This prospective study tested the contribution of occupational factors to a multifactorial predictive model of work status among patients with carpal tunnel syndrome (CTS). The study recruited a community-wide sample of patients and included cases that were non-occupational as well as occupational in etiology. At baseline and follow-up 18 months later, trained interviewers administered a structured telephone questionnaire to 102 participants, that included items on demographics, medical history, psychosocial, and occupational factors. Multivariate logistic regression analyses indicated that patients presenting with CTS were more likely to continue working if they had modifications to their jobs, worked for employers with fewer than 250 employees, and held jobs not characterized by the frequent use of force. We also found that White (non-Hispanic) patients were more likely to continue working than those from other ethnic groups. Our findings also suggest that job strain may contribute to earlier changes in work status following diagnosis. The receipt of worker compensation was not found to be a significant predictor of work status. Workplace assessment and job modification appear to be important aspects of care for the worker presenting with CTS, regardless of whether the CTS is occupationally caused or not.
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Tanaka S, Wild DK, Seligman PJ, Halperin WE, Behrens VJ, Putz-Anderson V. Prevalence and workrelatedness of self-reported carpal tunnel syndrome among U.S.workers: Analysis of the Occupational Health Supplement data of 1988 National Health Interview Survey. Am J Ind Med 1995; 27: 451–470.
deKrom MC, Knipschild PG, Kester AD, Boekkooi PF, Spaans F. Carpal tunnel syndrome: Prevalence in the general population. J Clin Epidemiol 1992; 45: 373–376.
Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosen I. Prevalence of carpal tunnel syndrome in a general population. J Am Med Assoc 1999; 282: 153–158.
Miller RS, Iverson DC, Fried RA, Green LA, Nutting PA. Carpal tunnel syndrome in primary care: A report from ASPN. Ambulatory Sentinel Practice Network. J Fam Practice 1994; 38: 337–344.
Nordstrom DL, DeStefano F, Vierkant RA, Layde PM. Incidence of diagnosed carpal tunnel syndrome in a general population. Epidemiology 1998; 9: 342–345.
Morse TF, Dillon C, Warren N, Levenstein C, Warren A. The economic and social consequences of workrelated musculoskeletal disorders: The Connecticut Upper-Extremity Surveillance Project (CUSP). Int J Occup Environ Health 1998; 4: 209–216.
Phalen GS. The carpal-tunnel syndrome. Seventeen years' experience in diagnosis and treatment of six hundred fifty-four hands. J Bone Joint Surg (American Vol) 1966; 48: 211–228.
Moore JS. Carpal tunnel syndrome. Occup Med: State of the Art Rev 1992; 7: 741–763.
Cheadle A, Franklin G, Wolfhagen C, Savarino J, Liu PY, Salley C, Weaver M. Factors influencing the duration of work-related disability: A population-based study of Washington State workers' compensation. Am J Public Health 1994; 84: 190–196.
Bureau of Labor Statistics, U.S. Dept. of Labor. Workplace Injury and Illness Summary, 1997.
Feuerstein M, Miller VL, Burrell LM, Berger R. Occupational upper extremity disorders in the federal workforce. Prevalence, health care expenditures, and patterns of work disability. J Occup Environ Med 1998; 40: 546–555.
Silverstein B, Kalat J. Work-related disorders of the back and upper extremity in Washington State, 1989- 1996. Report No. 40-1-1997, Safety and Health Assessment and Research for Prevention Program,Washington State Department of Labor and Industries, January 1998.
Leigh JP, Miler TR. Occupational illness within two national data sets. Int J Occup Environ Health 1998; 4: 99–113.
Katz JN, Lew RA, Bessette L, Punnett L, Fossel AH, Mooney N, Keller RB. Prevalence and predictors of long-term work disability due to carpal tunnel syndrome. Am J Ind Med 1998; 33: 543–550.
Faucett J, Werner R. Non-biomechanical factors potentially affecting musculoskeletal disorders. In: Workrelated musculoskeletal disorders: The research base (National Research Council). Washington, D.C.: National Academy Press, 1998.
Stevens JC, Beard CM, O'Fallon WM, Kurland LT. Conditions associated with carpal tunnel syndrome. Mayo Clin Proc 1992; 67: 541–548.
Hagberg M, Morgenstern H, Kelsh M. Impact of occupations and job tasks on the prevalence of carpal tunnel syndrome. Scand J Work and Environ Health 1992; 18: 337–345.
Silverstein BA, Fine LJ, Armstrong TJ. Occupational factors and carpal tunnel syndrome. Am J Ind Med 1987; 11: 343–358.
Nordstrom DL, Vierkant RA, DeStefano F, Layde PM. Risk factors for carpal tunnel syndrome in a general population. Occup Environ Med 1997; 54: 734–740.
Atcheson SG, Ward JR, Lowe W. Concurrent medical disease in work-related carpal tunnel syndrome. Arch Intern Med 1998; 158: 1506–1512.
Tanaka S, Wild DK, Cameron LL, Freund E. Association of occupational and non-occupational risk factors with the prevalence of self-reported carpal tunnel syndrome in a national survey of the working population. Am J Ind Med 1997; 32: 550–556.
Hanrahan LP, Higgins D, Anderson H, Haskins L, Tai S. Project SENSOR: Wisconsin surveillance of occupational carpal tunnel syndrome. Wisconsin Med J 1991; 90: 80, 82–83.
Feuerstein M, Carosella AM, Burrell LM, Marshall L, DeCaro J. Occupational upper extremity symptoms in sign language interpreters: Prevalence and correlates of pain, function, and work disability. J Occup Rehab 1997; 7: 187–206.
Bernard B, Sauter S, Peterson M, Fine L, Hales T. Health Hazards Evaluation Report-HETA #90-013: Preliminary Report (LA Times). U.S. Dept. of Health & Human Services, National Institute of Occupational Safety & Health, Cinncinati 1992.
Faucett JA, Rempel D. VDT-related musculoskeletal symptoms: Interactions between work posture and psychosocial work factors. Am J Ind Med 1994; 26: 597–612.
Bongers PM, de Winter CR, Kompier MA, Hildebrandt VH. Psychosocial factors atwork and musculoskeletal disease. Scand J Work Environ Health 1993; 19: 297–312.
Blanc PD, Faucett J, Kennedy JJ, Cisternas M, Yelin E. Self-reported carpal tunnel syndrome: Predictors of work disability from the National Health Interview Survey Occupational Health Supplement. Am J Ind Med 1996; 30: 362–368.
Yelin E, Meenan R, Nevitt M, Epstein WV. Work disability among persons with rheumatoid arthritis: The relative impact of disease, social, and work factors. Ann Internal Med 1980; 93: 551–556.
Yelin EH, Henke CJ, Epstein WV. Work disability among persons with musculoskeletal conditions. Arthrit Rheum 1986; 29: 1322–1333.
Yelin E, Henke C, Epstein W. The work dynamics of the person with rheumatoid arthritis. Arthrit Rheum 1987; 30: 507–512.
Reisine S, Grady K, Goodenow D, Fifield J. Work disability among women with rheumatoid arthritis: The relative importance of disease, social, work, and family factors. Arthrit Rheum 1989; 32: 538–543.
Sherrer Y, Bloch D, Mitchell D, Young DY, Fries JF. The development of disability in rheumatoid arthritis. Arthrit Rheum 1986; 29: 494–500.
Mitchell JM, Burkhauser R, Pincus T. The importance of age, education, and comorbidity in the substantial earnings losses of individuals with symmetric polyarthritis. Arthrit Rheum 1988; 31: 348–357.
Feuerstein M, Callan-Harris S, Hickey P, Dyer D, Armbruster W, Carosella AM. Multidisciplinary rehabilitation of chronic work-related upper extremity disorders. Long-term effects. J Occup Med 1993; 35: 396–403.
Himmelstein JS, Feuerstein M, Stanek E, Jr., Koyamatsu K, Pransky, GS, Morgan W, Anderson K. Work related upper-extremity disorders and work disability: Clinical and psychosocial presentation. J Occup Environ Med 1995; 37: 1278–1286.
Riley J, Ahern D, Follick M. Chronic pain and functional impairment: Assessing beliefs about their relationship. Arch Phys Med Rehab 1988; 69: 579–582.
Lorig K, Chastain R, Ung E, Shoor S, Holman HR. Development and evaluation of a scale to measure perceived self efficacy in people with arthritis. Arthrit Rheum 1989; 32: 37–44.
Leavitt F, Garron D, Whisler WW, Sheinkop MB. Affective and sensory dimensions of back pain. Pain 1978; 4: 273–281.
Grönblad M, Lukinmaa A, Kontinen Y. Chronic low back pain: Intercorrelation of repeated measures for pain and disability. Scand J Rehab Med 1990; 22: 73–77.
Baldwin ML, Johnson WG, Butler RJ. The error of using returns-to-work to measure the outcomes of health care. Am J Ind Med 1996; 29: 632–641.
Maizlish N, Rudolph L, Dervin K, Sankaranarayan M. Surveillance and prevention of work-related carpal tunnel syndrome: An application of the Sentinel Events Notification System for Occupational Risks. Am J Ind Med 1995; 27: 715–729.
Occupational disease surveillance: Carpal tunnel syndrome. Morbidity and Mortality Weekly Report 1989; 38: 485–489.
Information Publications. California Cities, Towns, and Counties, 1999.
Levine D, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, Katz JM. Development and validation of symptom severity and functional status scales for carpal tunnel syndrome. J Bone Joint Surg 1993; 75A: 1585–1592.
Nordstrom DL, Vierkant RA, Layde PM, Smith MJ. Comparison of self-reported and expert-observed physical activities at work in a general population. Am J Ind Med 1998; 34: 29–35.
Karasek R, Schwartz J, Pieper C. (Columbia University).Ajob characteristics scoring system for occupational analysis, 1982.
Statistical package for the social sciences (8th Ed.). Chicago: SPSS Inc., 1994.
Carmona L, Faucett J, Blanc P, Yelin E. Predictors of rate of return to work after carpal tunnel surgery. Arthrit Care Res 1998; 11: 298–305.
LeClerc A, Franchi P, Cristofari MF, Delemotte B, Mereau P, Teyssler-Cotte C, Tronranchet A. The Study Group on RepetitiveWork. Carpal tunnel syndrome andwork organization in repetitivework:Across sectional study in France. J Occup Environ Med 1998; 55: 180–187.
Katz JN, Keller RB, Fossel AH, et al. Predictors of return to work following carpal tunnel release [see comments]. Am J Ind Med 1997; 31: 85–91.
Huang GD, Feuerstein M, Berkowitz SM, Peck CA. Occupational upper extremity related disability: Demographic, physical, and psychosocial factors. Military Med 1998; 163: 552–558.
Yelin E, Felts W. A summary of the impact of musculoskeletal conditions in the United States. Arthrit Rheum1990; 33: 750–755.
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Faucett, J., Blanc, P.D. & Yelin, E. The Impact of Carpal Tunnel Syndrome on Work Status: Implications of Job Characteristics for Staying on the Job. J Occup Rehabil 10, 55–69 (2000). https://doi.org/10.1023/A:1009441828933
- carpal tunnel syndrome
- work disability
- job strain
- job modification