Journal Reviews
Journal Reviews
Walker WC, Metzler M, Cifu DX, et al. Neutral wrist splinting in carpal tunnel syndrome: A comparison of night-only versus full-time wear instructions. Arch Phys Med Rehabil 2000; 81:424-428.
Wrist splints are more effective in treating carpal tunnel syndrome when they are worn around the clock, rather than only at night time, according to this study by researchers in Virginia.
They organized the study to compare the effects of night-only splint use with full-time wear, measuring the effect on symptoms, function, and impairment in carpal tunnel syndrome. The participants were 38 patients recruited from an electrodiagnosis lab. All had untreated carpal tunnel syndrome. Fifty-four of the patients’ hands had carpal tunnel syndrome.
The patients were randomized to receive instructions on either wearing the splints only at night or 24 hours a day. The researchers note, however, that the patients did not comply completely with those instructions.
Of those instructed to wear the splints around the clock, 73% reported wearing them for less than half of their waking hours. Also, 23% of the night-only group reported occasionally wearing the splints during the day. Despite those reports, the researchers say the two groups differed substantially in the duration of splint use per day, as intended.
The researchers found that both groups improved nerve measurements and symptoms, but those wearing the splints full-time experienced the best gains in nerve function. That benefit, however, did not translate into any improved symptom relief or improved ability to perform daily activities. They theorize that the full-time patients may have experienced improvement in those areas if they had worn the splints all the time as they were instructed.
Nevertheless, the researchers say the study proves that full-time use is better than night-only.
"This study provides added scientific evidence to support the efficacy of neutral wrist splints in [carpel tunnel syndrome] and suggests that physiologic improvement is best with full-time splint wear instructions," they write. "Patients should be instructed to wear the splint continuously during the day, in addition to during the night."
Cubbin C, LeClere FB, Smith GS. Socioeco-nomic status and the occurrence of fatal and nonfatal injury in the United States. Am J Public Health 2000; 90:70-77.
Socioeconomic status is an important factor in determining an individual’s risk of injury, with those in low-income groups at higher risk than others, according to this study.
The researchers conclude that the individual’s income be considered when assessing the likelihood that any individual will be injured in a particular situation.
Investigators from several institutions analyzed data from the National Health Interview Study, an annual household survey conducted from 1987 through 1994. In that survey, a total of 547,536 adults ages 18 to 64 were asked to recall any injuries sustained in the two weeks before the interview. The researchers also studied death records from the survey period.
They found that men had almost three times more fatal injuries than women, no matter what the socioeconomic status or race. In addition, the data showed that people with lower socioeconomic status who were black or unemployed had higher rates of all types of injuries other than suicide.
Lower-income groups at higher risk
The highest risk of injury was found with black men and women, but most of those differences disappeared when the data were adjusted for socioeconomic status. Those in low income groups, regardless of gender or race, were at higher risk of injury. Blacks were at higher risk for homicide, but both blacks and Hispanics were at lower risk of suicide than whites.
"This research clearly shows that socioeconomic status is an important determinant of injury," the researchers conclude. They suggest that the effect of socioeconomic status in injury risk has been underestimated or ignored in the past, but that it can be a useful tool in predicting injury.
De Celis R, Feria-Velasco A, Gonzalez-Unzaga M, et al. Semen quality of workers occupationally exposed to hydrocarbons. Fertil Steril 2000; 73:221-228.
Exposure to benzene and other hydrocarbon chemicals in the workplace may cause men to have low sperm counts, according to this study.
Researchers in Mexico conducted the study on workers in the rubber industry, which uses the chemicals in the production process. The participants included 48 workers who had been exposed to hydrocarbons for two to 24 years, plus 42 workers in the industry who were not exposed to hydrocarbons. The investigation found that the percentage of subjects with normal ejaculates was much higher in the unexposed group, 76% vs. 17% for the group exposed to hydrocarbons.
More abnormal characteristics were found in the semen of exposed workers than unexposed workers, including alterations in viscosity, liquefication capacity, sperm count, sperm motility, and the proportion of sperm with normal morphology. Some of the abnormal characteristics correlated with the number of years of exposure to the hydrocarbons.
Exposure to hydrocarbons did not render the men sterile, however. The researchers point out that most of the exposed workers had fathered two or more children and remained fertile. They suggest that the findings are conclusive enough to suggest that exposure to hydrocarbons does impair the fertilization process and should be minimized.
Mozurkewich EL, Luke B, Avni M, et al. Working conditions and adverse pregnancy outcome: A meta-analysis. Obstet Gynecol 2000; 95: 623-635.
Most pregnant American women continue to work during their last trimester, and almost half continue working in the last month, according to this research.
Working conditions could contribute to an increased risk of preterm births and pregnancy complications, the study concluded.
The researchers analyzed 29 previous studies that included more than 169,000 working women. They determined that women whose jobs required prolonged standing and physically demanding work such as heavy lifting, manual labor, or significant physical exertion were more likely to give birth before term and to deliver babies that were small for their gestational age.
Reduce job fatigue to lower preterm rates
Women continuing to work late in the pregnancy also were more likely to develop hypertension or preeclampsia. Long work hours did not appear to affect pregnancy outcomes, but shift work and cumulative work fatigue did. The researchers estimate that as many as one out of every 12 preterm births could be prevented if women reduced their cumulative job fatigue. Discontinuing prolonged standing or physically demanding work could eliminate one out of 27 preterm births, they say.
The authors note that the effect of working conditions on birth outcome may be less significant than other factors affecting the pregnancy, but they point out that working conditions can be changed more easily than some other factors. They suggest that employers and occupational health professionals pay more attention to the strain placed on pregnant women who continue to work late in the pregnancy.
Subscribe Now for Access
You have reached your article limit for the month. We hope you found our articles both enjoyable and insightful. For information on new subscriptions, product trials, alternative billing arrangements or group and site discounts please call 800-688-2421. We look forward to having you as a long-term member of the Relias Media community.