Is skull sawing by autopsy assistants overlooked as a cause of vibration-induced white fingers ?
Background Workers using vibrating tools have an increased prevalence of vibration-induced white fingers.
One example of such workers is autopsy assistants, who use vibration for skull sawing.
Case history A previously healthy 42-year-old Swedish male smoker had worked as an autopsy assistant at a forensic department between 1977 and 1991.
He prepared corpses for autopsy, including sawing the skulls with an electric saw.
Beginning in 1983, his right index finger blanched in cold.
During subsequent years the blanching spread to the other fingers on the right hand, except for the thumb.
The findings in the physical examination and the results of blood tests were normal.
Digital blood pressure after cooling showed a severe vasospastic reaction in both middle fingers.
Vibration measurements during skull sawing showed a frequency-weighted acceleration level of 8.9 m s-2.
Questionnaire survey A questionnaire was mailed to all assistants (N=17) preparing autopsies and to all medical examiners, as referents (N=18), at the Swedish Institutes of Forensic Medicine.
It was answered by 13 assistants (76%), 1 woman and 12 men, and 16 medical examiners (89%), 3 women and 13 men.
Eleven of the assistants (85%), including one woman, and one of the physicians (6%), a man, reported a history of blanching fingers provoked by chill (difference 79%, P=0.00003, Fisher's exact test). (...)
Mots-clés Pascal : Raynaud syndrome, Vibration, Scie, Exposition professionnelle, Médecine légale, Etude cas, Autopsie, Homme, Médecine travail, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Capillaire sanguin pathologie, Peau pathologie, Système nerveux autonome pathologie, Acrosyndrome
Mots-clés Pascal anglais : Raynaud phenomenon, Vibration, Saw, Occupational exposure, Legal medicine, Case study, Autopsy, Human, Occupational medicine, Cardiovascular disease, Vascular disease, Capillary vessel disease, Skin disease, Diseases of the autonomic nervous system, Acrosyndrome
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0439043
Code Inist : 002B30B01B. Création : 10/04/1997.