Epidemiological evidence for new frequency weightings of hand-transmitted vibration

Relation of digital arterial dysfunction to alternative frequency weightings of hand-transmitted vibration

This study compared the relative performance of alternative frequency weightings of hand-transmitted vibration (HTV) to predict the extent of cold-induced vasoconstriction in the digital arteries of HTV workers. The cold response of digital arteries was related to measures of daily vibration exposure expressed in terms of r.m.s. acceleration magnitude normalised to an 8-h day, frequency weighted according to either the frequency weighting Wh defined in international standard ISO 5349-1:2001 (Ah(8) in ms-2 r.m.s.) or the hand-arm vascular frequency weighting Wp proposed in the ISO Technical Report 18570:2007 (Ap(8) in ms-2 r.m.s.). The measure of daily vibration exposure constructed with the frequency weighting Wp (Ap(8)) was a better predictor of the cold response of the digital arteries in the HTV workers than the metric derived from the conventional ISO frequency weighting Wh (Ah(8)). This finding suggests that a measure of daily vibration exposure constructed with the vascular weighting Wp, which gives more weight to intermediate- and high-frequency vibration (31.5-250 Hz), performed better for the prediction of cold induced digital arterial hyperresponsiveness than that obtained with the frequency weighting Wh recommended in ISO 5349-1 which gives more importance to lower frequency vibration (≤16 Hz).

Applied Force Alters Sensorineural and Peripheral Vascular Function in a Rat Model of Hand-Arm Vibration Syndrome

OBJECTIVE

This study described the effects of applied force (grip) on vascular and sensorineural function in an animal model of hand-arm vibration syndrome (HAVS).

METHODS

Rat tails were exposed to 0, 2, or 4 N of applied force 4 hr/d for 10 days. Blood flow and sensitivity to transcutaneous electrical stimulation and pressure were measured.

RESULTS

Applied force increased blood flow but reduced measures of arterial plasticity. Animals exposed to force tended to be more sensitive to 250-Hz electrical stimulation and pressure applied to the tail.

CONCLUSIONS

Effects of applied force on blood flow and sensation are different than those of vibration. Studies examining co-exposures to force and vibration will provide data that can be used to determine how these factors affect risk of workers developing vascular and sensorineural dysfunction (ie, HAVS).

Near-wall hemodynamic parameters of finger arteries altered by hand-transmitted vibration

BACKGROUND

Sustained exposure to high-level hand-transmitted vibrations may result in angioneurotic disorders, which partly originate from vibration-altered hemodynamics in the finger arteries when repeating these disturbances throughout working life. Hence, the aim of this study is to assess the most relevant hemodynamic descriptors in the digital arteries, determine the relationship between the latter and vibration features, and gain better understanding of the physiological mechanisms involved.

METHODS

An experimental setup, mainly comprised of an ultra-high frequency ultrasound scanner and a vibration shaker, was used to image the digital proper volar arteries of the forefinger. Raw ultrasound data were post-processed by custom-made numerical routines to supply a pulsatile fluid mechanics model for computing the hemodynamic descriptors. Twenty-four healthy volunteers participated in the measurement campaign. Classical statistical methods were then applied to the dataset and also the wavelet transform for calculating the signal power in the frequency bands matching cardiac, respiratory, myogenic and neurogenic activities.

RESULTS

The artery diameter, the wall shear stress - WSS - and the WSS temporal gradient - WSSTG - were found to be the most relevant descriptors. Vibration-induced WSS was divided by three compared to its basal value whatever the vibration frequency and it was proportional to log2 of the acceleration level. Marked increases in WSSTG when stopping vibration might also lead to adverse health effects. Vibration caused a drop in WSS power for the frequency band associated with the neurogenic activity of the sympathetic nervous system.

CONCLUSION

This study may pave the way for a new framework to prevent vibration-induced vascular risk.

Exposure-response relation for vibration-induced white finger: inferences from a published meta-analysis of population groups

PURPOSE

It is questioned whether the exposure-response relation for the onset of vibration-induced white finger (VWF) in ISO 5349-1:2001 needs to be revised based on the epidemiologic studies identified by Nilsson et al. (PLoS One https://doi.org/10.1371/journal.pone.0180795 , 2017), and whether the relation they derive improves the prediction of VWF in vibration-exposed populations.

METHODS

A pooled analysis has been performed using epidemiologic studies that complied with selection rules and reported a VWF prevalence of 10% or more, and exposure constructed according to the provisions of ISO 5349-1:2001. The lifetime exposures at 10% prevalence were calculated for various data sets using linear interpolation. They were then compared to both the model from the standard and that developed by Nilsson et al. RESULTS: Regression analyses reveal excluding extrapolation to adjust group prevalences to 10% produce models with 95-percentile confidence intervals that include the ISO exposure-response relation but not that in Nilsson et al. (2017). Different curve fits are obtained for studies involving daily exposure to single or multiple power tools and machines. Studies with similar exposure magnitudes and lifetime exposure durations but markedly different prevalences are observed to cluster.

CONCLUSIONS

A range of exposures and A(8)-values is predicted within which the onset of VWF is most likely to occur. The exposure-response relation in ISO 5349-1:2001, but not that proposed by Nilsson et al., falls within this range and provides a conservative estimate for the development of VWF. In addition, the analyses suggest that the method for evaluating vibration exposure contained in ISO 5349-1:2001 needs revision.

A Multiscale Approach for Predicting Certain Effects of Hand-Transmitted Vibration on Finger Arteries

Prolonged exposure to strong hand-arm vibrations can lead to vascular disorders such as Vibration White Finger (VWF). We modeled the onset of this peripheral vascular disease in two steps. The first consists in assessing the reduction in shearing forces exerted by the blood on the walls of the arteries (Wall Shear Stress—WSS) during exposure to vibrations. An acute but repeated reduction in WSS can lead to arterial stenosis characteristic of VWF. The second step is devoted to using a numerical mechano-biological model to predict this stenosis as a function of WSS. WSS is reduced by a factor of 3 during exposure to vibration of 40 m·s−2. This reduction is independent of the frequency of excitation between 31 Hz and 400 Hz. WSS decreases logarithmically when the amplitude of the vibration increases. The mechano-biological model simulated arterial stenosis of 30% for an employee exposed for 4 h a day for 10 years. This model also highlighted the chronic accumulation of matrix metalloproteinase 2. By considering daily exposure and the vibratory level, we can calculate the degree of stenosis, thus that of the disease for chronic exposure to vibrations.

Upper extremity musculoskeletal disorders and work exposures among railroad maintenance-of-way workers

BACKGROUND

Our objective was to examine occupational risk factors for musculoskeletal disorders of the shoulders, elbows, wrists, and hands among railroad maintenance-of-way (MOW) workers. Little systematic research on musculoskeletal disorders has been conducted in this occupational group.

METHODS

In total, 3995 active members of the Brotherhood of Maintenance of Way Employes Division (BMWED) completed a standardized survey focusing on disorders caused by hand-transmitted vibration. We computed adjusted prevalence ratios (aPRs) using Poisson regression for shoulder, elbow, carpal tunnel syndrome, and vibration white finger musculoskeletal symptoms by work exposures, adjusted for age, region, race/ethnicity, smoking, potential second job, and spare time vehicle vibration exposure, and other work exposures.

RESULTS

Among active male BMWED members, we found associations between >5.2 years (vs. 0.0-0.7 years) duration of full-time equivalent power tool use and shoulder pain (aPR = 2.01; 95% confidence interval [CI], 1.43-2.85), elbow pain (aPR = 2.88; 95% CI, 1.86-4.46), vibration white finger symptoms (aPR = 2.49; 95% CI, 1.06-5.85), hand/wrist pain (aPR = 2.40; 95% CI, 1.74-3.32), finger numbness or tingling (aPR = 1.86; 95% CI, 1.38-2.50) and self-reported carpal tunnel syndrome diagnosis (aPR = 2.16; 95% CI, 1.24-3.77). Associations were not consistent across outcomes for the duration of non-powered hand tool use and "repeated lifting, pushing, pulling, or bending." Positive gradients were observed for most outcomes.

CONCLUSIONS

Hand-arm vibration and some other biomechanical exposures were associated with shoulder, elbow, wrist, hand, and finger symptoms. Prevention programs should address occupational risk factors for upper extremity musculoskeletal disorders among MOW workers.

A Review of Hand-Arm Vibration Studies Conducted by US NIOSH since 2000

Studies on hand-transmitted vibration exposure, biodynamic responses, and biological effects were conducted by researchers at the Health Effects Laboratory Division (HELD) of the National Institute for Occupational Safety and Health (NIOSH) during the last 20 years. These studies are systematically reviewed in this report, along with the identification of areas where additional research is needed. The majority of the studies cover the following aspects: (i) the methods and techniques for measuring hand-transmitted vibration exposure; (ii) vibration biodynamics of the hand-arm system and the quantification of vibration exposure; (iii) biological effects of hand-transmitted vibration exposure; (iv) measurements of vibration-induced health effects; (iv) quantification of influencing biomechanical effects; and (v) intervention methods and technologies for controlling hand-transmitted vibration exposure. The major findings of the studies are summarized and discussed.

Powered-hand tools and vibration-related disorders in US-railway maintenance-of-way workers

Maintenance-of-way workers in North America who construct railroad tracks utilize specialized powered-hand tools, which lead to hand-transmitted vibration exposure. In this study, the maintenance-of-way workers were surveyed about neuro-musculoskeletal disorders, powered-hand tools and work practices. Information about vibration emission data of trade specific powered-hand tools for the North American and European Union markets was searched online to obtain respective user information of manufacturer and compared to non-commercial international data banks. The survey showed that maintenance-of-way workers frequently reported typical hand-transmitted vibration-related symptoms, and appear to be at a risk for neuro-musculoskeletal disorders of the upper extremity. Of all of the powered-hand tools used by this trade, 88% of the selected tools exceeded a=5 m/s² and were above vibration magnitudes of common tools of other comparable industries. This may create a risk if these tools are used throughout an 8-h work day and management of vibration exposure may be needed. In the North-American market, limited or no vibration emission data is available from manufacturers or distributors. Vibration emission information for powered-hand tools, including vibration emission levels (in m/s²), uncertainty factor K, and the applied testing standard/norm may assist employers, users and occupational health providers to better assess, compare and manage risk.

Riveting hammer vibration damages mechanosensory nerve endings

Hand-arm vibration syndrome (HAVS) is an irreversible neurodegenerative, vasospastic, and musculoskeletal occupational disease of workers who use powered hand tools. The etiology is poorly understood. Neurological symptoms include numbness, tingling, and pain. This study examines impact hammer vibration-induced injury and recoverability of hair mechanosensory innervation. Rat tails were vibrated 12 min/d for 5 weeks followed by 5 week recovery with synchronous non-vibrated controls. Nerve fibers were PGP9.5 immunostained. Lanceolate complex innervation was compared quantitatively in vibrated vs sham. Vibration peak acceleration magnitudes were characterized by frequency power spectral analysis. Average magnitude (2515 m/s² , root mean squared) in kHz frequencies was 109 times that (23 m/s² ) in low Hz. Percentage of hairs innervated by lanceolate complexes was 69.1% in 5-week sham and 53.4% in 5-week vibration generating a denervation difference of 15.7% higher in vibration. Hair innervation was 76.9% in 5-weeks recovery sham and 62.0% in 5-week recovery vibration producing a denervation difference 14.9% higher in recovery vibration. Lanceolate number per complex (18.4 ± 0.2) after vibration remained near sham (19.3 ± 0.3), but 44.9% of lanceolate complexes were abnormal in 5 weeks vibrated compared to 18.8% in sham. The largest vibration energies are peak kHz accelerations (approximately 100 000 m/s² ) from shock waves. The existing ISO 5349-1 standard excludes kHz vibrations, seriously underestimating vibration injury risk. The present study validates the rat tail, impact hammer vibration as a model for investigating irreversible nerve damage. Persistence of higher denervation difference after 5-week recovery suggests repeated vibration injury destroys the capability of lanceolate nerve endings to regenerate.

Frequency-dependent changes in mitochondrial number and generation of reactive oxygen species in a rat model of vibration-induced injury

Regular use of vibrating hand tools results in cold-induced vasoconstriction, finger blanching, and a reduction in tactile sensitivity and manual dexterity. Depending upon the length and frequency, vibration induces regeneration, or dysfunction and apoptosis, inflammation and an increase in reactive oxygen species (ROS) levels. These changes may be associated with mitochondria, this study examined the effects of vibration on total and functional mitochondria number. Male rats were exposed to restraint or tail vibration at 62.5, 125, or 250 Hz. The frequency-dependent effects of vibration on mitochondrial number and generation of oxidative stress were examined. After 10 days of exposure at 125 Hz, ventral tail arteries (VTA) were constricted and there was an increase in mitochondrial number and intensity of ROS staining. In the skin, the influence of vibration on arterioles displayed a similar but insignificant response in VTA. There was also a reduction in the number of small nerves with exposure to vibration at 250 Hz, and a reduction in mitochondrial number in nerves in restrained and all vibrated conditions. There was a significant rise in the size of the sensory receptors with vibration at 125 Hz, and an elevation in ROS levels. Based upon these results, mitochondria number and activity are affected by vibration, especially at frequencies at or near resonance. The influence of vibration on the vascular system may either be adaptive or maladaptive. However, the effects on cutaneous nerves might be a precursor to loss of innervation and sensory function noted in workers exposed to vibration.

Vibration and Noise Transmitted by Agricultural Backpack Powered Machines Critically Examined Using the Current Standards

European Directives 2002/44/EC and 2003/10/EC establish the exposure limit values for preventing operators’ risks to vibration and noise transmitted by machines. Few studies studied noise and vibration of agricultural backpack powered machines (as mist blowers and blowers), but nobody critically studied them. This work analyzed the field back vibration, hand-arm vibration (HAV), and noise transmitted to ten operators by eight blowers and mist blowers. Unweighted and weighted vibration were analyzed, using the standards ISO 2631-1 (back), and ISO 5349-1 and ISO/TR 18570 (hand-arm system). The noise was evaluated by recording the acoustic pressure level at the operators’ ears using the ISO 9612. With the ISO 2631-1, the vibration to the operators’ back was low (0.38 ms⁻²), but the unweighted vibration measured along y and z-axes (not used by the ISO 2631-1) were high (>11 ms⁻²). HAV were also low when using the ISO 5349-1 (the highest value was 2.51 ms⁻² in mist blowers), but high with the ISO/TR 18570 for the onset of vibration white finger (1446 ms^−1.5 in blowers). Noise levels were always high: more than 100 dB(A), excluding the blower with the exhaust inside the blower hose. This last machine had noise levels lower than 86 dB(A), but its specific feature could increase environmental pollution.

Application of cold intolerance symptom severity questionnaire among vibration-exposed workers as a screening tool for the early detection of hand-arm vibration syndrome: a cross-sectional study

Background

The detection rate of hand-arm vibration syndrome (HAVS) is very low in South Korea compared with other countries. The absence of uniform consensus and guidelines for diagnosing HAVS has been presumed to be one of the reasons. The HAVS has various manifestations including cold intolerance and its severity can be measured using the cold intolerance symptom severity (CISS) questionnaire. This study aimed to determine whether the CISS questionnaire, being used as a screening tool, can aid in the early detection of HAVS.

Methods

A total of 76 male workers with vibration-induced symptoms were enrolled as the final study participants. To compare the CISS score of healthy individuals, 41 men who had never been exposed to local vibration were included in the study. In addition to the former medical questionnaire, the participants answered the CISS questionnaire. A statistical analysis was conducted to identify the association of CISS scores with vibration induced symptom and to determine its cut off value.

Results

The reliability of the CISS questionnaire was proven to be good, with a total Cronbach’s alpha of 0.922. The mean CISS score of the exposed group increased in every vascular stage [stage 0 = 42.6 (18.5); stage 1 = 59.4 (14.1); and over stage 2 = 60.2 (21.6)]. They were significantly higher than that of the non-exposed group. The result was fairly consistent with those in the sensorineural stage. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under curve (AUC) of 30 were 88.5, 65.3, 76.1, 82.1 and 0.769, respectively. From the result of logistic regression, the adjusted odds ratio of both components increased by the CISS score grouped by 30s.

Conclusions

The self-reported CISS questionnaire, used to measure the degree of cold intolerance, showed high agreement with the Stockholm classification of HAVS. Hence, we recommend the use of this questionnaire to assess the level of cold intolerance among vibration-exposed workers and detect individuals who are at risk of vibration-induced impairment with a cutoff value of 30.

Trial registration

IRB No. 2018–07–040-001. Registered on 4 September 2018.

Risk assessment of vascular disorders by a supplementary hand-arm vascular weighting of hand-transmitted vibration

PURPOSE

To provide an updated epidemiological validation for a supplementary method for assessing the risk of vascular disorders from hand-transmitted vibration.

METHODS

The occurrence of vibration-induced white finger (VWF) in the vibration-exposed workers of the Italian cohort of the EU VIBRISKS study was related to measures of daily vibration exposure expressed in terms of r.m.s. acceleration magnitude normalised to an 8-h day, frequency weighted according to either the frequency weighting W_h defined in international standard ISO 5349-1:2001 [A_h(8) in ms^- 2] or the hand-arm vascular frequency weighting W_p proposed in the ISO technical report (TR) 18570:2017 [A_p(8) in ms^- 2]. To estimate a threshold value for vascular hand-arm vibration risk, the W_p-weighted vibration exposure value E_p,d (in ms^- 1.5) was calculated according to the ISO/TR document. The difference in the predictions of VWF between the exposure measures calculated with the frequency weightings W_h or W_p was investigated by means of logistic modelling.

RESULTS

Measures of daily vibration exposure constructed with the frequency weighting W_p [A_p(8) and E_p,d], which gives more importance to intermediate- and high-frequency vibration, were better predictors of the occurrence of VWF in the vibration-exposed workers than the metric derived from the conventional ISO frequency weighting W_h [A_h(8)]. There was some epidemiological evidence for a threshold value of E_p,d for the onset of VWF in the vibration-exposed workers.

CONCLUSIONS

Measures of daily vibration exposure evaluated with the vascular weighting W_p performed better for the predictions of VWF than those obtained with the frequency weighting W_h recommended in ISO 5349-1.

A three-dimensional visco-hyperelastic FE model for simulating the mechanical dynamic response of preloaded phalanges

This study lays the groundwork for a multi-scale strategy that will lead to a better understanding and prediction of the effects of vibration on the digital arterial network. This is accomplished by modelling the mechanical and biological factors that could disturb the basal vasoconstriction balance in the fingertip. The first stage of this novel approach involved building and validating an original dissipative constitutive law for the fingertip soft tissue for the purpose of finite element modelling of the mechanical response of preloaded phalanges in vibration. This visco-hyperelastic constitutive law was established by means of a two-stage procedure for combining a classical pure static nonlinear law with an original dissipative model. First, the parameters of an Ogden-Hill pure static nonlinear constitutive law were identified using a constrained optimisation algorithm. Second, an original viscous dissipation model was proposed in the spectral domain. This model is based on the linearization of the nonlinear quasi-linear viscoelasticity law and the use of a viscoelastic relaxation modulus, expressed as a continuous distribution of relaxation spectra suitable for living tissues. The experimental data used to fit this model were the static and dynamic stiffnesses of preloaded fingertips acquired from a group of 20 subjects. The relative errors between the measured and simulated stiffnesses were less than 5% in the static procedure and approximately 8% using dynamic analysis. The computed mechanical pressure and maximal tangential stress within the fingertip were high in the soft tissues close to the vibration excitation and also in the bones and interphalangeal cartilages far from the vibration source. Mechanical power was only dissipated significantly in the immediate vicinity of the contact area between the probe and the finger. The main contribution of this study was to implement and identify the parameters of a new spectral dissipative law for fingertip soft tissues. This work may apply in occupational health for modifying the vibration dose assessment or for the follow-up and screening of connective tissue diseases.

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.

Vibration and impulsivity analysis of hand held olive beaters

To provide more effective evaluations of hand arm vibration syndromes caused by hand held olive beaters, this study focused on two aspects: the acceleration measured at the tool pole and the analysis of the impulsivity, using the crest factor. The signals were frequency weighted using the weighting curve Wh as described in the ISO 5349-1 standard. The same source signals were also filtered by the Wh-bl filter (ISO/TS 15694), because the weighting filter Wh (unlike the Wh-bl filter) could underestimate the effect of high frequency vibration on vibration-induced finger disorders. Ten (experienced) male operators used three beater models (battery powered) in the real olive harvesting condition. High vibration total values were obtained with values never lower than 20 m(-2). Concerning the crest factor, the values ranged from 5 to more than 22. This work demonstrated that the hand held olive beaters produced high impulsive loads comparable to the industry hand held tools.

Transcriptional Pathways Altered in Response to Vibration in a Model of Hand-Arm Vibration Syndrome

OBJECTIVE

The aim of this study was to use an established model of vibration-induced injury to assess frequency-dependent changes in transcript expression in skin, artery, and nerve tissues.

METHODS

Transcript expression in tissues from control and vibration-exposed rats (4 h/day for 10 days at 62.5, 125, or 250 Hz; 49 m/s, rms) was measured. Transcripts affected by vibration were used in bioinformatics analyses to identify molecular- and disease-related pathways associated with exposure to vibration.

RESULTS

Analyses revealed that cancer-related pathways showed frequency-dependent changes in activation or inhibition. Most notably, the breast-related cancer-1 pathway was affected. Other pathways associated with breast cancer type 1 susceptibility protein related signaling, or associated with cancer and cell cycle/cell survivability were also affected.

CONCLUSION

Occupational exposure to vibration may result in DNA damage and alterations in cell signaling pathways that have significant effects on cellular division.

Effect of higher frequency components and duration of vibration on bone tissue alterations in the rat-tail model

To formulate more accurate guidelines for musculoskeletal disorders (MSD) linked to Hand-Arm Vibration Syndrome (HAVS), delineation of the response of bone tissue under different frequencies and duration of vibration needs elucidation. Rat-tails were vibrated at 125 Hz (9 rats) and 250 Hz (9 rats), at 49 m/s(2), for 1D (6 rats), 5D (6 rats) and 20D (6 rats); D=days (4 h/d). Rats in the control group (6 rats for the vibration groups; 2 each for 1D, 5D, and 20D) were left in their cages, without being subjected to any vibration. Structural and biochemical damages were quantified using empty lacunae count and nitrotyrosine signal-intensity, respectively. One-way repeated-measure mixed-model ANOVA at p<0.05 level of significance was used for analysis. In the cortical bone, structural damage quantified through empty lacunae count was significant (p<0.05) at 250 Hz (10.82 ± 0.66) in comparison to the control group (7.41 ± 0.76). The biochemical damage was significant (p<0.05) at both the 125 Hz and 250 Hz vibration frequencies. The structural damage was significant (p<0.05) at 5D for cortical bone while the trabecular bone showed significant (p<0.05) damage at 20D time point. Further, the biochemical damage increased with increase in the duration of vibration with a significant (p<0.05) damage observed at 20D time point and a near significant change (p=0.08) observed at 5D time point. Structural and biochemical changes in bone tissue are dependent upon higher vibration frequencies of 125 Hz, 250 Hz and the duration of vibration (5D, 20D).

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.

Analysis of long-term stored plasma samples for investigation into the pathophysiology of vibration-induced white finger: preliminary results

Blood samples were collected 25 yr ago from hand-arm vibration syndrome patients with vibration-induced white finge/VWF (VWF+ group) and without it (VWF- group), and healthy controls (n=12 in each group), and stored at -80 °C. The subjects provided venous blood twice: at baseline, and after cold exposure at 7 °C for 25 min. Blood specimens were analyzed for plasma endothelin-1 (ET-1) by an enzyme-linked immunosorbent assay. Baseline concentration of plasma ET-1 was found to be significantly larger in the VWF- group than the control group, whereas no such difference was observed for the VWF+ group. However, the %change was larger in the VWF+ group (107.73 ± 30.49%) than the other two groups, and more subjects in the VWF+ group showed the maximum increase in ET-1 than the other two groups. In conclusion, ET-1 appears to have a role in the pathophysiology of VWF.

Validity and inter-observer reliability of subjective hand-arm vibration assessments

Exposure to mechanical vibrations at work (e.g., due to handling powered tools) is a potential occupational risk as it may cause upper extremity complaints. However, reliable and valid assessment methods for vibration exposure at work are lacking. Measuring hand-arm vibration objectively is often difficult and expensive, while often used information provided by manufacturers lacks detail. Therefore, a subjective hand-arm vibration assessment method was tested on validity and inter-observer reliability. In an experimental protocol, sixteen tasks handling powered tools were executed by two workers. Hand-arm vibration was assessed subjectively by 16 observers according to the proposed subjective assessment method. As a gold standard reference, hand-arm vibration was measured objectively using a vibration measurement device. Weighted κ's were calculated to assess validity, intra-class-correlation coefficients (ICCs) were calculated to assess inter-observer reliability. Inter-observer reliability of the subjective assessments depicting the agreement among observers can be expressed by an ICC of 0.708 (0.511-0.873). The validity of the subjective assessments as compared to the gold-standard reference can be expressed by a weighted κ of 0.535 (0.285-0.785). Besides, the percentage of exact agreement of the subjective assessment compared to the objective measurement was relatively low (i.e., 52% of all tasks). This study shows that subjectively assessed hand-arm vibrations are fairly reliable among observers and moderately valid. This assessment method is a first attempt to use subjective risk assessments of hand-arm vibration. Although, this assessment method can benefit from some future improvement, it can be of use in future studies and in field-based ergonomic assessments.

Relation between vibrotactile perception thresholds and reductions in finger blood flow induced by vibration of the hand at frequencies in the range 8-250 Hz

PURPOSE

This study investigated how the vasoconstriction induced by vibration depends on the frequency of vibration when the vibration magnitude is defined by individual thresholds for perceiving vibration [i.e. sensation levels (SL)].

METHODS

Fourteen healthy subjects attended the laboratory on seven occasions: for six vibration frequencies (8, 16, 31.5, 63, 125, or 250 Hz) and a static control condition. Finger blood flow (FBF) was measured in the middle fingers of both hands at 30-second intervals during five successive periods: (i) no force or vibration, (ii) 2-N force, no vibration, (iii) 2-N force, vibration, (iv) 2-N force, no vibration, (v) no force or vibration. During period (iii), vibration was applied to the right thenar eminence via a 6-mm diameter probe during ten successive 3-min periods as the vibration magnitude increased in ten steps (-10 to +40 dB SL).

RESULTS

With vibration at 63, 125, and 250 Hz, there was vasoconstriction on both hands when the vibration magnitude reached 10 dB SL. With vibration at 8, 16, and 31.5 Hz, there was no significant vasoconstriction until the vibration reached 25 dB SL. At all frequencies, there was greater vasoconstriction with greater magnitudes of vibration.

CONCLUSIONS

It is concluded that at the higher frequencies (63, 125, and 250 Hz), the Pacinian channel mediates vibrotactile sensations near threshold and vasoconstriction occurs when vibration is perceptible. At lower frequencies (8, 16, and 31.5 Hz), the Pacinian channel does not mediate sensations near threshold and vasoconstriction commences at greater magnitudes when the Pacinian channel is activated.