[Hand-arm vibration syndrome in foundry workers].

Introduction: The hand-arm vibration syndrome of the foundry workers using chipping hammers and grinders were analysed in Hungary last in 1950th-s years. Therefore it seemed necessary to consider the present situation of the disease.

Aim: To study of the signs of the hand-arm vibration syndrome of the foundry workers using chipping hammers and grinders.

Method: Retrospective analysis of the clinical findings of 154 foundry workers using chipping hammers and grinders. The examination included the vascular, neurological and musculoskeletal systems of the upper extremities in 95 patients.

Results: The first symptoms referring to hand-arm vibration syndrome appeared on the average after seven years exposure. The signs of the 95 patients were as follows: vascular disorders: 75 cases (78.9%), peripheral neurologic lesion: 62 cases (65.3%), osteoarticular damage: 35 patients (36.8%). The Raynaud's phenomenon developed more commonly on the left than the right hand. The rate of the improvement of the Raynaud's phenomenon on the average 6.5 years after the cessation of the exposure on the basis of the result of the cold provocation test was 32.8%. Lesion of the peripheral nerves of the upper limbs, mostly of distal type was experienced in 41, whereas tunnel syndromes of the upper extremities in 21 cases. The most common amongst the latter (18 cases) was the thoracic outlet syndrome. Osteoporosis of the carpal bones was detected in 36 patients (37.9%), but osteoarthrosis of the joints of the upper limbs in 12 cases (12.6%). There was no aseptic necrosis of the bones. Fatigue fracture of the spinous process of the cervical VII vertebra occurred in one single case.

Conclusions: Using chipping hammers and grinders in foundry is one of the most dangerous hand-arm vibration exposure in Hungary. The most frequent signs are the vascular and neurological lesions. Due to relatively rare occurrence of osteoarticular damages X-ray examinations are not necessary during periodical medical follow up. The most effective possibility of the prevention is the diminishing of the daily exposure time.