Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, PO Box 266, FI-00029 HUS, Finland.
Scand J Work Environ Health. 2020 Jan 1;46(1):43-49. doi: 10.5271/sjweh.3835. Epub 2019 Jun 6.
Objectives Carpal tunnel syndrome (CTS) causes a considerable amount of sick leave and healthcare costs. The etiology of CTS is multifactorial, involving both personal and occupational risk factors. To date, few prospective cohort studies on occupational risk factors of CTS have examined the general working population. Methods The study population consisted of participants from the Northern Finland Birth Cohort of 1966 who attended the 31-year follow-up in 1997 and were working ≥3 days a week in a paid job (N=6326). Information on socio-economic status, weight and height, smoking, exposure to occupational physical factors, and long-term illnesses was collected at baseline in 1997. Data on hospitalizations due to CTS came from the Care Register for Health Care, 1997-2016. Results Between 1997 and 2016, 3.4% of the participants had been hospitalized (attended secondary care) for CTS. After adjusting for confounders, women [hazard ratio (HR) 3.77, 95% confidence interval (CI) 2.70-5.25], overweight/obese participants (HR 1.69, 95% CI 1.29-2.22), smokers (HR 1.48, 95% CI 1.12-1.96), farmers and manual workers (HR 3.02, 95% CI 1.85-4.92 compared with upper clerical workers), lower clerical workers (HR 1.74, 95% CI=1.08-2.80), workers exposed to hand vibration (HR 2.29, 95% CI 1.48-3.54) and participants with physically demanding jobs (HR 1.71, CI 1.06-2.76) were at increased risk of hospitalization for CTS. Physically demanding work increased the risk of hospitalization for CTS for overweight/obese participants at baseline, but not for participants of normal weight. Conclusions Excess body mass and occupational physical factors increase the risk of hospitalization for CTS. Excess body mass potentiates the adverse effects of strenuous work on CTS.
目的
腕管综合征(CTS)会导致大量的病假和医疗保健费用。CTS 的病因是多因素的,涉及个人和职业危险因素。迄今为止,很少有前瞻性队列研究探讨 CTS 的职业危险因素,这些研究都集中在一般工作人群。
方法
研究人群由参加 1966 年芬兰北部出生队列研究的参与者组成,他们在 1997 年参加了 31 年随访,并每周至少工作 3 天从事有偿工作(N=6326)。1997 年基线时收集了社会经济地位、体重和身高、吸烟、职业物理因素暴露和长期疾病的信息。来自 1997-2016 年的健康护理登记处的数据显示了因 CTS 住院的情况。
结果
在 1997 年至 2016 年期间,有 3.4%的参与者因 CTS 住院(接受二级护理)。在调整混杂因素后,女性(危险比[HR]3.77,95%置信区间[CI]2.70-5.25)、超重/肥胖参与者(HR1.69,95%CI1.29-2.22)、吸烟者(HR1.48,95%CI1.12-1.96)、农民和体力劳动者(HR3.02,95%CI1.85-4.92,与高级文员相比)、低级文员(HR1.74,95%CI1.08-2.80)、接触手部振动的工人(HR2.29,95%CI1.48-3.54)和从事体力要求高的工作的参与者(HR1.71,CI1.06-2.76)因 CTS 住院的风险增加。体力要求高的工作增加了基线时超重/肥胖参与者因 CTS 住院的风险,但对体重正常的参与者没有影响。
结论
超重和职业物理因素会增加 CTS 住院的风险。超重会加剧繁重工作对 CTS 的不利影响。