Introduction: The heterogeneity of occupational morbidity by gender in those suffering from carpal tunnel syndrome (CTS) has been little studied in the Latin American context. The objective of this study was to estimate the incidence and prevalence of CTS of occupational origin in the Ecuadorian salaried population according to gender, In addition, the differences in risk between women and men are compared. Methods: We use the only administrative registers of CTS qualified as occupational diseases in the country between the years 2017 and 2019. Period incidence rates were estimated to compare the risk in women versus men (RR, CI 95%) by age group and economic activity. Results: CTS is the second most common occupational disease in Ecuador. Women workers are more likely tosuffer from CTS and showed twice the risk compared to men [RR = 2.10 (95%CI: 1.94–2.11); p = 0.000]. This risk increases with age and for the vast majority of economic activities. The occupations of agriculture and warehousing stand out for their importance. Conclusions: The results shown in this study raise the fundamental need to improve epidemiological surveillance systems and occupational health policies by considering gender differences in order to adequately address risks and promote safe and healthy working environments for all.

Altuntaş, Y. D., & Çankaya, T. (2020). Effects of working years in cold environment on the musculoskeletal system and carpal tunnel symptoms. Agri/Journal of the Turkish Society of Algology, 32(3). doi: 10.14744/agri.2020.35651

Ashworth N. L. (2010). Carpal tunnel syndrome. BMJ clinical evidence, 2010, 1114

Atroshi I, Gummesson C, Johnsson R, Ornstein E, Ranstam J, Rosén I. Prevalence of Carpal Tunnel Syndrome in a General Population. JAMA. 1999;282(2):153–158. doi:10.1001/jama.282.2.153

Barcenilla, A., March, L. M., Chen, J. S., & Sambrook, P. N. (2012). Carpal tunnel syndrome and its relationship to occupation: a meta-analysis. Rheumatology, 51(2), 250-261. https://doi.org/10.1093/rheumatology/ker108

Barnhart, S., Demers, P. A., Miller, M., Longstreth Jr, W. T., & Rosenstock, L. (1991). Carpal tunnel syndrome among ski manufacturing workers. Scandinavian journal of work, environment & health, 46-52. https://doi.org/10.5271/sjweh.1735.

Bensefa-Colas, L., & Choudat, D. (2013). Main et maladies professionnelles. La Presse Médicale, 42(12), 1627-1631. https://doi.org/10.1016/j.lpm.2012.09.037

Cadena-Baquero, M. E., Pérez, E. B., Andrade, S. A., Lopez-Ruiz, M., García, A. R. G., & Merino-Salazar, P. (2020). Conflicto empleo-familia y autopercepción de la salud desde una perspectiva de género. Saúde e Sociedade, 29, e190033. • https://doi.org/10.1590/S0104-12902020190033

Carder, M., Bensefa-Colas, L., Mattioli, S., Noone, P., Stikova, E., Valenty, M., & Telle-Lamberton, M. (2015). A review of occupational disease surveillance systems in Modernet countries. Occupational Medicine, 65(8), 615-625. https://doi.org/10.1093/occmed/kqv081

Cranford, C. S., Ho, J. Y., Kalainov, D. M., & Hartigan, B. J. (2007). Carpal tunnel syndrome. The Journal of the American Academy of Orthopaedic Surgeons, 15(9), 537–548. https://doi.org/10.5435/00124635-200709000-00004

García Gómez, M., Castañeda López, R., Herrador, Z., & Simon-Soria, F. (2017). Reconocimiento de enfermedades profesionales según sexo, ocupación y actividad de la empresa en España (1999-2009. http://hdl.handle.net/20.500.12105/9182

Harris-Adamson, C., Eisen, E. A., Dale, A. M., Evanoff, B., Hegmann, K. T., Thiese, M. S., ... & Rempel, D. (2013). Personal and workplace psychosocial risk factors for carpal tunnel syndrome: a pooled study cohort. Occupational and environmental medicine, 70(8), 529-537. http://dx.doi.org/10.1136/oemed-2013-101365

Harris-Adamson, C., Eisen, E. A., Kapellusch, J., Hegmann, K. T., Thiese, M. S., Dale, A. M., Evanoff, B., Meyers, A. R., Bao, S., Gerr, F., Krause, N., & Rempel, D. (2022). Occupational risk factors for work disability following carpal tunnel syndrome: a pooled prospective study. Occupational and environmental medicine, 79(7), 442–451. https://doi.org/10.1136/oemed-2021-107771

Hassan, A., Beumer, A., Kuijer, P. P. F., & van der Molen, H. F. (2022). Work‐relatedness of carpal tunnel syndrome: Systematic review including meta‐analysis and GRADE. Health Science Reports, 5(6), e888. https://doi.org/10.1002/hsr2.888

Ibrahim, I., Khan, W. S., Goddard, N., & Smitham, P. (2012). Suppl 1: carpal tunnel syndrome: a review of the recent literature. The open orthopaedics journal, 6, 69. doi:10.2174/1874325001206010069

Instituto Ecuatoriano de Seguridad Social. Resolución - IESS. (2016). Reglamento del Seguro General de Riesgos del Trabajo. https://sart.iess.gob.ec/DSGRT/norma_interactiva/IESS_Normativa.pdf.

Jackson, R., Beckman, J., Frederick, M., Musolin, K., & Harrison, R. (2018). Rates of carpal tunnel syndrome in a state workers’ compensation information system, by industry and occupation—California, 2007–2014. Morbidity and Mortality Weekly Report, 67(39), 1094. doi: 10.15585/mmwr.mm6739a4

Jenkins, P. J., Srikantharajah, D., Duckworth, A. D., Watts, A. C., & McEachan, J. E. (2013). Carpal tunnel syndrome: the association with occupation at a population level. Journal of Hand Surgery (European Volume), 38(1), 67-72. https://doi-org.ezproxybib.pucp.edu.pe/10.1177/17531934124557

Jirapongsuwan, A., Klainin-Yobas, P., Songkham, W., Somboon, S., Pumsopa, N., & Bhatarasakoon, P. (2023). The effectiveness of ergonomic intervention for preventing work-related musculoskeletal disorders in agricultural workers: A systematic review protocol. PloS one, 18(7), e0288131. https://doi.org/10.1371/journal.pone.0288131

Kao, S. Y. (2003). Carpal tunnel syndrome as an occupational disease. The journal of the American board of family practice, 16(6), 533-542. https://doi.org/10.3122/jabfm.16.6.533

Kozak, A., Schedlbauer, G., Wirth, T., Euler, U., Westermann, C., & Nienhaus, A. (2015). Association between work-related biomechanical risk factors and the occurrence of carpal tunnel syndrome: an overview of systematic reviews and a meta-analysis of current research. BMC musculoskeletal disorders, 16(1), 1-19. https://doi.org/10.1186/s12891-015-0685-0

Lewczuk, E., & Affelska-Jercha, A. (2002). Zawodowe i pozazawodowe aspekty zespołu kanału nadgarstka. Medycyna Pracy, 5, 417-422.

Łach, P., & Cygańska, A. K. (2024). Effectiveness of prevention exercises protocol among office workers with symptoms of carpal tunnel syndrome. International journal of occupational medicine and environmental health, 37(1), 45–57. https://doi.org/10.13075/ijomeh.1896.02164

Mansfield, M., Thacker, M., & Sandford, F. (2018). Psychosocial risk factors and the association with carpal tunnel syndrome: a systematic review. Hand, 13(5), 501-508. https://doi-org.ezproxybib.pucp.edu.pe/10.1177/1558944717736398

McDiarmid, M., Oliver, M., Ruser, J., & Gucer, P. (2000). Male and female rate differences in carpal tunnel syndrome injuries: personal attributes or job tasks?. Environmental research, 83(1), 23-32. http://doi.org/10.1006/enrs.2000.4042.

Margolis, W., & Kraus, J. F. (1987). The prevalence of carpal tunnel syndrome symptoms in female supermarket checkers. Journal of occupational medicine, 953-956. https://www.jstor.org/stable/45007592

Messing, K., Chatigny, C., & Courville, J. (1998). ‘Light’and ‘heavy’work in the housekeeping service of a hospital. Applied ergonomics, 29(6), 451-459. http://doi.org/10.1016/S0003-6870(98)00013-1.

Messing, K., Punnett, L., Bond, M., Alexanderson, K., Pyle, J., Zahm, S., ... & de Grosbois, S. (2003). Be the fairest of them all: challenges and recommendations for the treatment of gender in occupational health research. American journal of industrial medicine, 43(6), 618-629. https://doi.org/10.1002/ajim.10225

Möllestam, K., Englund, M., & Atroshi, I. (2021). Association of clinically relevant carpal tunnel syndrome with type of work and level of education: a general-population study. Scientific reports, 11(1), 19850. https://doi.org/10.1038/s41598-021-99242-8

Mondelli, M., Grippo, A., Mariani, M., Baldasseroni, A., Ansuini, R., Ballerini, M., ... & Giannini, F. (2006). Carpal tunnel syndrome and ulnar neuropathy at the elbow in floor cleaners. Neurophysiologie Clinique/Clinical Neurophysiology, 36(4), 245-253. http://doi.org/10.1016/j.neucli.2006.08.013.

Newington, L., Harris, E. C., & Walker-Bone, K. (2015). Carpal tunnel syndrome and work. Best practice & research Clinical rheumatology, 29(3), 440-453. https://doi.org/10.1016/j.berh.2015.04.026

Organización Internacional del Trabajo - OIT. (2015). Indicadores Clave del Mercado de Trabajo (ICMT), Novena edición. https://www.ilo.org/wcmsp5/groups/public/---dgreports/---stat/documents/publication/wcms_498940.pdf

Organización Internacional del Trabajo - OIT. (2021). Guía rápida sobre fuentes y usos de estadísticas sobre seguridad y salud en el trabajo. https://www.ilo.org/wcmsp5/groups/public/---dgreports/---stat/documents/publication/wcms_794841.pdf

Osorio, A. M., Ames, R. G., Jones, J., Castorina, J., Rempel, D., Estrin, W., & Thompson, D. (1994). Carpal tunnel syndrome among grocery store workers. American journal of industrial medicine, 25(2), 229-245. http://doi.org/10.1002/ajim.4700250209.

Padua, L., Coraci, D., Erra, C., Pazzaglia, C., Paolasso, I., Loreti, C., ... & Hobson-Webb, L. D. (2016). Carpal tunnel syndrome: clinical features, diagnosis, and management. The Lancet Neurology, 15(12), 1273-1284. http://doi.org/10.1016/S1474-4422(16)30231-9.

Rempel, D., Evanoff, B., Amadio, P. C., De Krom, M., Franklin, G., Franzblau, A., ... & Pransky, G. (1998). Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. American journal of public health, 88(10), 1447-1451. doi/abs/10.2105/AJPH.88.10.1447

Riccò, M., & Signorelli, C. (2017). Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in Northern Italy. Medycyna pracy, 68(2), 199-209. http://doi.org/10.13075/mp.5893.00605.

Rigouin, P., Ha, C., Bodin, J., Le Manac’h, A. P., Descatha, A., Goldberg, M., & Roquelaure, Y. (2014). Organizational and psychosocial risk factors for carpal tunnel syndrome: a cross-sectional study of French workers. International archives of occupational and environmental health, 87, 147-154. https://doi.org/10.1007/s00420-013-0846-0

Roquelaure, Y., Fouquet, N., Chazelle, E., Descatha, A., Evanoff, B., Bodin, J., & Petit, A. (2018). Theoretical impact of simulated workplace-based primary prevention of carpal tunnel syndrome in a French region. BMC public health, 18(1), 426. https://doi.org/10.1186/s12889-018-5328-6

Roquelaure, Y., Garlantézec, R., Evanoff, B. A., Descatha, A., Fassier, J. B., & Bodin, J. (2020). Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: a structural equation modeling approach. Pain, 161(4), 749-757. DOI: 10.1097/j.pain.0000000000001766

Shiri, R., & Falah-Hassani, K. (2015). Computer use and carpal tunnel syndrome: a meta-analysis. Journal of the neurological sciences, 349(1-2), 15-19. https://doi.org/10.1016/j.jns.2014.12.037

Takala, J., Hämäläinen, P., Saarela, K. L., Yun, L. Y., Manickam, K., Jin, T. W., ... & Lin, G. S. (2014). Global estimates of the burden of injury and illness at work in 2012. Journal of occupational and environmental hygiene, 11(5), 326-337. DOI: 10.1080/15459624.2013.863131

Trillos-Chacón, M. C., Castillo-M, J. A., Tolosa-Guzman, I., Sánchez Medina, A. F., & Ballesteros, S. M. (2021). Strategies for the prevention of carpal tunnel syndrome in the workplace: A systematic review. Applied ergonomics, 93,103353. https://doi.org/10.1016/j.apergo.2020.103353

van Rijn, R. M., Huisstede, B. M., Koes, B. W., & Burdorf, A. (2009). Associations between work-related factors and the carpal tunnel syndrome--a systematic review. Scandinavian journal of work, environment & health, 35(1), 19–36. https://doi.org/10.5271/sjweh.1306

Vihlborg, P., Pettersson, H., Makdoumi, K., Wikström, S., Bryngelsson, L., Selander, J., & Graff, P. (2022). Carpal Tunnel Syndrome and Hand-Arm Vibration: A Swedish National Registry Case–Control Study. Journal of Occupational and Environmental Medicine, 64(3), 197. doi:10.1097/JOM.0000000000002451