The hypothesis that manual work and exposure to vibration are antecedents to the development of osteoarthrosis was assessed employing a cross sectional study design. The frequency of osteoarthrosis in the acromioclavicular joint was studied in three groups of workers in the construction industry. Two groups were manual workers (54 bricklayers and 55 rock blasters); the third group consisted of98 foremen. The 2-76-2134). In the analysis of vibration exposure, workers who had been highly exposed to vibration had an odds ratio of 1 99 (95% CI, 1-003-92) on the right side and 2-20 (95% CI, 1-07-456) on the left. This effect almost disappeared after simultaneous adjustment for manual work. Occupational and ergonomic factors, such as the sum of lifted tonnes during working life, job title, and the sum of years of manual work seem to be risk factors for osteoarthrosis of the acromioclavicular joint, whereas vibration alone was a weaker risk factor.In several reports it is indicated that stress and strain in the working place are factors in the development of occupational shoulder disorders.'`Other reports have dealt with osteoarthrosis in different joints in relation to varying occupational conditions.' The effect ofvibration on bone and joints has been studied among workers using pneumatic tools7 and operators of chainsaws,' and has been reviewed by Gemne and Saraste.' Shoulder pain is a common complaint among workers in the construction industry. Some of the structures that are believed to be the origin of shoulder pain are the muscular insertions, the bursae, and the shoulder joints-that is, the humeroscapular joint, the acromioclavicular joint, and the sternoclavicular joint. The acromioclavicular joint is situated in close relation to the supraspinatus muscle and the subacromial bursa and both are commonly affected among construction industry workers. The question raised was if changes in the acromioclavicular joint could explain this shoulder pain and if an increased risk of such changes existed among construction industry workers.Little has been published on the causes ofacromioclavicular osteoarthrosis. DePalma'°studied the acromioclavicular joint from different aspects but not the osteoarthrosis of the acromioclavicular joint in relation to occupational stress.The aim of the present investigation was to study the influence of manual work and the exposure to 588
We report two cases of hydrocephalus in adults. The radiological investigations and direct inspection during surgery in one of the cases indicate that the hydrocephalus is caused in both cases by a benign stricture in the region of the foramen of Monro and that this constriction is congenital. This origin of hydrocephalus has not been reported previously in adults.
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