When my regs are pressurized there is a strong axial force on the threads, making it impossible to unscrew the nut by hand, and very hard with the wrench. The nut becomes easy to unscrew only when not pressurised. So the risk that the nut self-unscrews underwater is zero even if hand-tightened.I saw a regulator that was only finger tight blow off the hose. It was a real eye-opening experience. I think our instructor did it on purpose.
The risk is that the nut was already almost completely unscrewed before pressurising the reg.
Of course checking the nuts (completely screwed in, but not overtightened) before pressurising the regs is a standard procedure for divers who, as me, hand screw the second stage.
On the first stage end, instead, the situation is very different. The O-ring is static and there is no swivel. An hand-tightened hose can effectively extrude the O-ring, as it is not designed for allowing rotation. This end of the hose is designed for being properly tightened with a torque-measuring wrench.