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Modeling the Effect of the 2018 Revised ACGIH® Hand Activity Threshold Limit Value® (TLV) at Reducing Risk for Carpal Tunnel Syndrome
Recent studies have shown the 2001 American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Value (TLV®) for Hand Activity was not sufficiently protective for workers at risk of carpal tunnel syndrome (CTS). These studies led to a revision of the TLV and Action Limit. This study compares the effect of applying the 2018 TLV vs. the 2001 TLV to predict incident CTS within a large occupational pooled cohort study (n = 4,321 workers). Time from study enrollment to first occurrence of CTS was modeled using Cox proportional hazard regression. Adjusted and unadjusted...
Risk factors of hospitalization for carpal tunnel syndrome among the general working population
Objectives: Carpal tunnel syndrome (CTS) causes a considerable amount of sick leave and healthcare costs. The etiology of CTS is multifactorial, involving both personal and occupational risk factors. To date, few prospective cohort studies on occupational risk factors of CTS have examined the general working population. Methods: The study population consisted of participants from the Northern Finland Birth Cohort of 1966 who attended the 31-year follow-up in 1997 and were working ≥3 days a week in a paid job (N=6326). Information on socio-economic status, weight and height, smoking, exposure...
Caractéristiques socioprofessionnelles, reconnaissance en maladie professionnelle et devenir fonctionnel et professionnel de patients opérés d’un syndrome du canal carpien en Île-de-France (2009-2012)
Points clés Cette étude menée par Santé publique France en partenariat avec le Réseau Prévention Main Île-de-France (IdF), chez des patients opérés d'un syndrome du canal carpien (SCC), décrit les caractéristiques socio-professionnelles (CSP, déclaration en maladie professionnelle…) des patients et leurs liens avec la durée d'arrêt de travail. Parmi les patients en activité au cours des 10 ans précédant l'intervention, 59 % considéraient leur travail comme...
Reversible median nerve impairment after three weeks of repetitive work
Little is known about the time relation between entry into a job with high mechanical exposures and median nerve affection. We found that 22 days of seasonal repetitive work led to impaired sensory and motor nerve conduction with recovery within 3-6 weeks post-season. If related to newly increased exposures, median nerve affection is most likely reversible if exposures are reduced. Source: Tabatabaeifar, S., Svendsen, S. W., Johnsen, B., Hansson, G. Å., Fuglsang-Frederiksen, A., & Frost, P. (2017). Scandinavian Journal of Work, Environment & Health .
Impact of Work Organizational Factors on Carpal Tunnel Syndrome and Epicondylitis
Objective: The aim of this study was to identify relationships between work organizational variables (job rotation, overtime work, having a second job, and work pacing) (These work organizational variables and their relationships with biomechanical and psychosocial exposures were studied previously and published in a separate paper.) and health outcome measures [carpal tunnel syndrome (CTS), lateral and medial epicondylitis (LEPI/MEPI)]. Methods: Using a pooled baseline cohort of 1834 subjects, the relationships were studied using logistic regression models. Results: Varied degrees of associations...
Carpal tunnel syndrome and manual work
The OCTOPUS cohort, results of a ten-year longitudinal study This large longitudinal cohort study provides a prospective validation of the ACGIH TLV® method for the assessment of biomechanical exposures at work. It confirmed that “forceful hand exertions” more than “any exertion” significantly increase the risk of CTS. This study suggests that the current limits (AL and TLV) might not be sufficiently protective for some workers. Source: Violante FS, Farioli A, Graziosi F, Marinelli F, Curti S, Armstrong TJ, Mattioli S, Bonfiglioli R. Scand J Work Environ Health , 2016...
Association Between Cardiovascular Risk Factors and Carpal Tunnel Syndrome in Pooled Occupational Cohorts
Objective: The aim of the study was to ascertain if cardiovascular (CVD) risk factors are carpal tunnel syndrome (CTS) risk factors. Methods: Analysis of pooled baseline data from two large prospective cohort studies (n?=?1824) assessed the relationships between a modified Framingham Heart Study CVD risk score both CTS and abnormal nerve conduction study prevalence. Quantified job exposures, personal and psychosocial confounders were statistically controlled. Odds ratio and 95% confidence intervals were calculated for individual risk scores. Results: There was a strong relationship between CVD...
High Prevalence of Carpal Tunnel Syndrome among Poultry Workers
Musculoskeletal disorders (MSD) of the upper extremities among poultry processing employees are well documented (Lipscomb et al. 2008; Cartwright et al. 2012). The combination of highly repetitive tasks, forceful movements and working in cold temperatures can increase risk for MSDs such as carpal tunnel syndrome, a disabling medical condition affecting the hands and wrists. In 2014, the National Institute for Occupational Safety and Health (NIOSH) was asked to perform a Health Hazard Evaluation at a poultry processing plant in Maryland. Source:
Acute effect of topical menthol on chronic pain in slaughterhouse workers with carpal tunnel syndrome
Triple-blind, randomized placebo-controlled trial Topical menthol gels are classified "topical analgesics" and are claimed to relieve minor aches and pains of the musculoskeletal system. In this study we investigate the acute effect of topical menthol on carpal tunnel syndrome (CTS). We screened 645 slaughterhouse workers and recruited 10 participants with CTS and chronic pain of the arm/hand who were randomly distributed into two groups to receive topical menthol (Biofreeze) or placebo (gel with a menthol scent) during the working day and 48 hours later the other treatment (crossover...
Exposure–response relationships for the ACGIH threshold limit value for hand-activity level
Results from a pooled data study of carpal tunnel syndrome Objectives: This paper aimed to quantify exposure–response relationships between the American Conference of Governmental Industrial Hygienists' (ACGIH) threshold limit value (TLV) for hand-activity level (HAL) and incidence of carpal tunnel syndrome (CTS). Methods: Manufacturing and service workers previously studied by six research institutions had their data combined and re-analyzed. CTS cases were defined by symptoms and abnormal nerve conduction. Hazard ratios (HR) were calculated using proportional hazards regression after...
Occupational and Biopsychosocial Risk Factors for Carpal Tunnel Syndrome
Objective: To investigate a biopsychosocial model of risk for carpal tunnel syndrome (CTS). In addition, a host of exploratory psychosocial variables was investigated as potential risk factors for CTS. Methods: A case–control design was used comparing 87 CTS and 74 sex-matched general orthopedic patients from an outpatient orthopedic clinic. All participants underwent the same diagnostic protocol (ie, physical evaluation and electrodiagnostic testing) and completed a self-report questionnaire assessing a wide range of potential occupational, personological, and psychosocial risk factors....
The Effectiveness of Post-Offer Pre-Placement Nerve Conduction Screening for Carpal Tunnel Syndrome
Objective: We evaluated post-offer pre-placement (POPP) nerve conduction studies (NCS) for carpal tunnel syndrome (CTS), testing diagnostic yield and cost-effectiveness. Methods: A total of 1027 newly hired workers underwent baseline NCS and were followed for an average of 3.7 years for diagnosed CTS. Measures of diagnostic yield included sensitivity, specificity, and positive predictive value (PPV). Cost-effectiveness of POPP screening was evaluated using a range of inputs. Results: Abnormal NCS was strongly associated with future CTS with univariate hazard ratios ranging from 2.95 to 11.25, depending...
Is Carpal Tunnel Syndrome Related to Computer Exposure at Work?
A Review and Meta-Analysis Objective: A meta-analysis on epidemiological studies was undertaken to assess association between carpal tunnel syndrome (CTS) and computer work. Methods: Four databases (PubMed, Embase, Web of Science, and Base de Donnees de Sante Publique) were searched with cross-references from published reviews. We included recent studies, original epidemiological studies for which the association was assessed with blind reviewing with control group. Relevant associations were extracted, and a metarisk was calculated using the generic variance approach (meta–odds ratio [meta...
Syndrome du canal carpien
Ce blog créé par la Carsat Alsace Moselle rassemble des données utiles sur le syndrome du canal carpien (symptômes, origines...) ainsi que des ressources pour détecter et prévenir ce trouble musculosquelettique. Source :
Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort
Background Between 2001 and 2010, six research groups conducted coordinated multiyear, prospective studies of carpal tunnel syndrome (CTS) incidence in US workers from various industries and collected detailed subject-level exposure information with follow-up symptom, physical examination, electrophysiological measures and job changes. Objective This analysis of the pooled cohort examined the incidence of dominant-hand CTS in relation to demographic characteristics and estimated associations with occupational psychosocial factors and years worked, adjusting for confounding by personal risk factors...
Validation of the ACGIH TLV for hand activity level in the OCTOPUS cohort: a two-year longitudinal study of carpal tunnel syndrome
Objectives This study aimed to evaluate the risk of musculoskeletal disorders to the hand-wrist system. The American Conference of Governmental Industrial Hygienists (ACGIH) proposed threshold limit values (TLV©) based on hand activity level (HAL) and normalized peak force (PF). We validated ACGIH TLV© in OCTOPUS, a large cohort study on carpal tunnel syndrome (CTS). Conclusions We found a dose–response relationship between ACGIH TLV© classification and risk of CTS. The increased risk observed for workers exposed between AL and TLV suggests that the current AL and TLV might...
Validation of the ACGIH TLV for hand activity level in the OCTOPUS cohort: a two-year longitudinal study of carpal tunnel syndrome
This study aimed to evaluate the risk of musculoskeletal disorders to the hand-wrist system. The American Conference of Governmental Industrial Hygienists (ACGIH) proposed threshold limit values (TLV©) based on hand activity level (HAL) and normalized peak force (PF). We validated ACGIH TLV© in OCTOPUS, a large cohort study on carpal tunnel syndrome (CTS). Source:
Study Uncovers Carpal Tunnel Syndrome Risk Factors
A recent study suggests that individual risk factors such as body mass index (BMI), wrist dimension ratio, steroid use, menopause and more may influence the likelihood of developing carpal tunnel syndrome (CTS), according to the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM). Source:

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