Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 1997 Dec;54(12):880–887. doi: 10.1136/oem.54.12.880

Vibrotactile sense and hand symptoms in blue collar workers in a manufacturing industry.

B T Flodmark 1, G Lundborg 1
PMCID: PMC1128969  PMID: 9470896

Abstract

OBJECTIVES: To study whether vibrotactile sense combined with questionnaires (subjective complaints) and a clinical examination (including scoring of the Stockholm workshop scale (sensorineural staging)) could serve as a screening procedure, in the health care service, for sensorineural symptoms. A group of blue collar workers exposed to vibration in a manufacturing industry (rock crushing plants) was used as the study group. Another group of workers not exposed to vibration but subjected to heavy manual work served as the control group. METHODS: Vibrotactile sense was determined. The index and the little fingers of both hands were investigated. A clinical examination was performed. Questionnaires were used for exposure data and for assessment of symptoms. RESULTS: Important findings were that impairment in vibrotactile sense correlated with impairment in grip force, cold sensitivity, and other sensorineural symptoms--such as numbness and tendency to drop items. Clinical findings such as Phalen's test and two point discrimination were related only in those workers with the poorest vibrotactile sense. There was a relation between vibrotactile sense and the Stockholm workshop scale (sensorineural staging) for the sensorineural symptoms. Muscle and joint problems were more often seen in workers with decreased vibrotactile sense. CONCLUSIONS: Tactilometry for assessment of vibrotactile sense is a useful tool in assessing and evaluating the severity of vibration induced neuromuscular symptoms and verifying the patients' clinical complaints. Heavy manual work without exposure to vibration may contribute to impairment of vibrotactile sense. The relation between impairment in vibrotactile sense and grip strength indicates that impaired sensory feedback may contribute to muscle weakness.

Full text

PDF
880

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Akesson I., Lundborg G., Horstmann V., Skerfving S. Neuropathy in female dental personnel exposed to high frequency vibrations. Occup Environ Med. 1995 Feb;52(2):116–123. doi: 10.1136/oem.52.2.116. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Armstrong T. J., Buckle P., Fine L. J., Hagberg M., Jonsson B., Kilbom A., Kuorinka I. A., Silverstein B. A., Sjogaard G., Viikari-Juntura E. R. A conceptual model for work-related neck and upper-limb musculoskeletal disorders. Scand J Work Environ Health. 1993 Apr;19(2):73–84. doi: 10.5271/sjweh.1494. [DOI] [PubMed] [Google Scholar]
  3. Arrighi H. M., Hertz-Picciotto I. The evolving concept of the healthy worker survivor effect. Epidemiology. 1994 Mar;5(2):189–196. doi: 10.1097/00001648-199403000-00009. [DOI] [PubMed] [Google Scholar]
  4. Brammer A. J., Piercy J. E., Auger P. L., Nohara S. Tactile perception in hands occupationally exposed to vibration. J Hand Surg Am. 1987 Sep;12(5 Pt 2):870–875. doi: 10.1016/s0363-5023(87)80252-6. [DOI] [PubMed] [Google Scholar]
  5. Brammer A. J., Pyykkö I. Vibration-induced neuropathy. Detection by nerve conduction measurements. Scand J Work Environ Health. 1987 Aug;13(4):317–322. doi: 10.5271/sjweh.2052. [DOI] [PubMed] [Google Scholar]
  6. Brammer A. J., Taylor W., Lundborg G. Sensorineural stages of the hand-arm vibration syndrome. Scand J Work Environ Health. 1987 Aug;13(4):279–283. doi: 10.5271/sjweh.2050. [DOI] [PubMed] [Google Scholar]
  7. Brammer A. J., Taylor W., Piercy J. E. Assessing the severity of the neurological component of the hand-arm vibration syndrome. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):428–431. doi: 10.5271/sjweh.2118. [DOI] [PubMed] [Google Scholar]
  8. Burström L. Measurements of the impedance of the hand and arm. Int Arch Occup Environ Health. 1990;62(6):431–439. doi: 10.1007/BF00379059. [DOI] [PubMed] [Google Scholar]
  9. Collier A., Patrick A. W., Bell D., Matthews D. M., MacIntyre C. C., Ewing D. J., Clarke B. F. Relationship of skin thickness to duration of diabetes, glycemic control, and diabetic complications in male IDDM patients. Diabetes Care. 1989 May;12(5):309–312. doi: 10.2337/diacare.12.5.309. [DOI] [PubMed] [Google Scholar]
  10. Coste J., Fermanian J., Venot A. Methodological and statistical problems in the construction of composite measurement scales: a survey of six medical and epidemiological journals. Stat Med. 1995 Feb 28;14(4):331–345. doi: 10.1002/sim.4780140402. [DOI] [PubMed] [Google Scholar]
  11. Ekenvall L., Lindblad L. E. Effect of tobacco use on vibration white finger disease. J Occup Med. 1989 Jan;31(1):13–16. [PubMed] [Google Scholar]
  12. Franzblau A., Werner R. A., Johnston E., Torrey S. Evaluation of current perception threshold testing as a screening procedure for carpal tunnel syndrome among industrial workers. J Occup Med. 1994 Sep;36(9):1015–1021. [PubMed] [Google Scholar]
  13. Färkkilä M., Aatola S., Starck J., Korhonen O., Pyykkö I. Hand-grip force in lumberjacks: two-year follow-up. Int Arch Occup Environ Health. 1986;58(3):203–208. doi: 10.1007/BF00432102. [DOI] [PubMed] [Google Scholar]
  14. Färkkilä M. Grip force in vibration disease. Scand J Work Environ Health. 1978 Jun;4(2):159–166. doi: 10.5271/sjweh.2713. [DOI] [PubMed] [Google Scholar]
  15. Färkkilä M., Pyykkö I., Korhonen O., Starck J. Vibration-induced decrease in the muscle force in lumberjacks. Eur J Appl Physiol Occup Physiol. 1980 Feb;43(1):1–9. doi: 10.1007/BF00421349. [DOI] [PubMed] [Google Scholar]
  16. Gemne G., Pyykkö I., Taylor W., Pelmear P. L. The Stockholm Workshop scale for the classification of cold-induced Raynaud's phenomenon in the hand-arm vibration syndrome (revision of the Taylor-Pelmear scale). Scand J Work Environ Health. 1987 Aug;13(4):275–278. doi: 10.5271/sjweh.2038. [DOI] [PubMed] [Google Scholar]
  17. Gerr F., Letz R. Vibrotactile threshold testing in occupational health: a review of current issues and limitations. Environ Res. 1993 Jan;60(1):145–159. doi: 10.1006/enrs.1993.1023. [DOI] [PubMed] [Google Scholar]
  18. Hagberg M., Morgenstern H., Kelsh M. Impact of occupations and job tasks on the prevalence of carpal tunnel syndrome. Scand J Work Environ Health. 1992 Dec;18(6):337–345. doi: 10.5271/sjweh.1564. [DOI] [PubMed] [Google Scholar]
  19. Kuorinka I., Jonsson B., Kilbom A., Vinterberg H., Biering-Sørensen F., Andersson G., Jørgensen K. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987 Sep;18(3):233–237. doi: 10.1016/0003-6870(87)90010-x. [DOI] [PubMed] [Google Scholar]
  20. Letz R., Cherniack M. G., Gerr F., Hershman D., Pace P. A cross sectional epidemiological survey of shipyard workers exposed to hand-arm vibration. Br J Ind Med. 1992 Jan;49(1):53–62. doi: 10.1136/oem.49.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lundborg G., Dahlin L. B., Lundström R., Necking L. E., Strömberg T. Vibrotactile function of the hand in compression and vibration-induced neuropathy. Sensibility index--a new measure. Scand J Plast Reconstr Surg Hand Surg. 1992;26(3):275–279. doi: 10.3109/02844319209015271. [DOI] [PubMed] [Google Scholar]
  22. Lundborg G., Lie-Stenström A. K., Sollerman C., Strömberg T., Pyykkö I. Digital vibrogram: a new diagnostic tool for sensory testing in compression neuropathy. J Hand Surg Am. 1986 Sep;11(5):693–699. doi: 10.1016/s0363-5023(86)80014-4. [DOI] [PubMed] [Google Scholar]
  23. Lundborg G., Sollerman C., Strömberg T., Pyykkö I., Rosén B. A new principle for assessing vibrotactile sense in vibration-induced neuropathy. Scand J Work Environ Health. 1987 Aug;13(4):375–379. doi: 10.5271/sjweh.2026. [DOI] [PubMed] [Google Scholar]
  24. Lundström R., Strömberg T., Lundborg G. Vibrotactile perception threshold measurements for diagnosis of sensory neuropathy. Description of a reference population. Int Arch Occup Environ Health. 1992;64(3):201–207. doi: 10.1007/BF00380910. [DOI] [PubMed] [Google Scholar]
  25. Necking L. E., Dahlin L. B., Fridén J., Lundborg G., Lundström R., Thornell L. E. Vibration-induced muscle injury. An experimental model and preliminary findings. J Hand Surg Br. 1992 Jun;17(3):270–274. doi: 10.1016/0266-7681(92)90113-g. [DOI] [PubMed] [Google Scholar]
  26. Necking L. E., Lundström R., Lundborg G., Thornell L. E., Fridén J. Skeletal muscle changes after short term vibration. Scand J Plast Reconstr Surg Hand Surg. 1996 Jun;30(2):99–103. doi: 10.3109/02844319609056390. [DOI] [PubMed] [Google Scholar]
  27. Nilsson T., Burström L., Hagberg M. Risk assessment of vibration exposure and white fingers among platers. Int Arch Occup Environ Health. 1989;61(7):473–481. doi: 10.1007/BF00386482. [DOI] [PubMed] [Google Scholar]
  28. Ohlsson K., Attewell R., Skerfving S. Self-reported symptoms in the neck and upper limbs of female assembly workers. Impact of length of employment, work pace, and selection. Scand J Work Environ Health. 1989 Feb;15(1):75–80. doi: 10.5271/sjweh.1879. [DOI] [PubMed] [Google Scholar]
  29. Okada A. Physiological response of the rat to different vibration frequencies. Scand J Work Environ Health. 1986 Aug;12(4 Spec No):362–364. doi: 10.5271/sjweh.2128. [DOI] [PubMed] [Google Scholar]
  30. Pyykkö I. Clinical aspects of the hand-arm vibration syndrome. A review. Scand J Work Environ Health. 1986 Oct;12(5):439–447. [PubMed] [Google Scholar]
  31. Strömberg T., Dahlin L. B., Lundborg G. Hand problems in 100 vibration-exposed symptomatic male workers. J Hand Surg Br. 1996 Jun;21(3):315–319. doi: 10.1016/s0266-7681(05)80192-5. [DOI] [PubMed] [Google Scholar]
  32. Weed D. L. Historical roots of the healthy worker effect. J Occup Med. 1986 May;28(5):343–347. [PubMed] [Google Scholar]
  33. Wen C. P., Tsai S. P., Gibson R. L. Anatomy of the healthy worker effect: a critical review. J Occup Med. 1983 Apr;25(4):283–289. [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES