Riccò Matteo, Signorelli Carlo
Provincial Agency for Health Services of the Autonomous Province of Trento, Trento, Italy (Department of Prevention, Occupational Health and Safety Unit).
University of Parma, Parma, Italy (Department of Biomedical, Biotechnological and Translational Sciences).
Med Pr. 2017 Mar 24;68(2):199-209. doi: 10.13075/mp.5893.00605. Epub 2017 Mar 15.
Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors.
A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (OR) for factors of interest were estimated through binary logistic regression.
Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person- years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107-3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743-7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917-21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200-6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689-28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (OR = 3.548, 95% CI: 1.379-9.131), repeated trauma of the hand (OR = 3.602, 95% CI: 1.248- 10.395), repeated movements of the wrist (OR = 2.561, 95% CI: 1.100-5.960).
Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2):199-209.
腕管综合征(CTS)是一种常影响工作能力的肌肉骨骼疾病。我们的目的是回顾性评估意大利北部肉类加工业中的身体暴露因素与腕管综合征之间的关联,并考虑非职业因素。
进行了一项横断面研究,纳入了来自肉类加工业的434名工人(236名男性,198名女性,年龄37.0±10.6岁,工作年限:12.6±10.8年)。在强制性职业医学监测中收集症状和体征。通过问卷调查和调查人员的直接评估来评估职业危险因素。通过二元逻辑回归估计感兴趣因素的调整比值比(OR)。
434名受试者中有61人(14.1%)被诊断为腕管综合征,发病率为11.3/1000人年。一般来说,腕管综合征的症状和体征与以下人口统计学因素有关:吸烟史(OR = 1.909,95%置信区间(CI):1.107 - 3.293)、上肢既往创伤(OR = 3.533,95% CI:1.743 - 7.165)、甲状腺功能减退状态(OR = 7.897,95% CI:2.917 - 21.38),仅在女性参与者中,既往怀孕(OR = 2.807,95% CI:1.200 - 6.566)以及口服避孕药治疗和/或甾体替代治疗个人史(OR = 11.57,95% CI:4.689 - 28.56)。腕管综合征病例与以下职业因素(每天>4小时)有关:手部用力(OR = 3.548,95% CI:1.379 - 9.131)、手部反复创伤(OR = 3.602,95% CI:1.248 - 10.395)、手腕反复运动(OR = 2.561,95% CI:1.100 - 5.960)。
手部活动和用力水平的增加与参与者中腕管综合征患病率的增加有关。必须提供建议以减少职业暴露于这些危险因素并改善医学监测。《医学实践》2017;68(2):199 - 209。