Ulnar Neuropathy Among Active Workers Based Upon Hand Diagram Ratings

Abstract

BackgroundLimited studies have estimated the prevalence of ulnar neuropathy (UN) in the workplace. Hand diagrams have been demonstrated to have a good sensitivity and specificity when attempting to identify patients with UN. ObjectiveTo determine the prevalence and associated risk factors for UN among active workers based on results of a hand diagram, and to determine the reliability of hand diagram scoring. DesignCross-sectional study. SettingSeven different industrial and clerical work sites. MethodsA total of 501 active workers were screened. Subjects completed a hand diagram and the Job Content Questionnaire, and had ergonomic assessment of their job. Each hand diagram was scored independently by 2 raters. Main Outcome MeasuresRating of the hand diagram for UN. ResultsInterrater reliability of scoring the hand diagram for UN was very high. The estimated prevalence of UN was 3.6%. Suspected UN was associated with positioning of the elbow but not by contact stress at the elbow or force at the hand. Smokers had a lower prevalence, but smokers with suspected UN had higher-pack year histories. Workers with suspected UN had a greater sense of job insecurity and lower job satisfaction rating. ConclusionsHand diagram rating has a high interrater reliability. Suspected UN has a relatively high prevalence among active workers in comparison to prior estimates of the prevalence of UN among the general population and is not strongly associated with ergonomic factors.