Use of sensorineural tests in a large volume of medico-legal compensation claims for HAVS

Background The Department of Trade and Industry set up a contract to examine miners and ex-miners claiming compensation for hand-arm vibration syndrome (HAVS). They had been exposed to hand-transmitted vibration. Over 100 000 have now been examined using sensorineural tests as part of that process. Aims The purpose of this paper was to examine the internal consistency of the vibrotactile threshold test (VTT) and the thermal aesthesiometry test (TA). Methods In 18 centres across the UK, nurses were trained to perform the measurement of VTT and TA in a controlled standardized manner. These tests were to aid the staging of the neurological component of the Stockholm Workshop Scales. The staging of this component was modified by dividing stage 2SN into 2SN (early) and 2SN (late). The test results and an automatic neurological staging were presented to the examining doctor following the clinical examination. The results of these sensorineural tests were held on a central database. The results and analysis of the first 57 000 tests are reported. Results The correlations within the VTT and TA scores were consistent with reliable measures. However, these correlations were not of such strength as to allow reliance on the results of a single test when making an assessment of the severity of neurological damage. Conclusions Different end organs and nerve fibres should be tested when making an assessment of damage in the sensorineural component of HAVS. The correlations demonstrated for the VTT and TA suggest that they are of value in assessing these claimants and would be for other vibration exposed workers.