Browsing by Author "Marcus, K"

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    I. Vibrationsskador hos bilmekaniker II. Handeksem hos bilmekaniker
    (Arbetslivsinstitutet, 1997) Barregård, L; Ehrenström, L; Marcus, K; L-E Sandén; Meding, B
    I. Vibrationsskador hos bilmekaniker Questionnaires on Raynaud's phenomenom, neurological symptoms in the hands, and occupational history, were completed by 806 out of 900 car mechanics affiliated to an occupational health center. Three hundred and nineteen of them were clinically examined, and vibration-induced white fingers (VWF) and sensory-neural stages classified according to the Stockholm Workshop scales. In 51 mechanics the actual work time with vibrating tools was recorded during 91 work days. The mean daily exposure time was 14 minutes, mainly with nut-runners. VWF were diagnosed in 128 car mechanics, most of them in stage 2, a minimum prevalence of 14 percent. After 20 years of exposure about 25 percent had VWF. The incidence was about 15 per 1000 person-years. Numbing of fingers or decreased sensitivity was found in 184 mechanics, a minimum prevalence of 20 percent. After 20 years of exposure 40 percent had neurological symptoms or signs in their hands. The hand-arm vibration syndrome is common among Swedish car mechanics in spite of short daily exposure time. Preventive measures should be taken to reduce the exposure to vibration. II. Handeksem hos bilmekaniker To estimate the prevalence of hand eczema, a questionnaire was distributed to 900 male car mechanics. Of the 801 persons who responded, 15 percent reported hand eczema on some occasion in the previous 12 months, and 57 percent stated dry skin on the hands. The proportions are higher than those previously found in a random sample of males in Göteborg. In a second part of the study, those who reported hand eczema were examined and patch tested with a standard series and a special "car mechanics' series". The hand eczema diagnosis was confirmed in 11 percent. However, the true prevalence should be higher considering non-attenders and falsely negative answers to the questionnaire. The most common diagnosis was irritant contact dermatitis, 55 percent, and second was allergic contact dermatitis, 19 percent. 35/105 (33 percent) had altogether 51 positive patch test reactions, all to substances in the standard series, except for two persons who reacted to oxidized d-limonene. The most frequent reactions were to thiomersal (9 percent), nickel (8 percent) and colophony (5 percent). One plausible explanation of the high prevalence of nickel allergy was the common use of nickel-plated tools. Five individuals had a history of contact urticaria but scratch tests were negative. It was concluded that car mechanics are at high risk for contact dermatitis on the hands, irritant as well as allergic.