Chiang Chia-Liang, Liao Chu-Yung, Kuo Hsien-Wen
China Medical University, Taichung, Taiwan (College of Public Health, Institute of Environmental Health).
Chung Chou University of Science and Technology, Yuanlin, Taiwan (College of Health, Department of Early Childhood Educare).
Int J Occup Med Environ Health. 2017 Mar 30;30(2):281-290. doi: 10.13075/ijomeh.1896.00566. Epub 2017 Mar 7.
Non-medical hospital staff members are in frequent contact with patients and therefore are required to perform a wide variety of repetitive and high-frequency activities. The objective of this study was to assess the relationships between upper extremity activity and carpal tunnel syndrome (CTS) among non-medical hospital staff members.
Carpal tunnel syndrome in 144 non-medical hospital staff members was diagnosed using the Nordic Musculoskeletal Questionnaire (NMQ), a physician's diagnosis, physical examination (Tinel's signs and Phalen test) and a nerve conduction velocity (NCV) test. In addition, an ergonomic assessment was performed and a video camera was used to record the physical activities at work.
The prevalence rate of CTS was highest for the NMQ (51.9%), followed by physician's diagnosis (49.5% for the right hand, 29.9% for the left hand), physical examination (54.7%), and nerve conduction test (motor nerve 27.5% and 25%, sensory nerve 21.7% and 15%, for right and left hands, respectively). Based on logistic regression models for the NMQ and physician's diagnoses, there was a dose-dependently higher risk of CTS with the upper extremity index among participants, but this was non-significant based on the physical examination and nerve conduction tests.
Nerve conduction velocity is the gold standard in diagnosis of CTS, but use of NMQ and physician's diagnosis may overestimate the incidence of CTS in workers who have been engaging in repetitive stress activities for a relatively short time. Int J Occup Med Environ Health 2017;30(2):281-290.
非医疗医院工作人员经常与患者接触,因此需要进行各种重复性高频活动。本研究的目的是评估非医疗医院工作人员上肢活动与腕管综合征(CTS)之间的关系。
采用北欧肌肉骨骼问卷(NMQ)、医生诊断、体格检查(Tinel征和Phalen试验)以及神经传导速度(NCV)测试,对144名非医疗医院工作人员的腕管综合征进行诊断。此外,进行了人体工程学评估,并使用摄像机记录工作中的身体活动。
CTS的患病率在NMQ中最高(51.9%),其次是医生诊断(右手为49.5%,左手为29.9%)、体格检查(54.7%)和神经传导测试(右手运动神经为27.5%,左手为25%;右手感觉神经为21.7%,左手为15%)。基于NMQ和医生诊断的逻辑回归模型,参与者中上肢指数与CTS风险呈剂量依赖性升高,但基于体格检查和神经传导测试,这一结果并不显著。
神经传导速度是诊断CTS的金标准,但使用NMQ和医生诊断可能会高估从事相对较短时间重复性应激活动的工人中CTS的发病率。《国际职业医学与环境卫生杂志》2017年;30(2):281 - 290。