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Occupational exposure to hand–arm vibration
International Journal of Cardiology 203 (2016) 959
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Occupational exposure to hand–arm vibration Hilal Olgun Kucuk a, Mehmet Eyuboglu b, Ugur Kucuk c,⁎, Sevket Balta d a
Siyami Ersek Thoracic and Cardiovascular Surgery, Training and Research Hospital, Department of Cardiology, Istanbul, Turkey Department of Cardiology, Special Izmir Avrupa Medicine Center, Karabaglar, Izmir, Turkey c Gulhane Military Medical Academy, Haydarpasa Training Hospital Department of Cardiology, Istanbul, Turkey d Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey b
a r t i c l e
i n f o
Article history: Received 12 November 2015 Accepted 16 November 2015 Available online 18 November 2015 Keywords: Coronary artery disease Hand–arm vibration Acute coronary dissection
if it is a rare cause of the disease. However there are no reported cases in the literature except Viala et al.'s report. Many diseases are linked to SCAD but in the majority of cases an underlying cause cannot be identified and is subsequently termed as idiopathic [7]. As a result vibration is an important occupational hazard. Its health effects have been extensively investigated. In the light of current literature it is more appropriate to conclude that the patient has idiopathic SCAD. Conflict of interest
Spontaneous coronary artery dissection (SCAD) is a very rare and enigmatic cause of acute coronary syndrome (ACS). Recently published manuscript by Viala et al. reported an ACS due to SCAD [1]. Authors concluded that vibrations generated during metallic plate drill had led to dissection. Vibration is an occupational hazard. Occupational exposure to excessive levels of vibration is associated with a range of diseases. There are two main types of vibration; whole body vibration and hand–arm vibration. Mentioned patient was exposed to hand–arm vibration. Health effects of hand–arm vibration have been extensively studied and several guidelines were published. Guidelines and previous studies report that hand–arm vibration causes vascular (vibration whitefinger) damage, sensory nerve damage, musculoskeletal disorders but it has not been associated with coronary artery dissection [2–4]. There are 3 billion workers in the world and approximately 25% of workers were exposed to vibration in their workplaces [5,6]. Given the large number of the population exposed to vibration more vibration associated coronary artery dissections should have been reported even
⁎ Corresponding author. E-mail address: [email protected] (U. Kucuk).
http://dx.doi.org/10.1016/j.ijcard.2015.11.122 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
The authors have no commercial associations or sources of support that might pose a conflict of interest. References [1] M. Viala, B. Lattuca, T. Vacter, F. Roubille, A rare cause of acute coronary syndrome in a handyman, Int. J. Cardiol. 203 (2015) 594–595. [2] Council TASaC, Vibration Exposure and the Provision of Vibration Control Measures in Australian Workplaces, 2009. [3] M.J. Griffin, H.V.C. Howarth, P.M. Pitts, S. Fischer, U. Kaulbars, P.M. Donati, et al., Guide to Good Practice on Whole-Body Vibration: non-Binding Guide to Good Practice for Implementing Directive 2002/44/EC on the Minimum Health and Safety Requirements Regarding the Exposure of Workers to the Risks Arising From Physical Agents, 2006. [4] The National Institute for Occupational Safety and Health CfDCaP, Criteria for a Recommended Standard: Occupational Exposure to Hand–Arm Vibration, 1989. [5] T. Re, World of Work Report 2013: Repairing the Economic and Social Fabric International LabourOrganisation, International Institute for Labour Studies, 2013. [6] wikipedia, https://en.wikipedia.org/wiki/Global_workforce 2015. [7] W. Tanis, P.R. Stella, J.H. Kirkels, A.H. Pijlman, R.H. Peters, F.H. de Man, Spontaneous coronary artery dissection: current insights and therapy, Neth. Hear. J. 16 (2008) 344–349.
Contents lists available at ScienceDirect
International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard
Correspondence
Occupational exposure to hand–arm vibration Hilal Olgun Kucuk a, Mehmet Eyuboglu b, Ugur Kucuk c,⁎, Sevket Balta d a
Siyami Ersek Thoracic and Cardiovascular Surgery, Training and Research Hospital, Department of Cardiology, Istanbul, Turkey Department of Cardiology, Special Izmir Avrupa Medicine Center, Karabaglar, Izmir, Turkey c Gulhane Military Medical Academy, Haydarpasa Training Hospital Department of Cardiology, Istanbul, Turkey d Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey b
a r t i c l e
i n f o
Article history: Received 12 November 2015 Accepted 16 November 2015 Available online 18 November 2015 Keywords: Coronary artery disease Hand–arm vibration Acute coronary dissection
if it is a rare cause of the disease. However there are no reported cases in the literature except Viala et al.'s report. Many diseases are linked to SCAD but in the majority of cases an underlying cause cannot be identified and is subsequently termed as idiopathic [7]. As a result vibration is an important occupational hazard. Its health effects have been extensively investigated. In the light of current literature it is more appropriate to conclude that the patient has idiopathic SCAD. Conflict of interest
Spontaneous coronary artery dissection (SCAD) is a very rare and enigmatic cause of acute coronary syndrome (ACS). Recently published manuscript by Viala et al. reported an ACS due to SCAD [1]. Authors concluded that vibrations generated during metallic plate drill had led to dissection. Vibration is an occupational hazard. Occupational exposure to excessive levels of vibration is associated with a range of diseases. There are two main types of vibration; whole body vibration and hand–arm vibration. Mentioned patient was exposed to hand–arm vibration. Health effects of hand–arm vibration have been extensively studied and several guidelines were published. Guidelines and previous studies report that hand–arm vibration causes vascular (vibration whitefinger) damage, sensory nerve damage, musculoskeletal disorders but it has not been associated with coronary artery dissection [2–4]. There are 3 billion workers in the world and approximately 25% of workers were exposed to vibration in their workplaces [5,6]. Given the large number of the population exposed to vibration more vibration associated coronary artery dissections should have been reported even
⁎ Corresponding author. E-mail address: [email protected] (U. Kucuk).
http://dx.doi.org/10.1016/j.ijcard.2015.11.122 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved.
The authors have no commercial associations or sources of support that might pose a conflict of interest. References [1] M. Viala, B. Lattuca, T. Vacter, F. Roubille, A rare cause of acute coronary syndrome in a handyman, Int. J. Cardiol. 203 (2015) 594–595. [2] Council TASaC, Vibration Exposure and the Provision of Vibration Control Measures in Australian Workplaces, 2009. [3] M.J. Griffin, H.V.C. Howarth, P.M. Pitts, S. Fischer, U. Kaulbars, P.M. Donati, et al., Guide to Good Practice on Whole-Body Vibration: non-Binding Guide to Good Practice for Implementing Directive 2002/44/EC on the Minimum Health and Safety Requirements Regarding the Exposure of Workers to the Risks Arising From Physical Agents, 2006. [4] The National Institute for Occupational Safety and Health CfDCaP, Criteria for a Recommended Standard: Occupational Exposure to Hand–Arm Vibration, 1989. [5] T. Re, World of Work Report 2013: Repairing the Economic and Social Fabric International LabourOrganisation, International Institute for Labour Studies, 2013. [6] wikipedia, https://en.wikipedia.org/wiki/Global_workforce 2015. [7] W. Tanis, P.R. Stella, J.H. Kirkels, A.H. Pijlman, R.H. Peters, F.H. de Man, Spontaneous coronary artery dissection: current insights and therapy, Neth. Hear. J. 16 (2008) 344–349.