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Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series
Department of Occupational and Environmental Medicine, Örebro University Hospital, Örebro, Sweden; Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-4192-8273
Örebro University, School of Health Sciences.ORCID iD: 0000-0002-9760-3785
Department of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
2016 (English)In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 8, p. 1712-1720Article in journal (Refereed) Published
Abstract [en]

Purpose: Symptoms described in previous studies indicate that electrical injury can cause longstanding injuries to the neurosensory nerves. The aim of the present case series was to objectively assess the profile of neurosensory dysfunction in electricians in relation to high voltage or low voltage electrical injury and the "no-let-go phenomenon".

Methods: Twenty-three Swedish male electricians exposed to electrical injury were studied by using a battery of clinical instruments, including quantitative sensory testing (QST). The clinical test followed a predetermined order of assessments: thermal perceptions thresholds, vibration perception thresholds, tactile gnosis (the Shape and Texture Identification test), manual dexterity (Purdue Pegboard Test), and grip strength. In addition, pain was studied by means of a questionnaire, and a colour chart was used for estimation of white fingers.

Results: The main findings in the present case series were reduced thermal perceptions thresholds, where half of the group showed abnormal values for warm thermal perception and/or cold thermal perception. Also, the tactile gnosis and manual dexterity were reduced. High voltage injury was associated with more reduced sensibility compared to those with low voltage.

Conclusion: Neurosensory injury can be objectively assessed after an electrical injury by using QST with thermal perception thresholds. The findings are consistent with injuries to small nerve fibres. In the clinical setting thermal perception threshold is therefore recommended, in addition to tests of tactile gnosis and manual dexterity (Purdue Pegboard).

Place, publisher, year, edition, pages
Oxford, United Kingdom: Elsevier, 2016. Vol. 42, no 8, p. 1712-1720
Keywords [en]
Voltage, thermal perception, vibration perception thresholds, manual dexterity, tactile gnosis, small fibre neuropathy
National Category
Dermatology and Venereal Diseases Surgery
Identifiers
URN: urn:nbn:se:oru:diva-50950DOI: 10.1016/j.burns.2016.05.017ISI: 000391073900012PubMedID: 27317339Scopus ID: 2-s2.0-85005942729OAI: oai:DiVA.org:oru-50950DiVA, id: diva2:939836
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0561
Note

Funding Agencies:

Örebro Research Committee

Department of Occupational and Environmental Medicine, Örebro University Hospital

Available from: 2016-06-20 Created: 2016-06-20 Last updated: 2018-09-04Bibliographically approved
In thesis
1. Self-reported symptoms and neurosensory function after electrical accidents: a survey among Swedish male electricians
Open this publication in new window or tab >>Self-reported symptoms and neurosensory function after electrical accidents: a survey among Swedish male electricians
2016 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Professionals working in electrical fields are at risk for accidental exposure to electricity on a daily basis. Electrical accidents can cause long-term sequelae manifesting as neurological symptoms, including in the peripheral nervous system.

The overall aim of this licentiate thesis was to describe the occurrence of selfreported and neurosensory symptoms after electrical accidents. Specifically, this thesis aimed to I) describe self-reported symptoms at different points in time; II) assess neurosensory function in relation to previous electrical accidents; III) evaluate the impact of high vs. low voltage as well as that of the no-let-go phenomenon; and IV) gain knowledge about the safety culture among Swedish electricians.

A retrospective survey including 523 Swedish male electricians was conducted. Electricians reporting persistent symptoms were invited to a clinical examination that included quantitative sensory testing (QST); 23 electricians participated. The most commonly self-reported symptoms associated with electrical accidents were pain, reduced sensation and reduced muscle function. For a small percentage, these symptoms were persistent. Reduced neurosensory function with regard to thermal perception was determined using QST and functional testing and was particularly evident in the thermal perception tests; roughly half of the group exhibited abnormally reduced clinical warmth and cold perception thresholds and tactile gnosis test values, the latter of which were all below normal except for those of two electricians. The findings also indicate that electricians accidentally exposed to high voltage (HV) frequently report more symptoms than do electricians exposed to low voltage (LV). There were deficiencies in the preventative efforts and reporting routines pertinent to potential electrical accidents. In summary, the main results of this licentiate thesis show that sensory symptoms can be persistent, especially after an HV accident, and that these selfreported symptoms can be manifested as injuries on the small nerve fibres. The results of the present study can provide methods to be used for follow-up testing in clinical practise. Furthermore, there is a need to improve the workplace safety culture for electricians in order to improve the numbers of follow-ups.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2016. p. 58
Keywords
Electrical accident, Neurosensory symptoms, No-let-go phenomenon, Pain, Voltage, Quantitative Sensory Testing
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-50982 (URN)
Presentation
2016-06-14, Campus USÖ, Örebro universitet, hörsal C1, Södra Grev Rosengatan, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2016-06-21 Created: 2016-06-21 Last updated: 2018-01-10Bibliographically approved

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Gunnarsson, Lars-GunnarNilsagård, Ylva

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