Health impairments in iron cast cleaners

U razdoblju od 1978. do 1984. godine u dvije ljevaonice radilo je prosječno oko 120 čistača odljevaka, od kojih je 29 zbog različitih subjektivnih smetnji u obliku bljedila prstiju, parestezija podlaktica i šaka i boli podlaktica, šaka i laktova upućeno u Centar za prevenciju, dijagnostiku i ocjenu radne sposobnosti radi potvrđivanja oštećenja u vezi s djelovanjem vibracija pneumatskih alata i brusilica. Od objektivnih pretraga učinjeni su test hladnoćom, digitalna pletizmografija, elektromiografija gornjih ekstremiteta, radiografska obrada pluća i audiometrija. Pri evaluaciji oštećenja vibracijama uzeta je u obzir i dužina ekspozicije vibracijama pneumatskih alata i brusilica. U prvih 5 godina rada na poslovima čišćenja odljevaka ustanovili smo rana oštećenja koja inače nismo očekivali. Ostala oštećenja pojavila su se nakon duge ili vrlo duge ekspozicije vibracijama, što se moglo i očekivati. Najveći broj čistača odljevaka imao je specifične smetnje koje su upućivale na pojavu vibracijskog sindroma. Digitalna pletizmografija je bila patološka samo unutar prvih 15 godina rada, a postojala su samo funkcionalna oštećenja krvnih žila prstiju ruku. Osim toga digitalna pletizmografija je u mnogo većem postotku svojim promjenama potvrđivala subjektivne tegobe radnika u obliku pojave bljedila prstiju negoli je to potvrđeno testom hladnoćom.From 1978 to 1984 among 120 cast cleaners working in two iron smelteries 29 complained of white fingers, paraesthesia of the fist and forearm, and of the pain in the forearm, fist and elbow. They were referred to the Centre for Prevention, Diagnosis and Assessment of Working Capacity for confirmation of diagnosis of occupational impairment due to vibration. The following tests were done: cold test, digital plethysmography, electromyography of the upper extremities, radiographic examination of the lungs and audiometric examination. In evaluating the vibration caused impairment the duration of vibration exposure from pneumatic tools and vibrating equipment was taken into account. Impairments were observed as early as in the first five years of work on cast cleaning. Impairments that appeared after a protracted or very long exposure to vibration were as expected. The complaints received from the greatest number of cast cleaning workers were specific and indicative of vibration syndrome. Pathological findings of digital plethysmography were established only within the first 15 years of exposure and these were mainly functional vascular disorders in the fingers. Furthermore, the symptom of white fingers was confirmed by changes in digital plethysmography in a far greater number of workers than by cold test