Top

International Archives of Occupational and Environmental Health

Published in:

01-04-2008 | Original Article

Thermal perception thresholds among young adults exposed to hand-transmitted vibration

Authors: T. Nilsson, L. Burström, M. Hagberg, R. Lundström

Published in: International Archives of Occupational and Environmental Health | Issue 5/2008

Abstract

Introduction

Quantitative sensory testing assesses non-invasively the function of the sensory pathways from receptors to cortex. Studies of workers exposed to vibration support evidence that neuro-sensory hand-arm vibration syndrome also encompasses neuropathy of the small-diameter nerve fibres.

Objectives

To assess the risk of disturbed thermal perception developing among young adults exposed to vibration and hand-intensive manual work. The aim also encompasses the study of alternative covariates in small-diameter nerve fibre neuropathy assessment.

Methods

This cross-sectional multi-centre study comprised 202 males and females from vocational school programs in auto mechanics, construction and catering. The testing included a baseline questionnaire, a clinical examination focusing on upper extremity disorders and quantitative somatosensory testing. Thermal perception thresholds were assessed, on both hands, second and fifth digits, using a modified Marstock method for warmth and cold.

Results

Reduced thermal perception sensitivity was found for digit II compared to digit V, for females compared to males, and between the two study centres. Subjects exposed to vibration at work showed reduced sensitivity to temperature compared to non-vibration exposed. In univariate analyses odds ratios of 1.06 (95% CI 1.006–1.118) and 1.02 (95% CI 0.971–1.078) for reduced perception to cold for the right and left hands, respectively, was found for vibration. This association was lost in multivariate analyses. The study centre was the strongest confounding influence.

Conclusions

Sensitivity to temperature appears to be reduced despite the subjects short exposure-time and low exposure to vibration. The effect is small in relation to other confounding factors. A low agreement between the modalities indicates the need for separate tests for cold and warmth. Hand-side, age, stature, and BMI were not important for thermal perception but study centre, gender and choice of digit were. Conventional electro-diagnostic investigations are inadequate for evaluating the status of the small-fibre afferent systems leaving QST of thermal perception as the preferred diagnostic tool.

Bartlett G, Stewart JD, Tamblyn R, Abrahamowicz M (1998) Normal distributions of thermal and vibration sensory thresholds. Muscle Nerve 21(3):367–374PubMedCrossRef

Bird SJ, Brown MJ, Spino C, Watling S, Foyt HL (2006) Value of repeated measures of nerve conduction and quantitative sensory testing in a diabetic neuropathy trial. Muscle Nerve 34(2):214–224PubMedCrossRef

Bovenzi M, Zadini A, Franzinelli A, Maiorano M, Mancini R (1992) Sensorineural disorders in forestry workers using chain saws. In: 6th International conference on hand arm vibration. BG, Bonn

Chong PS, Cros DP (2004) Technology literature review: quantitative sensory testing. Muscle Nerve 29(5):734–747PubMedCrossRef

Claus D, Hilz MJ, Hummer I, Neundorfer B (1987) Methods of measurement of thermal thresholds. Acta Neurol Scand 76(4):288–296PubMedCrossRef

Concato J, Feinstein AR, Holford TR (1993) The risk of determining risk with multivariable models. Ann Intern Med 118(3):201–210PubMed

Doeland HJ, Nauta JJ, van Zandbergen JB, van der Eerden HA, van Diemen NG, Bertelsmann FW, Heimans JJ (1989) The relationship of cold and warmth cutaneous sensation to age and gender. Muscle Nerve 12(9):712–715PubMedCrossRef

Ekenvall L, Gemne G, Tegner R (1989) Correspondence between neurological symptoms and outcome of quantitative sensory testing in the hand-arm vibration syndrome. Br J Ind Med 46(8):570–574PubMed

Ekenvall L, Lindblad LE, Carlsson A, Etzell BM (1988) Afferent and efferent nerve injury in vibration white fingers. J Auton Nerv Syst 24(3):261–266PubMedCrossRef

Ekenvall L, Nilsson BY, Falconer C (1990) Sensory perception in the hands of dentists. Scand J Work Environ Health 16(5):334–339PubMed

Ekenvall L, Nilsson BY, Gustavsson P (1986) Temperature and vibration thresholds in vibration syndrome. Br J Ind Med 43(12):825–829PubMed

England JD, Asbury AK (2004) Peripheral neuropathy. Lancet 363(9427):2151–2161PubMedCrossRef

Fruhstorfer H, Lindblom U, Schmidt WC (1976) Method for quantitative estimation of thermal thresholds in patients. J Neurol Neurosurg Psychiatry 39(11):1071–1075PubMed

Gelber DA, Pfeifer MA, Broadstone VL, Munster EW, Peterson M, Arezzo JC, Shamoon H, Zeidler A, Clements R, Greene DA et al (1995) Components of variance for vibratory and thermal threshold testing in normal and diabetic subjects. J Diabetes Complications 9(3):170–176PubMedCrossRef

Gerr F, Letz R (1994) Covariates of human peripheral nerve function: II. Vibrotactile and thermal thresholds. Neurotoxicol Teratol 16(1):105–112PubMedCrossRef

Golja P, Kacin A, Tipton MJ, Eiken O, Mekjavic IB (2004) Hypoxia increases the cutaneous threshold for the sensation of cold. Eur J Appl Physiol 92(1–2):62–68PubMedCrossRef

Golja P, Tipton MJ, Mekjavic IB (2003) Cutaneous thermal thresholds—the reproducibility of their measurements and the effect of gender. J Therm Bio 28:341–346CrossRef

Hagander LG, Midani HA, Kuskowski MA, Parry GJ (2000) Quantitative sensory testing: effect of site and pressure on vibration thresholds. Clin Neurophysiol 111(6):1066–1069PubMedCrossRef

Hansson P (1994) Possibilities and pitfalls of combined bedside and quantitative somatosensory analysis in pain patients, In: Boivie J et al (eds) Touch, temperature and pain in health and disease, IASP, Seattle, pp 113–132

Hilz MJ, Glorius S, Beric A (1995) Thermal perception thresholds: influence of determination paradigm and reference temperature. J Neurol Sci 129(2):135–140PubMedCrossRef

Hilz MJ, Stemper B, Axelrod FB, Kolodny EH, Neundorfer B (1999) Quantitative thermal perception testing in adults. J Clin Neurophysiol 16(5):462–471PubMedCrossRef

Hirosawa I (1983) Original construction of thermo-esthesiometer and its application to vibration disease. Int Arch Occup Environ Health 52(3):209–214PubMedCrossRef

Hirosawa I, Watanabe S, Fukuchi Y, Nishiyama K, Hosokawa M (1983) Availability of temperature sense indices for diagnosis of vibration disease. Int Arch Occup Environ Health 52(3):215–222PubMedCrossRef

Kelly KG, Cook T, Backonja MM (2005) Pain ratings at the thresholds are necessary for interpretation of quantitative sensory testing. Muscle Nerve 32(2):179–184PubMedCrossRef

Kojo I, Pertovaara A (1987) The effects of stimulus area and adaptation temperature on warm and heat pain thresholds in man. Int J Neurosci 32:875–880PubMedCrossRef

Lang PM, Schober GM, Rolke R, Wagner S, Hilge R, Offenbacher M, Treede RD, Hoffmann U, Irnich D (2006) Sensory neuropathy and signs of central sensitization in patients with peripheral arterial disease. Pain 124:190–200PubMedCrossRef

Lin YH, Hsieh SC, Chao CC, Chang YC, Hsieh ST (2005) Influence of aging on thermal and vibratory thresholds of quantitative sensory testing. J Peripher Nerv Syst 10(3):269–281PubMedCrossRef

Lindsell CJ, Griffin MJ (1999) Thermal thresholds, vibrotactile thresholds and finger systolic blood pressures in dockyard workers exposed to hand-transmitted vibration. Int Arch Occup Environ Health 72(6):377–386PubMedCrossRef

Liou JT, Lui PW, Lo YL, Liou L, Wang SS, Yuan HB, Chan KH, Lee TY (1999) Normative data of quantitative thermal and vibratory thresholds in normal subjects in Taiwan: gender and age effect. Zhonghua Yi Xue Za Zhi (Taipei) 62(7):431–437

Lundborg G (2004) Nerve injury and repair regeneration, reconstruction, and cortical remodeling, 2nd edn. Elsiever Churchill Livingstone, Philadelphia

Maeda S, Sakakibara H (2002) Thermotactile perception thresholds measurement conditions. Ind Health 40(4):353–361PubMedCrossRef

Magda P, Latov N, Renard MV, Sander HW (2002) Quantitative sensory testing: high sensitivity in small fiber neuropathy with normal NCS/EMG. J Peripher Nerv Syst 7(4):225–228PubMedCrossRef

McGeoch KL, Gilmour WH (2000) Cross sectional study of a workforce exposed to hand-arm vibration: with objective tests and the Stockholm workshop scales. Occup Environ Med 57(1):35–42PubMedCrossRef

Meh D, Denislic M (1994) Quantitative assessment of thermal and pain sensitivity. J Neurol Sci 127(2):164–169PubMedCrossRef

Miscio G, Guastamacchia G, Brunani A, Priano L, Baudo S, Mauro A (2005) Obesity and peripheral neuropathy risk: a dangerous liaison. J Peripher Nerv Syst 10(4):354–358PubMedCrossRef

Nilsson T, Lundstrom R (2001) Quantitative thermal perception thresholds relative to exposure to vibration. Occup Environ Med 58(7):472–478PubMedCrossRef

Rolke R, Baron R, Maier C, Tolle TR, Treede RD, Beyer A, Binder A, Birbaumer N, Birklein F, Botefur IC, Braune S, Flor H, Huge V, Klug R, Landwehrmeyer GB, Magerl W, Maihofner C, Rolko C, Schaub C, Scherens A, Sprenger T, Valet M, Wasserka B (2006a) Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): standardized protocol and reference values. Pain 123(3):231–243PubMed

Rolke R, Magerl W, Campbell KA, Schalber C, Caspari S, Birklein F, Treede RD (2006b) Quantitative sensory testing: a comprehensive protocol for clinical trials. Eur J Pain 10(1):77–88PubMedCrossRef

Sakakibara H, Maeda S, Yonekawa Y (2002) Thermotactile threshold testing for the evaluation of sensory nerve function in vibration-exposed patients and workers. Int Arch Occup Environ Health 75(1–2):90–96PubMed

Sanden H, Edblom M, Hagberg M, Wallin BG (2005) Bicycle ergometer test to obtain adequate skin temperature when measuring nerve conduction velocity. Clin Neurophysiol 116(1):25–27PubMedCrossRef

Sarlani E, Farooq N, Greenspan JD (2003) Gender and laterality differences in thermosensation throughout the perceptible range. Pain 106(1–2):9–18PubMedCrossRef

Shukla G, Bhatia M, Behari M (2005) Quantitative thermal sensory testing—value of testing for both cold and warm sensation detection in evaluation of small fiber neuropathy. Clin Neurol Neurosurg 107(6):486–490PubMedCrossRef

Shy ME, Frohman EM, So YT, Arezzo JC, Cornblath DR, Giuliani MJ, Kincaid JC, Ochoa JL, Parry GJ, Weimer LH (2003) Quantitative sensory testing: report of the therapeutics and technology assessment subcommittee of the American Academy of Neurology. Neurology 60(6):898–904PubMedCrossRef

Söderberg K, Sundström I Poromaa, Nyberg S, Bäckström T, Nordh E (2006) Psychophysically determined thresholds for thermal perception and pain perception in healthy women across the menstrual cycle. Clin J Pain 22(7):610–616PubMedCrossRef

Susser E, Sprecher E, Yarnitsky D (1999) Paradoxical heat sensation in healthy subjects: peripherally conducted by A delta or C fibres? Brain 122(Pt 2):239–246PubMedCrossRef

Taylor W, Ogston SA, Brammer AJ (1986) A clinical assessment of seventy-eight cases of hand-arm vibration syndrome. Scand J Work Environ Health 12(4 Spec No):265–268PubMed

Toibana N, Sakakibara H, Hirata M, Kondo T, Toyoshima H (2000) Thermal perception threshold testing for the evaluation of small sensory nerve fiber injury in patients with hand-arm vibration syndrome. Ind Health 38(4):366–371PubMedCrossRef

Virokannas H, Virokannas A (1995) Temparature and vibration perception thresholds in workers exposed to hand-arm vibration. Cent Eur J Public Health 3(Suppl):66–69PubMed

Yarnitsky D, Sprecher E (1994) Thermal testing: normative data and repeatability for various test algorithms. J Neurol Sci 125(1):39–45PubMedCrossRef

Zamyslowska-Szmytke E (1998) Efficacy of vibration, electric current and thermal perception tests in diagnosis of hand-arm vibration syndrome. Int J Occup Med Environ Health 11(3):247–254PubMed

Zaslansky R, Yarnitsky D (1998) Clinical applications of quantitative sensory testing (QST). J Neurol Sci 153(2):215–238PubMedCrossRef

Title: Thermal perception thresholds among young adults exposed to hand-transmitted vibration
Authors: T. Nilsson
L. Burström
M. Hagberg
R. Lundström
Publication date: 01-04-2008
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 5/2008
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-007-0258-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Thermal perception thresholds among young adults exposed to hand-transmitted vibration

Abstract

Introduction

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2008

Syndromes from segmental vibration and nerve entrapment: observations on case definitions for carpal tunnel syndrome

Grading of sensorineural disturbances according to a modified Stockholm workshop scale using self-reports and QST

New understanding of the diagnosis of injuries caused by hand-transmitted vibration

Normal values for thermotactile and vibrotactile thresholds in males and females

Normal values for finger systolic blood pressures in males and females

Musculoskeletal symptoms among young male workers and associations with exposure to hand–arm vibration and ergonomic stressors