背景:腕管综合征(CTS)是一种肌肉骨骼疾病,通常会损害工作的适应性。我们的目的是回顾性评估意大利北部肉类加工行业的物理暴露与CTS之间的关联,考虑非职业因素。
方法:进行了一项横断面研究,包括434名工人(236名男性,198名女性,37.0±10.6岁,工作年龄:12.6±10.8岁),来自肉类加工行业。在强制性职业医学监护中收集体征和症状。调查人员通过问卷调查和直接评估评估职业危险因素。通过二元逻辑回归估计感兴趣因素的调整后优势比(ORadj)。
结果:在434名受试者中有61名(14.1%)报告了CTS的诊断,发病率为11.3/1000人年。总的来说,CTS的体征和症状与以下人口统计学因素相关:吸烟史(OR=1.909,95%置信区间(CI):1.107-3.293),先前的上肢创伤(OR=3.533,95%CI:1.743-7.165),甲状腺功能减退状态(OR=7.897,95%CI:2.917-21.38)和,在只有女性参与者的情况下,既往妊娠(OR=2.807,95%CI:1.200-6.566)以及口服避孕药和/或类固醇替代治疗的个人病史(OR=11.57,95%CI:4.689-28.56).腕管综合征病例与以下职业因素(>4小时/天)相关:用力用力手(ORadj=3.548,95%CI:1.379-9.131),手部反复创伤(ORadj=3.602,95%CI:1.248-10.395),手腕反复运动(ORadj=2.561,95%CI:1.100-5.960)。
结论:增加的手活动和力量水平与参与者中CTS患病率增加相关。必须提供建议,以减少职业暴露于这些危险因素并改善医疗监测。医学博士2017年;68(2):199-209。
背景:腕管综合征(CTS)是一种肌肉骨骼疾病,通常会损害工作的适应性。我们的目的是回顾性评估意大利北部肉类加工行业的物理暴露与CTS之间的关联,考虑非职业因素。
方法:进行了一项横断面研究,包括434名工人(236名男性,198名女性,37.0±10.6岁,工作年龄:12.6±10.8岁),来自肉类加工行业。在强制性职业医学监护中收集体征和症状。调查人员通过问卷调查和直接评估评估职业危险因素。通过二元逻辑回归估计感兴趣因素的调整后优势比(ORadj)。
结果:在434名受试者中有61名(14.1%)报告了CTS的诊断,发病率为11.3/1000人年。总的来说,CTS的体征和症状与以下人口统计学因素相关:吸烟史(OR=1.909,95%置信区间(CI):1.107-3.293),先前的上肢创伤(OR=3.533,95%CI:1.743-7.165),甲状腺功能减退状态(OR=7.897,95%CI:2.917-21.38)和,在只有女性参与者的情况下,既往妊娠(OR=2.807,95%CI:1.200-6.566)以及口服避孕药和/或类固醇替代治疗的个人病史(OR=11.57,95%CI:4.689-28.56).腕管综合征病例与以下职业因素(>4小时/天)相关:用力用力手(ORadj=3.548,95%CI:1.379-9.131),手部反复创伤(ORadj=3.602,95%CI:1.248-10.395),手腕反复运动(ORadj=2.561,95%CI:1.100-5.960)。
结论:增加的手活动和力量水平与参与者中CTS患病率增加相关。必须提供建议,以减少职业暴露于这些危险因素并改善医疗监测。医学博士2017年;68(2):199-209。
BACKGROUND: Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors.
METHODS: A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj) for factors of interest were estimated through binary logistic regression.
RESULTS: Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person- years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107-3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743-7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917-21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200-6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689-28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (ORadj = 3.548, 95% CI: 1.379-9.131), repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248- 10.395), repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100-5.960).
CONCLUSIONS: Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2):199-209.
BACKGROUND: Carpal tunnel syndrome (CTS) is a musculoskeletal condition that often impairs the fitness to work. Our aim is to retrospectively evaluate the association between physical exposures in meat processing industry in Northern Italy and the CTS, taking into account non-occupational factors.
METHODS: A cross-sectional study was performed to include 434 workers (236 males, 198 females, 37.0±10.6 years old, working age: 12.6±10.8 years) from meat processing industries. Signs and symptoms were collected at the compulsory occupational medical surveillance. Occupational risk factors were assessed through a questionnaire and direct assessment by investigators. Adjusted odds ratios (ORadj) for factors of interest were estimated through binary logistic regression.
RESULTS: Diagnosis of the CTS was reported for 61 out of 434 subjects (14.1%) for an incidence of 11.3/1000 person- years. In general, signs and symptoms for the CTS were associated with the following demographic factors: smoking history (OR = 1.909, 95% confidence interval (CI): 1.107–3.293), previous traumas of the upper limb (OR = 3.533, 95% CI: 1.743–7.165), hypothyroidism status (OR = 7.897, 95% CI: 2.917–21.38) and, in the case of female participants only, previous pregnancies (OR = 2.807, 95% CI: 1.200–6.566) as well as a personal history of oral contraceptive therapy and/or steroidal replacement therapy (OR = 11.57, 95% CI: 4.689–28.56). The carpal tunnel syndrome cases were associated with the following occupational factors (> 4 h/day): forceful hand exertion (ORadj = 3.548, 95% CI: 1.379–9.131), repeated trauma of the hand (ORadj = 3.602, 95% CI: 1.248– 10.395), repeated movements of the wrist (ORadj = 2.561, 95% CI: 1.100–5.960).
CONCLUSIONS: Increasing levels of hand activity and force were associated with the increased CTS prevalence among participants. Recommendations have to be provided in order to reduce occupational exposure to these risk factors and improve medical surveillance. Med Pr 2017;68(2):199–209.