Responding to carpal tunnel syndrome: the role of the work environment

Whether you stay at work or take disability after developing carpal tunnel
syndrome appears to depend more on your work environment than on the severity
of the condition, according to a new study by University of California, San
Francisco researchers.

Although many recent studies have focused on what causes carpal tunnel
syndrome, few have investigated what factors might lead to or prolong work
disability after development of the condition.  The UCSF researchers found that
working conditions and type of job significantly influenced a person’s decision
to continue working, find a different job, or leave the workforce.

The researchers will present their findings as part of a symposium on women’s
symptoms at the 11th International Congress on Women’s Health Issues held in
San Francisco on Saturday, January 29, 2000.  The Congress is sponsored by the
University of California, San Francisco’s School of Nursing in affiliation with
the International Council on Women’s Health Issues and other co-sponsoring
institutions.

“We found that the ability to continue working after developing carpal tunnel
syndrome stems from job related factors over and above personal factors and the
severity of the medical condition,” said Julia Faucett, RN, PhD, UCSF professor
of Community Health Systems, School of Nursing and principal investigator of
the study.  “Regardless of how the syndrome developed, the best predictors of
who stayed at work had to do with what kind of work the individual was engaged
in and the psychological and physical conditions of the workplace.”

Carpal tunnel syndrome is a common disorder, caused by a variety of medical
conditions or overuse of the hands at work or home.  Typical symptoms are
numbness, burning, or pain in the fingers, palm or wrist, and are related to
damage to one of the nerves of the hand.  Women are two to four times more
likely to develop the syndrome, perhaps due to occupational as well as physical
and physiological differences.  For example, carpal tunnel syndrome is
associated with pregnancy and also rheumatoid arthritis, a condition that more
often afflicts women than men, said Faucett.

The researchers interviewed 102 people living in Santa Clara County, CA who
were referred to the study by their physicians.  The survey was conducted by
phone and included items about medical history, symptoms of carpal tunnel
syndrome, personal and job characteristics, and work history.  Work or
work-related conditions were most often considered the cause of the condition
and two-thirds of the study participants were receiving worker compensation,
said Faucett.

The researchers found that women had poorer function and greater fatigue
following the development of carpal tunnel syndrome.  They also reported poorer
support at home.  Women were also more likely to make changes in their work
situation to accommodate their CTS - they left the workforce, modified their
job, or accepted a new job more often than men.

Employees were less likely to continue working at jobs that could not be
modified, had high psychological demands, offered little control over job
tasks, or required frequent applications of force, such as in construction.  If
they worked for employers with a large number of employees, they were also less
likely to continue working.

In addition to Faucett, co-authors of the study include Paul Blanc, MD, MSPH,
UCSF associate professor of medicine; and Edward Yelin, PhD, UCSF professor of
medicine.

The symposium on women’s symptoms will also include research on the experiences
of Thai female burn survivors, the psychological well-being of Thai mothers
following childbirth, and activity patterns during menopause.

More information about the Congress, including a complete program of events, is
available at http://nurseweb.ucsf.edu/www/icowhi.htm.