Raynaud’s phenomenon in Northern Sweden: a population-based nested case–control study

Stjernbrandt, Albin; Pettersson, Hans; Liljelind, Ingrid; Nilsson, Tohr; Wahlström, Jens

doi:10.1007/s00296-018-4133-y

Cited by 15 publications

(18 citation statements)

References 32 publications

(34 reference statements)

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“…The increased prevalence of neurosensory symptoms in ngers among carpenters is well in line with the results from a previous questionnaire survey in the UK in 1997 of over 1000 men of working age [15]. Neural symptoms were found to dominate over vascular symptoms, which is also in agreement with previous studies [11,34,35]. Increased sensation of cold, which may be an important indication of vibration injury [36], was more common among carpenters than among painters.…”

Section: Neural Manifestationssupporting

confidence: 90%

“…Cold sensitivity/cold intolerance/cold hypersensitivity is de ned as abnormal aversion to cold with pain, sensory alterations, stiffness and/or colour change, but with no observable vasospasm. Pain in the ngers/hands when cold was reported among 24% of the carpenters, while the prevalence among painters (8%) was in agreement with that in the general population (5-15%) [34]. Concerning the clinical ndings, we found no statistically signi cant differences between carpenter and painters, although the ORs were high for impaired 2PD and VPT in the carpenters.…”

Section: Neural Manifestationssupporting

confidence: 76%

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

Tekavec¹,

Löfqvist

Larsson

et al. 2020

Preprint

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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.

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Section: Neural Manifestationssupporting

confidence: 90%

Section: Neural Manifestationssupporting

confidence: 76%

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

Tekavec¹,

Löfqvist

Larsson

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…The increased prevalence of neurosensory symptoms in fingers among carpenters is well in line with the results from a previous questionnaire survey in the UK in 1997 of over 1000 men of working age [15]. Neural symptoms were found to dominate over vascular symptoms, which is also in agreement with previous studies [11,34,35]. Increased sensation of cold, which may be an important indication of vibration injury [36], was more common among carpenters than among painters.…”

Section: Carpenters Versus Painters Neural Manifestationssupporting

confidence: 90%

Adverse health manifestations in the hands of vibration exposed carpenters - a cross sectional study

Tekavec

Löfqvist

Larsson

et al. 2021

J Occup Med Toxicol

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Background Despite EU regulatory standards, many workers suffer injury as a result of working with hand-held vibrating tools. Our aim of this study was to confirm whether carpenters, a highly exposed group, suffer more injuries to their hands than painters, a group assumed to be less exposed to vibration. Methods 193 carpenters (participation rate 100%) and 72 painters (participation rate 67%), all men, answered a questionnaire and underwent a clinical examination to identify manifestations of neural and vascular origin in the 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). Results Neurosensory 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. Conclusions Carpenters 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 under current conditions workers at these companies 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.

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“…This response may be altered following hand trauma or nerve compression 15 . Nerve injury, including amputation, in the upper extremity is associated with Raynaud's phenomenon and cold sensitivity 16 . Patients with a previous hand trauma reported that cold sensitivity negatively impacted their daily life 17 , but it improved over time 18 .…”

Section: Discussionmentioning

confidence: 99%

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

Zimmerman

Nyman

Dahlin

2020

Sci Rep

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Cold sensitivity is common following nerve injuries in the upper extremity, but is less well studied in carpal tunnel syndrome (CTS). We investigated cold sensitivity in CTS and its effects on surgical outcome. A search of the Swedish National Registry for Hand Surgery (HAKIR) for open carpal tunnel releases (OCTR) from 2010-2016 identified 10,746 cases. Symptom severity questionnaires (HQ-8; HAKIR questionnaire 8, eight Likert-scale items scored 0-100, one item on cold sensitivity) and QuickDASH scores before and after surgery were collected. Patient mean age was 56 ± SD 16 years, and 7,150/10,746 (67%) were women. Patients with severe cold sensitivity (defined as cold intolerance symptom severity score > 70; n = 951), scored significantly higher on QuickDASH at all time points compared to those with mild cold sensitivity (cold intolerance symptom severity scores ≤ 30, n = 1,532); preoperatively 64 [50-75] vs. 40 [25-55], at three months 32 [14-52] vs. 18 [9-32] and at 12 months 25 [7-50] vs. 9 [2-23]; all p < 0.0001. Severe cold sensitivity predicted higher postoperative QuickDASH scores at three [12.9 points (95% CI 10.2-15.6; p < 0.0001)] and at 12 months [14.8 points (11.3-18.4; p < 0.0001)] compared to mild cold sensitivity, and adjustment for a concomitant condition in the hand/arm, including ulnar nerve compression, did not influence the results. Cold sensitivity improves after OCTR. A higher preoperative degree of cold sensitivity is associated with more preoperative and postoperative disability and symptoms than a lower degree of cold sensitivity, but with the same improvement in QuickDASH score. Cold sensitivity is a disabling symptom that often presents after hand injuries, particularly those involving peripheral nerves in the upper extremity. It is also common, but often overlooked, in nerve compression syndromes. Cold sensitivity is defined as an abnormal response to cold, with symptoms such as numbness, pain, stiffness, weakness, and sometimes changes in colour 1. Cold sensitivity has also been associated with poorer sensory function following nerve compression 2 , and with reduced quality of life 3. In cases of nerve compression syndromes in the upper extremity, earlier studies have described cold sensitivity as occurring more commonly in patients with diabetes and in women 4. Cold sensitivity largely resolves following open carpal tunnel release (OCTR), but may persist longer in patients with diabetes than in those without 5. The population numbers in previous studies on cold sensitivity in nerve compression syndromes were limited. The impact of cold sensitivity on surgical outcome has not yet been completely clarified 5,6. Hence, our aim was to investigate the occurrence of cold sensitivity in carpal tunnel syndrome (CTS) both pre-and post-operatively, and its effects on the surgical outcome of OCTR.

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Raynaud’s phenomenon in Northern Sweden: a population-based nested case–control study

Cited by 15 publications

References 32 publications

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

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

Adverse health manifestations in the hands of vibration exposed carpenters - a cross sectional study

Occurrence of cold sensitivity in carpal tunnel syndrome and its effects on surgical outcome following open carpal tunnel release

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