Kivekäs J, Riihimäki H, Husman K, Hänninen K, Härkönen H, Kuusela T, Pekkarinen M, Tola S, Zitting A J
LEL Employment Pension Fund, Helsinki, Finland.
Scand J Work Environ Health. 1994 Apr;20(2):101-6. doi: 10.5271/sjweh.1425.
In 1978, a cross-sectional study of 279 lumberjacks exposed to hand-arm vibration and 178 unexposed referents was conducted. The aim of the present study was to provide a seven-year follow-up on (i) the changes in the white-finger symptoms among the lumberjacks and the referents, (ii) the effect of white-finger symptoms on the professional prognosis of the lumberjacks, and (iii) the relationship between hand-arm vibration and changes in wrist bones.
The methods consisted of a questionnaire, a routine clinical examination, and radiographs of the wrists and hands. The examinations were conducted as a field study using a mobile unit.
The prevalence of white-finger symptoms was 18% among the lumberjacks and 3% among the referents in the original study. Seven years later 213 lumberjacks and 140 referents participated in the follow-up. The prevalence of white-finger symptoms was 24.9 among the lumberjacks and 5.7 among the referents, and the seven-year cumulative incidence was 14.7% among the lumberjacks and 2.3% among the referents. After allowance for age, there was no difference in the incidence of white-finger symptoms between the lumberjacks with fewer than 15 years of exposure and the referents, but the risk increased with increasing duration of exposure (risk ratio 8.9, 95% confidence interval 2.5-28.9 for those exposed at least 25 years). There was no difference between the two groups in the prevalence of radiographically detectable translucencies or osteoarthrotic changes in the wrists and hands.
According to the results, white-finger symptoms are still a problem among lumberjacks who started chain-saw work before 1970.
1978年，对279名接触手臂振动的伐木工和178名未接触的对照对象进行了一项横断面研究。本研究的目的是对以下方面进行为期七年的随访：(i)伐木工和对照对象中白指症状的变化；(ii)白指症状对伐木工职业预后的影响；(iii)手臂振动与腕骨变化之间的关系。
研究方法包括问卷调查、常规临床检查以及手腕和手部的X光片检查。这些检查是通过一个移动单元进行的现场研究。
在最初的研究中，伐木工中白指症状的患病率为18%，对照对象中为3%。七年后，213名伐木工和140名对照对象参与了随访。伐木工中白指症状的患病率为24.9%，对照对象中为5.7%，伐木工的七年累积发病率为14.7%，对照对象为2.3%。在考虑年龄因素后，接触时间少于15年的伐木工和对照对象在白指症状发病率上没有差异，但随着接触时间的增加风险升高（接触至少25年者的风险比为8.9，95%置信区间为2.5 - 28.9）。两组在手腕和手部X光片可检测到的透亮区或骨关节炎变化的患病率上没有差异。
根据研究结果，对于1970年之前开始从事链锯工作的伐木工来说，白指症状仍然是一个问题。
