Objectives Exposure to hand-held vibrating tools may lead to adverse health effects, including the hand-arm vibration syndrome (HAVS), which is composed of vascular, neurological and muscular components. The aim of this study was to evaluate tremor among workers who use vibrating hand tools, taking into account the possible effects of alcohol and tobacco consumption. A further aim was to study tremor parameters in workers diagnosed with HAVS at the time of the examination and to identify factors that might increase the likelihood of being diagnosed with HAVS.
Methods In this cross-sectional study 55 road maintenance workers exposed to hand-held vibrating tools (mean age 41.0 years; range 21–62 years), were compared with 48 referents (mean age 38.5 years; range 19–64 years) recruited from the same company.
Exposure to vibrating tools (cumulative root mean square (r.m.s.) acceleration), and serum biomarkers of alcohol (carbohydrate-deficient transferrin; sCDT) and tobacco consumption (cotinine and nicotine) were measured.
The CATSYS Tremor Pen® was used to measure hand tremor.
Results and conclusions Cumulative exposure to vibration was associated with increased tremor (p < 0.01) with a higher centre frequency (p < 0.01) among smokers and users of smokeless tobacco, but no such associations with cumulative exposure were found among non-users of tobacco.
Twelve workers were diagnosed with HAVS. They had higher cumulative exposure, but they had also higher concentrations of serum cotinine and nicotine than the subjects who were free of HAVS. When taking biomarkers into account, a higher cumulative exposure was non-significantly associated with the likelihood of being diagnosed with HAVS (p = 0.058).
However, the workers’ cotinine concentrations were a stronger predictor than cumulative exposure of the likelihood of being diagnosed with HAVS.
The findings of increased tremor among subjects exposed to hand-arm vibration indicate that preventive actions to reduce exposure are warranted among workers who are exposed at their present levels.
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