{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T13:06:27Z","timestamp":1754399187359,"version":"3.37.3"},"reference-count":34,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100002706","name":"AFA F\u00f6rs\u00e4kring","doi-asserted-by":"publisher","award":["170124"],"award-info":[{"award-number":["170124"]}],"id":[{"id":"10.13039\/501100002706","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Occupational exposure to vibration using hand-held tools may cause hand-arm vibration syndrome (HAVS). Correct diagnosis and grading of severity are crucial in protecting the individual\u2019s health and for workers\u2019 compensation claims. The International Consensus Criteria (ICC) has been suggested to replace the widely used Stockholm Workshop Scale (SWS). The aims were to, in a clinical setting, assess the concordance between the SWS and the ICC neurosensory severity grading of vibration injury, and to present the clinical picture according to symptoms, type of affected nerve fibres and the relation between vascular and neurosensory manifestations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were collected from questionnaires, clinical examination and exposure assessment of 92 patients with HAVS. The severity of neurosensory manifestations was classified according to both scales. The prevalence of symptoms and findings was compared across groups of patients with increasing severity according to the SWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Classification with the ICC resulted in a shift towards lower grades of severity than with the SWS due to a systematic difference between the scales. Affected sensory units with small nerve fibres were far more prevalent than affected units with large nerve fibres. The most prevalent symptoms were numbness (91%) and cold intolerance (86%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using the ICC resulted in lower grades of the severity of HAVS. This should be taken into consideration when giving medical advice and approving workers\u2019 compensation. Clinical examinations should be performed to detect affected sensory units with both small and large nerve fibres and more attention should be paid to cold intolerance.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2023-108914","type":"journal-article","created":{"date-parts":[[2023,5,16]],"date-time":"2023-05-16T17:50:24Z","timestamp":1684259424000},"page":"418-424","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Concordance between the Stockholm Workshop Scale and the International Consensus Criteria for grading the severity of neurosensory manifestations in hand-arm vibration syndrome in a Swedish clinical setting"],"prefix":"10.1136","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1246-8471","authenticated-orcid":false,"given":"Eva","family":"Tekavec","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tohr","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jakob","family":"Riddar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-8337","authenticated-orcid":false,"given":"Anna","family":"Axmon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3640-7086","authenticated-orcid":false,"given":"Catarina","family":"Nordander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,5,16]]},"reference":[{"key":"2023061405450708000_80.7.418.1","doi-asserted-by":"crossref","unstructured":"Nilsson T , Wahlstr\u00f6m J , Burstr\u00f6m L . Hand-Arm vibration and the risk of vascular and neurological diseases-A systematic review and meta-analysis. PLoS One 2017;12:e0180795. doi:10.1371\/journal.pone.0180795","DOI":"10.1371\/journal.pone.0180795"},{"key":"2023061405450708000_80.7.418.2","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1093\/occmed\/kqab071","article-title":"Cold intolerance and hand-arm vibration syndrome","volume":"72","author":"Cooke","year":"2022","journal-title":"Occupational Medicine"},{"key":"2023061405450708000_80.7.418.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(02)00728-9"},{"key":"2023061405450708000_80.7.418.4","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1093\/occmed\/kqy097","article-title":"Functional limitations in workers with hand-arm vibration syndrome (HAVS)","volume":"68","author":"Budd","year":"2018","journal-title":"Occup Med (Chic Ill)"},{"key":"2023061405450708000_80.7.418.5","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.2050"},{"key":"2023061405450708000_80.7.418.6","doi-asserted-by":"crossref","unstructured":"Taylor W , Pelmear PL , James PB . Vibration-Induced white finger. BMJ 1971;3:583. doi:10.1136\/bmj.3.5774.583-b","DOI":"10.1136\/bmj.3.5774.583-b"},{"key":"2023061405450708000_80.7.418.7","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.2038"},{"key":"2023061405450708000_80.7.418.8","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqm076"},{"key":"2023061405450708000_80.7.418.9","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/S0266-7681(02)00361-3","article-title":"Hand function tests and questions on hand symptoms as related to the Stockholm workshop scales for diagnosis of hand-arm vibration syndrome","volume":"28","author":"Cederlund","year":"2003","journal-title":"J Hand Surg Br"},{"key":"2023061405450708000_80.7.418.10","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s00420-018-1359-7","article-title":"International consensus criteria for diagnosing and staging hand-arm vibration syndrome","volume":"92","author":"Poole","year":"2019","journal-title":"Int Arch Occup Environ Health"},{"key":"2023061405450708000_80.7.418.11","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/occmed\/kqab158","article-title":"Carpal tunnel syndrome and Raynaud\u2019s phenomenon: a narrative review","volume":"72","author":"Cooke","year":"2022","journal-title":"Occupational Medicine"},{"key":"2023061405450708000_80.7.418.12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s004200100278","article-title":"Neurological diagnosis: aspects of bedside and electrodiagnostic examinations in relation to hand-arm vibration syndrome","volume":"75","author":"Nilsson","year":"2002","journal-title":"Int Arch Occup Environ Health"},{"key":"2023061405450708000_80.7.418.13","doi-asserted-by":"publisher","DOI":"10.2486\/indhealth.38.366"},{"key":"2023061405450708000_80.7.418.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2013.01.025"},{"key":"2023061405450708000_80.7.418.15","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1016\/j.jpain.2010.06.010","article-title":"Median nerve small- and large-fiber damage in carpal tunnel syndrome: a quantitative sensory testing study","volume":"12","author":"Tamburin","year":"2011","journal-title":"The Journal of Pain"},{"key":"2023061405450708000_80.7.418.16","doi-asserted-by":"publisher","DOI":"10.1136\/oem.58.7.472"},{"key":"2023061405450708000_80.7.418.17","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1007\/s00420-020-01523-8","article-title":"Sensory perception testing by monofilaments in the digits of controls and workers with HAVS","volume":"93","author":"Poole","year":"2020","journal-title":"Int Arch Occup Environ Health"},{"key":"2023061405450708000_80.7.418.18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.5271\/sjweh.374","article-title":"Vibrotactile sense in the hand-arm vibration syndrome","volume":"24","author":"Str\u00f6mberg","year":"1998","journal-title":"Scand J Work Environ Health"},{"key":"2023061405450708000_80.7.418.19","doi-asserted-by":"crossref","unstructured":"Lundborg G , Dahlin LB , Lundstrom R , et al . Vibrotactile function of the hand in compression and vibration-induced neuropathy. sensibility index -- a new measure. Scandinavian Journal of plastic and reconstructive surgery and hand surgery \/ nordisk plastikkirurgisk forening. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery \/ Nordisk Plastikkirurgisk Forening [and] Nordisk Klubb for Handkirurgi 1992. doi:10.3109\/02844319209015271","DOI":"10.3109\/02844319209015271"},{"key":"2023061405450708000_80.7.418.20","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2007.139220"},{"key":"2023061405450708000_80.7.418.21","unstructured":"Skirven T OL , Fedorczyk J , Amadio P , et al . Rehabilitation of the hand and upper extremity 7 edn. Philadelphia: Elsevier, 2021."},{"key":"2023061405450708000_80.7.418.22","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s00420-017-1227-x","article-title":"Thermal perception thresholds among workers in a cold climate","volume":"90","author":"Burstr\u00f6m","year":"2017","journal-title":"Int Arch Occup Environ Health"},{"key":"2023061405450708000_80.7.418.23","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/SPC.0000000000000556","article-title":"Bedside testing for precision pain medicine","volume":"15","author":"Reimer","year":"2021","journal-title":"Curr Opin Support Palliat Care"},{"key":"2023061405450708000_80.7.418.24","unstructured":"Gemne G BA , Hagberg M , Lundstr\u00f6m R , et al . Proceedings of Stockholm workshop 94. hand-arm vibration syndrome: diagnostics and quatitative relationships to exposure. National Institute of Occupational Health; Arbete och H\u00e4lsa, 1995"},{"key":"2023061405450708000_80.7.418.25","unstructured":"Svenssons method \u00f6rebro: interactive software supporting svenssons method [ program ]. 1.3.1 version. 2021. Available: www.avdic.se"},{"key":"2023061405450708000_80.7.418.26","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/BSD.0b013e31821534da","article-title":"Reliability of the balanced inventory for spinal disorders, a questionnaire for evaluation of outcomes in patients with various spinal disorders","volume":"25","author":"Svensson","year":"2012","journal-title":"J Spinal Disord Tech"},{"key":"2023061405450708000_80.7.418.27","doi-asserted-by":"publisher","DOI":"10.1901\/jaba.1977.10-141"},{"key":"2023061405450708000_80.7.418.28","doi-asserted-by":"crossref","unstructured":"Hulsen T , de Vlieg J , Alkema W . BioVenn-a web application for the comparison and visualization of biological Lists using area-proportional venn diagrams. BMC Genomics 2008;9:488. doi:10.1186\/1471-2164-9-488","DOI":"10.1186\/1471-2164-9-488"},{"key":"2023061405450708000_80.7.418.29","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/J.JHSB.2004.02.008","article-title":"The two-point discrimination test \u2013 time for a re-appraisal?","volume":"29","author":"Lundborg","year":"2004","journal-title":"Journal of Hand Surgery"},{"key":"2023061405450708000_80.7.418.30","doi-asserted-by":"crossref","unstructured":"Nilsson T , Wahlstr\u00f6m J , Burstr\u00f6m L , et al . Hand-Arm vibration and the risk of vascular and neurological diseases\u2014A systematic review and meta-analysis. PLoS ONE 2017;12:e0180795. doi:10.1371\/journal.pone.0180795","DOI":"10.1371\/journal.pone.0180795"},{"key":"2023061405450708000_80.7.418.31","doi-asserted-by":"crossref","unstructured":"Tekavec E , L\u00f6fqvist L , Larsson A , et al . Adverse health manifestations in the hands of vibration exposed carpenters-a cross sectional study. J Occup Med Toxicol 2021;16:16. doi:10.1186\/s12995-021-00305-3","DOI":"10.1186\/s12995-021-00305-3"},{"key":"2023061405450708000_80.7.418.32","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(05)80192-5"},{"key":"2023061405450708000_80.7.418.33","doi-asserted-by":"crossref","unstructured":"Carlsson IK , Ros\u00e9n B , Dahlin LB . Self-Reported cold sensitivity in normal subjects and in patients with traumatic hand injuries or hand-arm vibration syndrome. BMC Musculoskelet Disord 2010;11:89. doi:10.1186\/1471-2474-11-89","DOI":"10.1186\/1471-2474-11-89"},{"key":"2023061405450708000_80.7.418.34","doi-asserted-by":"crossref","unstructured":"Carlsson IK , Dahlin LB . Self-Reported cold sensitivity in patients with traumatic hand injuries or hand-arm vibration syndrome-an eight year follow up. BMC Musculoskelet Disord 2014;15:83. doi:10.1186\/1471-2474-15-83","DOI":"10.1186\/1471-2474-15-83"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2023-108914","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T12:46:45Z","timestamp":1686746805000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2023-108914"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,16]]},"references-count":34,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,6,14]]},"published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1136\/oemed-2023-108914"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2023-108914","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"type":"print","value":"1351-0711"},{"type":"electronic","value":"1470-7926"}],"subject":[],"published":{"date-parts":[[2023,5,16]]}}}