TLV之间)过载。在基线和12个月时收集临床/个体数据。
根据共识标准定义的“典型/可能的”腕管综合征症状的一年发病率为7.3%(2092例中的153例)。“不可接受的”过载与相对于“可接受的”负荷发病风险增加3倍相关。在对症状状态变化进行有序逻辑回归分析时,“不可接受的”和“临界的”过载记录到风险增加。
鼓励工作场所遵守美国政府工业卫生学家会议建议的有效性值得作为大规模预防的可能关键进行调查。