Not so easy to diagnose carpal tunnel syndrome

To evaluate the utility of physical examination manoeuvres in the prediction of carpal tunnel syndrome (CTS) a cohort of 1108 newly employed workers in several industries was studied. Each worker completed a symptom questionnaire, a structured physical examination and nerve conduction study. To diagnose CTS both median nerve conduction abnormality and symptoms classified as “classic” or “probable” on a hand diagram were required. The prevalence of CTS in our cohort was 1.2% for the right hand and 1.0% for the left hand. The post-test probability of positive testing was <50% for all strategies tested. In this study it turned out that physical examination, alone or in combination with symptoms, was not predictive of CTS in a working population. Researchers suggest using specific symptoms as a first-level screening tool, and nerve conduction study as a confirmatory test

Diagnostic strategies using physical examination are minimally useful in defining carpal tunnel syndrome in population-based research
 Descatha, A, Dale, A-M, Franzblau, A, Coomes, J, Evanoff, B
Occup Environ Med 2010;67:133-135 doi:10.1136/oem.2009.047431

Filed under: Musculoskeletal problems, Occupational injury, Occupational medicine, CTS, Diagnosis

Short video explaining carpal tunnel syndrome

Always wanted to know what Carpal Tunnel Syndrome is?
Watch this short film by WorkSafe BC

or this simple, but clear one

Filed under: Musculoskeletal problems, Occupational injury, Physical load, Vibration, Carpal tunnel syndrome

Occupational injuries in emergency responders

Emergency responders frequently incur injuries while providing medical, fire, and law enforcement services. From a study in the National Electronic Injury Surveillance System – Occupational Supplement (NEISS-Work) for injuries treated in U.S. hospital emergency departments in 2000-2001, it turned out that sprains and strains were the leading injury (33-41%) among EMS, firefighter, and police occupations. Police officers and career firefighters had the highest injury rates (8.5 and 7.4 injuries per 100 full-time equivalent workers, respectively). The researchers conclude that The physical demands of emergency response are a leading cause of injuries.

Occupational injuries among emergency responders
Audrey A. Reichard, MPH, OTR, Larry L. Jackson, PhD
American Journal of Industrial Medicine, published Online: 5 Nov 2009

Filed under: Musculoskeletal problems, Occupational injury, Physical load, Occupational injuries

Occupational injuries among aides and nurses in acute care

The objective was to assess risk of work-related injuries in an acute care setting while contrasting injuries of aides and nurses. It turned out that aides had higher overall injury rates than nurses for no-lost work time (RR = 1.2, 95% CI: 1.1-1.3) and lost work time (RR = 2.8, 95% CI: 2.1-3.8) injuries. The risk of an injury due to lifting was greater among aides compared to nurses for both non-lost work time and lost work time injuries. Injury rates among aides were particularly high in rehabilitation and orthopedics units.

Occupational injuries among aides and nurses in acute care
R.L. Rodríguez-Acosta et al. American Journal of Industrial Medicine.

Filed under: Occupational diseases, Occupational injury, Reporting OD's, Nurse, Occupational injuries

Foreign-born workers more at risk for occupational injuries

Hispanic and foreign-born workers suffer high rates of occupational fatality. Reasons for this are not well understood. Eight years of data were obtained from an urban trauma center. Hispanics were more highly represented than expected; their number of injuries steadily rose. Hispanics were more likely to be injured by machinery and hand tools. Workers reported hazardous working conditions, lack of workers compensation, short time in current employment, and not working in their usual job.

Traumatic occupational injuries in Hispanic and foreign born workers
Linda Forst, MD, MPH , Susan Avila, BSN, MPH , Stella Anozie, MD, MPH, Rachel Rubin, MD, MPH
American Journal of Industrial Medicine, published online: 14 Sep 2009

Filed under: Accidents, Occupational injury

Temporary agency employed workers more at risk

The purpose of this study was to compare the workers’ compensation experience of a large cohort of temporary agency employed workers with those in standard forms of employment. Washington State Fund workers’ compensation data were obtained for claims with injury dates from January 1, 2003 to June 30, 2006, resulting in 342,540 accepted claims. It turns out that temporary agency employed workers have higher claims incidence rates than those in standard employment arrangements. The rate ratios are twofold higher in the construction and manufacturing industry sectors.

Temporary workers in Washington State

Caroline K. Smith, MPH *, Barbara A. Silverstein, PhD, MPH, CPE, David K. Bonauto, MD, MPH, Darrin Adams, BS, Z. Joyce Fan, PhD

American Journal of Industrial Medicine, Early View (Articles online in advance of print)Published Online: 17 Jul 2009

Filed under: Accidents, Occupational injury, Occupational injuries

Veterinarians suffer many work-related injuries

A high injury prevalence has been reported among veterinarians. In this study graduates in veterinary medicine from Australian universities completed questionnaires asking about injuries during their professional career.

Injuries were most frequently sustained on farms (55%) and associated with undertaking procedural activities (37%) and examining and moving animals (37%). The most frequent injuries sustained were open wounds (36%), fractures and dislocations (27%) and soft tissue bruising (12%). There were 63 reports of intracranial injury and 19 traumatic amputations reported. 

The major factors reported in association with injury were cattle (22%), horses (21%), dogs (20%) and cats (8%). Fifty-five per cent of veterinarians reported the use of safety precautions at the time of injury.

Lucas M., Day L., Shirangi A., Fritschi L.
Significant injuries in Australian veterinarians and use of safety precautions Occupational Medicine 2009 59(5):327-333

Filed under: Accidents, Occupational injury

Higher injury risk in female health care workers

To determine whether female healthcare workers are at higher risk of occupational injury researchers compared compensated work-related injuries among females to injuries among their male colleagues in the British Columbia healthcare sector. It turned out that female workers had significantly higher risk of all injuries [rate ratio (95% CI) = 1.58 (1.24–2.01)] and MSIs [1.43 (1.11–1.85)] compared to their male colleagues.

Differences in injury outcome by gender can be due to various physical, environmental and social factors. Anthropometrically, women are different than men and it has been suggested that even the same exposure or material load may apply greater strain on the average woman than on the average man. Men tend to have more physically strenuous tasks and women more repetitive tasks, which ultimately result in different types of strain.

In addition, gender differences in learning, socialization and upbringing may be contributing factors to variations in workers’ perception of injury risk and their predisposition to claim workers’ compensation or sick leave or to seek healthcare services.

Are female healthcare workers at higher risk of occupational injury? Hasanat Alamgir, Shicheng Yu, Sharla Drebit, Catherine Fast and Catherine Kidd; Occupational Medicine 2009 59(3):149-152

Filed under: Occupational injury, Health care, Occupational injuries