PREMUS 2025: 12th International Scientific Conference on the Prevention of Work-Related Musculoskeletal Disorders
Carpal tunnel syndrome and occupational hand exposures: a Danish nationwide cohort study
2Centre for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark
3Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Introduction: The aim was to examine exposure-response relations between occupational hand exposures and carpal tunnel syndrome (CTS), and to compare the relation between surgery and non-surgery treated CTS. The secondary aim was to study sex-specific differences in exposure-response relations.
Methods: We conducted a nationwide register-based cohort study of all persons born in Denmark (1945–1994). During follow-up (2010–2013), we identified first-time events of CTS. Occupational hand exposure estimates the year before each follow-up year were obtained by linking individual occupational codes with a job exposure matrix. We used multivariable logistic regression equivalent to discrete survival analysis based on sex and surgery. The excess fraction of cases was calculated.
Results: Among roughly 2.4 million persons, we identified 12,374 CTS diagnoses (4,519 among men and 7,855 among women). For both sexes, exposure-response relations were found for all occupational hand exposures. Among men, we found ORadj of 3.6 (95% CI 3.2-3.8) for hand-related force, 2.9 (95% CI 2.5-3.2) for repetitive hand movements, 3.8 (95% CI 2.7-5.2) for non-neutral hand posture, and 2.5 (95% CI 2.2-2.7) for hand-arm vibration in the highest exposure groups. For combined exposure (hand load), ORadj was 3.5 (95% CI 3.1-4.0). Slightly higher ORsadj were generally found for surgery-treated CTS compared to non-surgery treated CTS for both sexes. When comparing sex, somewhat higher ORsadj were found among men. The excess fraction was 49% among men, 38% among women.
Discussion: Occupational hand exposures carried a 3-5 fold increased risk of CTS with slightly higher risks for surgery treated compared to non-surgery treated CTS. Even though CTS occurs more frequent among women, somewhat higher exposure-response relations were found for men compared to women. In absolute terms, the number of cases potentially preventable is higher for women, due to a higher number of cases.
Conclusion: In the general working population, a substantial fraction of first-time CTS could be related to occupational hand exposures.
