Diagnostics of hand-arm system disorders in workers who use vibrating tools.

Abstract

A hand-arm vibration syndrome occurs in some workers who use hand held vibrating tools. It is recognised to consist of white fingers, diffusely distributed finger neuropathy, pain in the arm and hand, and a small excess risk of osteoarthrosis from percussion to the wrist and elbow. Carpal tunnel syndrome is mainly due to ergonomic factors other than vibration, but certain factors related to vibration may contribute to its development. A decrease in muscle power induced by vibration, and excessive hearing deficit have been postulated. (Occup Environ Med 1997;54:90-95)

Relation between vibrotactile perception thresholds and reductions in finger blood flow induced by vibration of the hand at frequencies in the range 8–250 Hz

“…It is not yet understood why vibration affects digital circulation or which mechanisms are involved in the dis-regulation of circulation. A common explanation has been that a central sympathetic reflex to vibration alters finger blood flow (Gemne, 1994;Bovenzi et al, 2006).…”

Carpal Tunnel Syndrome: Under-recognition of Occupational Risk Factors by Clinicians

“…It is associated with a marked symptomatology resulting from entrapment of the median nerve at the wrist, and can have serious occupational and economic implications. Works involving repetitive wrist and arm movements and jobs requiring strong grip, use of vibrating tools, and working in a cold environment are all known risk factors for CTS [1][2][3] . The burden of occupation-related CTS is substantial 4,5) , in particular among those employed in high-risk occupations such as the food industry, postal workers, and health care personnel.…”

Vascular and nerve damage in workers exposed to vibrating tools. The importance of objective measurements of exposure time

“…frequency, intensity, duration and direction of the vibrations, grip force, working posture as well as the large biological variation among individuals (Gemne 1997 Overestimations are more common in studies of workers using tools with a predominantly low-frequency percussive action, e.g. road breakers, rock drills and stone hammers (Bovenzi 1998).…”

“…Objective measurements of the vibration exposure and estimations of the vibration dose will facilitate risk assessment and increase the possibilities for preventive actions. Other factors of importance in this context are the risk of underestimating the effect due to diagnostic uncertainties, the biological variation and the healthy worker effect (Gemne 1997). …”

“…Exposure to vibrating tools may cause a variety of symptoms depicted as the hand-arm vibration syndrome (HAVS; Gemne 1997, Bovenzi 1998. The symptoms may be of vascular, neural, and muscular origin and may appear as digital vasospasm (vibration white fingers; VWF; Bovenzi et al 1995), sensorineural disturbances, and/or as muscular weakness and fatigue (Pyykkö 1986, Gemne 1997.…”