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

Rita Bast-Pettersen,Raymond Olsen,Bente Ulvestad,Thomas Aleksander C Clemm,Dag Gunnar Ellingsen,Karl Færden,Karl-Christian Nordby

doi:10.1007/s00420-016-1175-x

Abstract

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.

Highlights

Excessive use of hand-held vibrating tools may lead to adverse health effects, including the impairment of hand function
Future research using longitudinal design is required to validate the findings of the present study
Postural tremor parameters were more strongly associated with exposure than rest tremor

Summary

Introduction

Excessive use of hand-held vibrating tools may lead to adverse health effects, including the impairment of hand function. Vibration exposure may lead to hand-arm vibration syndrome (HAVS), which is composed of vascular, neurological and muscular components (Burström et al 1998; Ye et al 2015). Typical symptoms include vasospasm of the fingers induced by cold, loss of sensitivity, tingling and paresthesia, and impaired hand function (Heaver et al 2011). Severe HAVS can lead to difficulties in performing everyday activities (Buhaug et al 2014), with lowered work ability and quality of life (Gerhardsson and Hagberg 2014; Sauni et al 2015). 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.

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