Nordstrom D L, Vierkant R A, DeStefano F, Layde P M
Department of Epidemiology and Biostatistics, Marshfield Medical Research and Education Foundation, WI, USA.
Occup Environ Med. 1997 Oct;54(10):734-40. doi: 10.1136/oem.54.10.734.
To determine the individual, physical, and psychosocial risk factors for carpal tunnel syndrome in a general population.
Population based case-control study in Marshfield epidemiological study area in Wisconsin, USA. Cases were men and women aged 18-69 with newly diagnosed carpal tunnel syndrome (n = 206 (83.1%) of 248 eligible). Controls were a random sample of residents of the study area who had no history of diagnosed carpal tunnel syndrome (n = 211 (81.5%) of 259 eligible). Cases and controls were matched by age. Telephone interviews and reviews of medical records obtained height and weight, medical history, average daily hours of exposure to selected physical and organisational work factors, and self ratings on psychosocial work scales.
In the final logistic regression model, five work and three non-work variables were associated with risk of carpal tunnel syndrome, after adjusting for age. For each one unit of increase in body mass index (kg/m2), risk increased 8% (odds ratio (OR) 1.08; 95% confidence interval (95% CI) 1.03 to 1.14). Having a previous musculoskeletal condition was positively associated with carpal tunnel syndrome (OR 2.54; 95% CI 1.03 to 6.23). People reporting the least influence at work had 2.86 times the risk (95% CI, 1.10 to 7.14) than those with the most influence at work.
Carpal tunnel syndrome is a work related disease, although some important measures of occupational exposure, including keyboard use, were not risk factors in this general population study. The mechanism whereby a weight gain of about six pounds increases the risk of disease 8% requires explanation.
确定普通人群中腕管综合征的个体、身体和社会心理风险因素。
在美国威斯康星州马什菲尔德流行病学研究区域进行基于人群的病例对照研究。病例为年龄在18 - 69岁且新诊断为腕管综合征的男性和女性(248名符合条件者中有206名(83.1%))。对照是研究区域内无腕管综合征诊断史的居民随机样本(259名符合条件者中有211名(81.5%))。病例和对照按年龄匹配。通过电话访谈和病历审查获取身高、体重、病史、选定身体和组织工作因素的平均每日暴露小时数以及社会心理工作量表的自评结果。
在最终的逻辑回归模型中,调整年龄后,五个工作变量和三个非工作变量与腕管综合征风险相关。体重指数(kg/m²)每增加一个单位,风险增加8%(优势比(OR)为1.08;95%置信区间(95%CI)为1.03至1.14)。既往有肌肉骨骼疾病与腕管综合征呈正相关(OR为2.54;95%CI为1.03至6.23)。报告在工作中受影响最小的人比在工作中受影响最大的人患病风险高2.86倍(95%CI为1.10至7.14)。
腕管综合征是一种与工作相关的疾病,尽管在这项普通人群研究中,包括使用键盘在内的一些重要职业暴露指标并非风险因素。体重增加约6磅使疾病风险增加8%的机制尚需解释。