Abstract
BackgroundIncreased occurrence of Raynaud’s phenomenon, neurosensory injury and carpal tunnel syndrome has been reported for more than 100 years in association with work with vibrating machines. The current risk prediction modelling (ISO-5349) for “Raynaud’s phenomenon” is based on a few studies published 70 to 40 years ago. There are no corresponding risk prediction models for neurosensory injury or carpal tunnel syndrome, nor any systematic reviews comprising a statistical synthesis (meta-analysis) of the evidence.ObjectivesOur aim was to provide a systematic review of the literature on the association between Raynaud’s phenomenon, neurosensory injuries and carpal tunnel syndrome and hand-arm vibration (HAV) exposure. Moreover the aim was to estimate the magnitude of such an association using meta-analysis.MethodsThis systematic review covers the scientific literature up to January 2016. The databases used for the literature search were PubMed and Science Direct. We found a total of 4,335 abstracts, which were read and whose validity was assessed according to pre-established criteria. 294 articles were examined in their entirety to determine whether each article met the inclusion criteria. The possible risk of bias was assessed for each article. 52 articles finally met the pre-established criteria for inclusion in the systematic review.ResultsThe results show that workers who are exposed to HAV have an increased risk of vascular and neurological diseases compared to non-vibration exposed groups. The crude estimate of the risk increase is approximately 4–5 fold. The estimated effect size (odds ratio) is 6.9 for the studies of Raynaud’s phenomenon when including only the studies judged to have a low risk of bias. The corresponding risk of neurosensory injury is 7.4 and the equivalent of carpal tunnel syndrome is 2.9.ConclusionAt equal exposures, neurosensory injury occurs with a 3-time factor shorter latency than Raynaud’s phenomenon. Which is why preventive measures should address this vibration health hazard with greater attention.
Highlights
Extensive and prolonged exposure to manual work involving the use of vibrating power tools can lead to a number of adverse health effects, primarily in the peripheral neurological, vascular and musculoskeletal systems [1, 2]
We found a total of 4,335 abstracts, which were read and whose validity was assessed according to pre-established criteria. 294 articles were examined in their entirety to determine whether each article met the inclusion criteria
The results show that workers who are exposed to hand-arm vibration (HAV) have an increased risk of vascular and neurological diseases compared to non-vibration exposed groups
Summary
Extensive and prolonged exposure to manual work involving the use of vibrating power tools can lead to a number of adverse health effects, primarily in the peripheral neurological, vascular and musculoskeletal systems [1, 2]. The vascular component of HAVS represents an increased tendency to vasospasm in the digital capillaries, and is manifested by the appearance of “white finger” (Raynaud’s Phenomenon). The neurological component includes both a diffuse peripheral neurosensory injury and an entrapment of the median nerve at the wrist, entailing a symptom complex covered by the carpal tunnel syndrome (CTS) concept. In both neurosensory cases, symptoms of disturbed neural function include positive, negative and provokable manifestations [3]. Increased occurrence of Raynaud’s phenomenon, neurosensory injury and carpal tunnel syndrome has been reported for more than 100 years in association with work with vibrating machines. There are no corresponding risk prediction models for neurosensory injury or carpal tunnel syndrome, nor any systematic reviews comprising a statistical synthesis (meta-analysis) of the evidence
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