Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers

Background: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship betwe...

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Main Authors: Doohee You, Allan H. Smith, David Rempel
Format: Article
Language:English
Published: Elsevier 2014-03-01
Series:Safety and Health at Work
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2093791114000043
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author Doohee You
Allan H. Smith
David Rempel
author_facet Doohee You
Allan H. Smith
David Rempel
author_sort Doohee You
collection DOAJ
description Background: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS. Methods: PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: “work related”, “carpal tunnel syndrome”, “wrist posture”, and “epidemiology”. The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS. Results: Nine studies met the inclusion criteria. All were cross-sectional or case–control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646–2.43; p < 0.01: Shore-adjusted 95% CI: 1.32–2.97]. Conclusion: We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.
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spelling doaj.art-5fad56a65d66442ba60a9645671323582023-09-03T04:02:28ZengElsevierSafety and Health at Work2093-79112014-03-0151273110.1016/j.shaw.2014.01.003Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among WorkersDoohee You0Allan H. Smith1David Rempel2Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USAEnvironmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USAEnvironmental Health Sciences, School of Public Health, University of California, Berkeley, CA, USABackground: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS. Methods: PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: “work related”, “carpal tunnel syndrome”, “wrist posture”, and “epidemiology”. The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS. Results: Nine studies met the inclusion criteria. All were cross-sectional or case–control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646–2.43; p < 0.01: Shore-adjusted 95% CI: 1.32–2.97]. Conclusion: We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.http://www.sciencedirect.com/science/article/pii/S2093791114000043carpal tunnel syndromemeta-analysissystematic review
spellingShingle Doohee You
Allan H. Smith
David Rempel
Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
Safety and Health at Work
carpal tunnel syndrome
meta-analysis
systematic review
title Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
title_full Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
title_fullStr Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
title_full_unstemmed Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
title_short Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers
title_sort meta analysis association between wrist posture and carpal tunnel syndrome among workers
topic carpal tunnel syndrome
meta-analysis
systematic review
url http://www.sciencedirect.com/science/article/pii/S2093791114000043
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