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Vihlborg P, Lundberg O, Pettersson-Pablo P, Johansson N, Bryngelsson IL, Stjernbrandt A, Graff P. Blood biomarkers for occupational hand-arm vibration exposure. Toxicol Ind Health 2024:7482337241253996. [PMID: 38743488 DOI: 10.1177/07482337241253996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Hand-arm vibration is a common occupational exposure that causes neurological impairment, myalgia, and vibration-induced Raynaud's phenomena or vibration white fingers (VWF). The pathological mechanism is largely unknown, though several mechanisms have been proposed, involving both immunological vascular damage and defective neural responses. The aim of this study was to test whether the substances interleukin-33 (IL-33), macrophage-derived chemokine (MDC), interleukin-10 (IL-10), endothelin-1 (ET-1), C-C motif chemokine ligand 20 (CCL20), calcitonin, and thromboxane (TXA2) changed before and after occupational hand-arm vibration exposure. 38 full-time shift workers exposed to hand-arm vibration were recruited. All the participants underwent medical examinations regarding symptoms of Raynaud's phenomena. In 29 of the participants, the concentration of IL-33, MDC, IL-10, ET-1, CCL20, calcitonin, and TXA2 was measured before and after a workday. There was a significant increase in ET-1 and calcitonin concentration and a decrease in the CCL20 concentration after the work shift in all participants. In the group suffering from VWF, but not in the non-VWF group, MDC was statistically significantly lower before the work shift (p = .023). The VWF group also showed a significant increase in MDC after the work shift. Exposure to occupational hand-arm vibration is associated with changes in ET-1, calcitonin, and MDC concentration in subjects suffering from vibration white fingers, suggesting a role of these biomarkers in the pathophysiology of this condition.
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Affiliation(s)
- Per Vihlborg
- Department of Geriatrics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Oscar Lundberg
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Paul Pettersson-Pablo
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University Hospital, Örebro, Sweden
| | - Niclas Johansson
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Ophthalmology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Albin Stjernbrandt
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Pål Graff
- Department of Chemical Work Environment, National Institute of Occupational Health (STAMI), Oslo, Norway
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Christova M, Sylwester V, Gallasch E, Fresnoza S. Reduced Cerebellar Brain Inhibition and Vibrotactile Perception in Response to Mechanical Hand Stimulation at Flutter Frequency. CEREBELLUM (LONDON, ENGLAND) 2024; 23:67-81. [PMID: 36502502 PMCID: PMC10864223 DOI: 10.1007/s12311-022-01502-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/30/2022] [Indexed: 12/14/2022]
Abstract
The cerebellum is traditionally considered a movement control structure because of its established afferent and efferent anatomical and functional connections with the motor cortex. In the last decade, studies also proposed its involvement in perception, particularly somatosensory acquisition and prediction of the sensory consequences of movement. However, compared to its role in motor control, the cerebellum's specific role or modulatory influence on other brain areas involved in sensory perception, specifically the primary sensorimotor cortex, is less clear. In the present study, we explored whether peripherally applied vibrotactile stimuli at flutter frequency affect functional cerebello-cortical connections. In 17 healthy volunteers, changes in cerebellar brain inhibition (CBI) and vibration perception threshold (VPT) were measured before and after a 20-min right hand mechanical stimulation at 25 Hz. 5 Hz mechanical stimulation of the right foot served as an active control condition. Performance in a Grooved Pegboard test (GPT) was also measured to assess stimulation's impact on motor performance. Hand stimulation caused a reduction in CBI (13.16%) and increased VPT but had no specific effect on GPT performance, while foot stimulation had no significant effect on all measures. The result added evidence to the functional connections between the cerebellum and primary motor cortex, as shown by CBI reduction. Meanwhile, the parallel increase in VPT indirectly suggests that the cerebellum influences the processing of vibrotactile stimulus through motor-sensory interactions.
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Affiliation(s)
- Monica Christova
- Otto Loewi Research Center, Physiology Section, Medical University of Graz, Neue Stiftingtalstraße 6/D05, 8010, Graz, Austria.
- Institute of Physiotherapy, University of Applied Sciences FH-Joanneum, Graz, Austria.
| | | | - Eugen Gallasch
- Otto Loewi Research Center, Physiology Section, Medical University of Graz, Neue Stiftingtalstraße 6/D05, 8010, Graz, Austria
| | - Shane Fresnoza
- Institute of Psychology, University of Graz, Graz, Austria
- BioTechMed, Graz, Austria
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Schulze DG, Nilsen KB, Clemm T, Grotle M, Zwart JA, Ulvestad B, Nordby KC. Influence of ergonomic factors on peripheral neuropathy under HAV exposure. Occup Med (Lond) 2023; 73:13-18. [PMID: 36480225 DOI: 10.1093/occmed/kqac118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hand-arm vibration (HAV) is a risk factor for carpal tunnel syndrome (CTS) and ulnar neuropathy at the elbow (UNE). It is unclear how ergonomic factors influence the relationship between HAV exposure and CTS and UNE. AIMS We aimed to assess the relationship between cumulative HAV exposure and CTS and UNE in workers exposed to HAV from two tools with different ergonomic profiles. METHODS We performed nerve conduction studies (NCSs) of the sensory and motor median and ulnar nerves and recorded symptoms indicating CTS and UNE in workers exposed to HAV from impact wrenches or from rock drills. Exposure was measured as cumulative lifetime exposure. We used linear regression adjusted for age and body mass index to assess linear relationships. RESULTS Sixty-five workers participated (33 rock drill and 32 impact wrench operators). We found inverse linear associations between cumulative HAV exposure and median nerve sensory conduction velocity in impact wrench operators and ulnar nerve motor conduction velocity in rock drill operators (beta of 0.63 and 0.75). Based on NCS findings and symptoms, seven impact wrench operators had CTS and one UNE, and four rock drill operators had CTS and six UNE. CONCLUSIONS Our findings indicate that ergonomic factors influence the development of CTS and UNE under HAV exposure. The ergonomic profile seems to influence which type of neuropathy workers exposed to HAV will develop. Design of occupational exposure guidelines and future studies should be based on ergonomic profile and exposure characteristics for different tools and not merely HAV.
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Affiliation(s)
- D G Schulze
- Department of Neurology, Oslo University Hospital and University of Oslo, 0424 Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, 0424 Oslo, Norway
| | - K B Nilsen
- Department of Neurology, Oslo University Hospital and University of Oslo, 0424 Oslo, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, 0424 Oslo, Norway
| | - T Clemm
- National Institute of Occupational Health, 0304 Oslo, Norway
| | - M Grotle
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, 0424 Oslo, Norway
- Oslo Metropolitan University, 0130 Oslo, Norway
| | - J A Zwart
- Institute of Clinical Medicine, University of Oslo, 0316 Oslo, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, 0424 Oslo, Norway
| | - B Ulvestad
- National Institute of Occupational Health, 0304 Oslo, Norway
| | - K C Nordby
- National Institute of Occupational Health, 0304 Oslo, Norway
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Clemm T, Lunde LK, Ulvestad B, Færden K, Nordby KC. Exposure-response relationship between hand-arm vibration exposure and vibrotactile thresholds among rock drill operators: a 4-year cohort study. Occup Environ Med 2022; 79:oemed-2022-108293. [PMID: 35803711 PMCID: PMC9606510 DOI: 10.1136/oemed-2022-108293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 05/22/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The risk of developing hand-arm vibration syndrome (HAVS) from occupational hand-arm vibration (HAV) exposure is traditionally determined by the onset of vascular symptoms (white fingers). However, changes in tactile sensibility at the fingertips is a clinical sign of HAVS which in most cases precedes vascular signs. We aimed to assess relationships between occupational HAV exposure and HAVS-related signs including vibration perception thresholds (VPT) and pegboard score on an individual level, using a longitudinal study design with follow-up tests. METHODS We followed-up 148 workers exposed to different HAV levels for 4 years, with health examinations including VPT tests and pegboard tests carried out at baseline, 2 years and 4 years. VPT testing included seven frequencies, from 8 to 500 Hz. Second and fifth finger on both hands were tested, thus a total of 28 tests on each subject. We investigated associations using linear mixed models and significance level at p≤0.05. RESULTS There was a significant exposure-response relationship on an individual level between HAV exposure from rock drills and VPT for 16 of 28 test frequencies. The highest rise (worsening) in VPT was found at the 500 Hz test frequency with 1.54 dB increased VPT per 10-fold increase in cumulative exposure. We found no deterioration in pegboard performance associated with HAV exposure among the participants. CONCLUSIONS Risk predictions of HAVS may be based on exposure-response relationships between HAV exposure and VPT. The 500 Hz test frequency should be included in the VPT test protocols for early detection of signs related to reduced tactile sensibility.
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Affiliation(s)
- Thomas Clemm
- Department of Occupational Medicine and Epidemiology, STAMI, Oslo, Norway
| | | | - Bente Ulvestad
- Department of Occupational Medicine and Epidemiology, STAMI, Oslo, Norway
| | - Karl Færden
- Department of Environmental and Occupational Medicine, Oslo University Hospital, Oslo, Norway
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Clemm T, Nordby KC, Lunde LK, Ulvestad B, Bråtveit M. Hand-Arm Vibration Exposure in Rock Drill Workers: A Comparison between Measurements with Hand-Attached and Tool-Attached Accelerometers. Ann Work Expo Health 2021; 65:1123-1132. [PMID: 34254993 PMCID: PMC8577229 DOI: 10.1093/annweh/wxab051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 06/07/2021] [Accepted: 06/18/2021] [Indexed: 11/14/2022] Open
Abstract
Objectives To assess the hazard of tool vibrations, we need valid exposure measurements. The use of hand-attached accelerometers (vibration sensors) to measure hand-arm vibrations (HAVs) has become a popular approach. However, according to International Standard ISO 5349-2, the preferred attachment of accelerometers is at the tool handle. We compared measures of HAV between hand- and tool-attached accelerometers in rock drilling. Methods We measured HAV in five rock drillers using jackleg drills in normal working operations with simultaneous measures of both hand-attached and tool-attached accelerometers. Five to seven measurement cycles of 15 s were executed on each worker, resulting in a total of 29 measurement cycles. To identify possible differences in working technique, we recorded videos of tool handle handgrips during drilling. Results There was a significant difference (9.5 m s−2; P ≤ 0.05) in vibration magnitudes measured by the tool-attached accelerometers compared with the hand-attached accelerometers. The hand-attached accelerometer showed a lower vibration magnitude for all workers (range of difference: 2.3–14.6). The variation between the two accelerometer attachments was larger between workers than within workers (ICC = 0.68). Conclusions For measurements of HAV from jackleg drills, the use of hand-attached accelerometers may cause a lower recorded vibration level compared with tool-attached accelerometers. This difference is likely to vary depending on how workers grip the tool handle, and a misclassification of exposure will occur if workers grip the tool handle in a way that makes the accelerometer lose contact with the vibrating surface. Individual differences in how workers grip the tool handles should be considered when assessing HAV.
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Affiliation(s)
- Thomas Clemm
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), PO Box 5330 Majorstuen, NO-0304 Oslo, Norway
| | - Karl-Christian Nordby
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), PO Box 5330 Majorstuen, NO-0304 Oslo, Norway
| | - Lars-Kristian Lunde
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), PO Box 5330 Majorstuen, NO-0304 Oslo, Norway
| | - Bente Ulvestad
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), PO Box 5330 Majorstuen, NO-0304 Oslo, Norway
| | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway
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An Investigation of the Effects of Drill Operator Posture on Vibration Exposure and Temporary Threshold Shift of Vibrotactile Perception Threshold. VIBRATION 2021. [DOI: 10.3390/vibration4020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study involved performing an experiment to clarify whether vibration measurement values on the tool handle, in accordance with ISO 5349-1, can assess risk from workplace environments. The study investigated the relationship between the vibration magnitude of a hand-held electric drill with different operating postures. The experiment included the determination of the participant’s temporary threshold shift (TTS) of vibrotactile perception threshold (VPT) at the tip of the index finger. The experimental hypothesis was that the vibration measurement values on the tool handle, in accordance with the ISO 5349-1 standard, include the effect of posture on the vibration measurements obtained despite the variation in posture and test participants. The hand-transmitted vibration (HTV) was applied using a hand-held electric drill applied to a pre-cast concrete paving slab substrate (600 × 600 × 50 mm, 55 MPa) using a 10 mm diameter masonry drill bit (without hammer action). The tool was operated using the right hand on twelve male subjects with three working postures (n = 36). Vibration was measured in three orthogonal directions according to the international standard ISO 5349-1 procedure. Vibration magnitudes were expressed as root-mean-square (r.m.s.) acceleration, frequency-weighted using the Wh frequency weighting. Clause 4.3 states that the characterisation of the vibration exposure is assessed from the acceleration of the surface in contact with the hand as the primary quantity. The experimental results indicate that the TTS following vibration exposure is not related to the measured vibration magnitude on the tool handle. Therefore, the automatic inclusion of posture and test participant variation is not proven. The results suggest that the vibration measurement values on the tool handle do not predict the TTS after hand-transmitted vibration in varying posture across the test participants. The research concludes that tool handle vibration measurement, in accordance with ISO 5349-1, does not properly assess the potential hazard from authentic workplace tool usage conditions of varying postures.
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