Early signs of upper limb lesions in workers exposed to local vibration

Abstract

Vibration pathology, including disorders of the vascular, nervous and musculoskeletal systems, occupies one of the first places in the structure of health disorders in workers of vibration-hazardous industries.The aim of the study was to identify informative diagnostic criteria for identifying early signs of upper limb lesions.The observation group consisted of 90 workers aged 46.7±2.5 years (p>0.05), with experience of 22.4±3.9 years; the comparison group–60 workers whose working conditions were not associated with the studied factor; the average age of 45.8±2.4 years, experience of 24.1±4.1 years (p>0.05). The survey included the analysis of working conditions and professional route, clinical examination, questionnaires, laboratory and functional studies, statistical processing of the results, calculation of epidemiological indicators.The analysis of working conditions showed that the level of local vibration exceeded the maximum permissible level by 2–6 dB for the employees of the observation group. The survey showed that going to the doctor is a last resort for workers, even in the case of chronic pain. According to the results of the survey and examination, it was found that the formation of pain syndrome in employees of the observation group occurs against the background of the development of vascular and neurovascular disorders. There was an increase in the estimated age of the arteries of the upper extremities (5.3±2.8 years) in 23.3% of the observation group. Analysis of dynamometry results in dynamics for three years showed a slowly progressive decline in 21.1% of workers in vibration-hazardous professions with 11.3±3.4 years of experience, and only 3.3% of workers in the comparison group with 23.6±6.3 years of experience. In General, there is a high risk of decreased muscle strength, which is prognostically significant for the preservation of professional ability to work. The calculation of epidemiological indicators confirmed the connection of vasospastic reactions with the impact of local vibration (χ2=5.85, p<0.001; F=0.177, p<0.05; RR=2.5, 95% CI=1.7–3.7; EF=65%). Under the influence of local vibration, early signs of upper limb lesions develop with 5 years of experience and are characterized by vascular changes. Clinical syndromes characteristic of vibrational pathology are formed with an average length of service of 10 years. It is necessary to improve the complex of diagnostic measures aimed at identifying early signs of damage to the upper limbs, in order to improve the labor prognosis in workers under the influence of local vibration.