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
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.
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.
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.
849,000 new cases of carpal tunnel
syndrome occurred in 1994.-National Center for
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.
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.
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.
Each worker compensation claim
for repetitive stress injuries can cost up to $20,000
- $100,000. Consumer Watch Report, PC World, May
According to the National Council on Compensation
Insurance, Inc., the average total cost per workers'
compensation claim for CTS is $12,370.00. 1111 Jennifer Kish and Valdy Dobrila, Carpal Tunnel
Syndrome In Workers Compensation: Frequency, Costs
andClaim Characteristics , NCCI Research Brief
Vol. 3, Issue 3, June 1996, at *4. This total cost
includes lostwages and medical costs.
: Presently, the costs to businesses that employ
workers at high risk to develop Carpal Tunnel Syndrome
and other Repetitive Stress Injuries is staggering.
It is estimated that RSI "costs employers over
$80 billion yearly." According to the National
Council of Compensation Insurance, the average compensation
of a CTS victim is $33,000.00.
Along with increasing numbers of CTS, costs are
escalating too, quadrupling since 1987. The average
cost of a single case of Carpal Tunnel Syndrome,
for example, rose to $30,000 in 1988 per the Bureau
of National Affairs.
**The following sources are compiled from the Bureau of Labor and Statistics
and the National Institute for Occupational Safety and Health-NIOSH.**
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
Currently, Carpal Tunnel Syndrome
affects over 8-million Americans.
Carpal Tunnel Syndrome is the
#1 reported medical problem, accounting for about
50% of all work-related injuries
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.
Only 23% of all Carpal Tunnel
Syndrome patients were able to return to their
previous professions following surgery.
Up to 36% of all Carpal Tunnel
Syndrome patients require unlimited medical
Women are twice as likely to
develop Carpal Tunnel Syndrome as opposed to
their male counterparts.
While women account for about
45% of all workers, they experience nearly 2/3's
of all work-related Repetitive Strain Injuries.
Surgery for Carpal Tunnel
Syndrome is the second most common type of
surgery, with well over 230,000 procedures
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.
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
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.
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
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
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
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
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,
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
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
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%
STATISTICS & INFORMATION:
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
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.
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
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.MUST READ THIS BY ONE OF THE
MOST RENOUND MEDICAL JOURNALS- JAMA!!! http://www.mit.edu/people/wchuang/unix/CTS/CTS_Surgery.txt
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.
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
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.
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.
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.
Other researchers are warning
that misdiagnoses are more often the rule than
the exception. "By the time we've completely mutilated
the person, maybe then we'll decide
it's not carpal tunnel syndrome after all," says
one epidemiologist. Barbara Silverstein, research
director at the Washington State Department
of Labor and Industries, Olympia,
you type 40 words a minute : you press 12,000
keys per hour or 96,000 keys per 8-hour day.
Approximately 8 ounces of force
is necessary to depress one key.
Almost 16 tons
of force will be exercised by your fingers.
on computer users and typists: Repetitive
typing and key entry is highly associated
with missing work due to CTS. The risk for CTS
in this group, however, is still much lower
than with occupations involving heavy labor.
One small 2001 study reported that nerve
conduction tests on frequent computer users
showed the same rate of CTS (3.5%) as in
the general population. However, 10% of
the computer users complained of CTS symptoms
and 30% reported tingling and burning in
the hand. The typing speed may affect risk.
For example, the fingers of typists whose speed
is 60 words per minute exert up to 25 tons
of pressure each day . And in one, study typists
with CTS struck the keys with greater force
than those without the disorder did.