ferentiate between the relative roles of whole-body vibration and ergonomic risk fac-
tors, such as posture and awkward back movements, from epidemiological studies,
though both are clearly cofactors in the development of the observed pathology.
Exposure to repeated random jolts (in contrast to sinusoidal motion), such as the buf-
feting that occurs in aircraft, in small craft on rough water, or in off-the-road vehicles
is commonly associated with the chronic injuries described.
Chronic injuries may also be produced when the hand is exposed to intense vibra-
tion, such as occurs during occupational use of some power tools (e.g., pneumatic drills
and hammers, grinders, chain saws, and riveting guns).
3
Symptoms of numbness or
paresthesias in the fingers are common and may be accompanied by episodes of finger
blanching. Reduced grip strength and muscular weakness may also be experienced.
The vascular, nerve, and muscular disorders associated with the use of hand-held
vibrating power tools are known as the hand-arm vibration syndrome (HAVS). Patho-
logical changes have been observed in the structure of the nerves and walls of the
blood vessels in the fingers.
3
Changes in tactile function have been linked to changes
in acuity of specific types of mechanoreceptive nerve endings at the fingertips.
15
Few exposure-response relationships have been derived from epidemiological
data for any sign, or symptom, of HAVS resulting from occupational use of hand-
held power tools or industrial processes. For groups of workers who perform similar
tasks throughout the workday, the latency, that is, the duration of exposure (in years)
prior to the onset of episodes of finger blanching, and prevalence, may be predicted
from the acceleration of a surface in contact with the hand.
16
These relationships
serve as the basis for occupational exposure criteria (see Human Tolerance Criteria).
The tendons, tendon sheaths, muscles, ligaments, joints, and nerves in the hand
and arm can also be damaged by repeated movement of the hand relative to the
arm. These soft tissue and nerve injuries occur among blue- and white-collar work-
ers performing tasks involving repeated hand-wrist flexure (e.g., keyboard opera-
tors) and are termed repetitive strain injuries (RSI).
17
Nerve compression may result
from changes in the contents of restricted nerve passageways (e.g., the carpal tunnel
at the wrist—carpal tunnel syndrome).
3
Pain and paresthesias in the hand and arm
are common symptoms.
Physiological Responses. Vibration can induce physiological responses in the
cardiovascular, respiratory, skeletal, endocrine, and metabolic systems and in mus-
cles and nerves. The cardiovascular changes in response to intense vertical vibration
are similar to those accompanying moderate exercise: increased heart rate, respira-
tion rate, cardiac output, and blood pressure. Vibration of sufficient intensity will
cause mechanical pumping of the respiratory system, as already noted, but is
unlikely to produce significantly increased ventilation or oxygen uptake. Changes in
blood and urine constituents are commonly used as indicators of generalized body
stress and may, in consequence, be observed in persons exposed to vibration. It is dif-
ficult if not impossible, however, to relate specific endocrine and metabolic
responses to a given vibration stimulus. Vibration can stimulate a tonic reflex con-
traction in muscles, which is a response to the stretching force (the tonic vibration
reflex), disturb postural stability, and lead to body sway. Extremely low-frequency
whole-body vibration, such as occurs in many transportation vehicles and ships, may
also cause motion sickness (kinetosis).
1
Vibration of the hand may cause peripheral vascular, neurological, and muscular
responses.
3
Blood flow within the fingers may be reduced during stimulation, and
tingling and paresthesias in the hands may be reported after exposure. Somatosen-
sory perception and tactile function may be temporarily decreased. Grip strength
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