The clinical consequence of using less than four sensory perception examination methods in the Swedish surveillance system for Hand-Arm vibration syndrome

Objectives The Swedish surveillance system aiming to reveal undetected Hand-Arm Vibration Syndrome (HAVS) in workers exposed for vibrations is regulated by the provision AFS 2019:3. The goal for the surveillance system is to diagnose HAVS, as well as to find workers at risk for developing HAVS due to other conditions. The national guidelines stipulate examination using at least two out of four hand sensory examination methods (SEM); monofilament (touch), two-point discrimination (discriminative), tuning fork (vibrotactile), and Rolltemp (thermotactile). The aim of this study was to examine the clinical consequence of using less than four of these SEMs. Methods We collected data on SEMs from the medical records of all individuals that went through the specific surveillance medical check-up in a large occupational health service for 1 year. We then calculated the number of workers found with HAVS when using one, two, or three SEMs, and compared with the result from using all available SEMs. Results Out of 677 examined individuals, 199 had positive findings in at least one SEM. The detection rate for these findings was on average 47% when using one SEM, 71% using two SEMs, and 88% using three SEMs (out of 100% detection when all four SEMs were used). Conclusions If fewer than four sensory examination methods are used for surveillance of HAVS, many workers with incipient injuries may stay undetected. This may lead to further exposure resulting in aggravation of injury.

Automated summary

The aim of this study was to examine the clinical consequence of using less than four sensory examination methods for Hand-Arm Vibration Syndrome (HAVS) surveillance. The study found that if fewer than four sensory examination methods are used, many workers with incipient injuries may stay undetected.