[Lumbar discopathies: correlation between pathology, work eligibility and recognition of technopathy]. / Le discopatie lombari: correlazione fra patologia, idoneità alla mansione e riconoscimento di tecnopatia.

SUMMARY: Background. Spondylodiscopathies are usually counted among the "work-related diseases" that are those chronic-degenerative diseases with multifactorial etiology where the work environment can sometimes assume the role of direct and efficient contributing cause. Low back pain is the main cause of functional limitation and absence from work in the western world, resulting in a huge individually and socially economic burden. Objective. This work was designed to provide an overview of the impact that lumbar rachipathies have on health surveillance, highlighting the correlations between the pathology severity, characterization of professional risk and issue of elegibility for the specific task. Methods. Was analyzed a case studies of lumbar rachipathies reports received by INAIL in the entire Abruzzo region in 2017, the last year available in the INAIL database at the time of data extrapolation dating back to May 2019. For each dossier were collected data extrapolated from: DVR, medical record and risk, instrumental examinations and specialist visits. The software "Epi Info" version 7 was used for the statistical analysis of the sample, provided by the CDC (Centers for Disease Control and Prevention) in Atlanta. Results. The expression of work elegibility with limitations and/or prescriptions by the phisicians is related only to clinical symptoms and not to the presence of a herniated disc on CT or MRI tests. The exposure to risk from MMH and WBV, documented in the DVR, was not found to be related to the presence of a herniated disc on instrumental examinations. There was no significant difference in the average age between workers recognized as technopathic from non-technopathic. Conclusions. Although biomechanical overload has always been considered as an important wear element of the intervertebral disc, genetic influences and constitutional factors seem to be elements more implicated in the development of hernial disc disease.

An enhanced whole-body vibration emission index for railway vehicles.

Whole-body vibration (WBV) is a concept that is gaining importance in the railway sector. Occupational disorders, such as back pain and sciatica, frequently cause sick leave and have resulted in lawsuits against employers. Railway operators require a clear procedure for specification and purchase of certified rail vehicles that evaluate the vehicle from the point of view of the effect of WBV. However, a review of current standards and studies shows no clear and simple method for defining a vibration emission value, such as that defined in EN 1032 for mobile machinery. This study proposes a systematic and robust railway driver-related vibration index and describes the methodology for its determination. The proposed index, based on current WBV standards, is robust and allows comparisons between vehicles. For index validation, we used experimental results as well as results from a neural network using the cabin floor data. Practitioner summary: A new vibration emission index is proposed for the certification of railway vehicles, using whole-body vibration, based on current standards. It could be used as a criterion when purchasing a vehicle and as a design specification for manufacturers, thereby improving the ergonomics of drivers' working environment. Abbreviations: EAV: exposure action value; RMS: root mean square; VDV: vibration dose value; VEI: vibration emission index; VTV: vibration total value; WBV: whole-body vibration.

Whole body vibration therapy on a treatment bed as additional means to treat postprostatectomy urinary incontinence.

An innovative form of whole body vibration therapy on a treatment bed (Evocell®) to fight against the disabling and isolating symptom of postoperative incontinence in a prostate cancer patient is presented. A supervised program with outpatient active pelvic floor training and a novel form of synchronous high-intensity whole body vibration therapy using the Evocell® device was performed in a patient with postprostatectomy stress urinary incontinence. The patient had previously failed regular pelvic floor exercise. During the intervention, namely a whole body vibration treatment in a lying position on a treatment bed, the patient performed active and passive pelvic floor exercises under professional guidance. Over a period of 6 weeks after starting treatment, the patient regained continence (usage of 1 safety pad). Furthermore, his ability to work increased (return to work) and his ability to attend social activities improved.

Characterization of workers or population percentage affected by low-back pain (LPB), sciatica and herniated disc due to whole-body vibrations (WBV).

Whole-body vibrations have several harmful effects on the population's health. The most suitable way to characterize the vibrations is to use the daily vibration exposure A (8) and Vibration Dose Value as specified in Directive 2002/44/EC. Therefore, based on the existing literature, we propose Probit equations that allow us to relate the population percentage affected by the vibration effects (low-back pain, sciatica, and herniated disc) with the A (8) and the Vibration Dose Value. It is worth noting that there is a good correlation between the experimental data and the expressions obtained, especially for low-back pain and herniated discs. Once the expressions have been validated, we analyze the limit values given in the aforementioned legislation, showing that the percentage of the affected population is significant for them. Therefore, this study also proposes new limits based on their own definitions, which are more in line with the results shown in the bibliography.

A Pre-Post Study on the Cardiorespiratory Response to Different Protocols of Exposure on a Vibratory Platform in Young Healthy Individuals.

This study aimed to investigate the acute specific physiological effects of 15 min of whole-body vibration (WBV) exposure at six different types of vibrations on cardiorespiratory function in 26 healthy young subjects (sex ratio, 1:1; mean age, 20.73 years). The protocols included six variants of a combination of mechanical stimuli with different frequencies (15, 25, and 35 Hz) and direction of stimuli (vertical or diagonal). The investigated cardiorespiratory parameters were heart rate (HR), arterial oxygen saturation (SaO2), respiratory rate (RR), and spirometric indicators: tidal volume (TV), vital capacity (VC), forced vital capacity (FVC), forced expiratory volume at 1 s (FEV1), and maximum voluntary ventilation for 12 s (MVV). The data series were statistically processed by using descriptive and inferential statistical methods: the Shapiro-Wilk test, the two-way ANOVA with repeated measures, and post hoc analysis. We obtained significantly higher values for HR, TV, VC, FVC, FEV1, and MVV after the WBV exposure. These parameters are significantly influenced by both the frequency and direction of stimuli, and certain protocols of WBV are noticeable for their distinct effects. Our results offer a new perspective on the possibility of using preferential variants of vibratory stimulation to obtain maximum cardiorespiratory physiological effects.

Musculoskeletal diseases among French military high-speed boat pilots.

In 2016, the French Navy acquired a new high-speed boat, called ECUME. It exposes crewmembers to significant Whole Body Vibrations. This work explores the musculoskeletal diseases among this population. We conducted a retrospective declarative epidemiologic study using anonymous questionnaires. Eighty-four sailors were included. Fifty-six (66.7%) report acute traumas during a nautical raid during the 12 months study period. Sixty (71.4%) report chronic pains, which they associate with their nautical activity. Among them, only 16 (26.7%) have consulted a doctor, but 32 (53.3%) report consuming medication, including 18 through selfmedication. More than half rely to alternatives medicine, especially osteopathy. The traumatic risk of ECUME riding is obvious. Many crewmembers minimize their symptoms, and consult rarely a physician. They give preference to selfmedication and alternative medicines.

Effects of vibration training and detraining on balance and muscle strength in older adults.

The purpose of this study was to analyze the effects of 2 days/week versus 4 days/week of Whole Body Vibration (WBV) during eight weeks of WBV training on health-related quality of life (SF-36), balance and lower body strength, as well as short-term detraining (3 weeks) on balance and lower body strength among older adults. Thirty-four older adults were randomly assigned to a control group (Control; n = 11) or to one of the vibration training groups: WBV 2 days/week (WBV_2d; n = 11) or WBV 4 days/week (WBV_4d; n = 12). The WBV groups exercised for 8 weeks, following 3 weeks of detraining. Lower body strength increased significantly (p < 0.05) for both groups, WBV_2d and WBV_4d, after 8-week training. A significant reduction in strength was observed following 3 weeks of detraining only in WBV_2d group (p < 0.05). All variables of the SF-36 and the balance test did not change after intervention in any group. 2 days/week and 4 days/week of WBV during 8 weeks showed the same improvements on muscle strength. 3 weeks of detraining did not reverse the gains in strength made during 32 sessions of WBV. Key points2 days and 4 days per week of WBV training during 8 weeks showed the same improvements on muscle strength.3 weeks of detraining did not reverse the gains in strength made during 32 sessions of WBV exercise.3 weeks of detraining did reverse the gains in strength made during 16 sessions of WBV exercise.

Vibration transmissibility and apparent mass changes from vertical whole-body vibration exposure during stationary and propelled walking.

Whole-Body Vibration (WBV) is an occupational hazard affecting employees working with transportation, construction or heavy machinery. To minimize vibration-induced pathologies, ISO identified WBV exposure limits based on vibration transmissibility and apparent mass studies. The ISO guidelines do not account for variations in posture or movement. In our study, we measured the transmissibility and apparent mass at the mouth, lower back, and leg of participants during stationary and propelled walking. Stationary walking transmissibility was significantly higher at the lumbar spine and bite bar at 5 and 10 Hz compared to all higher frequencies while the distal tibia was lower at 5 Hz compared to 10 and 15 Hz. Propelled walking transmissibility was significantly higher at the bite bar and knee at 2 Hz than all higher frequencies. These results vary from previously published transmissibility values for static participants, showing that ISO standards should be adjusted for active workers.

The Estimate of Relative Increase in Stroke Volume of a Heart under Influence of Low Frequency Mechanical Vibrations.

BACKGROUND: An automatic massage produces health improving effects. After a single automatic massage, patients admit a feeling of invigoration, and a sense of relaxation. Some quantitative characteristics of physical effects produced by the automatic massage on the body, including the work of a heart were unavailable at that moment. OBJECTIVE: This study aims to find a quantitative impact of periodic low frequency mechanical vibrations on the relative change in a heart stroke volume. MATERIAL AND METHODS: In this experimental study, the patients were exposed to the low frequency (12 Hz) planar mechanical vibrations. The blood pressures were measured before and after the automatic massage. Based on the measured values in the arterial blood pressure, a relative change in a stroke volume (SV) in patients was calculated. RESULTS: The increased systolic blood pressure was 6.3±2.0 mm Hg in women and 11.1±2.7 mm Hg in men. The increased diastolic pressure was 1.9±1.2 mm Hg in women, and 4.9±1.5 mm Hg in men. The minor increase in heart rate for women was 1.2±1.0 beats per minute, and 1.2±2.0 beats per minute for men. The assessment of stroke volume changes provided 9.6% and 7.1% increase during systole and diastole in male patients, respectively, and corresponding 6.7% and 4.7% increases for female patients. CONCLUSION: The results of our work confirmed an increase in the systolic and diastolic blood pressures under the influence of periodic mechanical vibration of low frequency. We believe that the registered increase in blood pressure is a proof of the increase in a stroke volume (SV).

An extended model of the ISO-2631 standard to objectify the ride comfort in autonomous driving.

BACKGROUND: With the development of autonomous driving, the occupants' comfort perception and their activities during the drive are becoming increasingly the focus of research. Especially in one of the first applications, a drive on a motorway, vertical dynamics play a major role. OBJECTIVE: To be able to robustly objectify ride comfort, better models need to be developed. Initial studies have shown, that the current ISO-2631 standard creates good results in the objectification and can be regarded as benchmark. METHODS: To increase the accuracy in objectification, an extended model with the occupants' head as additional measuring point is introduced. Instead of the known frequency filters, weighting (k-factors) is used to differentiate possible excitations. For comparing the model with the ISO-2631, a simulator study with 5 excitations and 50 inattentive subjects is carried out. RESULTS: Evaluating the study with the ISO-2631, 3 out of 5 excitations indicate a significant difference between the occupant's impression and the calculated comfort value. In comparison the extended model has no significant difference. CONCLUSION: The results further show, that inattentive occupants move their heads significantly more. By measuring accelerations of the head, the extended model creates equivalent or more accurate comfort values than the ISO-2631.

A methodology for assessment of long-term exposure to whole-body vibrations in vehicle drivers to propose preventive safety measures.

INTRODUCTION: The appearance of musculoskeletal disorders (MDs) in professional drivers due to exposition to whole-body vibration (WBV) makes it relevant to assess this exposure. The European Directive 2002/44/EC has two methods to evaluate exposure to WBV (defined in ISO2631-1:2008). These methods evaluate the exposure associated with an 8-hour working day; however, MDs due to WBV could also be caused by accumulated exposure to vibrations over long term, and hence, the methods defined in the European directive may be limited in their ability to ensure the safety of workers exposed to WBV throughout their years of employment. METHOD: A detailed comparison and discussion of methods defined in the European Directive and the ISO2631-5:2018 was used as a starting point of the main results of this paper. On this basis, a new methodology for the management and organization of preventive measures is proposed to consider the assessment of ISO2631-5:2018 standard and the full working life of workers. Experimental data to assess exposure to WBV in heavy equipment vehicle (HEV) drivers under different road surface conditions and range of velocities were considered to illustrate the process of the proposed methodology. RESULTS: The methods defined in the standards provide different assessments leading to a different possible consideration of safe operations when the risks associated with them may actually be high. The proposed methodology can be used with the aim of ensuring safety of workers throughout their working lives and providing an easy implementation of the calculations of ISO2631-5:2018 standard. CONCLUSIONS: A procedure to assess the health risk probability to which the HEV worker is exposed in terms of the exposure years and a different range of operational vehicle speeds is proposed and exemplified with a study case. Practical applications: This study provides a practical tool for the management of WBV exposure related to work-tasks in HEV drivers. Safety managers should consider the global exposition to WBV throughout their working life, and this research provides an easy tool to accomplish it.