Sensory perception testing by monofilaments in the digits of controls and workers with havs

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International Archives of Occupational and Environmental Health


Sensory perception testing by monofilaments in the digits of controls 

and workers with HAVS

C. J. M. Poole


   · E. W. Robinson


 · G. Frost


Received: 2 July 2019 / Accepted: 28 January 2020 

© The Author(s) 2020



  To determine if heavy manual work affects sensory perception in the digits and whether Semmes–Weinstein 

monofilaments (SWM) can be used as a screening tool to detect sensory neuropathy in the digits of workers exposed to 

hand-transmitted vibration (HTV).


  A cross-sectional study of office workers, heavy manual workers not exposed to HTV and workers with hand-

arm vibration syndrome (HAVS). Sensory perception was measured in the digits by SWM using a forced-choice method 

to determine variability by sex, age, hand and digit. Frequency distributions were used to determine limit values and linear 

weighted kappa for intra-digit variability. Poisson regression was used to explore the relationship between sensory perception 

by SWM and abnormalities of thermal and vibration perception in the hands of workers with HAVS.


  The sensory perception threshold of office workers did not vary by hand or digit. It was significantly lower in 

women < 30 than women aged ≥ 30 years. The 95th percentile for heavy manual workers was 1.00 (95% CI 0.60–1.00) and 

significantly higher than for office workers at 0.16 (95% CI 0.16–0.16). Heavy manual workers > 50 years had the highest 

threshold at 1.40 (95% CI 1.00–2.00). Weighted kappa for reliability was 0.63 (95% CI 0.53–0.70). A mean SWM threshold 

of ≥ 1.0 gram-force had a 79% sensitivity and 64% specificity for detecting abnormalities of thermal and vibration perception 

in the ipsilateral index and little fingers of workers with HAVS.

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