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法国男性农民和农业工人的腕管综合征:它仅仅与身体暴露有关吗?

Carpal Tunnel Syndrome Among Male French Farmers and Agricultural Workers: Is It Only Associated With Physical Exposure?

作者信息

Roquelaure Yves, Jégo Sylvaine, Geoffroy-Perez Béatrice, Chazelle Emilie, Descatha Alexis, Evanoff Bradley, Garlantézec Ronan, Bodin Julie

机构信息

Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, IRSET (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-49000, Angers, France.

Santé Publique France, French National Public Health Agency, Direction of Occupational Health, F-94415, Saint-Maurice, France.

出版信息

Saf Health Work. 2020 Mar;11(1):33-40. doi: 10.1016/j.shaw.2019.12.003. Epub 2019 Dec 17.

Abstract

BACKGROUND

Exploratory study to investigate whether co-exposure to physical wrist stressors and chemicals is associated with carpal tunnel syndrome (CTS) in French male farmers and agricultural workers.

METHODS

Cross-sectional study of 711 men aged 30-65 years and working as either farmers or agricultural workers in 2009-2010 within a cohort covered by the French Agricultural Workers' and Farmers' Mutual Benefit Fund. CTS and exposure to physical wrist stressors and chemicals were assessed using a self-administered questionnaire. Associations between CTS and personal/medical factors, exposure to physical wrist stressors, exposure to chemicals, and co-exposure to physical wrist stressors and chemicals were studied using multivariate logistic regression models.

RESULTS

Forty-four men {5.6% [95% confidence interval (CI) 4.0-7.7]} reported that they had suffered from unilateral/bilateral CTS during the last 12 months. CTS was associated with age, current smoking [odds ratio (OR) = 2.1 (1.0-4.5)], and exposure to physical wrist stressors [OR = 2.6 (1.1-5.9)]. An association was found between CTS and co-exposure to physical wrist stressors and chemicals [OR = 3.3 (0.8-14.3),  = 0.044] in comparison with the no-exposure group.

CONCLUSIONS

This exploratory study shows an association of CTS with exposure to biomechanical wrist stressors in male farmers and agricultural workers and suggests an association of CTS with co-exposure to physical wrist stressors and chemicals. Owing to the limitations of the study, this result must be confirmed by a prospective study with objective assessments of the outcome and exposure before drawing conclusions on the possible synergistic effects of mechanical stressors and chemicals on the impairment of the median nerve.

摘要

背景

一项探索性研究,旨在调查法国男性农民和农业工人同时暴露于手腕物理应激源和化学物质是否与腕管综合征(CTS)有关。

方法

对2009年至2010年期间在法国农业工人和农民互助基金覆盖的队列中年龄在30至65岁之间、从事农民或农业工人工作的711名男性进行横断面研究。使用自填问卷评估CTS以及手腕物理应激源和化学物质的暴露情况。使用多变量逻辑回归模型研究CTS与个人/医学因素、手腕物理应激源暴露、化学物质暴露以及手腕物理应激源和化学物质同时暴露之间的关联。

结果

44名男性{5.6%[95%置信区间(CI)4.0 - 7.7]}报告称在过去12个月内患有单侧/双侧CTS。CTS与年龄、当前吸烟[比值比(OR)= 2.1(1.0 - 4.5)]以及手腕物理应激源暴露[OR = 2.6(1.1 - 5.9)]有关。与未暴露组相比,发现CTS与手腕物理应激源和化学物质同时暴露之间存在关联[OR = 3.3(0.8 - 14.3),P = 0.044]。

结论

这项探索性研究表明,男性农民和农业工人中CTS与手腕生物力学应激源暴露有关,并提示CTS与手腕物理应激源和化学物质同时暴露有关。由于该研究的局限性,在就机械应激源和化学物质对正中神经损伤的可能协同作用得出结论之前,这一结果必须通过对结局和暴露进行客观评估的前瞻性研究来证实。

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