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Reduced epidermal nerve density among hand-transmitted vibration-exposed workers.
Huey-Wen Liang1, Sung-Tsang Hsieh, Tsuen-Jen Cheng
1Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taiwan.
Journal of Occupational and Environmental Medicine
|June 13, 2006
Summary
Workers exposed to hand-transmitted vibration showed significantly reduced epidermal nerve density (END), indicating small nerve fiber damage. This histologic change may precede other nerve function abnormalities.
Area of Science:
- Occupational health
- Neurology
- Dermatology
Background:
- Hand-transmitted vibration (HTV) is common in many occupations.
- Prolonged exposure can lead to neurovascular disorders.
Purpose of the Study:
- To evaluate ultrastructural changes in epidermal nerve density (END) among workers exposed to HTV.
- To investigate the relationship between HTV exposure and nerve fiber alterations.
Main Methods:
- Skin biopsies were performed on the forearms of 10 male workers with occupational HTV exposure.
- Epidermal nerve density (END) was quantified and compared to 10 age- and gender-matched healthy controls.
Main Results:
- Nine out of ten exposed workers exhibited abnormally low END.
- Exposed workers had significantly lower END compared to controls (4.1 fibers/mm vs. 9.0 fibers/mm).
- Reduced END did not correlate with nerve conduction or sensory testing abnormalities.
Conclusions:
- Reduced END suggests involvement of small-diameter nerve fibers in workers exposed to HTV.
- Histologic changes in small nerve fibers may occur independently of or precede alterations in large myelinated nerve fibers.