The specific aims of this proposal are to develop and test a multifactorial model of work disability related to carpal tunnel syndrome (CTS), and entrapment of the median nerve at the wrist. CTS is associated with occupational ergonomic factors in addition to non-work related etiological factors. The primary hypothesis posed in this study is that occupation is also associated with the risk of work disability after onset of CTS, in a predictive model that includes medical severity, demographics, and other disability risk factors. The model predicts that work disability will be associated with ergonomic job hazards such as work tasks requiring forceful and repetitive motion, high psychological workload, low control over job-related decisions, and poor supervisory relationships. Methods: Initially, a predictive models of work disability from CTS will be developed using a secondary analysis of data from the National Health Interview Survey Occupational Health Supplement (NHIS-OHS). The model will then be tested on a CTS patient panel (n=225) garnered using a community case identification strategy developed and field tested as part of a NIOSH CT surveillance project. Disability is defined as lost work time, changes in job or job activities, and complete withdrawal from the labor force. The predictors of work disability in the model will include occupational (work task ergonomics, decision control, psychological work load, supervisor support and conflict, industry), medical severity (symptom severity, bilaterality, nocturnal symptoms, muscle wasting, surgery, co-morbidity), psychosocial (fear of reinjury, self-efficacy for pain control, family cohesion), and demographic (age, gender, ethnicity, education) factors. Panel subjects will be interviewed at baseline and annually for two years to obtain cross-sectional and longitudinal data. Relationships between the predictor variables and the disability outcomes will be analyzed cross-sectionally using multiple logistic regression and longitudinally using the Cox proportional hazards models. Long term objectives: Statistically and clinically significant occupational and individual risk factors for work disability will be identified in this study. Findings, together with those from other investigations, will contribute to the design of worksite interventions to reduce disability from cumulative trauma disorders.

Project Start
Project End
Budget Start
Budget End
Support Year
17
Fiscal Year
1994
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Type
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Briggs, F B S; Ramsay, P P; Madden, E et al. (2010) Supervised machine learning and logistic regression identifies novel epistatic risk factors with PTPN22 for rheumatoid arthritis. Genes Immun 11:199-208
Yazdany, Jinoos; Yelin, Edward (2010) Health-related quality of life and employment among persons with systemic lupus erythematosus. Rheum Dis Clin North Am 36:15-32, vii
Janssens, A Cecile J W; Steyerberg, Ewout W; Jiang, Yebin et al. (2006) Value of the HLA-DRB1 shared epitope for predicting radiographic damage in rheumatoid arthritis depends on the individual patient risk profile. J Rheumatol 33:2383-9
Katz, Patricia P (2006) Childbearing decisions and family size among women with rheumatoid arthritis. Arthritis Rheum 55:217-23
Yelin, Edward H; Trupin, Laura S; Katz, Patricia P (2005) Impact of managed care on the use of biologic agents for rheumatoid arthritis. Arthritis Rheum 53:423-30
Katz, Patricia P (2005) Use of self-management behaviors to cope with rheumatoid arthritis stressors. Arthritis Rheum 53:939-49
von Scheven, E; Elder, M E (2005) Association between beta2-glycoprotein I gene polymorphisms and pediatric SLE and antiphospholipid antibodies. Lupus 14:440-4
Yang, Nan; Li, Hongzhe; Criswell, Lindsey A et al. (2005) Examination of ancestry and ethnic affiliation using highly informative diallelic DNA markers: application to diverse and admixed populations and implications for clinical epidemiology and forensic medicine. Hum Genet 118:382-92
Seldin, Michael F; Morii, Takanobu; Collins-Schramm, Heather E et al. (2004) Putative ancestral origins of chromosomal segments in individual african americans: implications for admixture mapping. Genome Res 14:1076-84
Chang, Wenhan; Shoback, Dolores (2004) Extracellular Ca2+-sensing receptors--an overview. Cell Calcium 35:183-96

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