Risk factors for de Quervain's disease in a French working population.

OBJECTIVE De Quervain's disease (DQD) is a significant cause of musculoskeletal pain among workers. The aim of this study was to assess the relative importance of personal and occupational risk factors for DQD in a working population. METHODS A total of 3710 workers from a French region were randomly included in the cross-sectional study between 2002-2005. There were 45 subjects with DQD (of these, 5 subjects had a bilateral condition), diagnosed by 83 trained occupational physicians performing a standardized physical examination. Individual factors and work exposure were assessed by a standardized physical and a self-administered questionnaire. Statistical associations between DQD and individual and occupational factors were analyzed using logistic regression modeling in the whole sample and among women. RESULTS The prevalence rates of uni- or bilateral DQD for the whole, male and female working populations were 1.2% [95% confidence interval (95% CI) 0.9-1.6], 0.6% (95% CI 0.3-0.9) and 2.1% (95% CI 1.4-2.8), respectively. Personal risk factors for DQD were mainly age (1.1 for 1-year increase in age) and female gender [odds ratio (OR) 4.9, 95% CI 2.4-10.1]. Work-related factors were workpace dependent on (i) technical organization (OR 2.0, 95% CI 1.0-4.0), (ii) repeated or sustained wrist bending in extreme posture (OR 2.6, 95% CI 1.3-5.3) and (iii) repeated movements associated with the twisting or driving of screws (OR 3.4, 95% CI 1.7-7.1). No association was found with psychosocial factors. CONCLUSIONS Personal and work-related factors were associated with DQD in the working population; wrist bending and movements associated with the twisting or driving of screws were the most significant of the work-related factors.

[1]  L. Plewes,et al.  Peritendinitis Crepitans and Simple Tenosynovitis: A Clinical Study of 544 Cases in Industry , 1951, British journal of industrial medicine.

[2]  I Kuorinka,et al.  Prevalence of tenosynovitis and other injuries of the upper extremities in repetitive work. , 1979, Scandinavian journal of work, environment & health.

[3]  R. E. Johnson Soft tissue rheumatic pain: Recognition, management, prevention , 1982 .

[4]  Sheon Rp Soft tissue rheumatic pain. , 1982 .

[5]  E Viikari-Juntura,et al.  Neck and upper limb disorders among slaughterhouse workers. An epidemiologic and clinical study. , 1983, Scandinavian journal of work, environment & health.

[6]  T J Armstrong,et al.  Ergonomics considerations in hand and wrist tendinitis. , 1987, The Journal of hand surgery.

[7]  M. Corbett Soft Tissue Rheumatic Pain: Recognition, Management, Prevention , 1988 .

[8]  R. Inman,et al.  Prevalence of tendinitis and related disorders of the upper extremity in a manufacturing workforce. , 1990, The Journal of rheumatology.

[9]  E Viikari-Juntura,et al.  Incidence of tenosynovitis or peritendinitis and epicondylitis in a meat-processing factory. , 1991, Scandinavian journal of work, environment & health.

[10]  A Kilbom,et al.  Clinical Disorders and Pressure-Pain Threshold of the Forearm and Hand among Automobile Assembly Line Workers , 1995, Journal of hand surgery.

[11]  Todd P. Stitik,et al.  Work Related Musculoskeletal Disorders (WMSDs): A Reference Book for Prevention , 1996 .

[12]  J. Moore De Quervain's Tenosynovitis: Stenosing Tenosynovitis of the First Dorsal Compartment , 1997 .

[13]  B. Bernard,et al.  Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back , 1997 .

[14]  J. Harrington,et al.  Surveillance case definitions for work related upper limb pain syndromes. , 1998, Occupational and environmental medicine.

[15]  A. Leclerc,et al.  Carpal tunnel syndrome and work organisation in repetitive work: a cross sectional study in France. Study Group on Repetitive Work. , 1998, Occupational and environmental medicine.

[16]  T. Armstrong,et al.  Cross-sectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders. , 1999, American journal of industrial medicine.

[17]  C. Zetterberg,et al.  Carpal tunnel syndrome and other wrist/hand symptoms and signs in male and female car assembly workers , 1999 .

[18]  M Cherniack,et al.  Evaluation and management of chronic work-related musculoskeletal disorders of the distal upper extremity. , 2000, American journal of industrial medicine.

[19]  J. Sluiter,et al.  Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. , 2001, Scandinavian journal of work, environment & health.

[20]  J Malchaire,et al.  Review of the factors associated with musculoskeletal problems in epidemiological studies , 2001, International archives of occupational and environmental health.

[21]  S. Tanaka,et al.  Prevalence and risk factors of tendinitis and related disorders of the distal upper extremity among U.S. workers: comparison to carpal tunnel syndrome. , 2001, American journal of industrial medicine.

[22]  I. Niedhammer Psychometric properties of the French version of the Karasek Job Content Questionnaire: a study of the scales of decision latitude, psychological demands, social support, and physical demands in the GAZEL cohort , 2002, International archives of occupational and environmental health.

[23]  D. Kleinbaum,et al.  A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders. , 2002, American journal of industrial medicine.

[24]  Keith T Palmer,et al.  Soft-tissue rheumatic disorders of the neck and upper limb: prevalence and risk factors. , 2003, Seminars in arthritis and rheumatism.

[25]  Keith T Palmer Regional musculoskeletal conditions: pain in the forearm, wrist and hand. , 2003, Best practice & research. Clinical rheumatology.

[26]  Keith T Palmer,et al.  Pain in the forearm, wrist and hand , 2003 .

[27]  C. Cooper,et al.  Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. , 2004, Arthritis and rheumatism.

[28]  A. Barr,et al.  Work-related musculoskeletal disorders of the hand and wrist: epidemiology, pathophysiology, and sensorimotor changes. , 2004, The Journal of orthopaedic and sports physical therapy.

[29]  H. Bonel,et al.  "Baby wrist": MRI of an overuse syndrome in mothers. , 2004, AJR. American journal of roentgenology.

[30]  C. Cooper,et al.  Hard work never hurt anyone: or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb , 2005, Annals of the rheumatic diseases.

[31]  P. Bongers,et al.  Epidemiology of work related neck and upper limb problems: Psychosocial and personal risk factors (Part I) and effective interventions from a bio behavioural perspective (Part II) , 2006, Journal of Occupational Rehabilitation.

[32]  Yves Roquelaure,et al.  Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. , 2006, Arthritis and rheumatism.

[33]  L. Garzon,et al.  Recognition management, and prevention , 2007 .

[34]  E. C. Harris,et al.  Compensating occupationally related tenosynovitis and epicondylitis: a literature review. , 2006, Occupational medicine.

[35]  J P Bonde,et al.  Risk factors for hand-wrist disorders in repetitive work , 2007, Occupational and Environmental Medicine.

[36]  Laura Punnett,et al.  Medium- and long-term reproducibility of self-reported exposure to physical ergonomics factors at work. , 2007, Applied ergonomics.

[37]  Yves Roquelaure,et al.  Risk factors for upper-extremity musculoskeletal disorders in the working population. , 2009, Arthritis and rheumatism.

[38]  L. Punnett,et al.  Specific and non-specific upper extremity musculoskeletal disorder syndromes in automobile manufacturing workers. , 2009, American journal of industrial medicine.

[39]  B. Silverstein,et al.  Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk? , 2009, Scandinavian journal of work, environment & health.

[40]  R. Sturdivant,et al.  Incidence of de Quervain's tenosynovitis in a young, active population. , 2009, The Journal of hand surgery.