Based on a multidimensional discriminant analysis of the clinical and physiological characteristics derived as a result of examination of 593 miners, classification functions were plotted, allowing the diagnosis of vibratory disease in the automatic mode by means of mathematic computations. Functional indicators of skin sensitivity, particularly vibratory, dynamometry, rheovasography and thermography of the hand and fingers, a "white spot" symptom, and characteristics derived on a mathematic analysis of heart rhythm were established to be informative for automated diagnosis. The diagnosis was found to be more accurate in case of using a two-stage variant of the discriminant analysis where the differentiation is first made between healthy workers and workers with a pathology, followed by the discrimination of the preclinical and clinical phase of the disease. The automated diagnostic system is demonstrated to compare very favourably with the conventional method of diagnosis.
Characteristics, frequency and distribution of vertebrogenic diseases involving cervico-brachial region were studied in more than 1,000 miners from asian North and East exposed to vibration. The data were compared with the results of examination of drivers. The investigation revealed a high level of vertebrogenic cervical pain and cervico-brachial pain in miners with a long length of service, especially in those suffering from vibration disease and frequent osteochondrosis manifestation in younger age, especially in subjects working beyond the Polar Circle. Occupational hazards are proved to play a leading role in the early development of vertebrogenic diseases, and vibration disease predisposes to such pathology. The results make possible to consider the vertebrogenic cervical pain and cervico-brachial pain as occupational diseases in young-aged workers with long length of service or evaluate such diseases as complications of vibration disease in individuals facing this occupational pathology.
Premorbid condition represented by slightly expressed signs caused by vibration was studied in miners of northern mines and showed the absence of clear clinical manifestations in comparison with the vibration disease. Functional studies showed the disordered skin sensors, peripheral hemodynamics and muscles of the disordered skin sensors, peripheral hemodynamics and muscles of the upper limb: decreased distal blood flow rate in the upper limbs, lowered static endurance of the forearm muscles. Statistic and discriminative analysis helped to differ the groups of miners with preclinical and clinical manifestations of vibration disease by means of using the functional parameters.
Evaluation of miners in Northern and East Siberian regions revealed disorders of humoral immunity: increased B-lymphocytes count, higher production of autologic antibodies to peripheral nerves, greater serum concentration of circulating immune complexes and cryoglobulins. Cytostatic medications suppressed antibodies production and considerably increased efficiency of complex therapy of severe vibration disease.
Analyzing values of transitory disablement morbidity for workers engaged into mining enterprises of East Siberia and Asiatic Far North, the authors revealed high prevalence of locomotory disorders among inside workers. The authors specified diagnostic criteria for occupational etiology of those disorders, presented arguments against considering cervical and lumbar pains as occupational diseases.
The article covers a specified concept model of vibration disease pathogenesis. The leading mechanisms underlying the disease are nervous and hormonal dysfunction presenting hypercortisolemia and low serum levels of thyroid hormones, associated tunnel compression of upper limb nerves and immune disorders resulting in autoimmune aggression. Informative diagnostic methods are suggested and diagnostic values are justified. The authors proved efficiency of therapeutic measures aimed to relieve compression and ischemic changes in peripheral nerves, to correct immune disorders.