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The prevalence of abnormal median nerve conduction in applicants for industrial jobs was assessed to determine the extent to which workers diagnosed with carpal tunnel syndrome may have had preexisting disease. Nerve conduction studies were performed on both hands of 1,021 applicants following a conditional offer of employment at one of eight manufacturing companies. Each applicant completed a self administered symptom survey specific to the upper extremity at the time of health assessment. The nerve conduction studies were performed at a private medical clinic by experienced electromyographers. Sensory palmar latencies were determined over an 8 centimeter segment of the median and ulnar nerves. Median neuropathy was measured as the difference between the median and ulnar sensory latencies. Approximately 17% of the applicants were classified as having median neuropathy in at least one hand by electrophysiological criteria; only 10% of these applicants, however, acknowledged symptoms associated with carpal tunnel syndrome on their questionnaire or showed clinical symptoms upon examination. Public policy issues relating to these findings were addressed. The authors conclude that a large percentage of industrial workers do have objective evidence of preexisting abnormal median nerve conduction within the carpal tunnel; these findings may indicate the existence of a subclinical entity associated with carpal tunnel syndrome and warrant further study.
American Journal of Industrial Medicine, 30(3):355-361, 1996. (27 references)
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