Exposure-response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome

Jay M Kapellusch; Frederic E Gerr; Elizabeth J Malloy; Arun Garg; Carisa Harris-Adamson; Stephen S Bao; Susan E Burt; Ann Marie Dale; Ellen A Eisen; Bradley A Evanoff; Kurt T Hegmann; Barbara A Silverstein; Matthew S Theise; David M Rempel

doi:10.5271/sjweh.3456

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Exposure-response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome

Journal article

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Exposure-response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome

Jay M Kapellusch, Frederic E Gerr, Elizabeth J Malloy, Arun Garg, Carisa Harris-Adamson, Stephen S Bao, Susan E Burt, Ann Marie Dale, Ellen A Eisen, Bradley A Evanoff, …

Scandinavian journal of work, environment & health, Vol.40(6), pp.610-620

11/2014

DOI: 10.5271/sjweh.3456

PMCID: PMC4251712

PMID: 25266844

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Abstract

This paper aimed to quantify exposure-response relationships between the American Conference of Governmental Industrial Hygienists' (ACGIH) threshold limit value (TLV) for hand-activity level (HAL) and incidence of carpal tunnel syndrome (CTS). Manufacturing and service workers previously studied by six research institutions had their data combined and re-analyzed. CTS cases were defined by symptoms and abnormal nerve conduction. Hazard ratios (HR) were calculated using proportional hazards regression after adjusting for age, gender, body mass index, and CTS predisposing conditions. The longitudinal study comprised 2751 incident-eligible workers, followed prospectively for up to 6.4 years and contributing 6243 person-years of data. Associations were found between CTS and TLV for HAL both as a continuous variable [HR 1.32 per unit, 95% confidence interval (95% CI) 1.11-1.57] and when categorized using the ACGIH action limit (AL) and TLV. Those between the AL and TLV and above the TLV had HR of 1.7 (95% CI 1.2-2.5) and 1.5 (95% CI 1.0-2.1), respectively. As independent variables (in the same adjusted model) the HR for peak force (PF) and HAL were 1.14 per unit (95% CI 1.05-1.25), and 1.04 per unit (95% CI 0.93-1.15), respectively. Those with exposures above the AL were at increased risk of CTS, but there was no further increase in risk for workers above the TLV. This suggests that the current AL may not be sufficiently protective of workers. Combinations of PF and HAL are useful for predicting risk of CTS.

Adolescent

Adult

Aged

Biomechanical Phenomena - physiology

Carpal Tunnel Syndrome - epidemiology

Carpal Tunnel Syndrome - etiology

Female

Hand - physiology

Humans

Male

Middle Aged

Occupational Exposure

Risk Factors

Threshold Limit Values

Young Adult

Details

Title: Subtitle: Exposure-response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome
Creators: Jay M Kapellusch - University of Wisconsin–Milwaukee
Frederic E Gerr - University of Iowa
Elizabeth J Malloy - American University
Arun Garg - University of Wisconsin–Milwaukee
Carisa Harris-Adamson - University of California, Berkeley
Stephen S Bao - United States Department of State
Susan E Burt - National Institute for Occupational Safety and Health
Ann Marie Dale - Washington University in St. Louis
Ellen A Eisen - University of California, Berkeley
Bradley A Evanoff - Washington University in St. Louis
Kurt T Hegmann - Day Family Medicine
Barbara A Silverstein - United States Department of State
Matthew S Theise - University of Utah
David M Rempel - University of California, San Francisco
Resource Type: Journal article
Publication Details: Scandinavian journal of work, environment & health, Vol.40(6), pp.610-620
DOI: 10.5271/sjweh.3456
PMID: 25266844
PMCID: PMC4251712
NLM abbreviation: Scand J Work Environ Health
ISSN: 0355-3140
eISSN: 1795-990X
Grant note: P30 ES005605 / NIEHS NIH HHS UL1 TR000448 / NCATS NIH HHS R01OH009712 / NIOSH CDC HHS R01 OH009712 / NIOSH CDC HHS
Language: English
Date published: 11/2014
Academic Unit: Occupational and Environmental Health; Epidemiology
Record Identifier: 9984363618802771

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