目的:与振动暴露有关的手和前臂疾病的发生,根据相关背景因素进行调整,几乎没有报道。我们在一个大的人群中分析了这种情况的患病率,按性别分层,以及与振动手持工具接触的关联。
方法:这是一项回顾性队列研究。
方法:询问了马尔默饮食与癌症研究队列(MDCS;纳入1991-1996;直到2018年)中的个人,\'您的工作涉及使用振动手持工具吗?\'(响应:\'根本没有\',\'一些\'和\'很多\')。数据与国家登记册交叉链接,以确定腕管综合征(CTS)的治疗方法,尺神经卡压(UNE),Dupuytren病,触发指或第一腕掌关节(CMC-1)骨关节炎(OA)。Cox回归模型,未调整和调整(年龄,性别,普遍存在的糖尿病,吸烟,高血压和饮酒),进行了分析报告的振动暴露的影响。
方法:MDCS中回答了振动暴露问卷的个人(MDCS中最初的30446人中有14342人)被纳入研究。
结果:总计,12220/14342个人(76%)报告“没有”接触,1392/14342(9%)\“一些\”和730/14342(5%)\“大量\”暴露于振动的手持工具。在男人中,“多”暴露与CTS(HR1.71(95%CI1.11至2.62))和UNE(HR2.42(95%CI1.15至5.07))独立相关。某些暴露与男性UNE独立相关(HR2.10(95%CI1.12至3.95))。“大量暴露”与女性的触发手指独立相关(HR2.73(95%CI1.49至4.99))。我们发现振动暴露对Dupuytren病或CMC-1OA没有影响。“大量振动暴露可预测男性的手部和前臂诊断(HR1.44(95%CI1.08至1.80)),但不是女人。
结论:手持工具的振动暴露会增加发生CTS和UNE以及男性常见的手部和前臂疾病的风险,而女性仅有触发手指和CMC-1OA的风险。调整振动暴露中的相关混杂因素至关重要。
OBJECTIVE: The occurrence of hand and forearm disorders related to vibration exposure, adjusted for relevant background factors, is scarcely reported. We analysed the prevalence of such conditions in a large population cohort, stratified by sex, and associations with exposure to vibrating hand-held tools.
METHODS: This is a retrospective cohort
study.
METHODS: Individuals in the Malmö Diet and Cancer
Study cohort (MDCS; inclusion 1991-1996; followed until 2018) were asked, \'does your work involve working with vibrating hand-held tools?\' (response: \'not at all\', \'some\' and \'much\'). Data were cross-linked with national registers to identify treatment for carpal tunnel syndrome (CTS), ulnar nerve entrapment (UNE), Dupuytren\'s disease, trigger finger or first carpometacarpal joint (CMC-1) osteoarthritis (OA). Cox regression models, unadjusted and adjusted (age, sex, prevalent diabetes, smoking, hypertension and alcohol consumption), were performed to analyse the effects of reported vibration exposure.
METHODS: Individuals in the MDCS who had answered the questionnaire on vibration exposure (14 342 out of the originally 30 446 individuals in MDCS) were included in the
study.
RESULTS: In total, 12 220/14 342 individuals (76%) reported \'no\' exposure, 1392/14 342 (9%) \'some\' and 730/14 342 (5%) \'much\' exposure to vibrating hand-held tools. In men, \'much\' exposure was independently associated with CTS (HR 1.71 (95% CI 1.11 to 2.62)) and UNE (HR 2.42 (95% CI 1.15 to 5.07)). \'Some\' exposure was independently associated with UNE in men (HR 2.10 (95% CI 1.12 to 3.95)). \'Much\' exposure was independently associated with trigger finger in women (HR 2.73 (95% CI 1.49 to 4.99)). We found no effect of vibration exposure on Dupuytren\'s disease or CMC-1 OA. \'Much\' vibration exposure predicted any hand and forearm diagnosis in men (HR 1.44 (95% CI 1.08 to 1.80)), but not in women.
CONCLUSIONS: Vibration exposure by hand-held tools increases the risk of developing CTS and UNE and any common hand and forearm conditions in men, whereas women only risk trigger finger and CMC-1 OA. Adjustment for relevant confounders in vibration exposure is crucial.