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National
& International Statistics
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Carpal
tunnel syndrome results in the highest number
of days lost among all work related injuries.
Almost half of the carpal tunnel cases result
in 31 days or more of work loss.-National
Center for Health Statistics.
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According
to the U.S. Department of Labor, Occupational
Safety and Health Administration (OSHA), repetitive
strain injuries are the nation's most common
and costly occupational health problem, affecting
hundreds of thousands of American workers,
and costing more than $20 billion a year in
workers compensation.
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According
to the U.S. Bureau of Labor Statistics, nearly
two-thirds of all occupational illnesses reported,
were caused by exposure to repeated trauma
to workers upper body ( the wrist, elbow or
shoulder ). One common example of such an injury
is carpal tunnel syndrome.
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The only
national routine source of information on occupational
injuries and illnesses experienced by U.S.
workers is the Annual Survey of Occupational
Injuries and Illnesses conducted by the Bureau
of Labor Statistics (BLS). The survey is a
random sample of about 250,000 private sector
establishments, but excludes the self-employed,
farms with fewer than 11 employees, private
households, and ALL GOVERNMENT AGENCIES. -Statement
of Lina Rosenstck, M.D., M.P.H. Director of
National Institute For Occupational Safety
And Health before the Subcommittee on Workforce
Protections Committee on Education and the
Workforce-U.S. House of Representatives 5/21/97.
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Musculoskeletal
disorders, including carpal tunnel syndrome,
are among the most prevalent medical conditions
in the U.S., affecting 7% of the population.
They account for 14% of physician visits and
19% of hospital stays. 62% of the persons with
musculoskeletal disorders report some degree
of limitation on activity, compared with 14%
of the population at large, according to the
National Institute for Occupational Safety
and Health.
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849,000
new cases of carpal tunnel syndrome occurred
in 1994.-National Center for Health Statistics.
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Approximately
260,000 carpal tunnel release operations are
performed each year, with 47% of the cases
considered to be work related.-National Center
for Health Statistics.
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A report
by NIOSH revealed that more than 50% of all
food cashiers, (jobs predominantly held by
women), suffered some degree of carpal tunnel
syndrome and other forms of repetitive strain
injuries as a result of the physical demands
of scanning products at high speed.
The
following sources are compiled from the
Bureau of Labor and Statistics and the
National Institute for Occupational Safety
and Health-NIOSH.**
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The U.S.
Department of Labor has concluded that Carpal
Tunnel Syndrome is the "chief occupational
hazard of the 90's"-disabling workers in epidemic
proportions.
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Currently,
Carpal Tunnel Syndrome affects over 8-million
Americans.
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Carpal Tunnel
Syndrome is the #1 reported medical problem,
accounting for about 50% of all work-related
injuries
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Presently,
25% of all computer operators have Carpal
Tunnel Syndrome, with estimates that by the
year 2000, 50% of the entire workforce may
be affected.
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Only
23% of all Carpal Tunnel Syndrome patients
were able to return to their previous professions
following surgery.
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Up
to 36% of all Carpal Tunnel Syndrome
patients require unlimited medical trearment.
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Women
are twice as likely to develop Carpal
Tunnel Syndrome as opposed to their male
counterparts.
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While
women account for about 45% of all
workers, they experience nearly 2/3's
of all work-related Repetitive Strain
Injuries.
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Surgery
for Carpal Tunnel Syndrome is the
second most common type of surgery,
with well over 230,000 procedures
performed annually.
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The National
Institute of Occupational Safety
and Health (NIOSHA) reports
that by the year 2000 one half
of all office workers may suffer
symptoms of CTDs. If the incidences
should rise as NIOSHA predicts-
50% of all office workers will
be averaging a CTD cost of $2,000
each.
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Injuries
resulting
from
repeated
motion
(repetitive
/
cumulative
trauma
disorders
--
CTDs)
are
growing.
According
to
recent
annual
statistics
from the
U.S.
Survey
of
Occupational
Injuries
and
Illnesses ,
over
302,000
CTDs
account
for
nearly
two-thirds
all
of
workplace-related
illnesses
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Ergonomic
disorders are the fastest growing
category of work-related illness.
According to the most recent
statistics from the U.S.
Bureau of Labor Statistics ,
they account for 56 percent
of illnesses reported to the
Occupational Safety and Health
Administration.
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United
States, employers spend more
than $7.4 billion in workers
compensation costs, and untold
billions on medical treatment,
litigation costs, hidden costs
and lost productivity. U.S.
Bureau of Labor and Statistics.
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More
than eight million people are
affected by carpal tunnel syndrome
each year. Surgery for carpal
tunnel syndrome is the second
most common type of musculoskeletal
surgery, (back surgery is #1)
with well over 230,000 procedures
performed
annually.
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ONLY
23% of all carpal tunnel syndrome
patients returned to their previous
professions following surgery,
according to the Bureau of Labor & Statistics
and the National
Institute for Occupational
Safety & Health
(1997-2000 Statistics).
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Carpal
tunnel surgery has about a 57%
failure rate following patients
from 1-day to 6-years. At least
one of the following symptoms
re-occurred during this time:
Pain, Numbness, Tingling sensations. Source:
Nancollas, et al, 1995. J. Hand
Surgery.
- Musculoskeletal
disorders are the country's most costly category
of workplace injuries and illnesses. In addition
to spending $20 billion annually on workers'
compensation costs due to RSIs, the U.S. spends
another $100 billion on lost productivity,
employee turnover, and other indirect expenses; The
Agency for Health Care Policy and Research.
- According
to a recent survey conducted by CTD News (reported
June '98 issue, page 7), a common office
cumulative trauma disorder -carpal tunnel syndrome
or CTS- averaged $1,918 per case in 1997. (This
does not include surgery or rehabilitation
because the national average is more than
$12,000 per hand.)
- The U.S.
Department of Labor has concluded that
Carpal Tunnel Syndrome is the "chief
occupational hazard of the 90's"-disabling
workers in epidemic proportions.
- Each year
thousands of people are diagnosed with some
kind of an illness directly related to poorly
designed work stations. In the U.S., Repetitive
Strain Injury (RSI, for short) has become the
number one work-related health problem, according
to OSHA statistics.
- Other industries,
however, have higher total numbers of CTS-related
events that cause lost-work days. The following
is a list of occupations published by the Bureau
of Labor Statistics in 2002 that rates
workers with highest to lowest numbers of
such events: SOURCE: Bureau of Labor
Statistics, U.S. Department of Labor, April
2002 Assemblers Cashiers Secretaries General
office clerks Laborers, non-construction Bookkeeping,
accounting, and auditing clerks Welders
and cutters Data-entry employees Textile
sewing machine operators Order
clerks Supervisors
and proprietors, sales occupations Machine
operators (unspecified) Truck
drivers Investigators
and adjusters, (not insurance) Insurance
adjusters, examiners, and investigators Electrical
and electronic equipment assemblers Packaging
and filling machine operators Janitors
and cleaners Bank tellers Production
inspectors, checkers, and examiners
- In
the industrialized world, the incidence of musculoskeletal
injury (MSI) has reached epidemic proportions. In
the United States, these disorders affect one
out of every four people (American Academy
of Orthopedic Surgeons, 2000).
- According
to the National Institute for Occupational
Safety and Health (NIOSH), MSIs account for
one-third of all job-related injuries.
- A national
health survey completed by Statistics Canada
in 1998 found one out of fifteen Canadians
living with a potentially disabling MSI.
In Ontario, approximately one half of workers
compensation claims are for muscular strains
and strains (Workplace Safety and Insurance
Board, Statistical Supplement to the Annual
Report, 2000).
- MUSCULOSKELTAL
INJURIES (MSI's): Work related musculo-skeletal
injuries (MSIs) affecting the upper body
and limbs are now recognized as one of the
leading causes of worker pain and disability.
A work-related musculoskeletal disorder is
an injury to the muscles, tendons and/or nerves
of the upper body either caused or aggravated
by work. Other names used to describe work-related
musculoskeletal disorders include repetitive
motion injuries, repetitive strain injuries,
cumulative trauma disorders, soft tissue disorders
and overuse syndromes.
- One out
of every 10 Canadian adults had a
repetitive strain injury (RSI) serious enough
to limit their normal activities in 2000/01,
according to a new study published today in
Health reports , which shows that RSIs are
affecting a growing number of adults.
- An estimated 2.3 million
people aged 20 or older reported
having had an RSI at some point in the 12 months
prior to their participation in the Canadian
Community Health Survey, for which data collection
began in September 2000.
- This marked
an increase in the prevalence of RSIs during
the late 1990s. In 1996/97, 8%
of adults reported the problem, according to
the National Population Health Survey. The
proportion hit 10% in 2000/01. Work-related
activities were most often the cause.
- Repetitive
strain injury is an umbrella term for a group
of disorders usually caused by repetitive
movements that affect the muscles, tendons
and nerves. Unlike other injuries, which occur
at a single point in time, RSIs develop over
an extended period.
- In 2000/01,
men and women were almost equally likely to
report an RSI, although since 1996/97,
the percentage of women sustaining such injuries
rose faster than the percentage of men. For
women, the increase was from 7.9% to 10.3%,
compared with an increase from 8.2% to 9.9%
for men.
STATISTICS & STUDIES:
SURGERY
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The
fail rate for carpal
tunnel surgery is over 50%. Many
times I meet women who have undergone
multiple surgeries, still unable
to work and struggling with chronic
pain. (Sportstouch.com / Kate
Montgomery)
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School of Medicine researchers surveyed
166 people who had undergone the surgery
during an eight-year period. Eighty-one
percent of those who had received workers'
compensation reported residual symptoms,
compared with 49 percent of those who
had not. The former returned to work
12 weeks after their surgeries, whereas
the latter took only three weeks to get
back on the job.
"So our study suggests that the workers'
compensation system in some way affects
outcomes of carpal tunnel surgery," said
Philip E. Higgs, M.D., assistant professor
of surgery and of occupational therapy.
Higgs was lead author of the study, which
was described in a recent issue of the
Journal of Hand Surgery.
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National Center for Health Statistics
found that 32,000 carpal tunnel patients
were discharged from non-federal hospitals
in 1992. So Higgs and his colleagues
wanted to determine whether the availability
of workers' compensation influenced discharged
patients' recovery. "In surgical circles,
there has been a suspicion that people
covered under workers' compensation have
a different post-operative course than
those who are covered by conventional
insurance or are self-paying," he explained.
Researchers surveyed 166 people
by phone, inquiring about job status
and duties, pain, numbness and nocturnal
symptoms. They chose the subjects at
random from 1,700 patients who had undergone
carpal tunnel surgery at the Washington
University Medical Center between 1984
and 1992. The average time since surgery
was 42 months. One-hundred-thirteen of
the subjects had received workers' compensation,
whereas 53 had not. The survey excluded
people who were retired, unemployed,
homemakers, had non-related medical problems
or had undergone their surgeries within
the previous 18 months.
The two groups differed in job stability as well as in time off work and presence
of residual symptoms, the survey found. Half of the workers' compensation patients
had changed jobs since the surgery, and 65 percent of these attributed the change
to carpal tunnel syndrome. Only one-quarter of the other patients had changed
jobs, and only 14 percent of these blamed the switch on residual symptoms.
"So our data support
what has only been implied in the past
-- that our workers' compensation system
has some adverse effect on the outcome
of this particular surgical procedure," Higgs said.
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Carpal
tunnel surgery
has about a 57% failure rate
following patients from 1-day
to 6-years. At least one of
the following symptoms re-occurred
during this time: Pain, Numbness,
Tingling sensations. Source:
Nancollas, et al, 1995. J.
Hand Surgery
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Oftentimes,
the
surgery fails to produce
any lasting help. A
published study by
Dr. Strasberg, at the
Washington University
School of Medicine,
reported some startling
results. This study,
involving patients
requiring a second
surgery for CTS, revealed
that only 53% of the
patients showed significant
improvement in their
symptoms .
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Another
study produced
by the Washington
School of
Public Health
and Community
Medicine
showed that
relief from
pain was
complete
or modest
in 86% of
the patients.
Of the patients
studied,
only 67%
were able
to return
to their
old jobs
whereas,
15% had to
change
jobs and the
remainder
did not return
to work.
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School
of Medicine
researchers
surveyed
166 people
who had
undergone
the surgery
during
an eight-year
period.
Eighty-one
percent
of those
who had
received
workers'
compensation
reported
residual
symptoms
, compared
with
49 percent
of those
who had
not.
The former
returned
to work
12 weeks
after
their
surgeries,
whereas
the latter
took
only
three
weeks
to get
back
on the
job.
"So
our study
suggests
that
the workers'
compensation
system
in some
way affects
outcomes
of carpal
tunnel
surgery," said
Philip
E. Higgs,
M.D.,
assistant
professor
of
surgery
and
of occupational
therapy.
Higgs
was
lead
author
of
the
study,
which
was
described
in
a recent
issue
of the
Journal
of
Hand
Surgery.
The
two
groups
differed
in job
stability
as well
as in
time
off
work
and
presence
of residual
symptoms,
the
survey
found.
Half
of the
workers'
compensation
patients
had
changed
jobs
since
the
surgery
, and
65 percent
of these
attributed
the
change
to carpal
tunnel
syndrome.
Only
one-quarter
of the
other
patients
had
changed
jobs,
and
only
14 percent
of these
blamed
the switch
on residual
symptoms.
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The
author of the book, Occupation
and Disease: How Social Factors
Affect the Conception of Work
Related Disorders, says that
a very large number of the 240,000
carpal tunnel operations performed
in the U.S. each year are useless
or worse. While doctors claim
an 85-95 percent success rate
for their surgeries, another
expert in the field says that
among the patients she has spoken
to the rate of satisfaction
was closer to one percent. Stephanie
Barnes, director of the Association
for Repetitive Motion Syndromes
in
Santa Rosa.
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Many
patients
are undergoing
multiple
surgeries,
which
can
cause
complications
ranging
from
excessive
scar tissue
overgrowth
(re- compressing
the nerve
tunnel)
to surgical
injuries that
leave
the fingers
totally
devoid
of sensation. United
Press, August
8, 1996.
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