• Wrist Ratio/Index
• Rheumatoid Arthritis
• Psychosocial factors
• Distal upper extremity tendinopathies
• ACGIH Hand Activity Level at or above threshold
• Assembly line work
• Computer work
• Workplace forceful grip/exertion
Wrist ratio/index (ratio of wrist depth to width >0.7mm) was significantly associated with an increased risk of CTS in one high (Armstrong, 2008) and six moderate quality studies (Boz, 2004; Gordon, 1988; Hlebs, 2014; Moghtaderi, 2005; Sabry, 2009; Shariff-Mollayousefi, 2008).
Rheumatoid arthritis was associated with an increased risk of CTS in one high quality (Garg, 2012) and one moderate quality study (Burt, 2011). One moderate quality study (Geoghegan, 2004) showed an association between osteoarthritis and CTS.
Mood (“felt down, blue or depressed always/never, compared to seldom”) was associated with increased risk of CTS in one high quality study (Garg, 2012). One moderate quality study (Coggon, 2013) showed an association with increased risk based on self-rated mental health.
Hand, wrist or elbow tendinopathies (musculoskeletal conditions) were associated with increased risk of CTS in one high quality (Garg, 2012) and two moderate quality studies (Aktas, 2008; Nordstrom, 1997).
Gardening was associated with an increased risk of developing CTS in one high quality study (Garg, 2012).
The American Conference of Governmental Industrial Hygienists (ACGIH) hand activity level (HAL) is a standardized method for evaluating jobs that involves expert observation, direct measurement or video analysis to assess both pinch/grip force and hand/wrist repetition rate. There was one high quality (Bonfiglioli, 2013) and three moderate quality (Burt, 2011; Burt, 2013; Violante, 2007) studies, showing significant associations to increased risk of CTS when the ACGIH HAL was at or above the threshold limit. In addition, there was one high quality study (Garg, 2012) that showed an association with CTS by hazard ratio but this finding was limited by a wide confidence interval that included a value of 1.0 (HR: 2.01, CI: 0.8-5.0).
Assembly line work was associated with increased risk for the development of CTS in one high quality (Armstrong, 2008) and two low quality studies (Bonfiglioli, 2006; Lecler, 1998).
Computer work was significantly associated with increased risk of CTS by three moderate quality studies (Ali, 2006; Coggon, 2013; Eletheriou, 2012). One study found an increased association with an average of greater than eight hours of computer use per day and more than four years of computer work (Ali, 2006). Another study found an association between an increased risk of CTS and working on a keyboard or mouse for more than four hours per day (Coggon, 2013). The third study found an association with a very high number of keystrokes typed per year and a higher risk of CTS (Eleftheriou, 2012). There was one moderate quality study (Ali, 2006) evaluating internet use for leisure, which also found a significant result for increasing risk of CTS.
The use of vibrating hand-held tools was associated with an increased risk of CTS in one high quality (Armstrong, 2008) and three moderate quality studies (Coggon, 2013; Dale, 2014; Nordstrom, 1997).
Tendonitis in the shoulder, hand, finger, or wrist was shown to increase risk of CTS by one high quality (Armstrong, 2008) and one low quality study (Werner, 2005).
Workplace forceful grip/exertion was found to be significantly associated with increased risk of CTS by one high quality (Armstrong, 2008) and four moderate quality studies (Burt, 2011; Burt, 2013; Dale, 2014; Evanoff, 2012).
- (94) Werner RA, Franzblau A, Gell N. Randomized controlled trial of nocturnal splinting for active workers with symptoms of carpal tunnel syndrome. Arch.Phys.Med.Rehabil. 2005 Jan;86(1):1-7.
- Aktas,I.; Ofluoglu,D.; Albay,T. The relationship between benign joint hypermobility syndrome and carpal tunnel syndrome. Clin Rheumatol.; 2008/10: 10
- Ali,K.M.; Sathiyasekaran,B.W. Computer professionals and Carpal Tunnel Syndrome (CTS). Int.J Occup.Saf Ergon.; 2006: 3
- Armstrong,T.; Dale,A.M.; Franzblau,A.; Evanoff,B.A. Risk factors for carpal tunnel syndrome and median neuropathy in a working population. J Occup.Environ.Med; 2008/12: 12
- Bonfiglioli,R.; Mattioli,S.; Spagnolo,M.R.; Violante,F.S. Course of symptoms and median nerve conduction values in workers performing repetitive jobs at risk for carpal tunnel syndrome. Occup.Med (Lond); 2006/3: 2
- Boz,C.; Ozmenoglu,M.; Altunayoglu,V.; Velioglu,S.; Alioglu,Z. Individual risk factors for carpal tunnel syndrome: an evaluation of body mass index, wrist index and hand anthropometric measurements. Clin Neurol Neurosurg.; 2004/9: 4
- Burt,S.; Crombie,K.; Jin,Y.; Wurzelbacher,S.; Ramsey,J.; Deddens,J. Workplace and individual risk factors for carpal tunnel syndrome. Occup.Environ.Med; 2011/12: 12
- Burt,S.; Deddens,J.A.; Crombie,K.; Jin,Y.; Wurzelbacher,S.; Ramsey,J. A prospective study of carpal tunnel syndrome: workplace and individual risk factors. Occup.Environ.Med; 2013/8: 8
- Coggon,D.; Ntani,G.; Harris,E.C.; Linaker,C.; Van der Star,R.; Cooper,C.; Palmer,K.T. Differences in risk factors for neurophysiologically confirmed carpal tunnel syndrome and illness with similar symptoms but normal median nerve function: a case-control study. BMC Musculoskelet.Disord.; 2013: 0
- Dale,A.M.; Gardner,B.T.; Zeringue,A.; Strickland,J.; Descatha,A.; Franzblau,A.; Evanoff,B.A. Self-reported physical work exposures and incident carpal tunnel syndrome. Am J Ind.Med; 2014/11: 11
- Eleftheriou,A.; Rachiotis,G.; Varitimidis,S.; Koutis,C.; Malizos,K.N.; Hadjichristodoulou,C. Cumulative keyboard strokes: a possible risk factor for carpal tunnel syndrome. J Occup.Med Toxicol.; 2012: 1
- Evanoff,B.; Dale,A.M.; Deych,E.; Ryan,D.; Franzblau,A. Risk factors for incident carpal tunnel syndrome: results of a prospective cohort study of newly-hired workers. Work; 2012: 0
- Garg,A.; Kapellusch,J.; Hegmann,K.; Wertsch,J.; Merryweather,A.; Deckow-Schaefer,G.; Malloy,E.J. The Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of carpal tunnel syndrome (CTS) in a prospective cohort. ; 2012: 4
- Geoghegan,J.M.; Clark,D.I.; Bainbridge,L.C.; Smith,C.; Hubbard,R. Risk factors in carpal tunnel syndrome. J Hand Surg Br; 2004/8: 4
- Gordon,C.; Johnson,E.W.; Gatens,P.F.; Ashton,J.J. Wrist ratio correlation with carpal tunnel syndrome in industry. Am J Phys Med Rehabil.; 1988/12: 6
- Hakim,A.J.; Cherkas,L.; El,Zayat S.; MacGregor,A.J.; Spector,T.D. The genetic contribution to carpal tunnel syndrome in women: a twin study. Arthritis Rheum.; 2002/6/15: 3
- Hlebs,S.; Majhenic,K.; Vidmar,G. Body mass index and anthropometric characteristics of the hand as risk factors for carpal tunnel syndrome. Coll Antropol.; 2014/3: 1
- Leclerc,A.; Franchi,P.; Cristofari,M.F.; Delemotte,B.; Mereau,P.; Teyssier-Cotte,C.; Touranchet,A. Carpal tunnel syndrome and work organisation in repetitive work: a cross sectional study in France. Study Group on Repetitive Work. Occup.Environ.Med; 1998/3: 3
- Moghtaderi,A.; Izadi,S.; Sharafadinzadeh,N. An evaluation of gender, body mass index, wrist circumference and wrist ratio as independent risk factors for carpal tunnel syndrome. Acta Neurol Scand.; 2005/12: 6
- Nordstrom,D.L.; Vierkant,R.A.; DeStefano,F.; Layde,P.M. Risk factors for carpal tunnel syndrome in a general population. Occup.Environ.Med; 1997/10: 10
- Sabry,M.M.; Elkader,G.A.; Fahmi,M.K.; Abdel-Rehman,A. Correlation of nerve conduction studies to the anthropometric measurements of the hand and to the clinical severity of Carpal Tunnel syndrome. Egyptian Journal of Neurology, Psychiatry and Neurosurgery; 2009: 1
- Sharifi-Mollayousefi,A.; Yazdchi-Marandi,M.; Ayramlou,H.; Heidari,P.; Salavati,A.; Zarrintan,S.; Sharifi-Mollayousefi,A. Assessment of body mass index and hand anthropometric measurements as independent risk factors for carpal tunnel syndrome. Folia Morphol.(Warsz.); 2008/2: 1
- Violante,F.S.; Armstrong,T.J.; Fiorentini,C.; Graziosi,F.; Risi,A.; Venturi,S.; Curti,S.; Zanardi,F.; Cooke,R.M.; Bonfiglioli,R.; Mattioli,S. Carpal tunnel syndrome and manual work: a longitudinal study. J Occup.Environ.Med; 2007/11: 11