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. 2009 May;66(5):299-304.
doi: 10.1136/oem.2008.040212. Epub 2009 Mar 1.

Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy

S Mattioli  1 , A Baldasseroni, S Curti, R M T Cooke, A Mandes, F Zanardi, A Farioli, E Buiatti, G Campo, F S Violante
Affiliations

Incidence rates of surgically treated idiopathic carpal tunnel syndrome in blue- and white-collar workers and housewives in Tuscany, Italy

S Mattioli et al. Occup Environ Med. 2009 May.

Abstract

Objectives: Rates of surgically treated carpal tunnel syndrome (CTS) among blue- and white-collar workers and housewives in the general population were compared.

Methods: Surgically treated cases of idiopathic CTS were investigated among 25-59-year-old residents of Tuscany, Italy, during 1997-2000, based on obligatory discharge records from all Italian public/private hospitals, archived according to residence on Tuscany's regional database. Population data were extracted from the 2001 census.

Results: After excluding repeat admissions, 8801 eligible cases were identified. Age-standardised rates (per 100 000 person-years) of surgical CTS were: "blue-collar women", 367.8; "white-collar women", 88.1; "housewives", 334.5; "blue-collar men", 73.5; and "white-collar men", 15.3. Compared with reference categories (same-sex white-collar workers): female blue-collar workers experienced a 4.2-fold higher standardised rate; housewives, a 3.8-fold excess; and male blue-collar workers, a 4.8-fold excess (all p<0.001). Male and female blue-collar workers showed approximately three to sevenfold higher age-specific rates compared to their white-collar counterparts (all p<0.001). Housewives' rates were similar to those of blue-collar female workers up to 40-44 years of age, after which they were significantly lower (p<0.002). At all ages, housewives' rates were much higher (p<0.001) than those of white-collar women.

Conclusions: Surgically treated CTS was three to seven times more common (depending on age/gender) in blue-collar than in white-collar workers, which is difficult to explain by differences in body weight or other individual factors. Thus, occupational risk factors seem relevant throughout working life. The high rates for full-time housewives suggest that domestic chores should be investigated as a possible risk factor for CTS.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Flow chart of cases meeting the study eligibility criteria. *Cases also bearing the following ICD-9 codes were considered not to be idiopathic: 245 (hypothyroidism, thyroiditis), 250 (diabetes mellitus), 274.0 (gout), 277.3 (amyloidosis), 278 (overweight/obesity), 646.8 and 646.9 (complications of pregnancy), 710 (connective tissue diseases), 714 (rheumatoid arthritis), 715.3 and 715.4 (osteoarthritis of the hand/forearm), 813.4 (wrist fractures), 955 (shoulder/upper limb peripheral nerve injuries) and V22 (pregnancy). CTS, carpal tunnel syndrome.
Figure 2
Figure 2
Age-specific incidence rates of surgically treated idiopathic carpal tunnel syndrome according to occupational category in women (A) and men (B).
Figure 3
Figure 3
Age-sex specific rate ratios (A, women; B, men) for blue-collar workers and full-time housewives with respect to white-collar workers.
See this image and copyright information in PMC

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