Psychosocial and Occupational Factors Associated with Carpal Tunnel Syndrome using a National Sample of United States Working Adults
Carpal tunnel syndrome (CTS) is a common peripheral neuropathy with known personal, medical and biomechanical risk factors including specific work-related physical exertion. CTS accounts for approximately 10% of work-related musculoskeletal disorders (WMSDs) which make up almost 31% of all work-related injuries in the United States (US), 2015. Among the US working adults CTS injury results in a median of 28 days away from work, resulting in loss of work time, loss of earning power, low rate of returning to pre-injury status, and high cost for treatment. It is important to determine whether any work-related factors other than the known biomechanical risk factors could be potential contributing factors to CTS among working individuals in the U.S. Recent research has found that work characteristics (e.g., long work hours or non-standard employment arrangements) and occupational psychosocial factors (e.g., high job demand or work-life imbalance) could impact on a range of health outcomes either as direct risk factors or by interacting with physical or other personal or work-related risk factors. However, there has been a paucity of evidence on whether work characteristics or occupational psychosocial factors are associated with CTS in working populations with no evaluation of these factors in a general U.S. working population.
Data from the 2015 National Health Interview Survey (NHIS) and its supplementary Occupational Health Supplementary (OHS) Survey were analyzed using Chi Square for bivariate comparisons and multiple logistic regression models to examine associations between occupational psychosocial risk factors and prevalence of CTS, while controlling for demographic characteristics, relevant health comorbidities, and work-related physical exertion. The prevalence of self-reported ever CTS diagnosed by a healthcare provider was 6.3% while the prevalence of those reporting CTS symptoms in the last 12 months was 3.0%, translating to 3.4 and 1.7 million U.S. adult workers. The psychosocial factors found to be associated with ever having a diagnosis of CTS were hostile work environment, worrying about losing one’s job, and work-life interference. High job demand and worrying about losing job were found to be associated with those with a past diagnosis of CTS and experiencing CTS symptoms within the last 12 months. The role of these occupational psychosocial risk factors for CTS along with physical job demands of frequent lifting and pushing at work should be evaluated further in longitudinal studies.