Blanc P D, Faucett J, Kennedy J J, Cisternas M, Yelin E
Division of Occupational and Environmental Medicine, School of Medicine, University of California San Francisco 94143-0924, USA.
Am J Ind Med. 1996 Sep;30(3):362-8. doi: 10.1002/(SICI)1097-0274(199609)30:3<362::AID-AJIM16>3.0.CO;2-U.
The objective of this study was to identify risk factors for work disability among persons with carpal tunnel syndrome (CTS). The study was designed to analyze data from the Occupational Health Supplement of the National Health Interview Survey, a nationwide, population-based survey. Subjects included 544 survey respondents with self-report of CTS and 32,688 survey respondents without CTS, all aged 18-64 years, and with a history of labor force participation. Measurements were as follows: Dependent variables were work disability, defined either as cessation of employment without attribution of cause or, alternatively, as cessation of employment or job change specifically attributed to CTS by the survey respondent. Independent variables were ergonomic risk of work disability, defined by minutes of workplace repetitive hand and wrist bending for the most recent job held. This measure was derived from responses categorized by an occupation and industry matrix independent of CTS status. Socio-demographic and health status risk factors for work disability were based on the respondent report. The main results were as follows: Among 544 persons with CTS, 58 (11%, CI 8-13%) reported work disability specifically attributed to CTS, representing an estimated national prevalence of 240,578 persons with this limitation. Workplace ergonomic risk, measured as repetitive hand or wrist bending in the occupation and industry of last employment, was a significant factor predictive of CTS-attributed work disability (per 120 min of daily exposure, OR 1.7, CI 1.1-2.6), even after taking into account socio-demographic factors and health status. The conclusions were that work disability among persons with CTS is common. For those with CTS, working conditions characterized by repetitive bending of the hand or wrist may increase the risk of work disability associated with this condition.
本研究的目的是确定腕管综合征（CTS）患者工作残疾的风险因素。该研究旨在分析全国性的基于人群的调查——国民健康访谈调查职业健康补充调查的数据。研究对象包括544名自我报告患有CTS的调查受访者和32688名未患CTS的调查受访者，所有受访者年龄在18 - 64岁之间，且有劳动力参与史。测量方法如下：因变量为工作残疾，定义为无明确原因的就业终止，或者定义为调查受访者明确归因于CTS的就业终止或工作变动。自变量为工作残疾的工效学风险，由最近从事工作时手部和腕部重复性弯曲的分钟数定义。该测量值来自根据独立于CTS状态的职业和行业矩阵分类的回答。工作残疾的社会人口统计学和健康状况风险因素基于受访者报告。主要结果如下：在544名CTS患者中，58名（11%，CI 8 - 13%）报告工作残疾明确归因于CTS，这代表全国估计有240578名有此限制的患者。以最后就业的职业和行业中手部或腕部重复性弯曲衡量的工作场所工效学风险，即使在考虑社会人口统计学因素和健康状况后，仍是CTS所致工作残疾的显著预测因素（每日暴露120分钟，OR 1.7，CI 1.1 - 2.6）。结论是CTS患者的工作残疾很常见。对于CTS患者，以手部或腕部重复性弯曲为特征的工作条件可能会增加与此疾病相关的工作残疾风险。
