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办公人员手部背侧皮肤温度与上肢肌肉骨骼紊乱严重程度的关系。

Skin temperature in the dorsal hand of office workers and severity of upper extremity musculoskeletal disorders.

机构信息

Department of Public Health, Temple University, Philadelphia, PA 19122, USA.

出版信息

Int Arch Occup Environ Health. 2009 Nov;82(10):1281-92. doi: 10.1007/s00420-009-0450-5. Epub 2009 Jul 26.

Abstract

OBJECTIVE

This study aimed to examine the suitability of using mean dorsal (hand) skin temperature (MDT) before and after a short typing task as an indicator of upper extremity musculoskeletal disorder (UEMSD) severity. In addition, MDT reproducibility in controls was assessed for a pre-typing and three post-typing time periods over three trials.

METHODS

Asymptomatic office workers (n = 10) and office workers with distal UEMSD symptoms (n = 35) typed for 9 min at three ambient temperatures (18, 22, and 26 degrees C). Pre- and post-trial MDT was measured by infrared thermography. UEMSD severity was defined anamnestically by symptoms and by a physical examination and symptom-derived case definition.

RESULTS

Good to excellent reproducibility (intra-class correlation coefficients = 0.46-0.85) for MDT was found in controls at 22 degrees C. At 18 and 22 degrees C, pre-typing MDT differed between controls and cases by number of symptom sites marked on a hand-arm diagram (ANOVA, P <or= 0.05), and by number of UEMSD case definitions met (ANOVA, P <or= 0.05). Post hoc analyses showed colder temperatures in the most severely affected cases in comparison with controls. No post-typing skin temperature differentiation by severity was found.

CONCLUSION

Reduced dorsal hand skin temperature after acclimating to an ambient temperature of 18-22 degrees C in those with more severe UEMSDs may reflect an underlying dysfunctional sympathetic nervous system. Further testing in epidemiological cohorts would be desirable to evaluate the generalizability and feasibility of this physiological measurement for UEMSD severity in the workplace.

摘要

目的

本研究旨在检验在短时间打字任务前后使用平均手部(背侧)皮肤温度(MDT)作为上肢肌肉骨骼疾病(UEMSD)严重程度指标的适宜性。此外,还评估了在三个试验的三个预打字和三个打字后时间段中,健康对照者的 MDT 重复性。

方法

无症状的办公室工作人员(n = 10)和有远端 UEMSD 症状的办公室工作人员(n = 35)在三个环境温度(18、22 和 26°C)下打字 9 分钟。通过红外热成像测量预试验和试验后 MDT。UEMSD 严重程度通过症状和体格检查以及症状衍生的病例定义进行病史定义。

结果

在 22°C 时,健康对照者的 MDT 具有良好到极好的可重复性(组内相关系数=0.46-0.85)。在 18 和 22°C 时,与对照组相比,病例组在手部 - 手臂图上标记的症状部位数量(方差分析,P≤0.05)和满足的 UEMSD 病例定义数量(方差分析,P≤0.05)存在差异。事后分析显示,与对照组相比,病情最严重的病例的温度更低。未发现打字后皮肤温度因严重程度而有所不同。

结论

在适应 18-22°C 环境温度后,UEMSD 较严重的患者背部手部皮肤温度降低,可能反映出潜在的功能失调的交感神经系统。在流行病学队列中进一步测试将有助于评估这种生理测量在工作场所中用于 UEMSD 严重程度的普遍性和可行性。

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