Reducing the risk of Hand-Arm Vibration Syndrome (HAVS): a systematic review of interventions

摘要

A systematic literature review of 15 electronic databases was undertaken to evaluate the efficacy of interventions strategies for the prevention and management of HAVS. Only those intervention studies that adopted clearly defined health outcome measures and well defined intervention approaches were included in the review. The quality of each study was critically appraised and graded using a modified version of the Cochrane Musculoskeletal Injuries Group (CMIG) scoring system. A total of 11 intervention studies were considered to meet the inclusion criteria of this review. One study was considered to involve a mechanical intervention (i.e. the introduction of anti-vibration tools and gloves), while three studies incorporated combined mechanical and production system interventions (e.g. modified tool design and time management or protective measures). Seven modifier intervention studies focused primarily on the effects of drug treatment. The multi-dimensional approaches incorporated by many of the studies made it impossible to isolate the efficiency of the individual components of an intervention approach for reducing the incidence of HAVS. Whilst most drug therapy interventions showed improved symptoms of HAVS, these studies often involved relatively short periods of drug administration, lacked long term follow-up and sometimes resulted in notable side effects. The poor quality of studies stemmed primarily from the inherent difficulties of introducing interventions into occupational settings that were continually changing. Prevention and early intervention appears to offer most benefits in reducing the risk of developing HAVS, or affecting recovery from symptoms.