RESUMEN
OBJECTIVES: The aim was to examine exposure-response relations between occupational hand exposures and carpal tunnel syndrome (CTS) and to compare the relation between surgery-treated and non-surgery-treated CTS. The secondary aim was to study sex-specific differences in exposure-response relations. METHODS: We conducted a nationwide register-based cohort study of all persons born in Denmark (1945-1994). During follow-up (2010-2013), we identified first-time events of CTS. Occupational hand exposure estimates the year before each follow-up year were obtained by linking individual occupational codes with a job exposure matrix. We used multivariable logistic regression equivalent to discrete survival analysis based on sex and surgery. The excess fraction of cases was calculated. RESULTS: For both sexes, exposure-response relations were found for all occupational hand exposures. Among men, we found ORadj of 3.6 (95% CI 3.2 to 3.8) for hand-related force, 2.9 (95% CI 2.5 to 3.2) for repetitive hand movements, 3.8 (95% CI 2.7 to 5.2) for non-neutral hand posture and 2.5 (95% CI 2.2 to 2.7) for hand-arm vibration in the highest exposure groups. For combined exposure (hand load), ORadj was 3.5 (95% CI 3.1 to 4.0). Slightly higher ORsadj were generally found for surgery-treated CTS compared with non-surgery-treated CTS for both sexes. When comparing sex, somewhat higher ORsadj were found among men. The excess fraction was 42%. CONCLUSIONS: Occupational hand exposures carried a 3-5-fold increased risk of CTS with slightly higher risks for surgery-treated compared with non-surgery-treated CTS. Even though CTS occurs more frequently among women, somewhat higher exposure-response relations were found for men compared with women. In the general working population, a substantial fraction of first-time CTS could be related to occupational hand exposures.
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Síndrome del Túnel Carpiano , Mano , Enfermedades Profesionales , Exposición Profesional , Humanos , Síndrome del Túnel Carpiano/epidemiología , Síndrome del Túnel Carpiano/etiología , Dinamarca/epidemiología , Masculino , Femenino , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Adulto , Persona de Mediana Edad , Estudios de Cohortes , Factores Sexuales , Modelos Logísticos , Factores de Riesgo , Sistema de Registros , Vibración/efectos adversos , Trastornos de Traumas Acumulados/epidemiología , Trastornos de Traumas Acumulados/etiología , Postura , Síndrome por Vibración de la Mano y el Brazo/epidemiología , Síndrome por Vibración de la Mano y el Brazo/etiología , AncianoRESUMEN
Local vibration can induce vascular injuries, one example is the hand-arm vibration syndrome (HAVS) caused by hand-transmitted vibration (HTV). Little is known about the molecular mechanism of HAVS-induced vascular injuries. Herein, the iTRAQ (isobaric tags for relative and absolute quantitation) followed by liquid chromatography-tandem mass spectrometry (LC-MS/MS) proteomics approach was applied to conduct the quantitative proteomic analysis of plasma from specimens with HTV exposure or HAVS diagnosis. Overall, 726 proteins were identified in iTRAQ. 37 proteins upregulated and 43 downregulated in HAVS. Moreover, 37 upregulated and 40 downregulated when comparing severe HAVS and mild HAVS. Among them, Vinculin (VCL) was found to be downregulated in the whole process of HAVS. The concentration of vinculin was further verified by ELISA, and the results suggested that the proteomics data was reliable. Bioinformative analyses were used, and those proteins mainly engaged in specific biological processes like binding, focal adhesion, and integrins. The potential of vinculin application in HAVS diagnosis was validated by the receiver operating characteristic curve.
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Síndrome por Vibración de la Mano y el Brazo , Enfermedades Profesionales , Lesiones del Sistema Vascular , Humanos , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Síndrome por Vibración de la Mano y el Brazo/etiología , Enfermedades Profesionales/complicaciones , Enfermedades Profesionales/diagnóstico , Lesiones del Sistema Vascular/complicaciones , Vinculina , Cromatografía Liquida , Proteómica , Espectrometría de Masas en TándemRESUMEN
This study provides an overview of the relationships between exposure to work-related hand-arm vibration and the occurrence of pre-defined disorders of the hands. We searched Medline, Embase, Web of Science, Cochrane Central, and PsycINFO for cross-sectional and longitudinal studies on the association between work-related vibration exposure and the occurrence of hand-arm vibration syndrome (including vibration-induced white finger), Dupuytren's contracture, or hypothenar hammer syndrome. We used a 16-item checklist for assessing the risk of bias. We present results narratively, and we conducted random effects meta-analyses if possible. We included 10 studies with more than 24,381 participants. Our results showed statistically significant associations between the exposure to hand-arm vibrations and the occurrence of the selected disorders, with pooled odds ratios ranging between 1.35 (95% CI: 1.28 to 2.80) and 3.43 (95% CI: 2.10 to 5.59). Considerable between-study heterogeneity was observed. Our analyses show that exposure to vibrating tools at work is associated with an increased risk for the occurrence of selected disorders of the hands. Due to the majority of studies being cross-sectional, no firm conclusion is possible regarding causal relationships between vibration exposure and disorder occurrence. Future research should specifically address whether reducing exposure to hand-held vibrating tools at work reduces the incidence of the disorders of the hands investigated in this systematic review.
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Contractura de Dupuytren , Síndrome por Vibración de la Mano y el Brazo , Enfermedades Profesionales , Exposición Profesional , Humanos , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/complicaciones , Vibración/efectos adversos , Contractura de Dupuytren/epidemiología , Contractura de Dupuytren/etiología , Estudios Transversales , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Lugar de Trabajo , ManoRESUMEN
BACKGROUND: Constant use of hand-held vibratory tools may cause health issues, including hand dysfunction, among farmers. Thus, exposure to these vibratory instruments may cause hand-arm vibration syndrome (HAVS). OBJECTIVE: The study aimed to measure the prevalence of HAVS and evaluate neurological and vascular symptoms among farmers. METHODS: This cross-sectional study included 20 villages in Pakistan and used a three-part questionnaire to collect data from farmers exposed to vibration while farming. The study included demographics, the Health Surveillance Questionnaire, and the Stockholm Workshop Classification Scale. SPSS version 22 was used for the data entry and statistical analysis. RESULTS: 433 (43%) participants had musculoskeletal discomfort and 568 (57%) had hand vibration. Raynaud phenomenon was evident in 430 (43%) participants, whereas carpal tunnel syndrome was found in 218 (22%). Tingling was reported by 255 participants (26%), and numbness was reported by 543 (54%). According to the grading of neurological symptoms, 461 (46%) participants were exposed to vibration but did not experience any symptoms, placing them in stage 0. 185 (18.5%) participants with HAVS with infrequent episodes affecting just the tips of one or more fingers were categorized in stage 01 based on grading of vascular symptoms. CONCLUSION: HAVS are common among harvesting farmers, with the most noticeable vibrations occurring in the shoulder region. Similarly, most farmers had no vascular symptoms, and most were exposed to vibration but had no neurological symptoms.
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Síndrome por Vibración de la Mano y el Brazo , Enfermedades Profesionales , Exposición Profesional , Humanos , Síndrome por Vibración de la Mano y el Brazo/epidemiología , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Estudios Transversales , Agricultores , Pakistán/epidemiología , Vibración/efectos adversosRESUMEN
BACKGROUND: hand-arm vibration is one of the typical annoying physical factors. Hand-arm vibration syndrome (HAVS) is a disorder caused by vibrating working tools which vibrate hands beyond the threshold. Long-term HAVS may result in damage to blood vessels, chronic numbness in the fingers, bone injury, and muscular weakness. People are exposed to high-rate noise vibration in a variety of situations, including vessel employment and operating in tiny boats. Moreover, the extant study was conducted to examine manual function disability levels caused by Sailing Speed Vessels (SSV) vibration. METHODS: The extant study was quasi-experimental research in which, 52 male sailors in SSVs were chosen as the experimental group, and 27 office personnel were selected as the control group. The demographic factors questionnaire, DASH questionnaire, grip and pinch strength tests, the neurosensory exam, and the skill-dexterity test were all employed in this study. SPSS23 software was used to analyze the data. RESULTS: The findings suggested that the experimental group experienced greater vibration disorder symptoms than the control group. Because the experimental group had a higher score, the individuals experienced poorer circumstances in terms of arm, shoulder, and hand impairment as compared to the control group. The mean grip strength of hands and fingers in two hands of the experimental group was lower than the control group (P < 0.05). There was a statistically significant relationship among grip strengths of both experimental and control groups (P < 0.05). There was a reduction in skill and dexterity of both dominant and non-dominant hands of members in the experimental group. According to the statistical tests, there was no significant association between dominant (P = 0.001) skills and non-dominant (P = 0.010) hands in experimental and control groups. There was not also any significant relationship between skill and dexterity of both hands (P = 0.001) and the dominant hand tweezer test (P = 0.001) in two experimental and control groups. There was a statistically significant association between experimental and control groups in terms of assembly skill and dexterity (P = 0.482). CONCLUSION: Individuals who are at risk of vibration experience less physical and sensory function. DASH score, grip strength, skill, and dexterity could predict the reduction in physical function disability.
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Síndrome por Vibración de la Mano y el Brazo , Personal Militar , Mano , Fuerza de la Mano , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Síndrome por Vibración de la Mano y el Brazo/etiología , Humanos , Masculino , Vibración/efectos adversosRESUMEN
In 167 men with vibration syndrome (VS), allele and genotype frequencies of HSPA1B (+1267A>G) genetic polymorphism (rs1061581) were studied depending on the type of vibration exposure and on the presence or absence of metabolic syndrome (MetS). The examined subjects were divided into two groups: VS patients (n=80) and VS+MetS patients (n=87). The differences in the lipid profiles between groups were revealed against the background of the lack of distinctions in the age of patients for A/G and G/G genotypes carriers. An increase in A/A (p=0.03) and a decrease in A/G (p=0.04) genotype frequencies in VS patients caused by hand-transmitted vibration in comparison with those in whom the disease was caused by a combination of hand-transmitted and whole-body vibration were found. The shifts in the frequencies of the above genotypes (p=0.01) were similar in patients with both types of vibration exposure in the VS+MetS group in comparison with VS group; the carriage of genotypes with the G allele in VS group exceeded that in VS+MetS group (p=0.01).
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Frecuencia de los Genes , Proteínas HSP70 de Choque Térmico/genética , Síndrome por Vibración de la Mano y el Brazo/genética , Síndrome Metabólico/genética , Exposición Profesional/efectos adversos , Polimorfismo de Nucleótido Simple , Adulto , Alelos , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Expresión Génica , Estudio de Asociación del Genoma Completo , Genotipo , Proteínas HSP70 de Choque Térmico/sangre , Síndrome por Vibración de la Mano y el Brazo/complicaciones , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/patología , Heterocigoto , Humanos , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/patología , Persona de Mediana Edad , Triglicéridos/sangreRESUMEN
Prolonged and intensive vibration exposures during the grinding of handheld workpieces may cause hand-arm vibration syndrome. The objectives of this study are to develop an on-the-hand method for evaluating vibration-reducing (VR) gloves, and to determine whether VR gloves can significantly reduce the vibration exposures. A worker holding and pressing a typical workpiece (golf club head) against a grinding wheel or belt in order to shape the workpiece was simulated, and the input vibration and those on the workpiece and hand-arm system were measured. Ten human subjects participated in the experiment. The results demonstrate that VR gloves significantly reduced the vibrations at the palm, hand dorsum, and wrist. The grinding interface condition and hand feed force did not substantially affect glove effectiveness. The use of gloves slightly increased the workpiece resonant response, but the resonant response did not significantly affect glove effectiveness. This study concluded that the use of VR gloves can help control vibration exposures of workers performing grinding of handheld workpieces.
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Síndrome por Vibración de la Mano y el Brazo , Vibración , Guantes Protectores , Mano , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/prevención & control , Humanos , Vibración/efectos adversos , Articulación de la MuñecaRESUMEN
OBJECTIVES: To study the characteristics and the factors influencing the occurrence of the Hand-Arm Vibration Syndrome (HAVS) for a population grinding handheld workpieces in a subtropical environment. METHODS: A total of 803 workers grinding handheld workpieces formed the exposure group and 464 workers not exposed to hand-transmitted vibration (HTV) were recruited as the non-exposed group within the same factory in a subtropical climate area. The basic personal information and clinical symptoms reported were collected by trained physicians using a questionnaire and representative measurements were made of the HTV exposure levels and dose. RESULTS: The average HTV exposure dose A(8) was measured as 5.3 ± 2.0 m/s2. The proportion of grinders reporting finger blanching was 15.4% while it was 27.5% for finger numbness. Among the non-exposed group, that proportion was 0% and 6.3% respectively. There was a positive association between the vibration exposure duration and the occurrence of finger blanching, finger numbness and finger coldness. Riding a motorcycle to work was also identified as a factor that could contribute to a higher prevalence of finger blanching among the exposed workers, the OR value was found to be 1.75 (1.12, 2.75). CONCLUSIONS: Workers exposed to vibration in a subtropical area can also present evidence of finger blanching in addition to neurological symptoms. The reported rate of HAVS was positively associated with the exposure duration. And the levels of the duration of exposure relative to symptoms of vibration white finger in a subtropical temperate environment exposed to a high-frequency vibration might be deemphasized by the current ISO weighting. Motorcycle transportation to work was identified as a factor that could influence the development of the HAVS among the exposed population of grinders.
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Síndrome por Vibración de la Mano y el Brazo/epidemiología , Síndrome por Vibración de la Mano y el Brazo/etiología , Exposición Profesional/efectos adversos , Vibración/efectos adversos , Adulto , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Motocicletas , Factores de Riesgo , Encuestas y Cuestionarios , Clima Tropical , Adulto JovenRESUMEN
OBJECTIVE: To investigate whether low molecular organic biomarkers could be identified in blood samples from vibration exposed workers using a metabolomics. METHODS: The study population consisted of 38 metalworkers. All participants underwent a standardized medical examination. Blood samples were collected before and after work shift and analyzed with gas chromatography time-of-flight mass spectrometry. Multivariate modeling (orthogonal partial least-squares analysis with discriminant analysis [OPLS-DA]) were used to verify differences in metabolic profiles. RESULTS: Twenty-two study participants reported vascular symptoms judged as vibration-related. The metabolic profile from participants with vibration-induced white fingers (VWF) was distinctly separated from participants without VWF, both before and after vibration exposure. CONCLUSION: Metabolites that differed between the groups were identified both before and after exposure. Some of these metabolites might be indicators of health effects from exposure to vibrations. This is the first time that a metabolomic approach has been used in workers exposed to vibrations.
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Síndrome por Vibración de la Mano y el Brazo/sangre , Exposición Profesional/análisis , Adulto , Biomarcadores/sangre , Diagnóstico Diferencial , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Síndrome por Vibración de la Mano y el Brazo/etiología , Humanos , Masculino , Metabolómica , Metalurgia , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Vibración/efectos adversosRESUMEN
Hand-arm vibration syndrome (HAVS) is an irreversible neurodegenerative, vasospastic, and musculoskeletal occupational disease of workers who use powered hand tools. The etiology is poorly understood. Neurological symptoms include numbness, tingling, and pain. This study examines impact hammer vibration-induced injury and recoverability of hair mechanosensory innervation. Rat tails were vibrated 12 min/d for 5 weeks followed by 5 week recovery with synchronous non-vibrated controls. Nerve fibers were PGP9.5 immunostained. Lanceolate complex innervation was compared quantitatively in vibrated vs sham. Vibration peak acceleration magnitudes were characterized by frequency power spectral analysis. Average magnitude (2515 m/s2 , root mean squared) in kHz frequencies was 109 times that (23 m/s2 ) in low Hz. Percentage of hairs innervated by lanceolate complexes was 69.1% in 5-week sham and 53.4% in 5-week vibration generating a denervation difference of 15.7% higher in vibration. Hair innervation was 76.9% in 5-weeks recovery sham and 62.0% in 5-week recovery vibration producing a denervation difference 14.9% higher in recovery vibration. Lanceolate number per complex (18.4 ± 0.2) after vibration remained near sham (19.3 ± 0.3), but 44.9% of lanceolate complexes were abnormal in 5 weeks vibrated compared to 18.8% in sham. The largest vibration energies are peak kHz accelerations (approximately 100 000 m/s2 ) from shock waves. The existing ISO 5349-1 standard excludes kHz vibrations, seriously underestimating vibration injury risk. The present study validates the rat tail, impact hammer vibration as a model for investigating irreversible nerve damage. Persistence of higher denervation difference after 5-week recovery suggests repeated vibration injury destroys the capability of lanceolate nerve endings to regenerate.
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Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/patología , Mecanorreceptores/patología , Terminaciones Nerviosas/patología , Cola (estructura animal)/lesiones , Cola (estructura animal)/inervación , Vibración/efectos adversos , Animales , Modelos Animales de Enfermedad , Femenino , Ratas , Ratas Sprague-DawleyRESUMEN
A 56-year-old truck driver with a history of tobacco use presented with acute onset digital ischaemia in the ulnar distribution of his dominant hand, associated with severe pain. Occupational exposures included extensive manual labour and prolonged vibratory stimuli. Workup with Doppler and angiography confirmed the diagnosis of hypothenar hammer syndrome (HHS). After the failure of medical management, he underwent ulnar artery thrombectomy with reconstruction and arterial bypass grafting. His pain improved significantly postsurgically, and he was able to return to a normal routine. This case illustrates the classic presentation, examination, imaging findings and management options of HHS. HHS should be considered in patients with digital ischaemia and associated occupational exposures. Diagnosing the condition appropriately allows for optimal management, aiming at minimising symptoms and maximising quality of life.
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Arteriopatías Oclusivas/diagnóstico por imagen , Dedos/irrigación sanguínea , Síndrome por Vibración de la Mano y el Brazo/diagnóstico por imagen , Arteria Cubital/lesiones , Angiografía/métodos , Arteriopatías Oclusivas/etiología , Diagnóstico Diferencial , Dedos/patología , Síndrome por Vibración de la Mano y el Brazo/etiología , Humanos , Isquemia/diagnóstico , Isquemia/fisiopatología , Isquemia/cirugía , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/diagnóstico , Síndrome , Trombectomía/métodos , Resultado del Tratamiento , Arteria Cubital/patología , Arteria Cubital/cirugía , Ultrasonografía Doppler/métodos , Injerto Vascular/métodosRESUMEN
BACKGROUND: Prolonged exposure to hand-arm vibration is associated with a disorder of the vascular, neurological, and musculoskeletal systems of the upper limb known as hand-arm vibration syndrome (HAVS). Currently, the evidence of HAVS in tropical environments is limited. OBJECTIVES: To determine the prevalence and severity of HAVS among tyre shop workers in Kelantan, Malaysia. METHODS: A cross-sectional study involving 200 tyre shop workers from two districts in Kelantan was performed. Part one data were collected at the field using questionnaire, and hand-arm vibration was measured. Part two involved a set of hand clinical examinations. The workers were divided into high (≥5 m s-2 ) and low/moderate (<5 m s-2 ) exposure group according to their 8-hr time weighted average [A(8)] of vibration exposure. The differences between the two exposure group were then compared. RESULTS: The prevalence of the vascular, neurological, and musculoskeletal symptoms was 12.5% (95% CI 10.16 to 14.84), 37.0% (95% CI 30.31 to 43.69), and 44.5% (95% CI 37.61 to 51.38) respectively. When divided according to their exposure statuses, there was a significant difference in the prevalence of HAVS for all three components of vascular, neurological, and musculoskeletal (22.68% vs 2.91%, 62.89% vs 12.62% and 50.52% and 38.83%) respectively. All the clinical examinations findings also significantly differed between the two groups with the high exposure group having a higher abnormal result. CONCLUSION: Exposure to high A(8) of vibration exposure was associated with a higher prevalence of all three component of HAVS. There is a need for better control of vibration exposure in Malaysia.
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Síndrome por Vibración de la Mano y el Brazo/etiología , Industrias , Vehículos a Motor , Exposición Profesional , Adulto , Estudios Transversales , Humanos , Malasia/epidemiología , Masculino , Prevalencia , Clima Tropical , Adulto JovenRESUMEN
PURPOSE: To provide an updated epidemiological validation for a supplementary method for assessing the risk of vascular disorders from hand-transmitted vibration. METHODS: The occurrence of vibration-induced white finger (VWF) in the vibration-exposed workers of the Italian cohort of the EU VIBRISKS study was related to measures of daily vibration exposure expressed in terms of r.m.s. acceleration magnitude normalised to an 8-h day, frequency weighted according to either the frequency weighting Wh defined in international standard ISO 5349-1:2001 [Ah(8) in ms- 2] or the hand-arm vascular frequency weighting Wp proposed in the ISO technical report (TR) 18570:2017 [Ap(8) in ms- 2]. To estimate a threshold value for vascular hand-arm vibration risk, the Wp-weighted vibration exposure value Ep,d (in ms- 1.5) was calculated according to the ISO/TR document. The difference in the predictions of VWF between the exposure measures calculated with the frequency weightings Wh or Wp was investigated by means of logistic modelling. RESULTS: Measures of daily vibration exposure constructed with the frequency weighting Wp [Ap(8) and Ep,d], which gives more importance to intermediate- and high-frequency vibration, were better predictors of the occurrence of VWF in the vibration-exposed workers than the metric derived from the conventional ISO frequency weighting Wh [Ah(8)]. There was some epidemiological evidence for a threshold value of Ep,d for the onset of VWF in the vibration-exposed workers. CONCLUSIONS: Measures of daily vibration exposure evaluated with the vascular weighting Wp performed better for the predictions of VWF than those obtained with the frequency weighting Wh recommended in ISO 5349-1.
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Síndrome por Vibración de la Mano y el Brazo/epidemiología , Exposición Profesional/efectos adversos , Medición de Riesgo/métodos , Vibración/efectos adversos , Estudios de Cohortes , Dedos , Mano , Síndrome por Vibración de la Mano y el Brazo/etiología , Humanos , Italia , Masculino , Exposición Profesional/análisis , Enfermedades Vasculares Periféricas/epidemiología , Enfermedades Vasculares Periféricas/etiologíaRESUMEN
Workers in a number of different occupational sectors are exposed to workplace vibration on a daily basis. This exposure may arise through the use of powered-hand tools or hand-transmitted vibration (HTV). Workers might also be exposed to whole body vibration (WBV) by driving delivery vehicles, earth moving equipment, or through use of tools that generate vibration at low dominant frequencies and high amplitudes, such as jackhammers. Occupational exposure to vibration has been associated with an increased risk of musculoskeletal pain in the back, neck, hands, shoulders, and hips. Occupational exposure may also contribute to the development of peripheral and cardiovascular disorders and gastrointestinal problems. In addition, there are more recent data suggesting that occupational exposure to vibration may enhance the risk of developing certain cancers. The aim of this review is to provide an assessment of the occupations where exposure to vibration is most prevalent, and a description of the adverse health effects associated with occupational exposure to vibration. This review will examine (1) various experimental methods used to measure and describe the characteristics of vibration generated by various tools and vehicles, (2) the etiology of vibration-induced disorders, and (3) how these data were employed to assess and improve intervention strategies and equipment that reduces the transmission of vibration to the body. Finally, there is a discussion of the research gaps that need to be investigated to further reduction in the incidence of vibration-induced illnesses and injuries.
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Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/prevención & control , Exposición Profesional/efectos adversos , Salud Laboral , Vibración/efectos adversos , Síndrome por Vibración de la Mano y el Brazo/clasificación , Síndrome por Vibración de la Mano y el Brazo/epidemiología , Humanos , IncidenciaRESUMEN
INTRODUCTION: Weed control is one of the most important issues in the maintenance sectors of both agriculture and green areas. Small tools are employed for controlling grass and other growths on steep verges and river banks. This leads the operators being exposed to many risks among which vibration is one. The purpose of this study is to measure and evaluate hand-arm vibration and to verify the daily exposure to which workers are often subjected while weeding. MATERIAL AND METHODS: Two cutting heads, a brush knife and a mowing head were compared. Both were mounted on the same cow-horn brush cutter. The vibration total value was expressed as the root-mean-square (rms) of three component values according to the axes X, Y and Z. The signal was frequency weighted using the weighting curve Wh, as described in the ISO 5349-1 (2001) standard. In addition, the daily vibration exposure was calculated and compared with the thresholds set by EU Directive 2002/44/EC (2005). RESULTS: The obtained results showed that the exposure action value (EAV) of 2.5 ms-2 was exceeded while using both cutting heads. The exposure limit value (ELV) using the brush knife also exceeded 5 ms-2. CONCLUSIONS: The results highlighted important aspects in terms of exposure values that should be considered with the view of preventing the risk of Hand-Arm Vibration Syndrome (HAVS) to which the operators who frequently use these tools are exposed. Specific measures should therefore be taken to protect the exposed workers.
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Síndrome por Vibración de la Mano y el Brazo/etiología , Exposición Profesional/efectos adversos , Vibración/efectos adversos , Control de Malezas/instrumentación , Adulto , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Adulto JovenRESUMEN
Repetitive exposure to hand-transmitted vibration is associated with development of peripheral vascular and sensorineural dysfunctions. These disorders and symptoms associated with it are referred to as hand-arm vibration syndrome (HAVS). Although the symptoms of the disorder have been well characterized, the etiology and contribution of various exposure factors to development of the dysfunctions are not well understood. Previous studies performed using a rat-tail model of vibration demonstrated that vascular and peripheral nervous system adverse effects of vibration are frequency-dependent, with vibration frequencies at or near the resonant frequency producing the most severe injury. However, in these investigations, the amplitude of the exposed tissue was greater than amplitude typically noted in human fingers. To determine how contact with vibrating source and amplitude of the biodynamic response of the tissue affects the risk of injury occurring, this study compared the influence of frequency using different levels of restraint to assess how maintaining contact of the tail with vibrating source affects the transmission of vibration. Data demonstrated that for the most part, increasing the contact of the tail with the platform by restraining it with additional straps resulted in an enhancement in transmission of vibration signal and elevation in factors associated with vascular and peripheral nerve injury. In addition, there were also frequency-dependent effects, with exposure at 250 Hz generating greater effects than vibration at 62.5 Hz. These observations are consistent with studies in humans demonstrating that greater contact and exposure to frequencies near the resonant frequency pose the highest risk for generating peripheral vascular and sensorineural dysfunction.
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Nervios Periféricos/fisiopatología , Cola (estructura animal)/inervación , Vibración/efectos adversos , Animales , Antioxidantes/análisis , Modelos Animales de Enfermedad , Ensayo de Inmunoadsorción Enzimática , Expresión Génica , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/fisiopatología , Masculino , National Institute for Occupational Safety and Health, U.S. , Exposición Profesional/efectos adversos , Distribución Aleatoria , Ratas , Ratas Sprague-Dawley , Reacción en Cadena en Tiempo Real de la Polimerasa , Cola (estructura animal)/enzimología , Estados UnidosRESUMEN
OBJECTIVE: To provide family physicians with an understanding of the epidemiology, pathogenesis, symptoms, diagnosis, and management of hand-arm vibration syndrome (HAVS), an important and common occupational disease in Canada. SOURCES OF INFORMATION: A MEDLINE search was conducted for research and review articles on HAVS. A Google search was conducted to obtain gray literature relevant to the Canadian context. Additional references were obtained from the articles identified. MAIN MESSAGE: Hand-arm vibration syndrome is a prevalent occupational disease affecting workers in multiple industries in which vibrating tools are used. However, it is underdiagnosed in Canada. It has 3 components-vascular, in the form of secondary Raynaud phenomenon; sensorineural; and musculoskeletal. Hand-arm vibration syndrome in its more advanced stages contributes to substantial disability and poor quality of life. Its diagnosis requires careful history taking, in particular occupational history, physical examination, laboratory tests to rule out alternative diagnoses, and referral to an occupational medicine specialist for additional investigations. Management involves reduction of vibration exposure, avoidance of cold conditions, smoking cessation, and medication. CONCLUSION: To ensure timely diagnosis of HAVS and improve prognosis and quality of life, family physicians should be aware of this common occupational disease and be able to elicit the relevant occupational history, refer patients to occupational medicine clinics, and appropriately initiate compensation claims.
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Medicina Familiar y Comunitaria , Síndrome por Vibración de la Mano y el Brazo/diagnóstico , Síndrome por Vibración de la Mano y el Brazo/terapia , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/terapia , Adulto , Canadá/epidemiología , Síndrome por Vibración de la Mano y el Brazo/epidemiología , Síndrome por Vibración de la Mano y el Brazo/etiología , Humanos , Masculino , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/etiología , Pronóstico , Enfermedad de Raynaud/etiologíaRESUMEN
OBJECTIVES: In this study, the daily exposure action values (EAV) and the daily exposure limit values (ELV) for hand-transmitted vibration (HTV) and whole-body vibration (WBV), established by the EU Directive 2002/44/EC and the Italian Decree 81/2008, and expressed in terms of 8-hr frequency weighted r.m.s. acceleration magnitude, are discussed upon consideration of the findings of experimental and epidemiological studies. METHODS: There is some epidemiological support for the EAV A(8) of 2.5 ms-2 r.m.s. and the ELV A(8) of 5 ms-2 r.m.s. for HTV, at least for the vascular component (secondary Raynaud's phenomenon) of the hand-arm vibration syndrome. RESULTS: There is some experimental evidence for the EAV A(8) of 0.5 ms-2 r.m.s. for WBV, while there is neither biodynamic nor epidemiological validation for the ELV A(8) of 1.15 ms-2 r.m.s. for WBV, this latter lowered to 1 ms-2 r.m.s. in the Italian legislation.
Asunto(s)
Guías como Asunto , Enfermedades Profesionales/prevención & control , Exposición Profesional/efectos adversos , Vibración/efectos adversos , Unión Europea , Síndrome por Vibración de la Mano y el Brazo/etiología , Síndrome por Vibración de la Mano y el Brazo/prevención & control , Humanos , Italia , Enfermedades Profesionales/etiología , Enfermedad de Raynaud/etiología , Enfermedad de Raynaud/prevención & controlRESUMEN
OBJECTIVES: The aim of this study was to evaluate postural and rest tremor among workers using vibrating hand tools, taking into account the possible effects of toxicants such as alcohol and tobacco. A further aim was to study workers diagnosed with hand-arm vibration syndrome (HAVS) at the time of examination. METHODS: This study comprises 103 road maintenance workers, 55 exposed to vibrating hand tools (age 41.0 years; range 21-62) and 48 referents (age 38.5 years; range 19-64). They were examined with the CATSYS Tremor Pen®. Exposure to vibrating tools and serum biomarkers of alcohol and tobacco consumption were measured. RESULTS: Cumulative exposure to vibrating tools was associated with increased postural (p < 0.01) and rest tremor (p < 0.05) and with a higher Center Frequency of postural tremor (p < 0.01) among smokers and users of smokeless tobacco. Rest tremor Center Frequency was higher than postural tremor frequency (p < 0.001). CONCLUSIONS: The main findings indicate an association between cumulative exposure to hand-held vibrating tools, tremor parameters and consumption of tobacco products. The hand position is important when testing for tremor. Rest tremor had a higher Center Frequency. Postural tremor was more strongly associated with exposure than rest tremor. The finding of increased tremor among the HAVS subjects indicated that tremor might be a part of the clinical picture of a HAVS diagnosis. As with all cross-sectional studies, inferences should be made with caution when drawing conclusions about associations between exposure and possible effects. Future research using longitudinal design is required to validate the findings of the present study.
Asunto(s)
Industria de la Construcción , Síndrome por Vibración de la Mano y el Brazo/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Temblor/etiología , Vibración/efectos adversos , Adulto , Estudios Transversales , Humanos , Mantenimiento , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
OBJECTIVE: To investigate the exposure-response relationships between alternative frequency weightings of hand-transmitted vibration (HTV) and neck and upper limb musculoskeletal disorders (MSDs) in a cohort of HTV workers. METHODS: In a three-year longitudinal study, the occurrence of neck and upper limb MSDs was investigated in 249 HTV workers and 138 control men. In the HTV workers, MSDs were related to measures of daily vibration exposure expressed in terms of 8-h energy-equivalent frequency-weighted acceleration magnitude [A(8)]. To calculate A(8), the acceleration magnitudes of vibration were weighted by means of four alternative frequency weightings of HTV. The associations between MSDs, individual characteristics, physical work load other than vibration, and psychological strain were also investigated. RESULTS: The occurrence of upper limb MSDs was greater in the HTV workers than in the controls. After adjustment for potential confounders, the occurrence of elbow/forearm and wrist/hand MSDs increased with the increase in vibration exposure. A measure of model selection did not reveal any substantial difference in the performance of the alternative frequency weightings of HTV for the prediction of neck and upper limb MSDs. In the study population, age, hard physical work load, and poor psychological well-being were associated with both neck and upper limb MSDs. CONCLUSIONS: In this study, there was evidence for significant exposure-response relationships between HTV exposure and MSDs in the distal sites of the upper limbs. There were no differences in the prediction of neck and upper limb MSDs between measures of daily vibration exposure calculated with alternative frequency weightings of acceleration magnitude.