N. Cock et al., Can a battery of functional and sensory tests corroborate the sensorineural complaints of subjects working with vibrating tools?, INT A OCCUP, 73(5), 2000, pp. 316-322
Citations number
27
Categorie Soggetti
Envirnomentale Medicine & Public Health","Pharmacology & Toxicology
Journal title
INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH
Objectives: The objective of the present paper is to study the relationship
between the early sensorineural symptoms, classified according to the Stoc
kholm scale, and the results of the main functional and sensory tests descr
ibed in the literature, in subjects working with vibrating tools, Methods:
Three groups of male workers were selected from industry: one group (69 sub
jects) exposed to hand-arm vibration in several workplaces, one group (62)
pel forming heavy and repetitive hand and arm work but without exposure to
vibration, and one control group (46) performing light and non-repetitive t
asks without vibration. All the workers were interviewed by questionnaire,
about their personal characteristics, their health status, their actual and
past working conditions and the episodes of tingling at the level of the f
ingers. From these reported symptoms, the sensorineural stage of the hand-a
rm vibration was determined using the Stockholm scale. Based on the review
of the literature, we selected six functional and sensory tests: maximum vo
luntary grip force, maximum angles of the wrist, pressure perception thresh
old test, vibration perception threshold test, distal sensory latency and t
he Purdue Pegboard test. Each test was performed by the workers in the thre
e groups. Results: No main differences were observed between the personal c
haracteristics of the three groups. According to the Stockholm scale, the s
ensorineural symptoms were mainly at stage SN1, with 9% at stage SN2 and no
ne at stage SN3. These symptoms are associated with exposure to vibration,
and had a prevalence of 40% in group 1, versus 20% in the two other groups.
Furthermore, 25% of the workers exposed to vibration complained of symptom
s at least once a week, compared with only 2% in the other groups. The mult
ivariate logistic regression analysis showed an association between the exi
stence of symptoms and a decrease in the maximum flexion angle of the wrist
and an increase in the pressure perception threshold. This association, ho
wever, was too low to determine limit values with a sensitivity and specifi
city sufficiently high to make a reliable diagnosis. Conclusions: The senso
rineural symptoms at stage N1 on the Stockholm scale, experienced occasiona
lly by some 40% of the users of vibrating tools, could not be corroborated
by the functional and sensory tests.