Vol.:(0123456789)
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International Archives of Occupational
and Environmental Health
https://doi.org/10.1007/s00420-020-01523-8
ORIGINAL ARTICLE
Sensory perception testing by monofilaments in the digits of controls
and workers with HAVS
C. J. M. Poole
1
· E. W. Robinson
1
· G. Frost
2
Received: 2 July 2019 / Accepted: 28 January 2020
© The Author(s) 2020
Abstract
Objective
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).
Methods
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.
Results
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.