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Scand J Work Environ Health. 2009 Jan;35(1):19-36.

Associations between work-related factors and the carpal tunnel syndrome--a systematic review.

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Erasmus MC, Department of General Practice, Room Wk-109, PO Box 2040, NL-3000 CA Rotterdam, Netherlands.



The aim of this study was to make a quantitative assessment of the exposure-response relationships between work-related physical and psychosocial factors and the occurrence of carpal tunnel syndrome (CTS) in occupational populations.


A systematic review of the literature was conducted on the associations of type of work, physical load factors, and psychosocial aspects at work to the occurrence of CTS. The associations between work factors and CTS were expressed in quantitative measures, namely, odds ratios (OR) or relative risks.


Jobs with the highest risk of CTS included work in the meat- and fish-processing industry, forestry work with chain saws, and electronic assembly work (OR 76.5, 21.3, and 11.4, respectively). The occurrence of CTS was associated with high levels of hand-arm vibration, prolonged work with a flexed or extended wrist, high requirements for hand force, high repetitiveness, and their combination. No association was found between any psychosocial risk factor and CTS. Contradictory findings were reported for associations between computer work and CTS.


This review provides consistent indications that CTS is associated with an average hand force requirement of >4 kg, repetitiveness at work (cycle time 50% of cycle time performing the same movements), and a daily 8-hour energy-equivalent frequency-weighted acceleration of 3.9 m/s2.

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