Hand-arm vibration syndrome among travertine workers: a follow up study.

Abstract

In a six year follow up study of the handarm vibration syndrome, 62 stoneworkers operating hand held vibrating tools in 10 travertine quarries and mills were first investigated in 1985 and then in 1991. The frequency weighted acceleration ofvibration from the rock drills and stone hammers used by the travertine workers exceeded 20 m/s2, indicating a hazardous work activity according to the proposal of the EC directive for physical agents. A clinical examination and a cold provocation test were repeated with the same procedures as those adopted at the time of the first survey. The stoneworkers were divided into groups according to current work state: active stoneworkers who continued to use powered tools during the follow up (n = 21, median exposure time 22 years), and ex-stoneworkers with retirement vibration free intervals of three years (n = 22, median exposure time 27 5 years) and of six years (n = 19, median exposure time 20 years). In the group of active stoneworkers, a 38% onset of new cases of vibration-induced white finger (VWF) was found during the follow up (p < 0.01). Among the retired stoneworkers affected with VWF (n = 24), one recovered from VWF, one showed improvement, 20 remained stationary, and two deteriorated. The exstoneworkers experienced no significant change in sensorineural disturbances and a decrease in musculoskeletal symptoms of the upper limbs. At the cold provocation test, the currently active stoneworkers with VWF showed, on a group basis, a delayed finger rewarming time between the two examinations (p = 0.002). An abnormal response to cold provocation persisted in the fingers of the exstoneworkers with VWF, even in those reporting subjective improvement. These findings indicate a tendency towards the irreversibility of sensorineural and VWF symptoms in a group of ex-stoneworkers with prolonged exposure to high vibration levels in the past. The increased occurrence of VWF in the active stone workers after a few extra years of vibrating tool usage argues for an urgent implementation of preventive measures in the stone industry.

Longitudinal study on factors related to the course of vibration-induced white finger

“…Thus, VWF can improve to some extent when vibration exposure is stopped or reduced. On the other hand, several studies have indicated that VWF persisted even after vibration exposure ceased or was reduced (Agate 1949;Jepson 1954;Dandanell et al 1993;Bovenzi et al 1994). In the present study, VWF persisted in about 70% of patients with VWF during the 6-year follow-up.…”

A prospective study of the cold response of digital vessels in forestry workers exposed to saw vibration

“…Investigations of vibration-exposed worker groups other than chain-saw operators have produced contrasting results. VWF symptoms were reported to improve, remain unchanged, or deteriorate after the cessation of vibration exposure [1,2,6,10,19]. Most follow-up studies of the reversibility of VWF, however, have been based on anamnestic ®ndings.…”

Assessment of autonomic nervous activity in hand-arm vibration syndrome patients using time- and frequency-domain analyses of heart rate variation

“…Subjective improvements in the extent and frequency of ®nger-blanching attacks or complete remissions of vascular complaints have been reported in both active and retired forestry workers [10,18,20]. Some of these studies evidenced the natural course of VWF by means of objective clinical tests in addition to anamnestic ®ndings [3,30,33].…”

“…HAVS patients with VWF symptoms were reported to improve, remain unchanged, or deteriorate after the cessation of vibration exposure [3,30]. It has been shown in some epidemiological studies that symptoms of VWF may reverse if vibration exposure is reduced or ceased [4,8,10].…”