title: Work disability after diagnosis of hand-arm vibration syndrome.
abstract: OBJECTIVE
  Our aim was to study the course of vasospastic and sensorineural symptoms after the clinical diagnosis of hand-arm vibration syndrome (HAVS), and the association of current HAVS symptoms with occupational status, self-evaluation of health, quality of life, and work ability.
  
  
  METHODS
  We gathered all HAVS cases diagnosed at the Finnish Institute of Occupational Health in Helsinki and Tampere during 1990-2008. A questionnaire was sent to all these patients (n = 241). Altogether 149 of them (62 %) returned the questionnaire. Cumulative lifelong vibration exposure was evaluated on the basis of the data in the patient files.
  
  
  RESULTS
  On average, 8.5 years after the diagnosis of HAVS, approximately one-third of the patients reported improvement in symptoms of vibration-induced white finger (VWF) and the sensorineural symptoms. Young age and shorter exposure time were associated with improvement in VWF symptoms (p = 0.033 and p < 0.001, respectively). Persistent or deteriorated symptoms of both VWF and sensorineural symptoms were associated with lowered work ability, quality of life (EQ-5D), and general health, also after adjusting for age, smoking, and diseases other than HAVS. The patients' own prediction of work ability in 2 years was more negative if the VWF symptoms or sensorineural symptoms had continued after diagnosis of HAVS (p = 0.065 and p = 0.001, respectively).
  
  
  CONCLUSIONS
  Our results suggest that in about two-thirds of the patients, the HAVS symptoms may stabilize or deteriorate in the follow-up. Considering the effects on work ability, timely prevention measures should be taken more actively to help patients continue their working careers.
authors.affiliation: Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland. riitta.sauni@stm.fi.|Finnish Institute of Occupational Health, PO Box 486, 33101, Tampere, Finland. riitta.sauni@stm.fi.
authors.forename: Riitta
authors.initials: R
authors.lastname: Sauni
authors.affiliation: Finnish Institute of Occupational Health, PO Box 486, 33101, Tampere, Finland.
authors.forename: Pauliina
authors.initials: P
authors.lastname: Toivio
authors.affiliation: Finnish Institute of Occupational Health, PO Box 486, 33101, Tampere, Finland.
authors.forename: Rauno
authors.initials: R
authors.lastname: Pääkkönen
authors.affiliation: MediVita Terveyspalvelut Oy, Helsinki, Finland.
authors.forename: Jari
authors.initials: J
authors.lastname: Malmström
authors.affiliation: Clinic of Occupational Medicine, Tampere University Hospital, Tampere, Finland.|Finnish Institute of Occupational Health, PO Box 486, 33101, Tampere, Finland.|School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Jukka
authors.initials: J
authors.lastname: Uitti
mesh_terms: D000328:Adult; D000367:Age Factors; D059026:Diagnostic Self Evaluation; D018450:Disease Progression; D004651:Employment / Q000523:psychology; D005260:Female; D005387:Finland; D053421:Hand-Arm Vibration Syndrome / Q000473:pathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000523:psychology; D013997:Time Factors; D014732:Vibration / Q000009:adverse effects; D014937:Work / Q000523:psychology*; D014938:Work Capacity Evaluation
keywords: Disability; Hand-arm vibration syndrome; Quality of life; Work ability