Masci F, Tassoni M, Bossi M, Magenta Biasina A, Serrao G, Rosecrance J, Colosio C
Department of Health Sciences of the University of Milan and International Center for Rural Health of San Paolo Hospital, Milan, Italy.
San Paolo Ultrasounds Medical School, S. Paolo Hospital, University of Milan, Milan, Italy.
Work. 2016;55(4):747-756. doi: 10.3233/WOR-162462.
Dairy milking is a demanding work task that has been associated with hand and wrist musculoskeletal disorders. Clinical approaches to identify the early effects of musculoskeletal disorders among dairy parlor workers' wrist have not been well defined.
The purpose of this pilot study was to develop a study protocol that would assist in the identification and quantification of hand and wrist disorders among dairy workers that perform tasks in the dairy parlor. Additionally, such a study protocol was needed to perform relatively rapid assessments of the wrist/hand on large samples of dairy workers.
Fourteen dairy parlor workers were assessed for i) upper limb symptoms and work history through questionnaire, ii) a physical examination of the upper limb and in particular wrists and iii) wrist ultrasonography. An additional 21 unexposed paired participants (the control group) also participated in the data collection.
The study results identified two ultrasound acoustic windows characterized by the highest predictive value for alteration of the wrist's structure. Study results indicated an impairment of the distal median nerve in structure and mobility and impairment of the distal tendon of the muscle extensor carpi ulnaris that included dislocation and frank damage.
This study identified at least two acoustic windows that should be assessed with ultrasound studies on larger groups and in prospective periodical health surveillance of dairy workers. The study confirmed the wrist was at risk for biomechanical stress among workers conducting milking tasks in the dairy parlors.
挤奶工作要求较高，且与手部和腕部肌肉骨骼疾病相关。目前，针对奶牛场工人腕部肌肉骨骼疾病早期影响的临床诊断方法尚未明确。
本初步研究旨在制定一项研究方案，以帮助识别和量化奶牛场中从事相关工作的工人的手部和腕部疾病。此外，还需要这样一项研究方案，以便对大量奶牛场工人的手腕/手部进行相对快速的评估。
对14名奶牛场工人进行了以下评估：i）通过问卷调查了解上肢症状和工作史；ii）对上肢尤其是手腕进行体格检查；iii）进行手腕超声检查。另外21名未接触相关风险因素的配对参与者（对照组）也参与了数据收集。
研究结果确定了两个超声声学窗口，它们对腕部结构改变具有最高的预测价值。研究结果表明，正中神经远端在结构和活动度方面存在损伤，尺侧腕伸肌远端肌腱也有损伤，包括脱位和明显损伤。
本研究确定了至少两个声学窗口，在对更多奶牛场工人进行更大规模的超声研究以及前瞻性定期健康监测时应对其进行评估。该研究证实，在奶牛场从事挤奶任务的工人中腕部存在生物力学应力风险。
