手传振动对凿岩工指端温度觉阈值的影响
Effect of hand-transmitted vibration on fingertip thermotactile perception threshold among mine drilling workers
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摘要:
背景 手传振动危害日益严重，但目前尚缺乏手臂振动病患者小感觉神经纤维损害的判定依据。
目的 通过检测分析矿山凿岩工指端温度觉阈值水平，探讨其在手臂振动病职业健康检查中的应用价值。
方法 应用横断面调查的方法，以湖北省恩施州26家矿山相关作业工人为研究对象，依据其接触振动情况分为接振组和对照组，每组42人。使用HVLab指端温度觉阈值测试仪对矿山作业工人进行温度觉阈值（冷觉阈值和热觉阈值）检查，比较接振组与对照组之间的差异。
结果 本次调查对象全部为男性。凿岩工人主操作用手手传振动接触水平为
a hw（4）=16.3~19.1 m·s-2，辅助用手手传振动接触水平a hw（4）=8.3~14.4 m·s-2。对照组惯用手食指的冷觉阈值水平（26.92±3.10）℃明显高于小指（23.52±4.24）℃（P < 0.05），非惯用手食指的冷觉阈值水平（26.06±3.35）℃也明显高于小指（23.12±3.96）℃（P < 0.05）。接振组主操作用手食指的冷觉阈值水平（25.02±4.41）℃明显高于小指（21.39±5.23）℃（P < 0.05），辅助用手食指的冷觉阈值水平（25.01±3.98）℃也明显高于小指（21.50±4.97）℃（P < 0.05）。与对照组食指的热觉阈值水平（40.80±4.37）℃、小指的热觉阈值水平（41.72±3.78）℃相比，接振组食指的热觉阈值水平（42.20±4.39）℃、小指的热觉阈值水平（43.22±3.96）℃较高（P < 0.05）；与对照组食指的冷觉阈值水平（26.48±3.24）℃、小指的冷觉阈值水平（23.32±4.08）℃分别比较，接振组食指的冷觉阈值水平（25.02±4.17）℃、小指的冷觉阈值水平（21.45±5.07）℃较低（P < 0.05）。结论 温度觉阈值定量分析有助于判断手传振动人员小感觉神经纤维的损害情况。
Abstract:Background The threat to workers' health by hand-transmitted vibration is more and more serious, but the basis for diagnosing small sensory fiber neuropathy in patients with hand-arm vibration disease is insufficient.
Objective Through measuring fingertip thermotactile perception thresholds (TPTs) among mine drilling workers, this study aims to explore the application value of TPTs in occupational health examination of hand-arm vibration disease.
Methods A cross-sectional study was performed among workers from 26 mines in Enshi, Hubei, and they were divided into a vibration-exposed group with hand-transmitted vibration exposure and a control group without such an exposure. TPTs (cold and warm) were measured with an HVLab vibrotactile perception meter and the results were compared between the two groups.
Results All the investigated subjects were male. The mine drilling workers' dominant (16.3-19.1m·s-2) and non-dominant (8.3-14.4m·s-2) hand exposure levels of hand-transmitted vibration
a hw(4) exceeded the national occupational exposure limit. In the control group, the cold TPT of index finger of the dominant hand(26.92±3.10)℃ was higher than that of little finger(23.52±4.24)℃ (P < 0.05); the cold TPT of index finger of the non-dominant hand(26.06±3.35)℃ was also higher than that of little finger(23.12±3.96)℃ (P < 0.05). In the vibration-exposed group, the cold TPT of index finger of the dominant hand(25.02±4.41)℃ was higher than that of little finger(21.39±5.23)℃ (P < 0.05); the cold TPT of index finger of the non-dominant hand(25.01±3.98)℃ was also higher than that of little finger(21.50±4.97)℃ (P < 0.05). Compared with the control group(40.80±4.37)℃ and (41.72±3.78)℃ respectively, the warm TPTs of index fingers(42.20±4.39)℃ and little fingers(43.22±3.96)℃ of the vibration-exposed group were higher (P < 0.05). Compared with the control group(26.48±3.24)℃ and (23.32±4.08)℃ respectively, the cold TPTs of index fingers(25.02±4.17)℃ and little fingers(21.45±5.07)℃ of the vibrationexposed group were lower (P < 0.05).Conclusion The quantitative analysis of thermotactile perception threshold is helpful to evaluate the damage of small sensory fibers in workers with hand-transmitted vibration exposure.
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