Nurses at risk for carpal tunnel
Nurses at risk for carpal tunnel
Studies focus on possible risks
In a typical shift, nurses perform dozens of small actions that could put them at risk for carpal tunnel syndrome: pushing the plunger of syringes, pressing blood pressure bulbs, tapping into keyboards. Nurses are among the workers with the highest levels of overexertion injuries, and occupational health researchers are seeking interventions that could reduce that risk.
"If the symptoms are caught early and we can identify and correct the risk factors, there's pretty good evidence that we can prevent carpal tunnel from occurring in the first place or preventing it from becoming so severe that the person requires surgery," says Robert Harrison, MD, MPH, chief of the Occupational Health Surveillance and Evaluation Program at the California Department of Public Health in Oakland.
California tracks work-related incidents of carpal tunnel syndrome through doctors' reports, workers' compensation claims, hospital discharges and other data sources. Harrison is taking a closer look at the injury among nurses.
"We have identified nurses as one group where there are relatively large numbers of cases that are being reported of carpal tunnel syndrome," he says.
Meanwhile, a study of the force involved in activating retractable syringes sheds some light on one potential risk factor. Three syringes tested by researchers at the University of South Florida in Tampa required very different amounts of force to activate the retraction mechanism, which moves the needle back into the barrel of the syringe.1
"This is an area that needs to be studied further to determine if repetitive use with this type of device results in injury," says Donna Haiduven, PhD, RN, CIC, assistant professor in the College of Public Health and a researcher with the VA Research Center of Excellence in Tampa.
CTS is common surgery
Carpal tunnel syndrome involves the compression of the median nerve and leads to pain, numbness or weakness of the wrist and hand. Women are three times more likely than men to have the condition. In 2010, about 8 out of every 100,000 fulltime hospital workers had work-related carpal tunnel syndrome that was severe enough to require days away from work, according to the U.S. Bureau of Labor Statistics.
In fact, surgery to relieve pressure on the median nerve is one of the most common surgeries performed. "We also know that carpal tunnel has some of the highest number of days of disability for any work-related injury," says Harrison.
That influenced his interest in taking a closer look at the occupations at risk for carpal tunnel syndrome. "We have identified nurses as an occupation of interest to us because we think there might be some interesting or feasible interventions in the workplace, particularly hospitals or outpatient settings," he says.
The risk factors for carpal tunnel syndrome are repetition, awkward posture, flexion, excessive force and vibration. "You eventually cause inflammation and irritation and you start getting scar tissue on that nerve," he says. "Carpal tunnel s occurs slowly over months to years."
"If the symptoms are caught early and we can identify and correct the risk factors, there's pretty good evidence that we can prevent carpal tunnel from occurring in the first place or prevent it from becoming so severe that the person requires surgery," Harrison says.
Force may vary by user
Needle safety devices are effective at reducing needlesticks. But researchers also wanted to know how much force was required to activate a retractable device.
Haiduven and her colleagues evaluated the VantagePoint syringe by Retractable Technologies Inc. of Little Elm, TX, the BD Integra by Becton, Dickinson and Company of Franklin Lakes, NJ, and the Safe-1 Safety Syringe by Safety First Medical, Inc. of Santa Ana, CA.
During testing and in published results, Haiduven identified the devices simply as A, B and C. The forces ranged from 4.72 newtons to 83.36 newtons. (There are 4.45 newtons in a pound.) Safe-1 required the least force and BD Integra the most.
"It doesn't necessarily mean one is better than the other," cautions Haiduven. "It's up to the user to decide which feels best. Force is only one of the criteria in evaluating these devices."
Other selection factors include whether the device is intuitive and easy to use, clarity of the markings on the barrel, and reliability, she notes.
In fact, the amount of force needed to activate the device may vary by user. "In two of the devices, it appeared that human factors played a role in the amount of force," Haiduven says. That raises the possibility that users could be trained to reduce their force, she says.
Reference
1. Haiduven DJ, Applegarth SP, McGuire-Wolfe C, et al.Automated and manual measurement of the forces required to use retractable intramuscular syringes. Jrl Mus Res 2010; 13:65-74.
In a typical shift, nurses perform dozens of small actions that could put them at risk for carpal tunnel syndrome: pushing the plunger of syringes, pressing blood pressure bulbs, tapping into keyboards. Nurses are among the workers with the highest levels of overexertion injuries, and occupational health researchers are seeking interventions that could reduce that risk.Subscribe Now for Access
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