Safety and Health at Work (Mar 2014)

Meta-Analysis: Association Between Wrist Posture and Carpal Tunnel Syndrome Among Workers

  • Doohee You,
  • Allan H. Smith,
  • David Rempel

DOI
https://doi.org/10.1016/j.shaw.2014.01.003
Journal volume & issue
Vol. 5, no. 1
pp. 27 – 31

Abstract

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Background: Carpal tunnel syndrome (CTS) is a common work-related peripheral neuropathy. In addition to grip force and repetitive hand exertions, wrist posture (hyperextension and hyperflexion) may be a risk factor for CTS among workers. However, findings of studies evaluating the relationship between wrist posture and CTS are inconsistent. The purpose of this paper was to conduct a meta-analysis of existing studies to evaluate the evidence of the relationship between wrist posture at work and risk of CTS. Methods: PubMed and Google Scholar were searched to identify relevant studies published between 1980 and 2012. The following search terms were used: “work related”, “carpal tunnel syndrome”, “wrist posture”, and “epidemiology”. The studies defined wrist posture as the deviation of the wrist in extension or flexion from a neutral wrist posture. Relative risk (RR) of individual studies for postural risk was pooled to evaluate the overall risk of wrist posture on CTS. Results: Nine studies met the inclusion criteria. All were cross-sectional or case–control designs and relied on self-report or observer's estimates for wrist posture assessment. The pooled RR of work-related CTS increased with increasing hours of exposure to wrist deviation or extension/flexion [RR = 2.01; 95% confidence interval (CI): 1.646–2.43; p < 0.01: Shore-adjusted 95% CI: 1.32–2.97]. Conclusion: We found evidence that prolonged exposure to non-neutral wrist postures is associated with a twofold increased risk for CTS compared with low hours of exposure to non-neutral wrist postures. Workplace interventions to prevent CTS should incorporate training and engineering interventions that reduce sustained non-neutral wrist postures.

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