Su Anselm Ting, Fukumoto Jin, Darus Azlan, Hoe Victor C W, Miyai Nobuyuki, Isahak Marzuki, Takemura Shigeki, Bulgiba Awang, Yoshimasu Kouichi, Maeda Setsuo, Miyashita Kazuhisa
Centre for Occupational and Environmental Health, Department of Social and Preventive Medicine, University of Malaya.
J Occup Health. 2013;55(6):468-78. doi: 10.1539/joh.13-0059-oa. Epub 2013 Oct 26.
The aim of this study was to investigate the clinical characteristics of HAVS in a tropical environment in comparison with a temperate environment.
We conducted a series medical examinations among the forestry, construction and automobile industry workers in Malaysia adopting the compulsory medical examination procedure used by Wakayama Medical University for Japanese vibratory tools workers. We matched the duration of vibration exposure and compared our results against the Japanese workers. We also compared the results of the Malaysian tree fellers against a group of symptomatic Japanese tree fellers diagnosed with HAVS.
Malaysian subjects reported a similar prevalence of finger tingling, numbness and dullness (Malaysian=25.0%, Japanese=21.5%, p=0.444) but had a lower finger skin temperature (FST) and higher vibrotactile perception threshold (VPT) values as compared with the Japanese workers. No white finger was reported in Malaysian subjects. The FST and VPT of the Malaysian tree fellers were at least as bad as the Japanese tree fellers despite a shorter duration (mean difference=20.12 years, 95%CI=14.50, 25.40) of vibration exposure.
Although the vascular disorder does not manifest clinically in the tropical environment, the severity of HAVS can be as bad as in the temperate environment with predominantly neurological disorder. Hence, it is essential to formulate national legislation for the control of the occupational vibration exposure.
本研究旨在比较热带环境与温带环境下手部振动性白指（HAVS）的临床特征。
我们采用和歌山医科大学针对日本使用振动工具工人的强制体检程序，对马来西亚的林业、建筑和汽车行业工人进行了一系列医学检查。我们匹配了振动暴露时长，并将我们的结果与日本工人的结果进行比较。我们还将马来西亚伐木工的结果与一组被诊断为HAVS的有症状的日本伐木工的结果进行了比较。
马来西亚受试者报告的手指刺痛、麻木和迟钝的患病率相似（马来西亚=25.0%，日本=21.5%，p=0.444），但与日本工人相比，其手指皮肤温度（FST）较低，振动触觉感知阈值（VPT）较高。马来西亚受试者中未报告白指病例。尽管马来西亚伐木工的振动暴露时长较短（平均差异=20.12年，95%CI=14.50，25.40），但其FST和VPT至少与日本伐木工一样差。
尽管在热带环境中血管疾病在临床上未表现出来，但HAVS的严重程度可能与以神经疾病为主的温带环境一样严重。因此，制定国家立法以控制职业性振动暴露至关重要。
