Rui Francesca, D'Agostin Flavia, Negro Corrado, Bovenzi Massimo
Department of Public Health Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Centro Tumori, Trieste, Italy.
Int Arch Occup Environ Health. 2008 Apr;81(5):545-51. doi: 10.1007/s00420-007-0256-2. Epub 2007 Sep 21.
To investigate the relation between manipulative dexterity and vibration exposure, ergonomic risk factors, and upper limb disorders in a group of workers exposed to hand-transmitted vibration (HTV).
Manipulative dexterity was investigated on 115 HTV workers (82 forestry workers and 33 stone workers) and 64 control men over 1-year follow-up period. The Purdue pegboard method was used to test manipulative dexterity which was scored for the dominant hand, non-dominant hand, and both hands. Information about individual, work and health history was obtained by means of a standardised questionnaire. Vibration exposure was assessed in terms of tool vibration magnitudes, daily and total exposure duration, and cumulative vibration dose.
On the cross-sectional investigation, Purdue pegboard scores were significantly lower in the HTV workers than in the controls (0.001 < P < 0.05). Over 1-year follow-up period, Purdue pegboard scores were found to be inversely related to age, smoking and use of vibratory tools (0.001 < P < 0.05). Moreover, deterioration of some measures of manipulative dexterity was significantly associated with sensorineural and vascular symptoms in the fingers of the HTV workers. Random-intercept linear regression analysis showed that Purdue pegboard scores decreased with the increase of vibration exposure. The reduction of assembly score (i.e. number of pins, collars, and washers assembled in a 60-s period) was significantly associated with the increase in vibration exposure and ergonomic stress (neck-upper arm posture, hand-intensive work, and total ergonomic score). Purdue pegboard scores tended to improve over the follow-up period in both the controls and the HTV workers, suggesting a possible learning effect over time.
The findings of this longitudinal study suggest an association between deterioration of manipulative dexterity and neurovascular symptoms in the fingers of HTV workers. There was evidence for a significant relation between loss of precise manipulation and exposures to hand-transmitted vibration and ergonomic risk factors.
调查一组接触手部传递振动（HTV）的工人的操作灵巧性与振动暴露、工效学危险因素及上肢疾病之间的关系。
在1年的随访期内，对115名HTV工人（82名林业工人和33名石材工人）和64名对照男性进行操作灵巧性调查。采用普渡钉板法测试操作灵巧性，对优势手、非优势手和双手进行评分。通过标准化问卷获取个人、工作和健康史信息。根据工具振动幅度、每日和总暴露持续时间以及累积振动剂量评估振动暴露情况。
在横断面调查中，HTV工人的普渡钉板得分显著低于对照组（0.001<P<0.05）。在1年的随访期内，发现普渡钉板得分与年龄、吸烟和使用振动工具呈负相关（0.001<P<0.05）。此外，HTV工人手指的一些操作灵巧性指标的恶化与感觉神经和血管症状显著相关。随机截距线性回归分析表明，普渡钉板得分随振动暴露的增加而降低。装配得分（即60秒内装配的销、垫圈和螺母数量）的降低与振动暴露和工效学压力（颈部-上臂姿势、手部密集工作和总工效学得分）的增加显著相关。在随访期内，对照组和HTV工人的普渡钉板得分均有改善趋势，但可能存在学习效应。
这项纵向研究的结果表明，HTV工人手指的操作灵巧性恶化与神经血管症状之间存在关联。有证据表明，精确操作能力的丧失与手部传递振动暴露和工效学危险因素之间存在显著关系。
