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Effects of electrical accidents: occupational and health perspectives
Örebro universitet, Institutionen för medicinska vetenskaper.
2022 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Professionals working in the electrical industry are at risk of accidental injuries caused by electricity. Electrical accidents can cause persistent neurological symptoms, previously mainly described in patients whose injuries were initially extensive. The overall aim of this thesis was to study the prevalence of persisting, self-reported symptoms after electrical accidents and to explore their relationship to results obtained using clinical methods that are commonly used to study nerve function and hand-arm function. Another aim was to increase knowledge about the work situation and the safety culture of Swedish electricians and to describe the frequency with which electricians seek health care after electrical accidents. Study I was a retrospective survey of 523 Swedish male electricians. In study II, the electricians who reported persistent symptoms were further invited to undergo clinical examinations that included quantitative sensory testing (QST), assessment of fine motor skills and tactile gnosis. The most common self-reported symptoms were pain, reduced sensation and reduced muscle function. For a few, these symptoms persisted at the time of survey. Roughly half of the group exhibited abnormal warm and cold perception thresholds and tactile gnosis test values. Study III included 24 participants with persisting self-reported sensory symptoms, 1-5 years after an accident. Observations of nerve function; QST, laserevoked potentials (LEP) and nerve conductions studies, were performed. At least one neurosensory impairment was present- in at least one of the tests in 67% of the participants. The participants in study III were also evaluated in study IV, in which a control group of 24 healthy persons was added. Hand function was affected in many participants assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire as was tactil gnosis and manual dexterity, for the participants in the case group. Only a quarter of the participants in study I sought health care after their accidents, and the safety culture questionnaire revealed deficiencies, particularly in the reporting culture. The conclusions of this thesis are that self-reported neurosensory symptoms can persist for years after an electrical accident and that these symptoms can be evaluated using standard neurophysiological and functional tests that reflect changes in nerve function. Accordingly, hand function, examined using both objective and subjective measures, may be affected after work-related electrical accidents. This thesis highlights some aspects of safety culture and the work situations of professionals within the electrical industry. These areas need to be improved so that reporting routines provide opportunities to learn from and prevent accidents.

sted, utgiver, år, opplag, sider
Örebro: Örebro University , 2022. , s. 95
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 274
Emneord [en]
Electrical accident, Neurosensory symptoms, No-let-go phenomenon, Pain, Voltage, Quantitative sensory testing
HSV kategori
Identifikatorer
URN: urn:nbn:se:oru:diva-100921ISBN: 9789175294766 (tryckt)OAI: oai:DiVA.org:oru-100921DiVA, id: diva2:1690991
Disputas
2022-12-09, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (svensk)
Opponent
Veileder
Tilgjengelig fra: 2022-08-29 Laget: 2022-08-29 Sist oppdatert: 2022-11-21bibliografisk kontrollert
Delarbeid
1. Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians
Åpne denne publikasjonen i ny fane eller vindu >>Electrical injury in relation to voltage, "no-let-go" phenomenon, symptoms and perceived safety culture: a survey of Swedish male electricians
Vise andre…
2016 (engelsk)Inngår i: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 89, nr 2, s. 261-270Artikkel i tidsskrift (Fagfellevurdert) 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.

sted, utgiver, år, opplag, sider
Springer, 2016
Emneord
Electrical injury, Low-voltage injury, High-voltage injury, Safety management, Neurological symptoms, Pain
HSV kategori
Forskningsprogram
Folkhälsovetenskap
Identifikatorer
urn:nbn:se:oru:diva-48474 (URN)10.1007/s00420-015-1069-3 (DOI)000368806500008 ()26186954 (PubMedID)2-s2.0-84955733403 (Scopus ID)
Forskningsfinansiär
Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0561
Merknad

Funding Agency:

Örebro Research Committee

Tilgjengelig fra: 2016-02-23 Laget: 2016-02-23 Sist oppdatert: 2022-11-21bibliografisk kontrollert
2. Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series
Åpne denne publikasjonen i ny fane eller vindu >>Neurosensory findings among electricians with self-reported remaining symptoms after an electrical injury: A case series
2016 (engelsk)Inngår i: Burns, ISSN 0305-4179, E-ISSN 1879-1409, Vol. 42, nr 8, s. 1712-1720Artikkel i tidsskrift (Fagfellevurdert) 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).

sted, utgiver, år, opplag, sider
Oxford, United Kingdom: Elsevier, 2016
Emneord
Voltage, thermal perception, vibration perception thresholds, manual dexterity, tactile gnosis, small fibre neuropathy
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-50950 (URN)10.1016/j.burns.2016.05.017 (DOI)000391073900012 ()27317339 (PubMedID)2-s2.0-85005942729 (Scopus ID)
Forskningsfinansiär
Forte, Swedish Research Council for Health, Working Life and Welfare, 2010-0561
Merknad

Funding Agencies:

Örebro Research Committee

Department of Occupational and Environmental Medicine, Örebro University Hospital

Tilgjengelig fra: 2016-06-20 Laget: 2016-06-20 Sist oppdatert: 2022-11-21bibliografisk kontrollert
3. Clinical Evaluation of Nerve Function in Electrical Accident Survivors with Persisting Neurosensory Symptoms
Åpne denne publikasjonen i ny fane eller vindu >>Clinical Evaluation of Nerve Function in Electrical Accident Survivors with Persisting Neurosensory Symptoms
Vise andre…
2022 (engelsk)Inngår i: Brain Sciences, E-ISSN 2076-3425, Vol. 12, nr 10, artikkel-id 1301Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

OBJECTIVE: Work related electrical accidents are prevalent and can cause persisting symptoms. We used clinical neurophysiological techniques to assess neurosensory function following electrical accidents and correlated test results with the patients' symptoms.

METHODS: We studied 24 patients who reported persisting neurosensory symptoms following a workplace electrical accident. We assessed nerve function using quantitative sensory testing (QST), thermal roller testing, laser evoked potential (LEP), and electroneurography. The patients' results were compared with previously established normative data.

RESULTS: Altogether, 67% of the patients showed at least one neurosensory impairment with a large heterogeneity in test results across patients. At a group level, we observed significant deviations in in QST, LEP, and sensory and motor neurography. Overall, we found a weak correlation between test results and self-reported symptoms.

CONCLUSIONS: In a majority of patients with neurosensory symptoms after a workplace electrical accident, neurosensory testing confirmed the existence of an underlying impairment of the nervous system.

sted, utgiver, år, opplag, sider
MDPI, 2022
Emneord
LEP, QST, electrical accidents, neurography, neurophysiology, self-reported symptoms
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-101975 (URN)10.3390/brainsci12101301 (DOI)000874200300001 ()36291235 (PubMedID)2-s2.0-85140587293 (Scopus ID)
Merknad

Funding agencies:

Swedish government OLL-839111

AFA Insurance group 190010

Tilgjengelig fra: 2022-10-28 Laget: 2022-10-28 Sist oppdatert: 2024-07-04bibliografisk kontrollert
4. Hand function after an electrical accident: a case-control study
Åpne denne publikasjonen i ny fane eller vindu >>Hand function after an electrical accident: a case-control study
Vise andre…
2023 (engelsk)Inngår i: Journal of Occupational and Environmental Medicine, ISSN 1076-2752, E-ISSN 1536-5948, Vol. 65, nr 3, s. 242-248Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

OBJECTIVE: Electrical accidents cause both acute and long-term injuries. The care of acute injuries is somewhat standardized, but currently recommendations or assessment tools are not available for assessing the long-term effects of an accident on hand function.

METHODS: A case-control study of 24 healthy controls and 24 cases, 1-5 years after an electrical accident and with self-reported neurosensory symptoms, was performed using three hand-function tests: the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Purdue Pegboard test and the Shape and Identification (STI) test.

RESULTS: Compared to the control group, patients received statistically significantly lower scores for the DASH outcome measure and the Purdue Pegboard and for one finger on the STI test.

CONCLUSION: Hand function is affected after an electrical accident in individuals with self-reported neurosensory symptoms.

sted, utgiver, år, opplag, sider
Lippincott Williams & Wilkins, 2023
Emneord
Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, electrical accident, hand function, long-term
HSV kategori
Identifikatorer
urn:nbn:se:oru:diva-101676 (URN)10.1097/JOM.0000000000002720 (DOI)000943335100022 ()36198622 (PubMedID)2-s2.0-85149961179 (Scopus ID)
Merknad

Funding agencies:

AFA Insurance group 190010

Swedish Government

Örebro county councils

ALF-agreement OLL-839111

Örebro County Research Committee OLL-881331

Tilgjengelig fra: 2022-10-06 Laget: 2022-10-06 Sist oppdatert: 2023-04-11bibliografisk kontrollert

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