Kraut Allen, Rydz Elizabeth, Walld Randy, Demers Paul A, Peters Cheryl E
Departments of Internal Medicine and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
CAREX Canada, University of British Columbia, Vancouver, British Columbia, Canada.
Am J Ind Med. 2024 Mar;67(3):243-260. doi: 10.1002/ajim.23566. Epub 2024 Jan 24.
Carpal tunnel syndrome (CTS) is associated with occupational high-force repetitive tasks and vibration. This project examines the relationship between CTS and work to: (1) identify jobs and industries with increased CTS risk; (2) explore whether there is a sex difference in the risk of CTS after controlling for occupation; and (3) determine whether any observed relationships persist after excluding Workers Compensation Board (WCB) accepted time-loss CTS claims.
We linked 95.5% of time-loss WCB claims from 2006 to 2019 to provincial administrative health data. The cohort included 143,001 unique person-occupation combinations. CTS cases were defined as at least two medical claims for (ICD-9 354) within a 12-month period or a surgical claim for CTS from 2 years before the WCB claim to 3 years after. WCB accepted CTS time-loss claims not identified by the medical claims were also included.
A total of 4302 individuals (3.0%) met the CTS definition. Analysis revealed that the hazard ratios (HRs) of CTS vary considerably with occupation. Sex-based differences in CTS risks were observed, both in low- and high-risk occupations. In many occupations with increased HR, the HR remained elevated after excluding accepted time-loss WCB cases.
The risk of developing CTS varied with occupation. Job titles with ergonomic risk factors had higher risks than those with lower exposures. This finding remained after eliminating time-loss compensated WCB cases, suggesting that all cases of CTS in high risk jobs are not identified in WCB statistics. Female workers in some job titles had excess CTS cases compared to male workers within the same job title.
腕管综合征(CTS)与职业性高强度重复性任务及振动有关。本项目旨在研究CTS与工作之间的关系,以:(1)识别CTS风险增加的工作岗位和行业;(2)探讨在控制职业因素后CTS风险是否存在性别差异;(3)确定在排除工人赔偿委员会(WCB)受理的因CTS导致的误工索赔后,所观察到的任何关系是否仍然存在。
我们将2006年至2019年95.5%的因CTS导致误工的WCB索赔与省级行政卫生数据进行了关联。该队列包括143,001个独特的个人 - 职业组合。CTS病例定义为在12个月内至少有两份关于(国际疾病分类第九版,ICD - 9 354)的医疗索赔,或从WCB索赔前2年到索赔后3年期间有一份关于CTS的手术索赔。还包括WCB受理的但未被医疗索赔识别出的因CTS导致的误工索赔。
共有4302人(3.0%)符合CTS定义。分析显示,CTS的风险比(HRs)因职业而异。在低风险和高风险职业中均观察到CTS风险存在基于性别的差异。在许多HR增加的职业中,排除已受理的因CTS导致误工的WCB病例后,HR仍然升高。
患CTS的风险因职业而异。具有工效学风险因素的工作岗位比暴露风险较低的岗位风险更高。在排除因误工获得赔偿的WCB病例后,这一发现仍然存在,表明WCB统计数据中并未识别出高风险工作中所有的CTS病例。与同一工作岗位的男性工人相比,某些工作岗位的女性工人CTS病例过多。