Occupational Musculoskeletal Disorders of the Arm and Hand Occupational Musculoskeletal Disorders of

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    Occupational Musculoskeletal Disorders

    of the Arm and Hand

    Evidence of workplace factors in the development of hand osteoarthritis, nerve compression syndromes, Dupuytren’s contracture, de Quervain’s disease, trigger finger, hypothenar hammer syndrome and Kienbock’s

    disease according to manual work and hand/arm vibration

    A systematic review of the literature

    Paula ECG Nielsen Ann Kryger

    Lilli Kirkeskov Jens Peter Bonde

    Department of Occupational and Environmental Medicine Bispebjerg Hospital, Denmark

    October 2010

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    Forord Dette referencedokument er udarbejdet i henhold til de retningslinjer som Arbejdsmiljøforskningsfonden har beskrevet for udredningsprojektet ”Arbejdsbetinget Sygdomme i Hånd og Underarm – En Systematisk Litteraturgennemgang”, som blev udbudt i oktober 2009. Projektet er finansieret af Arbejdsmiljøforskningsfonden. Litteraturgennemgangen er foretaget af reservelæge Paula E. C. G. Nielsen i samarbejde med overlægerne Ann Kryger og Lilli Kirkeskov Jensen samt professor Jens Peter Bonde, alle Arbejds- og Miljømedicinsk Klinik, Bispebjerg Hospital, i perioden 1.4.2010 – 31.11.2010. For hver lidelse er der afslutningsvist foretaget en samlet vægtning af den videnskabelige evidens på basis af de kriterier, som er foreslået af Dansk Selskab for Arbejds- og Miljømedicin (DASAM). Disse kriterier er gengivet sidst i rapporten. Referencedokumentet har været uafhængigt bedømt af Professor Anders Fuglsang Frederiksen, Neurofysiologisk afdeling, Århus Sygehus Professor Niels Søe Nielsen, Ortopædkirurgisk afdeling; Gentofte Sygehus Overlæge dr.med Sigurd Mikkelsen, Afdeling for Arbejds- og Miljømedicin, Bispebjerg Hospital Professor Kristian Steengaard Pedersen, Reumatologisk afdeling, Århus Sygehus Den videnskabelige bedømmelse af dokumentets kvalitet er gengivet i rapporten sammen med forfatternes bemærkninger hertil. Dokumentet er efterfølgende revideret af forfatterne i forhold til de fremkomne bemærkninger. Vi vil gerne rette en varm tak til de uafhængige fagfællebedømmere for deres omfattende kritik som på væsentlige punkter har medført en bedre rapport. Bispebjerg December 2010 Forfatterne

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    Contents

    1. Dansk Resumé ........................................................................................................................... 6

    2. Overall Summary........................................................................................................................ 8

    3. Introduction ............................................................................................................................... 11

    4. Methods and Inclusion Criteria ................................................................................................. 12

    5. HAND OSTEOARTHRITIS....................................................................................................... 14

    5.1 Introduction........................................................................................................................... 14

    5.2 Literature search .................................................................................................................. 14

    5.3 Biomechanical occupational exposures ............................................................................... 15

    5.4 Exposure to hand/arm vibration ........................................................................................... 19

    5.5 Case reports......................................................................................................................... 20

    Table 5.6 – Epidemiological studies on hand osteoarthritis in relation to biomechanical occupational exposures.......................................................................................................................................... 21

    Tabel 5.7 – Epidemiological studies on hand osteoarthritis in relation to exposure to hand/arm vibration 26

    Tabel 5.8 – Case reports on hand osteoarthritis in relation to occupational exposures ................... 27

    5.9 Discussion ............................................................................................................................ 28

    5.10 Pathophysiology ................................................................................................................... 30

    5.11 Summary .............................................................................................................................. 31

    5.12 Conclusion............................................................................................................................ 31

    6. NERVE COMPRESSION SYNDROMES................................................................................. 33

    6.1 Introduction........................................................................................................................... 33

    6.2 Literature search .................................................................................................................. 35

    6.3 Ulnar nerve compressive syndromes................................................................................... 36

    6.4 Median nerve compressive syndromes................................................................................ 38

    6.5 Radial nerve compressive syndromes ................................................................................. 39

    Table 6.6 – Analytic epidemiological studies on nerve compression syndromes in relation to occupational exposures.......................................................................................................................................... 40

    Table 6.7 – Other epidemiological studies and case reports on ulnar nerve compressive syndromes in relation to occupational exposures.................................................................................................... 42

    Table 6.8 – Other epidemiological studies and case reports on median nerve compressive syndromes in relation to occupational exposures.................................................................................................... 44

    Table 6.9 – Other epidemiological studies and case reports on radial nerve compressive syndromes in relation to occupational exposures.................................................................................................... 45

    6.10 Discussion ............................................................................................................................ 46

    6.11 Pathophysiology ................................................................................................................... 48

    6.12 Summary .............................................................................................................................. 49

    6.13 Conclusion............................................................................................................................ 49

    7. DUPUYTREN’S CONTRACTURE ........................................................................................... 50

    7.1 Introduction........................................................................................................................... 50

    7.2 Literature search .................................................................................................................. 50

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    Table 7.3 – Epidemiological studies on Dupuytren’s disease in relation to occupational exposures.55

    7.4 Discussion ............................................................................................................................ 57

    7.5 Pathophysiology ................................................................................................................... 57

    7.6 Summary .............................................................................................................................. 59

    7.7 Conclusion................................................................................................................................... 59

    8. DE QUERVAIN’S DISEASE ..................................................................................................... 60

    8.1 Introduction.................................................................................................................................. 60

    8.2 Literature search .................................................................................................................. 61

    8.3 Epidemiological studies........................................................................................................ 61

    8.4 Historical case reports and case series ...................................................................................... 66

    Tabel 8.5 – Epidemiological studies on de Quervain’s disease in relation to occupational exposures67

    8.6 Discussion ............................................................................................................................ 70

    8.7 Pathophysiology .......................................................................................................................... 71

    8.8 Summary ......................................................................................................................