title: Tremor and hand-arm vibration syndrome (HAVS) in road maintenance workers.
abstract: OBJECTIVE
  The aim of this study was to evaluate postural and rest tremor among workers using vibrating hand tools, taking into account the possible effects of toxicants such as alcohol and tobacco. A further aim was to study workers diagnosed with hand-arm vibration syndrome (HAVS) at the time of examination.
  
  
  METHODS
  This study comprises 103 road maintenance workers, 55 exposed to vibrating hand tools (age 41.0 years; range 21-62) and 48 referents (age 38.5 years; range 19-64). They were examined with the CATSYS Tremor Pen®. Exposure to vibrating tools and serum biomarkers of alcohol and tobacco consumption were measured.
  
  
  RESULTS
  Cumulative exposure to vibrating tools was associated with increased postural (p < 0.01) and rest tremor (p < 0.05) and with a higher Center Frequency of postural tremor (p < 0.01) among smokers and users of smokeless tobacco. Rest tremor Center Frequency was higher than postural tremor frequency (p < 0.001).
  
  
  CONCLUSIONS
  The main findings indicate an association between cumulative exposure to hand-held vibrating tools, tremor parameters and consumption of tobacco products. The hand position is important when testing for tremor. Rest tremor had a higher Center Frequency. Postural tremor was more strongly associated with exposure than rest tremor. The finding of increased tremor among the HAVS subjects indicated that tremor might be a part of the clinical picture of a HAVS diagnosis. As with all cross-sectional studies, inferences should be made with caution when drawing conclusions about associations between exposure and possible effects. Future research using longitudinal design is required to validate the findings of the present study.
authors: National Institute of Occupational Health, Oslo, Norway. rita.bast@stami.no.
authors: Rita
authors: R
authors: Bast-Pettersen
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Bente
authors: B
authors: Ulvestad
authors: Department of Environmental and Occupational Medicine, Oslo University Hospital, Oslo, Norway.
authors: Karl
authors: K
authors: Færden
authors: Mesta AS, Baerum, Norway.
authors: Thomas Aleksander C
authors: TA
authors: Clemm
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Raymond
authors: R
authors: Olsen
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Dag Gunnar
authors: DG
authors: Ellingsen
authors: National Institute of Occupational Health, Oslo, Norway.
authors: Karl-Christian
authors: KC
authors: Nordby
mesh_terms: D000328:Adult; D060389:Construction Industry; D003430:Cross-Sectional Studies; D053421:Hand-Arm Vibration Syndrome / Q000209:etiology*; D006801:Humans; D008283:Maintenance; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D014202:Tremor / Q000209:etiology*; D014732:Vibration / Q000009:adverse effects*; D055815:Young Adult
keywords: CATSYS Tremor Pen®; Cotinine; Hand-arm vibration syndrome (HAVS); Postural tremor; Rest tremor