TOBACCO, CAFFEINE, ALCOHOL, AND CARPAL-TUNNEL SYNDROME IN AMERICAN INDUSTRY - A CROSS-SECTIONAL STUDY OF 1464 WORKERS

We investigated the effects of three Legal drugs (tobacco, caffeine, a nd alcohol) on the prevalence of carpal tunnel syndrome (CTS) confirme d by nerve conduction studies (definite CTS) in two groups of American industrial workers: 656 nonclaimant workers and 808 working patients referred for upper extremity symptoms. Comparing workers with definite CTS to workers without definite CTS revealed 26% greater current use of tobacco, 19% greater lifetime use of tobacco, 5% greater current us e of caffeine 14% lesser current use of alcohol, and 75% greater histo ry of alcohol abuse in the workers with definite CTS. All these differ ences were statistically significant. Those who currently used alcohol but not tobacco or caffeine were at the lowest risk for slowing sympt oms, and definite CTS. Those who currently used caffeine alone or in c ombination with tobacco were at the highest risk. In female workers, c urrent smoking, current caffeine use, and current coffee consumption i ndependently predicted 5.0% of the explainable risk for definite CTS. In male workers, history of alcohol abuse and current beer consumption independently predicted 3.0% of the explainable risk for definite CTS . Prevalence of slowing; symptoms, and definite CTS in 12 specific job categories correlated directly with current tobacco use. We conclude that the use of legal drugs affects the prevalence of median nerve slo wing, symptoms, and carpal tunnel syndrome, but the effects of the dru gs independently explain only a small portion of the total risk. Never theless, legal drug use or abuse may serve as a marker for increased C TS risk.