[Work performance as a risk factor for carpal tunnel syndrome]

Certification of carpal tunnel syndrome (CTS) as an occupational disease should be based on evidence that the job performance is a dominant factor responsible for its development. Features of the way the job is performed, which can increase the constriction in carpal tunnel and their quantitative analysis are presented. They include a specific position of the hand during the job performance (dorsal bending, alternate bending and extension), e.g., overcoming resistance with fingers, pincher grip, object catching and holding, exerting pressure on the hand, repeated movements or work with vibratory tools. These features characterize work of persons employed in meat processing, fitting of sub-assemblies, packing of products, or employed as supermarket cashiers. CTS occurrence in persons working with computers and thus using a keyboard or a mouse is now greatly limited owing to the improvement in ergonomic parameters of computer-equipped workposts. The paper indicates CTS risk factors (carpal tunnel size, post-traumatic lesions, rheumatoid arthritis, female gender, hormonal changes during menopause and pregnancy, and other hormonal disorders like hypothyreosis, diabetes, obesity, hypercholesterolemia, cigarette smoking, high alcohol consumption), which have been very well evidenced. In the summary, the attention was also paid to improper estimation of burden to upper limbs by listing jobs performed and stressing the need to quantitatively define hand burdening factors and estimate duration of such burdens.