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Zimmerman M, Åselius L, Dahlin E, Andersson GS, Dahlin LB. Impact of Exposure to Hand-Held Vibrating Tools on Patient-Reported Outcome Measures after Open Carpal Tunnel Release: A Retrospective Cohort Study with Matched Controls. J Clin Med 2024; 13:4954. [PMID: 39201094 PMCID: PMC11355075 DOI: 10.3390/jcm13164954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2024] [Revised: 08/18/2024] [Accepted: 08/20/2024] [Indexed: 09/02/2024] Open
Abstract
Objectives: Vibration exposure is a known risk factor for developing carpal tunnel syndrome (CTS), and insufficient outcomes for surgery for CTS have been reported after such exposure. We aim to investigate whether vibration exposure affects patient-reported outcomes following open carpal tunnel release. Methods: From a population surgically treated for CTS (n = 962), we identified patients who reported previous or present vibration exposure, had undergone preoperative electrophysiology testing and answered the Quick Disabilities of Arm, Shoulder and Hand (QuickDASH) questionnaire before and at 12 months post-surgery (n = 23). We then matched the patients with controls based on age, sex, diabetes status, type of diabetes and smoking (n = 23). Results: Most of the patients included were men (17/23; 74% in each group) and had a mean age of 61 years. The preoperative electrophysiology results were slightly worse among vibration-exposed individuals, although the differences were not statistically significant. The QuickDASH scores did not differ between the two groups (preoperative QuickDASH scores in vibration-exposed individuals: median 45 [interquartile range; IQR 30-61]; non-exposed individuals: 43 [25-64], p = 0.68; postoperative 12 months QuickDASH score in vibration-exposed individuals: 20 [2-45]; non-exposed individuals: 14 [5-34], p = 0.87). Conclusions: When controlling for known confounders, vibration-exposed individuals can expect the same symptom relief following open carpal tunnel release as non-exposed individuals. Individual assessments and treatment of CTS are warranted if there is a history of vibration exposure.
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Affiliation(s)
- Malin Zimmerman
- Department of Orthopedics, Helsingborg Hospital, SE-251 87 Helsingborg, Sweden
- Department of Translational Medicine—Hand Surgery, Lund University, SE-205 02 Malmö, Sweden; (L.Å.); (E.D.); (L.B.D.)
| | - Lisa Åselius
- Department of Translational Medicine—Hand Surgery, Lund University, SE-205 02 Malmö, Sweden; (L.Å.); (E.D.); (L.B.D.)
| | - Erik Dahlin
- Department of Translational Medicine—Hand Surgery, Lund University, SE-205 02 Malmö, Sweden; (L.Å.); (E.D.); (L.B.D.)
- Department of Orthopedics, Centrallasarettet, SE-352 34 Växjö, Sweden
| | - Gert S. Andersson
- Department of Clinical Sciences Lund, Clinical Neurophysiology, Lund University, SE-221 85 Lund, Sweden;
| | - Lars B. Dahlin
- Department of Translational Medicine—Hand Surgery, Lund University, SE-205 02 Malmö, Sweden; (L.Å.); (E.D.); (L.B.D.)
- Department of Hand Surgery, Lund University and Skåne University Hospital, SE-205 02 Malmö, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83 Linköping, Sweden
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Zhou Z, Yu L, Meng F, Wen J, Xiao Y, Shan H, Wan S, Zeng H, Yu F. Limb Salvage Using Lateral Circumflex Femoral Artery Graft for a Hand Vibration Syndrome. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5978. [PMID: 39015361 PMCID: PMC11251676 DOI: 10.1097/gox.0000000000005978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/31/2024] [Indexed: 07/18/2024]
Abstract
A 50-year-old man was admitted to the hospital with a chief complaint of long-standing cold-induced numbness in the fingers for more than a year, accompanied by persistent hand pain and fingertip ulceration for 3 months. On physical examination, radial and ulnar artery pulsation was absent in both limbs, and pale skin color, low skin temperature, and limited finger range of motion were noted. Gangrene was detected in the fingertips of the left index and middle fingers, and the right middle and ring fingers. The patient was diagnosed with bilateral arterial occlusion and vibration white finger. Upon admission, the patient underwent an intervention surgery on the right side. Subsequently, transplantation of the descending branches of the left and right lateral femoral circumflex arteries was performed to restore blood flow in the bilateral radial arteries. Additionally, debridement was conducted without shortening after the surgical procedure, the patient received anticoagulation, anti-inflammatory, and symptomatic treatment. The bilateral finger skin temperature increased by 3 °C postoperatively, and the accompanying pain and numbness were alleviated. The wound healed 1 month after surgery, and no recurrence of pain or ulcer was reported during the 1-year follow-up period. Eventually, his hand function recovered, without any impact on the vascular donor site.
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Affiliation(s)
- Zhegang Zhou
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Longbiao Yu
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Fanbin Meng
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Jingjing Wen
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yingfeng Xiao
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Huiming Shan
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Shengxiang Wan
- From the Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, China
| | - Hui Zeng
- Department of Orthopedics, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Fei Yu
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, China
- National and Local Joint Engineering Research Center of Orthopaedic Biomaterials, Shenzhen, China
- Shenzhen Key Laboratory of Orthopaedic Diseases and Biomaterials Research, Shenzhen, China
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Gerhardsson L. A follow-up study of vibration-induced injuries in workers exposed to transient and high frequency vibrations. J Occup Med Toxicol 2024; 19:27. [PMID: 38907277 PMCID: PMC11191195 DOI: 10.1186/s12995-024-00425-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024] Open
Abstract
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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Affiliation(s)
- Lars Gerhardsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16 A, Box 414, Gothenburg, SE-405 30, Sweden.
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Scholz MF, Brammer AJ, Marburg S. Exposure-response relation for vibration-induced white finger: inferences from a published meta-analysis of population groups. Int Arch Occup Environ Health 2023; 96:757-770. [PMID: 36976319 DOI: 10.1007/s00420-023-01965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 02/16/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE It is questioned whether the exposure-response relation for the onset of vibration-induced white finger (VWF) in ISO 5349-1:2001 needs to be revised based on the epidemiologic studies identified by Nilsson et al. (PLoS One https://doi.org/10.1371/journal.pone.0180795 , 2017), and whether the relation they derive improves the prediction of VWF in vibration-exposed populations. METHODS A pooled analysis has been performed using epidemiologic studies that complied with selection rules and reported a VWF prevalence of 10% or more, and exposure constructed according to the provisions of ISO 5349-1:2001. The lifetime exposures at 10% prevalence were calculated for various data sets using linear interpolation. They were then compared to both the model from the standard and that developed by Nilsson et al. RESULTS: Regression analyses reveal excluding extrapolation to adjust group prevalences to 10% produce models with 95-percentile confidence intervals that include the ISO exposure-response relation but not that in Nilsson et al. (2017). Different curve fits are obtained for studies involving daily exposure to single or multiple power tools and machines. Studies with similar exposure magnitudes and lifetime exposure durations but markedly different prevalences are observed to cluster. CONCLUSIONS A range of exposures and A(8)-values is predicted within which the onset of VWF is most likely to occur. The exposure-response relation in ISO 5349-1:2001, but not that proposed by Nilsson et al., falls within this range and provides a conservative estimate for the development of VWF. In addition, the analyses suggest that the method for evaluating vibration exposure contained in ISO 5349-1:2001 needs revision.
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Affiliation(s)
- Magdalena F Scholz
- School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748, Garching, Bavaria, Germany.
| | - Anthony J Brammer
- Department of Medicine, University of Connecticut Health, 263 Farmington Avenue, Farmington, CT, 06030, USA
| | - Steffen Marburg
- School of Engineering and Design, Technical University of Munich, Boltzmannstraße 15, 85748, Garching, Bavaria, Germany
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Nieto-Álvarez R, de la Hoz-Torres ML, Aguilar AJ, Martínez-Aires MD, Ruiz DP. Proposal of Combined Noise and Hand-Arm Vibration Index for Occupational Exposure: Application to a Study Case in the Olive Sector. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14345. [PMID: 36361218 PMCID: PMC9654875 DOI: 10.3390/ijerph192114345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
In many production and industrial sectors, workers are exposed to noise and hand-arm vibrations (HAV). European directives have established the maximum limit values or exposure action values for noise and vibration independently. However, in many cases, workers who endure hand-arm vibration also receive high noise levels. This research suggests a procedure to aid the establishment of precautionary measures for workers with simultaneous exposure to both physical agents. This procedure defines a combined index based on the energy doses for both noise and HAV. From this combined index, the suggested methodology allows a recommended exposure time for workers with simultaneous noise and HAV exposure to be calculated. This methodology can be adapted to tackle the relative importance assigned to both agents according to the safety manager and new knowledge on combined health effects. To test this method, a measurement campaign under real working conditions was conducted with workers from the olive fruit-harvesting sector, where a variety of hand-held machinery is used. The results of the study case show that the suggested procedure can obtain reliable exposure time recommendations for simultaneous noise and HAV exposures and is therefore a useful tool for establishing prevention measures.
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Affiliation(s)
- Raquel Nieto-Álvarez
- Department of Architectural Graphic Expression and Engineering, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | - María L. de la Hoz-Torres
- Department of Building Construction, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | - Antonio J. Aguilar
- Department of Applied Physics, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
| | | | - Diego P. Ruiz
- Department of Applied Physics, University of Granada, Av. Severo Ochoa s/n, 18071 Granada, Spain
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Witte J, Corominas A, Ernst B, Kaulbars U, Wendlandt R, Lindell H, Ochsmann E. Acute physiological and functional effects of repetitive shocks on the hand-arm system - a pilot study on healthy subjects. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022:1-10. [PMID: 35930057 DOI: 10.1080/10803548.2022.2110358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE Exposure to hand-transmitted shocks is a widespread phenomenon at the workplace. Separate risk assessments for shocks do not exist in current international hand-arm vibration regulations, leading to a potential underestimation of associated health risks. METHODS In a pilot study approach, N = 8 healthy males were exposed to sets of 3×5 minutes of repetitive shocks and 1×5 minutes of random vibration, controlled at a weighted vibration total value of 10 m/s2 respectively. Baseline and post-exposure measurements of vibration perception thresholds, finger skin temperature, maximal grip / pinch force and the Purdue Pegboard test were conducted. Muscle activity was monitored continuously by surface electromyography. RESULTS Shock exposures evoked a temporary increase of vibration perception thresholds with high examination frequencies. A decrease of skin temperature was hinted for 1 s-1 and 20 s-1 shocks. Electromyographical findings indicated an additional load on two forearm muscles during shock transmission. Maximum grip force and manual dexterity were not affected, pinch force only partially reduced after the exposures. CONCLUSION Physiological effects from shock exposure conform to those described for hand-arm vibration exposure in principle, although some divergence can be hypothesized. Randomized designs are required to conclusively assess the need of occupational health concepts specifically for hand-transmitted shocks.
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Affiliation(s)
- Jonathan Witte
- Luebeck Institute of Occupational Health, University of Lübeck, Lübeck, Germany
| | - Alexandra Corominas
- Luebeck Institute of Occupational Health, University of Lübeck, Lübeck, Germany
| | - Benjamin Ernst
- Institute for Occupational Safety and Health, German Social Accident Insurance, Sankt Augustin, Germany
| | - Uwe Kaulbars
- Institute for Occupational Safety and Health, German Social Accident Insurance, Sankt Augustin, Germany
| | - Robert Wendlandt
- Clinic for orthopedic and trauma surgery, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Hans Lindell
- Department of material manufacturing, Research Institutes of Sweden, Mölndal, Sweden
| | - Elke Ochsmann
- Luebeck Institute of Occupational Health, University of Lübeck, Lübeck, Germany
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Stjernbrandt A, Wahlström J. The impact of Raynaud's phenomenon on work ability - a longitudinal study. J Occup Med Toxicol 2022; 17:12. [PMID: 35676726 PMCID: PMC9175314 DOI: 10.1186/s12995-022-00354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To determine if having Raynaud's phenomenon (RP) affects the work ability, job retainment, or occurrence of sick leave. METHODS Surveys on the working-age general population of northern Sweden were conducted in 2015 and 2021, gathering data on RP, occupation and sick leave. Work ability was assessed using the Work Ability Score. RESULTS The study population consisted of 2,703 women and 2,314 men, among which 390 women and 290 men reported RP at follow-up. For women, the mean [standard deviation (SD)] Work Ability Score was 8.02 (2.24) for subjects reporting RP and 7.68 (2.46) for those without RP. For men, the corresponding numbers were 7.37 (2.03) and 7.61 (2.14), respectively. Multiple linear regression did not show an association between RP status and work ability (p = 0.459 for women and p = 0.254 for men), after adjusting for age, body mass index, physical workload, cardiovascular disease, and perceived stress. Having retained the same main livelihood since baseline was reported by 227 (58.5%) women with RP, 1,163 (51.2%) women without RP, 152 (52.6%) men with RP, and 1,075 (54.1%) men without RP (p = 0.002 for women and p = 0.127 for men). At follow-up, any occurrence of sick leave during the last year was reported by 80 (21.4%) women with RP, 410 (18.6%) women without RP, 48 (17.1%) men with RP, and 268 (13.7%) men without RP (p = 0.208 for women and p = 0.133 for men). Among those reporting sick leave, the mean (SD) duration in months was 2.93 (3.76) for women with RP, 3.00 (4.64) for women without RP, 2.77 (3.79) for men with RP, and 2.91 (12.45) for men without RP (p = 0.849 for women and p = 0.367 for men). CONCLUSION For neither women nor men was there a significant effect of having RP on work ability. Women with RP reported a slightly higher job retainment compared to those without the condition, while there was no difference in job retainment among men. For neither gender did the presence of RP influence the occurrence of recent sick leave, nor did it affect the length of time away from work.
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Affiliation(s)
- Albin Stjernbrandt
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 901 87, Umeå, Sweden.
| | - Jens Wahlström
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, 901 87, Umeå, Sweden
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Occupational Disease as the Bane of Workers' Lives: A Study of Its Incidence in Slovakia. Part 2. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412990. [PMID: 34948606 PMCID: PMC8701311 DOI: 10.3390/ijerph182412990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/01/2021] [Accepted: 12/07/2021] [Indexed: 11/25/2022]
Abstract
The main objective of this article is to monitor the development of the number of occupational diseases related to selected physical factors in the working environment (noise, vibration and dust). Each region of Slovakia has its own specific social and economic conditions. Due to the existence of a strong correlation between the several regional variables observed, principal component analysis (PCA) was used to determine the new variables. Cluster analysis was used to group regions with similar characteristics. A dendrogram was created using the average linkage method, which illustrated the similarity of the regions studied. The value of the cophenetic correlation coefficient (CC = 0.90) confirms the validity of the average linkage method. The result of the cluster analysis is the grouping of the eight regions into five homogenic groups (clusters). An analysis of the data shows that Slovakia’s regional differences significantly influence the incidence of occupational diseases in individual regions. It is shown that, in Slovakia, the development of the number of occupational diseases has seen a favourable trend in the long term.
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Rajabpour L, Selamat H, Barzegar A, Fadzli Haniff M. Design of a robust active fuzzy parallel distributed compensation anti-vibration controller for a hand-glove system. PeerJ Comput Sci 2021; 7:e756. [PMID: 34805509 PMCID: PMC8576561 DOI: 10.7717/peerj-cs.756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/01/2021] [Indexed: 06/13/2023]
Abstract
Undesirable vibrations resulting from the use of vibrating hand-held tools decrease the tool performance and user productivity. In addition, prolonged exposure to the vibration can cause ergonomic injuries known as the hand-arm vibration syndrome (HVAS). Therefore, it is very important to design a vibration suppression mechanism that can isolate or suppress the vibration transmission to the users' hands to protect them from HAVS. While viscoelastic materials in anti-vibration gloves are used as the passive control approach, an active vibration control has shown to be more effective but requires the use of sensors, actuators and controllers. In this paper, the design of a controller for an anti-vibration glove is presented. The aim is to keep the level of vibrations transferred from the tool to the hands within a healthy zone. The paper also describes the formulation of the hand-glove system's mathematical model and the design of a fuzzy parallel distributed compensation (PDC) controller that can cater for different hand masses. The performances of the proposed controller are evaluated through simulations and the results are benchmarked with two other active vibration control techniques-proportional integral derivative (PID) controller and active force controller (AFC). The simulation results show a superior performance of the proposed controller over the benchmark controllers. The designed PDC controller is able to suppress the vibration transferred to the user's hand 93% and 85% better than the PID controller and the AFC, respectively.
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Affiliation(s)
- Leila Rajabpour
- School of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
| | - Hazlina Selamat
- School of Electrical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
| | - Alireza Barzegar
- Electrical Engineering, Nanyang Technological University, Singapore
| | - Mohamad Fadzli Haniff
- Malaysia-Japan International Institute of Technology, Universiti Teknologi Malaysia, Kuala Lumpur, Federal Territory, Malaysia
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Miettinen L, Ryhänen J, Shiri R, Karppinen J, Miettunen J, Auvinen J, Hulkkonen S. Work-related risk factors for ulnar nerve entrapment in the Northern Finland Birth Cohort of 1966. Sci Rep 2021; 11:10010. [PMID: 33976337 PMCID: PMC8113547 DOI: 10.1038/s41598-021-89577-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 04/28/2021] [Indexed: 12/01/2022] Open
Abstract
Ulnar nerve entrapment (UNE) is the second most common entrapment neuropathy in the upper extremity. The aetiology of UNE is multifactorial and is still not fully understood. The aim of the study was to identify occupational risk factors for UNE and to determine whether smoking modifies the effects of work-related factors on UNE. The study population consisted of the Northern Finland Birth Cohort of 1966 (NFBC1966). In total, 6325 individuals active in working life participated at baseline in 1997. Occupational risk factors were evaluated by a questionnaire at baseline. The data on hospitalizations due to UNE were obtained from the Care Register for Health Care between 1997 and 2018. The incidence rate of hospitalization due to UNE was 47.6 cases per 100,000 person-years. After adjusting for confounders, entrepreneurs (Hazard ratio (HR) = 3.68, 95% CI 1.20–11.27), smokers (HR = 2.51, 95% CI 1.43–4.41), workers exposed to temperature changes (HR = 1.72, 95% CI 1.00–2.93), workers with physically demanding jobs (HR = 3.02, 95% CI 1.39–6.58), and workers exposed to hand vibration (HR = 1.94, 95% CI 1.00–3.77) were at an increased risk of hospitalization for UNE. Exposure to work requiring arm elevation increased the risk of hospitalization due to UNE among smokers (HR = 2.62, 95% CI 1.13–6.07), but not among non-smokers. Work-related exposure to vibration and temperature changes, and physically demanding work increase the risk of hospitalization for UNE. Smoking may potentiate the adverse effects of work-related factors on UNE.
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Affiliation(s)
- Laura Miettinen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
| | - Jorma Ryhänen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Rahman Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Jouko Miettunen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Sina Hulkkonen
- Department of Hand Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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11
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Vibration Exposure and Transmissibility on Dentist's Anatomy: A Study of Micro Motors and Air-Turbines. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084084. [PMID: 33924408 PMCID: PMC8069559 DOI: 10.3390/ijerph18084084] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 12/17/2022]
Abstract
The use of dental hand pieces endanger dentists to vibration exposure as they are subjected to very high amplitude and vibration frequency. This paper has envisaged a comparative analysis of vibration amplitudes and transmissibility during idling and drilling with micro motor (MM) and air-turbine (AT) hand pieces. The study aims to identify the mean difference in vibration amplitudes during idling, explore different grasp forces while drilling with irrigant injection by the dentist, and various vibration transmission of these hand pieces. The study utilized 22 separate frequency resonances on two new and eight used MMs and two new and eight used ATs of different brands by observing the investigator at 16 different dentist clinics. The study adopted a descriptive research design with non–probability sampling techniques for selecting dentists and hand pieces. Statistical methods like Levene Test of Homogeneity, Welch ANOVA, independent t-test, and Games–Howell test were utilized with SPSS version 22 and MS-Excel. The results reveal that vibration amplitudes and vibration transmissibility when measured at position 2 are higher than in another position 1. Vibrations during idling for used MMs are more than AT hand pieces, and the used MM (MUD) and used AT (AUA) hand pieces differ due to their obsolescence and over-usage. Vibration amplitudes increase every time with the tightening of grasping of the hand piece. Vibration amplitudes for each grasping style of MM hand piece differ from all other grasping styles of AT hand pieces. Routine exposure to consistent vibrations has ill physical, mental, and psychological effects on dentists. The used hand pieces more hazardous as compared to newer ones. The study suggests that these hand pieces must be replaced periodically, sufficient to break between two operations, especially after every hand piece usage. Hence, the present research work can be further extended by creating some control groups among dentists and then studying the vibration amplitude exposure of various dental hand pieces and subsequent transmissibility to their body parts.
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12
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Gerhardsson L, Ahlstrand C, Ersson P, Jonsson P, Gustafsson E. Vibration related symptoms and signs in quarry and foundry workers. Int Arch Occup Environ Health 2021; 94:1041-1048. [PMID: 33586079 PMCID: PMC8238773 DOI: 10.1007/s00420-021-01660-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/31/2021] [Indexed: 11/25/2022]
Abstract
Purpose The development of vascular and neurosensory findings were studied in two groups of long-term exposed quarry and foundry workers with different vibration exposures, working conditions and work tasks. Methods The study included 10 quarry workers (mean age 43 yrs., mean exposure time 16 yrs.) and 15 foundry workers (35 yrs.; 11 yrs.) at two plants in Sweden. All participants completed a basic questionnaire and passed a medical examination including a number of neurosensory tests, e.g. the determination of vibration (VPT) and temperature (TPT) perception thresholds as well as a musculoskeletal examination of the neck, shoulders, arms and hands. Results A high prevalence of neurosensory findings (40%) was found among the quarry workers. Both groups, however, showed a low prevalence of vibration white fingers (VWF). Foundry workers showed significantly better sensitivity than quarry workers for all monofilament tests (p ≤ 0.016), TPT warmth in dig 2 (p = 0.048) and 5 dexter (p = 0.008), and in dig 5 sinister (p = 0.005). They also showed a better VPT performance in dig 5 dexter (p = 0.031). Conclusions Despite high vibration exposure, the prevalence of VWF was low. The high prevalence of neurosensory findings among the quarry workers may depend on higher A(8) vibration exposure and higher exposure to high-frequency vibrations. An age-effect and exposure to cold could also be contributing factors. The nervous system seems to be more susceptible to high-frequency vibrations than the vascular system. For neurosensory injuries, the current ISO 5349-1 standard is not applicable.
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Affiliation(s)
- Lars Gerhardsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Medicinaregatan 16A, Box 414, SE-405 30, Gothenburg, Sweden.
| | - Christina Ahlstrand
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Medicinaregatan 16A, Box 414, SE-405 30, Gothenburg, Sweden
| | - Per Ersson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Medicinaregatan 16A, Box 414, SE-405 30, Gothenburg, Sweden
| | - Per Jonsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Medicinaregatan 16A, Box 414, SE-405 30, Gothenburg, Sweden
| | - Ewa Gustafsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Medicinaregatan 16A, Box 414, SE-405 30, Gothenburg, Sweden
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