Dose–Response Relationship Between Exposure to Hand-arm Vibration and Health Effects among Metalworkers

Sauni, Riitta; Pääkkönen, Rauno; Virtema, Pauliina; Toppila, Esko; Uitti, Jukka

doi:10.1093/annhyg/men075

Cited by 25 publications

(14 citation statements)

References 25 publications

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“…The present findings, which suggest that a doseresponse relationship exists, match the results of similar previous longitudinal studies showing evidence for a dose-response relationship between HAV exposure and neurological (sensorineural) impairment of the hand (4,20,21). However, this relationship has been unclear and has not yet been fully established (3).…”

Section: Edlund Et Alsupporting

confidence: 89%

“…The neurological symptoms of HAVS and CTS are very alike and often impossible to tell apart (4). Though it may be somewhat unspecific, it is important to investigate the impact of HAV on neurological symptoms as it appears that sensorineural symptoms or injuries are more resistant to improvement than are vascular disorders after cessation of exposure to HAV (24,25).…”

Section: Limitationsmentioning

confidence: 99%

“…Evidence for an exposure-response relationship for HAV exposure and neurological (sensorineural) symptoms is not very strong (3,4). There are few longitudinal studies investigating this relationship and most of the reported studies have been cross-sectional (5)(6)(7).…”

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confidence: 99%

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A prospective cohort study investigating an exposure–response relationship among vibration-exposed male workers with numbness of the hands

Edlund¹,

Burström²,

Gerhardsson³

et al. 2013

Scand J Work Environ Health

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A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands by Edlund M, Burström L, Gerhardsson L, Lundström R, Nilsson T, Sandén H, Hagberg M This study on hand-arm-vibration (HAV) exposed workers spanned 16 years; exposure dose was assessed for each individual; and the study may contribute to knowledge about an exposure-response relationship between neurological symptoms and HAV exposure. Furthermore, to our knowledge, there are no other studies reporting incidence of numbness in hands among HAV-exposed workers or how it affects work performance. Affiliation 203Original article Scand J Work Environ Health. 2014;40(2):203-209. doi:10.5271/sjweh.3386 A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands Objective The aim of this study was to investigate the exposure-response relationship of hand-arm vibration (HAV) exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers. MethodsThe baseline cohort comprised 241 office and manual workers with and without exposure to HAV.Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time-to-event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1. ResultsThe hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the nonexposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31 (95% CI 3.06-9.20) for groups 2 and 3, respectively. ConclusionThe results suggest a dose-response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.

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Section: Edlund Et Alsupporting

confidence: 89%

Section: Limitationsmentioning

confidence: 99%

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A prospective cohort study investigating an exposure–response relationship among vibration-exposed male workers with numbness of the hands

Edlund¹,

Burström²,

Gerhardsson³

et al. 2013

Scand J Work Environ Health

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“…Increased prevalence or excess risk for neurosensory disturbances, CTS and/or abnormal sensory testing have been reported in crosssectional studies of HTV-exposed workers carried out in several countries (19)(20)(21). Only few studies have investigated prospectively the occurrence of neurosensory disorders in HTV-exposed workers.…”

Section: Exposure-response Relationship For Vibration-induced Sensorymentioning

confidence: 99%

Relationships of neurosensory disorders and reduced work ability to alternative frequency weightings of hand-transmitted vibration

Bovenzi¹,

Prodi²,

Mauro³

2015

Scand J Work Environ Health

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“…Exposure–response relationships between vibration exposure and the vascular (Griffin et al 2003; Sauni et al 2009) and neurological (Edlund et al 2014; Sauni et al 2009) components of HAVS have been reported. The factors that may affect the risk of developing HAVS symptoms are the tools’ acceleration levels, the duration of exposure, the grip force required, the structure of the work surface, the working posture, the climatic conditions and individual susceptibility (Burström et al 2006; Griffin 1997; Ye et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Tremor and hand-arm vibration syndrome (HAVS) in road maintenance workers

Bast‐Pettersen

Ulvestad

Færden

et al. 2016

Int Arch Occup Environ Health

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ObjectivesThe aim of this study was to evaluate postural and rest tremor among workers using vibrating hand tools, taking into account the possible effects of toxicants such as alcohol and tobacco. A further aim was to study workers diagnosed with hand-arm vibration syndrome (HAVS) at the time of examination.MethodsThis study comprises 103 road maintenance workers, 55 exposed to vibrating hand tools (age 41.0 years; range 21–62) and 48 referents (age 38.5 years; range 19–64). They were examined with the CATSYS Tremor Pen®. Exposure to vibrating tools and serum biomarkers of alcohol and tobacco consumption were measured.ResultsCumulative exposure to vibrating tools was associated with increased postural (p < 0.01) and rest tremor (p < 0.05) and with a higher Center Frequency of postural tremor (p < 0.01) among smokers and users of smokeless tobacco. Rest tremor Center Frequency was higher than postural tremor frequency (p < 0.001).ConclusionsThe main findings indicate an association between cumulative exposure to hand-held vibrating tools, tremor parameters and consumption of tobacco products. The hand position is important when testing for tremor. Rest tremor had a higher Center Frequency. Postural tremor was more strongly associated with exposure than rest tremor. The finding of increased tremor among the HAVS subjects indicated that tremor might be a part of the clinical picture of a HAVS diagnosis. As with all cross-sectional studies, inferences should be made with caution when drawing conclusions about associations between exposure and possible effects. Future research using longitudinal design is required to validate the findings of the present study.

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Dose–Response Relationship Between Exposure to Hand-arm Vibration and Health Effects among Metalworkers

Cited by 25 publications

References 25 publications

A prospective cohort study investigating an exposure–response relationship among vibration-exposed male workers with numbness of the hands

A prospective cohort study investigating an exposure–response relationship among vibration-exposed male workers with numbness of the hands

Relationships of neurosensory disorders and reduced work ability to alternative frequency weightings of hand-transmitted vibration

Tremor and hand-arm vibration syndrome (HAVS) in road maintenance workers

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