Limits...
Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy.

Mattioli S, Baldasseroni A, Curti S, Cooke RM, Mandes A, Zanardi F, Farioli A, Buiatti E, Campo G, Violante FS - Occup Environ Med (2009)

Bottom Line: Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001).Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002).Thus, occupational risk factors seem relevant throughout working life.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Medicina Interna, dell'Invecchiamento e Malattie Nefrologiche, University of Bologna, Italy. s.mattioli@unibo.it

ABSTRACT

Objectives: Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared.

Methods: Surgically treated cases of idiopathic CTS were investigated among 25-59-year-old residents of Tuscany, Italy, during 1997-2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany's regional database. Population data were extracted from the 2001 census.

Results: After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives' rates were much higher (p<0.001) than those of white-collar women.

Conclusions: Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.

Show MeSH

Related in: MedlinePlus

Flow chart of cases meeting the study eligibility criteria. *Cases also bearing the following ICD-9 codes were considered not to be idiopathic: 245 (hypothyroidism, thyroiditis), 250 (diabetes mellitus), 274.0 (gout), 277.3 (amyloidosis), 278 (overweight/obesity), 646.8 and 646.9 (complications of pregnancy), 710 (connective tissue diseases), 714 (rheumatoid arthritis), 715.3 and 715.4 (osteoarthritis of the hand/forearm), 813.4 (wrist fractures), 955 (shoulder/upper limb peripheral nerve injuries) and V22 (pregnancy). CTS, carpal tunnel syndrome.
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2664992&req=5

bwc-66-05-0299-f01: Flow chart of cases meeting the study eligibility criteria. *Cases also bearing the following ICD-9 codes were considered not to be idiopathic: 245 (hypothyroidism, thyroiditis), 250 (diabetes mellitus), 274.0 (gout), 277.3 (amyloidosis), 278 (overweight/obesity), 646.8 and 646.9 (complications of pregnancy), 710 (connective tissue diseases), 714 (rheumatoid arthritis), 715.3 and 715.4 (osteoarthritis of the hand/forearm), 813.4 (wrist fractures), 955 (shoulder/upper limb peripheral nerve injuries) and V22 (pregnancy). CTS, carpal tunnel syndrome.

Mentions: To restrict the study to idiopathic CTS, we excluded cases with secondary (ie, coexisting) diagnoses of conditions thought to be associated with a increased risk of CTS,16–18 namely hypothyroidism (ICD-9 codes 243, 244), thyroiditis (245), diabetes mellitus (250), gout (274.0), amyloidosis (277.3), overweight/obesity (278), complications of pregnancy (646.8, 646.9), connective tissue diseases (710), rheumatoid arthritis (714), osteoarthritis of the hand/forearm (715.3, 715.4), wrist fractures (813.4), shoulder/upper limb peripheral nerve injuries (955) and pregnancy (V22). Because of limited numbers of cases in the youngest age groups and selection bias considerations related to “retired” occupational status, we decided to restrict the study to subjects aged 25–59 years. As shown in fig 1, we also excluded members of the armed forces (due to white-/blue-collar classification difficulties), students, full-time “househusbands”, cases with undeclared/unknown employment status (due to treatment outside Tuscany, etc), unemployed or retired subjects (due to lack of information about previous occupational status), first job seekers, and those with “other” (unspecified) job titles. We grouped the job titles reported on the hospital discharge records into occupational categories and classified them into blue-collar (including “mixed-collar”), white-collar and housewives, as shown in table 1.


Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy.

Mattioli S, Baldasseroni A, Curti S, Cooke RM, Mandes A, Zanardi F, Farioli A, Buiatti E, Campo G, Violante FS - Occup Environ Med (2009)

Flow chart of cases meeting the study eligibility criteria. *Cases also bearing the following ICD-9 codes were considered not to be idiopathic: 245 (hypothyroidism, thyroiditis), 250 (diabetes mellitus), 274.0 (gout), 277.3 (amyloidosis), 278 (overweight/obesity), 646.8 and 646.9 (complications of pregnancy), 710 (connective tissue diseases), 714 (rheumatoid arthritis), 715.3 and 715.4 (osteoarthritis of the hand/forearm), 813.4 (wrist fractures), 955 (shoulder/upper limb peripheral nerve injuries) and V22 (pregnancy). CTS, carpal tunnel syndrome.
© Copyright Policy - openaccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2664992&req=5

bwc-66-05-0299-f01: Flow chart of cases meeting the study eligibility criteria. *Cases also bearing the following ICD-9 codes were considered not to be idiopathic: 245 (hypothyroidism, thyroiditis), 250 (diabetes mellitus), 274.0 (gout), 277.3 (amyloidosis), 278 (overweight/obesity), 646.8 and 646.9 (complications of pregnancy), 710 (connective tissue diseases), 714 (rheumatoid arthritis), 715.3 and 715.4 (osteoarthritis of the hand/forearm), 813.4 (wrist fractures), 955 (shoulder/upper limb peripheral nerve injuries) and V22 (pregnancy). CTS, carpal tunnel syndrome.
Mentions: To restrict the study to idiopathic CTS, we excluded cases with secondary (ie, coexisting) diagnoses of conditions thought to be associated with a increased risk of CTS,16–18 namely hypothyroidism (ICD-9 codes 243, 244), thyroiditis (245), diabetes mellitus (250), gout (274.0), amyloidosis (277.3), overweight/obesity (278), complications of pregnancy (646.8, 646.9), connective tissue diseases (710), rheumatoid arthritis (714), osteoarthritis of the hand/forearm (715.3, 715.4), wrist fractures (813.4), shoulder/upper limb peripheral nerve injuries (955) and pregnancy (V22). Because of limited numbers of cases in the youngest age groups and selection bias considerations related to “retired” occupational status, we decided to restrict the study to subjects aged 25–59 years. As shown in fig 1, we also excluded members of the armed forces (due to white-/blue-collar classification difficulties), students, full-time “househusbands”, cases with undeclared/unknown employment status (due to treatment outside Tuscany, etc), unemployed or retired subjects (due to lack of information about previous occupational status), first job seekers, and those with “other” (unspecified) job titles. We grouped the job titles reported on the hospital discharge records into occupational categories and classified them into blue-collar (including “mixed-collar”), white-collar and housewives, as shown in table 1.

Bottom Line: Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001).Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002).Thus, occupational risk factors seem relevant throughout working life.

View Article: PubMed Central - PubMed

Affiliation: Dipartimento di Medicina Interna, dell'Invecchiamento e Malattie Nefrologiche, University of Bologna, Italy. s.mattioli@unibo.it

ABSTRACT

Objectives: Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared.

Methods: Surgically treated cases of idiopathic CTS were investigated among 25-59-year-old residents of Tuscany, Italy, during 1997-2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany's regional database. Population data were extracted from the 2001 census.

Results: After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives' rates were much higher (p<0.001) than those of white-collar women.

Conclusions: Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.

Show MeSH
Related in: MedlinePlus