1321 Hand-arm vibration and the risk of neurological diseases – a systematic review and meta-analysis

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IntroductionThe current risk prediction modelling (ISO-5349) for ‘Raynaud’s phenomenon’ is based on a few studies published 70 to 40 years ago. There are no corresponding risk prediction models for neurosensory injury or carpal tunnel syndrome, nor any systematic reviews comprising a statistical synthesis (meta-analysis) of the evidence.MethodsThis systematic review covers the scientific literature up to January 2016. The databases used for the literature search were PubMed and Science Direct. We found a total of 4335 abstracts, which were read and whose validity was assessed according to pre-established criteria. 294 articles were examined in their entirety to determine whether each article met the inclusion criteria. The possible risk of bias was assessed for each article. 52 articles finally met the pre-established criteria for inclusion in the systematic review. For the outcome neurosensory injury, 33 articles were included and for Carpal tunnel syndrome 7.ResultThe results show that workers who are exposed to HAV have an increased risk of neurological diseases compared to non-vibration exposed groups. The crude estimate of the risk increase is approximately 4–5 fold. The estimated effect size (odds ratio) of neurosensory injury is 7.4, when including only the studies judged to have a low risk of bias and the equivalent of carpal tunnel syndrome is 2.9.DiscussionAt equal exposures, neurosensory injury occurs with a 3-time factor shorter latency than Raynaud’s phenomenon. Which is why preventive measures should address this vibration health hazard with greater attention.Reference. Nilsson T, Wahlström J, Burström L. Hand-arm vibration and the risk of vascular and neurological diseases: A systematic review and meta-analysis. PloS One. 2017;12(7):e0180795.

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