Kim A Ram, Kim Dae Yun, Kim Ji Soo, Lee Heun, Sung Joo Hyun, Yoo Cheolin
1Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033 Republic of Korea.
2Department of Occupational and Environmental Medicine, Gyeongsang National University College of Medicine, Gyeongsang National University Changwon Hospital, Institute of Health Science, 15, Jinju-daero 816beon-gil, Jinju-si, Gyeonsangnam-do 52727 Republic of Korea.
Ann Occup Environ Med. 2019 Mar 1;31:6. doi: 10.1186/s40557-019-0284-x. eCollection 2019.
The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS.
A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value.
The reliability of the CISS questionnaire was proven to be good, with a total Cronbach's alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s.
The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30.
IRB No. 2018-07-040-001. Registered on 4 September 2018.
与其他国家相比，韩国手臂振动综合征（HAVS）的检出率非常低。据推测，缺乏关于HAVS诊断的统一共识和指南是原因之一。HAVS有多种表现，包括不耐寒，其严重程度可以使用不耐寒症状严重程度（CISS）问卷来衡量。本研究旨在确定用作筛查工具的CISS问卷是否有助于HAVS的早期检测。
共有76名有振动诱发症状的男性工人作为最终研究参与者。为了比较健康个体的CISS评分，研究纳入了41名从未接触过局部振动的男性。除了之前的医学问卷外，参与者还回答了CISS问卷。进行统计分析以确定CISS评分与振动诱发症状的关联，并确定其临界值。
CISS问卷的可靠性被证明良好，Cronbach's alpha总值为0.922。暴露组在每个血管阶段的平均CISS评分均有所增加[0期=42.6（18.5）；1期=59.4（14.1）；2期以上=60.2（21.6）]。它们显著高于未暴露组。结果与感觉神经阶段的结果相当一致。30分时的敏感性、特异性、阳性预测值（PPV）、阴性预测值（NPV）和曲线下面积（AUC）分别为88.5、65.3、76.1、82.1和0.769。根据逻辑回归结果，按30分组的CISS评分使两个成分的调整优势比均增加。
用于测量不耐寒程度的自我报告CISS问卷与HAVS的斯德哥尔摩分类高度一致。因此，我们建议使用该问卷评估接触振动工人的不耐寒程度，并以30为临界值检测有振动诱发损伤风险的个体。
IRB编号2018-07-040-001。于2018年9月4日注册。
