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  • 1.
    Nilsagård, Ylva
    et al.
    Örebro University, School of Health Sciences. Örebro University Hospital.
    Rådman, Lisa
    Jakobsson, Kristina
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences.
    Symtom efter strömgenomgång2017In: Elolyckor i arbetet / [ed] Kjell Torén, Lars-Gunnar Gunnarsson, Sara Thomée och Kristina Jakobsson, Göteborg, Sweden: Göteborgs universitet, 2017, p. 21-26Chapter in book (Other academic)
    Abstract [sv]

    523 elektriker som hade varit med om minst en elolycka med strömgenomgång besvarade en fördjupad enkät med fokus på frågor om symtom från perifera och centrala nervsystemet och muskulatur.

     Nio av tio som varit med om högspänningsolycka hade sökt akut sjukvård. Endast två av tio hade sökt vård efter lågspänningsolycka.

     Besvär framför allt i form av smärta och nedsatt känsel efter strömgenomgång var relativt vanligt, men för de allra flesta blev inte dessa besvär bestående.

     Symtom från nervsystem och hjärna var betydligt vanligare hos de som hade varit utsatta för högspänningsolyckor eller fastnat vid strömkällan på grund av muskelkramp.

  • 2.
    Rådman, Lisa
    Örebro University, School of Medical Sciences.
    Self-reported symptoms and neurosensory function after electrical accidents: a survey among Swedish male electricians2016Licentiate 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.

    List of papers
    1. Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians
    Open this publication in new window or tab >>Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians
    Show others...
    2016 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 2, p. 261-270Article in journal (Refereed) Published
    Abstract [en]

    Professional electricians are highly subjected to electrical injuries. Previous studies describing symptoms after electrical injury have not included people with less severe initial injuries. The purpose of the present study was to describe symptoms at different time points after electrical injury, the impact of "no-let-go" phenomenon and different electrical potential [high voltage (HV) vs. low voltage (LV)], and the safety culture at the workplace.

    A retrospective survey was conducted with 523 Swedish electricians. Two questionnaires were issued: the first to identify electricians who had experienced electrical injury and the second to gain information about symptoms and safety culture. Self-reported symptoms were described at different time points following injury. Symptoms for HV and LV accidents were compared. Occurrence or nonoccurrence of "no-let-go" phenomenon was analysed using two-tailed Chi-2. Safety culture was assessed with a validated questionnaire.

    Nearly all reported having symptoms directly after the injury, mainly paraesthesia and pain. For the first weeks after injury, pain and muscle weakness dominated. The most frequently occurring symptoms at follow-up were pain, muscle weakness and loss of sensation. HV injuries and "no-let go" phenomenon were associated with more sustained symptoms. Deficiencies in the reporting routines were present, as well as shortage of preventive measures.

    The results indicate that symptoms are reported also long time after an electrical injury and that special attention should be paid to HV injuries and "no-let go" accidents. The workplace routines to reduce the number of work-related electrical injuries for Swedish electricians can be improved.

    Place, publisher, year, edition, pages
    Springer, 2016
    Keywords
    Electrical injury, Low-voltage injury, High-voltage injury, Safety management, Neurological symptoms, Pain
    National Category
    Public Health, Global Health, Social Medicine and Epidemiology
    Research subject
    Public health
    Identifiers
    urn:nbn:se:oru:diva-48474 (URN)10.1007/s00420-015-1069-3 (DOI)000368806500008 ()26186954 (PubMedID)2-s2.0-84955733403 (Scopus ID)
    Funder
    Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0561
    Note

    Funding Agency:

    Örebro Research Committee

    Available from: 2016-02-23 Created: 2016-02-23 Last updated: 2019-03-22Bibliographically approved
    2. Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series
    Open this publication in new window or tab >>Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series
    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
    Keywords
    Voltage, thermal perception, vibration perception thresholds, manual dexterity, tactile gnosis, small fibre neuropathy
    National Category
    Dermatology and Venereal Diseases Surgery
    Identifiers
    urn:nbn:se:oru:diva-50950 (URN)10.1016/j.burns.2016.05.017 (DOI)000391073900012 ()27317339 (PubMedID)2-s2.0-85005942729 (Scopus ID)
    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: 2019-03-22Bibliographically approved
  • 3.
    Rådman, Lisa
    et al.
    Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden; Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden.
    Forsberg, Anette
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Family Medicine Research Centre, , Region Örebro County, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital. Centre for Health Care Sciences, Örebro University Hospital, Örebro, Sweden.
    Modified Rivermead Mobility Index: a reliable measure in people within 14 days post-stroke2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 2, p. 126-129Article in journal (Refereed)
    Abstract [en]

    Purpose: The reliability of the Modified Rivermead Mobility Index (MRMI) has not previously been investigated in the very early post-stroke phase. The aim of the study was to evaluate inter-rater and intra-rater reliability and internal consistency in patients, 1-14 d post-stroke.

    Method: A cohort study with repeated measures within 24 h, on 37 patients, 1-14 d post-stroke was conducted. Inter-rater (two raters) and intra-rater (one rater) reliability was analyzed using weighted kappa (kappa) statistics and internal consistency with Cronbach's alpha and intra-class correlation (ICC), 3.k.

    Results: Inter-rater and intra-rater reliability was excellent (ICC coefficient 0.97 and 0.99) for MRMI summary score. Intra-rater exact agreement for separate items was between 77% and 97%; kappa between 0.81 and 0.96. Inter-rater exact agreement for separate items was between 68% and 92%; kappa 0.59-0.87. The internal consistency was high (alpha 0.96; ICC 3.k 0.99). Conclusion: The MRMI is a reliable measure of physical mobility in the early post-stroke phase.

  • 4.
    Rådman, Lisa
    et al.
    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.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences. Department of Occupational and Environmental Medicine, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health Sciences.
    Nilsson, Tohr
    Department of Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
    Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series2016In: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, no 8, p. 1712-1720Article in journal (Refereed)
    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).

  • 5.
    Rådman, Lisa
    et al.
    Department of Occupational and Environmental Medicin, Örebro University Hospital, Örebro, Sweden; Department of Physiotherapy, Örebro University Hospital, Örebro, Sweden.
    Nilsagård, Ylva
    Örebro University, School of Health Sciences.
    Jakobsson, Kristina
    Division of Occupational and Environmental Medicine, Scania University Hospital, Lund, Sweden.
    Ek, Åsa
    Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden.
    Gunnarsson, Lars-Gunnar
    Örebro University, School of Medical Sciences.
    Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians2016In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, no 2, p. 261-270Article in journal (Refereed)
    Abstract [en]

    Professional electricians are highly subjected to electrical injuries. Previous studies describing symptoms after electrical injury have not included people with less severe initial injuries. The purpose of the present study was to describe symptoms at different time points after electrical injury, the impact of "no-let-go" phenomenon and different electrical potential [high voltage (HV) vs. low voltage (LV)], and the safety culture at the workplace.

    A retrospective survey was conducted with 523 Swedish electricians. Two questionnaires were issued: the first to identify electricians who had experienced electrical injury and the second to gain information about symptoms and safety culture. Self-reported symptoms were described at different time points following injury. Symptoms for HV and LV accidents were compared. Occurrence or nonoccurrence of "no-let-go" phenomenon was analysed using two-tailed Chi-2. Safety culture was assessed with a validated questionnaire.

    Nearly all reported having symptoms directly after the injury, mainly paraesthesia and pain. For the first weeks after injury, pain and muscle weakness dominated. The most frequently occurring symptoms at follow-up were pain, muscle weakness and loss of sensation. HV injuries and "no-let go" phenomenon were associated with more sustained symptoms. Deficiencies in the reporting routines were present, as well as shortage of preventive measures.

    The results indicate that symptoms are reported also long time after an electrical injury and that special attention should be paid to HV injuries and "no-let go" accidents. The workplace routines to reduce the number of work-related electrical injuries for Swedish electricians can be improved.

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