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2008.12.14 23:00 |  診療  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

振動病患者数と予防

・本日は、新大阪で振動病の研究会がありました。とっても小人数ですが、振動病研究の専門家の先生方（元祖振動病研究者といっても良い先生＝白蝋病の名付け親、も参加）とディスカッションできてとても有意義でした。病院にこもりっきりにならず、こういう場に出てくるのは、刺激になってやはり良いですね。

・本日の研究会の情報量はとても多かったのですが、今日のブログ記事は、統計とある報告書のご紹介。

・2006年度の振動障害療養者数は、7782名です。一番多かったのが、1987年の13501名です。この数字は、労災認定された数です。あの有名な「ハインリッヒの法則」（１：２９：３００）を当てはめ、7782名に29をかけると225678名となります。何を言いたいかというと、そんなにひどい障害が無いが、症状があるのに振動障害と診断されていない人が、20万人以上いるのではないかということです。で、300かけたら、2334600名となります。これは、振動障害のリスクがある人が200万人以上あるという推定です。じつは、振動曝露に曝されている労働者が何名いるのか統計的に明らかにされていないのです。私の友人の労働衛生の研究者が好んで言っていることですが、「我々は、なにが分かっていないかが、わかっていない」（正確な文言は忘れましたが）何か、ソクラテスの時代です。

・上記の試算は思いっきり、大雑把です。本日の研究会では、イギリスＨＳＥは手腕振動に曝されている労働者は、500万人と推定しているそうです。ということは、ＵＫより人口の多い日本は、それ以上の曝露者がいるとういことですね。で、ということは、日常臨床で、振動障害をもっている人に遭遇する機会は稀では、無いということです。

・臨床の話になりますが、医師は、患者さんが訴えないと病気が分からないことが多々あります。患者さんが、それを異常と思い、かつ、医師に訴えないと「闇にほおむられる」疾患が多々あるというわけです。

・患者さんが、病気とあまり考えない状態とはどういうものか。ひとつには、ある兆候が自分の周りであまりにも当たり前に起こっていたら、です。これは、ある炭鉱町の話ですが、耳が遠いのがあたりまえ、すこし歩いて息が切れるのが当たり前。その地域にすんでいる人のほとんどが炭坑労働者であり、そういう兆候があるから。

・また、調理師さんと話していて、左手が痺れるのが当たり前ということ。それで一人前。（フライパンを左手で扱うから）だから、わざわざ医師に訴えない。

・振動障害から、外れてしまいました。もう一つだけ、情報のご紹介。『振動障害等の防止にかかる作業管理のあり方検討会報告書（案）』というのが、本年6月に報告されています。（本日研究会参加の研究者もその検討会に参加）臨床医というか、私のような臨床をしながら職業性疾患を診ている医師は、「敗戦処理」です。本来は、予防が大切。そのためには、医師ではなく、振動工具を作るメーカーや、人間工学の専門家の役割が重要です。日本は、まだまだ予防に関する取り組みが弱いようです。

 

・明日のマネジメント学習のｐｐｔができて、ほっとし、ヘネシー飲みながら、この記事書いてます。（「アズナブール流しながら、この手紙を書いてます」って、わかります）で、ちょっと支離滅裂になったかもしれませんが、お許しを。明日は、5時45分起床です。

 

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充実した週末でしたね。お疲れ様です。

さぞかしヘネシーおいしいでしょう。

昔の洋画の文句でしたっけ？

>Paul Carpenterさま、コメントありがとうございます。
確かに研究会は充実しておりました。
ヘネシー関係の洋画は、「寡聞にして知らず」ですが、「ヘネシーおいしい」は韻をふんどりますね。
written by Paul Carpenter / 2008.12.15 19:01

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