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BACKGROUND: Carpal Tunnel Syndrome (CTS) is a common work-related musculoskeletal disorder, and is associated with excessive repetition, force, vibration, or awkward posture. We previously developed a case definition for claims in the California Workers Compensation Insurance System (WCIS) that categorized CTS cases as probable, possible, or uncertain. The objective of this study was to calculate rates of CTS by Census Industry Code (CIC) among possible and probable CTS claims, and to identify occupations within those industries that have numerous CTS claims.
METHODS: Possible and Probable CTS cases with an injury date between 2006-2011 were included in our dataset. To improve incomplete and incorrect industry coding within WCIS, we used various crosswalks; employer name, class code, and occupation to identify specific industries; aggregated and clarified problematic industries; and assigned industry based on other claims with the same employer name or FEIN. We manually checked coding accuracy in the top 30 industries. To calculate rates, the American Community Survey was used as a denominator for full-time equivalent (FTE) workers for each CIC. The ten industries with the highest rates of CTS were uploaded to the National Industry and Occupation Computerized Coding System (NIOCCS) for computer-assisted occupation coding.
RESULTS: 90,660 cases of carpal tunnel syndrome were included in our dataset. We assigned a CIC code to 83% of claims. The average rate of CTS was 106 x 100,000 FTE workers. Industries with the highest rates of CTS were textile and fabric finishing and coating mills (392 x 100,000 FTE); animal slaughtering and processing (342 cases x 100,000 FTE); and both sugar and confectionary product manufacturing and telecommunications (324 x 100,000 FTE). NIOCCS auto-coded between 37% (insurance carriers and related activities) and 81% (animal slaughtering and processing) of occupations in the top 10 industries, and manual coding was necessary for the remainder of occupations. Three percent of claims had unidentifiable occupations by either NIOCCS or an individual coder. Occupations with high numbers of CTS cases in our top 10 industries included: Customer service representatives, radio and telecommunications equipment installers and repairers, butchers, and managers.
CONCLUSIONS: We identified industries and occupations with an increased risk for CTS in California. Future interventions and prevention efforts should be directed toward industries and occupations identified as high-risk for CTS.