Exposure to Hand-Arm Vibrations in the Workplace and the Occurrence of Hand-Arm Vibration Syndrome, Dupuytren’s Contracture, and Hypothenar Hammer Syndrome A systematic Review and Meta-analysis

This study provides an overview on the relationships between exposure to work-related, hand-arm vibration and the occurrence of pre-defined disorders of the hands. We searched Medline, Embase, Web of Science, Cochrane Central, and PsycINFO for cross-sectional and longitudinal studies on the association between work-related vibration exposure and the occurrence of hand-arm vibration syndrome (including vibration-induced white finger), Dupuytren’s contracture, or hypothenar hammer syndrome. We used a 16-item checklist for assessing risk of bias. We present results narratively, and we conducted random effects meta-analyses if possible. We included 10 studies with more than 24,381 participants. Our results showed statistically significant associations between the exposure to hand-arm vibrations and the occurrence of the selected disorders, with pooled odds ratios ranging between 1.35 (95% CI: 1.28 to 2.80) and 3.43 (95% CI: 2.10 to 5.59). Considerable between-study hetereogeneity was observed. Our analyses show that exposure to vibrating tools at work is associated with an increased risk for the occurrence of selected disorders of the hands. Due to the majority of studies being cross-sectional, no firm conclusion is possible regarding causal relationships between vibration exposure and disorder occurrence. Future research should specifically address whether reducing the exposure to hand-held vibrating tools at work reduces the incidence of the disorders of the hands investigated in this systematic review.</p

Consensus for statements regarding a definition for spinal osteoarthritis for use in research and clinical practice: A Delphi study

Objective To determine consensus among an international, multidisciplinary group of experts regarding definitions of spinal osteoarthritis for research and for clinical practice. Methods A 15 member, multidisciplinary steering committee generated 117 statements for a three-round Delphi study. Experts in back pain and/or osteoarthritis were identified and invited to participate. In round one, participants could propose additional statements for voting. All statements were rated on a 1-9 Likert scale, and consensus was set at ≥70% of respondents agreeing or disagreeing with the statement and <15% of respondents providing the opposite response. Results In total, 255 experts from 11 different professional backgrounds were invited. From 173 available experts, 116 consented to participate. In round one, 103 participants completed the survey, followed by 85 of 111 participants in round two (77%) and 87 of 101 participants in round three (86%). One third of participants were from Europe (30%), most were male (58%), one fifth were physiotherapists (21%), and over one third had been in their profession for 11-20 years (35%). Of 131 statements, consensus was achieved for 71 statements (54%): 53 in agreement (75%) and 18 in disagreement (25%). Conclusion While there was consensus for statements for definitions of spinal osteoarthritis that were analogous to definitions of osteoarthritis in appendicular joints, a future definition still needs refinement. Importantly, this Delphi highlighted that a future definition should be considered across a spectrum of structural changes and patient symptoms, and expressed on a progressive scale