Raynaud′s phenomenon among men and women with noise-induced hearing loss in relation to vibration exposure

Thrombosed Persistent Median Artery with Coexisting Bifid Median Nerve in a Robotic Arthroplasty Surgeon: A Case Report

CASE

A 47-year-old orthopaedic surgeon presented with acute volar left wrist pain. He performed over 250 robot-assisted knee arthroplasties each year. Color Doppler evaluation revealed bilateral persistent median arteries and bifid median nerves, with focal occlusive thrombosis of the left median artery. He was advised rest and oral aspirin. He could return to his professional activities after 1 month. He had no recurrence of symptoms at 1 year of follow-up.

CONCLUSION

Orthopaedic surgeons use vibrating hand tools on a daily basis. The possibility of hand-arm vibration syndrome must be considered in the differential diagnosis of wrist pain among orthopaedic surgeons.

Proposal of Combined Noise and Hand-Arm Vibration Index for Occupational Exposure: Application to a Study Case in the Olive Sector

In many production and industrial sectors, workers are exposed to noise and hand-arm vibrations (HAV). European directives have established the maximum limit values or exposure action values for noise and vibration independently. However, in many cases, workers who endure hand-arm vibration also receive high noise levels. This research suggests a procedure to aid the establishment of precautionary measures for workers with simultaneous exposure to both physical agents. This procedure defines a combined index based on the energy doses for both noise and HAV. From this combined index, the suggested methodology allows a recommended exposure time for workers with simultaneous noise and HAV exposure to be calculated. This methodology can be adapted to tackle the relative importance assigned to both agents according to the safety manager and new knowledge on combined health effects. To test this method, a measurement campaign under real working conditions was conducted with workers from the olive fruit-harvesting sector, where a variety of hand-held machinery is used. The results of the study case show that the suggested procedure can obtain reliable exposure time recommendations for simultaneous noise and HAV exposures and is therefore a useful tool for establishing prevention measures.

Occupational noise exposure and Raynaud's phenomenon: a nested case-control study

The primary aim of this study was to determine if self-reported occupational noise exposure was associated with Raynaud’s phenomenon. In northern Sweden, a nested case–control study was performed on subjects reporting Raynaud’s phenomenon (N=461), and controls (N=763) matched by age, sex and geographical location. The response rate to the exposure questionnaire was 79.2%. The study showed no statistically significant association between occupational noise exposure and reporting Raynaud’s phenomenon (OR 1.10; 95% CI 0.83–1.46) in simple analyses. However, there was a trend towards increasing OR for Raynaud’s phenomenon with increasing noise exposure, although not statistically significant. Also, there was a significant association between noise exposure and hearing loss (OR 2.76; 95% CI 2.00–3.81), and hearing loss was associated with reporting Raynaud’s phenomenon (OR 1.52; 95% CI 1.03–2.23) in a multiple regression model. In conclusion, self-reported occupational noise exposure was not statistically significantly associated with Raynaud’s phenomenon, but there was a dose–effect trend. In addition, the multiple model showed a robust association between hearing loss and Raynaud’s phenomenon. These findings offer some support for a common pathophysiological background for Raynaud’s phenomenon and hearing loss among noise-exposed workers, possibly through noise-induced vasoconstriction.

The Association Between Occupational Exposure to Hand-Arm Vibration and Hearing Loss: A Systematic Literature Review

Background

Hearing loss is one of the most prevalent worker health conditions worldwide. Although the effect of noise exposure on hearing is well researched, other workplace exposures may account for significant hearing loss. The aim of this review was to determine whether occupational hand–arm vibration exposure through use of power or pneumatic tools, independent of noise exposure, is associated with permanent hearing loss. Do workers suffer from hand–arm vibration–induced hearing loss?

Methods

Peer-reviewed articles published in English between 1981 and 2020 were identified through five online databases with five search keywords. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, including online database search methodology, study selection, article exclusion, and assessment of potential study design confounders and biases, were followed.

Results

Database searches retrieved 697 articles. Fifteen articles that reported 17 studies met the criteria for review. All but two studies revealed statistically significant associations between occupational exposure to hand–arm vibration and hearing loss. The majority of the study results revealed associations between hand–arm vibration and hearing loss, independent of potential age and noise confounders.

Conclusion

Few studies have examined the association between occupational exposure to hand–arm vibration and hearing loss. Dose response data were limited as only one study measured vibration intensity and duration. Although the majority of studies identified statistically significant associations, causal relationships could not be determined. Further research using standardized and uniform measurement protocols is needed to confirm whether the association between occupational exposure to hand–arm vibration and permanent hearing loss is causal and the mechanism(s).

Raynaud's phenomenon in the occupational context

OBJECTIVE

To review articles that evaluated the prevalence of Raynaud's phenomenon of occupational origin.

METHODS

The search for articles was carried out in the Medline (via PubMed), Embase, Web of Science, Scientific Electronic Library Online (SciELO), and Latin America and Caribbean Health Sciences Literature (Lilacs) databases.

RESULTS

64 articles were obtained from the electronic search; 18 articles met the eligibility criteria. All studies discussed the exposure to vibrations in the upper limbs. In 6 of them, the thermal issue was directly or indirectly addressed. No studies have addressed exposure to vinyl chloride.

CONCLUSIO

In general, a higher prevalence of Raynaud's phenomenon was found among vibratory tool operators compared to non-exposed workers, with an increase in the number of cases the higher the level of vibration and the time of exposure. Cold is a triggering and aggravating factor of the Raynaud phenomenon and seems to play an important role in the emergence of vascular manifestations of the hand-arm vibration syndrome.