Occupational Medicine Advance Access published online on April 11, 2007
Occupational Medicine, doi:10.1093/occmed/kqm012
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Nerve conduction studies and current perception thresholds in workers assessed for hand–arm vibration syndrome
1 Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
2 Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Building I, Room 1418A, Boston, MA 02115, USA
3 Occupational and Environmental Health Clinic, St Michael's Hospital, Toronto, Ontario, Canada
Background Workers exposed to hand–arm vibration are at risk of developing the neurological abnormalities of hand–arm vibration syndrome (HAVS). The Stockholm classification of the neurological component of HAVS is based on history and physical examination. There is a need to determine the association between neurological tests and the Stockholm scale.
Aims The main objective of this study was to compare the Stockholm neurological scale and the results of current perception threshold (CPT) tests and nerve conduction studies (NCS).
Methods Detailed physical examinations were done on 162 subjects referred for HAVS assessment at a specialist occupational health clinic. All subjects had NCS and measurement of CPT. The Stockholm neurological classification was carried out blinded to the results of these neurological tests and compared to the test results.
Results The nerve conduction results indicated that median and ulnar neuropathies proximal to the hand are common in workers being assessed for HAVS. Digital sensory neuropathy was found in only one worker. Neither the nerve conduction results nor the current perception results had a strong association with the Stockholm neurological scale. Exposure to vibration in total hours was the main variable associated with the Stockholm neurological scale [right hand: OR 1.30, 95% CI (1.10–1.54); left hand: OR 1.18, 95% CI (1.0–1.39)].
Conclusion Workers being assessed for HAVS should have nerve conduction testing to detect neuropathies proximal to the hand. Quantitative sensory tests such as current perception measurement are insufficient for diagnostic purposes but may have a role in screening workers exposed to vibration.
Keywords Current perception; HAVS; nerve conduction; neurological; vibration
Correspondence to: Ron House, Occupational and Environmental Health Clinic, 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
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  J. J. Katims Re: Nerve conduction studies (NCS) and current perception thresholds (CPT) in workers assessed for hand-arm vibration syndrome (HAVS) Occup. Med., March 1, 2008; 58(2): 147 - 147. [Full Text] [PDF]
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