Association of clinically relevant carpal tunnel syndrome with type of work and level of education: a general-population study.

Carpal tunnel syndrome (CTS) is a common cause of work disability. The association with occupational load and education level has not been established in general-population studies. The purpose of this study was to investigate the association of clinically relevant CTS with work and education. From the Healthcare Register of Skane region (population 1.2 million) in southern Sweden we identified all individuals, aged 17-57 years, with first-time physician-made CTS diagnosis during 2004-2008. For each case we randomly sampled 4 referents, without a CTS diagnosis, from the general population matched by sex, age, and residence. We retrieved data about work and education from the national database. The study comprised 5456 individuals (73% women) with CTS and 21,667 referents. We found a significant association between physician-diagnosed CTS and type of work and level of education in both women and men. Compared with white-collar workers, the odds ratio (OR) for CTS among blue-collar workers was 1.67 (95% CI 1.54-1.81) and compared with light work, OR in light-moderate work was 1.37 (1.26-1.50), moderate work 1.70 (1.51-1.91), and heavy manual labor 1.96 (1.75-2.20). Compared with low-level education, OR for CTS in intermediate level was 0.82 (0.76-0.89) and high-level 0.48 (0.44-0.53). In women and men there is significant association with a dose-response pattern between clinically relevant CTS and increasing manual work load and lower education level. These findings could be important in design and implementation of preventive measures.