对暴露于瞬时和高频振动下的工人因振动而受伤的跟踪研究。

IF 2.9 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Occupational Medicine and Toxicology Pub Date : 2024-06-21 DOI:10.1186/s12995-024-00425-6
Lars Gerhardsson
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引用次数: 0

摘要

背景:在 2018 年的一项先前研究中,对 38 名轮式装载机装配工人进行了检查,结果显示他们暴露于瞬态振动和高频振动的程度较高。调查结束后,立即实施了预防措施,以减少振动暴露。2022 年,开展了一项跟踪研究,以检查这些措施的效果:跟踪研究包括最初 38 名工人中的 35 人(27 名男性和 8 名女性)。他们被分为两组,24 名持续接触振动的工人和 11 名自 2018 年以来未接触振动的工人。所有参与者都填写了调查问卷,并接受了全面检查,包括多项神经生理学测试和肌肉骨骼症状综合评估。问卷答复和现场振动水平测量结果构成了个人振动暴露评估的基础:2018 年,两组在振动感知阈值(VPT)、针刺试验、2-PD(两点辨别)和单丝试验方面存在明显差异,未暴露组的结果存在偏差。在 2022 年的随访检查中,两组之间的差异明显缩小,在振动感知阈值和单丝测试方面仍存在差异,未暴露组的测试结果出现偏差。如果分别比较 2018 年和 2022 年暴露组和未暴露组的变量值,未暴露组的变量值基本没有变化,而暴露工人的 VPT、针刺测试和温度敏感性测试在随访期间出现恶化。在随访期间,暴露工人中振动白指的发病率约为 30%-40%,神经病变的发病率约为 75%,而未暴露组的发病率分别约为 60%和 85%:根据斯德哥尔摩工作坊量表,白手指和神经病变的总体分类在两个研究组中从 2018 年到 2022 年基本保持不变。引入具有成本效益且相对简单的预防措施可能是导致这一结果的原因。在整个随访期间,工厂中患肌肉骨骼疾病的暴露工人人数和新报告的振动伤害病例都有所减少。如果没有这项预防计划,在随访期间,血管和神经症状很可能会因持续暴露于振动环境而加重。
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A follow-up study of vibration-induced injuries in workers exposed to transient and high frequency vibrations.

Background: In a previous study from 2018, 38 wheel loader assembly workers were examined, showing high exposures to transient and high-frequency vibrations. After the investigation, preventive measures were immediately implemented to reduce the vibration exposure. In 2022, a follow-up study was carried out to examine the effect of these measures.

Methods: The follow-up study included 35 (27 men and 8 women) of the original 38 workers. They were divided into two groups, 24 workers with ongoing vibration exposure and 11 workers, not vibration exposed since 2018. All participants completed a questionnaire and underwent a thorough examination, including several neurophysiological tests and a comprehensive assessment of musculoskeletal symptoms. The questionnaire responses and on-site vibration level measurements formed the basis for the individual vibration exposure assessment.

Results: In 2018, clear differences were noted between the two groups regarding vibration perception thresholds (VPT), needle test, 2-PD (2-point discrimination), and monofilament test with deviating results in the unexposed group. The difference between the two groups was significantly smaller at the follow-up examination in 2022, where differences remained for VPT and monofilament tests, with deviating test results in the unexposed group. When comparing variable values between 2018 and 2022 within the exposed and unexposed groups, respectively, the unexposed group showed mostly unchanged values, while a deterioration was observed for VPT, needle test and temperature sensitivity test among the exposed workers during follow-up. The prevalence of VWF (Vibration white fingers) was around 30-40% and neuropathy around 75% among exposed workers during follow-up compared to about 60% and 85% respectively, in the unexposed group.

Conclusion: The overall categorization of white fingers and neuropathy, according to the Stockholm Workshop Scale, remained largely unchanged in both study groups from 2018 to 2022. The introduction of cost-effective and relatively simple preventive measures may have contributed to this result. Throughout the follow-up period, the number of exposed workers who developed musculoskeletal disorders and newly reported cases of vibration injuries at the factory decreased. Without this preventive program, increased vascular and nerve symptoms would most likely have occurred during follow-up due to continued vibration exposure.

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来源期刊
Journal of Occupational Medicine and Toxicology
Journal of Occupational Medicine and Toxicology PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.00
自引率
0.00%
发文量
23
审稿时长
19 weeks
期刊介绍: Aimed at clinicians and researchers, the Journal of Occupational Medicine and Toxicology is a multi-disciplinary, open access journal which publishes original research on the clinical and scientific aspects of occupational and environmental health. With high-quality peer review and quick decision times, we welcome submissions on the diagnosis, prevention, management, and scientific analysis of occupational diseases, injuries, and disability. The journal also covers the promotion of health of workers, their families, and communities, and ranges from rehabilitation to tropical medicine and public health aspects.
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