There is controversy over the relative contributions of work exposures and personal characteristics in the etiology of carpal tunnel syndrome (CTS), and over effective preventive strategies for CTS. Some have advocated pre-employment screening nerve conduction studies, with the rationale that these studies can predict future risk of developing carpal tunnel syndrome (CTS). Workers at higher risk for CTS can then be kept from jobs requiring intensive hand activity. Though screening for CTS is common, its effectiveness and the role of placement strategies in preventing carpal tunnel syndrome have not been studied. Questions surrounding use of pre-placement nerve conduction studies are part of a larger controversy concerning the relative contributions of different risk factors in the multi-factorial etiology of CTS. We propose a prospective, longitudinal study of 1500 workers who are new or recent hires in a mixture of industries at increased risk for CTS. Baseline data include nerve conduction studies, a medical history, symptoms, physical examination, and job exposures. All workers will be followed for 3 years through repeated questionnaires and collection of administrative data. A sub- cohort of 450 workers, including all those with abnormal baseline nerve conduction studies and matched controls, will receive more detailed followup, including repeat nerve conduction testing and observation of job exposures. Our proposed study will address four aims: Compare the cumulative incidence of CTS in workers with and without baseline abnormalities of median nerve conduction, in order to test the predictive validity of pre-placement nerve conduction studies. Measure the interaction between baseline nerve conduction abnormalities and physical job demands in conferring increased risk of CTS. Measure costs associated with CTS and estimate the costs per case of CTS avoided by pre-placement, post-offer screening with nerve conduction studies. Determine risk factors for CTS in a study that prospectively measures baseline nerve conduction values, job exposures, demographic and anthropometric variables, and history of concurrent medical conditions.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Research Project (R01)
Project #
5R01OH008017-04
Application #
7241613
Study Section
Safety and Occupational Health Study Section (SOH)
Program Officer
Frederick, Linda J
Project Start
2004-06-01
Project End
2009-05-31
Budget Start
2007-06-01
Budget End
2008-05-31
Support Year
4
Fiscal Year
2007
Total Cost
$493,734
Indirect Cost
Name
Washington University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
068552207
City
Saint Louis
State
MO
Country
United States
Zip Code
63130
Dale, Ann Marie; Ekenga, Christine C; Buckner-Petty, Skye et al. (2018) Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures. Occup Environ Med 75:501-506
Dale, Ann Marie; Miller, Kim; Gardner, Bethany T et al. (2016) Observed use of voluntary controls to reduce physical exposures among sheet metal workers of the mechanical trade. Appl Ergon 52:69-76
Evanoff, Bradley; Gardner, Bethany T; Strickland, Jaime R et al. (2016) Long-term symptomatic, functional, and work outcomes of carpal tunnel syndrome among construction workers. Am J Ind Med 59:357-68
Dale, Ann Marie; Gardner, Bethany T; Buckner-Petty, Skye et al. (2016) Postoffer Pre-Placement Screening for Carpal Tunnel Syndrome in Newly Hired Manufacturing Workers. J Occup Environ Med 58:1212-1216
Gardner, Bethany T; Dale, Ann Marie; Buckner-Petty, Skye et al. (2016) Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders. J Occup Rehabil 26:84-94
Gardner, Bethany T; Dale, Ann Marie; Buckner-Petty, Skye et al. (2016) Comparison of Employer Productivity Metrics to Lost Productivity Estimated by Commonly Used Questionnaires. J Occup Environ Med 58:170-7
Mediouni, Z; Bodin, J; Dale, A M et al. (2015) Carpal tunnel syndrome and computer exposure at work in two large complementary cohorts. BMJ Open 5:e008156
Dale, Ann Marie; Gardner, Bethany T; Buckner-Petty, Skye et al. (2015) Responsiveness of a 1-Year Recall Modified DASH Work Module in Active Workers with Upper Extremity Musculoskeletal Symptoms. J Occup Rehabil 25:638-47
Dale, Ann Marie; Evanoff, Bradley; Al-Lozi, Muhammad (2015) Reply: To PMID 25463687. PM R 7:551
Dale, Ann Marie; Agboola, Folasade; Yun, Amber et al. (2015) Comparison of automated versus traditional nerve conduction study methods for median nerve testing in a general worker population. PM R 7:276-82

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