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定量神经感觉研究结果,年轻振动暴露工人的症状和体征。

Quantitative neurosensory findings, symptoms and signs in young vibration exposed workers.

机构信息

Occupational and Environmental Medicine, University of Gothenburg, Box 414, Gothenburg, SE-405 30, Sweden.

出版信息

J Occup Med Toxicol. 2013 Mar 27;8(1):8. doi: 10.1186/1745-6673-8-8.

Abstract

BACKGROUND

Long-term exposure to hand-held vibrating tools may cause the hand arm vibration syndrome (HAVS) including vibration induced white fingers and sensorineural symptoms. The aim was to study early neurosensory effects by quantitative vibrotactile and monofilament tests in young workers with hand-held vibration exposure.

METHODS

This cross-sectional study consisted of 142 young, male machine shop and construction workers with hand-held exposure to vibrating tools. They were compared with 41 non-vibration exposed subjects of the same age-group. All participants passed a structured interview, answered several questionnaires and had a physical examination including the determination of vibrotactile perception thresholds (VPTs) at two frequencies (31.5 and 125 Hz) and Semmes Weinstein's Monofilament test.

RESULTS

In the vibration exposed group 8% of the workers reported episodes of tingling sensations and 10% numbness in their fingers. Approximately 5-10% of the exposed population displayed abnormal results on monofilament tests. The vibrotactile testing showed significantly increased VPTs for 125 Hz in dig II bilaterally (right hand, p = 0.01; left hand, p = 0.024) in the vibration exposed group.A multiple regression analysis (VPT - dependent variable; age, height, examiner and five different vibration dose calculations - predictor variables) in dig II bilaterally showed rather low R2-values. None of the explanatory variables including five separately calculated vibration doses were included in the models, neither for the total vibration exposed group, nor for the highest exposed quartile.A logistic multiple regression analysis (result of monofilament testing - dependent variable; age, height, examiner and five vibration dose calculations - predictor variables) of the results of monofilament testing in dig II bilaterally gave a similar outcome. None of the independent variables including five calculated vibration doses were included in the models neither for the total exposed group nor for the highest exposed quartile.

CONCLUSION

In spite of the fairly short vibration exposure, a tendency to raised VPTs as well as pathologic monofilament test results was observed. Thus, early neurophysiologic symptoms and signs of vibration exposure may appear after short-term exposure also in young workers.

摘要

背景

长期接触手持式振动工具可能会导致手部手臂振动综合征(HAVS),包括振动诱发的白指和感觉神经性症状。目的是通过定量振动触觉和单丝测试研究年轻接触手持式振动工人的早期神经感觉效应。

方法

这项横断面研究包括 142 名年轻的男性机械厂和建筑工人,他们接触手持式振动工具。他们与同年龄组的 41 名非振动暴露的受试者进行了比较。所有参与者都接受了结构化访谈,回答了几个问卷,并进行了身体检查,包括在两个频率(31.5Hz 和 125Hz)和 Semmes-Weinstein 单丝测试下测定振动触觉感知阈值(VPT)。

结果

在振动暴露组中,有 8%的工人报告手指有刺痛感,10%的工人报告手指麻木。大约 5-10%的暴露人群在单丝测试中显示异常结果。振动触觉测试显示,在振动暴露组中,双侧 Dig II 的 125Hz VPT 明显升高(右手,p=0.01;左手,p=0.024)。双侧 Dig II 的 VPT (因变量)的多元回归分析(年龄、身高、检查者和五种不同的振动剂量计算-预测变量)显示,R2 值相当低。在模型中,包括五个单独计算的振动剂量在内的任何解释变量都没有包括在内,无论是对于总振动暴露组,还是对于最高暴露四分位数。双侧 Dig II 中单丝测试结果(因变量)的逻辑多元回归分析(年龄、身高、检查者和五个振动剂量计算-预测变量)得出了类似的结果。在模型中,包括五个计算出的振动剂量在内的任何独立变量都没有包括在内,无论是对于总暴露组,还是对于最高暴露四分位数。

结论

尽管振动暴露时间相当短,但仍观察到 VPT 升高以及单丝测试结果异常的趋势。因此,即使在年轻工人中,短期接触也可能出现早期神经生理症状和振动暴露迹象。

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