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使用轨道砂光机的女性工人上肢的工作相关疾病

Work-related disorders of the upper limb in female workers using orbital sanders.

作者信息

Bovenzi Massimo, Della Vedova Anna, Nataletti Pietro, Alessandrini Barbara, Poian Tullio

机构信息

Clinical Unit of Occupational Medicine, Department of Public Health Sciences, University of Trieste, Trieste, Italy.

出版信息

Int Arch Occup Environ Health. 2005 May;78(4):303-10. doi: 10.1007/s00420-004-0574-6. Epub 2005 Mar 25.

Abstract

OBJECTIVES

To investigate the prevalence of vascular, neurological and musculoskeletal disorders of the upper limb in a group of female workers performing either mechanical or hand sanding in the furniture industry (n=100) and in a control group of female office workers (n=100). A further aim was to study the possible adverse effects of exposure to a combination of vibration and ergonomic risk factors in female workers.

METHODS

All female workers underwent a medical interview and a complete physical investigation. The clinical diagnoses of Raynaud's phenomenon and carpal tunnel syndrome (CTS) were made according to international consensus criteria. Hand-transmitted vibration from orbital sanders was measured according to International Organization for Standardization (ISO) recommendations. Daily vibration exposure was assessed in terms of 8-h energy-equivalent frequency-weighted acceleration [A(8)] according to the European Directive on physical agents. Ergonomic load on the upper limbs was estimated by means of strain index methodology.

RESULTS

There was no significant difference in the prevalence of Raynaud's phenomenon between the furniture workers (4%) and the controls (8%). The prevalence of CTS, peripheral sensorineural disturbances (after exclusion of CTS cases) and upper-limb musculoskeletal complaints was significantly greater in the furniture workers than in the controls. CTS was clinically diagnosed in 19% of the furniture workers and 8% of the controls. A log-binomial regression analysis showed that the occurrence of soft-tissue disorders of the upper limb increased significantly with the increase of both daily vibration exposure and the strain index score. It was estimated that the risk for CTS increased by a factor of 1.30 (95% CI 1.11-1.53) for each unit of increase in A(8) (ms(-2)), and by 1.09 (95% CI 1.02-1.15) for each unit of increase in the strain index score.

CONCLUSIONS

Even though the cross-sectional design of this epidemiological study does not allow aetiological considerations, our findings suggest a significant association between occupational use of vibratory tools and soft-tissue disorders in the upper limbs of female workers. Quantitative estimation of vibration exposure and ergonomic stress showed that these physical risk factors seem to contribute in a multiplicative way to the occurrence of chronic nerve and musculoskeletal disorders in female workers operating hand-held vibrating tools in the furniture industry.

摘要

目的

调查家具行业中从事机械打磨或手工打磨的一组女工(n = 100)以及女性办公室职员对照组(n = 100)上肢血管、神经和肌肉骨骼疾病的患病率。另一个目的是研究接触振动与人体工程学风险因素的组合对女工可能产生的不良影响。

方法

所有女工均接受了医学访谈和全面的体格检查。雷诺现象和腕管综合征(CTS)的临床诊断依据国际共识标准进行。根据国际标准化组织(ISO)的建议测量了轨道式砂光机的手传振动。根据欧洲物理因子指令,按照8小时能量等效频率加权加速度[A(8)]评估每日振动暴露量。通过应变指数方法评估上肢的人体工程学负荷。

结果

家具工人(4%)和对照组(8%)中雷诺现象的患病率无显著差异。家具工人中CTS、周围感觉神经障碍(排除CTS病例后)和上肢肌肉骨骼不适的患病率显著高于对照组。19%的家具工人和8%的对照组临床诊断为CTS。对数二项回归分析表明,随着每日振动暴露量和应变指数评分的增加,上肢软组织疾病的发生率显著增加。据估计,A(8)(ms(-2))每增加一个单位,CTS风险增加1.30倍(95%可信区间1.11 - 1.53),应变指数评分每增加一个单位,CTS风险增加1.09倍(95%可信区间1.02 - 1.15)。

结论

尽管这项流行病学研究的横断面设计无法进行病因学分析,但我们的研究结果表明,职业性使用振动工具与女工上肢软组织疾病之间存在显著关联。对振动暴露和人体工程学压力的定量评估表明,这些物理风险因素似乎以相乘的方式促成了在家具行业操作手持振动工具的女工慢性神经和肌肉骨骼疾病的发生。

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