| 1. |
- Edlund, Maria, 1972, et al.
(författare)
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A prospective cohort study investigating an exposure-response relationship among vibration-exposed male workers with numbness of the hands
- 2014
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Ingår i: Scandinavian Journal of Work Environment & Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 40:2, s. 203-209
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Tidskriftsartikel (refereegranskat)abstract
- Objective The aim of this study was to investigate the exposure response relationship of hand-arm vibration (HAY) exposure to neurological symptoms (numbness) of the hand in a cohort of vibration-exposed workers. Methods The baseline cohort comprised 241 office and manual workers with and without exposure to HAY. Numbness (the symptom or event) in the hand was assessed for all subjects at baseline and follow-ups after 5, 10, and 16 years. The workers were stratified into quartiles with no exposure in the first quartile and increasing intensity of exposure in quartiles 2-4 (groups 1-3). Data analysis was performed using survival analysis (time-to-event). Information on cumulative exposure and years of exposure to event was collected via questionnaires. Measurements were performed in accordance with the International Organization for Standardization (ISO) 5349-1. Results The hazard ratio (HR) of risk of event (numbness) differed statistically significantly between the non-exposed group (group 0) and the two higher exposure groups (groups 2 and 3). There was also a significant ratio difference between the lowest exposure group (group 1) and the two higher groups. The ratio for group 1 was 1.77 [95% confidence interval (95% CI) 0.96-3.26] compared with 3.78 (95% CI 2.15-6.62) and 5.31(95% CI 3.06-9.20) for groups 2 and 3, respectively. Conclusion The results suggest a dose response relationship between vibration exposure and numbness of the hands. This underlines the importance of keeping vibration levels low to prevent neurological injury to the hands.
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| 2. |
- Edlund, Maria, 1972, et al.
(författare)
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Physical capacity and psychological mood in association with self-reported work ability in vibration-exposed patients with hand symptoms.
- 2012
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Ingår i: Journal of occupational medicine and toxicology (London, England). - : Springer Science and Business Media LLC. - 1745-6673. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: The aim of this study was to investigate whether self-reports of work ability correlated to the results of quantitative tests measuring physical capacity and a questionnaire assessing psychological mood in vibration-exposed patients with hand symptoms. METHODS: The participants comprised 47 patients (36 men and eleven women) with exposure to hand vibration and vascular and/or neurological symptoms in the hands. They performed several quantitative tests (manual dexterity, hand grip strength, finger strength) and completed the Work Ability Index (WAI) and Hospital Anxiety and Depression Scale (HADS) questionnaires. RESULTS: Correlation analysis revealed statistically significant associations between the WAI results, the HADS indices, hand grip and finger strength, and manual dexterity measured using the Purdue Pegboard(R). Multiple regression analysis revealed age and HADS indices as the strongest predictors of work ability. CONCLUSIONS: The patient's age and psychological mood may be stronger predictors of work ability compared with results from tests measuring physical capacity of the hands in vibration-exposed patients with hand symptoms. When using the WAI as an instrument for assessing work ability in these patients, health care providers need to be more aware of the impact of the psychological mood.
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| 3. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Cerebrospinal fluid/plasma quotients of essential and non-essential metals in patients with Alzheimer's disease.
- 2011
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Ingår i: Journal of neural transmission (Vienna, Austria : 1996). - : Springer Science and Business Media LLC. - 1435-1463 .- 0300-9564. ; 118:6, s. 957-62
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Tidskriftsartikel (refereegranskat)abstract
- In this study, the quotients (Q) between metal concentrations in cerebrospinal fluid (CSF) and plasma were studied in subjects with Alzheimer's disease (AD) and referents to investigate if the leakage through the blood-CSF barrier (BCB) increased with increased duration and severity of the disease. Concentrations of 18 metals (Mg, Ca, Mn, Fe, Co, Ni, Cu, Zn, Se, Rb, Sr, Mo, Cd, Sn, Sb, Cs, Hg, and Pb) were determined by ICP-MS in plasma and cerebrospinal fluid in 264 patients with AD, and in 54 healthy referents. The quotients Q (Mn), Q (Rb), Q (Sb), Q (Pb) and Q (Hg) were significantly lower (p≤0.003) and Q (Co) significantly higher (p≤0.001) in subjects with AD as compared with the controls. Subjects in a subgroup with more severe AD, showed the same pattern. The metal leakage into CSF did not increase with increased duration and/or severity of the disease. The permeability of BCB varied considerably between the studied metals with low median quotients (Q≤0.02) for Cd, Cu, Sb, Se and Zn and higher median quotients for Ca (Q~0.5) and Mg (Q~1.3), probably partly depending on differences in size and lipophilicity of metal-carrier complexes and specific carrier mechanisms.
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| 4. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Metal concentrations in blood and hair in pregnant females in southern Sweden.
- 2010
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Ingår i: Journal of environmental health. - 0022-0892. ; 72:6, s. 37-41
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Tidskriftsartikel (refereegranskat)abstract
- The study described here was comprised of 100 pregnant females from two prenatal care units at the cities of Hassleholm and Simrishamn in southern Sweden. It included a questionnaire as well as whole blood (total mercury, cadmium, and lead) and hair (total mercury) sampling (collection period 2002-2003). The median values of total mercury (B-Hg 0.70 microg/L; range 0.27-2.1 microg/L), cadmium (0.30 microg/L, 0.05-4.8 microg/L) and lead (11.0 microg/L, 4.2-79 microg/L) in whole blood were low in the total material, as were the hair mercury concentrations (Hair-Hg 0.22 microg/g, 0.04-0.83 microg/g). In a multiple linear regression model, B-Hg was related to the number of fish meals per week and to the number of occlusal amalgam fillings (multiple r = 0.51; p < .001). The levels of mercury, cadmium, and lead in whole blood were lower than suggested biological reference intervals, and did not indicate risks for adverse health effects.
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| 5. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Neurophysiologic symptoms and vibration perception thresholds in young vibration-exposed workers - a follow-up study
- 2011
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Ingår i: Canadian Acoustics, June 2011. Proceedings of The Twelfth International Conference on Hand-Arm Vibration.. - 0711-6659 .- 2291-1391. ; 39:2, s. 16-17
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Tidskriftsartikel (refereegranskat)abstract
- Vibration exposure may cause the hand-arm vibration syndrome (HAVS), including digital vasospasms (vibration white fingers; VWF), sensorineural symptoms and/or muscular weakness and fatigue (Gemne, 1997). Neurophysiologic symptoms include numbness and/or tingling, impaired touch sensitivity, impaired manual dexterity and reduced grip strength in the hands. The Stockholm Workshop Scale is commonly used for sensorineural (SN) staging (OSN - 3 SN). Sensorineural symptoms of this in combination with difficulties in handling small objects may interfere both with the workers social- and work-related activities (Sakakibara et al., 2005).
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| 6. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Noise disturbances in daycare centers before and after acoustical treatment.
- 2013
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Ingår i: Journal of environmental health. - 0022-0892. ; 75:7, s. 36-40
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Tidskriftsartikel (refereegranskat)abstract
- The authors' aim was to study noise-related problems in personnel at Swedish daycare centers. The authors' study comprised staff (N = 81) who completed a questionnaire (noise, illumination, indoor climate, hearing problems) at five daycare centers with noise problems. After basic and activity sound measurements, absorbers were attached to the ceilings and to two adjacent walls in the playing and dining rooms. Thereafter, basic and activity sound measures were repeated and the questionnaire was also repeated six months later. The acoustical treatment reduced the sound pressure levels by 2 to 6 dB in the playing rooms and by 0 to 3 dB in the dining rooms. The reverberation time was reduced by 20% to 50%. After the treatment the perceived noise disturbance level decreased slightly but not significantly and the proportion of the staff who often or very often planned the daily activities to reduce the noise level had decreased from about 39% to 25%. Similarly, the percentage that often or very often had a need for silence after work had decreased from 42% to 37%.
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| 7. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Quantitative neurosensory findings, symptoms and signs in young vibration exposed workers.
- 2013
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Ingår i: Journal of occupational medicine and toxicology (London, England). - : Springer Science and Business Media LLC. - 1745-6673. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Background: Long-term exposure to hand-held vibrating tools may cause the hand arm vibration syndrome (HAVS) including vibration induced white fingers and sensorineural symptoms. The aim was to study early neurosensory effects by quantitative vibrotactile and monofilament tests in young workers with hand-held vibration exposure. Methods: This cross-sectional study consisted of 142 young, male machine shop and construction workers with hand-held exposure to vibrating tools. They were compared with 41 non-vibration exposed subjects of the same age-group. All participants passed a structured interview, answered several questionnaires and had a physical examination including the determination of vibrotactile perception thresholds (VPTs) at two frequencies (31.5 and 125 Hz) and Semmes Weinstein ’ s Monofilament test. Results: In the vibration exposed group 8% of the workers reported episodes of tingling sensations and 10% numbness in their fingers. Approximately 5 – 10% of the exposed population displayed abnormal results on monofilament tests. The vibrotactile testing showed significantly increased VPTs for 125 Hz in dig II bilaterally (right hand, p = 0.01; left hand, p = 0.024) in the vibration exposed group. A multiple regression analysis (VPT - dependent variable; age, height, examiner and five different vibration dose calculations – predictor variables) in dig II bilaterally showed rather low R 2 -values. None of the explanatory variables including five separately calculated vibration doses were included in the models, neither for the total vibration exposed group, nor for the highest exposed quartile. A logistic multiple regression analysis (result of monofilament testing - dependent variable; age, height, examiner and five vibration dose calculations – predictor variables) of the results of monofilament testing in dig II bilaterally gave a similar outcome. None of the independent variables including five calculated vibration doses were included in the models neither for the total exposed group nor for the highest exposed quartile. Conclusion: In spite of the fairly short vibration exposure, a tendency to raised VPTs as well as pathologic monofilament test results was observed. Thus, early neurophysiologic symptoms and signs of vibration exposure may appear after short-term exposure also in young workers.
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| 8. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Test-retest reliability of neurophysiological tests of hand-arm vibration syndrome in vibration exposed workers and unexposed referents
- 2014
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Ingår i: Journal of Occupational Medicine and Toxicology. - : Springer Science and Business Media LLC. - 1745-6673. ; 9:38
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Tidskriftsartikel (refereegranskat)abstract
- Background: Exposure to hand-held vibrating tools may cause the hand-arm vibration syndrome (HAVS). The aim was to study the test-retest reliability of hand and muscle strength tests, and tests for the determination of thermal and vibration perception thresholds, which are used when investigating signs of neuropathy in vibration exposed workers. Methods: In this study, 47 vibration exposed workers who had been investigated at the department of Occupational and Environmental Medicine in Gothenburg were compared with a randomized sample of 18 unexposed subjects from the general population of the city of Gothenburg. All participants passed a structured interview, answered several questionnaires and had a physical examination including hand and finger muscle strength tests, determination of vibrotactile (VPT) and thermal perception thresholds (TPT). Two weeks later, 23 workers and referents, selected in a randomized manner, were called back for the same test-procedures for the evaluation of test-retest reliability. Results: The test-retest reliability after a two week interval expressed as limits of agreement (LOA; Bland-Altman), intra-class correlation coefficients (ICC) and Pearson correlation coefficients was excellent for tests with the Baseline hand grip, Pinch-grip and 3-Chuck grip among the exposed workers and referents (N = 23: percentage of differences within LOA 91 - 100%; ICC-values >= 0.93; Pearson r >= 0.93). The test-retest reliability was also excellent (percentage of differences within LOA 96-100 %) for the determination of vibration perception thresholds in digits 2 and 5 bilaterally as well as for temperature perception thresholds in digits 2 and 5, bilaterally (percentage of differences within LOA 91 - 96%). For ICC and Pearson r the results for vibration perception thresholds were good for digit 2, left hand and for digit 5, bilaterally (ICC >= 0.84; r >= 0.85), and lower (ICC = 0.59; r = 0.59) for digit 2, right hand. For the latter two indices the test-retest reliability for the determination of temperature thresholds was lower and showed more varying results. Conclusion: The strong test-retest reliability for hand and muscle strength tests as well as for the determination of VPTs makes these procedures useful for diagnostic purposes and follow-up studies in vibration exposed workers.
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| 9. |
- Gerhardsson, Lars, 1952, et al.
(författare)
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Work ability in vibration-exposed workers.
- 2014
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Ingår i: Occupational medicine (Oxford, England). - : Oxford University Press (OUP). - 1471-8405 .- 0962-7480. ; 64:8, s. 629-634
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Tidskriftsartikel (refereegranskat)abstract
- Hand-arm vibration exposure may cause hand-arm vibration syndrome (HAVS) including sensorineural disturbances.
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