Vascular component of hand-arm vibration syndrome: a 22-year follow-up study

Abstract

BackgroundVibration-induced white finger (VWF) is often assessed using the Stockholm Workshop Scale (SWS) and cold challenge plethysmography. However, long-term longitudinal studies using both methods are scarce.AimsTo study the long-term course and prognostic factors of VWF assessed with the SWS and photoplethysmography (PPG), and to examine the effects of lifestyle on PPG score, regardless of VWF status.MethodsForty male construction workers were examined with a test battery and clinical examination in 1994 and 2016/17.ResultsAt baseline, the sample comprised 27 workers with, and 13 without, symptoms of hand-arm vibration syndrome (HAVS). Thirty-five workers reported vibration exposure during follow-up. The mean age of the workers was 60 years (45–78) at follow-up. The paired t-test showed that PPG scores deteriorated from 1994 to 2017 in the 27 workers with HAVS in 1994 (mean difference 2.7 min, 95% confidence interval (CI) 0.2–5.2). However, there was no statistically significant change in SWS scores in these workers over time. Smoking and age were associated with PPG score deterioration. Vibration exposure during follow-up predicted SWS score deterioration: 1000 h of exposure predicted a deterioration stage of 0.09 (95% CI 0.03–0.16). Analysis of all 40 workers showed that 2017 PPG scores were associated with positive serum cotinine and self-reported smoking during follow-up.ConclusionsWhereas age and smoking predicted a PPG deterioration, continued vibration exposure predicted worsening of white finger symptoms. The association of PPG score and smoking should be considered in diagnostic and prognostic factor evaluations.

Occupational risk factors for musculoskeletal disorders among railroad maintenance‐of‐way workers

“…Our cross‐sectional study design limits our ability to draw firm conclusions about causality, since exposures and outcomes were measured at the same time. However, associations between our study's work exposures and health outcomes have been shown to be causally related in prospective studies 15,38–40 …”

“…However, associations between our study's work exposures and health outcomes have been shown to be causally related in prospective studies. 15,[38][39][40] Self-report of exposures and outcomes increases the possibility of information bias. For example, it was suggested that some (Table 2), due to missing covariate, exposure and health data, only between 2334 and 2787 participants were included in each of these regression analyses.…”

Neurosensory component of hand–arm vibration syndrome: a 22-year follow-up study

“…In 1994, all employees ( n = 211) in two workshop units (sheet metal workers performing grinding/welding and machinists) of an engineering and construction company participated in a HAVS examination [4]. We used the 1994 questionnaire to select workers for the 2017 study.…”

“…The vibration measurements are described in the ISO 1309-1/2 standard. Blood samples (cotinine, carbohydrate-deficient transferrin (CDT), glycosylated haemoglobin (HbA1c) and folate) were collected during the examination in 2017, as described previously [4].…”

“…To our knowledge, there are no studies of possible prognostic factors, such as comorbidity and lifestyle factors. Previously, we examined the vascular component of HAVS [4]. This study aims to assess the course and prognostic factors of the neurosensory component.…”