Annals of Occupational and Environmental Medicine

Research Article

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data: Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim; Ann Occup Environ Med 2019;31:e31. Published online November 7, 2019; DOI: https://doi.org/10.35371/aoem.2019.31.e31

Background

The present study aimed to investigate the basic characteristics of carpal tunnel syndrome (CTS) and its differences between occupations using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI).

Methods

The study participants were obtained from the NEI and NHI data from 2008 to 2015, with a diagnosis code of G560 (CTS) as the main or sub-diagnosis. Data about gender, age, diabetes mellitus, smoking, drinking, and length of employment, information about type of occupation, and number of employees according to age and occupation were obtained from NHI and NEI data. In total, 240 occupations were classified into blue-collar (BC) and white-collar (WC) work. In addition, each occupation was classified as high-risk and low-risk groups depending on the degree of wrist usage.

Results

The number of patients with CTS per 100,000 individuals increased with advancing age, and it was higher in women (4,572.2) than in men (1,798.5). Furthermore, the number was higher in BC workers (3,247.5) than in WC workers (1,824.1) as well as in the high-risk group than in the low-risk group in both BC workers (3,527.8 vs. 1,908.2) and WC workers (1,829.9 vs. 1,754.4). The number of patients with CTS was higher in the high-risk group than in the low-risk group among male and female BC workers and female WC workers. However, the number was higher in the low-risk group among male WC workers. In the BC category, the number of patients with CTS was highest among food processing-related workers (19,984.5). In the WC category, the number of patients with CTS was highest among social workers and counselors (7,444.1).

Conclusions

The results of this study are expected to help identify occupational differences in patterns of CTS. High number of patients with CTS was seen in new jobs, as well as in previous studies.

Citations

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Original Articles

Comparing the Characteristics of CTS by the Frequency of Exposure to Wrist-burdening Work: CTS Surveillance System, 2001-2004: Sukchul Jung, Yoomi Chae, Sangchul Roh; Korean Journal of Occupational and Environmental Medicine 2010;22(2):85-94. Published online June 30, 2010; DOI: https://doi.org/10.35371/kjoem.2010.22.2.85

Abstract PDF

OBJECTIVE: We investigated the differences among the patients who were diagnosed with carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work by using carpal tunnel syndrome surveillance system.
METHODS
The study subjects were a total of 855 patients from 1,017 patients who were diagnosed with carpal tunnel syndrome in 9 university hospitals from May, 2001 to October, 2004, and we excluded 161 patients who had no clear information for their occupational status. The subjects were classified into three groups according to four types of wrist-burdening work: 1) repetitive use of wrists, 2) inappropriate posture of the hand, 3) use of vibrating tools, and 4) overpressure work on the hand or palm, - as defined in the operational definition by the National Institute for Occupational Safety and Health (NIOSH). The subjects with two or more types of wrist-burdening work were classified as 'high risk group', the subjects with one type of wrist-burdening work were classified as 'intermediate risk group', and the subjects with none of the types of wrist-burdening work were classified as 'low risk group'. We used chi-square test, Fisher's exact test and ANOVA for comparing the characteristics according to the 3 subgroup.
RESULTS
The mean age in the high risk group was the lowest(53 years), and there was a significant difference among the groups for the mean age(p<0.05). The high risk group included the most males with 39(22.0%). The subjects in the high risk group had significantly more jobs in agriculture.forestry.fisheries, factory work, and simple labor and less comorbidities, including diabetes and rheumatoid arthritis(p<0.05). The subjects in the intermediate risk group had a higher proportion of service workers. There were significant differences for the symptoms of carpal tunnel syndrome according to the frequency of exposure to wrist-burdening work. The subjects in the high risk group showed the highest proportion of work-related aggravation of symptoms with 88(76.5%) and the highest mean number of days absent from work(6 days) as related to carpal tunnel syndrome.
CONCLUSION
Worker in agriculture.forestry.fisheries, factory work, and simple labor showed significantly more frequent carpal tunnel syndrome, and so management strategies are needed to prevent them from developing carpal tunnel syndrome.

Citations

Citations to this article as recorded by

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools
GyeongAe Seomun, Sung-Bom Pyun, Jung-Ah Lee, Eun-Jung Kim, Wonjung Noh
Work.2016; 53(4): 909. CrossRef
Prevalence and Related Characteristics of Carpal Tunnel Syndrome Among Orchardists in the Gyeongsangnam-do Region
Ho-Yeon Jung, Min Sik Kong, Seung Hun Lee, Chang Han Lee, Min-Kyun Oh, Eun Shin Lee, Heesuk Shin, Chul Ho Yoon
Annals of Rehabilitation Medicine.2016; 40(5): 902. CrossRef
Work-related musculoskeletal disorders in Korean farmers
Chul Gab Lee
Journal of the Korean Medical Association.2012; 55(11): 1054. CrossRef
Work-related diseases of agricultural workers in South Korea
Sangchul Roh
Journal of the Korean Medical Association.2012; 55(11): 1063. CrossRef

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Surveillance of work-related carpal tunnel syndrome in Korea: Woo Chul Jeong, Ho Jang Kwon, Mina Ha, Sang Chul Roh, Beom Seon Kwon, Jeong Gun Hyun, Seong Jae Lee, Jong Min Lee, Jeong Yi Kwon, Jun Seong Kim, Nam Jong Baek, Ho Lee, Kyng Woo Lee, Sam Kyu Lee; Korean Journal of Occupational and Environmental Medicine 2004;16(1):37-47. Published online March 31, 2004; DOI: https://doi.org/10.35371/kjoem.2004.16.1.37

Abstract PDF

OBJECTIVES
Carpal tunnel syndrome (CTS) is one of the most important work related musculo-skeletal diseases in Korea. However, there are few epidemiologic studies on the work-related CTS (WR-CTS). This study aimed to investigate the epidemiologic characteristics of WR-CTS in Korea.
METHODS
Data obtained from the"CTS Surveillance System". Physician case-reports in the surveillance were used to document patterns of WR-CTS by age, gender, occupation, sign, symptom, working history.
RESULTS
Six hundred and seventy-two cases of WR-CTS were ascertained. of which 314 with complete information on occupational history were analyzed. It has been estimated that as many as 72% of all CTS cases are work-related. The highest proportion of WR-CTS was observed in 'elementary occupation workers', followed by 'skilled agricultural, forestry and fishery workers'. The distributions of WR-CTS cases were similar with respect to age, obesity, and past medical history. The proportion of WR-CTS was higher in females. There was no significant difference in physical examination findings between WR-CTS and non WR-CTS cases. Repetitive work and the inappropriate hand posture seemed to be the risks for WR-CTS.
CONCLUSION
WR-CTS is a significant public health problem. The CTS surveillance system is quite useful to elucidate the characteristics of WR-CTS, but it remains of limited use in targeting specific industries and occupations for intervention.

Citations

Citations to this article as recorded by

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Work-relatedness of lung cancer by smoking and histologic type in Korea
Young-Il Lee, Sang-Gil Lee, Dong-Mug Kang, Jong-Eun Kim, Young-Ki Kim, Jong-Han Leem, Hwan-Cheol Kim
Annals of Occupational and Environmental Medicine.2014;[Epub] CrossRef
Disease Prevalence and Mortality among Agricultural Workers in Korea
Won Jin Lee, Eun Shil Cha, Eun Kyeong Moon
Journal of Korean Medical Science.2010; 25(Suppl): S112. CrossRef

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Carpal Tunnel Configuration Measured by Ultrasonography as a Risk Factor of Carpal Tunnel Syndrome in Motor Part Manufacturing Workers: Duck Soo Kim, Hae Kwan Cheong, Hyun Sul Lim, Yong Wook Kwon, Jong Min Lee, Dae Hyun Cho, Dae Seob Choi; Korean Journal of Occupational and Environmental Medicine 2002;14(3):213-226. Published online September 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.3.213

Abstract PDF

OBJECTIVES
This study was conducted to evaluate individual susceptibility to carpal tunnel syndrome (CTS) by ultrasonographic measurement of the carpal tunnel configuration in workers doing repetitive work.
METHODS
The study subjects consisted of 24 male and 11 female workers in a soundproof material manufacturing company in Gyeongju. We conducted a self-reported questionnaire survey, a physical examination and an electrodiagnostic study (EDS) in April 2000. After the examination, jobs were rearranged for workers with CTS. A follow up physical examination, EDS, and measurement of the carpal tunnel by ultrasonography was done six months later.
RESULTS
Of those studied, prevalence of CTS was 63.6/100 persons among women and 29.2/100 persons among men. Mean depth and width of wrist was shorter in those with CTS compareal to the controls (p<0.05). The risk of CTS was higher in workers whose carpal tunnel ratio (displacement/width) was 0.17 or higher (OR 7.13, 95 % confidence interval 1.18-43.1), and in workers whose carpal tunnel area was less than 300 mm2 (OR 8.00, 95 % confidence interval 1.18-68.5). Carpal tunnel depth and depth/width ratio had a positive correlation with motor latency of the median nerve and median-ulnar sensory latency difference (p<0.05), whereas the carpal tunnel width, displacement/depth ratio, and area (width X displacement) had a negative correlation with median nerve latencies after adjusting for gender. Workers who showed an improvement in the clinical stage of CTS after job rearrangement had a significantly lower carpal tunnel displacement/width ratio and displacement/depth ratio. They also had smaller upper carpal tunnel area ( width X displacement) and larger upper carpal tunnel area [(depth-displacement) X width] than the controls (p< 0.05 ).
CONCLUSIONS
Ultrasonographic measurement of the carpal tunnel is a good predictor of susceptibility and prognosis of CTS in workers doing repetivive work.

Citations

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The Health Effect of Hand Arm Transmitted Vibration
Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. CrossRef
Changes in the Thickness of Median Nerves Due to Excessive Use of Smartphones
Yeon-Seop Lee, Hoe-Song Yang, Chan-Joo Jeong, Young-Dae Yoo, Gwang-Yun Jeong, Jin-Seon Moon, Min-Kung Kang, Seong-Woo Hong
Journal of Physical Therapy Science.2012; 24(12): 1259. CrossRef

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Hand-Arm Vibration Syndrome and Neural Conduction Impairment in Swagging Workers Exposed to Hand-Arm Vibration: Seong Ah Kim, Sang Woo Kim, Sang Jae Jung, Chae Yong Lee, Kyu Sang Kim, Bo Woo Jung, Sang Kyu Park; Korean Journal of Occupational and Environmental Medicine 2002;14(2):169-182. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.169

Abstract PDF: OBJECTIVES
To investigate the hand-arm vibration syndrome (HAVS) among symptomatic swagging workers exposed to hand-arm vibration, using medical evaluation and measurement of workplace vibration. Furthermore, to evaluate the neurophysiological METHODS: Four workers showing symptoms relevant to HAVS were evaluated. Medical evaluation consisted of medical interview, questionnaire, nail-bed compression test, and sensory perception tests for vibration and pain. Some other diseases were excluded by a medical interview, hematological assessment, and urinalysis. Cold provocation test was used to assess the peripheral vascular changes, and a nerve conduction velocity (NCV) test was implemented to ascertain the peripheral neural changes. Pegboard, hole plate, and tapping board tests were performed to assess motor nerve function. The hand-arm vibration acceleration levels of the swagging machines were measured. Six months later, follow-up NCV tests were performed.
RESULTS
The actual exposure time to vibration was not longer than 15 minutes per day. The hand-arm vibration acceleration levels of the swagging machines, according to actual exposure time, were from 3.63 to 12.98 m/sec2, by ISO 5349. The vibratory perception thresholds and the recovery time of a nail color following finger cooling were significantly increased in all four workers. The perception of pain was mildly increased. The nerve conduction studies at first diagnosis and follow-up showed multifocal neural impairment caused by vibration. However, we could not rule out the concomitant presence of the carpal tunnel syndrome in one worker.
CONCLUSIONS
These results show that HAVS can be caused by hand-arm vibration in swagging workers. Interestingly, the NCV results suggested that vibration-induced neural conduction impairments could vary, and need to be interpreted cautiously.

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Utility of a Self-administered Hand Symptom Diagram for the Diagnosis of Carpal Tunnel Syndrome: Cha Jae O, Byung Mann Cho; Korean Journal of Occupational and Environmental Medicine 2001;13(4):360-368. Published online December 31, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.4.360

Abstract PDF: OBJECTIVES
This study was conducted to compare a self-administered hand symptom diagram with other diagnostic tests and to assess its value in the diagnosis of carpal tunnel syndrome.
METHODS
A self-administered hand symptom diagram has been developed for the evaluation of upper extremity paresthesias. A rating system was devised to classify the diagrams into four categories: classic, probable, possible, or unlikely carpal tunnel syndrome. Before nerve conduction testing, a medical history and demographic data were collected, a physical examination was conducted, and a hand symptom diagram was obtained from each patient. The diagram ratings of 85 patients(130 hands) were evaluated by an occupational and environmental medicine physician and a nerve conduction study was administered and interpreted by a rehabilitation medicine physician.
RESULTS
Of 85 patients, 48(56.5 %) had carpal tunnel syndrome confirmed by nerve conduction study. A hand symptom diagram rating of classic or probable CTS had a sensitivity of 75.6 %, a specificity of 59.6 %, a positive predictive value of 73.8 % and a negative predictive value of 62.0 %. Of the combinations of clinical findings in carpal tunnel syndrome, a classic or probable hand symptom diagram or a positive Tinel's sign showed the highest sensitivity.
CONCLUSIONS
A self-administered hand symptom diagram is valuable in the diagnosis of carpal tunnel syndrome among patients with upper extremity paresthesias. It is a useful diagnostic tool and may be valuable for occupational or population screening.

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Wrist Ratio as a Risk Factor of Carpal Tunnel Syndrome: Duck Soo Kim, Hae Kwan Cheong, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 2001;13(3):242-252. Published online September 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.3.242

Abstract PDF

OBJECTIVES
To evaluate the risk factors of the carpal tunnel syndrome (CTS) and the impact of the wrist ratio on the prevalence of CTS in workers on repetitive work over a long term.
METHODS
Study subjects consisted of 45 male and 16 female workers in a company that produces soundproof material in Gyeongju. We conducted a physical examination, a self-reported questionnaire survey and a nerve conduction study. CTS cases were defined as those subjects that had a positive finding in both the nerve conduction study and the physical examination done by a doctor specializing in rehabilitation medicine.
RESULTS
Prevalence of CTS among the study subjects was 26.2/100 persons. The prevalence of CTS was positively associated with increasing age (p<0.01, using the chi-square test for trend) and female gender (OR=6.98, 95% CI=1.66-31.0), but was negatively associated with the educational level (p<0.01 by the chi-square for trend). Workers in the production area had a higher prevalence of CTS compared to those in the clerical area (OR=10.8 in the frame manufacturing process, OR=32.2 in the vacuum molding process). Patients with CTS had a narrower mean wrist width and a shorter mean hand and palm length, compared to those that had no disease (p<0.01 by the Student's t-test). The number of subjects who had a wrist ratio of 0.74 or more was significantly higher in cases of CTS (OR=4.0, 95% CI=1.01-16.3). However, a multiple logistic regression analysis showed only that the type of work was a significant variable after adjusting for the other variables.
CONCLUSIONS
The wrist ratio, a surrogate of carpal tunnel configuration, can represent individual susceptibility to CTS. However this study shows that the use of the wrist ratio for predicting CTS risk is not adequate. The development of a new carpal tunnel configuration index based on more direct measurements of the tunnel shape will provide a better predictor of individual susceptibility to CTS.

Citations

Citations to this article as recorded by

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
A comparison of carpal tunnel syndrome between digital and paper textbook users in elementary schools
GyeongAe Seomun, Sung-Bom Pyun, Jung-Ah Lee, Eun-Jung Kim, Wonjung Noh
Work.2016; 53(4): 909. CrossRef
Factors Influencing on Fatigue in Operating Room Nurses
Eun-Seon Lee, In-Sook Kim
Korean Journal of Occupational Health Nursing.2012; 21(3): 229. CrossRef

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Survey on the Prevalence of Carpal Tunnel Syndrome in Simple Repetitive Workers Who Use Upper Extremities: Ji Eun Son, Tae Woon Jang, Yoon Kou Kim, Young Seoub Hong, Kap Yeol Jung, Dong Ill Kim, Kang Jin Lee, Nam Jin Ha, Sang Boum Kim, Joon Youn Kim; Korean Journal of Occupational and Environmental Medicine 2001;13(3):209-219. Published online September 30, 2001; DOI: https://doi.org/10.35371/kjoem.2001.13.3.209

Abstract PDF

OBJECTIVES
This study was carried out to survey on the prevalence of Carpal Tunnel Syndrome(CTS) in high risk jobs(meat and fish processing plant and wood plant), by application of Nerve Conduction Study(NCS), a confirmatory diagnostic method.
METHODS
Experimental group was 69 workers sampled from meat and fish processing plants and 17 workers sampled from wood plants, who were simple, repetitive workers using upper extremities and control group was 28 workers sampled from managers, secretaries and keepers. All employees were examined through work history, physical examination and NCS.
RESULTS
18 workers(26.09%) in meat and fish processing plants, and 5 workers(29.41%) in wood plants had compatible findings to NIOSH diagnostic criteria for CTS. The experimental group had more symptoms(complaint of upper extremities, Visual Analogue Scale >or= 4(VAS: total 10 point)), signs(Tinel and Phalen test) and prevalence of CTS than control group ( p<0.05). The prevalence of symptoms and signs were higher in short term worke r s (<7 years), but the prevalence of CTS was higher in long term workers(>or=7 years).
CONCLUSIONS
The prevalence of CTS in meat and fish processing plant and wood plant were 26.09% and 29.41% respectively. Authors propose that meat and fish processing and wood plants should be managed as a risk job category which were designated by OSHA in 1996

Citations

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Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Prevalence and Related Characteristics of Carpal Tunnel Syndrome Among Orchardists in the Gyeongsangnam-do Region
Ho-Yeon Jung, Min Sik Kong, Seung Hun Lee, Chang Han Lee, Min-Kyun Oh, Eun Shin Lee, Heesuk Shin, Chul Ho Yoon
Annals of Rehabilitation Medicine.2016; 40(5): 902. CrossRef
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Hak Young Rhee, Jae Hwan Cho, Jong Min Seok, Taek Sang Cho, Woo Jin Jeon, Jin Gu Lee, Sung Kyu Kim
Archives of Environmental & Occupational Health.2015; 70(4): 177. CrossRef

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Carpal Tunnel Syndrome among Service and Manufacturing Workers with Repetitive Motion Tasks: Kyoo Sang Kim, Se Wi Lee, Younghyu Choi, Mi Ryeong Jin; Korean Journal of Occupational and Environmental Medicine 1998;10(4):505-523. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.505

Abstract PDF

The objectives of this study were to investigate the prevalence and risk factors of occupationally related carpal tunnel syndrome (CTS) among workers employed in services and manufacturing industries analysing the sensitivity and specificity of clinical symptoms and signs. Three surveys were made for this study. The first survey was done for 1,447 workers employed by 25 companies. The jobs of the employees were repetitive works at VDT and assembly lines. Therefore, employees could be divided to two groups, doing repetitive works and non repetitive works. The second survey was made for 189 workers who were randomly selected from 517 workers complained some symptoms at their hands and wrists. We examined their symptoms and carried out neurological examinations for CTS (Tinel's sign, Phalen's sign, pin prick test, carpal compressive test, toniquet compression test). The third survey was made for nerve conduction study (NCS) for 57 workers who had shown positive signs for CTS. The main results of this study were as follows: 1. From the first survey, we have found that there were significant statistical differences in getting uncomfortable neuromuscular symptoms by sex, job type, total working hours during a week, duration of current work, and kinds of work. Odds ratio in male vs female, repetitive vs non repetitive, service vs manufacturing companies, total working hours during a week, and duration of current work were 1.867(95% CI=1.467-2.377), 1.680 (95% CI=1.121-2.279), 1.663(95% CI=1.213-2.279), 1.016(95% CI=1.006-1.027) and 1.283 (95% CI=1.097-1.501) respectively. 2. From the second survey, we have found that 46 peoples (25.0%) were positive for one or more than one signs in neurological examinations of NIOSH criteria. Positive findings from neurological examinations were high among workers of low level of education (p-value=0.008), manufacturing jobs (p-value=0.00), long hours a week (p-value=0.028), and long duration of current work (p-value=0.00). 3. From the third survey, we diagnosed 35 peoples (61.4%) had CTS by NCS. They had abnormally delayed latent period or velocity in median nerve conduction velocity.

Citations

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Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data
Il-Ho Lee, Young-Ki Kim, Dong-Mug Kang, Se-Yeong Kim, In-Ah Kim, Eun-Mi Kim
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
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You Lim Kim, Suk Min Lee, Hyun-Soo Lee, Juyeong Song, Si-On Song, Min-Ji Seol, Yu-Mi Jang, Jin-Sik Im, Ji-Woo Im
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The incidence of carpal tunnel syndrome in patients with rheumatoid arthritis
Kwang-Hyun Lee, Chang-Hun Lee, Bong-Gun Lee, Jin-Sik Park, Wan-Sun Choi
International Journal of Rheumatic Diseases.2015; 18(1): 52. CrossRef

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