Mattioli S, Baldasseroni A, Curti S, Cooke R M T, Mandes A, Zanardi F, Farioli A, Buiatti E, Campo G, Violante F S
Dipartimento di Medicina Interna, dell'Invecchiamento e Malattie Nefrologiche, University of Bologna, Italy.
Occup Environ Med. 2009 May;66(5):299-304. doi: 10.1136/oem.2008.040212. Epub 2009 Mar 1.
Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared.
Surgically treated cases of idiopathic CTS were investigated among 25-59-year-old residents of Tuscany, Italy, during 1997-2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany's regional database. Population data were extracted from the 2001 census.
After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives' rates were much higher (p<0.001) than those of white-collar women.
Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.
比较普通人群中蓝领、白领工作者及家庭主妇接受手术治疗的腕管综合征（CTS）发生率。
基于意大利所有公立/私立医院的强制出院记录，对1997年至2000年期间意大利托斯卡纳地区25至59岁居民中接受手术治疗的特发性CTS病例进行调查，这些记录按居住地存档于托斯卡纳地区数据库。人口数据从2001年人口普查中提取。
排除重复入院病例后，共识别出8801例符合条件的病例。手术治疗CTS的年龄标准化发生率（每10万人年）分别为：“蓝领女性”367.8；“白领女性”88.1；“家庭主妇”334.5；“蓝领男性”73.5；“白领男性”15.3。与参照类别（同性白领工作者）相比：女性蓝领工作者的标准化发生率高4.2倍；家庭主妇高3.8倍；男性蓝领工作者高4.8倍（均p<0.001）。与白领同行相比，蓝领男女的年龄特异性发生率高出约三至七倍（均p<0.001）。40至44岁之前家庭主妇的发生率与蓝领女工相似，之后则显著降低（p<0.002）。在所有年龄段，家庭主妇的发生率均远高于白领女性（p<0.001）。
接受手术治疗的CTS在蓝领工作者中比白领工作者普遍三至七倍（取决于年龄/性别），这难以用体重差异或其他个体因素来解释。因此，职业风险因素在整个工作生涯中似乎都很重要。全职家庭主妇的高发生率表明，应将家务劳动作为CTS的一个可能风险因素进行调查。
