手传振动与噪声对作业工人心电图影响的调查

手传振动与噪声对作业工人心电图影响的调查浙江省劳动卫生职业病防治所（杭州市老浙大直路，３１０００９）杨锦蓉高华玲黄德明盛琴琴浙江省绍兴市卫生防疫站曹婉娟振动作业环境常与噪声共存。有关振动与噪声对心血管系统的影响国内外已有不少研究和报道，但结论并非一致...     

手传振动与噪声对工人健康影响的调查

手传振动与噪声对工人健康影响的调查浙江省劳动卫生职业病防治所（杭州３１０００９）黄德明杨锦蓉浙江省丽水地区卫生防疫站陈卫平长期接触手传振动与噪声不仅会引起局部振动病和噪声性耳聋，而且对人体心血管系统、神经系统产生不良影响。为了解上述职业因素对工人健康...     

噪声暴露对工人心电图影响的研究进展

噪声是最常见的职业病危害因素之一,其对听力的损害很早就引起了人们的重视,而对心血管系统影响的研究近年也日益增多,但结果不尽一致.     

噪声和手传振动协同作用对工人听力的影响

目的 分析噪声、手传振动对听力功能的影响,评估手传振动和噪声对作业人员听力的协同作用,为职业健康监护提出建议。
方法 2018年5月选取某金属加工企业473名操作工,以同时接触噪声、手传振动的操作工为观察组,单纯接触噪声的操作工为对照组。通过纯音听阈测试检测工人高频和语频听力损失情况,并进行统计学分析。
结果 观察组的高频听力损失检出率（40.8%）和语频听力损失检出率（4.3%）均高于对照组（26.3%和1.8%）,观察组和对照组的高频听力损失检出率均高于语频听力损失检出率,以上差异均有统计学意义（P < 0.05）。观察组3~6年工龄段的语频听力损失检出率（10.2%）高于0~3年工龄段（2.3%）。
结论 噪声与手传振动相结合,可导致语频和高频的听力损失率增加。随着工作时间的增长,语频听力损失的概率进一步提升。噪声作业人员的职业体检中,需要考虑振动的影响,对于既受到振动又受到噪声影响的工人,应缩短体检间隔时间,提高体检频率,及时发现损害。
     

磨光作业工人手传振动剂量分析

为了解工业生产中各种类型打磨工具的振动加速度 ,采用 1 2种打磨机的振动测试数据 ,分析比较各种打磨机的振动危害程度。结果表明 ,手持砂轮机和角向磨光机的频率计权振动加速度 (ahw)较高 ,波动较大 ;座式砂轮机ahw较稳定 ,棒砂轮机ahw最低。由于工人每日使用手持砂轮机的时间较长 ,其 4h等能量频率计权振动加速度 [ahw(4) ]最高 ,角向磨光机次之 ,使用这些工具的多数工人的ahw(4) 明显超过 5m/s2卫生限值 ;使用石英砂纸打磨机ahw(4) 在 5m/s2 上下波动 ;棒砂轮机的ahw(4) <5m/s2 。提示 ,减轻手传振动危害的关键是控制接振时间 ,打磨工具中尤其应控制手持砂轮机的使用时间     

噪声与振动对钻探工人心电图异常的影响

噪声与振动对钻探工人心电图异常的影响福建省水利水电勘测设计研究院医疗所（福州市东大路，３５０００１）吴维卿已知噪声与振动等物理因素可以影响人体的心血管系统［１］，但是噪声与振动对钻探工人心血管系统影响的报道不多。本文通过对照分析，探讨噪声与振动对钻探...     

噪声与高温联合作用对钢铁厂作业工人心电图的影响

目的探讨噪声与高温联合作用对作业工人心电图的影响。方法选取南通市某钢铁厂不同车间183名同时接触噪声与高温的作业工人为暴露组,接触其他粉尘的作业工人139名为对照组,对他们进行统一体检,分析其心电图结果。结果心电图异常率暴露组为22.53%,对照组为10.79%,差异有统计学意义(P0.01)。相对危险度(RR)为2.08,中等关联;暴露组工龄≥10 a作业工人的心电图异常率27.35%,显著高于对照组工龄≥10 a作业工人和暴露组工龄10 a作业工人的心电图异常率。结论噪声与高温两种职业危害因素对作业工人的心血管具有联合作用,影响作业工人的身体健康。     

噪声对作业工人血压的影响

目的：比较和观察噪声对作业工人高血压发病的影响。方法：通过接触不同强度，不同时间长短噪声作业者高血压的发病率的对比，观察其差异。结果：接触噪声作业者高血压患病率与普通人群患病率有显著性差异（P〈0．05），接触噪声强度越大，时间越长的作业者患高血压病可能性越大。结论：噪声能导致高血压患病率增高，且与噪声强度大小，接触时间长短呈正相关关系。     

785名噪声作业工人血压和心电图检查结果分析

了解兰州市120家噪声危害严重企业噪声作业工人血压和心电图状况,按照GBZ 188—2007《职业健康监护技术规范》等相关规范,2011年4—12月对兰州市噪声危害企业的785名噪声作业工人进行血压和心电图检查。结果显示,785人中,高血压检出率为19.4%,男女性工人检出率比较,差异无统计学意义(P>0.05),接触噪声工龄>20a者检出率明显高于工龄<20a者(P<0.05);心电图异常率为9.9%,心电图异常率无明显性别及工龄差异(P>0.05)。提示,职业噪声暴露可影响噪声作业工人的血压,且工龄越长影响越明显。     

职业性粉尘和噪声对血压及心电图的影响

为探讨职业性粉尘与噪声对血压和心电图的影响,对南昌市某车辆厂单纯接触粉尘261人、单纯接触噪声292人、同时接触粉尘和噪声249人以及对照组不接触粉尘和噪声300人行血压测量及常规同步十二导联心电图检查。结果显示,粉尘组(50/261)、噪声组(36/292)、粉尘+噪声组(67/249)血压异常率高于对照组(17/300),粉尘+噪声组的血压异常率高于粉尘组和噪声组,差异均有统计学意义(P<0.05);粉尘组(26/261)、噪声组(20/292)、粉尘+噪声组(40/249)心电图异常率高于对照组(9/300),粉尘+噪声组的心电图异常率高于粉尘组和噪声组,差异有统计学意义(P<0.05);粉尘+噪声组随着接害工龄的增长,血压和心电图异常率均增加,差异有统计学意义(P<0.05)。提示,单纯接触粉尘或噪声与同时接触粉尘和噪声对心电图和血压均有影响;同时接触粉尘和噪声对血压和心电图的影响更明显,粉尘和噪声对血压和心电图的影响呈联合作用。     

接触噪声与粉尘对工人血压的影响

目的 了解噪声、粉尘接触对职业人群血压的影响。
方法 采用整群抽样方法，选取广东省某钢琴制造厂765名工人为研究对象。将研究对象分为不接触粉尘和噪声组（对照组，n=237）、噪声接触组（n=167）、粉尘接触组（n=222）和噪声与粉尘联合接触组（n=139），分析4组人群血压情况。
结果 4组人群在年龄、BMI指数和体育锻炼方面比较，差异无统计学意义（P>0.05）。4组人群的收缩压、舒张压水平差异均有统计学意义（P < 0.05），其中对照组人群收缩压和舒张压水平均低于其他3组。高血压总患病率为20.3%（155/765），4组人群高血压患病率差异有统计学意义（P < 0.01），其中以对照组最低，同时接触噪声与粉尘组高血压患病率最高。多元线性回归分析结果显示，男性、吸烟、噪声、粉尘及噪声粉尘联合暴露均能增加收缩压和舒张压上升的风险。多因素logistic回归结果显示:相比对照组，噪声（OR=2.646）、粉尘（OR=1.713）及噪声和粉尘联合暴露（OR=2.624）能增加人群罹患高血压的风险（P < 0.01）。
结论 噪声、粉尘接触对职业人群的舒张压、收缩压都可产生一定的影响。而同时接触噪声、粉尘危害因素的职业人群罹患高血压的风险可能比单独接触粉尘的人群更高。
     

A longitudinal study of finger systolic blood pressure and exposure to hand-transmitted vibration

Objectives

To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools.

Methods

Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: $ \text{dose} = \sum a_i^m t_iObjectives To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools. Methods Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: , where a _i is the acceleration magnitude on tool i, t _i is the lifetime exposure duration for tool i, and m = 0, 1, 2 or 4. Results Among the HTV workers, the initial prevalence and the 1-year incidence of VWF were 18.1 and 1.7%, respectively. At the first examination, the HTV workers with moderate or severe score for VWF showed a significantly increased cold reaction in the fingers when compared with the controls and the HTV workers with no vascular symptoms. At the follow-up, the controls, the asymptomatic HTV workers, and the prevalent cases of VWF did not show significant changes in the cold response of digital arteries. A deterioration of cold-induced digital vasoconstriction was found in the incident cases of VWF. In the HTV workers, vibration doses with high powers of acceleration (i.e., with m > 1) were major predictors of the vasoconstrictor response to cold at the follow-up examination. Conclusions The measurement of FSBP after local cooling may be a helpful objective test to monitor prospectively the change in vibration-induced vascular symptoms. The findings of this longitudinal study suggest a dose–effect relationship between cold-induced digital arterial hyperresponsiveness over time and measures of cumulative vibration exposure. In the controls, the cold response of the digital arteries was stable over 1-year follow-up period. Work presented at the second International Workshop 2006 on Diagnosis of Hand–Arm Vibration Syndrome in G?teborg, Sweden.     

职业性噪声暴露对个体动态血压和心电图的影响

目的研究职业性连续稳态噪声对暴露者动态血压、心电图等心血管系统指标的影响。方法用自身前后对照的方法,在某企业选出30例接触不同强度连续稳态噪声的劳动者为调查对象,在正常上班的某一天,工作期间对其进行个体动态噪声暴露量、个体动态血压、心电图监测;然后在对象休息的某一天按工作时段进行同样的监测,比较其血压、心率、心电图的变化情况。结果在监测的2个时段,研究对象动态噪声暴露量,动态收缩压、心率、心电图ST段缺血型改变等差异有统计学意义(P<0．01),而舒张压差异无统计学意义(P>0．05)。但心电图、血压等指标的改变与个体动态噪声暴露量(LAeq.8h)均无相关关系(P>0．05)。结论连续稳态职业性噪声暴露可能对劳动个体动态血压、心率、心电图产生影响,长期噪声暴露可能对心血管系统造成一定程度的损害。     

Scleroderma and occupational exposure to hand-transmitted vibration

OBJECTIVES: To determine whether occupational exposure to hand-transmitted vibration is a risk factor for scleroderma (systemic sclerosis, SSc), two case-control studies were conducted in the provinces of Trento and Verona, northeastern Italy. METHODS: In the Trento study, 21 patients with a diagnosis of either systemic or localised scleroderma were recruited from those admitted to all hospitals of the province from 1 January 1976 to 31 December 1991. For each case, two age- and gender-matched controls were selected. In the Verona study, cases included 55 patients diagnosed with SSc and clinically followed at the rheumatology clinic of the local university hospital between 1 January 1997 and 30 June 1999. The controls included 171 subjects frequency-matched by gender and age group. In both studies, all subjects were interviewed by structured questionnaire containing items on personal characteristics, smoking and drinking habits, use of medicines, occupational history and complete medical history. Women were also investigated about silicone implants and cosmetic surgery. Jobs and job tasks involving the use of vibratory tools, with or without concomitant exposure to silica dust in mining and non-mining occupations, were carefully investigated. A minimum criterion of 6 months was required for exposure duration. RESULTS: In the Trento study, men with scleroderma were more likely than controls to have had exposure to hand-transmitted vibration (odds ratio (OR) 1.5, 95% confidence interval (95% CI) 0.1-74.1) or silica dust (OR 5.2, 95% Cl 0.5-74.1), but the association was not significant. The scleroderma patients were miners or stone workers who had operated jackhammers and rock drills. In the Verona study, a greater, although not statistically significant, odds of SSc was observed in men exposed to hand-transmitted vibration (OR 2.4, 95% CI 0.4-14.0) and in women exposed to silica (OR 2.4, 95% Cl 0.4-15.5). The SSc patients with vibration exposure were machinery operators or metal workers who had used grinders and impact wrenches. CONCLUSIONS: Our case-control studies did not show a significant association between scleroderma and hand-transmitted vibration, with or without concomitant exposure to silica dust. Owing to the rarity of the disease and the small number of cases in the present studies, a genetic susceptibility to connective tissue disorders in SSc patients with occupational exposure to hand-transmitted vibration and/or silica cannot be ruled out.     

Combined exposure to noise and vibration and its effects on workers' hearing

OBJECTIVE: To assess the exposure of bus drivers to noise and whole-body vibration (WBV) and to examine the possibility of an association between these risk factors for noise-induced hearing loss. METHODS: A cross-sectional study was carried out among 141 bus drivers who underwent an audiometry test. This group was classified and internally stratified in subgroups of "exposed" and "controls" according to cumulative working time as bus drivers. Their exposure to noise and vibration was assessed. The association between noise-induced hearing loss (NIHL) and the set of explanatory variables was analyzed through logistic regression. RESULTS: The average (+/- standard deviation) weekly noise exposure of front-engine bus drivers was 83.6 +/- 1.9 dB(A), while rear-engine bus drivers were exposed to 77.0 +/- 1.1 dB(A). The weighted average of vibration acceleration was 0.85/m(2). In the best adjusted model, the multivariable analysis showed that age (>44; OR=2.54; 95% CI=1.15-5.62), diabetes (OR=5.46; 95% CI=0.95-31.4), and the level of noise emission [>86.8 dB(A); OR=2.76; 95% CI=1.24-6.15] were risk factors for NIHL. In another model studied, WBV exposure was significant in determining NIHL. CONCLUSIONS: Bus drivers were exposed to significant WBV levels. The noise exposure was more pronounced in front engine than in rear-engine vehicles. No association between WBV exposure and NIHL was observed and no interaction was found between WBV and noise exposure. Further studies are required as other model indicated an association between WBV and NIHL.     

Effects of occupational noise exposure on blood pressure

We measured 24-hour ambulatory blood pressure and 16-hour noise exposure continuously for 20 automobile workers, and used linear mixed-effects regression models to estimate transient and sustained effects of noise exposure on blood pressure. The occupational noise levels of the high-exposure workers with 85 +/- 8 dBA were significantly higher than those of the low-exposure workers with 59 +/- 4 dBA (P < 0.05). We found a significant difference of 16 +/- 6 mm Hg in sleep-time systolic blood pressure (SBP) existed between 2 exposure groups, and a marginal increase of 1 mm Hg SBP per 1-dBA increase in occupational noise exposure at a 60-minute lag time during work (P = 0.07). Occupational noise exposure had both transient and sustained effects on workers' SBP.     

Effect of the magnitude and frequency of hand-transmitted vibration on finger blood flow during and after exposure to vibration

Background  

Acute exposures of the hand to vibration result in changes in finger blood flow, but it is not clear how the changes depend on the characteristics of the vibration.     

Association between vasoconstriction during and following exposure to hand-transmitted vibration

Objectives

This study investigated whether reductions in finger blood flow (FBF) during and after vibration are similarly dependent on the magnitude and duration of the vibration.

Methods

FBF on the left and right hand was measured every minute during, and for 1 h following, exposure of the right hand to one of three magnitudes of 125-Hz sinusoidal vibration (0, 22, or 88 ms^?2 rms) for one of two durations (7.5 or 15 min). Each of five experimental sessions was comprised of five periods: (i) no force and no vibration (5 min), (ii) 2-N force and no vibration (5 min), (iii) 2-N force and vibration (7.5 or 15 min), (iv) 2-N force and no vibration (5 min), and (v) no force and no vibration (60 min).

Results

Vibration reduced FBF in the exposed and unexposed hands, both during and after vibration. With increased magnitude of vibration, there was increased vasoconstriction in all fingers during and after exposure, and longer recovery times after vibration exposure. With increased duration of vibration, there were no changes in vascular responses during exposure but increased vasoconstriction after exposure and prolonged recovery times. With the greater vibration magnitude, the reduction in FBF during exposure was correlated with the time taken to recover after exposure.

Conclusions

Subjects with greater reduction in blood flow during vibration exposure also have stronger and longer vasoconstriction during subsequent recovery. The correlation between vascular changes during and after vibration exposure suggests similar mechanisms control FBF during and after vibration exposure.