The present study was performed to assess peripheral neural involvement by exposure to hand-arm vibration. Segmental sensory nerve conduction in the median and ulnar nerves were measured in shipyard workers exposed to vibration. The subjects were 47 male adults exposed to hand-arm vibration and 7 healthy male controls. The subjects underwent an extensive bilateral neurophysiological examination. Sensory compound nerve action potential (SNAP) of the median and ulnar nerves in palm-finger and wrist-palm segments were measured by antidromic method. And SNAP of the median and ulnar nerves in wrist-proximal finger and wrist-distal finger segments were measured by orthodromic method. Result of sensory nerve conduction study was abnormal in 31 patients $(66\%)$ and normal in 16 patients $(34\%)$ of subjects. The pathological pattern in the hand-arm vibration exposed group was 13 patients $(28\%)$ of carpal tunnel syndrome, 18 patients $(38\%)$ of distal sensory neuropathy, 7 patients $(15\%)$ of multifocal and 1 patient $(2\%)$ of Guyon syndrome. The present study indicates that vibration-induced nerve impairments exist both in the finger-palm and palm-wrist segment of median and ulnar sensory nerves. The results suggest that segmental sensory nerve conduction study would be useful as objective indication of peripheral nerve impairment induced by the hand-arm vibration.
Youn, Jeong Taek;Park, Sang Kyu;Kim, So Yeon;Lee, Tae Yeoung;Jang, Jae Yeon
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.9
no.2
/
pp.52-65
/
1999
This study was performed to evaluate the hand-arm vibration of the steel processing factory workers. Measurement, evaluation and as sessment were based on the International Standard(ISO 5349). The frequency weighted accelerations of the various hand-held tools and total exposure time were measured to assess the periods for the white finger symptom to occur. As a result, it was found that the air angle grinder and the air baby grinder are more harmful than other hand-held tools. It was also found that using various vibratory tools together is more harmful than using a single tool.
Dong, Ren G.;Sinsel, Erik W.;Welcome, Daniel E.;Warren, Christopher;Xu, Xueyan S.;McDowell, Thomas W.;Wu, John Z.
Safety and Health at Work
/
v.6
no.3
/
pp.159-173
/
2015
The hand coordinate systems for measuring vibration exposures and biodynamic responses have been standardized, but they are not actually used in many studies. This contradicts the purpose of the standardization. The objectives of this study were to identify the major sources of this problem, and to help define or identify better coordinate systems for the standardization. This study systematically reviewed the principles and definition methods, and evaluated typical hand coordinate systems. This study confirms that, as accelerometers remain the major technology for vibration measurement, it is reasonable to standardize two types of coordinate systems: a tool-based basicentric (BC) system and an anatomically based biodynamic (BD) system. However, these coordinate systems are not well defined in the current standard. Definition of the standard BC system is confusing, and it can be interpreted differently; as a result, it has been inconsistently applied in various standards and studies. The standard hand BD system is defined using the orientation of the third metacarpal bone. It is neither convenient nor defined based on important biological or biodynamic features. This explains why it is rarely used in practice. To resolve these inconsistencies and deficiencies, we proposed a revised method for defining the realistic handle BC system and an alternative method for defining the hand BD system. A fingertip-based BD system for measuring the principal grip force is also proposed based on an important feature of the grip force confirmed in this study.
Low energy x-rays that occur in the low tube voltage radiography of general radiography are absorbed strongly in the body and do not aid image quality enhancement. This study maintains titer in general radiography while using tube current that are proportional to density and the tube voltage 15% principle according to density to reduce patient exposure doses, and area doses and entrance surface doses were measured to compare patient exposure doses. In hand, knee, abdomen, and skull radiography, kVp was increased to 115% and mAs was decreased to 50% and kVp was decreased to 85% while mAs was increased to 200% and area doses and entrance surface doses were measured to compare relative doses. Also, 5 places in each image were set, density was measured, and Kruskal wallis H test was conducted to observe significance probabilities between groups. To fix density, kVp was increased to 115% and mAs was decreased to 50% and after measurements of mean area doses and entrance surface doses were made by each part, each decreased to 58.68% and 59.85% when standard doses were set to 100%, and each increased to 147.28% and 159.9% when kVp was decreased to 85% and mAs was increased to 200%. Comparisons of density changes showed that hand, knee, abdomen, and skull radiography all displayed significance probabilities>0.05, showing no changes in concentration. Radiography that increases kVp and lowers mAs through reasonable calculations within ranges that don't affect resolution and contrast seems to be a simple way to decrease patient exposure doses.
Kim, Rock Bum;Kim, Byoung-Gwon;Kim, Yu-Mi;Hong, Young-Seoub;You, Chang-Hun;Kim, Dae-Seon
Environmental Analysis Health and Toxicology
/
v.28
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pp.15.1-15.8
/
2013
Objectives The aim of this study was to determine the association between low-level mercury exposure and neurobehavioral functions in adults living in coastal regions of Korea. Methods We selected 172 adults aged 20-65 years living in a city in the coastal region of Korea. A sociodemographic survey was conducted, mercury levels in the blood, urine, and hair were measured, and the associations according to computerized neurobehavioral tests were determined using univariate analysis. After adjustment for associated variables, a multivariate linear regression analysis was performed. Results The geometric mean mercury levels in the blood, urine, and hair were $5.41{\mu}g/L$ (range, $0.00-15.84{\mu}g/L$), $1.17{\mu}g/g$-creatinine (range, $0.00-32.86{\mu}g/g$-creatinine), and 1.37 mg/kg (range, 0.42-6.56 mg/kg), respectively. Variables that were associated with simple reaction time according to the neurobehavioral test results were age and urine mercury level. Variables associated with choice reaction time were the recent use of Korean traditional medicine and urine mercury level. Variables associated with the right-hand finger tapping speed test were age, gender, smoking behavior, education level, monthly household income, and urine mercury level. Variables associated with the left-hand finger tapping speed test were age, gender, education level, and urine mercury level. After adjustment for associated variables, there was no significant association between urine mercury level and simple reaction time (${\beta}=25.96$; p =0.47), choice reaction time (${\beta}=50.37$; p =0.32), or the number of left-hand finger taps (${\beta}=-1.54$; p =0.21). However, urine mercury level was significantly associated with the number of right-hand finger taps (${\beta}=-3.86$; p =0.01). Conclusions We found no evidence that low-level mercury exposure in adults is associated with deficits in neurobehavioral functions. A longer follow-up study is required to confirm this conclusion.
Kim, Dae-Seon;Kim, Guen-Bae;Kang, Tack-Shin;Lee, Jong-Hwa;Nam, Sang-Hoon
Journal of Environmental Health Sciences
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v.33
no.5
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pp.345-352
/
2007
As mercury absorbed into body can cross the blood-brain barrier and react with DNA and RNA. Central nervous system has been known to be affected especially in children. But it was very difficult to know the influences of chronic low-does Hg exposure on the health. Although many studies investigated the affect, most of results were still disparate. In order to investigate the health effects of mercury exposure, several test were conducted for some Korean school children. The general health effects were investigated using blood test, Posturography and computer-based neurobehavioral test was done to examine the affect of Hg into neural responses. About 400 children were chosen for blood test whose blood Hg level were upper and lower 10% of population participated in the nationwide Hg exposure survey. The concentration of calcium and creatine, the number of white and red blood cell showed statistical significance with Hg exposure in blood test. Another 36 children were selected from the same participants for the posturography and neurobehavioral test. The intensity and center frequency of hand tremor which were related to unconsciousness also showed distinct significances. Any general relations with Hg exposure were not found in all test including computer-based neurobehavioral test.
Kim, Ki Youn;Oh, Sung Eop;Hong, Mun Ki;Lee, Kwon Seob
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.25
no.2
/
pp.134-145
/
2015
Objectives: An objective of this study was to perform a risk assessment and social cost-benefit analysis for revising permissible exposure limits for seven substances: Nickel(Insoluble inorganic compounds), benzene, carbon disulfide, formaldehyde, cadmium(as compounds), trichloroethylene, touluene-2,4-diisocyanate. Materials and Methods: The research methods were divided into risk and hazard assessment and cost-benefit analysis. The risk and hazard assessment for the seven substances consists of four steps: An overview of GHS MSDS(1st), review of document of ACGIH's TLVs (2nd), comparison between international occupational exposure limits and domestic permissible exposure limits(3rd), and analysis of excess workplace and excess rate for occupational exposure limits based on previous work environment measurement data(4th). Total cost was estimated using cost of local exhaust ventilation, number of excess workplace and penalties for exceeding a permissible exposure limit. On the other hand, total benefit was calculated using the reduction rate of occupational disease, number of workplaces treating each substance and industrial accident compensation. Finally, the net benefit was calculated by subtracting total cost from total benefit. Results: All the substances investigated in this study were classified by CMR(Carcinogens, Mutagens or Reproductive toxicants) and their international occupational exposure limits were stricter than the domestic permissible exposure limits. As a result of excess rate analysis, trichloroethylene was the highest at 11%, whereas nickel was the lowest at 0.5%. The excess rates of all substances except for trichloroethylene were observed at less than 10%. Among the seven substances, the total cost was highest for trichloroethylene and lowest for carbon disulfide. The benefits for the seven substances were higher than costs estimated based on strengthening current permissible exposure limits. Thus, revising the permissible exposure limits of the seven substances was determined to be acceptable from a social perspective. Conclusions: The final revised permissible exposure limits suggested for the seven substances are as follows: $0.2mg/m^3$ for nickel, 0.5 ppm(TWA) and 2.5 ppm(STEL) for benzene, 1 ppm(TWA) for carbon disulfide, $0.01mg/m^3$(TWA) for cadmium, 10 ppm(TWA) and 25 ppm(STEL) for trichloroethylene, 0.3 ppm(TWA) for formaldehyde, and 0.005 ppm(TWA) and 0.02 ppm(STEL) for toluene diisocynate(isomers).
This study was intended to measure and analyze hand-transmitted vibrations from cultivator in idle and operation modes for three different types of field works. Based on this analysis a time for the white finger syndrome to appear on 10% of the operators was estimated assuming that their daily exposure is 3 hours. The 4 methods to reduce the hand vibration were also proposed and compared with each other. The results of the study were summarized as follows : The highest vibration level was recorded during trenching operation, resulting in a total average vibration of 11.5 m/s$^2$. Followings were 7.6 m/s$^2$ during rotary tillage and 7.0 m/s$^2$ for weeding. When exposed to these levels of vibrations three hours a day, the white finger syndrome is likely to appear in 4 years for trenching, 6.2 years for rotary tillage and 6.8 years for weeding operations. Isolation of hand vibration performed by a rubber pad, anti-vibration gloves, a handle anti-vibration device and engine mounts were respectively 15.7%, 16.5%. 26.1% and 27.0%, resulting in most effective methods of the handle anti-vibration device and engine mounts. A better performance of about 33.9% was achieved when both the handle anti-vibration device and engine mounts were used.
Sapino, Gianluca;Gonvers, Stephanie;Cherubino, Mario;di Summa, Pietro G.
Archives of Plastic Surgery
/
v.49
no.3
/
pp.453-456
/
2022
When the scrotal sac is entirely debrided following a Fournier gangrene, testes exposure poses unique challenges for the reconstructive surgeon. Despite the anterolateral thigh (ALT) flap is considered a workhorse in such context, aesthetic results are often suboptimal because of the lack of natural ptosis and patchwork appearance. We describe the use of a super-thin pedicled ALT flap for total scrotal reconstruction, modified according to a peculiar flap design and inset technique. A 42-year-old man was referred to our department for delayed total scrotal reconstruction 8 months after a Fournier gangrene extensive debridement. A super-thin pedicled ALT flap from the right thigh was designed: in the central portion of the ALT, a lateral skin paddle extension was marked to guarantee adequate posterior anchorage during insetting and ptosis of the scrotal sac. This particular flap arrangement has inspired the name "sombrero" as the shape is akin to the famous hat. No secondary refinements were needed, and the patient showed satisfying aesthetic and functional results at 12 months' follow-up. The ALT flap design "sombrero" modification proposed in this article can improve scrotum cosmesis and patient satisfaction in a single-stage single-flap procedure.
Objectives: This study was conducted to identify the correlation between belief in hand hygiene, activities and related hand hygiene performance rates among dental staff. Methods: This study was based on the evaluation of 329 dental practitioners, including dental hygienists who work at dental clinics, dental hospitals, general and university dental hospitals in Seoul, Gyeonggi-do Province, and Incheon. The questionnaire consisted of a total of 46 questions, including 7 questions on general characteristics, and 25 questions on hand hygiene beliefs, and 5 questions on hand hygiene activities, and 9 questions on hand hygiene practices. This study used 291 subjects for the final analysis, excluding subjects who had provided incomplete or inappropriate responses to the questionnaire. The collected data were analyzed using an independent t-test, ANOVA, $x^2$ test, correlation analysis, and multiple linear regression analysis, where p-values of <0.05 were considered statistically significant. Results: Longer clinical career was associated with a significant increase in behavior and norm beliefs, but no sequential difference in control beliefs. The hand hygiene performance was higher in staff at larger hospitals after contact with pollutants and contaminated environments. Higher age was associated with a significant increase in hand hygiene performance rates, but profession was not statistically significant in the performance rate of hand hygiene. The hand hygiene performance rate was ranked higher among those with average work hours per week of greater than 8 hours followed by those who worked fewer than 8 hours. Fewer work hours per week, a stronger belief in hand hygiene, less frequent exposure to contaminated environments, and a greater number of hand hygiene performance had a positive effect on higher hand hygiene performance rates. Conclusions: In order to increase the hand hygiene performance rate of dental practitioners, it is considered that required time for hand washing should be ensured sufficiently. Proper usage of hand sanitizers should also be promoted efficiently.
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