Gerhardsson Lars, Hagberg Mats
Occupational and Environmental Medicine, University of Gothenburg, Medicinaregatan 16, Box 414, SE-405 30 Gothenburg, Sweden.
J Occup Med Toxicol. 2019 Jul 15;14:21. doi: 10.1186/s12995-019-0242-0. eCollection 2019.
Long-term vibration exposure may cause neurophysiological disturbances such as numbness and tingling, reduced grip strength and difficulties in handling small objects. The dominant hand will usually have a higher vibration exposure than the non-dominant hand, which may cause more severe neurological symptoms and signs in the dominant hand.
The study is based on 47 (36 males and 11 females) vibration exposed workers, all former patients from the department of Occupational and Environmental medicine, Gothenburg university. The comparison group consisted of 18 randomly selected subjects from the general population of Gothenburg. All participants completed several questionnaires and had a standardized medical examination. Thereafter, neurophysiological tests such as the determination of vibration and thermal perception thresholds were performed, as well as muscle strength tests in hands and fingers.
The temperature perception thresholds (TPTs) and the vibration perception thresholds (VPTs) did not differ significantly between the dominant and non-dominant hand in vibration exposed workers. The referents showed a significantly better performance ( ≤ 0.02 and ≤ 0.034, respectively) than the workers for both TPTs and VPTs, indicating a negative effect on the Aß, as well as on the Aδ and C-fibers among the exposed workers.The Purdue Pegboard test showed a significantly better performance in the dominant vs non-dominant hand in both workers ( = 0.001) and referents ( = 0.033). The referents showed a better performance than the workers in both hands ( < 0.001). The Baseline handgrip, the Pinch grip and 3-Chuck grip tests did not differ significantly between the dominant and non-dominant hand in neither workers nor referents.
In this study, minor differences between the dominant and non-dominant hand were noted for the Purdue Pegboard test in both workers and referents. Despite a probably higher vibration exposure in the dominant hand (mostly the right hand), however, quite similar test results were noted for VPTs, TPTs, Baseline handgrip, Pinch grip and 3-Chuck grip when comparing the dominant and non-dominant hand in the vibration exposed workers. In case of lack of time and financial obstacles, neurological tests in solely the dominant hand, will probably satisfactory reflect the conditions in the non-dominant hand.
长期接触振动可能会导致神经生理紊乱,如麻木和刺痛、握力下降以及操作小物体困难。优势手通常比非优势手接触到更高的振动,这可能会在优势手上导致更严重的神经症状和体征。
该研究基于47名(36名男性和11名女性)接触振动的工人,他们均为哥德堡大学职业与环境医学系的 former 患者。对照组由从哥德堡普通人群中随机选取的18名受试者组成。所有参与者都完成了几份问卷并进行了标准化的医学检查。此后,进行了神经生理测试,如测定振动和热感觉阈值,以及手部和手指的肌肉力量测试。
在接触振动的工人中,优势手和非优势手的温度感觉阈值(TPTs)和振动感觉阈值(VPTs)没有显著差异。对照组在TPTs和VPTs方面的表现均明显优于工人(分别为≤0.02和≤0.034),表明接触振动的工人的Aß以及Aδ和C纤维受到了负面影响。普渡钉板测试显示,在工人(=0.001)和对照组(=0.033)中,优势手的表现均明显优于非优势手。对照组双手的表现均优于工人(<0.001)。在工人和对照组中,优势手和非优势手的基线握力、捏力和三指握力测试均无显著差异。
在本研究中,工人和对照组在普渡钉板测试中优势手和非优势手之间存在细微差异。尽管优势手(主要是右手)可能接触到更高的振动,但在比较接触振动的工人的优势手和非优势手时,VPTs、TPTs、基线握力、捏力和三指握力的测试结果相当相似。在时间有限和存在经济障碍的情况下,仅对优势手进行神经学测试可能会令人满意地反映非优势手的状况。