两种不同频率接振工人末梢循环和末梢神经损伤特征  

Peripheral circulation and peripheral nerve injury in workers exposed to vibration at two different frequencies

作　　者：黄惠民 白研[1] 陈子宇 梁芷珊 李律蓉 林瀚生 李嘉杰 韦苑 杨虹雨 陈青松 HUANG Huimin;BAI Yan;CHEN Ziyu;LIANG Zhishan;LI Lyurong;LIN Hansheng;LI Jiajie;WEI Yuan;YANG Hongyu;CHEN Qingsong􀀁(Guangdong Provincial Engineering Technology Research Center of Public Health Detection and Assessment/School of Public Health,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China;Guangdong Provincial Key Laboratory of Occupational Disease Prevention and Treatment,Guangdong Province Hospital for Occupational Disease Prevention and Treatment,Guangzhou,Guangdong 510300,China)

机构地区：[1]广东药科大学,广东省公共卫生检测与评价工程技术研究中心/公共卫生学院,广东广州510310 [2]广东省职业病防治院广东省职业病防治重点实验室,广东广州510300

出　　处：《环境与职业医学》2022年第11期1198-1203,共6页Journal of Environmental and Occupational Medicine

基　　金：广州市科技计划项目(201904010222);广东省自然科学基金面上项目(2022A1515011357)。

摘　　要：[背景]手臂振动病危害严重,现缺乏有效的治疗和诊断,且现行接触限值低估了高频振动造成的健康损害。[目的]比较分析接触不同频率振动作业工人末梢循环和末梢神经损伤的情况。[方法]应用横断面调查的方法,以山东省某矿业公司凿岩工(187人)和广东省某运动器材厂高尔夫球杆头打磨工(228人)为研究对象,对其手部症状进行调查。使用SV106型振动测量仪测量接振工人的作业频谱,并计算8 h等能量频率计权加速度、累积振动暴露水平(CVEL),采用ISO计权模型预测10%白指患病率时的接振工龄。[结果]本次调查对象均为男性。接振组中打磨工手部症状报告率均高于凿岩工(P均<0.001),如末梢循环损伤(52.6%vs 19.3%)、末梢神经损伤(71.5%vs 23.0%)、手僵(64.0%vs7.0%)及手指变形(69.7%vs 4.3%)。打磨作业接振主频率(500~800 Hz)高于凿岩作业(125~160 Hz)。CVEL、接振工龄与接振工人末梢循环损伤、末梢神经损伤累积患病率呈线性上升趋势,拟合直线的效果均较好(R2=0.812~0.988),且打磨工直线斜率均大于凿岩工。实际上,10%白指患病率时打磨工的接振工龄比凿岩工更短(6.81年vs 10.27年),而ISO计权模型预测10%白指患病率时凿岩工接振工龄更短(3.12年vs 8.23年)。[结论]两种不同频率振动作业暴露水平及手部症状检出率均较高,高频作业对作业工人手部损害倾向于更大。[Background]Hand-arm vibration disease is harmful to human body,but there are no effective diagnosis and treatment so far,and current occupational exposure limits underestimate the health damage caused by high-frequency vibration exposure.[Objective]To evaluate and compare the damage to workers’peripheral circulation and peripheral nerve caused by different frequencies of vibration operation.[Methods]Drilling workers(n=187)from a mining company in Shandong Province and golf club head grinding workers(n=228)from a sports equipment factory in Guangdong Province were selected as study subjects.Hand symptoms were investigated.SV106 vibration meter was used to measure the target operation-associated vibration frequency spectrum.The 8 h energy-equivalent frequency weighted acceleration,cumulative vibration exposure level(CVEL),and the working age related to causing white finger in 10%of an exposed group were calculated.[Result]The study subjects were all male.More grinding workers reported hand symptoms than the drilling workers,e.g.peripheral circulation injury(52.6%vs 19.3%),peripheral nerve injury(71.5%vs 23.0%),hand stiffness(64.0%vs7.0%),and deformed fingers(69.7%vs 4.3%)(all P<0.001).The main vibration frequencies of grinding operation(500-800 Hz)were much higher than those of drilling operation(125~160 Hz).CVEL and working age of vibration exposure showed a linear rising relationship with the cumulative prevalence rate of peripheral circulation and peripheral never injury,the fitting lines all showed good fitting effects(R~2=0.812-0.988),and the slope of the fitting line of the grinding worke rs was larger than that of the drilling worke rs.The working age of vibration exposure associated with 10%cumulative prevalence of white finger was shorter in the grinding workers than in the drilling workers(6.81 years vs 10.27 years).According to the ISO prediction formula,the working age of vibration exposure was associated with10%white finger prevalence shorter in the drilling worke rs than in the grinding workers(3.1

关 键 词：手传振动 手臂振动病 患病率 累积振动暴露水平 

分 类 号：R135[医药卫生—劳动卫生]