Health effects associated with occupational exposure to hand-arm or whole body vibration.

Workers in a number of different occupational sectors are exposed to workplace vibration on a daily basis. This exposure may arise through the use of powered-hand tools or hand-transmitted vibration (HTV). Workers might also be exposed to whole body vibration (WBV) by driving delivery vehicles, earth moving equipment, or through use of tools that generate vibration at low dominant frequencies and high amplitudes, such as jackhammers. Occupational exposure to vibration has been associated with an increased risk of musculoskeletal pain in the back, neck, hands, shoulders, and hips. Occupational exposure may also contribute to the development of peripheral and cardiovascular disorders and gastrointestinal problems. In addition, there are more recent data suggesting that occupational exposure to vibration may enhance the risk of developing certain cancers. The aim of this review is to provide an assessment of the occupations where exposure to vibration is most prevalent, and a description of the adverse health effects associated with occupational exposure to vibration. This review will examine (1) various experimental methods used to measure and describe the characteristics of vibration generated by various tools and vehicles, (2) the etiology of vibration-induced disorders, and (3) how these data were employed to assess and improve intervention strategies and equipment that reduces the transmission of vibration to the body. Finally, there is a discussion of the research gaps that need to be investigated to further reduction in the incidence of vibration-induced illnesses and injuries.

[Guidelines for occupational exposures to mechanical vibration.] / I valori guida nella valutazione del rischio da vibrazioni meccaniche.

OBJECTIVES: In this study, the daily exposure action values (EAV) and the daily exposure limit values (ELV) for hand-transmitted vibration (HTV) and whole-body vibration (WBV), established by the EU Directive 2002/44/EC and the Italian Decree 81/2008, and expressed in terms of 8-hr frequency weighted r.m.s. acceleration magnitude, are discussed upon consideration of the findings of experimental and epidemiological studies. METHODS: There is some epidemiological support for the EAV A(8) of 2.5 ms-2 r.m.s. and the ELV A(8) of 5 ms-2 r.m.s. for HTV, at least for the vascular component (secondary Raynaud's phenomenon) of the hand-arm vibration syndrome. RESULTS: There is some experimental evidence for the EAV A(8) of 0.5 ms-2 r.m.s. for WBV, while there is neither biodynamic nor epidemiological validation for the ELV A(8) of 1.15 ms-2 r.m.s. for WBV, this latter lowered to 1 ms-2 r.m.s. in the Italian legislation.

The Effect of a Mechanical Arm System on Portable Grinder Vibration Emissions.

Mechanical arm systems are commonly used to support powered hand tools to alleviate ergonomic stressors related to the development of workplace musculoskeletal disorders. However, the use of these systems can increase exposure times to other potentially harmful agents such as hand-transmitted vibration. To examine how these tool support systems affect tool vibration, the primary objectives of this study were to characterize the vibration emissions of typical portable pneumatic grinders used for surface grinding with and without a mechanical arm support system at a workplace and to estimate the potential risk of the increased vibration exposure time afforded by the use of these mechanical arm systems. This study also developed a laboratory-based simulated grinding task based on the ISO 28927-1 (2009) standard for assessing grinder vibrations; the simulated grinding vibrations were compared with those measured during actual workplace grinder operations. The results of this study demonstrate that use of the mechanical arm may provide a health benefit by reducing the forces required to lift and maneuver the tools and by decreasing hand-transmitted vibration exposure. However, the arm does not substantially change the basic characteristics of grinder vibration spectra. The mechanical arm reduced the average frequency-weighted acceleration by about 24% in the workplace and by about 7% in the laboratory. Because use of the mechanical arm system can increase daily time-on-task by 50% or more, the use of such systems may actually increase daily time-weighted hand-transmitted vibration exposures in some cases. The laboratory acceleration measurements were substantially lower than the workplace measurements, and the laboratory tool rankings based on acceleration were considerably different than those from the workplace. Thus, it is doubtful that ISO 28927-1 is useful for estimating workplace grinder vibration exposures or for predicting workplace grinder acceleration rank orders.

Do exposure limits for hand-transmitted vibration prevent carpal tunnel syndrome?

BACKGROUND: An apparently high frequency of carpal tunnel syndrome (CTS) among shipyard workers undergoing health surveillance because of exposure to hand-transmitted vibration (HTV) prompted concerns that current regulatory limits on exposure might not protect adequately against the disorder. AIMS: To explore whether within regulatory limits, higher exposures to HTV predispose to CTS. METHODS: As part of a retrospective audit, we compared duration and current intensity of exposure to HTV in cases with new-onset CTS and controls matched for age. Conditional logistic regression was used to quantify associations, which were summarized by odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: There were 23 cases and 55 controls. After adjustment for body mass index and previous diagnosis of diabetes, no clear associations were observed either with duration of exposure to HTV or with current intensity of exposure. Risk was non-significantly elevated in men with ≥30 years' exposure to HTV (OR 1.6), but in the highest category of current exposure [8-h energy-equivalent frequency-weighted acceleration (A8) ≥ 4.0 m/s(2)], risk was lower than that in the reference category (A8 < 2.5 m/s(2)). Moreover, there was a significantly reduced risk of CTS in men with a previous diagnosis of hand-arm vibration syndrome (HAVS) (OR 0.2, 95% CI 0.1-0.9). CONCLUSIONS: We found no evidence that below the current limit for A(8) of 5 m/s(2), higher exposures to HTV predispose to CTS. However, care should be taken not to overlook the possibility of treatable CTS when workers with diagnosed HAVS present with new or worsening sensory symptoms in the hand.

[Exposure to hand-arm vibrations in orthopaedic plaster room: risk management]. / Esposizione a vibrazioni mano-braccio nel personale di sala gessi: risk management.

BACKGROUND: In hospitals, the use of vibrating tools, such as oscillating saws to cut plaster, can expose the staff to hand-arm vibrations. OBJECTIVES: The aim of the study was to assess the exposure of workers to vibrations in the plaster room and then  identify the most appropriate  intervention for  prevention and protection to be implemented in order to minimize  exposure and  protect  workers' health, considering different individual hyper-susceptibility conditions. METHODS: Four different models of plaster saws were examined for the evaluation.  Various measurements were made in normal working conditions of the operators. RESULTS AND CONCLUSIONS: The values of acceleration and noise detected on the instruments  were  in line with those reported in the literature. The preventive measure adopted (replacing plaster saws currently used in the hospital with similar ones with lower vibration emission) was an adequate means of protection. Health surveillance activities  recorded a higher level of wellbeing, both environmentally and individually and, specifically, an increased protection level for the hyper-susceptibility conditions observed during health checks of exposed personnel  which will be monitored regularly by the Occupational Health Service.

Antivibration gloves: effects on vascular and sensorineural function, an animal model.

Anti-vibration gloves have been used to block the transmission of vibration from powered hand tools to the user, and to protect users from the negative health consequences associated with exposure to vibration. However, there are conflicting reports as to the efficacy of gloves in protecting workers. The goal of this study was to use a characterized animal model of vibration-induced peripheral vascular and nerve injury to determine whether antivibration materials reduced or inhibited the effects of vibration on these physiological symptoms. Rats were exposed to 4 h of tail vibration at 125 Hz with an acceleration 49 m/s(2). The platform was either bare or covered with antivibrating glove material. Rats were tested for tactile sensitivity to applied pressure before and after vibration exposure. One day following the exposure, ventral tail arteries were assessed for sensitivity to vasodilating and vasoconstricting factors and nerves were examined histologically for early indicators of edema and inflammation. Ventral tail artery responses to an α2C-adrenoreceptor agonist were enhanced in arteries from vibration-exposed rats compared to controls, regardless of whether antivibration materials were used or not. Rats exposed to vibration were also less sensitive to pressure after exposure. These findings are consistent with experimental findings in humans suggesting that antivibration gloves may not provide protection against the adverse health consequences of vibration exposure in all conditions. Additional studies need to be done examining newer antivibration materials.

Anti-vibration gloves?

For exposure to hand-transmitted vibration (HTV), personal protective equipment is sold in the form of anti-vibration (AV) gloves, but it remains unclear how much these gloves actually reduce vibration exposure or prevent the development of hand-arm vibration syndrome in the workplace. This commentary describes some of the issues that surround the classification of AV gloves, the assessment of their effectiveness and their applicability in the workplace. The available information shows that AV gloves are unreliable as devices for controlling HTV exposures. Other means of vibration control, such as using alternative production techniques, low-vibration machinery, routine preventative maintenance regimes, and controlling exposure durations are far more likely to deliver effective vibration reductions and should be implemented. Furthermore, AV gloves may introduce some adverse effects such as increasing grip force and reducing manual dexterity. Therefore, one should balance the benefits of AV gloves and their potential adverse effects if their use is considered.

Laboratory and workplace assessments of rivet bucking bar vibration emissions.

Sheet metal workers operating rivet bucking bars are at risk of developing hand and wrist musculoskeletal disorders associated with exposures to hand-transmitted vibrations and forceful exertions required to operate these hand tools. New bucking bar technologies have been introduced in efforts to reduce workplace vibration exposures to these workers. However, the efficacy of these new bucking bar designs has not been well documented. While there are standardized laboratory-based methodologies for assessing the vibration emissions of many types of powered hand tools, no such standard exists for rivet bucking bars. Therefore, this study included the development of a laboratory-based method for assessing bucking bar vibrations which utilizes a simulated riveting task. With this method, this study evaluated three traditional steel bucking bars, three similarly shaped tungsten alloy bars, and three bars featuring spring-dampeners. For comparison the bucking bar vibrations were also assessed during three typical riveting tasks at a large aircraft maintenance facility. The bucking bars were rank-ordered in terms of unweighted and frequency-weighted acceleration measured at the hand-tool interface. The results suggest that the developed laboratory method is a reasonable technique for ranking bucking bar vibration emissions; the lab-based riveting simulations produced similar rankings to the workplace rankings. However, the laboratory-based acceleration averages were considerably lower than the workplace measurements. These observations suggest that the laboratory test results are acceptable for comparing and screening bucking bars, but the laboratory measurements should not be directly used for assessing the risk of workplace bucking bar vibration exposures. The newer bucking bar technologies exhibited significantly reduced vibrations compared to the traditional steel bars. The results of this study, together with other information such as rivet quality, productivity, tool weight, comfort, worker acceptance, and initial cost can be used to make informed bucking bar selections.

Effective information campaign for management of exposure to hand-arm vibration in the metal and construction industries.

European Directive 2002/44/EC defines employers' responsibilities in the risk management of hand-arm vibration (HAV). However, the directive is still not completely implemented in all risk industries. The aim of our study was to determine whether it is possible to improve the recognition and management of the risks of HAV at workplaces with a one-year information campaign. A questionnaire on opinions and measures for controlling HAV exposure at workplaces was sent to all occupational safety representatives and occupational safety managers in the construction and metal industry in Finland (n=1887) and once again to those who responded to the first questionnaire (n=961) one year after the campaign. The campaign increased recognition of HAV in risk assessment from 57.0% to 68.3% (p=.001), increased measures to decrease exposure to HAV from 54.6% to 64.2% (p=.006) and increased the number of programmes to control the risks due to HAV (p<.001). The information campaign, which focuses on the construction and metal industries, proved to be effective in increasing the awareness of the risks of HAV and the measures needed to control exposure to HAV. A similar campaign can be recommended in the case of risks specific to certain occupations.

Occupational exposure to physical agents: the new Italian database for risk assessment and control.

This article presents the new Italian database of physical agents, which is available at http://www.portaleagentifisici.it. It supports in risk assessment employers who have to comply with Italy's Legislative Decree 81/2008 (transposing into law European Union Directives 2003/10/EC, 2002/44/EC, 2004/40/EC and 2006/25/EC). The database currently contains measurements and declared European Community (EC) values from over 2540 machines; in particular, the database hosts data on mechanical vibration from over 1430 hand-held power tools (e.g., pneumatic and electric hammers, chainsaws, grinders, drills, sanders and saws) and from over 1020 whole-body machines (e.g., buses, fork lifts and wheel tractors). The database is continuously updated as soon as new experimental and declared data are acquired.