The effect of work related mechanical stress on the peripheral temperature of the hand

Abstract

The evolution and developments in modern industry have resulted a wide range of occupational activities, some of which can lead to industrial injuries. Due to the activities of occupational medicine, much progress has been made in transforming the way that operatives perform their tasks. However there are still many occupations where manual tasks have become more repetitive, contributing to the development of conditions that affect the upper limbs. Repetitive Strain Injury is one classification of those conditions which is related to overuse of repetitive movement. Hand Arm Vibration Syndrome is a subtype of this classification directly related to the operation of instruments and machinery which involves vibration. These conditions affect a large number of individuals, and are costly in terms of work absence, loss of income and compensation. While such conditions can be difficult to avoid, they can be monitored and controlled, with prevention usually the least expensive solution. In medico-legal situations it may be difficult to determine the location or the degree of injury, and therefore determining the relevant compensation due is complicated by the absence of objective and quantifiable methods. This research is an investigation into the development of an objective, quantitative and reproducible diagnostic procedure for work related upper limb disorders. A set of objective mechanical provocation tests for the hands have been developed that are associated with vascular challenge. Infrared thermal imaging was used to monitor the temperature changes using a well defined capture protocol. Normal reference values have been measured and a computational tool used to facilitate the process and standardise image processing. These objective tests have demonstrated good discrimination between groups of healthy controls and subjects with work related injuries but not individuals, p<0.05, and are reproducible. A maximum value for thermal symmetry of 0.5±0.3ºC for the whole upper limbs has been established for use as a reference. The tests can be used to monitor occupations at risk, aiming to reduce the impact of these conditions, reducing work related injury costs, and providing early detection. In a medico-legal setting this can also provide important objective information in proof of injury and ultimately in objectively establishing whether or not there is a case for compensation