Occupational Medicine Advance Access originally published online on December 21, 2005
Occupational Medicine 2006 56(2):115-121; doi:10.1093/occmed/kqj007
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Course of symptoms and median nerve conduction values in workers performing repetitive jobs at risk for carpal tunnel syndrome
1 Occupational Health Unit, Alma Mater Studiorum University of Bologna, via Palagi 9, Bologna 40138, Italy
2 Department of Public Health, Work Environment Safety and Health Service, via Beretta 7, Ferrara 44100, Italy
Background Carpal tunnel syndrome (CTS) is a common occupational disorder associated with repetitive manual work. Little information exists about the possible relation between the variation of biomechanical hand/wrist exposure and the development of symptoms and median nerve conduction values.
Aims To investigate the prevalence of CTS in a group of workers exposed to intensive use of the hands and the course of symptoms and median nerve conduction values after a period of reduced exposure to biomechanical risk factors.
Methods CTS was assessed in assembly and non-assembly line workers by means of clinical examinations and nerve conduction studies (NCS). Ergonomic analysis was conducted for each assembly line workstation.
Results Prevalence of CTS was significantly higher in assembly line workers compared to non-assembly line workers but there was a high prevalence of median nerve conduction abnormalities in both groups (60/102 hands and 40/110 hands, respectively). In a sizable proportion of both groups there was no relationship between symptoms and electrodiagnostic findings (45 hands and 48 hands in assembly and non-assembly line workers, respectively). When assembly line workers were re-examined after 2 years following a period of reduced work schedule, a significant proportion reported resolution of symptoms or had reverted to having normal NCS.
Conclusions In our study, repetitive work was associated with a higher level of CTS and abnormal NCS. These findings appeared to be reversible following a period of less repetitive work. Overall, there was generally poor correlation between symptoms and electrodiagnostic findings.
Keywords Biomechanical risk factors; carpal tunnel syndrome; nerve conduction abnormalities; reversibility of symptoms; work-related nerve disorders
Correspondence to: Roberta Bonfiglioli, Occupational Health Unit, Alma Mater Studiorum University of Bologna, via Palagi 9, Bologna 40138, Italy. Tel: +39 051 6362611; fax: +39 051 6362609; e-mail: bonfiglioli{at}aosp.bo.it