Occupational Medicine Advance Access originally published online on March 4, 2009
Occupational Medicine 2009 59(3):167-173; doi:10.1093/occmed/kqp016
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Published by Oxford University Press on behalf of the Society of Occupational Medicine 2009.
Upper extremity disability in workers with hand–arm vibration syndrome
1 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
2 Department of Occupational and Environmental Health, St Michael's Hospital, Toronto, Ontario, Canada
3 Department of Rehabilitation Sciences, University of Toronto, Toronto, Ontario, Canada
4 Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE, USA
Background Hand–arm vibration syndrome (HAVS) is a common occupational problem and it is important to understand the disability associated with this condition.
Aims To measure upper extremity disability using the disabilities of the arm, shoulder and hand (DASH) questionnaire in workers with HAVS and to determine how this disability is affected by the vascular and neurological components of HAVS and other factors, in particular musculoskeletal variables.
Methods Subjects were recruited from HAVS patients assessed at St Michael's Hospital, Toronto, Canada, over a 2-year period. All participants were assessed by an occupational medicine specialist to determine the specific components of HAVS and musculoskeletal variables including upper extremity pain score measured by the Borg scale. The DASH questionnaire was completed on the same day as the clinical assessment and before any feedback had been given about the clinical findings.
Results A total of 141 workers with HAVS were recruited and 139 agreed to participate in the study. This study group had a statistically significantly higher mean DASH score than the US population (P < 0.001). The multiple linear regression analysis indicated that upper extremity pain score (P < 0.001), the Stockholm sensorineural scale (P < 0.01) and the number of fingers blanching (P < 0.05) had a statistically significant association with an increase in the DASH score. The highest partial R2 value was for the upper extremity pain score.
Conclusions Workers with HAVS have significant upper extremity disability and musculoskeletal factors appear to make an important contribution to this disability.
Keywords DASH questionnaire; disability; hand–arm vibration; HAVS; musculoskeletal
Correspondence to: Ron House, Department of Occupational and Environmental Health, St Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Tel: +1 416 864 5074; fax: +1 416 864 5421; e-mail: houser{at}smh.toronto.on.ca