Assessment of the long-term trend in angiodystonic syndrome of the upper extremities in stage I vibration disease using the ultrasound method

Introduction. Diseases of the upper extremities caused by exposure to local vibration at the workplace are a ubiquitous problem. These diseases occur or are aggravated by exposure to vibration at the workplace when using vibration-hazardous equipment.

Purpose of the study – is to identify the features of upper limb angiodystonic syndrome in vibration disease at stage I, depending on work experience.

Materials and methods. Ultrasound scanning of the arteries of the upper extremities was performed in seventy patients. Spectral and velocity indices such as resistance index (RI), diastolic blood flow rate (V ED), systolic (pulse) blood flow rate (V PS) and pulsation index (PI) were measured in the distal part of the forearm.

Results. Upon contact with a vibration tool, for each year of work experience, the systolic (pulse) blood flow rate (V PS) in the radial and left ulnar arteries significantly were found to decrease by an average of 0.57–0.58 (p<0.05). In the ulnar artery, PI increases on average by 0.03–0.062, but the changes are not statistically significant (p>0.05). With an increase in the length of service by 1 year, the RI in the left radial and ulnar arteries significantly increases by 0.0003–0.0012 (p<0.05).

Limitations of the study. The main disadvantages of ultrasound are the long-term and operator-dependent method.

Conclusion. With an increase in work experience, the indices characterizing angiodistonic disorders: pulsation index (PI), resistance index (RI) – significantly increase with each year of experience when exposed to local vibration. This can be used for differential diagnosis of peripheral angiodistonic upper limb syndrome of occupational etiology, in particular, vibration disease associated with exposure to local vibration at stage 1. With an increase in work experience, the indices characterizing angiodistonic disorders: pulsation index (PI), resistance index (RI) – significantly elevate with each year of experience when exposed to local vibration. As part of the ultrasound screening study, scanning of the arteries of the upper extremities in patients at the clinic of occupational pathology can be performed at the preclinical stage to prevent prolonged chronic ischemia of the upper extremities. This diagnostic method can be especially valuable in differentiating peripheral angiodistonic upper limb syndrome of occupational etiology, in particular, vibration disease at the stage 1.

Compliance with ethical standards. The study was conducted in compliance with the ethical standards of the Helsinki Declaration of the World Medical Association. The minutes of the meeting of the Local Ethics Committee of the Northwestern Scientific Center for Hygiene and Public Health No. 2022/50.2 dated 12/28/2022 were received.

Contribution:
Kuprina N.I. — the concept and design of the study, collection and processing of material, statistical processing, writing a text, editing;
Petrova M.D. — processing of material, writing a text;
Shilov V.V., Nikanov A.N., Makeeva L.V. — responsibility for the integrity of all parts of the manuscript and approval of the manuscript final version.

Conflict of interest. The authors declare no conflict of interest.

Acknowledgement. The study had no sponsorship.

Received: May 6, 2024 / Revised: July 10, 2024 / Accepted: June 19, 2024 / Published: September 10, 2024