Exposure–response relationship between work-related hand–arm vibration exposure and musculoskeletal disorders of the upper extremities: the German hand–arm vibration study
Yi Sun, Frank Bochmann, Jürgen Dohlich, Winfried Eckert, Benjamin Ernst, Christian Freitag, Uwe Nigmann, Nastaran Raffler, Christina Samel, Christian van den Berg, Uwe Kaulbars
Abstract
Objective: To quantify the exposure-response relationship between hand-arm-vibration exposure and the risk of musculoskeletal disorders of upper extremities (UMSDs), a case-control study was carried out among workers in the construction, mining, metal, and wood working industries.Methods: 209 male cases and 614 controls were recruited. Cases were newly reported patients with UMSDs. Controls were a random sample of persons with compensable occupational injuries. Standardized personal interviews were performed among cases and controls by well-trained safety engineers. In addition to leisure activities and comorbidities, work histories of all participants were collected in detail. To quantify hand-arm-vibration exposures, a database of vibration measurements of over 700 power tools was used. This database allows the detailed quantification of vibration exposures over time. A dose-response relationship between hand-arm-vibration exposure and UMSDs was quantified by conditional logistic regression analyses.Results and Conclusions: After adjusting for relevant confounders, statistically significant exposure-response relationships between cumulative hand-arm-vibration exposure and MSDs of the upper extremities were established. A cumulative hand-arm-vibration exposure of Dhv (vibration total value in three measuring directions) = 142,300 (95%CI: 90,600-333,200) m2/s4·day or Dhw (vibration value in the direction along the forearm) = 38,700 (95%CI: 25,400-80,900) m2/s4·day is associated with a doubled risk of MSDs of upper extremities.