In brief
Carpal tunnel syndrome is explicitly listed in the physical agents group of the list of occupational diseases, under the heading "nerve palsies resulting from continuous local pressure"; in other words, it can be accepted as an occupational disease. Acceptance requires the diagnosis to be confirmed by electrodiagnostics (EMG) and a match between the work done and the disease established by a detailed job analysis. The workplace physician refers a suspected case to a healthcare provider authorised by the SGK; the employer also reorganises the work that strains the wrist.
What is carpal tunnel syndrome, and where does the link with work come from?
Picture a sewing operator who wakes at night shaking their hand, struggles to do up buttons in the morning and puts down the scissors during the day to rub their fingers. This picture is often wrist nerve compression: pressure on the median nerve, which passes through a narrow channel (the carpal tunnel) on the palm side of the wrist. The person has numbness and tingling in the thumb, index and middle fingers, reduced grip strength and, at a later stage, wasting of the muscles at the base of the thumb.
Anything that increases the pressure inside the tunnel puts a load on the nerve. The main work-related factors are:
- Repetition: The same wrist movement being made thousands of times during a shift.
- Force: Cutting with blunt scissors, tight gripping, strong pinching with the fingertips.
- Posture: Working for long periods with the wrist bent forwards or backwards.
- Local pressure: A tool handle or bench edge pressing into the palm or wrist.
- Vibration: Vibrating hand tools.
There are also factors unrelated to work: pregnancy, diabetes, thyroid disease, rheumatic diseases and previous wrist fractures are some of them. This is the difficult part of an occupational disease assessment: it is not the diagnosis alone but the link between the disease and the work done that must be proven.
Tasks in textiles that strain the wrist
In weaving and garment businesses in and around Bursa, the repetitive work wrist load is concentrated especially on the line, in cutting and in final ironing and packing. The table below shows the examples we encounter most often on site and the first measure that should come to mind:
| Task | Wrist-straining movement | First measure |
|---|---|---|
| Cutting fabric by hand | Strong, repeated squeezing with blunt scissors | Sharpening schedule, spring-loaded lightweight scissors, electric cutting if possible |
| Sewing and overlock line | Keeping the wrist constantly bent while feeding fabric, fingertip pressure | Adjusting stool and bench height to the person, arranging product flow so the wrist stays straight |
| Ironing | Repeatedly pushing a heavy iron with the wrist bent | Lightweight suspended iron, ironing table height, rotation |
| Folding, labelling, packing | Short-cycle, fast, pinch-type gripping | Combining tasks to lengthen the cycle time, micro-breaks |
| Knotting, bobbin and yarn work in weaving | Frequent, precise fingertip gripping | Use of aids, job rotation |
| Hand-held cutting machine in the cutting room | Vibration and holding the arm steady | Well-maintained, balanced machine, vibration assessment |
For the general safety of cutting machines, see our article on cutting room and band knife safety, and for other garment risks, our article on OHS in garment workshops. Ways of measuring repetition on a production line are in our article on repetitive movements and assembly lines.
Is carpal tunnel syndrome an occupational disease? Where does it sit on the list?
The short answer is yes: carpal tunnel syndrome can be accepted as an occupational disease. The list of occupational diseases is in Annex 2 of the SGK's Regulation on Procedures for Determining the Rate of Loss of Working Capacity and Earning Capacity. Group E of the list covers occupational diseases caused by physical agents, and heading E-6 e of this group is "nerve palsies resulting from continuous local pressure". Carpal tunnel syndrome is written explicitly under this heading, in connection with median nerve palsy.
Each disease on the list has a liability period; the disease must appear within this period after the employee leaves the job. Even if the period has been exceeded, if the disease has been confirmed by clinical and laboratory findings and the agent has been proven by a workplace investigation, it may be accepted as an occupational disease by decision of the Social Insurance High Health Board (Art. 17). We explained how to read the groups and periods in our article on the list of occupational diseases.
The definition on the insurance side is in Art. 14 of Law No. 5510: a disease suffered due to a repeated cause arising from the nature of the work or because of the conditions under which the work is carried out. Carpal tunnel syndrome is one of the most typical examples of a "repeated cause".
How does the assessment work, and what evidence is required?
The process starts with the workplace physician's suspicion. Under Art. 14/3 of Law No. 6331 on Occupational Health and Safety, the workplace physician or healthcare providers refer cases they provisionally diagnose as occupational disease to healthcare providers authorised by the SGK. Medical board reports contain only the medical diagnosis; the SGK decides whether the disease arises from the occupation. For the detailed flow, see our article on what an occupational disease is, diagnosis and notification.
To enable the Institution to decide, having the following documents in the file speeds up the process:
- Job description and duration: What job the employee did, for how many years, how many hours per shift; information on product and pace.
- Ergonomic risk analysis: An assessment showing wrist posture, number of repetitions and force requirement. For choosing a method, our article on REBA and RULA offers guidance.
- Health surveillance records: Dated records of complaints and findings at pre-employment and periodic examinations.
- Diagnostic documents: EMG report and specialist examination.
- Assessment of other causes: Records showing that conditions such as diabetes and thyroid disease have been investigated.
An occupational disease is notified to the SGK by the employer within 3 working days of it becoming known (Law No. 6331 Art. 14/2). The 2026 basic amount for failing to notify is 44,443 TL, and this fine is imposed by the SGK; for other amounts, see the OHS administrative fines tool.
When does an EMG test come up in the workplace?
Most employers who search for "EMG test workplace" ask whether the test can be done at the factory. EMG, that is nerve conduction studies and needle electromyography, is a diagnostic test performed by a neurologist or physical medicine specialist; it is not a routine test given to all employees for screening. Its role in the workplace is as follows:
- Screening: At the periodic examination, the workplace physician asks about night-time numbness, tingling and difficulty gripping; in the wrist examination, simple tests such as Tinel's and Phalen's strengthen the suspicion.
- Referral: If there is a suspicion, the employee is referred for EMG and specialist assessment. We plan tests with authorised laboratories and healthcare providers.
- Follow-up: The result and the physician's recommendation are entered into the personal health file; if necessary, the employee's fitness for the job is reassessed.
On high-risk lines, the cheapest way to catch cases early is for the physician not to limit questioning about complaints to the periodic examination, for example screening the line with a short questionnaire after a new model or an increase in pace.
Job adaptation: after diagnosis and before diagnosis
Carpal tunnel workplace adjustments are made at two points. The first is after diagnosis: the physician states in writing which tasks the employee can do during treatment. During this period, rather than having the employee work "a bit slower" on the same line, they should be moved temporarily to a task that does not strain the wrist. For an employee who has had surgery, a return-to-work examination and a phased return plan are carried out.
The second, and more important, is before diagnosis. Art. 5 of Law No. 6331 on Occupational Health and Safety lists adapting the work to the individual, and in particular preventing the adverse effects of monotonous work and the pace of production, among the principles of protection from risks. In textiles this means:
- Put scissors and knives on a sharpening schedule; a blunt tool multiplies the force needed.
- Adjust bench, stool and ironing table heights to the employee; the elbow roughly at bench level, the wrist straight.
- Lengthen the cycle by combining short-cycle tasks, and write short hourly breaks into the schedule.
- Set up rotation so that the same person does not spend the whole shift on a single wrist movement.
- For vibrating tools, carry out the assessment under the vibration regulation.
- Link the results to your programme for preventing musculoskeletal disorders.
We implement these measures together with workplace physician services and ergonomic risk assessment. For sector-specific topics, see our textile page.
Frequently Asked Questions
Is carpal tunnel syndrome on the list of occupational diseases?
Yes. Heading E-6 e in the physical agents group of the list covers nerve palsies resulting from continuous local pressure and explicitly mentions carpal tunnel syndrome in connection with median nerve palsy. Acceptance requires a definitive diagnosis by EMG and a detailed job analysis.
Does every case of carpal tunnel syndrome count as an occupational disease?
No. The link between the disease and the work must be proven. Causes unrelated to work, such as pregnancy, diabetes or thyroid disease, are also assessed; the decision is the SGK's.
Can the workplace physician carry out the EMG test?
EMG is a diagnostic test performed by a specialist physician in hospital. The workplace physician asks about symptoms, carries out an examination and refers a suspected case for further tests.
Can an employee who has been diagnosed continue in the same job?
The physician makes this decision. During treatment, a temporary task that does not strain the wrist is usually better; on return to work, the workstation and method should also have been corrected.
A physician assigned for the time your hazard class requires: pre-employment and periodic examinations, fitness-for-work reports and health surveillance.
Bursa SİSTEMER OSGB Technical Team — written from the field experience of our OHS specialists and workplace physicians. Legal information is valid as of the publication/update date; contact us for an assessment specific to your business.