Adverse Health Manifestations in the Hands of Vibration Exposed Carpenters - A Cross Sectional Study

Abstract

BackgroundDespite EU regulatory standards, many workers suffer injury as a result of working with hand-held vibrating tools. Our aim of this study was to investigate whether carpenters, a highly exposed group, suffer more injuries to their hands than painters, a group assumed to be less exposed to vibration. Methods193 carpenters and 72 painters, all men, answered a questionnaire and underwent a clinical examination to identify manifestations of neural and vascular origin in hands. Neurosensory affection was defined as having at least one symptom in the fingers/hands (impaired perception of touch, warmth, or cold, impaired dexterity, increased sensation of cold, numbness or tingling, or pain in the fingers/hands when cold) and at least one clinical finding (impaired perception of touch, warmth, cold, vibration, or two-point discrimination). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). ResultsNeurosensory affection was fulfilled for 31% of the carpenters and 17% of the painters, age-adjusted OR 3.3 (CI 1.6–7.0). Among carpenters with neurosensory affection 18% reported interference with daily life activities, the most common symptoms being increased sensation of cold, numbness and pain in the fingers/hands when cold, the most common clinical findings were impaired perception of touch and vibration. Neurosensory affection was found in 12 % of young carpenters (≤ 30 years old). No difference was found in the prevalence of white fingers between carpenters and painters. ConclusionsCarpenters showed more symptoms and clinical findings of neurosensory affection than painters, probably due to vibration exposure. Also young carpenters showed signs of neurosensory affection, which indicates that workers at today´s working conditions are not protected against injury. This underlines the importance of reducing exposure to vibration, and conducting regular medical check-ups to detect early signs of neural and vascular manifestations indicating hand-arm vibration injuries. Special attention should be given to symptoms of increased sensation of cold, pain in the fingers when cold, and numbness, as these were the most common initiating ones, and should be addressed as early as possible in the preventive sentinel process. It is also important to test clinically for small- and large-fibre neuropathy, as the individual may be unaware of any pathology.

The clinical consequence of using less than four sensory perception examination methods in the Swedish surveillance system for Hand-Arm vibration syndrome

“…15 The use of 2PD has been questioned 5,21 but has also been reported to provide valuable information. 22 A recent study by Tekavec et al concludes that diminished perception of touch and vibrotactile perception are the most common clinical findings in vibration exposed carpenters and painters. 22 In this study, all four SEMs are used in conjunction, as described in the National guidelines, with the alternation that vibrotactile perception was examined with the more advanced Vibrosense equipment instead of tuning fork.…”

“…22 A recent study by Tekavec et al concludes that diminished perception of touch and vibrotactile perception are the most common clinical findings in vibration exposed carpenters and painters. 22 In this study, all four SEMs are used in conjunction, as described in the National guidelines, with the alternation that vibrotactile perception was examined with the more advanced Vibrosense equipment instead of tuning fork. Rolke et al found that a 64 Hz tuning fork was the most sensitive instrument to detect sensory loss in HAVS in comparison with monofilament and cold and warm detection thresholds in a population of mainly lumberjacks.…”

“…As for comparing the different SEMs to each other in terms of importance for diagnosis, a study on HAVS by McGeoch et al gave a coefficient of 1.30 for 2PD compared to 1.13 for a temperature neutral zone test, which is very similar to the Rolltemp, indicating a that 2PD is of greater importance than Rolltemp 15 . The use of 2PD has been questioned 5,21 but has also been reported to provide valuable information 22 . A recent study by Tekavec et al concludes that diminished perception of touch and vibrotactile perception are the most common clinical findings in vibration exposed carpenters and painters 22 .…”