Affiliations: [a] Department of Health Sciences, University of Milano, Milan, Italy, International Centre for Rural Health, Occupational Health Unit, Hospitals Santi Paolo e Carlo, Milan, Italy
| [b] Department of Biomedical, Dental and Morphological and Functional Imaging, University of Messina, Messina, Italy
| [c] University of Milan, Milan, Italy
| [d] Diagnostic and Interventional Radiology, Hospitals Santi Paolo e Carlo, Milan, Italy
| [e] “Aldo Ravelli” Research Center, Department of Health Sciences, University of Milan, Milan, Italy
Correspondence:
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Address for correspondence: Federica Masci, Department of Health Sciences, University of Milano, Milan, Italy. E-mail: [email protected].
Abstract: BACKGROUND:In the arboriculture sector, some activities are still manually performed by forestry workers, which result consequently exposed to a high risk of developing muscle skeletal disorders. The Italian Compensation Authority reported an increase of work-related tendinopathies and carpal tunnel syndrome in loggers, but screening protocols are not available yet. OBJECTIVES:The objectives were: a) to evaluate the prevalence of tendinopathies and carpal tunnel syndrome in a sample of loggers and b) identify a sound screening approach. METHODS:41 loggers and 41 paired control workers were recruited for a total of 164 hands. The protocol included 1) demographic data; 2) medical history; 3) identification of CTS symptoms through a questionnaire and a hand-chart; 4) upper limbs clinical examination; 5) Raynaud’s diseases questionnaire; 6) wrists ultrasound; 7) NCS of the distal median nerve. RESULTS:The prevalence of tendinopathies was statistically significant only in the non-dominant hand (75, 5% in the exposed group and 53, 6% in the non-exposed group). The prevalence of CTS was 32, 2% in the exposed group and 15, 5% in the non-exposed group. The questionnaire had a sensitivity of 56, 7% and a specificity of 75%. The hand-chart had a sensitivity of 30% and a specificity of 92%. The clinical examination had sensitivity of 30% and specificity of 80%. The ultrasound had a sensitivity of 70% and a specificity of 56%. CONCLUSIONS:Loggers are a population at risk of occupational hand and wrist disorders. The hand-chart could be considered, together with the questionnaire, as the best secondary prevention tool to diagnose CTS.
