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Background Vascular endothelial injury is an important pathogenic step of vibration-induced hand arm vibration disease (HAVD), and long-term vibration exposure can lead to vascular endothelial cell dysfunction and cell damage. Cell ferroptosis may be one of the important mechanisms of vibration-induced vascular endothelial cell injury and HAVD. Objective To explore whether vibration can induce changes in ferroptosis-related indicators in vascular endothelial cells in vitro. Methods Human umbilical vein endothelial cells (HUVEC) were divided into four vibrationgroups and two control groups. The vibration groups were exposed to an vibration setting of 125 Hz, 6.5 m·s−2 frequency band and for different durations: 1 d 2 h (total 1 d, 2 h per day), 1 d 4 h (total 1 d, 4 h per day), 2 d 2 h (total 2 d, 2 h per day), and 2 d 4 h (total 2 d, 4 h per day), respectively. All control groups were treated the same as the experimental groups except no vibration exposure. When the cells were 80% confluent, the control groups and the corresponding experimental groups were harvested at the same time. The effects of subgroup treatments on iron, reduced glutathione (GSH), and malondialdehyde (MDA) in HUVEC were detected with a cell ferrous colorimetric test kit, a reduced GSH colorimetric test kit, and a trace MDA test kit, respectively. Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect the mRNA expressions of ferroptosis-related genes acyl-CoA synthetase long chain family member 4 (ACSL4), tumor protein 53 (P53), recombinant human ferritin heavy chain (FTH1), and glutathione peroxidase 4 (GPX4). Western blot (WB) was used to detect the expression levels of ferroptosis-related proteins in HUVEC. Results Compared with the control groups, the vibration induced an increase in the iron content of HUVEC with a dose-response trend. Compared with the control groups, the reduced GSH content of HUVEC in the vibration group decreased with the increase of vibration time and frequency, and there was a dose-response trend. Compared with the control groups, the intracellular MDA content of HUVEC in the 1 d 2 h, 1 d 4 h, and 2 d 4 h vibration groups increased, and the MDA content in the 1 d 2 h and 1 d 4 h vibration group increased with time. The RT-PCR results showed that the mRNA expression levels of ACSL4 and P53 in the 1 d 4 h group increased compared with the 1 d 2 h group. Compared with the 2 d control group, the mRNA expression levels of ACSL4 in the 2 d 2 h vibration group and the 2 d 4 h vibration group increased, and the mRNA expression level of P53 in the 2 d 4 h vibration group increased. Compared with the 1 d control group, the mRNA expression levels of FTH1 and GPX4 in endothelial cells in the vibration 1 d 2 h group decreased. The WB results showed that compared with the control groups, the expression level of ferroptosis-related protein ACSL4 in endothelial cells increased in the vibration 1 d 2 h group; the expression levels of P53 in the 1 d 2 h and 2 d 4 h vibration groups increased; the expression levels of GPX4 decreased in the 1 d 4 h and 2 d 2 h vibration group, and the decrease was more obvious in the 2 d 2 h vibration group than in the 1 d 2 h vibration group; the above differences were statistically significant (P<0.05). Conclusion Vibration induces an increase in iron content, a decrease in GSH, and an increase in MDA in vascular endothelial cells in vitro, as well as mRNA and protein expressions of ferroptosis-related genes ACSL4, P53, FTH1, and GPX4.
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ObjectiveTo explore the influencing factors of occupational hand-arm vibration disease (OHAVD) caused by handheld workpiece polishing. Methods A total of 222 OHAVD patients (case group), 275 hand-transmitted vibration-exposed workers (exposed group) and 243 healthy workers without hand-transmitted vibration exposure (control group) in a sports equipment manufacturing enterprise were selected as the study subjects using the convenience sampling method. Worksite survey of occupational health was conducted on these three groups, and the human vibration measurement equipment was used to measure the vibration exposure level of handheld vibration among the study subjects. The 8-hour energy equivalent frequency-weighted vibrating acceleration ［A(8)］ and cumulative vibration exposure level (CVEL) were calculated. Results The prevalence of coldness, numbness, tingling fingers, and vibration-induced white finger was higher in the exposed group and the case group compared with the control group (all P<0.05). The prevalence of the above-mentioned hand symptoms was higher in the case group compared with the exposed group (all P<0.05). The A(8) and CVEL levels of the study subjects in the case group were higher than those in the exposed group (all P<0.05). Binary logistic analysis result showed that age and CVEL were both influencing factors of OHAVD (all P<0.05). According to the restricted cubic spline models, CVEL of the study subjects in the exposed group had a positive nonlinear dose-response relationship with the risk of OHAVD (overall trend P<0.01, nonlinear P<0.01), indicating an increasing risk of OHAVD with increasing CVEL. Conclusion Hand-transmitted vibration exposure is a risk factor for OHAVD. Early intervention should be carried out for hand-transmitted vibration-exposed individuals to reduce vibration-exposed levels and control vibration exposure time.
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Objective To analyze the epidemiological characteristics of occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022, and to evaluate the key risk points of its incidence. Methods The data of newly diagnosed and suspected occupational diseases caused by physical factors in Guangdong Province from 2013 to 2022 were collected from the Occupational Diseases and Hazards Monitoring Information System under China Disease Prevention and Control Information System, and were analyzed retrospectively. The key risk points of occupational diseases caused by physical factors were evaluated. Results A total of 661 cases of occupational diseases caused by physical factors were reported in Guangdong Province from 2013 to 2022, showing an overall increasing trend, with an average annual growth rate of 29.6%. The major occupational diseases caused by physical factors were occupational hand-arm vibration disease and occupational heat stroke, accounting for 59.5% and 39.6%, respectively. The nine prefecture-level cities of Pearl River Delta region accounted for 98.5% of the new cases. The cases were distributed mainly in the manufacturing industry (77.0% of the cases). A total of 294 enterprises were involved in the analysis of newly diagnosed occupational diseases caused by physical factors. Occupational hand-arm vibration cases appeared to be significantly aggregated in specific enterprises, and other disease cases were mostly sporadic. The types of enterprise registration were mainly Hong Kong-, Macao-, and Taiwan-invested enterprises and domestic-funded enterprises, accounting for 53.1% and 41.4%, respectively. In terms of enterprise size, large-scale and small-scale enterprises accounted for 56.5% and 21.4% of cases, respectively. A total of 27.4% of workers with occupational diseases caused by physical factors were identified as suspected occupational diseases before be diagnosed as occupational diseases, all of which were hand vibration disease and heat stroke In the future, attention should be paid to the risks of mass events of occupational hand-arm vibration disease, outbreaks of occupational heat stroke, and missed diagnosis of suspected occupational hand-arm vibration disease. Conclusion Among all occupational diseases caused by physical factors in Guangdong Province, attention should be paid on occupational hand-arm vibration disease and occupational heat stroke. Occupational hand-arm vibration disease has a high risk of group morbidity. Construction workers and sanitation workers have a high potential risk of occupational heat stroke.
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Background Hand arm vibration disease (HAVD) is one of the legal occupational diseases in China, and its pathogenesis is not clear. Operators exposed to electric vibration tools for a long time have an increased risk of HAVD. Objective To conduct a systematic evaluation of the effects of vibration operations on workers' upper limb nerves, blood vessels, and muscles. Methods Relevant studies on the effects of hand-transmitted vibration on HAVD were searched and collected from the China Knowledge Infrastructure, Wanfang, and PubMed databases, and the literature was published from January 1974 to April 2021. The quality of cohort and case-control studies was assessed by the Newcastle-Ottawa Scale (NOS), and the quality of cross-sectional studies was by the evaluation criteria recommended by the Agency for Healthcare Quality and Research (AHRQ). Statistical analyses of outcome indicators (OR) in the included literature were performed using RevMan 5.4.1 software, effect sizes in the literature on vibration-induced white finger and neurosensory impairment were combined using a random-effect model, those that included carpal tunnel syndrome were combined using a fixed-effect model, and subgroup and publication bias analyses were also performed. To explore sources of study heterogeneity, meta-regression was performed using Stata 16.0 software, and sensitivity analyses were performed on the included literature. Results A total of 716 papers were retrieved from the databases, and 18 articles were retrieved by manual searching. A total of 34 papers were included after excluding those not meeting the criteria. Of the papers, 11004, 7270, and 1722 subjects related to vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome, respectively. The results of meta-analysis showed that compared with the control group, the combined ORs of hand-transmitted vibration exposure were 4.25 (95%CI: 2.72−6.65) for vibration-induced white finger, 4.03 (95%CI: 2.46−6.61) for neurosensory impairment, and 2.44 (95%CI: 1.61−3.71) for carpal tunnel syndrome. Heterogeneity was identified in the original studies related to vibration-induced white finger (I2=81%, P < 0.001) and neurosensory impairment (I2=90%, P < 0.001), except carpal tunnel syndrome (I2=23%, P < 0.001). The results of sensitivity analysis showed that the combined effect sizes (ORs) were stable and reliable. The results of meta-regression showed that the factors contributing to high heterogeneity of combined vibration-induced white finger and neurosensory impairment were time of publication (t=−2.10, P=0.049) and working age (t=−2.40, P=0.032), respectively. Conclusion Hand-transmitted vibration is a risk factor for vibration-induced white finger, neurosensory impairment, and carpal tunnel syndrome in operators.
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The hand-arm vibration disease due to widespread hand-transmitted vibration operations is difficult to cure and seriously affects the health and quality of life of patients. Focusing on the prevention and control of hand-transmitted vibration and its occupational hazards, advances in occupational health relevant to hand-transmitted vibration were reviewed from the aspects of occupational hazard status, health impact, exposure monitoring, prevention and control of hand-transmitted vibration, as well as health surveillance, diagnosis, and treatment of hand-arm vibration disease. In addition, further suggestions on prevention and control of occupational hazards related with hand-transmitted vibration were prospected.
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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% vs 7.0%), 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 (R2=0.812-0.988), and the slope of the fitting line of the grinding workers was larger than that of the drilling workers. 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 with 10% white finger prevalence shorter in the drilling workers than in the grinding workers (3.12 years vs 8.23 years). Conclusion Both the vibration exposure level and the prevalence of hand symptoms are high in two groups of workers with different vibration frequencies, and vibration exposure at a higher frequency tends to have severer damage to workers' hands.
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Background Hand-arm vibration disease (HAVD) is a chronic progressive disease caused by long-term exposure to hand-transmitted vibration, but the mechanism by which vibration affects peripheral vascular function of fingers is not completely clear. Objective To study the association between vasoactive factors and HAVD, and to screen specific indicators for its early diagnosis and prevention. Methods Judgmental sampling method was used to select workers with (HAVD group) and without HAVD (vibration contact group), and non-hand-transmitted vibration operation workers (control group), with 60 workers in each group. The levels of leukotriene B4 (LTB4), vascular endothelial growth factor (VEGF), 5-hydroxy tryptamine (5-HT), interleukin-1β (IL-1β), and calcitonin gene-related peptide (CGRP) in plasma of the three groups were measured by enzyme-linked immunosorbent assay. The association between vasoactive factors and HAVD was analyzed using logistic regression, and the diagnostic HAVD indicators were screened by receiver operator characteristic (ROC) curve of a multivariate model indicator \begin{document}$ \widehat{Y} $\end{document}. Results The hand symptom rates of the HAVD group, the vibration contact group, and the control group were 26.7%, 66.7%, and 96.7% respectively, with a significant difference (P<0.05). The levels of LTB4, 5-HT, IL-1β, and CGRP in the HAVD group were the highest followed by the vibration contact group, and lowest levels were in the control group (P<0.05). There was no significant difference in the VEGF level among the three groups (P>0.05). The logistic regression results showed that higher levels of LTB4 (OR=1.048, 95%CI: 1.022-1.076), 5-HT (OR=1.011, 95%CI: 1.004-1.018), IL-1β (OR=1.148, 95%CI: 1.071-1.230), and CGRP (OR=1.055, 95%CI: 1.008-1.104) were associated with a higher risk of HAVD (P<0.05). The order of the potential indicators' area under the ROC curve from high to low was:\begin{document}$ \widehat{Y} $\end{document} (0.969) > IL-1β (0.907) > LTB4 (0.876) > 5-HT (0.858) > CGRP (0.836). Conclusion The expression levels of LTB4, 5-HT, IL-1β, and CGRP are altered with occupational exposure in hand-transmitted vibration operations and may be associated with HAVD; VEGF is not found to be associated with HAVD. The accuracy of early screening for HAVD can be improved by combining the monitoring of various biochemical indicators.
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Background Wearing anti-vibration gloves is a simple and effective way to prevent hand-arm vibration disease. The requirements for vibration damping gloves are varied by types of operations exposed to vibration. Objective To study the vibration attenuation and dexterity of different types of protective gloves, and to provide reference for scientific wearing of vibration damping gloves for people working with vibration exposure. Methods Nine kinds of common protective gloves (A and B were dipping gloves; C, D, and E were rubber gloves; F and G were textile and fabric gloves; H was cotton gloves; I was leather gloves) used by workers exposed to vibration in 28 factories in Guangdong Province were selected as research objects by typical case sampling method, and the basic parameters of included protective gloves were investigated and measured. According to ISO 10819:2013, a glove vibration transmissibility (GVT) test system was used to detect the vibration transmissibility values and analyze vibration attenuation characteristics of the subjects wearing different protective gloves. The dexterity was tested by Minnesota Manual Dexterity Test. Pearson test was used to analyze the correlations among glove thickness, vibration transmissibility, dexterity score, and grip strength score. Results For rubber gloves (C, D, and E), the associated average adjusted vibration transmissibility at middle and low frequencies \begin{document}$ {\overline T _{\text{M}}} $\end{document} and average adjusted vibration transmissibility at high frequency \begin{document}$ {\overline T _{\text{H}}} $\end{document} were lower than those of other gloves (0.89-0.91 and 0.59-0.80 respectively), the vibration transmissibility values of 50-200 Hz frequency band was 0.81-0.97, and the vibration transmissibility values of 315-1250 Hz frequency band decreased with the increase of frequency (the minimum value was 0.13). For other types of gloves (A, B, F, G, H, and I), the \begin{document}$ {\overline T _{\text{M}}} $\end{document} and \begin{document}$ {\overline T _{\text{H}}} $\end{document} were 0.95-0.98 and 1.03-1.11 respectively, the vibration transmissibility values of 50-200 Hz frequency band was 0.96-1.02, and the vibration transmissibility values of 400-1250 Hz frequency band increased (the maximum value was 1.29). The \begin{document}$ {\overline T _{\text{M}}} $\end{document}, \begin{document}$ {\overline T _{\text{H}}} $\end{document}, and vibration transmissibility values of 40-1250 Hz frequency band of rubber gloves with double-layer protective materials (C, D, and E) were significantly lower than those of gloves with single-layer protective materials. But the \begin{document}$ {\overline T _{\text{M}}} $\end{document} and \begin{document}$ {\overline T _{\text{H}}} $\end{document} of gloves of other types with double-layer materials (F, H, and I) were still greater than 0.9 and 1.0 respectively. Compared with single-layer protective materials, the gloves of other types with double-layer materials showed no significant changes in the vibration transmissibility values of 25-200 frequency band (0.91-1.06), and an increase in the vibration transmissibility values of 250-630 Hz frequency band (the maximum value was 1.22). The dexterity scores and grip strength scores of dipping gloves (A and B) were the lowest. Rubber gloves C had the highest dexterity score and grip strength score. The thickness of protective gloves was negatively correlated with the vibration transmissibility values, and positively correlated with the dexterity score and the grip strength score (P < 0.05). The vibration transmissibility value was negatively correlated with the dexterity score and the grip strength score (P < 0.05). Conclusion Among the 9 kinds of gloves, cotton gloves and leather gloves have no damping effect. Rubber gloves have certain vibration reduction effect, and the vibration reduction effect on high frequency band is better than that on low frequency band. The thicker the damping material is, the better the damping effect is, but the less the dexterity is. Appropriate damping gloves should be selected according to actual vibration operations.
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Background Hand-transmitted vibration is one of the most common occupational hazards and is closely related to symptoms of fingertip terminal nerve damage. Objective To analyze the effects of hand-transmitted vibration on the terminal nerve of fingertips. Methods We systematically searched literature about the effects of hand-transmitted vibration on fingertip terminal nerve at home and abroad. The outcome index was the number (rate) of fingertip terminal nerve symptoms reported by the vibration group and the control group, such as finger numbness and finger tingling, and the search period was from database inception to December 2021. The quality of cross-sectional studies was assessed using the criteria recommended by the Agency for Healthcare Research and Quality (AHRQ), and the quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). NoteExpress 3.2 was used for literature management, and Excel 2003 was used for data collection and extraction. RevMan 5.4.1 software was used for statistical analysis, and random effect model was used to calculate the OR value of pooled effects and to draw forest plots. Subgroup analysis was carried out according to the working years with vibration exposure. At the same time, sensitivity analysis was performed after excluding studies with the largest weight and funnel plots were generated to evaluate publication bias. Results A total of 3619 articles were retrieved, and 39 articles were finally included, including 29 Chinese articles and 10 English articles; 36 cross-sectional studies and 3 cohort studies. In total, 8399 subjects were studied, including 5673 cases in the vibration exposure group and 2726 cases in the control group. Random effect model was used to merge the included literature. The results of meta-analysis showed that compared with the control group, hand-transmitted vibration was significantly associated with the self-reported occurrence of finger numbness (OR=8.29, 95%CI: 5.43-12.66), finger tingling (OR=7.50, 95%CI: 4.78-11.77), finger swelling (OR=8.25, 95%CI: 4.06-16.76), finger stiffness (OR=10.71, 95%CI: 3.60-31.87), finger trembling (OR=5.11, 95%CI: 2.60-10.04), hand weakness (OR=11.05, 95%CI: 3.98-30.68), hand sweating (OR=2.70, 95%CI: 1.64-4.43), hand coldness (OR=3.54, 95%CI: 2.42-5.18) (P<0.01). The subgroup analysis showed that the odds ratios of both finger numbness and finger tingling increased in the early and middle stages of vibration exposure (<5 years and 5-10 years of exposure duration）(finger numbness: OR=11.11, 19.07; finger tingling: OR=4.70, 16.55, respectively)(P<0.01), and decreased in the late stage of vibration exposure (10-15 years and ≥15 years of exposure duration) (finger numbness: OR=9.57, 2.30; finger tingling: OR=5.71, 6.00, respectively) (P<0.01). The results of sensitivity analysis showed a stable pooled effect (OR=13.96, 95%CI: 4.85-40.13, Z=4.89, P<0.01). The funnel plot results showed positive publication bias. Conclusion Occupational exposure to hand-transmitted vibration can cause finger numbness, finger tingling, finger swelling, finger stiffness, finger trembling, hand weakness, hand sweating, and hand coldness.
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Occupational hand-arm vibration diseases(HAVD) is a legitimate occupational disease in China, and the mechanism of its pathogenesis is vibration-induced vascular injury. Once HAVD occurs, it is difficult for the patients to recover and can cause great harm to workers exposed to hand-arm vibration. It is difficult to detect and evaluate the occurrence and progress of the disease at an early stage using existing technology, which is disadvantageous to the early prevention and treatment of the disease. Long noncoding RNAs(lncRNAs) play an important role in regulating the development, growth, and remodeling of blood vessels and other biological processes. This article reviews the role and mechanism of lncRNAs in vascular injury, and provides scientific theoretical basis for early diagnosis and treatment of HAVD.
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OBJECTIVE: To investigate the effect of warm needling therapy on the conduction of hand-arm motor nerve and sensory nerve in patients with occupational hand-arm vibration disease(HAVD). METHODS: Male occupational HAVD patients were divided into control group(39 cases) and experimental group(36 cases) by random number table method. The control group received routine therapy, while the experimental group was treated with routine therapy plus warm needling therapy five times a week for four consecutive weeks. The changes on the conduction of motor nerve and sensory nerve in these two groups before and after treatment were compared. RESULTS: Before treatment, the motor nerve conduction velocity(MCV), distal motor latency(DML), compound muscle action potential amplitude(CMAP), sensory nerve conduction velocity(SCV) and sensory nerve action potential amplitude(SNAP) of the median nerve and ulnar nerve in the two groups were compared, and there was no statistically significant difference(all P>0.05). After treatment, the MCV and SCV of median nerve and ulnar nerve in the experimental group were accelerated(all P<0.05), the DML of median nerve and ulnar nerve were shortened(all P<0.01), and the CMAP of median nerve increased compared with the control group(P<0.01). However, there was no significant difference in the CMAP of ulnar nerve and SNAP of median nerve and ulnar nerve(all P>0.05). CONCLUSION: Warm needling therapy can improve the conduction of motor nerve and sensory nerve. Warm needling therapy might be able to promote the repair of injury in axons and myelin sheaths.
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OBJECTIVE: To study the literature characteristics and research status of occupational hand-arm vibration disease in China. METHODS: Literature information on occupational hand-arm vibration disease published before 2018 in China were searched and collected through the China National Knowledge Infrastructure(CNKI) and Wanfang Database. The bibliometrics was used to analyze the publication time, type, journal sources, authors and their institutions, citation situation, funds and high-frequency key words. RESULTS: From 1975 to 2018, a total of 349 papers on occupational hand-arm vibration disease were published. The main article type was monograph, with a total of 179 articles(accounting for 51.3%). The articles were distributed in 79 kinds of journals, among them, 10 journals including China Occupational Medicine and Industrial Health and Occupational Diseases were the main carriers to publish related articles(237 papers, accounting for 67.9%). The main research institutions of the literature were Jining Medical College and Guangdong Province Hospital for Occupational Disease Prevention and Treatment, with 134 papers(accounting for 38.4%) published. Among the 5 core authors of the literature, 4 were from the above 2 research institutions. A total of 121 articles(accounting for 34.7%) were cited, and 77 articles(accounting for 22.1%) were supported by research fund. The top 3 high-frequency key words used were arm vibration disease, hand-transmitted vibration/local vibration and occupational disease. CONCLUSION: Occupational hand-arm vibration disease has attracted the attention of Chinese researchers, however, follow-up research, literature quality and funding support still need to be improved.
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OBJECTIVE: To investigate the changes of hemorheology and blood lipid index in patients with occupational hand-arm vibration disease(OHAVD). METHODS: A total of 78 patients with OHAVD were selected as the OHAVD group, and 78 workers without hand transmitted vibration exposure were selected as control group by judgment sampling method. The hemorrheology and blood lipid indexes of the two groups were detected. RESULTS: The whole blood viscosities(low-, medium-and high-shear), hematocrit, erythrocyte aggregation index, and abnormal rate of whole blood viscosities(mid-and high-shear) in the OHAVD group were higher in the OHAVD group than that in the control group(P<0.05). The erythrocyte deformability index and erythrocyte electrophoresis index were lower in the OHAVD group than that of the control group(P<0.05). In the vibration-induced white finger(VWF) subgroup of the OHAVD group, the whole blood viscosity(low-, medium-and high-shear), hematocrit were increased(P<0.05), and the abnormal rate of whole blood viscosity(high-shear) was higher(P<0.017) than that of the control group.The whole blood viscosity(medium shear), hematocrit and erythrocyte aggregation index were increased in the non-VWF subgroup than that of the control group(P<0.017). The concentration of low density lipoprotein cholesterol in the OHAVD group and non-VWF subgroup was higher than that in the control group(P<0.05). The whole blood viscosity(low-, medium-and high-shear), hematocrit, erythrocyte deformability index, erythrocyte aggregation index and erythrocyte electrophoresis index were not correlated with the length of service and age in the OHAVD group(P>0.05). CONCLUSION: The changes of hemorheological properties and blood lipids in OHAVD patients may be associated with vibration vascular injury.
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OBJECTIVE: To analyze the correlation between vascular endothelia injury factors and occupational hand-arm vibration disease( HAVD). METHODS: A judge sampling method was used to select 23 male patients with HAVD as the HAVD group,61 male workers who exposed to hand-arm vibration without HAVD as the vibration exposure group,64 male workers without hand-arm vibration exposure as the control group. The plasma levels of myosin light chain 2( MLC2),endothelin-1( ET-1) and vinculin( VCL) were detected by enzyme-linked immunosorbent assay. Logistic regression analysis was used to analyze the related indicators of HAVD for building the new multivariable model index Y. The indicators of HAVD were screened and judged by receiver operating characteristic( ROC) curves. RESULTS: There was significant difference in plasma levels of MLC2 among the three groups( P < 0. 05). The levels from high to low was as follows: HAVD group > vibration exposure group > control group. The plasma level of ET-1 in HAVD group was lower than that in the control group( P < 0. 05),but there was no significant difference between vibration exposure group and HAVD group( P > 0. 05). There was no significant difference among the three groups in the plasma level of VCL( P > 0. 05).The logistic regression analysis results showed that after adjusting confounding factors such as age,length of service,smoking,alcohol drinking and subjective symptoms,the higher MLC2 plasma level,the higher risk of HAVD( P < 0. 01),and the lower ET-1 plasma level,the higher risk of HAVD( P < 0. 05). According to ROC curve analysis,the area under the ROC curve( A_Z) value of the plasma levels of MLC2 and ET-1 were 0. 820 and 0. 524,respectively( P < 0. 01). The predictive probability index Y built with MLC2 and ET-1 by logistic regression model was used to judge the A_Z value of HAVD to be 0. 799( P < 0. 01). The A_Z values from high to low was as follows: MLC2 > Y> ET-1( P < 0. 01).CONCLUSION: The plasma levels of MLC2 and ET-1 are correlated with HAVD. The efficacy of MLC2 as a biomarker for screening HAVD is better than that of ET-1. No association was found between VCL and HAVD.
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Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.
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Objective To explore the relationship between the objective indexes and TCM syndromes of occupational hand arm vibration disease ,and to provide clinical data for the objectification of TCM syndrome differentiation. Methods 101 patients with occupational hand arm vibration disease were collected ,including 24 patients with Xingbi,39 with Tongbi and 38 with Zhuobi,according to the theory of traditional Chinese medicine syndrome differentiation ,the relationship was observed between different TCM Syndrome types and various of parameters,such as 5-and 10-minute rewarming rates in cold water rewarming test,terminal latency,amplitude, conduction velocity ,average time ,average amplitude of abductor pollicis brevis and abductor digiti minimi in electromyography. Results 5-and 10-minute rewarming rate in cold water rewarming test did not differ significantly among the three groups(P > 0.05). Amplitude of median nerve motor conduction differed significantly among the three groups of Xingbi,Tongbi and Zhuobi(χ2 = 6.14,P < 0.05),Further comparison between the groups was made in Xingbi and Tongbi(χ2=0.132,P=0.895),Xingbi and Zhuobi(χ2=2.277,P=0.023),Tongbi and Xingbi (χ2 = 2.172 ,P = 0.030). There were no significant differences among the three groups in latency and conduction velocity of the median nerve motor conduction and latency ,amplitude and conduction velocity of ulnar nerve motor conduction(P>0.05). The differences of conduction velocity and amplitude of median nerve and ulnar nerve sensory conduction,average time and average amplitude of abductor pollicis brevis and abductor muscle among the three groups had no statistical differences(P>0.05). Conclusions The distribution is different in the amplitude of median nerve motor conduction among the three groups of Xingbi,Tongbi and Zhuobi,further analysis shows that the difference is mainly reflected in the Xingbi group. We conclude that the median nerve axonal injury is lighter in Xingbi group than in the other two groups.
ABSTRACT
OBJECTIVE: To evaluate the clinical value of high-frequency ultrasonagraphy in testing carpal canal structure in the diagnosis of patients with occupational hand-arm vibration disease( HAVD). METHODS: Eighteen patients with occupational mild HAVD( 36 wrists) were selected as the case group and 20 healthy volunteers( 40 wrists) were enrolled as the control group by using convenience sampling method. The color doppler ultrasound was used to measure the crosssectional areas( CSA) of median nerve at the level of pisiform bone,the thickness of transverse carpal ligament,and the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook of the 2 groups. Fisher discriminant analysis and receiver operating characteristic( ROC) curve were performed to assess the effect of diagnosing HAVD with the CSA of median nerve at the level of pisiform bone in patients with HAVD. RESULTS: The CSA of median nerve at the level of pisiform bone in both hands was smaller than that of the control group( P < 0. 01). However,there was no statistical significance in the thickness of transverse carpal ligament of both hands,the internal diameter of median nerve and the CSA of median nerve at the level of hamate hook in the case and control groups( P > 0. 05). Through the Fisher discriminant analysis which was carried on and the distinction equation which was established meanwhile by using the CSA of median nerve at the level of pisiform bone in both hands as HAVD diagnostic criterion,the HAVD predictive accuracy rate was 78. 9%. The ROC curve was underway with the discriminant score as an indicator for distinguishing HAVD,and the result showed that the area under the curve was 0. 842,with sensitivity of 75. 00% and specificity of 88. 90%. CONCLUSION: High-frequency ultrasonography can be used to observe and quantify the imaging changes of carpal canal structure in patients with HAVD,which can provide objective and scientific diagnostic basis for the diagnosis of HAVD.