Risk of hand and forearm conditions due to vibrating hand-held tools exposure: a retrospective cohort study from Sweden

BMJ Open. 2024 Jun 18;14(6):e080777. doi: 10.1136/bmjopen-2023-080777.

Abstract

Objectives: The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools.

Design: This is a retrospective cohort study.

Setting: Individuals in the Malmö Diet and Cancer Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, 'does your work involve working with vibrating hand-held tools?' (response: 'not at all', 'some' and 'much'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren's disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure.

Participants: Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the study.

Results: In total, 12 220/14 342 individuals (76%) reported 'no' exposure, 1392/14 342 (9%) 'some' and 730/14 342 (5%) 'much' exposure to vibrating hand-held tools. In men, 'much' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). 'Some' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). 'Much' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren's disease or CMC-1 OA. 'Much' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women.

Conclusions: Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.

Keywords: aged; general diabetes; hand & wrist; hypertension; musculoskeletal disorders.

MeSH terms

  • Adult
  • Aged
  • Carpal Tunnel Syndrome* / epidemiology
  • Carpal Tunnel Syndrome* / etiology
  • Dupuytren Contracture / epidemiology
  • Female
  • Hand
  • Humans
  • Male
  • Middle Aged
  • Occupational Diseases / epidemiology
  • Occupational Diseases / etiology
  • Occupational Exposure* / adverse effects
  • Prevalence
  • Proportional Hazards Models
  • Retrospective Studies
  • Risk Factors
  • Sweden / epidemiology
  • Trigger Finger Disorder / epidemiology
  • Ulnar Nerve Compression Syndromes / epidemiology
  • Ulnar Nerve Compression Syndromes / etiology
  • Vibration* / adverse effects