Annals of Occupational and Environmental Medicine

Review

Technetium-99m hand perfusion scintigraphy (Raynaud’s scan) as a method of verification in hand arm vibration syndrome: a review: Taewoong Ha, Hyeoncheol Oh, Jungwon Kim; Ann Occup Environ Med 2022;34:e26. Published online October 11, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e26

Abstract Abstract in Korean PDF PubReader ePub

It is important to assess the blood flow of fingers in the verification of hand-arm vibration syndrome. In the Republic of Korea, most assessments of the blood flow in the fingers are performed using a cold provocation test with finger skin color change. However, this test is a non-objective method with a relatively low sensitivity, leading to possible social and legal problems. Thus, we reviewed the characteristics of several tests that assess the blood flow in the fingers. Among these tests, using the radioactive isotope method, Raynaud’s scan has a relatively higher sensitivity and specificity than other tests, provides objective results, and is approachable in many hospitals. So we suggest using Raynaud's scan as an alternative test when cold provocation test with finger skin color change is negative in vibration exposed worker.

테크네튬-99m 레이노 스캔을 이용한 수완진동 증후군 진단 리뷰
수완진동증후군의 검증에서는 손가락의 혈류를 평가하는 것이 중요하다. 대한민국에서는 레이노증후군의 업무관련성 평가 시 대부분 손가락의 혈류량 평가를 냉각부하 손가락 피부색 변화 검사만으로 시행하고 있다. 그러나 이 검사는 상대적으로 민감도가 낮은 주관적인 검사방법으로 사회적, 법적 문제가 발생할 수 있다. 따라서 우리는 손가락의 혈류를 평가할 수 있는 여러 검사의 특성을 검토하였다. 이 검사 방법들 중, 방사성 동위원소법을 이용한 레이노스캔은 객관적인 결과를 제공하며 다른 검사방법들에 비하여 상대적으로 민감도와 특이도가 높고 많은 병원에서 접근성이 좋다. 따라서 진동노출작업자에서 냉각부하 손가락 피부색 검사 결과가 음성인 경우 대안검사로서 레이노스캔을 사용할 것을 제안한다.

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Raynaud’s Phenomenon: A Current Update on Pathogenesis, Diagnostic Workup, and Treatment
Hirut Yadeta Ture, Nan Young Lee, Na Ri Kim, Eon Jeong Nam
Vascular Specialist International.2024;[Epub] CrossRef

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Original Article

The relevant factors of work-related fatigue for occupational vibration-exposed employees: YongDuk Ahn, Jeongbae Rhie, Min-Gi Kim; Ann Occup Environ Med 2022;34:e6. Published online March 22, 2022; DOI: https://doi.org/10.35371/aoem.2022.34.e6

Abstract Abstract in Korean PDF PubReader ePub: Background
To date, little is known about the effects of factors linked to work-related fatigue on vibration-exposed workers. Thus, the purpose of this study was (1) to assess the effects of vibration exposure time per week and work-related fatigue on workers and (2) to identify factors associated with work-related fatigue caused by long-term exposure to occupational vibration.
Methods
This study used data collected from the 5th Korean Working Conditions Survey. A total of 34,820 non-vibration-exposed and 10,776 vibration-exposed employees were selected from the data. The χ² and multiple logistic regression were used to determine the effect of vibration exposure time per week and the effects of factors of work-related fatigue on workers.
Results
The prevalence of work-related fatigue in vibration-exposed workers (30.5%) was higher than that of non-exposed workers (15.9%). The prevalence of work-related fatigue was higher for female and workers with depression, anxiety, and shift work, and those with authority to control their work pace had statistically significantly higher odds than those who did not. The employees who had the authority to control their order of work (odds ratio [OR]: 0.88; 95% confidence interval [CI]: 0.81–0.95) and method of work (OR: 0.90; 95% CI: 0.82–0.98) had statistically significantly lower odds than those who did not. The OR of work-related fatigue symptoms was highest among employees whose vibration exposure time per week were 30.0%–40.0% (OR: 2.36; 95% CI: 1.96–2.83). Lower OR was observed as vibration exposure time per week decreased.
Conclusions
The results of the present study suggest an association between occupational vibration and work-related fatigue and longer vibration exposure time per week, causing an increased prevalence of work-related fatigue symptoms. Measures to protect workers exposed to occupational vibration from work-related fatigue must be taken.; 직업성 진동 노출 근로자들의 업무 관련 피로
목적
상대적으로 관련성이 상세히 밝혀진 근골격계와 비교하여, 직업성 진동에 노출된 근로자에 대한 업무 관련 피로에 영향을 미치는 요인에 대해서는 아직 알려진 바가 많지 않다. 본 연구의 목적은 (1) 주당 진동 노출 시간과 업무 관련 피로가 근로자에게 미치는 영향을 평가하고 (2) 직업적 진동에 장기간 노출되어 발생하는 작업 관련 피로와 관련된 요인을 파악하는 것이다.
방법
본 연구는 제5차 근로환경조사에서 수집한 자료를 사용하였다. 직업성 진동 노출이 없는 34,820 명과 직업성 진동에 노출되는 10,776 명을 대상으로 선정하여 카이 제곱 검정 및 다중 로지스틱 회귀분석을 사용하여 주당 진동 노출 시간의 영향과 작업 관련 피로 요인이 근로자에게 미치는 영향을 분석하였다.
결과
직업성 진동에 노출된 근로자 (30.5%)의 업무 관련 피로 유병률은 직업성 진동에 노출되지 않은 근로자 (15.9%)보다 높았다. 주당 진동 노출 시간이 30%-40%에 해당하는 근로자들에서 가장 높은 업무 관련 피로가 나타났으며, 이는 주당 진동 노출 시간이 감소함에 따라 감소하였다.
결론
직업성 진동에 노출된 근로자에서 업무 관련 피로 유병률이 높게 나타났으며 직업성 진동에 노출된 근로자를 업무 관련 피로의 발생으로부터 보호할 방안을 마련해야 한다.

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Original Article

Association between physical hazardous agent exposure and mental health in the Korean working population: the 5th Korean Working Conditions Survey: Daeil Kwon, Kyeongmin Kwak, Kiook Baek, Youngchan Chi, Sewhan Na, Jong-Tae Park; Ann Occup Environ Med 2021;33:e33. Published online November 8, 2021; DOI: https://doi.org/10.35371/aoem.2021.33.e33

Abstract Abstract in Korean PDF Supplementary Material PubReader ePub

Background

Mental health problems are emerging issues in occupational safety and health, whereas the findings on the relationship between physical hazards and mental health are not consistent. The aim of our study was to investigate the association between physical hazard exposure and mental health outcomes including depression and anxiety.

Methods

We included 48,476 participants from the fifth Korean Working Conditions Survey (KWCS) in this study. The χ² test and logistic regression analyses were conducted to assess the association between physical hazard exposures and mental health. All statistical analyses were performed sex-specifically.

Results

In logistic regression analysis, the odds ratios (ORs) of depression were significantly increased in male workers who were exposed to vibration (severe OR: 1.54, 95% confidence interval [CI]: 1.21–1.95) and noise (severe OR: 1.93, 95% CI: 1.49–2.48) whereas the ORs of depression were not significant in female workers from vibration (severe OR: 0.86, 95% CI: 0.50–1.38) or noise exposure (severe OR: 1.39, 95% CI: 0.84–2.17). The ORs of anxiety were significantly increased in male workers with vibration (severe OR: 1.76, 95% CI: 1.43–2.15) and noise exposure (severe OR: 2.12, 95% CI: 1.69–2.63) whereas the OR between vibration and anxiety (severe OR: 1.45, 95% CI: 0.91–2.21) was not significant in female workers. High or low temperature exposure had significant associations with depression and anxiety in both male and female subjects.

Conclusions

Results of our study suggest that physical hazard exposures may be associated with increased risk of mental health problems including depression and anxiety. These associations are more prominent in male workers in comparison with female workers.

한국 노동인구에서 물리적 위험요인 노출과 정신건강의 연관: 제5차 근로환경조사 자료
목적
산업보건에서 정신건강 문제가 새롭게 대두되고 있으나 물리적 위험요인과 정신건강의 관련성에 대한 일치된 결과는 없었다. 본 연구는 물리적 위험요인 노출과 우울 및 불안의 상관관계를 밝히는 데에 목적을 두고 있다.
방법
본 연구는 제5차 근로환경조사에서 추출한 48,476명을 대상으로 수행하였다. 카이제곱 검정과 로지스틱 회귀분석을 수행하여 물리적 유해인자 노출과 정신건강의 상관관계를 평가하였다. 모든 통계 분석은 성별에 따라 각각 이루어졌다.
결과
로지스틱 회귀분석에서 우울의 오즈비(odds ratio; OR)는 진동(심한 노출 OR: 1.54, 95% 신뢰구간 [confidence interval; CI]: 1.21, 1.95) 및 소음(심한 노출 OR: 1.93, 95% CI: 1.49, 2.48) 노출이 있는 남성 근로자에서 통계적으로 유의하게 증가한 반면 여성 근로자에서는 진동(심한 노출 OR: 0.86, 95% CI: 0.50, 1.38) 및 소음(심한 노출 OR: 1.39, 95% CI: 0.84, 2.17) 모두 통계적 유의성이 나타나지 않았다. 불안의 오즈비는 남성 근로자에서 진동(심한 노출 OR: 1.76, 95% CI: 1.43, 2.15) 및 소음(심한 노출 OR: 2.12, 95% CI: 1.69, 2.63)이 있는 경우 통계적으로 유의한 상승을 보였으나 여성 근로자에서 진동과 불안 간의 오즈비(심한 노출 OR: 1.45, 95% CI: 0.91, 2.21)는 유의하지 않았다. 고온 및 저온 노출의 경우 남녀 모두에서 우울, 불안과 유의한 상관관계가 확인되었다.
결론
본 연구의 결과는 물리적 유해인자 노출이 우울, 불안 등의 정신건강 문제 위험의 증가와 관련이 될 수 있음을 시사한다. 이러한 관계는 여성 근로자보다 남성 근로자에서 더 두드러지게 나타났다.

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Exploring the Chemical Space of the Exposome: How Far Have We Gone?
Saer Samanipour, Leon Patrick Barron, Denice van Herwerden, Antonia Praetorius, Kevin V. Thomas, Jake William O’Brien
JACS Au.2024; 4(7): 2412. CrossRef
Exploring the relationship between adverse working environments and poor psychological states of Chinese workers: A comprehensive study
Feifei Cheng, Yuanyuan Wu, Min Yao, Xin Wang, Ling'ou Li
Journal of Affective Disorders.2024; 351: 442. CrossRef
Association between physical risk factors and sleep disturbance among workers in Korea: The 5th Korean Working Conditions Survey
Inho Park, Seunghan Kim, Yangwook Kim, Byungyoon Yun, Jin-Ha Yoon
Sleep Medicine.2022; 100: 157. CrossRef
Proposal of Combined Noise and Hand-Arm Vibration Index for Occupational Exposure: Application to a Study Case in the Olive Sector
Raquel Nieto-Álvarez, María L. de la Hoz-Torres, Antonio J. Aguilar, María Dolores Martínez-Aires, Diego P. Ruiz
International Journal of Environmental Research and Public Health.2022; 19(21): 14345. CrossRef

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Research Article

Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study: A Ram Kim, Dae Yun Kim, Ji Soo Kim, Heun Lee, Joo Hyun Sung, Cheolin Yoo; Ann Occup Environ Med 2019;31:6. Published online March 1, 2019; DOI: https://doi.org/10.1186/s40557-019-0284-x

Abstract PDF PubReader ePub

Background

The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS.

Methods

A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value.

Results

The reliability of the CISS questionnaire was proven to be good, with a total Cronbach’s alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s.

Conclusions

The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30.

Trial registration

IRB No. 2018–07–040-001. Registered on 4 September 2018.

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Jeongsoo Kim, Joon Cha, Sheung Nyoung Choi, Gang Heo, Yongjae Yoo, Jee Youn Moon
Anesthesia & Analgesia.2024;[Epub] CrossRef
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International Journal of Environmental Research and Public Health.2024; 21(7): 894. CrossRef
Cold intolerance and hand-arm vibration syndrome
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David John Edwards, Igor Martek, Obuks Ejohwomu, Clinton Aigbavboa, M. Reza Hosseini
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Research Article

Vibration upshot of operating mechanical sewing machine: an insight into common peroneal nerve conduction study: Prakash Kumar Yadav, Ram Lochan Yadav, Deepak Sharma, Dev Kumar Shah, Niraj Khatri Sapkota, Dilip Thakur, Nirmala Limbu, Md Nazrul Islam; Ann Occup Environ Med 2017;29:8. Published online March 24, 2017; DOI: https://doi.org/10.1186/s40557-017-0164-1

Abstract PDF PubReader ePub

Background

Most of the people associated with tailoring occupation in Nepal are still using mechanical sewing machine as an alternative of new technology for tailoring. Common peroneal nerves of both right and left legs are exposed to strenuous and chronic stress exerted by vibration and paddling of mechanical sewing machine.

Methods

The study included 30 healthy male tailors and 30 healthy male individuals. Anthropometric variables as well as cardio respiratory variables were determined for each subject. Standard Nerve Conduction Techniques using constant measured distances were applied to evaluate common peroneal nerve (motor) in both legs of each individual. Data were analyzed and compared between study and control groups using Man Whitney U test setting the significance level p ≤ 0.05.

Results

Anthropometric and cardio respiratory variables were not significantly altered between the study and control groups. The Compound muscle action potential (CMAP) latency of common peroneal nerves of both right [(11.29 ± 1.25 vs. 10.03 ± 1.37), P < 0.001] and left [(11.28 ± 1.38 vs. 10.05 ± 1.37), P < 0.01] legs was found to be significantly prolonged in study group as compared to control group. The Amp-CMAP of common peroneal nerves of both right [(4.57 ± 1.21 vs. 6.22 ± 1.72), P < 0.001] and left [(4.31 ± 1.55 vs. 6.25 ± 1.70), P < 0.001] legs was found significantly reduced in study group as compared to control group. Similarly, the motor nerve conduction velocity (MNCV) of common peroneal nerves of both right [(43.72 ± 3.25 vs. 47.49 ± 4.17), P < 0.001] and left [(42.51 ± 3.82 vs. 46.76 ± 4.51), P < 0.001] legs was also found to be significantly reduced in study group in comparison to control group.

Conclusion

Operating mechanical sewing machine by paddling chronically and arduously could have attributed to abnormal nerve conduction study parameters due to vibration effect of the machine on right and left common peroneal nerves. The results of present study follow the trend towards presymptomatic or asymptomatic neuropathy similar to subclinical neuropathy.

Citations

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Prognostic factors in patients who underwent surgery for common peroneal nerve injury: a nest case–control study
Zhenhui Liu, Maimaiaili Yushan, Yanshi Liu, Aihemaitijiang Yusufu
BMC Surgery.2021;[Epub] CrossRef

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Original Article

The General Characteristics and Results of the Cold Provocation Test in the Risk Group of HAVS: Jae Kook Yoon, Chang Sun Sim, Myoung Soon Oh, Joo Hyun Sung, Ji Ho Lee, Choong Ryeol Lee, Yangho Kim, Cheol In Yoo, Hun Lee; Korean Journal of Occupational and Environmental Medicine 2012;24(3):207-216. Published online September 30, 2012; DOI: https://doi.org/10.35371/kjoem.2012.24.3.207

Abstract PDF

OBJECTIVES
The cold provocation test for diagnosing the vascular component in hand-arm vibration syndrome (HAVS) is likely to be accepted as an objective test, and a few studies have been performed. However, controversy has continued regarding the diagnostic performance of this method. Although objective methods such as plethysmography and laser doppler flowmetry have been studied, they have not received as much attention as other diagnostic methods. Therefore, our study aim was to spread the awareness of HAVS by reporting the results of the cold provocation test in a hand-transmitted vibration exposure group.
METHODS
The study subjects were 549 workers who had been exposed to hand-transmitted vibrations and reported symptoms in their hands. While the subject immersed both their hands in 10degrees C water for 10 minutes, the skin temperature of 10 fingers was recorded from pre-immersion time to 20 minute postimmersion including 10 minutes immersion time. The recovery rates were calculated from the recorded skin temperatures. The 'decreased recovery rate' criteria were less than 30% at 5 minutes post-immersion and 60% at 10 minute post-immersion.
RESULTS
Of the subjects, 69.1% and 30.9% had more severe symptoms in the right and left hands, respectively. The mean finger skin temperature of the right hand after cold-water immersion for 10 minutes was approximately 10degrees C, which increased gradually with time, but they did not reach the baseline temperature at 20 minutes post-immersion. The deviations of the skin temperature in the subjects were higher in the recovery phase than in the baseline and cold immersion phase. The 3rd finger of both hands showed the lowest 5-minute recovery rate among the fingers examined, and the left 4th finger and right 3rd finger showed the lowest 10-minute recovery rate. Of the subjects, 37.6% and 10.4% of subjects showed a lower recovery rate at 5 and 10 minutes in at least one finger, respectively, while 10.2% showed a lower recovery rate at both 5 and 10 minutes simultaneously in at least one finger.
CONCLUSIONS
The larger deviations in the recovery phase than in the other phases indicated that interindividual differences are more prominent in the recovery phase. There might be no benefit in observing the finger skin temperature for an additional 10 minutes after 10 minutes post-immersion. Overall, approximately 10% of the subjects in the HAVS risk group had HAVS.

Citations

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Technetium-99m hand perfusion scintigraphy (Raynaud’s scan) as a method of verification in hand arm vibration syndrome: a review
Taewoong Ha, Hyeoncheol Oh, Jungwon Kim
Annals of Occupational and Environmental Medicine.2022;[Epub] CrossRef
Trend of Human Vibration Research in Korea
Hee-Sok Park
Journal of the Ergonomics Society of Korea.2013; 32(4): 293. CrossRef

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Original Article

Relationship between Workplace Physical and Chemical Hazard Exposures and Mental Health Problems in Korea: Kee Ock Joh, Tae Jun Park, Jae Il Oh, Do Myung Paek, Jung Sun Park, Sung Il Cho; Korean Journal of Occupational and Environmental Medicine 2011;23(3):287-297. Published online September 30, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.3.287

Abstract PDF

OBJECTIVES
Mental health and work efficiency are adversely affected by exposure to physical and chemical hazards in the workplace. This study is the first large scale evaluation of the relationship between physical and chemical hazard exposure in the workplace in relation to the mental health of Korean workers.
METHODS
A national survey of a random sample of workers (n=10,043) was conducted between June and September 2006 in Korea. Physical and chemical hazards in the workplace were considered if exposure occurred over more than a quarter of the time spent at work. Mental health problems were defined as work-related depression, anxiety or insomnia. We analyzed whether physical and chemical hazards were independent risk factors for work-related mental health problems by multiple logistic regression analysis after adjusting for age, gender, employment type, education, occupation, duty schedule, work hours, smoking, and alcohol consumption.
RESULTS
The mean age of surveyed workers was 42 years and 58% were male. A total of 7.8% of workers had work-related mental health problems. Exposure to high temperature, mist, fumes, dust, chemicals, and radiation were associated with an increased risk of work-related mental health problems.
CONCLUSIONS
This study reaffirmed that physical and chemical hazard exposure in the workplace significantly elevates the risk of work-related mental health problems.

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Original Article

Effect of Hand Transmitted Vibration on the Auditory System: Jae Kook Yoon, Cheol In Yoo, Ji Ho Lee; Korean Journal of Occupational and Environmental Medicine 2011;23(1):18-30. Published online March 31, 2011; DOI: https://doi.org/10.35371/kjoem.2011.23.1.18

Abstract PDF

OBJECTIVES
This study was undertaken to estimate the effect of hand transmitted vibration exposure for long time period on the auditory system in shipyard grinder workers.
METHODS
From 2006 to 2009, the study was carried out on 87 grinder workers for hand transmitted vibration exposure group, with 81 welders who were served as the control group. All subjects were male; at baseline, none of the participants had ear disease or diabetes mellitus. Auditory threshold at different frequencies ranged from 0.25 kHz to 8 kHz for both ear was recorded; the following were also collected from the subjects: age, exposure duration, noise exposure level of investigation year, total cholesterol, systolic/diastolic blood pressure, and smoking history.
RESULTS
In comparison of two groups, mean of age, exposure duration, noise level, total cholesterol, systolic/diastolic blood pressure, smoking rate were not significantly different between the groups. Auditory thresholds of 0.25, 0.5 kHz frequencies in both ear, 1 kHz frequency in right ear, and 8 kHz frequency in left ear were higher in hand-transmitted vibration exposure group than that in the control group at a statistically significant level. After stratification by age 50 years, there were no significant differences between the two groups in less than 50-years old age group, but auditory threshold of 0.25, 0.5, 1 and 8 kHz frequency were significantly different between the two groups in above 50-years old age group. The differences between two groups ranged from 0.4 dB(HL) to 6.7 dB(HL). Multiple linear regression analysis showed that hand transmitted vibration exposure was significant only in 0.25, 0.5 kHz frequency and the regression coefficients of vibration exposure ranged from 3.826 to 5.028 in those frequencies.
CONCLUSIONS
The differences of hearing threshold between two groups only in the 50-years old group were possibly owing to changed peripheral vascular system with autonomic nervous system, and significances only in low frequencies such as 0.25, 0.5 kHz probably mean that hand vibration exposure have been transmitted to auditory organ over long term. Collectively, older people can be more susceptible to hearing loss in the presence of hand transmitted vibration exposure and auditory threshold at low frequency may be more affected by the hand transmitted vibration exposure than high frequency.

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The Health Effect of Hand Arm Transmitted Vibration
Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. CrossRef

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Case Report

Cervical HIVD Related to Long-Term Whole Body Vibration and Awkward Posture: Jong Do Jeong, Sangchul Roh; Korean Journal of Occupational and Environmental Medicine 2009;21(4):396-405. Published online December 31, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.4.396

Abstract PDF

BACKGROUND
The relationship between whole body vibration and awkward neck posture to cervical herniated intervertebral disc (HIVD) has been rarely reported. In this report, we present the case of an overhead crane operator, that had no known history of neck injury, but had long-term exposure to whole body vibration and improper neck posture, who developed cervical HIVD, which raises concerns over the possibility of occupational causation.
CASE
A patient, operating an overhead crane since Dec 26th 1986, began to suffer from a neck pain and developed cervical HIVD in 1998. He had been frequently treated in an outpatient clinic, but the symptom was not improve. Eventually, he got HIVD surgery in Sep 6th 2007, and then the symptom was relieved. There were 4 groups and 3 shift system in the patient's overhead crane operation. He worked eight hours a day and 5 days a week. Actual crane work time was about 6 hours a day. The crane was located at 20 meters above the work field so that the crane operator had to look downward and the neck was bent by more than 20degrees for nearly the entire working day. Daily vibration exposure was expressed in terms of an 8-hour energy-equivalent frequency-weighted acceleration magnitude (A(8)) and vibration dose value (VDV). The daily A(8) was measured to be 0.23 m/s2 and the daily VDV was 7.4 m/s(1.75). Although these levels were below the action level recommended by the International Organization for Standardization (ISO) and European Commission (EC), it cannot be ignored that whole body vibration in addition to an awkward neck posture may be related to an increased risk for neck disease. A long-term awkward posture can adversely impact the prevalence of neck disease. In addition, occupational exposure to whole body vibration along with an awkward neck posture seems to exacerbate these effects.
CONCLUSION
An overhead crane operator may have acquired cervical HIVD due to an occupational causation. Therefore, to elucidate the causal relationship of an improper neck posture and whole body vibration to neck diseases, further investigations need to be conducted for lager sample of overhead crane operators that were exposed to a long-term awkward neck posture and whole body vibration.

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Retrospective Statistical Analysis of Patients with Disc Herniation Treated with Cervical or Lumbar Decompression Treatment
Ye Ji Lee, Jeong il Kim, Ju Hyun Jeon, Eunseok Kim, Young Il Kim
Journal of Korean Medicine.2021; 42(2): 1. CrossRef
Trend of Human Vibration Research in Korea
Hee-Sok Park
Journal of the Ergonomics Society of Korea.2013; 32(4): 293. CrossRef

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Original Article

Early Objectified Detection Method of Sensorineural Component in Hand Arm Vibration Syndrome: Jae Kuk Yoon, Hun Lee, Nari Choy, Suk Hwan Kim, Hyoung Ouk Park, Ji Ho Lee, Cheol In Yoo; Korean Journal of Occupational and Environmental Medicine 2009;21(2):143-153. Published online June 30, 2009; DOI: https://doi.org/10.35371/kjoem.2009.21.2.143

Abstract PDF

OBJECTIVES
In order to determine find out the best methods for a more objective detection of neurologic abnormality in early hand arm vibration syndrome(HAVS), early with analyzing the validity of each of the detection methods was analyzed. We evaluated the relationships between the sensorineural stage of Stockholm-revised vibration syndrome classification and the results of several tests.
METHODS
497 workers were investigated for symptom, exposure duration, the types of tools used, and medical history from January 2000 to December 2007. Pain sense threshold, vibrotactile threshold, hand grasp force, finger grasp force, and a finger tapping frequency test were performed by the workers.
RESULTS
The grinder(67.3%) was the most commonly used tool and the mean exposure duration was 14.8 years. Although the pain sense and vibrotactile threshold level tended to increase according to sensorineural stage of the Stockholm classification, there was statistically significant difference in the vibrotactile threshold of 125, 250 Hz (p=0.006~0.038) but not in the pain sense threshold. Hand and finger grasp force tended to decrease according to the sensorineural stage of Stockholm classification and there was statistically significant difference(p=0.041,<0.001, 0.034) only on the right hand side. The tapping frequency also generally decreased according to the sensorineural stage of the Stockholm classification and there was statistically significant difference (p=0.002~0.019) only on the left hand side.
CONCLUSIONS
Although there is no single standardized method that can objectively diagnose the sensorineural component of early HAVS early, the combination of subjective symptoms, the sensorineural stage of Stockholm classification, the pain and vibrotactile threshold test, the hand and finger grasp force, and the finger agility (tapping) test can objectively detect sensorineural component of HAVS early.

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Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study
A Ram Kim, Dae Yun Kim, Ji Soo Kim, Heun Lee, Joo Hyun Sung, Cheolin Yoo
Annals of Occupational and Environmental Medicine.2019;[Epub] CrossRef
Trend of Human Vibration Research in Korea
Hee-Sok Park
Journal of the Ergonomics Society of Korea.2013; 32(4): 293. CrossRef

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Case Report

A Case of Raynaud's Phenomenon of both Feet in a Rock Drill Operator with Hand-arm Vibration Syndrome: Nari Choy, Chang Sun Sim, Jae Kuk Yoon, Suk Hwan Kim, Hyoung Ook Park, Ji Ho Lee, Cheol In Yoo; Korean Journal of Occupational and Environmental Medicine 2008;20(2):119-126. Published online June 30, 2008; DOI: https://doi.org/10.35371/kjoem.2008.20.2.119

Abstract PDF

BACKGROUND
There have been many studies on hand-arm vibration syndrome (HAVS) for almost a century. The Stockholm Workshop scale has been accepted as a useful tool in diagnosing HAVS. Although they are not standard tests for diagnosis, cold provocation test and plethysmography of the fingers are commonly used as objective measurements to confirm the vascular component of HAVS. However, there are only a handful of case reports and studies worldwide on Raynaud's phenomenon in the toes. We report the case of a patient with HAVS who developed Raynaud's phenomenon in the toes after the vibration exposure had ceased. To our knowledge, this is the first report of this entity in Korea.
CASE
REPORT: A 58-year-old male, who had been diagnosed with HAVS in 2003, first noticed white toes in the summer of 2006 after immersing his feet in cold water. He had been working as a rock drill operator since 1976 for almost 30 years and had symptoms on his fingers since 1992. He underwent the cold provocation test, photoplethysmography, Nerve conduction velocity, and basic laboratory tests to rule out other causes of secondary Raynaud's phenomenon. To describe the severity of his feet, it could be classified as vascular stage 2 and sensorineural stage 1 if we were to apply the Stockholm Workshop scale.
CONCLUSIONS
The patient showed vibration-induced white toes, and we would like to share the results of objective findings related to his condition. When diagnosing HAVS, symptoms of the feet should be assessed by the occupational and environmental medicine physicians. Further studies are needed to standardize test methods to diagnose "vibration-induced white toes."

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Raynaud’s phenomenon in the feet of Arctic open-pit miners
Albin Stjernbrandt, Hans Pettersson, Per Vihlborg, Anje Christina Höper, Anna Aminoff, Jens Wahlström, Tohr Nilsson
International Journal of Circumpolar Health.2024;[Epub] CrossRef
Body physiological responses of city bus drivers subjected to noise and vibration exposure in working environment
Ramin Rahmani, Mohsen Aliabadi, Rostam Golmohammadi, Mohammad Babamiri, Maryam Farhadian
Heliyon.2022; 8(8): e10329. CrossRef
The Health Effect of Hand Arm Transmitted Vibration
Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. CrossRef
Examination of Vibration Characteristics, and Reported Musculoskeletal Discomfort for Workers Exposed to Vibration via the Feet
Mallorie Leduc, Tammy Eger, Alison Godwin, James P. Dickey, Ron House
Journal of Low Frequency Noise, Vibration and Active Control.2011; 30(3): 197. CrossRef

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Original Article

Epidemiologic Characteristics of Hand-Arm Vibration Syndrome through Occupational Disease Surveillance System in Busan, Ulsan, Kyungnam Province: Young hee Choi, Cheol In Yoo, Ji Ho Lee, Choong Ryeol Lee, Hun Lee, Young Wook Kim, Chang Ho Chae, Sang Baek Koh, Euna Kim, Lu Jin Lee, Yang ho Kim; Korean Journal of Occupational and Environmental Medicine 2003;15(3):261-268. Published online September 30, 2003; DOI: https://doi.org/10.35371/kjoem.2003.15.3.261

Abstract PDF: OBJECTIVES
The objectives of this study were to estimate the epidemiologic characteristics of hand-arm vibration syndrome (HAVS) due to occupational exposure of hand transmitted vibration and to identify the occupations and industries where such exposures arises, and the main sources of exposure.
METHODS
In April 2001 the Busan, Ulsan, and Kyung-Nam Province occupational disease surveillance system was established to measure the incidence and prevalence of work-related HAVS and other occupational diseases in these Korean provinces. Occupational physicians of nine hospitals in Busan, Ulsan, and Kyung-nam Province were involved in this project between April 2001 and November 2002. Physicians collected information through questionnaires and interviews. Information gathered included age, occupation, types of vibration tools used and presence of subjective symptoms such as vibration-induced white finger (VWF), numbness and tingling.
RESULTS
A total 192 cases were reported with 188 males and 4 females. The shipbuilding industry was the most common type of industry and grinders were the most common source of exposure. Symptoms of neurological disorder were more common than those of vascular disorder.
CONCLUSIONS
The authors concluded that exposure to hand transmitted vibration is common and that HAVS is one of the most common occupational diseases in Korea. However, the range and extent of hand transmitted vibration and the overall prevalence of HAVS in Korea is still unknown. More extensive research on this syndrome in order to priorite necessary preventive measures is required.

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Original Article

Hand-Arm Vibration Syndrome and Neural Conduction Impairment in Swagging Workers Exposed to Hand-Arm Vibration: Seong Ah Kim, Sang Woo Kim, Sang Jae Jung, Chae Yong Lee, Kyu Sang Kim, Bo Woo Jung, Sang Kyu Park; Korean Journal of Occupational and Environmental Medicine 2002;14(2):169-182. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.169

Abstract PDF: OBJECTIVES
To investigate the hand-arm vibration syndrome (HAVS) among symptomatic swagging workers exposed to hand-arm vibration, using medical evaluation and measurement of workplace vibration. Furthermore, to evaluate the neurophysiological METHODS: Four workers showing symptoms relevant to HAVS were evaluated. Medical evaluation consisted of medical interview, questionnaire, nail-bed compression test, and sensory perception tests for vibration and pain. Some other diseases were excluded by a medical interview, hematological assessment, and urinalysis. Cold provocation test was used to assess the peripheral vascular changes, and a nerve conduction velocity (NCV) test was implemented to ascertain the peripheral neural changes. Pegboard, hole plate, and tapping board tests were performed to assess motor nerve function. The hand-arm vibration acceleration levels of the swagging machines were measured. Six months later, follow-up NCV tests were performed.
RESULTS
The actual exposure time to vibration was not longer than 15 minutes per day. The hand-arm vibration acceleration levels of the swagging machines, according to actual exposure time, were from 3.63 to 12.98 m/sec2, by ISO 5349. The vibratory perception thresholds and the recovery time of a nail color following finger cooling were significantly increased in all four workers. The perception of pain was mildly increased. The nerve conduction studies at first diagnosis and follow-up showed multifocal neural impairment caused by vibration. However, we could not rule out the concomitant presence of the carpal tunnel syndrome in one worker.
CONCLUSIONS
These results show that HAVS can be caused by hand-arm vibration in swagging workers. Interestingly, the NCV results suggested that vibration-induced neural conduction impairments could vary, and need to be interpreted cautiously.

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Original Article

Evaluation of Finger Skin Temperature by Cold Provocation Test for Diagnosis of Hand-Arm Vibration Syndrome: Cheol In Yoo, Ji Ho Lee, Choong Ryeol Lee, Hun Lee, Young Hee Choi, Yang Ho Kim; Korean Journal of Occupational and Environmental Medicine 2002;14(2):124-133. Published online June 30, 2002; DOI: https://doi.org/10.35371/kjoem.2002.14.2.124

Abstract PDF

OBJECTIVES
Various objective tests have been widely used worldwide for diagnosing the hand-arm vibration syndrome. Among these, the cold provocation test has been frequently used to confirm the presence of Raynaud's phenomenon. This study was carried out in order to evaluate finger skin temperature by cold provocation test(10 degrees C for 10 minute) for the diagnosis of hand-arm vibration syndrome METHODS: Fifty-eight workers who had been exposed to local vibration were examined. Information concerning age, occupation, types of vibration tools used, presence of subjective symptoms such as vibration induced white finger(VWF), and numbness and tingling were collected. The subjects were classified into three groups according to their symptoms(Vascular, Neural, and No symptom group). In order to examine the applicability of the cold provocation test using water at 10 degrees C for 10 minute, we compared finger skin temperature between the groups.
RESULTS
The mean value of the finger skin temperature at 5 minutes and 10 minutes after cold provocation as well as the recovery rate in the vascular group were significantly lower than that seen in the other groups.
CONCLUSIONS
The evaluation of finger skin temperature by cold provocation test is very useful method for the diagnosis of hand-arm vibration syndrome. The test results will assist in confirming the diagnosis of the hand-arm vibration syndrome.

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The Health Effects of Whole Body Vibration
Soo-Jin Lee, Soo-Yong Roh
Journal of the Ergonomics Society of Korea.2013; 32(4): 297. CrossRef

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Case Report

6 Cases of Hand Arm Vibration Syndrome in Grinding Workers Exposed to Hand-arm Vibration: Shang Hyuk Yim, Rokho Kim, Gil Seung Yang, Jung In Yang, Sang Sup Kim, Hyoung Joon Chun, Si Bog Park; Korean Journal of Occupational and Environmental Medicine 2000;12(3):421-429. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.421

Abstract PDF

OBJECTIVES
To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes.
RESULTS
8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS.
CONCLUSIONS
So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.

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Severity of grinder injuries and related factors compared with other high-rotation cutting tool injuries: a multicenter retrospective study from 2011 to 2018
Juni Song, Yang Bin Jeon, Jae Ho Jang, Jin Seong Cho, Jae Yeon Choi, Woo Sung Choi
Journal of Trauma and Injury.2023; 36(1): 32. CrossRef
The Health Effect of Hand Arm Transmitted Vibration
Jung-Wan Koo
Journal of the Ergonomics Society of Korea.2013; 32(4): 303. CrossRef
Occupational Diseases in Korea
Seong-Kyu Kang, Eun A Kim
Journal of Korean Medical Science.2010; 25(Suppl): S4. CrossRef

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Original Article

Evaluation of Early Neurologic Abnormalities on the Workers Exposed to Acrylamide: Seong Soon Kim, Hae Kwan Cheong, Yong Wook Kwon; Korean Journal of Occupational and Environmental Medicine 2000;12(3):367-383. Published online September 30, 2000; DOI: https://doi.org/10.35371/kjoem.2000.12.3.367

Abstract PDF

OBJECTIVES
Acrylamide is a neurotoxin inducing central-peripheral distal axonopathy. The authors evaluated several neurologic tests to screen the early effect of occupational acrylamide exposure.
METHODS
Fifty-two males working either in the production of acrylamide monomer or in the handling of acrylamide in Ulsan, Korea, were selected and subcategorized into the high-exposure group (n=10, mean age of 30. 4 years) and the low-exposure group (n=42, mean age of 28.9 years). Twenty-three males (mean age 29.4 years) from medical professionals and students were chosen as a non-exposed reference group. Symptom questionnaire, neurologic examination, electrodiagnostic test, vibrotactile threshold test, and Lanthony desaturated 15 panel test (LD-15D) were done.
RESULTS
The high-exposure group showed more number of specific symptoms on questionnaire and more abnormal two point discrimination test. High-exposure group showed a significant difference in the median motor conduction velocity, peroneal nerve motor latency, sensory amplitude of median nerve action potential, and sensory latency of sural nerve. The vibrotactile threshold of the high-exposure group was significantly higher in both hands and feet than that of the low-exposure group and the reference group. Average color confusion index on the LD-15D was significantly higher in the high-exposure group (median 22.7, range 0-135.7) than in the reference group (median 2.4, range 0-33.2).
CONCLUSIONS
The symptom questionnaire, vibrotactile threshold test, and color discrimination test are sensitive in detection of the early acrylamide-induced neuropathy, and the combination of these tests would further facilitate the effectiveness of the screening.

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Usefulness of Color Vision Test for Early Detection of Neurological Damages by Neurotoxic Substances
Eun-Hee Lee, Kyungho Choi, Hong Jae Chae, Domyung Paek
Journal of Preventive Medicine and Public Health.2008; 41(6): 397. CrossRef

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Original Article

Evaluation of Health Exams on Local Vibration Illness among Shipyard Workers: Yeong Su Ju, Hong Ryul Choi, Mi Kyung Kim, Hong Sohn, Sun Ja Jeon, Sung Il Cho, Hyong Sik Kim; Korean Journal of Occupational and Environmental Medicine 1998;10(4):413-427. Published online December 31, 1998; DOI: https://doi.org/10.35371/kjoem.1998.10.4.413

Abstract PDF

A hand-arm vibration syndrome, local vibration illness, occurs in some workers who use hand held vibration tools. It consists of white fingers, diffusely distributed finger neuropathy, pain in the hand and arm, and a small excess risk of osteoarthritis. This study is aimed to identify effective methods to confirm local vibration illness among various health exams, which are mentioned in worker's special health exam regulation. In addition, this study is aimed to quantitatively assess the daily vibration exposure level as a major determinant of vibration illness. The subjects, 46 vibration workers, were selected according to the results of the first special health exam about vibration hazards at shipbuilding industry in 1997. They all had experiences of work related blanching of fingers. Fifteen controls, who had no vibration exposure at all, were also recruited to compare their test results with the results of vibration workers. We adopted 1 subjective and 6 objective tests to evaluate the effectiveness and feasibility for confirming local vibration illness. These tests were history taking of subjective symptoms according to the Stockholm classification, checking blood pressure of finger, checking grasp power, checking finger skin temperature, nail-bed pressing test, vibration perceptional threshold test, and skin prick test for pain perception. Among these, checking skin temperature, nail-bed pressing test, and vibration perception test included cold water provocations. We also estimated some vibration exposure levels of hand held vibration tools by using previously published data from one automobile company. In conclusion, history taking of subjective symptoms according to the Stockholm classification, nail-bed pressing test, and vibration perceptional threshold test were discovered to be effective to diagnose local vibration illness. Furthermore, vibration perceptional threshold on right fingers showed a dose-response relationship to daily vibration exposure levels. The parameter beta was 0.0005(+/-0.0002), and statistically significant by REM (random effects model).

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Assessment on the Actual Vibration Exposure of Workers Engaging in Vibration Induced Works
Kab-Bae Kim, Eun-Kyo Chung, Ki-Ho You, Jae-Kil Jang
Transactions of the Korean Society for Noise and Vibration Engineering.2012; 22(10): 940. CrossRef

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Original Article

Quantitative Sensory and Vascular Tests in the Assessment of Hand-Arm Vibration Syndrome: Seung Wan Kang, Eun Il Lee, Yong Tae Yum, Hae Joon Kim; Korean Journal of Occupational and Environmental Medicine 1996;8(2):210-222. Published online September 30, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.2.210

Abstract PDF

This study was conducted on 103 male workers exposed to local vibration (exposure workers) and 23 male clergical workers not exposed to local vibration (reference workers) to evaluate the effect of local vibration in a automobile industry workers who had used vibratory tools such as electric bolt impacter or grinder. The assessment methods of this study were some tests recommended by Wasserman and Taylor. None of reference workers complained sensorineural symptoms, but 43.7% of exposed workers complained over one of those symptoms. The proportion of non-recovery type, which means that there was no full recovery of temperature of finger tips, was from 0% to 31. 3% in reference workers and from 10.7% to 15.5% in exposure workers. There was statistically significant difference of recovery time of plethysmogram after cold provocation between mean recovery time of 0.44 minutes in reference workers and that of 3.05 minutes in exposure workers. The proportion of bad plethysmogram was from 0% to 4.4% in reference workers and from 3.9% to 7.8% in exposure workers. There was statistically significant difference of discrimination sense between mean length of 2.04 mm in reference workers and that of 2.9 mm in exposure workers. There were also statistically significant difference of pain sense between mean weights of from 5.02 g to 5.26 g in reference workers and those of from 6.81 g to 7.6 g in exposure workers. By the results of multiple stepwise regression analysis the statistically significant variable affecting discrimination and pain sense was exposure and those affecting vibration sense were exposure and age. We concluded that exposure of local vibration in automobile workers was significaritly associated with decrease of sensorineural sense regardless of age and other, possible related variables.

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Trans‐Cranial Doppler and Peripheral Sensory Threshold Tests for Carbon Disulfide Poisoning
Eunil Lee, Hun‐Jong Chung, Soon‐Duck Kim, Jong‐Tae Park, Donggeun Sul, Myung‐Hyun Kim
Journal of Occupational Health.2001; 43(6): 307. CrossRef

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Original Article

Vibration Perception Threshold of Male Workers Exposed to Carbon Disulfide: Seung Hoi Park, Eun Il Lee, Byung Chul Chun, Yong Tae Yum, Jae Wook Chi; Korean Journal of Occupational and Environmental Medicine 1996;8(1):85-96. Published online February 29, 1996; DOI: https://doi.org/10.35371/kjoem.1996.8.1.85

Abstract PDF

This study was conducted on 367 male workers to evaluate the change of vibration perception threshold (VPT) according to exposure degree to carbon disulfide. VPT was measured on both metacarpal bones of index and little fingers and on fibular malleoli by Vibrometer (Rion, on 125Hz). The exposure degree was classified by the name of department. Workers in department 1 had been exposed to high concentration of carbon disulfide, those in. department 2 had been exposed to carbon disulfide moderately or intermittently, and those in department 3 had been exposed to undetectable concentration of carbon disulfide. The results were as follows: 1. The mean values of VPT of metacarpal(MC) bones showed dose-response pattern, i.e., the mean values of VPT at department 1 were highest, and those of VPT at department 3 were lowest with similar work duration or age. But the mean values of VPT of fibular malleoli (FM) showed dose-response pattern only in workers having above 5 years of work duration or whose age were above 30. 2. The mean values of VPT of MC bone of workers increased by age. 3. There were statistically significant difference in mean values of VPT of MC bone only in workers having 5-10 year work duration. And there were statistically significant difference of mean values of VPT of left 2nd and 5th MC bone in workers whose age was 30's, of right 2nd MC bone in those whose age was 40's, and of left 2nd MC bone in those whose age was 50's. 4. The variables affecting VPT significantly were department and age (or age group) both in multiple regression and general linear model. The department showed to have more effect to VPT than age in multiple regression, but age group showed to have more effect to VPT than department in general linear model. 5. The variables were transformed to indicator variable to do logistic regression analysis. Department 1, 2, 3 were classified into high exposure (spinning department) and low exposure (other department), age was classified into old (above 30) and young, and work duration was classified into long(above 10 years) and short. The exposure and age were significant variables by logistic regression analysis. Odds ratios of department and VPT on metacarpal bones or malleoli were 2.7-3.2 and those of age and VPT were 2.6 or 2.7. Odds ratio of age and abnormality of VPT on'any point was 3.3(1.59-6.;8), and that of department and VPT was 2.8(1.5-5.5). We concluded that exposure of carbon disulfied was significantly associated with reduction of VPT regardless of age; and that the test of VPT would be useful tool for screening and early detection in neuropathy by carbon disulfide or other neurotoxic chemicals,even though it is simple and cheap.

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Trans‐Cranial Doppler and Peripheral Sensory Threshold Tests for Carbon Disulfide Poisoning
Eunil Lee, Hun‐Jong Chung, Soon‐Duck Kim, Jong‐Tae Park, Donggeun Sul, Myung‐Hyun Kim
Journal of Occupational Health.2001; 43(6): 307. CrossRef
Carbon Disulfide Poisoning in Korea with Social and Historical Background
Eunil Lee, Soonduck Kim, Haejoon Kim, Kwangjong Kim, Yongtae Yum
Journal of Occupational Health.1996; 38(4): 155. CrossRef

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Original Article

Selection of Testing Frequency in Bone Vibrator of Audiometer for Measurement of Vivration Perception Threshold: Jong Young Lee, Wan Seoup Park, Yeong Hwan Kim, Doohie Kim; Korean Journal of Occupational and Environmental Medicine 1994;6(1):17-25. Published online February 28, 1994; DOI: https://doi.org/10.35371/kjoem.1994.6.1.17

Abstract PDF: Both to determine testing frequency in bone vibrator of audiometer for measurement of vibration perception threshold(VPT) and to evaluate factors influencing VPT, ninty seven healthy adults were tested on their second metacarpal head of both hands, at 250Hz, 500Hz, 1,000Hz and so on. Measures of the VPTs at 1,000Hz were excluded in analysis because frequency 1,000Hz was not recognized as a vibration sense. Mean and standard deviation(S.D.) of the VPTs in the both hands measured at 250Hz were 19.9+/-6.7dB, 21.0+/-7.3dB, respectively and at 500Hz were 33.6+/-8.3dB, 34.9+/-8.1dB, respectively. Both mean and S.D. tended to be lower at 250Hz than 500Hz, and mean differences of VPTs between the left and the right hand at the both frequencies appeared statistically significant (p<0.01). VPTs were significantly correlated with each other (p<0.01). Age was positively correlated(p<0.001) with VPTs and education was negatively(p<0.01). Multiple regression analysis showed that age was the only factor influenced on VPT. These results suggest that, when using the bone vibrator of audiometer for measurement of VPT, the frequency 250Hz as a testing frequency may be more useful than frequency 500Hz, and VPT should be measured on both hands.

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Original Article

Nailfold capillary microscopy for evaluating hand-arm vibration syndrome: Lee, Chan Boo , Sung, Joo Hyun , Park, Jung Hun , Yoo, Cheol In , Sim, Chang Sun , Oh, Ji Seon , Lee, Hun; Ann Occup Environ Med 2014;26(1):27-27.; DOI: https://doi.org/10.1186/s40557-014-0027-y

Abstract: OBJECTIVES
We evaluated nailfold capillary abnormalities in patients with hand-arm vibration syndrome using nailfold capillary microscopy.
METHODS
Fifty workers who underwent a special health examination because of exposure to hand-arm vibration at Ulsan University Hospital in 2012 (exposed group) and a control group of 50 white-collar employees were evaluated through a questionnaire survey regarding their present tasks, types of tools used, vibration exposure duration, use of protective wear, and medical history. Then, an occupational physician performed a physical examination for any hand deformities, skin problems, or motor and sensory dysfunctions of the upper extremities. The nailfold capillary morphologies (tortuous, crossing, bushy, meandering, branching, hemorrhage, avascular area, enlarged, and giant), capillary dimensions (afferent, top, venous, total width, and length), and specific counts (crossing and branching) on both fourth fingers were determined by a rheumatologist. Thereafter, the exposed subjects were assessed according to the Stockholm workshop classification scale. In total, 8 and 6 subjects in the exposed and control groups, respectively, were excluded from the study because of poor capillary microscopic image quality. In addition, 24 subjects in the exposed group with Stockholm vascular stage 0 were excluded. Finally, capillary morphology, dimensions, and specific counting were compared between the exposed (n = 18) and control groups (n = 44).
RESULTS
The exposed group had significantly greater crossing capillaries and abnormal capillary numbers that included crossing capillaries (crossing, branching, bushy, and meandering) but smaller branching and abnormal capillary numbers that excluded crossing capillaries (branching, bushy, and meandering) than the control group did. No significant difference in capillary dimensions was observed between the two groups. Despite the adjustment for age, smoking status, and underlying diseases, the statistical significance was unchanged. In the specific counting of the type of capillaries, the exposed group had a significantly higher total crossing count but fewer total branching count than the control group did. However, no statistical significance resulted after adjustment for age, smoking status, and underlying diseases.
CONCLUSIONS
In this study, the exposed group had significantly more crossing capillaries and a higher crossing count than the control group did.

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