PREVALENCE AND PREDICTORS OF LONG-TERM WORK DISABILITY DUE TO CARPAL-TUNNEL SYNDROME

The objective of this study was to describe patterns and predictors of work absence in the prospective, community-based Maine Carpal Tunnel Study. Three hundred fifteen patients with carpal tunnel syndrome (CTS ) were recruited from physicians' offices throughout Maine. The patien ts completed questionnaires at entry and after 6, 18, and 30 months. T he questionnaires included scales measuring symptom severity, function al status, general and mental health status, exposure to physical stre ssors, work status, and other indicators. The analyses examined univar iate and multivariate correlates of work absence. The mean age was 43, 72% of subjects were female, 71% underwent carpal tunnel release, and 45% were receiving Workers' Compensation. Fifty-two percent worked in managerial or technical occupations, 15% in service occupations, and 13% in heavy labor or machine operation. Forty;five percent of patient s changed jobs or were absent from work (aside from postoperative reco very) during the 30-month follow-up. In multivariate logistic regressi on models, correlates of work absence at 18 months included worse func tional status of the hand at study entry and at 6-month follow-up, inv olvement of an attorney at the time of enrollment (P < 0.002 for each) , and work absence at 6 months (P = 0.03). Worse upper extremity, func tional status and having a contested Workers' Compensation claim are c ritical predictors of work absence and should be principal targets of interventions to reduce work disability in CTS. (C) 1998 Wiley-Liss, I nc.