Wieslander G, Norbäck D, Edling C
Department of Occupational and Environmental Medicine, Uppsala University, Sweden.
Occup Environ Med. 1996 Apr;53(4):276-80. doi: 10.1136/oem.53.4.276.
To study relations between cryosectioning work, skin temperature, early signs of neuropathy in the hands, and vasospastic and neurological symptoms. Microtome work is carried out at histological and toxicological laboratories all over the world. It implicates local cold exposure of -20 degrees C on the hands of exposed laboratory technicians.
Thirty nine laboratory technicians who use microtomes at the preclinical and clinical laboratories at the University of Uppsala, Sweden were studied. An equal number of nonexposed laboratory technicians served as controls, matched for workplace, sex, age, and smoking habits. Information on symptoms, type of work, and personal factors were assessed by means of a self administered questionnaire. Two point discrimination ability was tested, and vibration perception threshholds were measured for both hands by a bio-thesiometer. Also, skin temperature was measured during cryosectioning work in those 15 technicians performing cryosectioning work during the study period.
Most laboratory technicians did not use any gloves during cryosectioning work, and direct contact with frozen materials sometimes occurred and resulted in a rapid cooling of the skin. In six of 15 exposed subjects (40%), the mean skin temperature during microtome work was below 20 degrees C. A later rise in skin temperature, due to a compensatory vasodilation, was found in two subjects. The group exposed to cold had signs of early neuropathy on the right hand, indicated both by vibrametry and two point discrimination test. Significant work related differences in clinical signs within the group exposed to cold was also found. No differences between exposed and nonexposed people were found for symptoms of Raynaud's phenomenon, numbness, or musculosceletal complaints.
Our study shows that cryosectioning laboratory work may cause adverse health effects--for example, peripheral neuropathy--and measures should be taken to protect the hands from the local cold exposure.
研究冷冻切片工作、皮肤温度、手部神经病变早期迹象以及血管痉挛和神经症状之间的关系。世界各地的组织学和毒理学实验室都有切片机操作。这意味着暴露于其中的实验室技术人员的手部会局部暴露在-20摄氏度的低温环境下。
对瑞典乌普萨拉大学临床前和临床实验室使用切片机的39名实验室技术人员进行了研究。选取同等数量未接触切片机的实验室技术人员作为对照，这些对照人员在工作场所、性别、年龄和吸烟习惯方面进行了匹配。通过自我填写问卷来评估症状、工作类型和个人因素等信息。测试两点辨别能力，并使用生物感觉阈值测量仪测量双手的振动感觉阈值。此外，在研究期间对15名进行冷冻切片工作的技术人员在工作时测量皮肤温度。
大多数实验室技术人员在冷冻切片工作期间不戴任何手套，有时会直接接触冷冻材料，导致皮肤迅速冷却。在15名暴露人员中的6人（40%）中，切片机操作期间的平均皮肤温度低于20摄氏度。在两名受试者中发现，由于代偿性血管扩张，皮肤温度随后有所上升。暴露于寒冷环境的组右手有早期神经病变的迹象，振动测量和两点辨别测试均表明了这一点。在暴露于寒冷环境的组内，还发现了与工作相关的临床体征的显著差异。在雷诺现象、麻木或肌肉骨骼症状方面，暴露组和未暴露组之间未发现差异。
我们的研究表明，冷冻切片实验室工作可能会对健康产生不良影响，例如周围神经病变，应采取措施保护手部免受局部寒冷暴露。
