Gold J E, Punnett L, Cherniack M, Wegman D H
Department of Work Environment, University of Massachusetts, Lowell, MA 01854, USA.
Ergonomics. 2005 Jan;48(1):66-77. doi: 10.1080/00140130412331311408.
Upper extremity musculoskeletal disorders (UEMSDs) comprise a large proportion of work-related illnesses in the USA. Physical risk factors including manual force and segmental vibration have been associated with UEMSDs. Reduced sensitivity to vibration in the fingertips (a function of nerve integrity) has been found in those exposed to segmental vibration, to hand force, and in office workers. The objective of this study was to determine whether an association exists between digital vibration thresholds (VTs) and exposure to ergonomic stressors in automobile manufacturing. Interviews and physical examinations were conducted in a cross-sectional survey of workers (n = 1174). In multivariable robust regression modelling, associations with workers' estimates of ergonomic stressors stratified on tool use were determined. VTs were separately associated with hand force, vibration as felt through the floor (whole body vibration), and with an index of multiple exposures in both tool users and non-tool users. Additional associations with contact stress and awkward upper extremity postures were found in tool users. Segmental vibration was not associated with VTs. Further epidemiologic and laboratory studies are needed to confirm the associations found. The association with self-reported whole body vibration exposure suggests a possible sympathetic nervous system effect, which remains to be explored.
上肢肌肉骨骼疾病（UEMSDs）在美国与工作相关的疾病中占很大比例。包括体力和局部振动在内的物理风险因素已被证实与UEMSDs有关。在接触局部振动、手部用力的人群以及办公室职员中，均发现指尖对振动的敏感度降低（这是神经完整性的一项功能）。本研究的目的是确定在汽车制造行业中，手指振动阈值（VTs）与人体工程学压力源暴露之间是否存在关联。在一项针对1174名工人的横断面调查中，进行了访谈和体格检查。在多变量稳健回归模型中，确定了与按工具使用情况分层的人体工程学压力源工人估计值之间的关联。在工具使用者和非工具使用者中，VTs分别与手部用力、通过地板感受到的振动（全身振动）以及多重暴露指数相关。在工具使用者中还发现了与接触压力和上肢不良姿势的其他关联。局部振动与VTs无关。需要进一步的流行病学和实验室研究来证实所发现的关联。与自我报告的全身振动暴露之间的关联表明可能存在交感神经系统效应，这还有待探索。
