Preplacement nerve testing for carpal tunnel syndrome: is it cost effective?

UNLABELLED Is not hiring otherwise-qualified workers who have an abnormal post-offer preplacement (POPP) median nerve test a cost-effective strategy to reduce workers' compensation expenses related to carpal tunnel syndrome (CTS)? We performed a retrospective dynamic cohort study based on 2150 workers hired at a company between January 1996 and December 2001 and who underwent POPP median nerve testing. Workers were followed until they left the company or until follow-up ended in May 2003. RESULTS Thirty-five cases of work-related CTS occurred during follow-up, and 9.13 cases could have been avoided. However, if the company had not hired workers with abnormal POPP nerve test results, it would have suffered a net loss of $357,353. CONCLUSION Not hiring workers with abnormal POPP nerve tests to reduce costs of work-related CTS is not a cost-effective strategy for employers.