SURVEILLANCE AND PREVENTION OF WORK-RELATED CARPEL TUNNEL-SYNDROME - AN APPLICATION OF THE SENTINEL EVENTS NOTIFICATION SYSTEM FOR OCCUPATIONAL RISKS

In response to limitations in state-based, occupational disease survei llance, the California Department of Health Services developed a model for provider- and case-based surveillance of work-related carpal tunn el syndrome. The objectives were to enhance case reporting, identify r isk factors and high-risk work sites, and link preventive intervention s to work sites and the broader community. Using elements from surveil lance of communicable diseases and sentinel health events, a model was integrated into the pre-existing reporting system in one California c ounty. Between 1989 and 1991, 54 Santa Clara County health care provid ers reported 382 suspected cases, of which 365 from 195 work sites met reporting guidelines. Risk factors were profiled from interviews of 1 35 prioritized cases and 38 employers. Of 24 work sites prioritized fo r a free, voluntary, nonenforcement inspection, 18 refused and 6 compl eted an on-site visit. Sentinel Event Notification System for Occupati onal Risks (SENSOR) captured many cases not reported to the pre-existi ng reporting system. Case interviews indicated a profile of symptoms a nd signs, treatment, and exposure to uncontrolled occupational risk fa ctors, including a lack of training on ergonomics hazards. Employer he alth insurance, rather than workers' compensation, was the apparent so urce of payment for most medical bills. Employers lacked knowledge and motivation to reduce ergonomic risks. Governmentally mandated occupat ional ergonomics standards are urgently needed. (C) 1995 Wiley-Liss, I nc.