Background: Carpal tunnel syndrome (CTS) is the most common upper extremity nerve entrapment syndrome . The aim of this study was to determine the association between occupational biomechanical exposures and occurrence of surgically treated CTS in construction workers over a 16-year follow-up.
Methods: A cohort of 220 610 male construction workers who participated in a national occupational health surveillance program (1971–1992) were examined prospectively (2001–2016) for surgically treated CTS. Cases were determined via a linkage with the Swedish Hospital Outpatient Register. Job title (construction trade), smoking status, height, weight and age were recorded on examination. Job titles were merged into occupational groups of workers performing similar work tasks and having similar training. Occupational biomechanical exposure estimates were assigned to each occupational group using a job exposure matrix (JEM) developed for the study. Poisson regression models were used to assess the relative risks for each biomechanical exposure. Relative risks were adjusted for age, surgical time period, BMI, and smoking status at first examination.
Results: There were 4048 cases of surgically treated CTS within the cohort which represented an incidence rate of 134 cases per 100 000 person years. Workers exposed to medium and high forceful handgrip factors had relative risks of 1.3 (95% CI 1.16-1.38) and 1.6 (95% CI 1.50-1.77), respectively, of undergoing surgical treatment for CTS compared to low exposed workers. Workers exposed to medium and high exposure to hand-arm vibration had relative risks of 1.3 (95% CI 1.19-1.34) and 1.2 (95% CI 1.07-1.28), respectively, of undergoing surgical treatment for CTS compared to low exposed workers.
Conclusions: In conclusion, forceful hand-grip work and exposure to hand-arm vibration increased the risk for surgically treated carpal tunnel syndrome.