Saturday, November 8, 2008

What is the evidence that vibratory hand tools cause carpal tunnel syndrome (CTS)?

What is the evidence that vibratory hand tools cause carpal tunnel syndrome (CTS)?: "We found a 2007 systematic review that assessed occupational risk factors for carpal tunnel syndrome, they concluded that there was “reasonable evidence that regular and prolonged use of hand-held vibratory tools increases the risk of CTS is > 2-fold”. We have reproduced below the reviews discussion on the use of vibratory tools," says ATTRACT on its homepage. Read also what is written in italic below:

This document is presented for information purposes only. The document cannot and should not be used as a basis for diagnosis or choice of treatment, and is in no way intended to replace professional medical care or attention by a qualified practitioner. ATTRACT is not responsible or liable for, directly or indirectly, ANY form of damage whatsoever resulting from the use/misuse of information contained in or implied by these documents.

In the United Kingdom, the current prescription of CTS as an occupational disease for social security purposes is limited to occupational use of hand-held vibratory tools. We found seven reports that support a substantially elevated risk from work of this kind. Four studies related to specific occupations (quarry/rock drillers, stonemasons, forestry workers and aircraft engine workers—mainly grinders, polishers and buffers), while two case–control studies and one household community survey suggested an association with hand-held vibratory tools in general. Among these investigations, one confirmed the diagnosis of CTS in cases by measuring nerve conduction, two focused on cases identified through hospital and surgical records, one involved self-reported but ‘medically called’ CTS and the remainder relied on clinical history and examination. Two other papers reported a high prevalence of CTS (20–26%) in male forestry workers, but without providing comparative data on controls," informs ATTRACT.

ATTRACT was created in 1997 in response to a large needs assessment exercise carried out with members of the primary care team in Gwent, South Wales. Clinicians were keen to practice 'evidence-based medicine' but found that they didn't have the time and/or expertise in which to keep 'up to date'. What the clinicians wanted was rapid access to the literature via a mechanism that meant that they had minimum resource implication for them. Our findings were broadly in line with those published by McColl et al (click here for full text article).

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