Quantitative thermal perception thresholds relative to exposure to vibration.

OBJECTIVES To assess the risk of disturbed thermal perception relative to exposure to vibration, to investigate a possible exposure-response relation and to analyse a possible relation between thermal perception and sensory symptoms. METHODS The study was based on a cross section of 123 male workers exposed to vibration and 62 male workers who were not exposed. Thermal perception of cold, warmth, and heat pain was bilaterally determined from the thenar eminence by the method of limits. Perception of cold and warmth were also tested in the second digit. Personal energy equivalent exposure to vibration was measured for all subjects. Vibration was measured in accordance with International Standards Organisation (ISO) 5349 and assessed separately for the left and right hand. RESULTS Combining exposure times and intensities gave the left hand an 0.80 exposure to vibration compared with the right. The risk of having contracted reduced thermal perception was increased at all test sites. The risk was higher for the thenar measurements than the finger measurements. A yearly extra contribution of 4000 mh/s(2) in cumulative exposure increases the risk of contracting a wider neutral zone by 18% (95% confidence interval (95% CI) 1.06 to 1.32) for the right and 18% (1.05 to 1.32) for the left hand side. Subjects with symptoms of nocturnal paraesthesia had a rate ratio (95% CI) of 2.80 (1.17 to 6.67) for the right hand and 2.72 (1.12 to 6.63) for the left hand for increased neutral zones at the thenar eminence. CONCLUSIONS The results indicate thermal sensory impairment related to cumulative exposure to vibration. The effect appeared at vibration levels below the current guiding standard. Quantitative sensory testing of thermal perception offers the chance to assess this specific hazard to the peripheral sensorineural system associated with hand intensive work entailing vibration.