Keep Vibrations to a Minimum to Prevent Certain CTS

Sarasota, FL (WorkersCompensation.com) – Work-related carpal tunnel syndrome (CTS) is a leading cause of disability. Understanding the particular cause of a worker’s CTS can be crucial to ensure appropriate treatment is provided. CTS caused by hand-arm vibrations (HAV) can be addressed more effectively when the proper diagnosis is made early, according to a new study.

“CTS associated with HAV exposure causes chronic disability and results in less improvement than in CTS of other etiologies,” according to researchers. “For the development of preventive measures, it is therefore important to further understand the relation between CTS and HAV.”

A study of thousands of workers in Sweden sheds new light on HAV-related CTS. The findings, published in the Journal of Occupational and Environmental Medicine, stress the importance of measures to protect HAV-exposed workers.

The Study

Hand-held power tools and equipment are prevalent in a number of industries. Chainsaws, ratchet screwdrivers, concrete breakers, and hand-held grinders are among the many devices that can put workers at increased risk of developing HAV-related injuries. In addition to ‘white fingers’ and HAV syndrome, CTS has also been associated with HAV exposure. However, ergonomic factors – such as static load, power grip and unfavorable hand posture – may also contribute to CTS.

Researchers seeking to distinguish between ergonomic factors and HAV for CTS analyzed data on nearly 9,000 Swedish workers for the period 2005 to 2016. Roughly half the cases had diagnoses of CTS while the control group did not.

“The individual’s occupations and employment time were then linked to a Swedish job-exposure matrix (JEM) with timespecific estimates of HAV exposure for different occupational codes,” the authors explained. “Based on the length of employment of each occupation, HAV exposure before time of diagnosis was calculated according to the JEM for each individual.”

HAV-exposed workers had a higher risk for CTS, especially high-exposed males, the researchers found. The findings also revealed different risk levels among males and females according to their ages.

“The result shows an increased risk in most age groups except among younger women,” according to the study. “The highest risk was among males, especially in males below 30 years of age although the number of cases and controls were few. In women above 30 years of age there is a significant increased risk, which indicates that HAV also increases the risk of CTS in women, though lower than for males.”

A high proportion of women with CTS did not have vibration exposure. The researchers said that suggests other risk factors may be more important among women than men. They also said men with HAV exposure may have a high grip force, which increases the risk for CTS.

“These findings underline the importance of treating HAV exposure as a distinct risk factor to have in mind during clinical consultations, in particular when younger men present clinical signs of CTS,” the study said.

Interventions

HAV occurs when vibration is transmitted from a work process to the employee’s hands and arms. There are a number of ways employers can help prevent or mitigate injuries from HAV. While OSHA does not have a specific vibration standard, the agency offers a number of recommendations, including:

• Maintain vibrating tools in proper working order
• Arrange tasks so vibrating and non-vibrating tool use can be alternated
• Limit the number of hours a worker uses a vibrating tool and allow employees to take 10-to-15 minute breaks from tool use every hour
• Train workers about the hazards of working with vibrating tools, including the sources of vibration exposure, early signs and symptoms of HAV Syndrome and work practices for minimizing vibration exposure
• Instruct workers to keep their hands warm and dry and to not grip a vibrating tool too tightly; instead, allowing the tool or machine to do the work
• Routinely assess the degree of vibration emitted from a device, as this can change with the age of the tool
• Consider using vibration monitors that can track worker exposures to vibrations

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