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Risk assessment of vibration exposure and white fingers among platers.

The dose-response relationship between vibration exposure and vascular disorders in the hands was examined in platers. The study was based on a cross section of 89 platers and 61 office workers divided according to exposure to vibration into four groups. Vibration exposure was assessed by measuring the acceleration intensity on a sample of tools, together with both subjective rating and objective measurements of the exposure time. The frequency-weighted energy equivalent acceleration for 4 h was 4.6-4.7 m/s2. The point prevalence of white fingers was 42% for the plater category currently exposed with an odds ratio of 85. The time laps before contraction of white fingers (latency time) was four years for the 10th percentile, and was shorter than predicted according to the ISO-5349 standard. The prevalence of white finger symptoms staged according to the Taylor-Pelmear scale was comparable to the prevalences according to the Stockholm Workshop Scale. Vibration exposure was the dominant source of white fingers and each year of vibration exposure increased the odds ratio for white fingers by 11%. Distal circulation in the hands was assessed by a timed Allen test. The odds ratio for a positive Allen test was higher for the workers exposed to vibration compared to the non-exposed workers. The use of the timed Allen test is suggested in the clinical examination for vibration white fingers. The observed high risk for contracting white fingers could be prevented by exposure level reduction and/or restriction of exposure duration.

Adult↗

On auditory evoked potentials and heart rate in man during whole-body vibration.

Auditory evoked brain potentials and heart rate were recorded from three healthy male subjects during sinusoidal whole-body vibration exposure in the longitudinal (+/- aZ) direction (two intensities: I1 = 0.57 ms-2 r.m.s., I2 = 3.2 ms-2 r.m.s., frequency: 4 HZ) and under no-vibration control conditions according to a change-over design. All conditions were performed at a constant noise level. The part of vibration-synchronous activity contaminating the averaged evoked potentials (AEP) was eliminated by means of a subtraction technique. The AEP amplitude N1--P2 showed a significant decrease during vibration exposure; this decrease was slightly greater during I2 than during I1. Except for a shortening of P2 due to vibration of I1, the peak latencies did not change significantly. The heart rate increased when subjects were exposed to vibration at I1; there were interindividually opposite significant changes under I2 exposure. Time effects and subject effects were also proved. The AEPs are considered to be an informative measure for studying the effect of vibration on central nervous information processing.

Acoustic Stimulation↗

Cutaneous signs (Raynaud's phenomenon, sclerodactylia, and edema of the hands) and hand-arm vibration exposure.

Dermatological tests and examinations of the hand(s) were carried out in vibration-exposed and unexposed males. The subjects were 179 chain-saw workers in private forestry companies and 205 local inhabitants who had never used vibrating tools. The prevalences of Raynaud's phenomenon (RP), sclerodactylia, and edema of the hands were estimated in both groups, and associations between these cutaneous signs and vibration exposure were evaluated. The prevalences of RP and edema in the exposed group were 9.5% and 1.7%, respectively, and in the unexposed group, 2.9% and 1.5%, respectively. Sclerodactylia was seen in 31.8% of the chain-saw workers but in only 6.4% of the unexposed individuals. In statistical analyses based on unconditional logistic regression models with adjustment for age, RP was associated with long-term (> or = 20 years) vibration exposure [odds ratio (OR) = 7.06; 95% confidence interval (CI) = 2.51-19.87]. Sclerodactylia was associated with both short- and long-term vibration exposure (OR = 6.54, CI = 3.30-13.36; OR = 7.05; CI = 3.41-14.60, respectively). There were significant dose-response relationships between RP and duration of exposure and between sclerodactylia and duration of exposure. Results of function tests indicated a longer recovery time and a higher vibration threshold for the workers with RP. The presence of sclerodactylia, however, did not have any significant influence on function test results. It is possible to conclude that not only RP but also sclerodactylia could be induced by vibration exposure. However, most cases of sclerodactylia were not so serious as to involve disturbances of peripheral circulatory and nerve function.

Adult↗

Effects of grip and push forces on the acute response of the hand-arm system under vibrating conditions.

The purpose of the occupational medicine component of a joint research project was to study the effects of grip and push forces on the acute reaction of the hand-arm system under vibrating conditions. Several series of experiments were carried out by means of a vibration simulator in a laboratory environment in order to study biodynamic vibration behaviour, muscle response, skin temperature, shifts of the vibration perception threshold and the intensity of subjective vibration perception; in addition, field tests with hammer drills were conducted. On the whole, the findings obtained suggest that the coupling of the hand with the handle involved in using vibrating tools has a considerable impact on the stresses to which the hand-arm system is exposed. For this reason, future national and international rules and regulations on vibration assessment should take into consideration the effects of variations in coupling intensity.

Adult↗

Response characteristics of vibration-sensitive neurons in the midbrain of the grassfrog, Rana temporaria.

European grassfrogs (Rana temporaria) were stimulated with pulsed sinusoidal, vertical vibrations (10-300 Hz) and the responses of 46 single midbrain neurons were recorded in awake, immobilized animals. Most units (40) had simple V-shaped excitatory vibrational tuning curves. The distribution of best frequencies (BF's) was bimodal with peaks at 10 and 100 Hz and the thresholds ranged from 0.02 to 1.28 cm/s2 at the BF. Twenty-three neurons showed phasic-tonic and 11 neurons phasic responses. The dynamic range of seismic intensity for most neurons was 20-30 dB. In contrast to the sharp phase-locking in peripheral vibration-sensitive fibers, no phase-locking to the sinusoidal wave-form was seen in the midbrain neurons. The midbrain cells did not respond at low stimulus intensities (below 0.01-0.02 cm/s2) where a clear synchronization response occurs in saccular fibers. Six midbrain neurons had more complex response characteristics expressed by inhibition of their spontaneous activity by vibration or by bi- and trimodal sensory sensitivities. In conclusion, the vibration sensitive cells in the midbrain of the grassfrog can encode the frequency, intensity, onset and cessation of vibration stimuli. Seismic stimuli probably play a role in communication and detection of predators and the vibration-sensitive midbrain neurons may be involved in the central processing of such behaviorally significant stimuli.

Acoustic Stimulation↗

Influence of sympathetic activity, temperature, ischemia and diazepam on thermal and vibration thresholds.

In healthy volunteers thermal specific, thermal pain and vibration thresholds were assessed and correlated to each other and to sympathetic nervous system parameters. Additionally, different factors such as temperature, diazepam and ischemia affecting perception thresholds were evaluated. The thresholds assessed did not correlate significantly to each other and to sympathetic skin response latency or amplitude. Diazepam influenced the thermal specific, thermal pain and vibration thresholds assessed. The preingestion and postingestion (after 30, 60 and 90 minutes) thresholds did not differ significantly, meanwhile the scatter of thermal and vibration thresholds increased obviously. The skin temperature within the range of naturally occurring values of control subjects in a state of "thermal comfort" affected neither the warm-cold difference limen nor the heat and cold pain thresholds. Considerable temperature changes (the warming for 5 degrees C and cooling for 10 degrees C) influenced the vibration thresholds measured. Warming increased and cooling decreased the values recorded. Tourniquet-induced ischemia influenced only the vibration disappearance thresholds. Vibration perception and vibration thresholds varied but differences were not significant.

Auditory Threshold↗

Effects of vibration on arm and shoulder muscles in three body postures.

The electromyographic responses of arm and shoulder muscles to vibrations were studied in three postures similar to the postures of drilling in a ceiling, drilling in a wall and drilling in a floor. This experiment was performed within the defined parameters of: vibrational frequency at 30 Hz, acceleration level 40 m.s-2 (rms), pushing force expressed as percentage maximal voluntary contraction, and gripping force which was set at 100 N. The exposure time for each test was 5 min. The general findings from these three body postures show that all the examined muscles were affected by exposure to vibration. The EMG index increased as follows: trapezius muscle 39% (p less than 0.05), lower-arm flexor muscles 23% (p less than 0.05), infraspinatus muscle 14% (p less than 0.05), lower-arm extensor muscles 14% (p less than 0.1) and biceps muscle 6% (p less than 0.1). The muscle most affected by vibration was found to be the trapezius muscle. It should be taken into consideration that vibration can be a contributing factor in neck/shoulder disorders among power handtool operators. The general conclusion from this study is that changes in working posture give different transmissions of vibration in the upper extremities. It seems as if the prime movers and muscles with an increased muscle length or increased degree of contraction are most affected by vibration.

Adult↗

The integration of multiple proprioceptive information: effect of ankle tendon vibration on postural responses to platform tilt.

Previous studies have looked at co-processing of multiple proprioceptive inputs but few have investigated the effect of separate dynamic and tonic predominantly proprioceptive disruptions applied concurrently at the same segment. The purpose of the present study was to investigate how simultaneous ankle tendon vibration, a tonic stimulus, with a dynamic toes-up (TU) or toes-down (TD) platform perturbation (1) affects postural stability and (2) influences the adaptation process. Sixteen normal subjects (ten male, six female, mean age 26 +/- 4.8 years) stood blindfolded on a moving platform with vibrators attached bilaterally over the Achilles tendons. Participants were tested in quiet stance (QS), and with five successive TU and TD tilts. All tests were conducted both with (QS+V, TU+V, TD+V) and without vibration. Centre of pressure (CoP) displacements and pitch angular trunk velocity were recorded. Results for QS+V showed a significant 1.02-cm backward CoP displacement (P<0.01) and a significant increase in trunk velocity (peak-to-peak amplitude, P<0.05; SD of trunk velocity, P<0.05). TU+V resulted in a non-significant increase of maximum backwards CoP displacement when compared to TU alone. In addition, no notable effect of vibration on other measures of CoP (pre-tilt position, SD and area of sway) and trunk velocity (peak-to-peak, SD and area of sway) indicates that TU+V does not introduce significantly greater instability compared to tilt alone. In the TD condition, vibration was found to be a stabilising influence, causing a significant shift of the mean pre-tilt position 0.85 cm backwards (P<0.01) and a substantial decrease in the area of forward CoP displacement (P<0.01). However, maximum forwards CoP displacement and trunk velocity measures were not significantly altered during TD+V. Furthermore, in neither TU nor TD was the time-course or pattern of adaptation disrupted by the additional application of vibration. In conclusion, although vibration significantly affects postural measures when applied in isolation, this finding does not hold when it is applied in combination with a more dynamic stimulus. Instead it seems that once postural stability has been disrupted the central nervous system can rapidly assess information from a weaker tonic input and utilise or suppress it appropriately, depending on its effect towards overall postural control. It can be concluded that postural responses to the concurrent application of different predominantly proprioceptive stimuli are dependent upon the type of stimulus and the ability of the central nervous system to rapidly assess and re-weigh available sensory inputs.

Adaptation, Physiological↗

Memory for fingertip forces: passive hand muscle vibration interferes with predictive grip force scaling.

When subjects repetitively lift an object, the grip force they select is influenced by the mechanical object properties of the preceding lift. Similar effects on grip force scaling are observed whether the subsequent lift is performed with the same hand or the hand contralateral to the preceding lift. Here we demonstrate that passive vibration of the hand muscles involved in the generation of grip force in the interval between two blocks of lifting trials interferes with predictive grip force scaling. Following ten trials in which subjects lifted an object with constant mechanical properties with the dominant hand, muscle vibration was given to the first interosseus and adductor pollicis muscles of the dominant hand during a 10-min rest period. Compared with the last lift preceding vibration, peak rates of grip force increase and peak grip forces were scaled too high during the first lift following vibration whether the lift was made with the dominant or non-dominant hand. Subjects scaled grip force accurately to the object properties within three lifts following vibration. If subjects rested for 10 min after the first ten trials and received no vibration, then there was no significant difference in the peak grip force or its rate of increase between the last lift preceding rest and the first lift following it. We suggest that vibration impairs the memory processes responsible for predictive grip force scaling. Our data are consistent with the recent suggestion that these memory processes are neither specific for a certain motor action nor do they reflect internal representations of mechanical object properties.

Adult↗

The Ia afferent feedback of a given movement evokes the illusion of the same movement when returned to the subject via muscle tendon vibration.

The aim of the present study was to further investigate the contribution of primary muscle spindle feedback to proprioception and higher brain functions, such as movement trajectory recognition. For this purpose, complex illusory movements were evoked in subjects by applying patterns of muscle tendon vibration mimicking the natural Ia afferent pattern. Ia afferent messages were previously recorded using microneurographic method from the six main muscle groups acting on the ankle joint during imposed "writing like" movements. The mean Ia afferent pattern was calculated for each muscle group and used as a template to pilot each vibrator. Eleven different vibratory patterns were applied to ten volunteers. Subjects were asked both to copy the perceived illusory movements by hand on a digitizing tablet and to recognize and name the corresponding graphic symbol. The results show that the Ia afferent feedback of a given movement evokes the illusion of the same movement when it is applied to the subject via the appropriate pattern of muscle tendon vibration. The geometry and the kinematic parameters of the imposed and illusory movements are very similar and the so-called "two-thirds power law" is present in the reproduction of the vibration-induced illusory movements. Vibrations within the "natural" frequency range of Ia fibres firing (around 30 Hz) produce clear illusions of movements in all the tested subjects. In addition, increasing the mean frequency of the vibration patterns resulted in a linear increase in the size of the illusory movements. Lastly, the subjects were able to recognize and name the symbols evoked by the vibration-induced primary muscle spindle afferent patterns in 83% of the trials. These findings suggest that the "proprioceptive signature" of a given movement is associated with the corresponding "perceptual signature". The neural mechanisms possibly underlying the sensory to perceptual transformation are discussed in the general framework of "the neuronal population vector model".

Adult↗

Effects of neck muscles vibration on the perception of the head and trunk midline position.

The present study focused on the influence of neck vibration on the perception of the head and trunk midline position (orientation and localization). The orientation of the head and trunk was investigated by the rolling adjustment of a rod on their midline while their localization was investigated by the adjustment of the position of a visual dot as being straight-ahead the eyes or the sternum. The first experiment investigated whether a head-trunk dissociation was induced by the unilateral vibration of neck muscles in upright and restrained subjects. Results showed that the subjective orientation and localization of whole-body midline were shifted toward the vibrated side. The second experiment determined the effect of the neck muscles vibration when the subjects were lying on their side. The effect of vibration disappeared when the side of vibration was opposed to the side of postural inclination and it was stronger than in the upright position when the side of vibration and the side of postural inclination were congruent. Whereas, results suggested that the input from neck muscle proprioceptors participates directly to the elaboration of the egocentric space, the question may be raised as to how the sensory cues interacted in their contribution to the neural generation of an egocentric, body centred coordinate system.

Adult↗

Mechanical stimulation in the form of vibration prevents postmenopausal bone loss in ovariectomized rats.

Physical exercise is recommended for the prevention and treatment of osteoporosis. However, its exact role and effectiveness in adulthood is unclear. While vigorous exercise of long duration enhances bone density, few adult individuals comply with such training programs. The present study evaluates the influence of nonphysiological mechanical stimulation, in the form of low intensity vibration (frequency: 50 Hz, acceleration: 2 g, 30 min/day for 5 days/week), on the prevention of bone loss in an animal model of postmenopausal osteoporosis. In the ovariectomised groups of rats a statistically significant (p < 0.05) decrease of bone density (femur and tibia) was recorded at 5 weeks postovariectomy. This effect was maintained for the 12 week duration of the study. Vibration prevented early bone loss after ovariectomy. Vibrated ovariectomised rats showed statistically significantly higher (p < 0.05) BMD values compared to those of their ovariectomised controls at 5 weeks. Vibration did not influence the bone density of the SHAM-operated rats. Although vibration increased ultimate strength (fracture load of the rat femur) in the ovariectomised rats, this finding was not statistically significant. Our data indicate that this method of safe and easily applicable vibration, in the form of a vibrating platform, is effective in preventing early postovariectomy bone loss in an animal model.

Animals↗

Power absorption in women and men exposed to hand-arm vibration.

OBJECTIVES: The aim of the study was to determine whether there are gender differences as regards the quantity of absorbed power, i.e., vibration absorption per unit of time, during exposure to vibration from a specially constructed handle. METHODS: The study was conducted on 24 subjects (12 female and 12 male). The experiments were performed with exposure in two vibration directions, X(h), and Z(h), and with two vibration levels, 3 and 6 m/s(2). RESULTS: The male subjects had significantly higher power absorption during exposure to vibrations in the Z(h) direction at the vibration level of 6 m/s(2) than did the female subjects. When adjusted for anthropometrical measurements the difference did not remain significant. Higher vibration levels resulted in significantly higher absorption of power for both X(h) and Z(h) directions. The absorption was significantly higher in the Z(h) direction than in the X(h) direction. CONCLUSIONS: No gender difference in power absorption was shown.

Adult↗

The impact of whole-hand vibration exposure on the sense of angular position about the wrist joint.

OBJECTIVES: The purpose of this research is to determine the impact of whole-hand vibration on the capacity of subjects to identify previously presented positions of the hand in both wrist flexion and extension. METHODS: In each movement direction, targets of 15 or 30 degrees were presented with an imposed passive movement from the start position. During the second imposed movement, subjects were required to identify when the target position had been reached. For the vibration condition, 15 s of whole-hand vibration exposure was repeated immediately prior to each target position trial. Proprioceptive capacity was assessed by comparing the identified angular position with the reference position-angular distance expressed in terms of absolute error (AE), constant error (CE), and variable error (VE). RESULTS: For three of the four target positions (15 and 30 degrees flexion and 15 degrees extension), the absolute, constant, and VEs of target identification were insensitive to vibration, whereas for the 30 degrees extension target, both the absolute and CE were significantly different before and after the vibration application, showing the subjects overshooting previously presented target position. All three error measures were larger for the long targets than the short targets. CONCLUSIONS: Short-duration exposure to whole-hand vibration is insufficient to compromise post-vibration position sense in the wrist joint, except near the end range of joint movement in wrist extension. Complement contribution of different proprioceptive receptors (muscle, joint, and skin receptors) seems to be crucial for accuracy to reproduce passive movements, since the capacity of any individual class of receptor to deliver information about movement and position of the limbs is limited.

Adult↗

Effect of prior exposure to hand-transmitted vibration on cold response of digital arteries.

OBJECTIVES: To investigate whether prior exposure to hand-transmitted vibration on the day of a cold provocation test affects the cold response of digital arteries. METHODS: Each of ten healthy men attended two experimental sessions in which their right hands were exposed for 60 min to either contact force alone (5 N) or a combination of contact force (5 N) and 125-Hz vertical vibration with an acceleration magnitude of 64 m s(-2) r.m.s. (unweighted). Finger systolic blood pressure (FSBP) during local cooling to 10 degrees C was measured in the second right finger (exposed hand) and the second left finger (unexposed hand) before exposure and at 30 and 70 min after the end of both exposure conditions. RESULTS: Analysis of repeated measures of FSBP during local cooling by means of an autoregressive model revealed no significant difference in cold-induced vasoconstriction of the digital arteries between exposure to contact force alone and combined exposure to contact force and vibration. There were no significant changes in the cold response of digital arteries over time in either the right or the left hand after exposure of the right hand to either the contact force alone or the combined contact force and vibration. CONCLUSIONS: The results of this experimental study of the influence of prior vibration exposure on the cold test results suggest that in healthy men recent exposure to contact force and moderate levels of hand-transmitted vibration does not affect the response of finger circulation to cold provocation. These findings may be of practical importance for the definition of test conditions in the field, especially the length of time required between the last occupational exposure to tool vibration and the commencement of objective vascular testing.

Arteries↗

Whole-body vibration and low back pain: a systematic, critical review of the epidemiological literature 1992-1999.

OBJECTIVES: A previous extensive review of the literature including that from the middle of 1992 concluded that whole-body vibrations may contribute to low back pain, but that the exposure-response relationship had not been clarified. We reviewed the literature of the past 7 years to find out: (i) whether there is evidence in the recent epidemiological literature for a causal association between whole-body vibrations and low back pain, and (ii) if there is evidence in the recent literature for a dose-response relationship between whole-body vibrations and low back pain. METHODS: All relevant epidemiological articles which were obtained through a search in the databases MEDLINE, OSH-ROM and TOXLINE, and through personal communication, were reviewed independently by the two authors, using a checklist. RESULTS: Twenty-four original articles concerning the association between whole-body vibrations and the lower back were retained for use. The quality of the papers was mostly low, but improved with time. Only seven articles passed our predetermined quality criteria. Of the seven reports, one showed increased frequency of lumbar prolapse in occupational drivers, and six showed low back pain to be more frequent in whole-body vibration-exposed groups. Only two out of the four articles reporting on dose, showed a dose-response association. CONCLUSIONS: Despite the lack of definite evidence, we found sufficient reasons for the reduction of whole-body vibration-exposure to the lowest possible level. If new knowledge is to be produced, good prospective studies with repeated measurements of exposure, analyses of work postures, and clear definitions and subgroupings of low back pain are needed. Other research in this field should be given up, and the resources used for more important issues, as the size of the problem of whole body vibration is probably on the decrease because of the technical prophylactic developments that are already in progress.

Adult↗

Neurological and functional effects of short-term exposure to hand-arm vibration.

OBJECTIVE: The aim of the present study was to quantify the sensory and functional effects resulting from a short-duration (30 min) exposure to hand-arm vibration. SUBJECTS AND METHODS: Nine subjects went through nine laboratory experiments. For 32 min they grasped a handle vibrating at three different amplitudes (5, 20, and 80 ms-2) and at three frequencies (31.5, 125, and 500 Hz). Additionally, a reference experiment was conducted in which the handle did not vibrate. Three sensory tests [vibration perception threshold (VPT), pressure perception threshold (PPT), and distal sensory latency time (DSL)], two functional tests [Purdue peg-board (PPB) and maximal voluntary force (MVF)], and a questionnaire concerning the perceived paresthesia and numbness were completed before, during, and after exposure. RESULTS: A 32-min period of exposure to vibration leads to a temporary threshold shift (TTS) of the VPT and to the development of paresthesia and numbness. The VPT appears to vary with the exposure duration according to a first-order model with a time constant about equal to 3 min. The TTS increases with the vibration acceleration amplitude and is greater for an exposure frequency of 125 Hz than for that of 31.5 or 500 Hz. It is also greater at the test frequency 125 Hz than at 31.5 Hz. The other tests do not demonstrate any significant variation. In particular, the PPB test does not demonstrate any loss of dexterity. CONCLUSION: After some 30 min of exposure to vibration the VPTs are increased and paresthesia and numbness develop. However, these do not appear to influence significantly the capacity or performance at work.

Adult↗

Thermotactile threshold testing for the evaluation of sensory nerve function in vibration-exposed patients and workers.

OBJECTIVES: The aim of the present study was to ascertain the usefulness of thermotactile testing under the measuring conditions clarified by our previous study in the evaluation of vibration-induced neuropathy. METHOD: Thermal (warm and cold) thresholds were examined on the index fingers of both hands of ten patients with hand-arm vibration syndrome, 36 workers exposed to hand-transmitted vibration, and ten healthy controls, using an aesthesiometer under the following measuring conditions: change rate of the applicator temperature was fixed at a rate of 1 degrees C/s; finger contact force on the applicator was kept at 0.5 N; and forearm was positioned on a support. Vibrotactile thresholds at 125 Hz and pain thresholds were also measured on the index fingers. RESULTS: Both warm and cold thresholds had more severely deteriorated in the patients than in the controls. Vibrotactile and pain thresholds were also increased in the patients. In the vibration-exposed workers, the neutral zone between the warm and cold threshold differed from in the controls. Thermotactile thresholds were likely to have deteriorated with advanced nerve impairment. Likelihood ratios of thermotactile testing were significantly high between the patients and the controls. For vibration-exposed workers with elevated vibrotactile and pain thresholds, the ratios were also significantly high, particularly in the neutral zone, though the accuracy tended to be lower than in the patients. Thermotactile thresholds appeared to be more closely correlated with pain thresholds than vibrotactile thresholds. CONCLUSIONS: Thermotactile threshold testing under the present measuring conditions can be useful for evaluating small sensory nerve fibre dysfunction in vibration-exposed subjects, and the neutral zone may be a sensitive indicator in vibration-exposed workers who may have slight or mild nerve impairments.

Adult↗