Journal article
Biomechanical and psychosocial exposures are independent risk factors for carpal tunnel syndrome: assessment of confounding using causal diagrams
Occupational and environmental medicine (London, England), Vol.73(11), pp.727-734
11/2016
DOI: 10.1136/oemed-2016-103634
PMCID: PMC6555409
PMID: 27466616
Abstract
BackgroundBetween 2001 and 2010, six research groups conducted coordinated prospective studies of carpal tunnel syndrome (CTS) incidence among US workers from various industries to estimate exposure–response relationships.ObjectiveThis analysis examined the presence and magnitude of confounding between biomechanical and workplace psychosocial factors and incidence of dominant-hand CTS.Methods1605 participants, without CTS at enrolment, were followed for up to 3.5 years (2471 person-years). Demographic information, medical history and workplace psychosocial stress measures were collected at baseline. Individual workplace biomechanical exposures were collected for each task and combined across the workweek using time-weighted averaging (TWA). CTS case criteria were based on symptoms and results of electrophysiological testing. HRs were estimated with Cox proportional hazard models. Confounding was assessed using causal diagrams and an empirical criterion of 10% or greater change in effect estimate magnitude.ResultsThere were 109 incident CTS cases (IR=4.41/100 person-years; 6.7% cumulative incidence). The relationships between CTS and forceful repetition rate, % time forceful hand exertion and the Threshold Limit Value for Hand Activity Level (TLV-HAL) were slightly confounded by decision latitude with effect estimates being attenuated towards the null (10–14% change) after adjustment. The risk of CTS among participants reporting high job strain was attenuated towards the null by 14% after adjusting for the HAL Scale or the % time forceful hand exertions.ConclusionsAlthough attenuation of the relationships between CTS and some biomechanical and work psychosocial exposures was observed after adjusting for confounding, the magnitudes were small and confirmed biomechanical and work psychosocial exposures as independent risk factors for incident CTS.
Details
- Title: Subtitle
- Biomechanical and psychosocial exposures are independent risk factors for carpal tunnel syndrome: assessment of confounding using causal diagrams
- Creators
- Carisa Harris-Adamson - University of California, San FranciscoEllen A Eisen - University of California, BerkeleyAndreas Neophytou - University of California, BerkeleyJay Kapellusch - University of Wisconsin–MilwaukeeArun Garg - University of Wisconsin–MilwaukeeKurt T Hegmann - University of UtahMatthew S Thiese - University of UtahAnn Marie Dale - Washington University in St. LouisBradley Evanoff - Washington University in St. LouisStephen Bao - United States Department of StateBarbara Silverstein - United States Department of StateFred Gerr - University of IowaSusan Burt - National Institute for Occupational Safety and HealthDavid Rempel - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- Occupational and environmental medicine (London, England), Vol.73(11), pp.727-734
- DOI
- 10.1136/oemed-2016-103634
- PMID
- 27466616
- PMCID
- PMC6555409
- NLM abbreviation
- Occup Environ Med
- ISSN
- 1351-0711
- eISSN
- 1470-7926
- Language
- English
- Date published
- 11/2016
- Academic Unit
- Occupational and Environmental Health; Epidemiology
- Record Identifier
- 9984363574502771
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