Document Detail

Raynaud's syndrome in workers who use vibrating pneumatic air knives.
MedLine Citation:
PMID:  10394148     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The use of vibrating tools has been shown to cause Raynaud's syndrome (RS) in a variety of workers, including those who use chain saws, chippers, and grinders. The diagnosis of RS in workers who use vibrating tools is difficult to document objectively. We studied a patient cohort with RS caused by the use of a vibrating pneumatic air knife (PAK) for removal of automobile windshields and determined our ability to document RS in these workers by means of digital hypothermic challenge testing (DHCT), a vascular laboratory study that evaluates digital blood pressure response to cooling.
METHODS: Sixteen male autoglass workers (mean age, 36 years) with RS were examined by means of history, physical examination, arm blood pressures, digital photoplethysmography, screening serologic studies for underlying connective tissue disorder, and DHCT.
RESULTS: No patient had RS before they used a PAK. The mean onset of RS (color changes, 100%; pain, 93%; parathesias, 75%) with cold exposure was 3 years (range, 1.5 to 5 years) after initial PAK use (mean estimated PAK use, 2450 hours). Fifty-six percent of workers smoked cigarettes. The findings of the physical examination, arm blood pressures, digital photoplethysmography, and serologic testing were normal in all patients. At 10 degrees C cooling with digital cuff and patient cooling blanket, a significant decrease in digital blood pressure was shown by means of DHCT in 100% of test fingers versus normothermic control fingers (mean decrease, 75%; range, 25% to 100%; normal response, less than 17%; P <.001). The mean follow-up period was 18 months (range, 1 to 47 months). No patient continued to use the PAK, but symptoms of RS were unchanged in 69% and worse in 31%.
CONCLUSION: PAK use is a possible cause of vibration-induced RS. The presence of RS in workers who use the PAK was objectively confirmed by means of DHCT. Cessation of PAK use in the short term did not result in symptomatic improvement.
R B McLafferty; J M Edwards; B L Ferris; G L Moneta; L M Taylor; G J Landry; J M Porter
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  30     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-08-04     Completed Date:  1999-08-04     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
Division of Vascular Surgery, Department of Surgery, Oregon Health Sciences University, Portland, OR 97201, USA.
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MeSH Terms
Blood Pressure / physiology
Cohort Studies
Cold Temperature / diagnostic use
Fingers / blood supply
Occupational Diseases / diagnosis,  etiology*
Occupational Exposure / adverse effects
Raynaud Disease / diagnosis,  etiology*
Vibration / adverse effects*

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