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Occupational Medicine Advance Access published online on November 23, 2006
Occupational Medicine, doi:10.1093/occmed/kql127
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

Compensating occupationally related tenosynovitis and epicondylitis: a literature review

Keith T. Palmer 1 *, E. Clare Harris 1, and David Coggon 1

1 MRC Epidemiology Resource Centre, University of Southampton, Southampton, UK

* To whom correspondence should be addressed.
Keith T. Palmer, E-mail: ktp{at}mrc.soton.ac.uk


  Abstract

Objectives To assess occupational associations with tenosynovitis and epicondylitis, we conducted a systematic literature review. We focused particularly on evidence that might support compensation of these disorders ‘on the balance of probabilities’.

Methods We searched the MEDLINE and EMBASE electronic biomedical databases to 1 January 2005 using combinations of keyword and medical subject headings, and also the references cited in two state-of-the-art reviews from the 1990s. Primary research reports were retrieved and checked for further relevant citations. From each paper, we abstracted a standardized set of information on study populations, exposure contrasts and estimates of effect.

Results We found and summarized 18 papers. In the main, these based analysis on job titles rather than on directly assessed physical activities. Few occupations were studied more than once, however, and there was little consistent evidence of jobs or work activities that carried more than a doubling of risk for either disorder.

Conclusion Compensation of occupational illness can be problematic for disorders that are not specific to work and for which there are no distinctive clinical features in occupationally related cases. Attribution can, however, be made on the balance of probabilities if there is convincing evidence that risk is at least doubled in an occupational group. Our review highlights the relative lack of data to support such attribution for tenosynovitis and epicondylitis, and discusses the difficulty of compensating upper limb disorders.

Keywords: Compensation; epicondylitis; risk factors; tenosynovitis.
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