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Trauma

THE NS-SEC SHOULD BE USED WITH CAUTION WHEN ASSESSING OCCUPATION AND CARPAL TUNNEL SYNDROME

European Federation of National Associations of Orthopaedics and Traumatology (EFORT) - 12th Congress



Abstract

Introduction

Carpal tunnel syndrome is a common neuropathy of the median nerve. Occupation has been widely examined as a risk factor for the development of carpal tunnel syndrome. The aim of this study was to examine the validity of the United Kingdom (UK) NS-SEC (National Statistics Socioeconomic Classification) in the assessment of correlation between occupation and CTS.

Methods

A prospective audit database was collected of patients diagnosed with CTS over a 6 year period. Occupation was assessed using the NS-SEC self coded method, where occupation is classified depending on the type of job and the size of the employer. UK Census data from 2001 was used to compare the occupation profile of the cohort with the regional population.

Results

There were 1564 patients diagnosed with CTS over a 6 year period. There were fewer patients with CTS in managerial and professional occupations (OR 0.77 95% CI 0.66 to 0.9), lower supervisory and technical occupations (OR 0.33, 0.23 to 0.45), and semi-routine and routine occupations (OR 0.68, 95% CI 0.58 to 0.79). There was a higher proportion of patients who were self-employed (OR 4.60, 3.93 to 5.30).

Discussion

The NS-SeC is superficially attractive to assess occupational differences between a general population and a study group due to the availability of census data. This study has shown a higher proportion of patients having CTS in the self-employed category than in the general population. Such occupational classifications that are based on economic inidicators may not be useful in assessing exposure to risk factors for musculoskeletal disorders. Caution should be exercised in their use and more accurate scores developed that address physical intensity of an occupation.