ACRL News Issue (B) of College & Research Libraries 164 / C&RL News W hat, ex a ctly , is carpal tu n n el syndrom e? By Thomas W. Ricks Science Reference Librarian University o f Colorado at Colorado Springs A look at an increasingly common work-related disorder. C arpal tunnel syndrome is a debilitating disorder that is threatening the health and well-being of too many people in this country. Approximately 19 million Americans are disabled each year from cumulative traum a disorders (CTDs), such as carpal tunnel syndrome. CTDs are charac­ terized by repetitive motions for prolonged periods of time that result in injury. Such injuries include In 1981 CTDs accounted fo r 18% o f the 126,000 occupational ill­ nesses. By 1989 this number had risen to 52% o f the 283,700 cases. not only carpal tunnel syndrome, b ut tendonitis, tenosynovitis, and other inflammatory ailments of the u pper arms, shoulders, and back. The associ­ ated cost (direct and indirect) is estim ated at $100 billion annually.1 In 1981 CTDs accounted for 18 percent o f the 126,000 occupational illnesses. By 1989 this num ­ ber had risen to 52 percent of the 283,700 cases.2 G erald Scannell, head of the Occupational Safety and Health Administration (OSHA), has labelled CTD as the “occupational disease of the 1990s.”3 C a u s e s a n d t r e a t m e n t The carpal tunnel is the passageway for the nerves and tendons passing through the wrist and extending into the hand and fingers. The actual “tunnel” is composed of bones and ligament. Since the tunnel is narrow, inflammation and swelling resulting from overuse and continuous flexing causes pressure and compression on the median nerve. T he median nerve provides sensation to the hand and fingers. The results are the classic signs and symptoms of carpal tunnel syndrome: • numbness o r tingling sensation in the hands and fingers; • pain in the wrist, which may radiate up into the forearm or down into the hand or fingers; • numbness or pain m aybe intensified at night. If the condition is identified early, conservative therapy can be initiated and hopefully surgery can be avoided. Conservative therapy consists of splint­ ing the hand and forearm, taking anti-inflammatory agents such as aspirin or ibuprofen, and starting an exercise program designed to strengthen the af­ fected area. W ithout alterations in the work environment, however, therapy of any kind is of little use. The circumstances associated with the onset of the disease must be resolved or the injury cycle will likely continue. The cost of surgery is very expensive compared to conservative therapy; over $20,000 for the sur­ gery, lost work time, disability payments, and reha­ bilitation. Furtherm ore, surgery is not always effec­ tive and even if it is, the likelihood of reoccurrence is high.4 Therefore, the emphasis must be on pre­ vention not treatm ent. March 1992 /1 6 5 T he increase in th e incidence o f carpal tu nnel syndrom e is directly related to autom ation in the workplace and th e ethic o f “increase productivity.” Jobs are b eing sim plified into sm aller m ore r e p e ti­ tive tasks so that people can work faster and longer while producing m ore. C om puters allow people to type m uch faster than was ever possible on ty p e ­ writers; th e r’s no changing paper, using w hite-out, o r pausing after th e e nd of each line, th e re ’s only rapid continual motion. P r e v e n t i o n Clearly, prevention is th e answer to solving th e carpal tunnel syndrom e question. By initiating som e basic changes in th e workplace m uch can b e done to reverse the high incidence o f carpal tu nnel syndrom e and associated suffering. T hese changes include: • provide properly designed work stations and keyboards, including high-quality ergonom ic chairs th a t adjust to the user; • encourage adequate rest periods to stretch and relax hands; • include job rotation w here possible; • im plem ent a long-term educational program for all employees, including supervisors, as to the causes and m ethods for prevention. C o n c l u s i o n s As libraries continue to im plem ent new te c h ­ nologies and atte m p t to do m ore with few er re ­ sources, the risk o f developing carpal tu n n el syn­ drom e am ong library employees will increase even m ore. It is im perative th at libraries with unsafe working conditions initiate preventative m easures now b e ­ fore th e problem grows worse. Librarians have the responsibility to ensure that th e library is a safe place to work for all. N O TES 1G reg LaBar, “B ent o ut o f shape,” Occupational Hazards (June 1991): 37-39. 2U. S. D e p artm en t o f Labor, B ureau o f L abor Statistics, Bulletin 2379 (W ashington, D.C.: Gov­ ern m e n t Printing Office, 1989), pp. 5, 46. 3B arbara Goldoftas, “H ands that hurt: R epetitive m otion injuries on th e jo b ,” Technology R eview 91 (January 1991): 42-50. 4M ichael Schachner, “T reat symptoms b efore it worsens: E xperts,” Business Insurance 24 (S eptem ­ b e r 1990): 30-31. ■ ■ Chernobyl Bibliographic Search System Battelle Software Products is proud to announce ChemoLit, an exten sive bib­ liographic search system about the Chernobyl nuclear accident. ChemoLit contains4 ,5 0 0 references and abstracts in an easy-to-use format and allow s users to interactively search the biblio­ graphic data through menu-driven soft­ ware. W ith yearly updates y ou can be assured it is o n e o f the m ost com plete bibliographic sources for Chernobyl research. 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