Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region

Yves Roquelaure (1) , Natacha Fouquet (1, 2) , Emilie Chazelle (2) , Alexis Descatha (3) , Bradley Evanoff (4) , Julie Bodin (1) , Audrey Petit (1)

1 Irset - Institut de recherche en santé, environnement et travail
2 Santé publique France - French National Public Health Agency [Saint-Maurice, France]
3 CONSTANCES - Cohortes épidémiologiques en population
4 WUSTL - Washington University in Saint Louis

Background - Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy in the working-age population. The reduction of CTS incidence in the workforce is a priority for policy makers due to the human, social and economic costs. To assess the theoretical impact of workplace-based primary interventions designed to reduce exposure to personal and/or work-related risk factors for CTS. Methods - Surgical CTS were assessed using regional hospital discharge records for persons aged 20-59 in 2009. Using work-related attributable fractions (AFEs), we estimated the number of work-related CTS (WR-CTS) in high-risk jobs. We simulated three theoretical scenarios of workplace-based primary prevention for jobs at risk: a mono-component work-centered intervention reducing the incidence of WR-CTS arbitrarily by 10% (10%-WI), and multicomponent global interventions reducing the incidence of all surgical CTS by 5% and 10% by targeting personal and work risk factors. Results - A limited proportion of CTS were work-related in the region's population. WR-CTS were concentrated in nine jobs at high risk of CTS, amounting to 1603 [1137-2212] CTS, of which 906 [450-1522] were WR-CTS. The 10%-WI, 5%-GI and 10%-GI hypothetically prevented 90 [46-153], 81 [58-111] and 159 [114-223] CTS, respectively. The 10%-GI had the greatest impact regardless of the job. The impact of the 10%-WI interventions was high only in jobs at highest risk and AFEs (e.g. food industry jobs). The 10%-WI and 5%-GI had a similar impact for moderate-risk jobs (e.g. healthcare jobs). Conclusion - The impact of simulated workplace-based interventions suggests that prevention efforts to reduce exposure to work-related risk factors should focus on high-risk jobs. Reducing CTS rates will also require integrated strategies to reduce personal risk factors, particularly in jobs with low levels of work-related risk of CTS.

Mots clés: Carpal tunnel syndrome; Prevention; Preventive efficiency; Simulation; Work-related; Attributable risk

Domaines: Santé

Yves Roquelaure, Natacha Fouquet, Emilie Chazelle, Alexis Descatha, Bradley Evanoff, et al.. Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region. BMC Public Health, 2018, 18 (1), pp.426. ⟨10.1186/s12889-018-5328-6⟩. ⟨hal-01780223⟩