Phenomenon Of Occupational Origin Research Articles

Raynaud's phenomenon in the occupational context.

To review articles that evaluated the prevalence of Raynaud's phenomenon of occupational origin. The search for articles was carried out in the Medline (via PubMed), Embase, Web of Science, Scientific Electronic Library Online (SciELO), and Latin America and Caribbean Health Sciences Literature (Lilacs) databases. 64 articles were obtained from the electronic search; 18 articles met the eligibility criteria. All studies discussed the exposure to vibrations in the upper limbs. In 6 of them, the thermal issue was directly or indirectly addressed. No studies have addressed exposure to vinyl chloride. In general, a higher prevalence of Raynaud's phenomenon was found among vibratory tool operators compared to non-exposed workers, with an increase in the number of cases the higher the level of vibration and the time of exposure. Cold is a triggering and aggravating factor of the Raynaud phenomenon and seems to play an important role in the emergence of vascular manifestations of the hand-arm vibration syndrome.

Vibration Exposure, Vibration-Induced White Finger and Digital Arterial Tone in Chain Saw Operators

In a group of 65 Italian forestry operators using chain saws, the overall prevalence of vibration-induced white finger (VWF) was found to be 29.2%. The occurrence of VWF was higher in the chain sawyers who had operated non-antivibration (non-A/V) as well as A/V saws (46.4%) than in those with experience limited to A/V saws (16.2%). The latency time before VWF averaged 9.4 yr (SD 6.8). The mean value of the four-hour energy-equivalent frequency-weighted acceleration [(ah,w)eq(4)] was 7.2 m/s2 (SD 1.2). On the basis of the known VWF prevalence and of [(ah,w)eq(4)], a latent period before VWF of 7.1 yr was expected according to ISO 5349. The measurement of finger systolic pressure (FSP) at 15°C and 10°C by plethysmographic technique showed that the chain sawyers affected with VWF experienced a more intense digital vasospasm than a group of comparable controls and the chain sawyers without VWF. The sensitivity of the method to detect vibration-induced digital arterial hyper-responsiveness to cold was 84.2% and the specificity was 100%. The findings of this study showed a good agreement between the expected and observed latency times before VWF, even though the ISO dose-effect relationship seems to overestimate slightly the risk. The results of the cold test indicated that the measurement of FSP during local cooling is an accurate laboratory method to diagnose objectively Raynaud's phenomenon of occupational origin.

Raynaud's Phenomenon of Occupational Origin

Vibration delivered to the hand and arm by industrial pneumatic tools is a common cause of vascular and neurovascular problems, including cold-induced vascular spasm (vibration white finger) and peripheral neuropathies with paresthesias, dysesthesias, and sensory abnormalities. A decade ago, the US Public Health Service estimated that 1.2 million American workers were at risk. Differentiation of primary and secondary Raynaud's phenomenon from the thoracic outlet syndrome and from the carpal tunnel syndrome pose potential diagnostic difficulties. Despite growing public recognition of upper extremity problems caused by repetitive trauma, there have been few investigations of vibration-induced disorders in the United States. This is not true worldwide, particularly in Northern Europe, where there has been significant intervention in medical surveillance and tool design. There does appear to be, however, frequent misdiagnosis and misdirected surgery. This has particular significance for the clinician, since in the 1990s, cumulative trauma injuries are expected to exceed all other work-related injuries.

Raynaud's phenomenon of occupational origin

Raynaud's phenomenon of occupational origin

Finger systolic pressure during local cooling in normal subjects aged 20 to 60 years: reference values for the assessment of digital vasospasm in Raynaud's phenomenon of occupational origin.

Measurements of finger systolic pressure (FSP) during a standardized cold test (finger cooling to 30, 15 and 10 degrees C during 5 min ischemia) were performed on 103 healthy subjects divided into four subgroups according to age: 20-29 years (n = 22), 30-39 years (n = 32), 40-49 yr (n = 27), 50-60 years (n = 22). Among the age groups there was no difference in the reduction of FSP (FSP%) and in the digit-to-brachial systolic pressure index (DBI%) after cold provocation at 15 and 10 degrees C. Cold-induced digital vasoconstriction was more intense in smokers than in non smokers (P = 0.025). In the entire study population the lower normal limits of FSP% were 74% at 15 degrees C and 63% at 10 degrees C. Using an FSP%10 of less than 60% as a discriminating threshold between normals and patients with vibration white finger, the sensitivity of the cold test was 87% and the specificity was 100%. The findings of this study suggest the following considerations: (a) age does not seem to influence the digital arterial response to cold in healthy subjects; (b) smoking has a harmful effect on finger cold reaction in normal individuals; (c) the measurement of FSP during cooling is an accurate method of objectively diagnosing Raynaud's phenomenon of occupational origin.

Vibration white finger, digital blood pressure, and some biochemical findings on workers operating vibrating tools in the engine manufacturing industry

A clinical and laboratory investigation was carried out on 76 operators using pneumatic hand grinders and impact wrenches in the engine manufacturing industry. Twenty-two vibration-exposed workers (28.9%) had no symptoms in the hands (stage 0 of the Stockholm Workshop scale), 34 (44.7%) were affected with sensorineural disturbances in the fingers (stage SN), and 20 (26.3%) suffered from vibration white finger (VWF stages 1-2-3). In the vibration-exposed operators and in 30 comparable referents not exposed to vibration, finger systolic blood pressure (FSP) was measured on a test finger and on a control finger after digit cooling to 30 degrees C and 10 degrees C. The results of the cold provocation test were expressed as percent change of FSP by cooling the test finger from 30 degrees C to 10 degrees C (FSP%t, 10 degrees) and as digital/brachial pressure index during local cooling at 10 degrees C (DPIt, 10 degrees). After cold provocation the mean values of FSP%t, 10 degrees and DPIt 10 degrees were more significantly reduced in the vibration-exposed workers with VWF than in those without VWF and the referents (p less than 0.001). The cold provocation test was found to differentiate between VWF subjects with stages 1-2 and stage 3 (p less than 0.02). It is concluded that the measurement of FSP combined with finger cooling is a useful laboratory test to diagnose objectively Raynaud's phenomenon of occupational origin. The vibration-exposed workers and the referents were also tested for serum levels of immunoglobulins and complement and for daily excretion of urinary free catecholamines. Between the reference and vibration groups no differences in the mean values of the immunologic parameters and urinary catecholamines were found. The meaning of these findings is discussed.

Biological effects of vibration on the hand and arm: Historical perspective and current research

Raynaud's phenomenon of occupational origin, or the vibration syndrome of hand and arm, was first recognized in North America by Dr. Alice Hamilton in the limestone quarries of Bedford, Indiana around 1890 to 1900. It is a tribute to the American pioneers in this area that the Acoustical Society of America now formally recognizes Biological Response to Vibration as a technical area. The objective of this paper is to highlight gaps of information regarding mechanisms of vascular, neurological, and musculo‐skeletal damage caused by vibration. Also addressed is evidence that high noise level may act synergistically to the development of vibration syndrome of the hand and arm. Areas of research currently active in psychophysical and neurophysiological investigations to increase our understanding of tactile and spatial discrimination are discussed. Although the importance of sensory loss or “fine touch” is understood there is neither a proven objective scientific test with which the syndrome can be diagnosed nor is there a scale of damage assessment. Determining the exact role of the central nervous system in assessing damage from vibration is difficult in view of nonspecific symptoms reported from Eastern Europe and from Japan. To complicate matters still further, there is the possibility that repeated, rapid mechanical movements of the hand and arm associated with handling heavy tools produce Carpal Tunnel Syndrome but that the injury is not directly attributed to vibration. Therefore, it follows that there could exist an element of Carpal Tunnel Syndrome in many vibration syndrome cases. Clearly, there is an area within the framework of the Acoustical Society of America for worldwide cooperative efforts to solve many fundamental problems concerned with the effect of vibration on a hand or arm.

Raynaud's Phenomenon as It Relates to Hand-Tool Vibration in the Workplace

The current status of Raynaud's phenomenon of occupational origin as it occurs in various U.S. workplace situations is examined and discussed. Methods of reducing the effects of hand-arm vibration exposure as well as the status of current vibration standards also are discussed. A work practices guide is recommended.

An Association Between Raynaud's Phenomenon and Hearing Loss in Forestry Workers

Forestry workers using chain saws run the risk of both vibration disease and noise-induced hearing loss. It was reported that people with Raynaud's phenomenon of occupational origin had more severe hearing loss than those without it. A possibility of confounding due to age and duration of noise exposure from the tools remained unsolved, however. A matched pair case-control study was conducted to eliminate such confounding. Forestry workers operating chain saws, bush cleaners and/or winches were investigated. For 37 men with Raynaud's phenomenon a control was chosen from those unaffected whose age and operating hours for the tools were almost equal to those of the cases. Good matching was achieved for age and for total hours of work with the tools. The cases had higher median hearing threshold than the controls at every frequency. The difference was significant (p less than 0.05) at 4 and 8 kHz and almost significant at 2 kHz (p not equal to 0.06). According to our classification of the audiogram, the cases had more advanced types of noise-induced hearing loss than did the controls. Thus, an association between Raynaud's phenomenon and hearing impairment in forestry workers handling chain saws and/or other tools was found to persist even after the effect of age and exposure time was eliminated.

Effect of the air hammer on the hands of stonecutters. The limestone quarries of Bedford, Indiana, revisited.

In the limestone quarries of Indiana, USA, pneumatic percussive hammers replaced the mallet and hammer around 1900. By 1917 the air hammer was being used exclusively for periods of eight to ten hours a shift. In 1918 Alice Hamilton investigated an unusual "disease" in these stonecutters of Bedford, Indiana, who complained of "attacks of numbness and blanching of the fingers coming on suddenly under the influence of cold and then disappearing." The prevalence of vibration induced white finger (VWF) found in this population of 38 stonecutters was 89%, with decreased light touch, pain, and temperature appreciation in advanced cases. In 1978 a VWF research team revisited these limestone quarries. During the 60 year interval the stonecutting industry had contracted from 4000 workers in 40 quarries in 1918 to 3-400 in 10 quarries in 1978, with only 50 employees remaining in the Bedford area. In a population of 30 stonecutters the prevalence of VWF in 1978 was 80%, with similar sensory loss in light touch, pain, and temperature appreciation. Between 1918 and 1978 no change had taken place in the design of the air hammers used for stonecutting. Vibration levels of 4859 metres/s2 on the chisel, and 2010 metres/s2 on the barrel were measured over a frequency range 6.3 to 1000 Hz. The fundamental frequency was 75 Hz. These measured vibration levels are outside the ISO/DIS/5349 (1979) recommended limits for human exposure to vibration transmitted to the hand. The VWF data presented in this paper, and those originally reported by Hamilton in 1918, call for an immediate redesign of stonecutting pneumatic hammers in order to remove one cause of Raynaud's phenomenon of occupational origin.

Screening test for Raynaud's phenomenon of occupational origin.

The efficiency of various screening test methods for Raynaud's phenomenon was closely examined in a comparison between a Raynaud's phenomenon-positive group and a control group when the subject is seen between attacks. An attempt was made to discover a new screening test method. The following experiments were carried out: skin temperature, palm-press test, nail-press test, grasping power, reactive congestion test, rheumatoid arthritis test, and cold pressor test. The cold pressor recovery index (CPRI), or Okada-Yamashita index, newly devised as an index expressing the degree of recovery of high blood pressure caused by a cold load, was extremely useful as a screening test, because a statistically significant difference was observed at the 1% level between both groups.

International classification of radiographs of pneumoconioses.

Agate, J. N. (1949). An outbreak of cases of Raynaud's phenomenon of occupational origin. Brit. J. industr. Med., 6, 144-163. -, Druett, H. A., and Tombleson, J. B. L. (1946). Raynauds phenomenon in grinders of small metal castings. A clinical and experimental study. Brit. J. industr. Med., 3, 167-174. Hunter, D. (1969). The Diseases of Occupations, 4th ed., pp. 885-895. English Universities Press, London. -, McLaughlin, A. I. G., and Perry, K. M. A. (1945). Clinical effects of the use of pneumatic tools. Brit. J. industr. Med., 2, 10-16. Industrial Injuries Advisory Council (1954). Raynaud's phenomenon. Report of the Industrial Injuries Advisory Council in accordance with Section 61 of the National Insurance (Industrial Injuries) Act, 1946, on the question whether Raynaud's phenomenon should be prescribed under the Act. Cmd. 9347. H.M.S.O., London. (1970). Vibration syndrome. Interim report by the Industrial Injuries Advisory Council in accordance with Section 62 of the National Insurance (Industrial Injuries) Act 1965 on the question whether diseases of bones, joints, muscles, blood-vessels or nerves of the hand, arm or shoulder (including Raynaud's phenomenon) caused by vibrating machines should be prescribed under the Act. Cmnd. 4430. H.M.S.O., London. Marshall, J., Poole, E. W., and Reynard, W. A. (1954). Raynaud's phenomenon due to vibrating tools. Neuro logical observations. Lancet, 1, 1151-1156. Reynard, W. A. (1954). Effects of vibrating machines. In British Encyclopaedia of Medical Practice. Interim Supplement (February), pp. 11-14. Butterworth, London. Stewart, A. M., and Goda, D. F. (1970). Vibration syn drome. Brit. J. industr. Med., 27, 19-27.

振動工具使用に伴って生ずるレイノー現象と皮膚温度との関係 (その2)

Many efforts have been made to find the best way of diagnosing Raynaud's phenomenon of occupational origin, but so far it has not been successful. The previous paper described the findings related to the recovery of the skin temperatures of the fingers having been exposed to the cold water for a short time, and the results as to the skin temperatures at the end of the 5-minute-immersion of hands in the cold water. The results of these examinations, however, were not satisfactory for diagnosing the phenomenon precisely. This paper presents an experimental study of the skin temperatures of the fingers during immersion of hands in the cold water for ten minutes. The average skin temperatures every one minute after the sixth minute of 10-minute-immersion were observed, since it was found that some cases had an initial fall or a gradual fall in the skin temperatures in the first five minutes and all cases had the skin temperature stabilized after the sixth minute. The results obtained from the workmen suffering from the phenomenon were compared with those from 10 healthy male subjects, which is defined here as the standard skin temperature (SST). In the water at 10°C the skin temperature of the workmen suffering from the phenomenon showed a tendency to be a little lower than SST. In the water at 5°C it was further lower than SST. Skin temperatures of 8.8°C (M-σ or the mean value less by one standard deviation obtained in the health subjects) or less were observed in many of the workmen suffering from the phenomenon, and those of 7.0°C (M-2σ) or less were observed in those suffering severely from the phenomenon. Consequently, measurement of the skin temperature of the hand immersed in the water at 5°C is considered appropriate for diagnosing the phenomenon. Besides, by immersion in 5°C water the 4 workmen suffered severely from the phenomenon and showed blanching of the fingers with their skin temperatures of 5.0-5.6°C.

Survey of Current Status of Raynaud's Phenomenon of Occupational Origin

(1960). Survey of Current Status of Raynaud's Phenomenon of Occupational Origin. American Industrial Hygiene Association Journal: Vol. 21, No. 1, pp. 80-83.

Outbreak of Cases of Raynaud'S Phenomenon of Occupational Origin

Outbreak of Cases of Raynaud'S Phenomenon of Occupational Origin