{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T15:02:45Z","timestamp":1774969365019,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003252","name":"Lund University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003252","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Occup Med Toxicol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>EU workers exposed to hand-arm vibration should be offered health surveillance to detect early symptoms, and findings, of Hand-Arm Vibration Syndrome (HAVS). To execute the mandatory vocational rehabilitation, the employer needs to be aware of injuries found in the medical check-up. We aimed to analyse: 1) How physicians graded the neurosensory component of HAVS on the Stockholm Workshop Scale (SWS), compared to semi-objective findings. 2) What vocational rehabilitative decisions (VRD) were taken by physicians after examinations. 3) Whether the VRDs differed in relation to the SWS-grading.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Data came from 660 medical records - all examinations performed during twelve consecutive months in one large Swedish occupational healthcare company. 572 individuals had data on the SWS from the physician. For the qualitative analysis, we used the inductive-iterative immersion-crystallization method.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>60% of the examined workers had symptoms and 32% had semi-objective findings consistent with HAVS. The physicians\u2019 SWS gradings were underestimated in 59% of the cases with semi-objective findings. The VRDs were classified, relative to communication with the employer, as: \u201c<jats:bold>Adequate<\/jats:bold>\u201d (57%), when no injury was present, communication had already taken place, was planned, or was no longer needed in the absence of further exposure, \u201c<jats:bold>Semi-adequate\u201d<\/jats:bold> (18%), if no plan for communication was yet established or only communicated through a document with a shorter time until next check-up, and \u201c<jats:bold>Inadequate<\/jats:bold>\u201d(25%), when patients refused (20%), or physicians failed to communicate with the employer, despite findings (80%). Underestimated SWS-gradings of HAVS were significantly associated with more \u201cInadequate\u201d VRDs in the group with semi-objective findings.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Occupational physicians underestimate the number of individuals with SWS 2\u20133 compared with semi-objective findings and regularly fail to communicate to the employer despite findings of HAVS. The underestimation of SWS-grading, followed by inadequate VRDs, excludes many workers from the employer\u2019s mandatory protective measures which may lead to aggravation of an untreatable injury in the affected individual and development of HAVS in their similarly exposed colleagues.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12995-024-00432-7","type":"journal-article","created":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T14:03:38Z","timestamp":1723471418000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Vocational rehabilitative decisions after symptoms and findings consistent with hand-arm vibration syndrome in the Swedish surveillance system\u2009\u2013\u2009a mixed-method design"],"prefix":"10.1186","volume":"19","author":[{"given":"Frida","family":"Thors\u00e9n","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catarina","family":"Nordander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Antonson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"issue":"4","key":"432_CR1","first-page":"25","volume":"6","author":"A Hamilton","year":"1918","unstructured":"Hamilton A. Effect of the air hammer on the hands of stonecutters. Monthly Rev US Bureau Labor Stat. 1918;6(4):25\u201333.","journal-title":"Monthly Rev US Bureau Labor Stat"},{"issue":"7","key":"432_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0180795","volume":"12","author":"T Nilsson","year":"2017","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(7):1\u201325.","journal-title":"PLoS ONE"},{"issue":"3","key":"432_CR3","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1093\/occmed\/kqz029","volume":"69","author":"L Aarhus","year":"2019","unstructured":"Aarhus L, Veiersted KB, Nordby K-C, Bast-Pettersen R. Neurosensory component of hand - arm vibration syndrome: a 22-year follow-up study. Occup Med. 2019;69(3):215\u20138.","journal-title":"Occup Med"},{"key":"432_CR4","volume-title":"To prevent vibration injuries (att f\u00f6rebygga vibrationsskador)","author":"L Ekenvall","year":"1991","unstructured":"Ekenvall L, Hagberg M, Lundborg G, Lundstr\u00f6m R. To prevent vibration injuries (att f\u00f6rebygga vibrationsskador). Stockholm: Arbetsmilj\u00f6fonden; 1991."},{"issue":"4","key":"432_CR5","first-page":"74","volume":"49","author":"T Nilsson","year":"2016","unstructured":"Nilsson T, Wahlstr\u00f6m J, Burstr\u00f6m L. Systematic reviews of knowledge; 9 vascular and nerve injuries in relation to exposure to hand transimitted vibrations (Systematiska kunskaps\u00f6versikter; 9. K\u00e4rl- och nervskador i relation till exponering f\u00f6r hand\u00f6verf\u00f6rda vibrationer). Arbete Och H\u00e4lsa. 2016;49(4):74.","journal-title":"Arbete Och H\u00e4lsa"},{"key":"432_CR6","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1007\/s00420-018-1359-7","volume":"92","author":"C Poole","year":"2019","unstructured":"Poole C, Bovenzi M, Nilsson T, Lawson I, House R, Thompson A, et al. International consensus criteria for diagnosing and staging hand\u2013arm vibration syndrome. 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Stockholm: Arbetsmilj\u00f6verket; 2019."},{"issue":"12","key":"432_CR9","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1097\/00043764-200212000-00017","volume":"44","author":"YNY Kurozawa","year":"2002","unstructured":"Kurozawa YNY, Hosoda T, Nose T. Long-term follow-up study on patients with vibration-induced white finger (VWF). J Occup Environ Med. 2002;44(12):1203\u20136.","journal-title":"J Occup Environ Med"},{"key":"432_CR10","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1093\/occmed\/kqh112","volume":"54","author":"KL McGeoch","year":"2004","unstructured":"McGeoch KL, Lawson IJ, Burke F, Proud G, Miles J. Use of sensorineural tests in a large volume of medico-legal compensation claims for HAVS. Occup Med. 2004;54:528\u201334.","journal-title":"Occup Med"},{"key":"432_CR11","unstructured":"Arbetsmilj\u00f6verket. AFS 2005:6 Medical check-ups in work life and general advice on the application of the provision (Medicinska kontroller i arbetslivet och allm\u00e4nna r\u00e5d om till\u00e4mpningen av f\u00f6reskrifterna). Stockholm: Arbetsmilj\u00f6verket; 2005."},{"issue":"8","key":"432_CR12","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1007\/s00420-015-1034-1","volume":"88","author":"R Sauni","year":"2015","unstructured":"Sauni R, Toivio P, P\u00e4\u00e4kk\u00f6nen R, Malmstr\u00f6m J, Uitti J. Work disability after diagnosis of hand-arm vibration syndrome. Int Arch Occup Environ Health. 2015;88(8):1061\u20138.","journal-title":"Int Arch Occup Environ Health"},{"key":"432_CR13","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1007\/s00420-007-0249-1","volume":"81","author":"R Lundstr\u00f6m","year":"2008","unstructured":"Lundstr\u00f6m R, Nilsson T, Hagberg M. 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Scand J Work Environ Health. 1987;13:279\u201383.","journal-title":"Scand J Work Environ Health"},{"key":"432_CR16","unstructured":"Enstam D, Paulsson S, Svensson U, Gram S, Hagberg M, Gerhardsson L et al. Instruction medical check-up vibration (Instruktion medicinsk kontroll vibration) fhvmetodik.se: FHV-metodik; 2019 [https:\/\/fhvmetodik.se\/wp-content\/uploads\/2020\/04\/Instruktion-MKA-vibration4.pdf"},{"key":"432_CR17","unstructured":"Dahlin L, Enstam D, Gerhardsson L, Gram S, Hagberg M, Holmdahl P et al. The occupational healthcare\u2019s guide for medical check-ups for hand-arm vibratinos in work life (F\u00d6RETAGSH\u00c4LSANS GUIDE F\u00d6R MEDICINSK KONTROLL VID HAND- & ARMVIBRATIONER I ARBETSLIVET) Stockholm: Sveriges F\u00f6retagsh\u00e4lsor; 2022 [2:[ https:\/\/www.foretagshalsor.se\/sites\/default\/files\/2022-11\/Vibrationsguide NOV_2022.pdf"},{"key":"432_CR18","unstructured":"Antonson C, Thors\u00e9n F, SLUTRAPPORT:, HUR \u00d6KAR VI VIBRATIONSEXPONERADE ARBETARES DELTAGANDE I MEDICINSKA KONTROLLER I ARBETSLIVET? Stockholm. ; 2023 2023 Feb 28. Contract No.: 13905."},{"issue":"4","key":"432_CR19","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1093\/occmed\/kqw013","volume":"66","author":"CJM Poole","year":"2016","unstructured":"Poole CJM, Mason H, Harding A-H. The relationship between clinical and standardized tests for hand\u2013arm vibration syndrome. 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BMC Med Res Methodol. 2011;11(40):1\u20134.","journal-title":"BMC Med Res Methodol"},{"key":"432_CR23","unstructured":"International Committee of Medical Journal Editors. Disclosure of financial and non-financial relationships and activities, and conflict of interest 2021 [http:\/\/www.icmje.org\/recommendations\/browse\/roles-and-responsibilities\/author-responsibilities--conflicts-of-interest.html#one"}],"container-title":["Journal of Occupational Medicine and Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12995-024-00432-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12995-024-00432-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12995-024-00432-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T14:07:45Z","timestamp":1723471665000},"score":1,"resource":{"primary":{"URL":"https:\/\/occup-med.biomedcentral.com\/articles\/10.1186\/s12995-024-00432-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,12]]},"references-count":24,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["432"],"URL":"https:\/\/doi.org\/10.1186\/s12995-024-00432-7","relation":{},"ISSN":["1745-6673"],"issn-type":[{"value":"1745-6673","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,12]]},"assertion":[{"value":"25 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Swedish Ethical Review Authority (reference no 2021\u2009\u2212\u200900152). All research was conducted in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"Consent for publication and to participate was arranged as an opt-out model as recommended for registry studies []. This was approved by the Swedish Ethical Review Authority. No one opted out.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"One author was employed at Feelgood, a company that co-funded the study. However, none of the funding organizations had any influence over any part of the scientific process or analysis of data. All authors could also access the original data. We have followed the guidelines of the International Committee of Medical Journal Editors [] and we believe that the study has no biases on the basis of conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"33"}}