産 業 医 学
18巻,
Jap.
J.
COLD
Ind.
Health,
Vol.
WATER
18,
453
1976
IMMERSION
WITH
TEST
VIBRATION Cheng-Po
IN PATIENTS
DISEASE
CHANG†
振動病患者における冷水浸漬試験 張
Peripheral
vascular
disease.
Several
Among
those
used
method
wrist
joint
severe
is
and
safer
and
using
water
tests,
a
joined
this
suffering
10•Ž
in
is
The
milder
in
case
seemed
to
of
water
at
suffer
more
order
5•Ž,
and
that for 10•Ž from
than chest
gin" suggested by Agate2) has been widely accepted. Later, it was found that vibrating tools may cause not only the peripheral vasof
Environmental
School of Medicine for publication, July
* 久留米大学医学部環境衛生学教 室 昭和51年7月6日 受付
Health,
6, 1976
Kurume
to
know
at
10•Ž The
at
the
5•Ž
discomfort
for
can
be
an
both than
effective scores
the the
of suffering
with
students
to
test
the is
so
examinations,
applicability of
generally up
the
group
patients
self-rating
the
during
degree
29
function.
immersed
during the
and
Japan,
hand
suffering
examine
students
water
It has long been known that using handheld vibratory tools may induce peripheral vascular disorder since Loriga (1911) first described "vascular spasm" or white finger in the hands of pneumatic tool miners.1) A similar name "Hakurobyo" (white wax disease) was used to describe the vibration-induced intermittent blanching attacks of the fingers in Japan for some years. However, the name "Raynaud's phenomenon of occupational ori -
University Received
to
vibration
vascular
In the
observed
evaluation.
INTRODUCTION
† Department
been
In
of the
diagnosing
peripheral
applied.
finger
because
Sixteen
used
one
in
the
mostly
of
have
at
symptoms
evaluate
been
However,
that
suggest is
to
has
desirable.
results
important
temperature
performed.
response
most
symptoms
with
was
博*
introduced
minutes.
more
comparison study
study.
patients
10
the
test
skin
warning
method
rewarming was
the
for
unfavorable
milder
of been
immersion the
5•Ž
one
have
water
at
comparative in
is
tests
measure
water
at
of
cold to
some
immediate
And
tests,
in
disorder
kinds
正
a
the
test
during
vibration
the disease
stimulus, revealed and
by
if that
the
the the
patients.
students.
cular disorder but also primary lesions in the musculoskeletal system and the peripheral nervous system.3-5) And some authors (Andreeva-Galanina, Takamatsu and Futatsuka, Matoba et al.)6-8) emphasized that central nervous system can also be affected. Thus, "vibration disease" has now been considered as an entity of systemic disease in Japan. Some cases with symptoms of vibration disease have been reported in Japan since 1938.4) However, systematic researches on the disease had not been done until 1965 when the outbreak of a large number of patients with vibration disease among chain saw operators became a nationwide social problem.9,10) A series of epidemiologic studies revealed the severe situation with vibration disease among the forest workers throughout Japan. Peripheral vascular disorder is one of the most important symptoms in diagnosing vibration disease. Several kinds of tests have been
454
産 業 医 学
used
to
tion 4,11)
evaluate
or to Among
test
has
1)
it
been
can in
before
mostly
the
as
and
and
ing
it
is
immersion
three
occurs,
2)
test the
economic
test
as
was
also
a
se
is
measure
the
the
of
joint
get
water
screen-
of
pre-shock
test
state
tests
So,
more
be
raise
a
ing
suffering
safer
durnot
cases
water
method
practicable
method the
examine
the
water
at to
10•Ž
a
inarily
in
reduce
in
the
comparison
the
of
used.
study and
was
then
by
5•Ž,
figures
at
the
patients
of
with
in
severe
slight
the
1.
Preliminary
1) students in
these
studies.
the
then
about
2)
were
in
They
4
22.6)
1)
into
later
by
other
by
the
the
8
two
examintest
first,
two
tests
versa
sequence. The
subjects
drink
as
little
day,
and
no
hour
before
room.13)
were as
smoking they
They
take
extra
the
morning
asked
possible was entered were
exercise of
to
also and
the
smoke
and
the
previous
since allowed the
since
one
was was
out
contraindicated
and
30
minutes
test
was Two
later,
to
hands
immersed
respectively.
thermosensory
not
to
since
phalanx
examination
day.
They
the
nail,
to of by
the the
the
exBlood.
examinatest
to
rule
Then, and to
they
the
detail
them.
water
About
immersion
thermometers and
the
For part
attached
exposure
general
for day.
the
cold
thermistor
applied
thermal
the
physical
explained the
the ques-
out.
of the
on
relaxed
was
and him.
simple
previous and
chairs
carried sets
for
conditions.
in
chest
room, a
before
procedure
hand
the
hard
items
the
sub-
immersed in
conditions
performed
seated
the
26
measured
tion
the
answer
mental
day
pressure
to
examination
instructed
and
of
(group vice
including
physical
were
5•Ž-water
students
tionnaire
amination
joined
were
immersion
The
medical
divided
(group
hours
examined
(ave.
were
students
test.
male
years
10•Ž-water
immersion
students
healthy
19-26
Eight
by
in
Sixteen
aged
groups. ed
studies
Subjects.
to
For the
examination
asked
three sensa-
that
is fairly the
were
evalof
suffering.
means
in
5
subjects
tightness
sensation
suffering
into 3=fair;
number
pain,
423
pain
entering
subjects
scored
general
tightness
general After
METHODS
to
number
tightness
subjective
a
5 in
suffering.
The
by
and
1 to
2=slight;
their
suffering
the
was
all;
report
chest
feels
with
AND
the
hand, general
item
corresponding
tion
ject
disease.
SUBJECTS
the
during
expressed
5=extreme. to
A
container.
grade
was
at
and
instance,
prelim-
each
was
suffering from
and
10•Ž
water
the
immersed
1=not
instructed
uation
the
chest,
ap-
and
immersion.
as
scale
the
of
i.e.
were
using
during made
in
to
used
suffering
the
severity
grades,
The
was
in
in
5•Ž
the
evaluate
pain
All and
were
at
during
The
of
tem-
10a.m.
temperature
self-rating
4=severe;
suffer-
that
suffering
to
order
test
with
degree
students
the In
to a
sensation
seems
test. of
comparative
vibration
to
immersion applicability
know
tests,
temperature
slowly
order test,
wind
25.2•Ž.
between
controlled
icebox
terms
group
milder
In the
The the
outdoor
and
accuracy.
very
was
with
during
and
stirred
was
22.5•Ž.
The
water
were
waterproof
could
several
they
the
1975.
of
within •}0.5•Ž
the
minutes.12)
subjects
observed
a
to
plied,
they at
and
22.1
conducted
October
but
temperature and
0.3m/sec.
kinds
The
the
during
and
10
severe
to
desirable.
To
in
1976
clothes
70-75%,
between
were
4p.m.
from up
for
and
were
examinations. is
5•Ž
the
is
temperature
some
the
used
immersed
at
immersion,
through
skin
hand
because
the
generally
in
the
in
However, ing
method
change
finger
wrist
than was
Two
Japan,
one
less
the
room
18,
liked, of
20.5
around
Vol.
they
kinds
The
was
Health,
as
between
perature
test. In
Methods.
can
per
same
maintained
Raynaud's
procedure
dress
tests.
humidity
it
for
to the
two 2)
early
J. Ind.
dress
to
function
vascular
3)
an
the
Jap.
allowed
had
reasons: of
peripheral
phenomenon, simple
water for
provocative
were
func-
phenomenon.2-
information
disorder
a
vascular
used
the
obvious
used
peripheral
Raynaud's tests , cold
give
change
be
the
provoke those
18巻,
of dorsal
middle
means
the
of
each
adhesive
hand,
the
thermometer
surface finger,
were
non-immersed
of just
was the
distal
proximal tape.
And
to to
産 業 医 学
the
18巻,
finger
Jap.
to
vaseline
be
was
and
the
J.
Ind.
Health,
immersed
applied
borders
a
over of
Vol.
thin
the
the
18,
layer
of
adhesive
tape
455
1976
for
tape
making
it
waterproof. The
finger
were before
(for
age
5
30
of
the
initial
their
the
been
finger
bath
height
of
the
subject
water
water could
without
the
trunk.
the
immersed
water,
wiped
armrest for
and
30
ing
to and
other
after
the
the
different the
water
same
been again
to
between test
they To
sponse
were suffering
be
durand
expressed
about
4
the
and
10°C)
two
were
hours test
or
of with
tests
had
interviewed
difference
tests
inter-
immersion (5°C
the
two
the
continued
of
And
subjects
describe the
the on
subjects
not
After
the
rested
immersion,
second
procedure.
and
immersion,
were
temperature
finished,
the
arm
from
and
could
the
in
the
of
10-minute
scale.
took
the that
relaxed of
course
that
The and
removed
the
the
self-rating they
hand
towel
5•Ž)
so adjusted
minutes
Then
sufferings
later,
was
posture
describe
or
chair
recordings
minutes.
viewed
(10•Ž
the
was
had immersed
beside
with
the
was
minutes.
10
dry
minute.
temperature
water
his
the
report
according one
10
put
hand
to
for
awkward After
At
asked
hand
level
5
regarded
suffering
cold
put
the
was
skin
joint
was
and aver-
every
right
wrist
water
the
of
finger the
the
min),
temperature.
scale
well-stirred
to
hands minute
during
were
feeling
initial
the
up
skin
subjects
recorded,
into
10
immersion
self-rating
After
(for
temperature
the
both one
immersion. -The
the
subjective the
during
to
time,
to
of every
the
skin
prior
same
by
min)
min)
the
minutes
temperatures
simultaneously
(for
after
as
skin
taken
in to
suffering
report
which
preferred.
evaluate after
indices
were
the the
immediate
rewarming
10-minute
used
in
this
immersion, study
rethree
:
(a )
Recovery
activity14)
(b)
Rewarmingrate=(T13-T10)/3
(℃/min)
(℃/min)
(c )
Recovery
Where
To:
(%)
rate the
initial
skin
temperature
of the immersed finger (the average skin temp. during the 5 minutes before the immer sion) T10: the skin temperature of the immersed finger at the end of the 10-minute immersion T11: the skin temperature of the immersed finger one minute after removal of the hand from the water T12: the skin temperature of the immersed finger two minutes after removal of the hand from the water T13: the skin temperature of the immersed finger three minutes after removal of the hand from the water 2. Studies in patients with vibration disease 1) Subjects. Twenty-nine newly hospitalized male patients with vibration disease, aged 3256 years (ave. 46.8), participated in these studies. Sixteen of them (55.2%) were at the stage II and the other thirteen (44.8%) were at the stage III according to the AndreevaGalanina' s classification. Twenty-seven of the patients were chain saw operators with an average job history of 11.6±5.1 years (2-18.3 ys), and the other two patients were bush cleaner operators with job histories of 12.1 and 16.7 years. Of the 29 patients, 13 had history of Raynaud's phenomenon in the past however, only 4 of the 13 patients had Ray naud' s phenomenon within one year prior to their hospitalization. 2) Methods. In consideration of the patients' physical and mental conditions and to avoid any interference with the treatment scheme, the two tests were performed on different days (the 4th and 5th or the 5th and 6th days of hospitalization) but at the same hour of the day. According to the treatment scheme, medication would be given from the 7th hospitalization day, after several kinds of precise examinations were completed. As usual, the worse hand that the patient felt was used for immersion. The skin temperature was taken from the worst finger among the index, middle and ring fingers, and the
456
産 業 医 学
skin
temperature
other
hand
the
test
of
lowed
in
the
the
studies
All
the
November the
peratures
of in
the
seldom
The
of
was
days
of
outdoor days
in
the
thought
be
and
rhythm.
patients since
of
to
morning
the
they
will a
after
the
was
The
the
im-
during students
It
it
remarkable
initial
tests
was
skin less
of
such
temperature
each
on
the
patient,
temperature than
the
(which
influence For
the
circadian
that
skin
the
in
tests
seemed
not
to
results two
initial
response.
as
the
later), the
was
test
such
the
by second
due
immersion
of
skin
the
was
from
in
initial increased
when
reasons
in cause
changes
16
performed.
first
presented
two
the
increase
response
difference
for
students
However,
not
of both hands
afternoon
other
rewarming
RESULTS
the
the
difference
did
hospitalization.
of
four
the of
be
dur-
respectively.
test
rewarming
outdoor
lessened
in
or
courses
state.
whether
21-
18, 1976
temperature
the
tests
patients
of
influence
tem-
the
immersion
2-3•Ž
sure
Vol.
non-immersed
Pre-immersion
immersion
skin
2 show
the
29
Health.
temperatures
temperatures
was
were
hospital
the
The
November
influence
two
and
about
around
room
Because
the
of
system.
12.5-13.2•Ž
out
temperature
at
examination
hospitalized,
three
22.5•Ž.
the
Ind.
finger
and
skin and
1)
wards
examination
December.
came
were
mersed
J.
test
1
finger
October,
The
heating
the and
different
in
the
Figures in
pre-
Jap.
Changes ing
fol-
the
in
1975.
1.
different
in
conducted
central
October, in
on
air-conditioned
of
6-7•Ž
used
the took
students.
were
21.0
22•Ž
those
of
were
5•Ž
from
were
between
and
at
nothing
December
the
first
was
and
by
patients
water
tests
temperature
finger
the
there
in
hospital
20-24•Ž
10•Ž
of
methods
same
All
at
test
Otherwise
liminary
the
read.
water
by
days.
of
was
18巻,
the between
2•Ž
and
could
be
the
rewarm-
neglected. As
to
the
response no
cold
the
of
students
scores
were
for
for
groups
self-rating
the
in
both
of
of
the
suffering
will
initial
the
two
ing
response
and
patients.
the the
selftests
between the
no skin
not
significant
correlation
temperature
and
for
both
Though
temperature than
the
results
presented
was
the
during
So, be
There
was
immersed
aspects
students.
the
there
However,
some
scores
degree
between
hands.
different
two
the immersion,
difference
non-immersed
rating
and water
significant
groups
by
pattern
to
of
that
of
the the
the
statistically
the
patients,
students
average
students
between
was the
and initial a little
difference
the skin
higher was
significant.
of
separately
groups.
Fig.
1.
Changes
ing the Vertical The
in finger
two immersion bars indicate
initial
skin
skin temperature to the immersion.
skin temperature
dur-
tests for the students. standard errors.
temperature during
was the
the
5 minutes
average prior
Fig. 2. Changes in finger skin temperature during the two immersion tests for the patients. Vertical The skin
bars
indicate
initial skin temperature
to the
immersion.
standard
errors.
temperature was the average during the 5 minutes prior
産 業 医 学
18巻,
Table
(All of
1.
the
Jap.
J.
Ind.
Evaluation
index
are
for
Vol.
18,
of the rewarming
values
significance
Health,
the
response
mean•}S.E.),
difference
457
1976
after
*Correlation between
the
the
10-minute
coefficient
students
(5•Ž
and
the
immersion
by different
vs.
**p
18巻,
Jap.
J.
COLD
Ind.
Health,
Vol.
WATER
18,
453
1976
IMMERSION
WITH
TEST
VIBRATION Cheng-Po
IN PATIENTS
DISEASE
CHANG†
振動病患者における冷水浸漬試験 張
Peripheral
vascular
disease.
Several
Among
those
used
method
wrist
joint
severe
is
and
safer
and
using
water
tests,
a
joined
this
suffering
10•Ž
in
is
The
milder
in
case
seemed
to
of
water
at
suffer
more
order
5•Ž,
and
that for 10•Ž from
than chest
gin" suggested by Agate2) has been widely accepted. Later, it was found that vibrating tools may cause not only the peripheral vasof
Environmental
School of Medicine for publication, July
* 久留米大学医学部環境衛生学教 室 昭和51年7月6日 受付
Health,
6, 1976
Kurume
to
know
at
10•Ž The
at
the
5•Ž
discomfort
for
can
be
an
both than
effective scores
the the
of suffering
with
students
to
test
the is
so
examinations,
applicability of
generally up
the
group
patients
self-rating
the
during
degree
29
function.
immersed
during the
and
Japan,
hand
suffering
examine
students
water
It has long been known that using handheld vibratory tools may induce peripheral vascular disorder since Loriga (1911) first described "vascular spasm" or white finger in the hands of pneumatic tool miners.1) A similar name "Hakurobyo" (white wax disease) was used to describe the vibration-induced intermittent blanching attacks of the fingers in Japan for some years. However, the name "Raynaud's phenomenon of occupational ori -
University Received
to
vibration
vascular
In the
observed
evaluation.
INTRODUCTION
† Department
been
In
of the
diagnosing
peripheral
applied.
finger
because
Sixteen
used
one
in
the
mostly
of
have
at
symptoms
evaluate
been
However,
that
suggest is
to
has
desirable.
results
important
temperature
performed.
response
most
symptoms
with
was
博*
introduced
minutes.
more
comparison study
study.
patients
10
the
test
skin
warning
method
rewarming was
the
for
unfavorable
milder
of been
immersion the
5•Ž
one
have
water
at
comparative in
is
tests
measure
water
at
of
cold to
some
immediate
And
tests,
in
disorder
kinds
正
a
the
test
during
vibration
the disease
stimulus, revealed and
by
if that
the
the the
patients.
students.
cular disorder but also primary lesions in the musculoskeletal system and the peripheral nervous system.3-5) And some authors (Andreeva-Galanina, Takamatsu and Futatsuka, Matoba et al.)6-8) emphasized that central nervous system can also be affected. Thus, "vibration disease" has now been considered as an entity of systemic disease in Japan. Some cases with symptoms of vibration disease have been reported in Japan since 1938.4) However, systematic researches on the disease had not been done until 1965 when the outbreak of a large number of patients with vibration disease among chain saw operators became a nationwide social problem.9,10) A series of epidemiologic studies revealed the severe situation with vibration disease among the forest workers throughout Japan. Peripheral vascular disorder is one of the most important symptoms in diagnosing vibration disease. Several kinds of tests have been
454
産 業 医 学
used
to
tion 4,11)
evaluate
or to Among
test
has
1)
it
been
can in
before
mostly
the
as
and
and
ing
it
is
immersion
three
occurs,
2)
test the
economic
test
as
was
also
a
se
is
measure
the
the
of
joint
get
water
screen-
of
pre-shock
test
state
tests
So,
more
be
raise
a
ing
suffering
safer
durnot
cases
water
method
practicable
method the
examine
the
water
at to
10•Ž
a
inarily
in
reduce
in
the
comparison
the
of
used.
study and
was
then
by
5•Ž,
figures
at
the
patients
of
with
in
severe
slight
the
1.
Preliminary
1) students in
these
studies.
the
then
about
2)
were
in
They
4
22.6)
1)
into
later
by
other
by
the
the
8
two
examintest
first,
two
tests
versa
sequence. The
subjects
drink
as
little
day,
and
no
hour
before
room.13)
were as
smoking they
They
take
extra
the
morning
asked
possible was entered were
exercise of
to
also and
the
smoke
and
the
previous
since allowed the
since
one
was was
out
contraindicated
and
30
minutes
test
was Two
later,
to
hands
immersed
respectively.
thermosensory
not
to
since
phalanx
examination
day.
They
the
nail,
to of by
the the
the
exBlood.
examinatest
to
rule
Then, and to
they
the
detail
them.
water
About
immersion
thermometers and
the
For part
attached
exposure
general
for day.
the
cold
thermistor
applied
thermal
the
physical
explained the
the ques-
out.
of the
on
relaxed
was
and him.
simple
previous and
chairs
carried sets
for
conditions.
in
chest
room, a
before
procedure
hand
the
hard
items
the
sub-
immersed in
conditions
performed
seated
the
26
measured
tion
the
answer
mental
day
pressure
to
examination
instructed
and
of
(group vice
including
physical
were
5•Ž-water
students
tionnaire
amination
joined
were
immersion
The
medical
divided
(group
hours
examined
(ave.
were
students
test.
male
years
10•Ž-water
immersion
students
healthy
19-26
Eight
by
in
Sixteen
aged
groups. ed
studies
Subjects.
to
For the
examination
asked
three sensa-
that
is fairly the
were
evalof
suffering.
means
in
5
subjects
tightness
sensation
suffering
into 3=fair;
number
pain,
423
pain
entering
subjects
scored
general
tightness
general After
METHODS
to
number
tightness
subjective
a
5 in
suffering.
The
by
and
1 to
2=slight;
their
suffering
the
was
all;
report
chest
feels
with
AND
the
hand, general
item
corresponding
tion
ject
disease.
SUBJECTS
the
during
expressed
5=extreme. to
A
container.
grade
was
at
and
instance,
prelim-
each
was
suffering from
and
10•Ž
water
the
immersed
1=not
instructed
uation
the
chest,
ap-
and
immersion.
as
scale
the
of
i.e.
were
using
during made
in
to
used
suffering
the
severity
grades,
The
was
in
in
5•Ž
the
evaluate
pain
All and
were
at
during
The
of
tem-
10a.m.
temperature
self-rating
4=severe;
suffer-
that
suffering
to
order
test
with
degree
students
the In
to a
sensation
seems
test. of
comparative
vibration
to
immersion applicability
know
tests,
temperature
slowly
order test,
wind
25.2•Ž.
between
controlled
icebox
terms
group
milder
In the
The the
outdoor
and
accuracy.
very
was
with
during
and
stirred
was
22.5•Ž.
The
water
were
waterproof
could
several
they
the
1975.
of
within •}0.5•Ž
the
minutes.12)
subjects
observed
a
to
plied,
they at
and
22.1
conducted
October
but
temperature and
0.3m/sec.
kinds
The
the
during
and
10
severe
to
desirable.
To
in
1976
clothes
70-75%,
between
were
4p.m.
from up
for
and
were
examinations. is
5•Ž
the
is
temperature
some
the
used
immersed
at
immersion,
through
skin
hand
because
the
generally
in
the
in
However, ing
method
change
finger
wrist
than was
Two
Japan,
one
less
the
room
18,
liked, of
20.5
around
Vol.
they
kinds
The
was
Health,
as
between
perature
test. In
Methods.
can
per
same
maintained
Raynaud's
procedure
dress
tests.
humidity
it
for
to the
two 2)
early
J. Ind.
dress
to
function
vascular
3)
an
the
Jap.
allowed
had
reasons: of
peripheral
phenomenon, simple
water for
provocative
were
func-
phenomenon.2-
information
disorder
a
vascular
used
the
obvious
used
peripheral
Raynaud's tests , cold
give
change
be
the
provoke those
18巻,
of dorsal
middle
means
the
of
each
adhesive
hand,
the
thermometer
surface finger,
were
non-immersed
of just
was the
distal
proximal tape.
And
to to
産 業 医 学
the
18巻,
finger
Jap.
to
vaseline
be
was
and
the
J.
Ind.
Health,
immersed
applied
borders
a
over of
Vol.
thin
the
the
18,
layer
of
adhesive
tape
455
1976
for
tape
making
it
waterproof. The
finger
were before
(for
age
5
30
of
the
initial
their
the
been
finger
bath
height
of
the
subject
water
water could
without
the
trunk.
the
immersed
water,
wiped
armrest for
and
30
ing
to and
other
after
the
the
different the
water
same
been again
to
between test
they To
sponse
were suffering
be
durand
expressed
about
4
the
and
10°C)
two
were
hours test
or
of with
tests
had
interviewed
difference
tests
inter-
immersion (5°C
the
two
the
continued
of
And
subjects
describe the
the on
subjects
not
After
the
rested
immersion,
second
procedure.
and
immersion,
were
temperature
finished,
the
arm
from
and
could
the
in
the
of
10-minute
scale.
took
the that
relaxed of
course
that
The and
removed
the
the
self-rating they
hand
towel
5•Ž)
so adjusted
minutes
Then
sufferings
later,
was
posture
describe
or
chair
recordings
minutes.
viewed
(10•Ž
the
was
had immersed
beside
with
the
was
minutes.
10
dry
minute.
temperature
water
his
the
report
according one
10
put
hand
to
for
awkward After
At
asked
hand
level
5
regarded
suffering
cold
put
the
was
skin
joint
was
and aver-
every
right
wrist
water
the
of
finger the
the
min),
temperature.
scale
well-stirred
to
hands minute
during
were
feeling
initial
the
up
skin
subjects
recorded,
into
10
immersion
self-rating
After
(for
temperature
the
both one
immersion. -The
the
subjective the
during
to
time,
to
of every
the
skin
prior
same
by
min)
min)
the
minutes
temperatures
simultaneously
(for
after
as
skin
taken
in to
suffering
report
which
preferred.
evaluate after
indices
were
the the
immediate
rewarming
10-minute
used
in
this
immersion, study
rethree
:
(a )
Recovery
activity14)
(b)
Rewarmingrate=(T13-T10)/3
(℃/min)
(℃/min)
(c )
Recovery
Where
To:
(%)
rate the
initial
skin
temperature
of the immersed finger (the average skin temp. during the 5 minutes before the immer sion) T10: the skin temperature of the immersed finger at the end of the 10-minute immersion T11: the skin temperature of the immersed finger one minute after removal of the hand from the water T12: the skin temperature of the immersed finger two minutes after removal of the hand from the water T13: the skin temperature of the immersed finger three minutes after removal of the hand from the water 2. Studies in patients with vibration disease 1) Subjects. Twenty-nine newly hospitalized male patients with vibration disease, aged 3256 years (ave. 46.8), participated in these studies. Sixteen of them (55.2%) were at the stage II and the other thirteen (44.8%) were at the stage III according to the AndreevaGalanina' s classification. Twenty-seven of the patients were chain saw operators with an average job history of 11.6±5.1 years (2-18.3 ys), and the other two patients were bush cleaner operators with job histories of 12.1 and 16.7 years. Of the 29 patients, 13 had history of Raynaud's phenomenon in the past however, only 4 of the 13 patients had Ray naud' s phenomenon within one year prior to their hospitalization. 2) Methods. In consideration of the patients' physical and mental conditions and to avoid any interference with the treatment scheme, the two tests were performed on different days (the 4th and 5th or the 5th and 6th days of hospitalization) but at the same hour of the day. According to the treatment scheme, medication would be given from the 7th hospitalization day, after several kinds of precise examinations were completed. As usual, the worse hand that the patient felt was used for immersion. The skin temperature was taken from the worst finger among the index, middle and ring fingers, and the
456
産 業 医 学
skin
temperature
other
hand
the
test
of
lowed
in
the
the
studies
All
the
November the
peratures
of in
the
seldom
The
of
was
days
of
outdoor days
in
the
thought
be
and
rhythm.
patients since
of
to
morning
the
they
will a
after
the
was
The
the
im-
during students
It
it
remarkable
initial
tests
was
skin less
of
such
temperature
each
on
the
patient,
temperature than
the
(which
influence For
the
circadian
that
skin
the
in
tests
seemed
not
to
results two
initial
response.
as
the
later), the
was
test
such
the
by second
due
immersion
of
skin
the
was
from
in
initial increased
when
reasons
in cause
changes
16
performed.
first
presented
two
the
increase
response
difference
for
students
However,
not
of both hands
afternoon
other
rewarming
RESULTS
the
the
difference
did
hospitalization.
of
four
the of
be
dur-
respectively.
test
rewarming
outdoor
lessened
in
or
courses
state.
whether
21-
18, 1976
temperature
the
tests
patients
of
influence
tem-
the
immersion
2-3•Ž
sure
Vol.
non-immersed
Pre-immersion
immersion
skin
2 show
the
29
Health.
temperatures
temperatures
was
were
hospital
the
The
November
influence
two
and
about
around
room
Because
the
of
system.
12.5-13.2•Ž
out
temperature
at
examination
hospitalized,
three
22.5•Ž.
the
Ind.
finger
and
skin and
1)
wards
examination
December.
came
were
mersed
J.
test
1
finger
October,
The
heating
the and
different
in
the
Figures in
pre-
Jap.
Changes ing
fol-
the
in
1975.
1.
different
in
conducted
central
October, in
on
air-conditioned
of
6-7•Ž
used
the took
students.
were
21.0
22•Ž
those
of
were
5•Ž
from
were
between
and
at
nothing
December
the
first
was
and
by
patients
water
tests
temperature
finger
the
there
in
hospital
20-24•Ž
10•Ž
of
methods
same
All
at
test
Otherwise
liminary
the
read.
water
by
days.
of
was
18巻,
the between
2•Ž
and
could
be
the
rewarm-
neglected. As
to
the
response no
cold
the
of
students
scores
were
for
for
groups
self-rating
the
in
both
of
of
the
suffering
will
initial
the
two
ing
response
and
patients.
the the
selftests
between the
no skin
not
significant
correlation
temperature
and
for
both
Though
temperature than
the
results
presented
was
the
during
So, be
There
was
immersed
aspects
students.
the
there
However,
some
scores
degree
between
hands.
different
two
the immersion,
difference
non-immersed
rating
and water
significant
groups
by
pattern
to
of
that
of
the the
the
statistically
the
patients,
students
average
students
between
was the
and initial a little
difference
the skin
higher was
significant.
of
separately
groups.
Fig.
1.
Changes
ing the Vertical The
in finger
two immersion bars indicate
initial
skin
skin temperature to the immersion.
skin temperature
dur-
tests for the students. standard errors.
temperature during
was the
the
5 minutes
average prior
Fig. 2. Changes in finger skin temperature during the two immersion tests for the patients. Vertical The skin
bars
indicate
initial skin temperature
to the
immersion.
standard
errors.
temperature was the average during the 5 minutes prior
産 業 医 学
18巻,
Table
(All of
1.
the
Jap.
J.
Ind.
Evaluation
index
are
for
Vol.
18,
of the rewarming
values
significance
Health,
the
response
mean•}S.E.),
difference
457
1976
after
*Correlation between
the
the
10-minute
coefficient
students
(5•Ž
and
the
immersion
by different
vs.
**p
