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Occupational Medicine Advance Access originally published online on May 12, 2005
Occupational Medicine 2005 55(5):389-392; doi:10.1093/occmed/kqi076
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H. Mason, Health & Safety Laboratory © Crown Copyright 2005. Reproduced with the permission of the Controller of Her Majesty's Stationery Office.

Upper limb disability in HAVS cases—how does it relate to the neurosensory or vascular elements of HAVS?

H. J. Mason, K. Poole and J. Elms

Health & Safety Laboratory, Broad Lane, Sheffield S3 7HQ, UK

Aims Hand–arm vibration syndrome (HAVS) consists of vascular, neurosensory and musculoskeletal components, characterized by symptoms that include Raynaud's phenomenon, tingling and numbness in the hands. However, there has been little published data on the effects of HAVS on the capability to carry out normal daily tasks. We have investigated the application of the widely-used disability, arm, shoulder and hand (DASH) disability questionnaire that reflects functionality problems in the upper extremities, as well as symptoms, in a HAVS cohort.

Methods The cohort consisted of 118 males who, as a part of their health surveillance, had been referred for further assessment and Stockholm workshop staging. This process involved medical interview, physical examination and quantitative tests covering neurosensory function, manual dexterity and handgrip strength.

Results The relationship between DASH outcome metric and a combination of quantitative tests reflecting a range of abnormalities found in HAVS, supports the validity of this questionnaire in HAVS studies. The data suggest that HAVS cases have a greater level of upper extremity disability compared with a general population. The study confirms that disability in HAVS is very largely related to sensorineural Stockholm workshop staging, rather than vascular staging. Any influence of vibration-induced Raynaud's phenomenon on upper extremity disability is related to the frequency of blanching attacks rather than their extent across the digits.

Conclusion This study strengthens the importance of identifying and preventing the exacerbation of the neurosenory component of HAVS, that unlike the blanching attacks of the vascular component does not have such an obvious pathognomic signal.

Keywords      DASH questionnaire; disability; hand–arm vibration syndrome

Correspondence to: H. J. Mason, Health & Safety Laboratory, Broad Lane, Sheffield S3 7HQ, UK. Email: howard.mason{at}hsl.gov.uk


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