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Yan, Ji-Geng ; Matloub, Hani S. ; Zhang, Lin-Ling ; Sanger, James R. ; Yan, Yuhui ; ... More +
Yan, Ji-Geng ; Matloub, Hani S. ; Zhang, Lin-Ling ; Sanger, James R. ; Yan, Yuhui ; Riley, Danny A. ; Agresti, Michael ; Rowe, David ; Galaviz, Paula ; Marchant-Hanson, Judith Less -
Description:
Until now there has been controversy about which tests should be performed to diagnose early Hand-Arm Vibration Syndrome (HAVS). Initial screening questions, especially about tingling and numbness, routinely given to patients prior to examinations proved to be a very important tool in the diagnostic process1, 4. However, standardized tests that are simple, quick, valid and reliable are needed to support a diagnosis of HAVS. Purpose: To find the most valid and reliable tests to diagnose HAVS. Material and Methods Five major tests were performed on Group I and Group II. Group I: Control group of 12 volunteers including students, nurses, secretaries and physicians with no history of using vibrating tools (age 20 to 50y, mean age 38.5y; 5male, 5 female.) Group II: 12 workers (age 17 to 65y, mean age 39y; 9 male, 3 female) were sent by a local trade union with a history of using vibrating power tools on their jobs for varying amounts of time (mean 12.2y, from 0.5 to 35y.) Pre-enrollment survey showed that each had more than 4 complaints commonly associated with use of vibrating tools (including numbness, tingling, weakness, pain, finger color or nail changes, temperature change, and difficulty moving.) 1. Sensory nerve conductive tests: Amplitude and nerve conductive velocity (NCV) were evaluated. 2. Cold Stress-Temperature recovery time tests were done on the index finger of the dominant hand following these steps: Confirm water bath is within 4-5º C. Place the finger temperature probe on pad of the index finger of the dominant hand. Record temperature every 15 seconds. Place subject’s hand in the cold- water bath for exactly five minutes. Record temperature every 15 seconds for ten minutes. 3. Blood test: Venous blood was taken by a 21-gauge needle with the yellow collection tube adapter. S-ICAM, Sera Thrombomodulin, Norepinephrine levels were evaluated by Henderson Research Centre, Canada. 4. Finger Sensory Evaluation: Semmes-Weinstein monofilament test and 2-point discrimination tests were performed on bilateral fingers. 5. Digital blood pressure test: blood pressure was measured in bilateral index fingers. Results 1. Median nerve sensory conductive amplitude from palm to wrist : GI: mean 96 ± 31µm; GII: mean 43± 30µm; for dominant hands. GI vs GII: P<0.001
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NIOSH

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National Institute for Occupational Safety and Health
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urn:sha256:ac9e7d9db83e854f2915749fe92a2aff440499fc05817f49beeada21facd8391
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