The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnelsyndrome (CTS) in a prospective cohort

The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnelsyndrome (CTS) in a prospective cohort

A cohort of 536 workers was enrolled from 10 diverse manufacturing facilities and was followed monthly for six years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, current musculoskeletal disorders (MSDs) and nerve conduction studies (...

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Bibliographic Details
Published in:Ergonomics Vol. 55; no. 4; pp. 396 - 414
Main Authors: Garg, A., Kapellusch, J., Hegmann, K., Wertsch, J., Merryweather, A., Deckow-Schaefer, G., Malloy, E.J., the WISTAH Hand Study Research Team
Format: Journal Article
Language:English
Published: London Taylor & Francis 01-04-2012
Taylor & Francis LLC
Subjects:
Adjustment
Biomechanics
Carpal tunnel syndrome
cohort
epidemiology
Ergonomics
Estimating
Exposure
Manufacturing
Mathematical models
Medical
Musculoskeletal diseases
Risk
Risk assessment
Strain
Strain Index
Thresholds
TLV for HAL
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Summary:A cohort of 536 workers was enrolled from 10 diverse manufacturing facilities and was followed monthly for six years. Job physical exposures were individually measured. Worker demographics, medical history, psychosocial factors, current musculoskeletal disorders (MSDs) and nerve conduction studies (NCS) were obtained. Point and lifetime prevalence of carpal tunnel syndrome (CTS) at baseline (symptoms + abnormal NCS) were 10.3% and 19.8%. During follow-up, there were 35 new CTS cases (left, right or both hands). Factors predicting development of CTS included: job physical exposure (American conference of governmental industrial hygienists Threshold Limit Value (ACGIH TLV) for Hand Activity Level (HAL) and the Strain Index (SI)), age, BMI, other MSDs, inflammatory arthritis, gardening outside of work and feelings of depression. In the adjusted models, the TLV for HAL and the SI were both significant per unit increase in exposure with hazard ratios (HR) increasing up to a maximum of 5.4 (p = 0.05) and 5.3 (p = 0.03), respectively; however, similar to other reports, both suggested lower risk at higher exposures. Data suggest that the TLV for HAL and the SI are useful metrics for estimating exposure to biomechanical stressors. Practitioner Summary: This study was conducted to determine how well the TLV for HAL and the SI predict risk of CTS using a prospective cohort design with survival analysis. Both the TLV for HAL and the SI were found to predict risk of CTS when adjusted for relevant covariates.
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ISSN:0014-0139
1366-5847
DOI:10.1080/00140139.2011.644328