AMERICAN JOURNAL OF INDUSTRIAL MEDICINE 45:139–152 (2004) Work-Related Carpal Tunnel Syndrome (WR-CTS) in Massachusetts, 1992 – 1997: Source of WR-CTS, Outcomes, and Employer Intervention Practices Helen Wellman, MS, 1,2,3 Letitia Davis, ScD, 2 Laura Punnett, ScD, 3 and Robin Dewey, MPH 2,4 Background The Massachusetts Sentinel Event Notification System for Occupational Risks (MASS SENSOR) receives reports of work-related carpal tunnel syndrome (WR- CTS) cases from (1) workers’ compensation (WC) disability claims for 5 or more lost work days; and (2) physician reports (PR). Methods From 1992 through 1997, 1,330 WC cases and 571 PR cases completed follow- back surveys to provide information on industry, occupation, attributed source of WR-CTS, outcomes, and employer intervention practices. Results Sixty-four percent of the respondents had bilateral CTS and 61% had surgery, both of which were proportionally more frequent among WC cases. Office and business machinery was the leading source of WR-CTS (42% of classifiable sources) in every economic sector except construction, followed by hand tools (20%). Managers and professional specialty workers were the most likely to report employers’ interventions and were up to four times more likely to report equipment or work environment changes than higher risk groups. Conclusions State-based surveillance data on the source of WR-CTS provided valuable information on how and where to implement interventions. New occurrences of WR-CTS are likely, especially in the highest risk industries where very few cases reported primary prevention measures (e.g., changes to equipment or work environment) implemented by their employers. Am. J. Ind. Med. 45:139 – 152, 2004. ß 2004 Wiley-Liss, Inc. KEY WORDS: work-related carpal tunnel syndrome; surveillance; source; outcomes; interventions INTRODUCTION Carpal tunnel syndrome (CTS) is the most common nerve entrapment disorder of the upper extremities [Stevens et al., 1988]. Each year close to one million people may develop CTS that requires medical care and leaves them temporarily disabled [Tanaka et al., 1995]. Approximately 50% of all medically diagnosed CTS may be work-related [Cummings et al., 1989; Tanaka et al., 1995]. In the work- place, repetitive and forceful exertion of the hand and wrist and segmental vibration are associated with the development of CTS [Bernard, 1997; Viikari-Juntura and Silverstein, 1999]. Since work-related CTS (WR-CTS) is a preventable disorder, up-to-date information about the occupations, ß 2004 Wiley-Liss, Inc. 1 Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts 2 Occupational Health Surveillance Program,Massachusetts Department of Public Health, Boston, Massachusetts 3 Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts 4 Labor Occupational Health Program, University of California, Berkeley California Work was performed at Massachusetts Department of Public Health. Contract grant sponsor: National Institute for Occupational Safety and Health; Contract grant number: U60/CC103010. *Correspondence to: HelenWellman, E-mail: Helen.Wellman@LibertyMutual.com Accepted 2 October 2003 DOI10.1002/ajim.10326. Published online in Wiley InterScience (www.interscience.wiley.com)