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一项针对暴露于锯子振动环境下的林业工人手指血管冷反应的前瞻性研究。

A prospective study of the cold response of digital vessels in forestry workers exposed to saw vibration.

作者信息

Bovenzi M, Alessandrini B, Mancini R, Cannavà M G, Centi L

机构信息

Institute of Occupational Medicine, University of Trieste, Centro Tumori, Italy.

出版信息

Int Arch Occup Environ Health. 1998 Oct;71(7):493-8. doi: 10.1007/s004200050311.

Abstract

OBJECTIVES

To investigate the occurrence of vibration-induced white finger (VWF) and the cold response of digital vessels in a group of 68 forestry workers who underwent a first clinical examination in 1990 and were then reexamined in 1995.

METHODS

The forestry workers were divided into three groups: group A (n = 27), active workers who did not have VWF in 1990 and continued to use chain saws; group B (n = 29), workers who did not have VWF in 1990 and retired before 1995; and group C (n = 12), active or retired workers who had VWF in 1990. The subjects underwent a medical interview, a complete physical examination, and a cold provocation test, which were performed by the same physicians at both surveys. The cold test consisted of measurement of the finger systolic blood pressure (FSBP) after local cooling to 10 degrees C, expressed as a percentage of the pressure recorded at 30 degrees C (FSBP%10 degrees).

RESULTS

Three new cases of VWF occurred during the follow-up period among workers who had used only antivibration (AV) chain saws. The vasoconstrictor response to cold was unchanged in group A and improved in group B (P < 0.001). A significant decrease in VWF symptoms and abnormal response to cold was observed in group C (P < 0.05). As a result of preventive measures curtailing saw usage time in the VWF workers, the daily vibration exposure in group C was lower in 1995 than in 1990 (P = 0.02). In the retired workers, FSBP%10 degrees was positively related to the time since the cessation of work with chain saws (P < 0.01).

CONCLUSIONS

The findings of this follow-up study indicate that a reduction in or cessation of exposure to vibration has a beneficial effect on finger-blanching symptoms and the cold response of digital vessels. The occurrence of new cases of VWF in subjects whose work experience was limited to AV chain saws argues for the maintenance of health surveillance in these workers.

摘要

目的

调查68名林业工人中振动性白指(VWF)的发生情况以及手指血管的冷反应,这些工人于1990年接受首次临床检查,之后于1995年再次接受检查。

方法

将林业工人分为三组:A组(n = 27),1990年无VWF且继续使用链锯的在职工人;B组(n = 29),1990年无VWF且在1995年之前退休的工人;C组(n = 12),1990年有VWF的在职或退休工人。在两次调查中,由相同的医生对受试者进行医学访谈、全面体格检查和冷激发试验。冷试验包括将手指局部冷却至10摄氏度后测量手指收缩压(FSBP),以30摄氏度时记录的压力的百分比表示(FSBP%10度)。

结果

在仅使用防振(AV)链锯的工人的随访期间出现了3例新的VWF病例。A组对冷的血管收缩反应未改变,B组有所改善(P < 0.001)。C组VWF症状和对冷的异常反应显著降低(P < 0.05)。由于采取了减少VWF工人锯使用时间的预防措施,C组1995年的每日振动暴露低于1990年(P = 0.02)。在退休工人中,FSBP%10度与停止使用链锯后的时间呈正相关(P < 0.01)。

结论

这项随访研究的结果表明,减少或停止振动暴露对手指苍白症状和手指血管的冷反应有有益影响。工作经验仅限于AV链锯的受试者中出现新的VWF病例,这表明应对这些工人进行健康监测。

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