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Title: Raynaud's phenomenon of occupational origin
Author: Taylor, William
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 1978
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Many industrial processes are using hand -held vibratory tools and grinding operations in which there is increasing vibration energy entering the hands and arms of operators. The vibration stimulus causes digital artery changes giving rise to Raynaud's Phenomenon of Occupational Origin. The serious nature of this hazard came to the author's attention in chain saw forestry workers around 1965 -68 when the saw usage time, and therefore the vibration exposure time, increased from 1 -1z hours to 52 -6 hours per day for 5 days per week, resulting in a prevalence of vibration -induced white finger (VWF) of over 90% in one forest in Norfolk. From 1968 to 1976, the period covered by this Thesis, an epidemiological study of 18 work situations (1283 vibration exposed subjects and controls) has been carried out to define the extent of VWF in industry and to assess its severity. At the same time a team of physicists and engineers measured the vibration characteristics of these work processes, the object being to relate the prevalence rates of VWF, the latent intervals (time interval between vibration exposure and the appearance of the first white finger tip), and Stage assessments (severity) to the vibration spectra, thus establishing damage risk criteria. With the help of this survey data, as opposed to limits obtained from subjective comfort responses, a British Standard Draft Proposal (1975) for hand -arm vibration has been issued mainly to act as a guide to hand -held vibratory tool manufacturers and to prevent the complications of VWF such as finger tip tissue necrosis from arising following long -term vibration exposure. A suggested Code of Practice is described. The difficult question whether to accept Raynaud's phenomenon of occupational origin as a Prescribed Disease is discussed. Raynaud's phenomenon arising from chain saw operation has not been reported since anti -vibration treatment of the chain saw introduced by Forestry Commission in 1970. No new case of VWF has been found after six years of A/V saw usage. On the other hand pneumatic tool users still constitute a high risk VWF area despite the fairly long latent interval (6 -7 years compared with 2 -3 years for chain saws). Measurement of vibration and the energy entering the hands of pneumatic tool operators (grip force) have proved difficult both from the instrumentation (destruction of accelerometers) and standardisation of method. Further medical surveys of pneumatic tool operators with measurement of the vibration characteristics of these percussive tools are required to establish scientifically based damage risk criteria. Such work is being actively pursued in Britain (Universities of Dundee and Salford) and surveys are being planned with the author for chippers and grinders using pneumatic tools in foundries in the United States of America. Despite considerable efforts to find an objective test which would establish the diagnosis of Raynaud's phenomenon and its degree of severity other than by the subject's own description of VWF attacks, no single reliable field test has been devised on an individual basis. All the established tests quoted in the literature, heating and cooling of the digits, plathysmography, vibro- tactile threshold levels and neurological tests (light touch, pain and temperature) - will differentiate, at a significant level, differences between vibration exposed populations and controls. All fail, however, on an individual basis. The long term solution lies in prospective surveys as opposed to the retrospective surveys described in this Thesis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available