Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region

• Published in: BMC public health Vol. 18; no. 1; p. 426
• Main Authors: Roquelaure, Yves, Fouquet, Natacha, Chazelle, Emilie, Descatha, Alexis, Evanoff, Bradley, Bodin, Julie, Petit, Audrey
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 02.04.2018; BioMed Central; BMC
• Subjects: Age; Analysis; Attributable risk; Biomechanics; Carpal tunnel syndrome; Cost assessments; Distribution; Ecology, environment; Economic impact; Employment; Entrapment; Food industry; Food processing industry; Health; Health promotion; Health surveillance; Impact analysis; Incidence; Intervention; Life Sciences; Medical research; Medicine, Experimental; Neuropathy; Overuse injuries; Population; Prevention; Preventive efficiency; Public health; Regional analysis; Risk analysis; Risk factors; Simulation; Surgery; Systematic review; Work-related; Workers; France; Prevention; Carpal tunnel syndrome; Simulation; Work-related; Attributable risk; Preventive efficiency
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-018-5328-6

Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy in the working-age population. The reduction of CTS incidence in the workforce is a priority for policy makers due to the human, social and economic costs. To assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or work-related risk factors for CTS. Surgical CTS were assessed using regional hospital discharge records for persons aged 20-59 in 2009. Using work-related attributable fractions (AFEs), we estimated the number of work-related CTS (WR-CTS) in high-risk jobs. We simulated three theoretical scenarios of workplace-based primary prevention for jobs at risk: a mono-component work-centered intervention reducing the incidence of WR-CTS arbitrarily by 10% (10%-WI), and multicomponent global interventions reducing the incidence of all surgical CTS by 5% and 10% by targeting personal and work risk factors. A limited proportion of CTS were work-related in the region's population. WR-CTS were concentrated in nine jobs at high risk of CTS, amounting to 1603 [1137-2212] CTS, of which 906 [450-1522] were WR-CTS. The 10%-WI, 5%-GI and 10%-GI hypothetically prevented 90 [46-153], 81 [58-111] and 159 [114-223] CTS, respectively. The 10%-GI had the greatest impact regardless of the job. The impact of the 10%-WI interventions was high only in jobs at highest risk and AFEs (e.g. food industry jobs). The 10%-WI and 5%-GI had a similar impact for moderate-risk jobs (e.g. healthcare jobs). The impact of simulated workplace-based interventions suggests that prevention efforts to reduce exposure to work-related risk factors should focus on high-risk jobs. Reducing CTS rates will also require integrated strategies to reduce personal risk factors, particularly in jobs with low levels of work-related risk of CTS.