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Ulnar Neuropathy Among Active Workers Based Upon Hand Diagram Ratings
Robert A Werner1, Alfred Franzblau2, Bradley Evanoff3
1Department of Physical Medicine and Rehabilitation, Veterans Administration Health System, 2215 Fuller Rd. (117), Ann Arbor, MI 48105; Department of Physical Medicine and Rehabilitation, University of Michigan Health Systems, Ann Arbor, MI; Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI; Center for Ergonomics, College of Engineering, University of Michigan, Ann Arbor, MI(∗).
Background:
Limited studies have estimated the prevalence of ulnar neuropathy (UN) in the workplace. Hand diagrams have been demonstrated to have a good sensitivity and specificity when attempting to identify patients with UN.
Objective:
To determine the prevalence and associated risk factors for UN among active workers based on results of a hand diagram, and to determine the reliability of hand diagram scoring.
Design:
Cross-sectional study.
Setting:
Seven different industrial and clerical work sites.
Methods:
A total of 501 active workers were screened. Subjects completed a hand diagram and the Job Content Questionnaire, and had ergonomic assessment of their job. Each hand diagram was scored independently by 2 raters.
Main Outcome Measures:
Rating of the hand diagram for UN.
Results:
Interrater reliability of scoring the hand diagram for UN was very high. The estimated prevalence of UN was 3.6%. Suspected UN was associated with positioning of the elbow but not by contact stress at the elbow or force at the hand. Smokers had a lower prevalence, but smokers with suspected UN had higher-pack year histories. Workers with suspected UN had a greater sense of job insecurity and lower job satisfaction rating.
Conclusions:
Hand diagram rating has a high interrater reliability. Suspected UN has a relatively high prevalence among active workers in comparison to prior estimates of the prevalence of UN among the general population and is not strongly associated with ergonomic factors.
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