Nilsson T, Lundström R, Burström L, Hagberg M
Department of Occupational and Environmental Medicine, Sundsvall Hospital, Sweden.
Cent Eur J Public Health. 1995;3 Suppl:70-2.
The effect of vibration on thin unmyelinated sensory fibers was studied by perception threshold measurement of heat pain. The investigation was a cross-sectional study of 98 vibration-exposed and 53 non-vibration-exposed workers. Pain perception was determined by using the "Marstock" method. The perception threshold of contact heat induced pain was assessed by the method of limits. Quantified personal energy-equivalent vibration exposure was assessed for all subjects on a group basis. The cumulated lifetime equivalent frequency-weighted vibration exposure was estimated based on measurements according to ISO 5349. The mean heat perception threshold was 46.2 degrees C (SD 2.6 degrees C) for the right hand and 46.0 degrees C (SD 2.7 degrees C) for the left. The results showed no mean difference (left = 0.1 degree C, right = 0.6 degree C) in heat pain perception between vibration-exposed and non-exposed subjects. There was a high correlation between the right and left hand measurements (r = 0.81). The risk (rate ratio) for impairment was 1.02 (95% CI 0.81-1.30) for the right hand and 1.00 (95% CI 0.79-1.26) for the left. The results of the study did not indicate any impairment as assessed by an increased perception threshold for heat pain. The lack of an increased heat pain threshold among the vibration-exposed workers in our study cannot exclude a possible lesional somatosensory influence from the exposure, as the lesional effect may also be a lowering of the threshold. The multiple and unrelated percepts of thermal sensations imply that it is not legitimate to draw conclusions about the total status of the small calibre afferents when testing only the heat pain perception.
通过热痛感知阈值测量研究了振动对细的无髓感觉纤维的影响。该调查是一项横断面研究，涉及98名接触振动的工人和53名未接触振动的工人。采用“马斯托克”方法确定疼痛感知。通过极限法评估接触热诱发疼痛的感知阈值。对所有受试者进行了基于群体的个人能量等效振动暴露量化评估。根据ISO 5349的测量结果估算累积终身等效频率加权振动暴露量。右手的平均热感知阈值为46.2摄氏度（标准差2.6摄氏度），左手为46.0摄氏度（标准差2.7摄氏度）。结果显示，接触振动和未接触振动的受试者在热痛感知方面无平均差异（左手 = 0.1摄氏度，右手 = 0.6摄氏度）。左右手测量结果之间存在高度相关性（r = 0.81）。右手损伤风险（率比）为1.02（95%置信区间0.81 - 1.30），左手为1.00（95%置信区间0.79 - 1.26）。研究结果未表明热痛感知阈值升高所评估的任何损伤。在我们的研究中，接触振动的工人中热痛阈值未升高，并不能排除暴露可能产生的损伤性躯体感觉影响，因为损伤效应也可能是阈值降低。热感觉的多种且不相关的感知意味着仅测试热痛感知时，就小口径传入神经的总体状态得出结论是不合理的。
