Fenga C, Rapisarda V, Valentino M, Cacciola A, Deboli R, Calvo A, Germanò D
Dipartimento di Medicina Sociale del Territorio, Sez. di Medicina del Lavoro, Università degli Studi di Messina, Messina, Italy.
G Ital Med Lav Ergon. 2007 Jul-Sep;29(3 Suppl):592-3.
Vibration exposure of the hand-arm system is associated with an increased risk of upper-limb vascular, neurological and musculoskeletal lesions, or hand-arm vibration syndrome (HAVS). The prevalence of occupational HAVS and upper-limb disorders was studied among 278 Forestry Service workers in Sicily and Calabria. Subjects who used chain-saws (18 weeks/year) had a greater prevalence of peripheral sensory-neural disturbances (28%), upper-limb musculoskeletal disorders (33%) and carpal tunnel syndrome (19%) compared with 260 manual workers from the same Corps not exposed to hand-transmitted vibration. Raynaud's phenomenon was comparable in exposed and control subjects (5.3% vs. 4.7%.) Upper-limb neuropathies were significantly associated with energy-equivalent frequency-weighted acceleration; exposure duration; and cumulative vibration dose (m2/s4h). The variable "years of work with vibrating tools" was strongly associated with peripheral neuropathies; carpal tunnel syndrome; and upper-limb musculotendinous syndromes. Data suggest that in Sicily and Calabria, where the climate is milder than in other areas of Italy, forestry work with hand-held vibrating tools does not entail a greater prevalence of peripheral vascular disorders (Raynaud's phenomenon), while the prevalence of occupational upper-limb neurological and musculoskeletal disorders, in which combined ergonomic and mechanical risk factors have a large pathogenic role, is significantly increased.
手臂系统的振动暴露与上肢血管、神经和肌肉骨骼损伤风险增加有关，即手臂振动综合征（HAVS）。对西西里岛和卡拉布里亚的278名林业工人进行了职业性手臂振动综合征和上肢疾病患病率的研究。与来自同一部门未接触手部传递振动的260名体力劳动者相比，使用链锯（每年18周）的受试者外周感觉神经障碍患病率更高（28%），上肢肌肉骨骼疾病患病率更高（33%），腕管综合征患病率更高（19%）。雷诺现象在暴露组和对照组中相当（5.3%对4.7%）。上肢神经病变与能量等效频率加权加速度、暴露持续时间和累积振动剂量（m²/s⁴h）显著相关。“使用振动工具的工作年限”变量与周围神经病变、腕管综合征和上肢肌腱综合征密切相关。数据表明，在西西里岛和卡拉布里亚，其气候比意大利其他地区更为温和，使用手持式振动工具进行林业工作并不会导致外周血管疾病（雷诺现象）患病率更高，而职业性上肢神经和肌肉骨骼疾病的患病率显著增加，在这些疾病中，人体工程学和机械风险因素共同起着很大的致病作用。
