MECHANICAL VIBRATIONS

DEFINITION
Oscillatory motion generated by pressure waves
that are transmitted through solid bodies.

Features of vibration:
• period, of complete oscillation time (s);
• frequency, N. of oscillations per second (Hz)
• amplitude the displacement (cm);
• speed, (cm/s);
• acceleration, (m/s2)
 PATHOGENESIS
Relating to the stimulus of vibration, the body is a
complex system of structures:
•inertia (mass: bones)
•Elastic (muscles)
•dissipative (joints)
that warns especially
the variations in acceleration
vibration.
 PATHOGENESIS
The effects of vibration depend on:
1.Wave direction:
• vertical vibrations are damped by the lower limbs (especially in
the upright posture)
• horizontal vibrations are damped by the upper limbs (arms,
hands and elbows)
2.Frequency
• 0-2 Hz, the body reacts single mass, motion sickness
• 2-80 Hz,
3.Application axis
 PATHOGENESIS

Wisner, depending on the frequency,

distinguishes vibrations in three classes:
Low frequencies
Mid frequencies
High frequencies
 VIBRATIONS: CLASSIFICATION
(sec. Wisner)

Low frequencies (0-2Hz): means of

communication and transport
(cars, ships, aircraft).
cause the so-called
Motion Sickness.
 VIBRATIONS: CLASSIFICATION
(sec. Wisner)

Medium frequencies (> 2-

20Hz): industrial machinery
and equipment (tractors,
cranes, excavators, mills,
etc.) determine effects on
the whole body and bone
diseases.
 VIBRATIONS: CLASSIFICATION
(sec. Wisner)

High frequencies (> 20Hz):

vibrating tools in percussion (eg.
chisel); in rotation (Eg. Drills);
joint movement (Eg. Hammer).
They induce bone and joint
diseases and angioneurotic.
 VIBRATIONS
Statement

 EU Vibration Directive 2002/44 /CEE

 D.Lgs n. 187 of the 19.08.2005 (G.U. n. 220,

21.09.2005)

 D. Lgs n.81 / 08 : title VII CHAPTER III - PROTECTION

OF WORKERS FROM RISKS EXPOSURE Flip N° 7
articles (from Art. 199 to Art. 205)
 VIBRATIONS
D-Lgs 81/08
Definition (art.200)
Vibrations transmitted to the hand-arm system:
The mechanical vibration that pose a risk to the health and
safety of workers, in particular vascular, bone or joint,
neurological or muscular disorders.
Vibrations transmitted to the whole body:
The mechanical vibrations that involve risks in particular low
back pain and trauma of the spine.
 Occupational Classification field
Vibrations transmitted to whole body
(Whole-body vibration WBV)

Generalized fluctuations in low (Between 0 and 2 cycles / sec.)

And medium frequencies (between 2 and 20 cycles / sec.).

Vibrations transmitted to hand-arm system

(Hand-arm Transmitted or segmental HAV)

localized oscillations, to high frequency (over 20-30 cycles / sec).

VIBRATIONS: EFFECTS

Pathology from vibrations

transmitted to whole
body vibration (WBV)

discrict pathology by high-

frequency vibrating tools
(HAV)
 VIBRATION WB

The clinical manifestations attributed to low vibration and

medium frequencies involving:

Apparatus
Osteoarticular Apparatus
Otovestibolare
 VIBRATIONS WB: EFFECTS

Otovestibolare system:
motion sickness or sore transportation to
hyperstimulation of the vestibule and the
semicircular canals.
In the pathogenesis of the disorder the afferent
impulses from skin mechanoreceptors and
subcutaneous and the mesenteric and abdominal
areas play an important role.
 VIBRATIONS WB: EFFECTS

Osteo-articular system:
the spine is the structure
which is most sensitive to
damage from vibrations, in
particular the lumbar spine,
followed by the dorsal and
cervical spine.
 VIBRATIONS WB
Pathology from vibrations transmitted to the whole
body
Osteo-articular system

 Nonspecific low back pain, acute low back pain

 Early Degenerative changes (not age-related) of the

lumbar spine

 Discopathies and herniated discs of the lumbar

spine
 VIBRATIONS HAV: EFFECTS
District Pathology from high frequency vibrating
tools

Vascular lesions
(Secondary form of Raynaud's syndrome
or white finger)
Neurological Injury
(Predominantly peripheral sensory
neuropathy)

injuries
Osteo-Articular - tendon
(Chronic degenerative lesions of the bone and
joint segments but also to load the ligaments)
VIBRATIONS HAV: EXPOSED
Chippers, Scalers, Riveting Construction -lapidei, metalworking
Punchers Hammers Construction stone -Extraction
Breakers and Pick Hammers metalworking
Impact drills Metalworking, Foundries
Impact wrenches
Metalworking -Lapidei -Wood
Sandblasters Hammers
Shears and Nibblers for metals agriculture-forestry Processing
Orbital sanders and rotary-orbital
Circular saws and jigsaws
Grinders And Axial
Straight Grinders for light work
Chainsaws
Brush Cutters
Cultivator
 VIBRATIONS HAV: EFFECTS
Pathology district from tools High frequency
vibrating.
Determining Factors:
 Features of vibration: frequency, amplitude, direction.
 vibrating tool features: tool type, tool weight, state of repair.
 Display Features: daily exposure time, total duration of
exposure, exposure intermittently.
 biodynamic factors: posture of the hand-arm system and the
body, a force for grasping the tool, location area of ​the parts
of the hands exposed to microtrauma vibratory.
 VIBRATIONS HAV: EFFECTS
Pathology district from tools vibrant high-frequency.
Determining factors:
biodynamic factors: posture of the hand-arm and
the body system, a force for grasping the tool,
location area of ​the parts of the hands exposed to
vibratory microtrauma.
Environmental factors: Microclimate, noise,
chemicals angiotoxic.
individual factors: Age, working method and
operator skill, assumptions of vasoconstrictor
agents (smoking, drugs), pre-existing disease
(vascular disease, trauma or injury of fingers).
 VIBRATIONS HAV: EFFECTS
District Pathology from high frequency vibrating
tools
Vascular lesions
Secondary Raynaud's Phenomenon (FR)
A fundamental characteristic of the FR vibration is that of
absence, except in severe cases of trophic skin disorders
more. This phenomenon consists in a transitional stop, after
exposure to cold, of the arterial flow in acral areas of the
hands.
 VIBRATIONS HAV: EFFECTS
Secondary Raynaud's Phenomenon (FR)
 VIBRATIONS HAV EFFECTS
District Pathology from vibrating tools
Vascular lesions

Secondary Raynaud's Phenomenon (FR)

Systemic factors
Reducing systemic blood flow of arterial hypotension
Increased peripheral resistance, autoimmune diseases
Local factors
Stenosis of the lumen upstream
Protracted impairment of the vascular bed of the fingers
Fulfillment of intense muscular work with redistribution of blood
from the skin circulation to the muscle.
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Vascular lesions

Secondary Raynaud's Phenomenon (FR): stages

Stages of secondary Raynaud's phenomenon in vibration
microtrauma (Stokholm Workshop 86):
Stage 0: vasospastic no symptoms in the subject exposed to hand-
arm vibration
Stage 1 (mild): Occasional episodes of pallor at the ends of one or
more fingers
Stage 2 (moderate): Occasional episodes of distal phalanges and
intermediate pallor of one or more fingers
 VIBRAZIONIHAV: EFFECTS
District Pathology from vibrating tools
Vascular lesions

Stage 3 (severe): frequent episodes of pallor against

all phalanges of most fingers

Stage 4 (very severe): as stage 3 associated with

trophic skin disorders at the ends of the fingers.
 VIBRATIONS: EFFECTS
District Pathology from vibrating tools
vascular lesions

Secondary Raynaud's Phenomenon (FR): diagnosis

Main functional and instrumental investigations:

Photoplethysmography (FPG): simple, reliable; and sensitive;

It is an expression of the instantaneous conditions of the distal
circulation or microcirculation.
Thermal and pharmacodynamic tests: Cold tests and
pharmacodynamic tests.

d.d. between functional and organic phase

d.d. other vascular and other etiology
 VIBRATIONS: EFFECTS
District Pathology from vibrating tools
Vascular lesions

Secondary Raynaud's Phenomenon (FR): diagnosis

A) Cold test: immersion of the hands in cold water
(about 10°C), in comfortable environment subject to
rest for at least 15 min., In thermal comfort provided
and abstention from at least 60 min tobacco smoke.
The key issue is the evaluation of thermal and
fluximetric recovery times, assuming as normal a
time> 20 min.
Cold Test

A series of sensors / detectors are applied (Fig.1) to

the fingers to record their starting temperature. the
hand is then immersed in ice water for 20 seconds.
once the necessary time has elapsed, it is removed
from the cold bath and the temperature is recorded
every 5 minutes until the initial parameters return
WHAT HAPPENS: the fingers become white due to
a lack of blood in the circulation (1), then turn
towards a bluish color (2) as the vases dilate in
order to keep the spraying to the tissues finally,
become reddish when finally the blood returns to
the circle (3).
POSITIVE COLD TEST: the test is considered positive
if the hand temperature returns to normal with a
time> 20min
 VIBRATIONS: EFFECTS
District Pathology from vibrating tools
Vascular lesions

Secondary Raynaud's Phenomenon (FR): diagnosis

B) pharmacodynamic test: a grain of TNG (glyceryl
trinitrate) is administered sublingually to the
patient in resting conditions and in a sitting
position, then the photopletysmographic and / or
Doppler trace is performed immediately after the
dissolution of the granules and also 8 min later.
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Vascular lesions

Secondary Raynaud's Phenomenon (FR): diagnosis

Doppler Velocimetry (flowmetry)
Video - Capillaroscopy (GOLD)
In strain- gauge plethysmography
Oximetry skin
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Osteo-articular lesions
Alterations of necrotic-degenerative osteo-
cartilaginous comparable to osteoarthritis.
They can occur at any level of osteoarticular
apparatus.
Radiologically can be observed:

• vacuolar lesions in carpal bones (especially

lunate)
• exostosis and osteophytes at the elbow
• softening and bone remodeling
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Osteo-articular lesions

• necrosis of the lunate

• periarthritis of shoulder
(Arthrosis degenerative joint
acromion-clavicular and shoulder
joint)
• calcification and ossification
radiographically notes with the
beak name and spur olecranon
 VIBRATIONS HAV: EFFECTS

District Pathology from vibrating tools

Tendon injuries

Are represented by ischemic inflammatory and

degenerative processes of the tendons: especially
at the level of the olecranon and hands
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Neurologic Injury
A. Alterations of touch and temperature of hands
B. Alterations of motor sensory conduction velocity
peripheral nerve fibers of the median and ulnar
nerve
Both detectable by EMG and evoked potentials
 VIBRATIONS HAV: EFFECTS

District Pathology from vibrating tools

Neurologic Injury

Hands: aponeurosis
retraction handheld or
Dupuytren's disease
 VIBRATIONS HAV: EFFECTS
District Pathology from vibrating tools
Neurologic Injury

Carpal tunnel syndrome:

chronic inflammation of the tendon flexor bag
(tenosynovitis), which compresses the median nerve
with sensitivity disorders (pain, paresthesia) and
weakness of I, II, III and middle of the fourth finger.
Potential progressive and irreversible loss of sensitivity
to the first three fingers and hand to the side to fly,
followed by hypo-thenar atrophy.
 VIBRATIONS HAV: EFFECTS

THE EMG is important for Carpal Tunnel

Syndrome
the carpal tunnel syndrome
characterized by paralysis of
the median nerve, secondary
to compression of the nerve
in the carpal channel for
inflammatory edema
 VIBRATIONS HAV: EFFECTS

District Pathology from vibrating tools

Venous Thrombosis of the succlavio-maxillo-brachial
district
When the position with the upper limb raised and
abducted is associated with the action of the
vibrations.
 LIMITS VALUES
(D-Lgs 81/08)
Definitions (Art.200)
Daily exposure to hand-arm system vibration: [ms-2]:
Averaged value over time of the measured acceleration for a
nominal eight-hour working day.
Daily exposure to whole body vibration : [ms-2]: Averaged
value over time of the measured acceleration for a nominal eight-
hour working day.
 VIBRATIONS
D-Lgs 81/08
Exposure limit values ​and action values ​(art. 201)

For the vibrations transmitted to the hand-arm system:

a) the daily exposure limit value, normalized to a period of 8
hours, is set at 5 m/s2; while over short periods is 20 m/s2

b) the daily action value, normalized to a period of 8 hours

reference that triggers the action, It is set at 2.5 m/s2
 VIBRATIONS
D-Lgs 81/08
Exposure limit values ​and action values ​(art. 201)

For the vibrations transmitted to the whole body:

a) the daily exposure limit value, normalized to a period
of reference of 8 hours, is set at 1.0 m/s2; while over
short periods it is 1.5 m/s2

b) the daily action value, Normalized to a period of 8

hours reference, It is set at 0.5 m/s2
In the case of variability of the daily exposure level, the
maximum daily level applicant should be considered.
 VIBRATIONS
D-Lgs 81/08
Risk assessment (Art. 201)
The employer needs to evaluate and, when
necessary, to measure, mechanical vibration levels to
which workers are exposed.

The exposure to mechanical vibration emission may be assessed by

observation of specific working practices and reference to relevant
information on the probable magnitude of vibration corresponding
to the equipment or the types of equipment in the particular
conditions of use available at ISPESL databases or regions or, failing
that, from the information provided in the manufacturer of the
equipment.
 VIBRATIONS
D-Lgs 81/08
Measures of prevention and protection

Where, subsequent to the risk assessment, it appears

that they have been exceeded the action values,
the employer establish and implement a program of
technical or organizational measures, aimed at
minimizing the exposure and the resulting risks.
 VIBRATIONS
D-Lgs 81/08

Workers exposed to higher levels vibration than

the action values are subjected to
health surveillance

The monitoring is carried out periodically, normally once a

year or other period decided by the competent doctor with
adequate reasons given in the risk assessment document and
known to the representatives for the safety of workers in
relation to the risk assessment
 VIBRATIONS
D-Lgs 81/08
Training and Information

Based on the general rules contained in Title I and VIII of the

DLgs.81/08 it requires that workers exposed to vibration
receive information and training adequate concerning in
particular:

 the results of the evaluation and vibration measurements

 the concepts of the exposure limit values ​and action values
 the potential injury arising from the work equipment used
 VIBRATIONS
D-Lgs 81/08
Training and Information

 the measures taken to eliminate or reduce to a minimum the

risks;
 how to detect and report the adverse effects of exposure to
health;
 the correct use of appropriate personal protective equipment
and its indications and contraindications health;
 the circumstances in which workers are entitled to health
surveillance;
 safe working procedures to minimize exposure.