Hand-arm Vibration Disease Research Articles

Analysis of three cases of hand-arm vibration disease

Analysis of three cases of hand-arm vibration disease

Prevalence of comorbid pathology in patients with vibration disease caused by exposure to local vibration

Introduction. Vibration as a factor of production is one of the leading that influences negatively on workers in various sectors of the economy. In available literature there no adequate information on the comorbid pathology in hand-arm vibration disease (HAVD) patients. The purpose of the study is to analyze the prevalence of somatic pathology in HAVD patients. Material and methods. The analysis of comorbidity of HAVD patients according in-depth medical data is carried out. The degree of relationship between work-related health disorders is assessed. The results are presented by average values, intensive and extensive indices, the relationship of work-related health disorders is confirmed by the calculation of the relative risk. Results. The main syndrome in the clinical picture of HAVD is autonomous-sensory polyneuropathy of the upper extremities, which is recorded in all patients, while some patients have a combination of two or more clinical syndromes of HAVD. A significant prevalence of diseases of the musculoskeletal and circulatory systems, eyes and its adnexa, ear and mastoid process, digestive, genitourinary system, and respiratory systems was revealed. Number of patients who have diseases of endocrine (up to 25.0%, p <0.01), digestive (up to 43.8%, p <0.01), urogenital (up to 37.5%, p <0.01), respiratory (up to 37.5%, p <0.05) and the circulatory (up to 52.9%, p <0.05) systems grows up with an increase of the experience dose of local vibration. Conclusion. The results of the study can serve as the basis for the implementation of measures for primary and secondary prevention of occupational diseases caused by local vibration, aimed at preventing the development of health disorders.

Clinical effect and mechanism of acupuncture and moxibustion on occupational hand-arm vibration disease: A retrospective study

IntroductionThis is a retrospective study exploring clinical effect of acupuncture and moxibustion on upper limb disorder induced by occupational hand-arm vibration disease (OHAVD), and preliminarily exploring mechanism of the effect. Methods43 patients diagnosed with occupational HAVD were divided into experimental group (n = 21) and control group (n = 22). Before and after 4 weeks treatment, the occurrence of vibration-induced white finger(VWF) was observed, upper limb function was assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, based on which the DASH scores were determined, and the serum concentration of TNFα was detected using ELISA. ResultsPre-treatment DASH score was not significantly different between two groups, but post-treatment score was significantly lower in experimental group than in control group (21.94 ± 5.79vs.35.87 ± 3.80, p < 0.05).Post-treatment the occurrence of VWF in experimental group was significantly lower than that of pre-treatment (χ2 = 5.081, p = 0.024).88.37% of the pretreatment serum TNFα concentration was above reference range 8.1 pg/ml, and it was not significantly different between two groups. However, post-treatment TNFα concentration in experimental group was significantly lower than that in control group (10.51 ± 3.68 pg/ml vs.14.72 ± 8.66 pg/ml, p = 0.045). Further, the difference in DASH score and TNFα concentration before and after treatment was statistically significant between groups (p < 0.05). ConclusionsCombination of acupuncture and moxibustion may be an effective treatment for occupational HAVD, the mechanism is possibly related to reduction of the serum TNFα levels.

Doppler ultrasound observation of finger artery in patients with hand-arm vibration disease

目的： 观察手臂振动病手指动脉的彩色多普勒超声表现特点，为手臂振动病的诊断提供科学依据。 方法： 应用PHILIPS G4彩色多普勒超声诊断仪，探头频率7.5~12.0 MHz，对手臂振动病患者13例及正常健康人11例的拇指、示指、中指5条动脉即拇指桡掌侧固有动脉、拇指尺掌侧固有动脉、示指桡侧动脉、示指指掌侧固有动脉、中指指掌侧固有动脉的彩色束宽（示血管内径）、收缩期峰值流速、舒张末期流速、血管搏动指数、阻力指数进行检测。 结果： 病例组拇指桡掌侧固有动脉、拇指尺掌侧固有动脉、示指桡侧动脉、示指指掌侧固有动脉、中指指掌侧固有动脉彩色束宽(血管内径)均小于健康对照组，差异有统计学意义（P<0.05）。病例组拇指尺掌侧固有动脉、示指桡侧动脉、示指指掌侧固有动脉、中指指掌侧固有动脉阻力指数均高于健康对照组，差异有统计学意义（P<0.05）。病例组与健康对照组手指动脉收缩期峰值流速、舒张末期流速、血管搏动指数，差异均无统计学意义（P>0.05）。 结论： 手指动脉彩色多普勒超声可在一定程度上反映手臂振动病外周血管损伤，对手臂振动病的诊断具有一定的价值。.

Features of peripheral nerve injuries in workers exposed to vibration: an analysis of 197 cases

Objective: To investigate the features of peripheral nerve injuries in workers exposed to vibration. Methods: A total of 197 male workers [median age: 34 years (21-50 years) ; median working years of vibration exposure: 7.3 years (1-20 years) ] engaged in grinding in an enterprise were enrolled. Their clinical data and electromyography results were analyzed to investigate the features of peripheral nerve impairment. Results: Of all workers, 96 (48.73%) had abnormal electromyography results. Of all workers, 88 (44.7%) had simple mild median nerve injury in the wrist, who accounted for 91.7% (88/96) of all workers with abnormal electromy-ography results. Six workers had ulnar nerve injury, superficial radial nerve injury, or/and superficial peroneal nerve injury and accounted for 6.3% of all workers with abnormal electromyography results. Of all workers, 88 had a reduced amplitude of median nerve sensory transduction, and 28 had slowed median nerve sensory transduction. A total of 46 workers were diagnosed with occupational hand-arm vibration disease and hospitalized for treatment. They were followed up for more than 4 months after leaving their jobs, and most of them showed improvements in neural electromyography results and returned to a normal state. Conclusion: Workers exposed to vibration have a high incidence rate of nerve injury in the hand, mainly sensory function impairment at the distal end of the median nerve, and all injuries are mild peripheral nerve injuries. After leaving the vibration job and being treated, most workers can achieve improvements and return to a normal state.

Carpal canal ultrasound examination in patients with mild hand-arm vibration disease

Objective: To investigate the clinical value of ultrasound examination of carpal canal structure in patients with mild hand-arm vibration disease. Methods: A total of 29 patients (58 wrists) with mild hand-arm vibration disease who were treated in Shenzhen Prevention and Treatment Center for Occupational Diseases from May to December, 2015 were enrolled as observation group, and 20 healthy volunteers (40 wrists) were enrolled as the control group. Color Doppler ultrasound was used to observe the morphology and echo of the median nerve in the carpal canal and 9 muscle tendons and transverse carpal ligament. The thickness of transverse carpal ligament and diameter of the median nerve at the level of the hamulus of hamate bone were measured, as well as the cross-sectional area of the median nerve at the level of pisiform bone. Results: In the 29 patients with hand-arm vibration disease patients in the observation group, 8 experienced entrapment of the median nerve in the carpal canal, among whom 5 had entrapment in both wrists; there were 13 wrists (23%) with nerve entrapment and 45 wrists (77%) without nerve entrapment. Compared with the control group, the patients with hand-arm vibration disease and nerve entrapment in the observation group showed significant thickening of the transverse carpal ligament at the level of the hamulus of hamate bone and a significant increase in the cross-sectional area of the median nerve at the level of pisiform bone (P<0.05) , while there were no significant differences in the thickness of transverse carpal ligament at the level of the hamulus of hamate bone and the cross-sectional area of the median nerve at the level of pisiform bone (t=-9.397 and -4.385, both P>0.05) . Conclusion: Ultrasound examination can clearly show the radiological changes of carpal canal contents in patients with mild hand-arm vibration disease and has a certain diagnostic value in nerve damage in patients with hand-arm vibration disease.

Field investigation of occupational disease diagnosis in Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014: an analysis of 136 cases

To investigate the characteristics of 136 patients with occupational diseases, to summarize key techniques used in field investigation, and to provide a scientific basis for the development of standard operating procedures for field investigation of occupational disease diagnosis. Field investigation and routine data analysis were performed to analyze the cases diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from January 2009 to December 2014. A total of 136 cases of occupational diseases were diagnosed by Guangdong Provincial Hospital for Occupational Disease Prevention and Treatment from 2009 to 2014, and there were 66 cases of leukemia, 18 cases of suspected occupational benzene poisoning, 12 cases of suspected occupational handarm vibration disease, and 11 cases of suspected pneumoconiosis. Of all these patients, 41.91% were engaged in at least three types of work, 70.59% were exposed to at least three types of chemicals, 25.74% experienced changes in technical processes and chemicals, and 47.06% had disputes on the chemicals they were exposed to during verification by both parties. Occupational hazard factors were detected. Most samples (358)were used to measure benzene concentration in workplace air, among which 11.7% had a benzene concentration of >6.00 mg/m(3)(exceeding standard), 13.41% had a benzene concentration of 3.26~6.00 mg/m(3), 75.42% had a benzene concentration of<0.03 to <3.25 mg/m(3). The samples of suspected occupational hand-arm vibration disease, suspected pneumoconiosis, and suspected occupational noiseinduced hearing loss had high overstandard rates (100%, 93.8%, and 83.3%, respectively). Field investigation of occupational disease diagnosis reveals large numbers of cases of leukemia, suspected occupational benzene poisoning, suspected occupational hand-arm vibration disease, and suspected pneumoconiosis. The key aspects of field investigation include confirmation of the history of occupational exposure, identification of occupational hazard factors, confirmation of the changes in technical processes and chemicals, detection of occupational hazard factors, sampling and analysis of raw materials, and epidemiological investigation of workers with the same type of work.

Clinical efficacy of mouse nerve growth factor in treatment of occupational hand-arm vibration disease

To investigate the efficacy of mouse nerve growth factor (mNGF) in treating occupational hand-arm vibration disease (HAVD). Sixty-four patients with HAVD were equally and randomly divided into treatment group and control group. The control group was given Salvia miltiorrhiza Bunge and deproteinized extract of calf blood to improve circulation, and also given methylcobalamin tablets and vitamin B6 for neurotrophic treatment. In addition to the above treatments for the control group, the treatment group was also given 30 µg/d mNGF by intramuscular injection for two courses (4 weeks for each course) with a 15-day interval. Both the treatment group and the control group showed significant improvements in clinical symptoms and signs (hand numbness and pain, and reduced senses of touch, pain, and vibration), cold water loading test (CWLT), and electroneuromyography (ENMG) after treatments (P < 0.05). And the treatment group had significantly more improvements than the control group (P < 0.05). mNGF can significantly improve hand numbness and pain, reduced senses of touch, pain, and vibration, CWLT, and ENMG, so it has better clinical effect and safety in treating HAVD. Early diagnosis and treatment can improve the outcome of patients with HAVD.

Problems of "Diagnostic criteria of occupational hand-arm vibration disease" (GBZ 7-2002) and proposal in its revision

GBZ 7-2002 [1](以下简称 )于2002年颁布实施,至今已有7年多,按照常规,已到对该 进行修订的时间了.笔者结合近几年自己的研究成果和经验,特提出该 中存在的问题以及对于修订该标准的几点建议,供同行参考,并为 的修订做准备。

On research of hand-arm vibration disease and suggestions

关于手臂振动病的研究,国外早有不少报道[1-3],笔者也发表了一些粗浅见解[4-7].特别是新近修订、发布了国家职业卫生标准《职业性手臂振动病诊断标准》(GBZ 7-2002),以及国家推荐标准《手持式机械作业防振要求》(GB/T17958-2000)和《手套掌部振动传递率的测量与评价》(GB/T 18703-2002)等,充分反映了国内这一领域的最新科研成果。

Discussion of several problems in hand-arm vibration disease.

Discussion of several problems in hand-arm vibration disease.

Magnetic resonance imaging for the wrist joint of the coal miners in vibration department

To study the magnetic resonance imaging (MRI) in the wrist joint of coal miners who work in excavation and vibration department. Forty-three coal miners with the hand-arm vibration disease served as the observation group while 20 workers who were not working in the vibration department acted as the control group. The patients in the observation group were divided into five subgroups according to the time when they received vibration. The regularity of the development of signs and symptoms of MRI was observed and analyzed. The hydroarthrosis was most found in MRI. There were significant difference in hydroarthrosis (chi(2) = 8.80, P < 0.01), osteoporosis and osteomyelitis (chi(2) = 3.91, chi(2) = 5.01, P < 0.05 respectively) between the observation group and the control group. The edema of bone marrow and the avascular necrosis of ossa carpi were found only in the observation group and not found in the control group. The hydroarthrosis and the edema of bone marrow occurred most in the early stage of vibration. The signal in the edema of the bone marrow of the distal end of the radius was decreased in the GE sequence T(2)WI with the specificity. (1) Changes in the wrist joint occur in the early stage of the vibration work, and can be found in the MRI. (2) The edema of the bone marrow of the distal end of the radius is of great value in the diagnosis of the hand-arm vibration disease.

Progress in studies on hand-arm vibration disease in China

手臂振动病是我国的法定职业病.20世纪90年代以来,手臂振动病在应用研究和基础理论研究方面均取得了一定成果,并为现行的 提供了重要的参考资料.笔者对1996年以来国内有关手臂振动防治研究的研究论文进行了检索,共获取100余篇文章(包括本研究所的论文60余篇).现结合这些文献资料,将这一研究领域中的国内研究进展进行简要综述。

Artériopathies des maladies professionnelles

Arteriopathies of occupational diseases predominate in the upper limbs and are usually expressed as Raynaud's phenomenon ("white finger"), sometimes complicated by digital gangrene. Hand-arm vibration disease, hypothenar hammer syndrome, exposure to silica even without silicosis and vinyl chloride intoxication are the principal causes of occupational diseases acknowledged as such by the laws. In a personal series of 60 patients with complicated upper limb arteriopathies, 25% had a recognized occupational disease. Since December 1992, Erasmus' syndrome and systemic scleroderma due to silica without silicosis have been accepted in France as being occupational diseases. The therapeutic problems are discussed, notably the surgical indications in hypothenar hammer syndrome, the possible medical treatments of finger necrosis occurring in Erasmus' syndrome and, in particular, the role played by spinal cord neurostimulation.

Treatments for Hand-Arm Vibration Disease in Japan

Treatments for Hand-Arm Vibration Disease in Japan