Arthritis of the wrist

Question: Does anyone have any knowledge of osteoarthritis occurring in the wrist in middle aged road workers who are using pneumatic drills etc? Anything  in the literature?

Answer 1: I am not sure about link between osteoarthritis and using pneumatic drills, but I understand one of the occupational hazards of using pneumatic drills could be Raynaud’s phenomenon. Handling a pneumatic jack constantly can damage the minute blood vessels in your hands causing `white fingers’ or Raynaud’s phenomenon. As the damaged blood vessels reduce blood supply, the fingers feel cold and painful.

Answer 2: Yes, although not restricted to pneumatic drills. Long list of vibrating equipment associated with VWF (Vibration White Finger). I am doing much work in this field and am seeing cases of VWF diagnoses connected with smaller hand held tools such as hammer drills. Also r recently instructed by a bus driver with VWF from constant heavy vibration from the driving wheel. If anyone has come across this connection I would welcome hearing from them.

Answer 3: T H Hettinger (from isometric exercise fame) and his associate Beck published some quite detailed work in the 1950’s on bone joint disease in miners as a result of work with vibrating tools. He confirmed an earlier theory that some people are much more susceptible to these problems than others. Those whose forearm temperature rose after vibration (i.e. who vasodilated) rarely experienced problems, but those whose temperature fell were much more likely to develop problems. The work then focused on susceptibility to tenosynovitis;

Hettinger studied typists, stenographers, and glass cutters. Hettinger concluded that it was a sympathetic nervous system effect. The work was continued in Australia by Robert Welch in the 1970’s, and I was part of further work with the same test in the 1980’s. There are various quite detailed arguments about the test, but if anyone is interested they could read the paper by Brown, Coyle and Beaumont in Applied Ergonomics in 1985 (“The Automated Hettinger Test in the Diagnosis and Prevention of Repetition Strain Injury“) or send me an email. The test is presently being used in glaucoma research.


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