Su Anselm Ting, Maeda Setsuo, Fukumoto Jin, Miyai Nobuyuki, Isahak Marzuki, Yoshioka Atsushi, Nakajima Ryuichi, Bulgiba Awang, Miyashita Kazuhisa
Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Malaysia.
Ind Health. 2014;52(4):367-76. doi: 10.2486/indhealth.2013-0137. Epub 2014 Apr 17.
This study aimed to explore the clinical characteristics of hand arm vibration syndrome (HAVS) in a group of tree fellers in a tropical environment. We examined all tree fellers and selected control subjects in a logging camp of central Sarawak for vibration exposure and presence of HAVS symptoms utilizing vibrotactile perception threshold test (VPT) and cold water provocation test (CWP). None of the subjects reported white finger. The tree fellers reported significantly higher prevalence of finger coldness as compared to the control subjects (OR=10.32, 95%CI=1.21-87.94). A lower finger skin temperature, longer fingernail capillary return time and higher VPT were observed among the tree fellers as compared to the control subjects in all fingers (effect size >0.5). The VPT following CWP of the tree fellers was significantly higher (repeated measures ANOVA p=0.002, partial η(2)=0.196) than the control subject. The A (8) level was associated with finger tingling, numbness and dullness (effect size=0.983) and finger coldness (effect size=0.524) among the tree fellers. Finger coldness and finger tingling, numbness and dullness are important symptoms for HAVS in tropical environment that may indicate vascular and neurological damage due to hand-transmitted vibration exposure.
本研究旨在探讨热带环境下一组伐木工手臂振动综合征(HAVS)的临床特征。我们在砂拉越中部的一个伐木营地对所有伐木工和选定的对照对象进行了振动暴露及HAVS症状检查,采用了振动触觉感知阈值测试(VPT)和冷水激发试验(CWP)。所有受试者均未报告出现白指现象。与对照对象相比,伐木工报告的手指发冷患病率显著更高(OR = 10.32,95%CI = 1.21 - 87.94)。与对照对象相比,在所有手指上,伐木工的手指皮肤温度更低、指甲毛细血管回血时间更长且VPT更高(效应量>0.5)。伐木工在CWP后的VPT显著高于对照对象(重复测量方差分析p = 0.002,偏η² = 0.196)。在伐木工中,A(8)水平与手指刺痛、麻木和钝痛(效应量 = 0.983)以及手指发冷(效应量 = 0.524)相关。在热带环境中,手指发冷以及手指刺痛、麻木和钝痛是HAVS的重要症状,可能表明因手部传递振动暴露导致血管和神经损伤。