Journal Reviews
September 1, 1999 6 minutes read
Journal Reviews
Atroshi I, Gummesson C, Johnson R, et al. Prevalence of carpal tunnel syndrome in a general population. JAMA 1999; 282:153-158.
Symptoms commonly associated with carpal tunnel syndrome are found in a large proportion of the general population, according to this research from Sweden.
The researchers conducted a survey to determine how common the symptoms are in the general population, as opposed to a workplace population in which work conditions could be blamed for the symptoms. They conducted a mail survey inquiring about symptoms of pain, numbness, and tingling in any part of the body, followed two months later by clinical examination and nerve conduction testing of anyone reporting symptoms in the median nerve distribution in the hands. The researchers also tested a sample of those not reporting symptoms.
Of 3,000 people surveyed, 2,466 responded. Of the symptomatic responders, 81% underwent clinical examination. Of the 2,466 responders, 354 reported pain, numbness, and/or tingling in the median nerve distribution in the hands, for a prevalence of 14.4%. On clinical examination, 94 symptomatic subjects were diagnosed with carpal tunnel syndrome, for a prevalence of 3.8%.
The researchers conclude that compression neuropathy is common in the general population. Such information about the general population was not previously available, they say, and the new data could affect the way occupational health professionals respond to such symptoms. Symptoms of carpal tunnel syndrome do not necessarily mean that the problem is work-related, the data suggest.
"The high prevalence of these symptoms in the general population should be borne in mind when assessing the possible relationship of upper-extremity complaints to specific occupations," they write.
Blanc PD, Eisner MD, Israel L, et al. The association between occupation and asthma in general medical practice. Chest 1999; 1,259-1,264.
One in 10 patients with asthma has a work history strongly suggestive of work-related cause for the asthma, according to this research from the University of California-San Francisco.
General practitioners previously have not had reliable measures of how many asthma cases can be traced to work conditions, the researchers say. This study was intended to estimate the proportion of adult asthma cases that can be attributed to occupational factors initiating new disease onset and exacerbating preexisting disease. The researchers found that a great many patients who present with asthma work, or previously worked, in conditions that triggered or contributed to the asthma. In many cases, the patient had no idea that there might be an occupational link.
The researchers studied 150 adult patients with asthma recruited from a random sample of family practice specialists. After studying the work histories of the subjects and analyzing other data, they found that 49% of the subjects reported adult-onset asthma while employed and another 17% reported recurrence of previously quiescent childhood-onset asthma during employment. Of those with new-onset asthma while employed, 23% were employed in occupations at increased risk of occupational asthma initiation. Of those with recurrence of childhood asthma, 28% were employed in occupations at increased risk of exposures aggravating asthma.
Although work-associated asthma may be common, the researchers say there appear to be few obvious demographic or clinical features distinguishing those with a temporal association between their disease and employment status.
"These findings underscore the critical importance of a targeted occupational history in the evaluation of all adults with asthma," the researchers conclude. "Without such an assessment, the link between exposure and new onset or worsening disease cannot be established."
Guo HR, Tanaka S, Halperin WE, et al. Back pain prevalence in U.S. industry and estimates of lost workdays. Am J Public Health 1999; 89:1,029-1,035.
People working in the lumber and building material retail industries are at highest risk for back injuries, even though the construction industry produces a higher number of back injuries, according to this research from the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati.
Because research previously had shown that back pain is the most common reason for filing workers’ compensation claims and often causes lost work days, this new research was intended to identify high-risk industries and to estimate the prevalence of work-related back pain and the number of workdays lost. The researchers studied data from 30,074 respondents who worked during the 12 months before the survey, defining a case of back pain as having back pain every day for a week or more in that previous 12 months. They found a prevalence of 4.6% for lost workday back pain. The workers reporting back pain had lost 101.8 million workdays because of the pain. Men and women lost about the same number of workdays.
Among major industries, workers were most at risk for back injury in the lumber and building material retail industries, where the prevalence of work-related back pain was 23.9%. Crude petroleum and natural gas extraction was next, with a prevalence of 22%. The next highest industries were (in descending order) sawmills, planing mills, and millwork; grocery stores; construction; trucking services and furniture and home furnishing stores, agricultural production and crops; auto- and home-supply stores; and blast furnaces, steelworks, and rolling and finishing mills.
Back risks differ by gender
The overall prevalence of back pain among the entire study group was 17.6%. Data from some industries indicate that men and women have very different risks for back pain, particularly in construction, motor vehicles, and motor vehicle equipment, and the U.S. Postal Service. The researchers suggest those differences should be studied further.
"If the differences are attributable to differences in job tasks, comparing job tasks may lead to identification of risk factors for back pain," they write.
Damron D, Langenberg P, Anliker J, et al. Factors associated with attendance in a voluntary nutrition education program. Am J Health Promotion 1999; 13:268-275.
Previous knowledge of good nutritional habits increased the likelihood of women attending nutrition classes, but many factors also can work to dissuade women from attending. This research from the University of Maryland School of Medicine in Baltimore suggests that knowledge of which factors influence attendees can help occupational health providers successfully educate workers.
The study participants were 1,528 women on public assistance. The women received personal invitations, letters, and telephone reminders from peer educators encouraging their attendance at three bimonthly nutrition sessions. Attendance data were augmented by a post-intervention survey and focus groups asking participants why they attended or skipped the sessions.
Fifty-four percent of enrollees attended at least one session. Factors increasing the likelihood of attendance included older age, breast-feeding practices, and previous knowledge of the recommendation to eat at least five servings of fruits and vegetables a day. Factors decreasing the likelihood of attendance included being pregnant and having children already, being unmarried, and being African-American.
"The most common reasons reported for nonattendance were scheduling, transportation, and child care difficulties," they write. "Our attendance results are similar to those from other published data showing that it is difficult to get people who have agreed to participate in a program to become active participants."
Hansen J. Breast cancer risk among relatively young women employed in solvent-using industries. Am J Industrial Medicine 1999; 36:43-47.
Long-term occupational exposure to organic solvents may play a role in breast cancer risk, these researchers conclude. The study suggests that organic solvents have carcinogenic properties to the female breast, even though the causes of breast cancer are considered largely unknown.
The Danish researchers studied national data to examine the adjusted breast cancer risk among relatively young women (ages 20 to 55) employed in industries with extensive use of organic solvents. Examples include metal product industries; wood and furniture working; printing; and the chemical, textile, and clothing industries. Relative risks were estimated from a comparison with 7,802 women with breast cancer.
The relative risk for breast cancer after 15 years latency was increased in each of the selected industrial groups. For the entire group with more than 10 years of employment, the relative risk was elevated to twofold.
"This study supports the observation that long-term occupational exposure to organic solvents may play a role in breast cancer risk," the researchers say.
You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content