Centre for Workplace Health, Health and Safety Executive, Harpur Hill, Buxton, SK17 9JN, UK.
Analysis and Data Group, Health and Safety Executive, Harpur Hill, Buxton, SK17 9JN, UK.
Int Arch Occup Environ Health. 2020 Aug;93(6):723-731. doi: 10.1007/s00420-020-01523-8. Epub 2020 Feb 20.
To determine if heavy manual work affects sensory perception in the digits and whether Semmes-Weinstein monofilaments (SWM) can be used as a screening tool to detect sensory neuropathy in the digits of workers exposed to hand-transmitted vibration (HTV).
A cross-sectional study of office workers, heavy manual workers not exposed to HTV and workers with hand-arm vibration syndrome (HAVS). Sensory perception was measured in the digits by SWM using a forced-choice method to determine variability by sex, age, hand and digit. Frequency distributions were used to determine limit values and linear weighted kappa for intra-digit variability. Poisson regression was used to explore the relationship between sensory perception by SWM and abnormalities of thermal and vibration perception in the hands of workers with HAVS.
The sensory perception threshold of office workers did not vary by hand or digit. It was significantly lower in women < 30 than women aged ≥ 30 years. The 95th percentile for heavy manual workers was 1.00 (95% CI 0.60-1.00) and significantly higher than for office workers at 0.16 (95% CI 0.16-0.16). Heavy manual workers > 50 years had the highest threshold at 1.40 (95% CI 1.00-2.00). Weighted kappa for reliability was 0.63 (95% CI 0.53-0.70). A mean SWM threshold of ≥ 1.0 gram-force had a 79% sensitivity and 64% specificity for detecting abnormalities of thermal and vibration perception in the ipsilateral index and little fingers of workers with HAVS.
SWM are a useful screening tool for detecting sensory loss in the digits of workers exposed to HTV.
确定重体力劳动是否会影响手指的感觉知觉，以及 Semmes-Weinstein 单丝（SWM）是否可用于作为一种筛查工具，以检测接触手部传振（HTV）的工人的手指感觉神经病变。
对办公室工作人员、未接触 HTV 的重体力劳动者以及手部手臂振动综合征（HAVS）工人进行横断面研究。使用 SWM 通过强迫选择法测量手指的感觉知觉，以确定性别、年龄、手和手指的变异性。使用频率分布确定限值和线性加权 kappa 用于评估手指内的变异性。使用泊松回归探讨 SWM 感觉知觉与 HAVS 工人手部热觉和振动觉异常之间的关系。
办公室工作人员的感觉知觉阈值不受手或手指的影响。女性<30 岁的阈值显著低于年龄≥30 岁的女性。重体力劳动者的第 95 百分位数为 1.00（95%CI 0.60-1.00），明显高于办公室工作人员的 0.16（95%CI 0.16-0.16）。年龄>50 岁的重体力劳动者的阈值最高为 1.40（95%CI 1.00-2.00）。可靠性的加权 kappa 为 0.63（95%CI 0.53-0.70）。SWM 阈值均值≥1.0 克力对检测 HAVS 工人同侧食指和小指的热觉和振动觉异常具有 79%的敏感性和 64%的特异性。
SWM 是一种有用的筛查工具，可用于检测接触 HTV 的工人手指的感觉丧失。
