Sensorineural stages of the hand-arm vibration syndrome.

Brammer, Anthony J.; Taylor, W.; Lundborg, Göran

doi:10.5271/sjweh.2050

Cited by 183 publications

(77 citation statements)

References 13 publications

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“…With current practice, the disability of an employee is only roughly reflected in the widely used methods of staging the hand-arm vibration syndrome (the Stockholm vascular scale and the Stockholm sensorineural stage [1,3]), and other methods may be appropriate [8]. If it were concluded that suitable precautionary measures (especially health surveillance) could have restricted the disease to a lower stage on an appropriate scale, the apportionment of responsibility would be based on the difference between a compensation award appropriate to the higher stage (as experienced by the employee) and an award appropriate to the lower stage (to which the disease should have been restricted).…”

Section: Methods A: Negligence Based On Severity Of Diseasementioning

confidence: 99%

Negligent exposures to hand-transmitted vibration

Griffin

2007

Int Arch Occup Environ Health

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Objectives: If the negligence of an employer results in the disability in an employee, the employer is responsible, in whole or in part, for the disability. The employer is wholly responsible when the worker would not have developed the disability if the employer had taken all reasonable preventative measures. The employer is only partly responsible if the worker would probably have developed some disability even if the employer had taken all reasonable precautions. The employer's responsibility may be estimated from the difference between the actual disability of the worker and the disability that the worker would have suffered if the employer had taken all reasonable preventative measures. This paper considers alternative ways of apportioning negligent and non-negligent exposures to hand-transmitted vibration.Results: The equivalent daily vibration exposure, A(8), used in current EU Directives is shown to be unsuitable for distinguishing between the consequences of negligent and non-negligent exposures because the risks of developing a disorder from hand-transmitted vibration also depend on the years of exposure. Furthermore, daily exposures take no account of individual susceptibility or the practicality of reducing exposure. The consequences of employer negligence may be estimated from the delay in the onset and progression of disorder that would have been achieved if the employer had acted reasonably, such as by reducing vibration magnitude and exposure duration to the minimum that was reasonably achievable in the circumstances. This seems to be fair and reasonable for both employers and employees and indicates the consequences of negligence -the period of the worker's life with disease as a result of negligence and the period for which their employment opportunities may be restricted as a result of the onset of the disorder due to negligence. Conclusions:The effects of negligence may be estimated from the delay in the onset of disease or disability that would have occurred if the employer had behaved reasonably. This definition of negligence encourages employers to reduce risks to the lowest reasonably practical level, consistent with EU Directives.

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Section: Methods A: Negligence Based On Severity Of Diseasementioning

confidence: 99%

Negligent exposures to hand-transmitted vibration

Griffin

2007

Int Arch Occup Environ Health

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“…In Japan, a stage classification for peripheral vascular disorders and peripheral nervous disorders was proposed [11]. In 1987, a separation of the vascular and neurological effects in the system of Taylor et al was proposed in the classification of vibration-induced white finger according to the 'Stockholm vascular staging system' [4] and the classification of the neurological effects of handtransmitted vibration according to the 'Stockholm sensorineural staging system' [2].…”

Section: Staging Systemsmentioning

confidence: 99%

“…There are various neurological disorders but, because they not clearly classified, their extent and form are poorly reported and poorly understood. Like vibration-induced white finger, there are staging systems for categorising so-called sensorineural disorders caused by hand-transmitted vibration (e.g., [2]). …”

Section: Introductionmentioning

confidence: 99%

Measurement, evaluation, and assessment of peripheral neurological disorders caused by hand-transmitted vibration

Griffin

2007

Int Arch Occup Environ Health

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Regular exposure to hand-transmitted vibration can result in symptoms and signs of peripheral vascular, neurological and other disorders collectively known as the handarm vibration syndrome. The measurement of the effects of hand-transmitted vibration involves converting the evidence of disorder (symptoms and signs) into information that can be stored. Evaluation requires the use of scales on which to indicate the severity of the various symptoms and signs. Assessment involves a judgement of severity relative to a criterion, usually for a specific purpose (e.g. to decide on removal from work or compensation). The measurement and evaluation of symptoms and signs is necessary when monitoring patient health and when performing epidemiological studies for research. The assessment of the severity of the hand-arm vibration syndrome is currently performed with staging systems, but the criteria are not clear and not related to defined methods for measuring or evaluating the symptoms and signs. Recognising that similar symptoms can occur without injury from occupational exposures to hand-transmitted vibration, this paper attempts to define significant peripheral neurological symptoms caused by hand-transmitted vibration (i.e. 'unusual symptoms') and how these symptoms and related signs may be measured. Scales for evaluating the symptoms (e.g. their extent) and the related signs (e.g. their probability relative to the probability of the sign being present in persons not exposed to vibration) are defined. A method of relating unusual symptoms to both the signs of disorder and the pattern of vibration exposure is illustrated. Assessments of severity will vary according to the reasons for assessing the health effects of vibration, and will depend on local practice and convenience, but a way of combining evaluations of symptoms and signs is demonstrated in a staging system. Although inherently complex, the methods may assist the collection of data required to improve understanding of the effects of hand-transmitted vibration and also support a more complete reporting of the condition in those adversely affected by hand-transmitted vibration.

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“…The syndrome includes sensorineural, vasospastic, and neuromuscular symptoms, and the disease seems to have a progressive course with continued long-term use of vibrating tools (1,2). After vibration-exposure has ceased, symptoms may be reversed, persist, or even progress (3,4).…”

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confidence: 99%

Vibrotactile sense in the hand-arm vibration syndrome

Strömberg¹,

Dahlin²,

Lundborg³

1998

Scand J Work Environ Health

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Stromberg T, Dahlin LB, Lundborg G. Vibrotactile sense in the hand-arm vibration syndrome. Scand J Work Environ Health 1998;24(6): 495-502. Objectives The pulyose of this study was to investigate disturbances of the vibrotactile sense and their relation to clinical symptoms and findings among male symptomatic workers suffering froin the hand-arm vibration syndrome. MethodsNinety-six such patients were interviewed and given a clinical and tactilo~netric examination. The symptoms were classified according to the Stockholm Workshop Scale. A sensibility index was used to quantify vibrotactile sense in the tactilogram.Results An abnormal sensibility index (<0.8) was recorded for 57.3% of the patients (mean of 4 fingers), at least 1 finger being ab~lormal in 72.9% of the patients. The sensibility index did not statistically differ between the patients suffering from sensorineural symptoms and those with vibration white finger. The stages of sensorineural symptoms, accordi~lg to the Stockholm Workshop Scale, corresponded with the sensibility index, whereas the stages of vibration white finger did not. There were significant differences in the sensibility index between the fingers, between the right and left hands, and between the fingers inllervated by the ulnar and median nerves. Bilateral symptoms and cold intolerance were associated with considerable impairment of the vibrotactile sense. Clinical median nerve involvement in the carpal tunnel was not reflected by the sensibility index. C O~C~U S~O~SThere is a considerable degree of neural involvement in all symptomatic vibration-exposed patients irrespective of symptoms. As symptoms progress, the severity of sensorineural symptoms, but not of vibration white finger, is reflected by the sensibility index. Cold intolerance is strongly related to nervous involvement and should be noted in the patient history. Tactilometry should be performed on 1 median and 1 ulnar nerve-innervated finger of both hands, as an examination of 1 finger alone may be misleading.

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Sensorineural stages of the hand-arm vibration syndrome.

Cited by 183 publications

References 13 publications

Negligent exposures to hand-transmitted vibration

Negligent exposures to hand-transmitted vibration

Measurement, evaluation, and assessment of peripheral neurological disorders caused by hand-transmitted vibration

Vibrotactile sense in the hand-arm vibration syndrome

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