![]() ![]() 15 Furthermore, a prolonged latency time has been observed for CTS segments in nerve conduction for HAV and manual workers compered to office workers. 14 In HAV-exposed workers, sensory nerve conduction was reduced compared to heavy manual workers and controls, which suggests that HAV exposure is a separate contributing exposure for peripheral nerve disorder. 2, 13 The mechanism according to which HAV causes CTS is not fully understood, though biopsies from exposed workers show structural damage to nerves and oedema formation. 3, 13 In research, the coexisting ergonomic factors from hand-held tools are therefore difficult to differentiate from HAV. 1 However, exposure to HAV is also associated with concomitant exposure to various ergonomic factors such as static load, power grip, and unfavorable hand posture, which themselves increase the risk of CTS. ![]() Increased prevalence of CTS is reported in vibration-exposed workers as compared to unexposed workers, with an increased risk of OR 2.93 (95% CI 1.74–4.95). 12 For the development of preventive measures, it is therefore important to further understand the relation between CTS and HAV. 3, 4 CTS associated with HAV exposure causes chronic disability and result in less improvement after surgical treatment than in CTS of other etiologies. 3, 4, 10, 11 Occupational factors such as flexion, extension of the wrist, high grip force, repetitive work, and vibrating tools are also risk factors for CTS. In the majority of cases the cause of CTS is unknown, but risk factors include previous wrist fracture, female gender, rheumatoid arthritis or osteoarthritis of the wrist, pregnancy, genetic predisposition, obesity, diabetes, hypothyroidism, and monotonous wrist activity. 7 CTS is an important contributor to work disability and is important to prevent. 3, 4, 6 Nerve conduction examination of the median nerve is often used to confirm the diagnosis prior to any treatment such as wrist brace, steroid injection, or surgery. 4, 5 Clinically, CTS is often diagnosed with provoking tests, such as Tinel's test (percussion on palmar side) and Phalen's test (flexion of the wrist), which may induce symptoms or decrease vibro-tactile sense. 3, 4 Symptoms of CTS are neurological symptoms from the median nerve innervated area with numbness and tingling during the night or when the wrist is flexed. 1, 2 HAV exposure is also associated with carpal tunnel syndrome (CTS).ĬTS is one of the most common peripheral entrapments and is caused by compression of the median nerve passing the carpal tunnel in the wrist. 1 Vibration white fingers (Raynaud's phenomena caused by HAV exposure) and vibration neuropathy are well known symptoms of HAV. Hand-arm vibration (HAV) is a global work-related exposure that can cause different injuries. ![]() Summarize the findings on worker characteristics associated with HAV-related CTS risk. ![]()
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