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International Archives of Occupational and Environmental Health

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01.04.2008 | Original Article

Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome

verfasst von: Martin Cherniack, Anthony J. Brammer, Ronnie Lundstrom, Tim F. Morse, Greg Neely, Tohr Nilsson, Donald Peterson, Esko Toppila, Nicholas Warren, Ulysses Diva, Marc Croteau, Jeffrey Dussetschleger

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 5/2008

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Abstract

Objectives

The purpose of this paper is to assess the overlap and stability of two different case definitions of carpal tunnel syndrome CTS. The analysis considers the association between different case definitions and objective tests (sensory nerve conduction velocities, SNCVs and vibrotactile perception thresholds, TTS), and the natural history of CTS, in the context of two vibration-exposed cohorts.

Methods

Clinical CTS cases were defined in two ways: (1) by the study physician using fixed criteria, and; (2) by questionnaire and hand diagram. SNCV in median and ulnar nerves was measured for digital, transpalmar, and transcarpal segments, and conventionally as from wrist-digit. Skin temperature was assessed as a point measurement by thermistor and regionally by thermal imaging. VTTs were determined at the bilateral fingertips of the third and fifth digits using a tactometer meeting the requirements of ISO 13091-1 (ISO 2001). The subjects were cohorts of shipyard workers in 2001 and 2004, and dental hygienists in 2002 and 2004.

Results

Results are reported for 214 shipyard workers in 2001 and 135 in 2004, and for 94 dental hygienists in 2002 and 66 in 2004. In 2001, 50% of shipyard workers were diagnosed as CTS cases by at least one of the diagnostic schemes, but only 20% were positive by both criteria. Among study physician diagnosed cases, 64% were CTS negative in 2001, 76% were negative in 2004, 13% were positive in both years, 22% became negative after being positive, and 11% became positive after being negative. For only study physician diagnosed CTS did VTTs differ between cases differ and non-cases in digit 3; there was no such distinction in digit 5. The dental hygienists had little CTS.

Conclusion

Clinical case definitions of CTS based on diagrams and self-assessment, and clinical evaluation have limited overlap. Combining clinical criteria to create a more narrow or specific case definition of CTS does not appear to predict SNCV. The natural history of CTS suggests a protean disorder with considerable flux in case status over time.

Borg K, Lindblom U (1986) Increase of vibration threshold during wrist flexion in patients with carpal tunnel syndrome. Pain 26:211–219PubMedCrossRef

Bovenzi M, Giannini F, Rossi S (2000) Vibration induced multifocal neuropathy in forestry workers: electrophysiological findings in relation to vibration exposure and finger circulation. Int Arch of Occup Environ Health 73:519–527CrossRef

Brammer AJ, Pyykkö I (1987) Vibration-induced neuropathy: detection by nerve conduction measurements. Scand J Work Environ Health 13:317–322PubMed

Brammer AJ, Piercy JE (1995) Method and apparatus for identifying vibrotactile perception thresholds of nerve endings with subject inconsistency detection. U.S. Patent 5,433,211

Brammer AJ, Piercy JE (2000) Rationale for measuring vibrotactile perception at the fingertips as proposed for standardization in ISO-13091-1. Arbetslivsrapport 4:125–132

Brammer AJ, Taylor W, Lundborg G (1987) Sensorineural stages of the hand–arm vibration syndrome. Scand J Work Environ Health 13:279–283PubMed

Brismar T, Ekenvall L (1992) Nerve conduction in the hands of vibration exposed workers. Electroencephalogr Clin Neurophysiol 85(3):173–6PubMedCrossRef

Cannon LJ, Bernacki EJ, Walther SD (1981) Personal and occupational factors associated with carpal tunnel syndrome. JOM 23:255–258PubMed

Chatterjee DS, Barrwick DD, Pertrie A (1982) Exploratory electromyography in the study of vibration-induced white fingers in rock driller. Brit J Indus Med 39:89–97

Cherniack MG, Letz C, Gerr F, Brammer A, Pace P (1992) Detailed clinical assessment of neurologic function in symptomatic shipyard workers. J Indust Med 47:566-572

Cherniack M, Brammer AJ, Lundström R, Meyer J, Morse TF, Neely G, Nilsson T, Peterson D, Toppila E, Warren N, Fu RW, Bruneau H (2004a) Segmental nerve conduction velocity in vibration exposed shipyard workers. Int Arch Occup Environ Health 77(3):159–176PubMedCrossRef

Cherniack M, Morse TF, Brammer AJ, Lundström R, Meyer J, Nilsson T, Peterson D, Toppila E, Warren N, Fu RW, Bruneau H, Croteau M (2004b) Vibration exposure, workplace modification, and disease in a shipyard: a 13-year revisit. Am J Indus Med 45:500–512CrossRef

Cherniack M, Brammer AJ, Lundström R, Meyer JD, Morse T, Neeley G, Nilsson T, Peterson D, Toppila E, Warren N, Atwood-Sanders M, Michalak-Turcotte C, Abbas U, Bruneau H, Croteau M, Fu RW (2006a) Sensory deficits and motor function in dental hygienists using high frequency ultrasound handpieces. AJIM 49:313–326CrossRef

Cherniack M, Brammer AJ, Lundström R, Meyer JD, Morse TF, Neely G, Nilsson T, Peterson D, Toppila E, Warren N (2006b) The Hand–Arm Vibration International Consortium (HAVIC): prospective studies on the relationship between power tool exposure and health effects (in review)

de Zwart BCH, Broersen JPG, Frings-Dresen MHW, van Dijk FJH (1997) Repeated survey on changes in musculoskeletal complaints relative to age and work demands. Oem 54:793–799

de Zwart BC, Frings-Dresen MH, van Duivenbooden JC (1999) Senior workers in the Dutch construction industry: a search for age-related work and health issues. Exp Aging Res 25:385–391PubMedCrossRef

Fagarasanu M, Kumar S (2003) Work-related carpal tunnel syndrome: current concepts. J Musculoskeletal Res 7:87–96CrossRef

Gemne G, Pyykkö I, Taylor W, Pelmear PL (1987) The Stockholm Workshop scale for the classification of cold-induced Raynaud’s phenomenon in the hand–arm vibration syndrome. Scand J Work Environ Health 13:275–278PubMed

Gerr F, Letz R, Harris-Abbot D, Hopkins L (1995) Sensitivity and specificity of vibrometry for detection of carpal tunnel syndrome. JOEM 37:1108–1115PubMed

Giannini F, Rossi S, Passeroa S, Bovenzi M, Cannava G, Mancini R, Cionia R, Battistini N (1999) Multifocal neural conduction impairment in forestry workers exposed and not exposed to vibration. Clin Neurophysiol 110:1276–1283PubMedCrossRef

Hirata M, Sakakibara H, Abe M (2002) Reduced sensory nerve conduction velocity of the distal part of the radial nerve among patients with vibration syndrome. Electromyogr Clin Neurophysiol 42(2):113–8PubMed

ISO 13091-1 (2001) International Organization for Standardization. Mechanical vibration—vibrotactile perception thresholds for the assessment of nerve dysfunction: Part 1—Method of measurement at the fingertips

Katz JN, Stirrat CR (1990) A self-administered hand diagram for the diagnosis of carpal tunnel syndrome. J Hand Surg (AM) 15:360–363CrossRef

Koskimies K, Farkilla M, Pyykko I, Jantti V, Aatola S, Starck J, Inaba R (1990) Carpal tunnel syndrome in vibration disease. Brit J Indus Med 47:411–416

McGeough KL, Gilmour WH (2000) Cross sectional study of a workforce exposed to hand–arm vibration: with objective tests and the Stockholm workshop scales. Occup Environ Med 57:35–42CrossRef

McGeough KL, Lawson J, Burke F, Proud G, Miles J (2005) Use of sensorineural tests in a large volume of medico-legal compensation claims for HAVS. Occup Med 54:528–534CrossRef

Nathan PA, Keniston RC, Myers LD, Meadows KD, Lockwood RS (1998) Natural history of median nerve sensory conduction in industry: relationship to symptoms and carpal tunnel syndrome in 558 hands over 11 years. Muscle Nerve 21(6):711–21PubMedCrossRef

Nathan PA, Meadows KD, Istvan JA (2002) Predictors of carpal tunnel syndrome: an 11-year study of industrial workers. J Hand Surg (Am) 27:644–651CrossRef

Nilsson T (2002) Neurological diagnosis: aspects of bedside and electrodiagnostic examinations in relation to hand–arm vibration syndrome. Int Arch Environ Health 75:55–67

Nilsson T, Hagberg M, Burstöm L, Kihlberg S (1994) Impaired nerve conduction in the carpal tunnel of platers and truck assembles exposed to hand–arm vibration. Scand J Work Environ Health 20:189–99PubMed

Padua L, Mondelli M (2005) Evaluation of hand dysfunction and symptoms in untreated carpal tunnel syndrome. Muscle Nerve 32:545–547PubMedCrossRef

Padua L, Padua R, Aprile I, Pasqualetti P, Tonali P (2001) Multiperspective follow-up of untreated carpal tunnel syndrome: a multicenter study. Neurology 56:1459–1466PubMed

Rosén I, Stromberg T, Lundborg G (1993) Neurophysiological investigation of hands damaged by vibration: comparison with idiopathic carpal tunnel syndrome. Scand J Plast Reconstr Hand Surg 27:209–16CrossRef

Sakakibara H, Kondo T, Miyao M, Yamada S (1994) Digital nerve conduction velocity as a sensitive indication of peripheral neuropathy in vibration syndrome. Am J Ind Med 26:359–366PubMedCrossRef

Sakakibara H, Hirata M, Hashiguchi T, Toibana N, Koshiyama H, Zhu S-K, Kondo T, Miyao M, Yamada S (1998) Digital sensory nerve conduction velocity and vibration perception threshold in peripheral neurological test for hand-arm vibration syndrome. AJIM 30:219–224CrossRef

Sandén H, Edblom HM, Hagberg M, Wallin BG (2005) Bicycle ergometer test to obtain adequate skin temperature when measuring nerve conduction velocity. Clin Neurophysiol 116:25–27PubMedCrossRef

Seppäläinen A-M (1972) Peripheral neuropathy in forest workers. A field study. Work Environ Health 9:106–111

Silverstein BA, Fine LJ, Armstrong TJ (1986) Hand wrist cumulative trauma disorders in industry. Br J Indus Med 43:779–784

Silverstein BA, Fine LJ, Armstrong TJ (1987) Occupational factors and carpal tunnel syndrome. Am J Ind Med 11:343–358PubMedCrossRef

Sluiter JK, Rest KM, Frings-Dresen MH (2001) Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. Scand J Work Environ Health 27(1):1–102PubMed

Strömberg T, Dahlin LB, Brun A, Lundborg G (1997) Structural nerve changes at wrist level in workers exposed to vibration. Occup Environ Med 54:307–311PubMedCrossRef

Strömberg T, Dahlin LB, Lundborg G (1998) Vibrotactile sense in the hand-arm vibration syndrome. Scand J Work Environ Health 24(6):495–502PubMed

Viikari-Juntura E, Rauas S, Martikainen R, Kuosma E, Riihimaki H, Takala E-P, Sarrenmaa K (1996) Validity of self-reported physical work load in epidemiologic studies on musculoskeletal disorders. Scand J Work Environ Health 22:251–259PubMed

Virokannas H (1992) Dose–response relation between exposure to two types of hand–arm vibration and sensorineural perception of vibration. OEM 52:332–336

Titel: Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome
verfasst von: Martin Cherniack
Anthony J. Brammer
Ronnie Lundstrom
Tim F. Morse
Greg Neely
Tohr Nilsson
Donald Peterson
Esko Toppila
Nicholas Warren
Ulysses Diva
Marc Croteau
Jeffrey Dussetschleger
Publikationsdatum: 01.04.2008
Verlag: Springer-Verlag
Erschienen in: International Archives of Occupational and Environmental Health / Ausgabe 5/2008
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-007-0268-y

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Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome

Abstract

Objectives

Methods

Results

Conclusion

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusion

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