Hazards in the development of

Carpal Tunnel Syndrome

The factors which have been most widely accepted as occupational hazards in the
development of CTS include repetitive or sustained flexion of the wrist or contraction of
the muscles whose tendons pass through the carpal tunnel, especially when doing
forceful work (Zakaria et al. 2002; Palmer
et al. 2007; WSIB, 2008). This type of work has been found to cause inflammation of
tendons which can alter the space within the carpal tunnel, and to apply external
pressure and thus
compress the median nerve (Zakaria et al. 2002). Vibration and mechanical pressure
have also been associated with an increased risk of developing CTS (Zakaria et
al. 2002; Palmer et al.2007; WSIB, 2008). Awkward postures at the wrist can increase
pressure in the carpal tunnel, or directly compress the median nerve, which may lead to
the development of CTS (Zakaria et al.2002).Vibration is oscillatory motion. The extent
of oscillatory motion defines the magnitude and the repetition rate of cycles of oscillation
determines frequency of vibrations. (page 3)
Figure showing categorization of type of oscillatory motions(page 4).
Human vibration is a multidisciplinary subjects involving discipline from engineering,
ergonomics, mathematics, medicine, physics, physiology, psychology and statistics page
3
The motions experienced in an off road vehicle are highly dependent on both the terrain
and the manner in which the vehicle is driven. A standard tractor 498-503
Handbook of human vibration by M J griffin ed
Vibration is concerned with oscillatory motion of the body and the forces associated with
them. Those bodies which possess mass and elasticity are capable of vibration. So
,most engineering machines and structures experience vibrations and their design
generally requires considerations of their oscillatory behaviour
These oscillatory systems can be characterised broadly as linear or nonlinear. There are
two general classes of vibration free and forced vibration. Free vibration takes place
when system oscillate under action of forces inherent in the system itself and when
external inpressed forces are absent. The system under free vibration will vibrate at one
or more of its natural frequencies
Vibration that takes place under excitation of external force is known as forced vibration.
When excition is oscillatory system is forced to vibrate at excitation frequency. If
frequency of external excitation coincides with natural frequency of system, resonance is

produced and as a result large oscillation may results. Theory of vibration and
application by willam Thomson page no 5., 4th edition.
Farming is an occupation exposed to whole body vibration
(WBV), mechanical shock, awkward postures and heavy manual
lifting, which are all accepted as low back pain (LBP) risk factors
(Bovenzi et al., 2006; European Union, 2006; Hoy et al., 2005; Lis
et al., 2007; Okunribido et al., 2006b).
Since daily occupational driving is likely to include both WBVs
as well as mechanical shocks it is difficult to distinguish between
the adverse health effects of these factors (Hoy et al., 2005; Waters et al., 2007).
While many studies have examined occupational WBV exposure
(Bovenzi et al., 2006; Hoy et al., 2005; Johanning et al., 2006;
Okunribido et al., 2006a, 2007; Rehn et al., 2005), research into
occupational mechanical shocks and their effects on the human
body have not been as comprehensive. Although the European
Union (2006) has set a daily vibration dose value (VDV) of 9.1 m/
s1.75 as an action limit (AL) and 21.0 m/s1.75 as a maximum
permissible limit (MPL) risk to the health and safety of an operator
is probably greater when such exposure includes transient
mechanical shocks (European Union, 2006; Sandover, 1998;Waters
et al., 2007).
The International Organization for Standardization (ISO) 2631-1
standard (ISO, 1997) advocates use of the vibration dose value (VDV
m/s1.75) as a method for evaluating WBV particularly when the crest
factor exceeds 9.0, indicating the presence of mechanical shock.

However, the ISO 2631-5 (2004) standard has now been introduced
as a guideline for a more direct evaluation of exposure to
mechanical shock which is are thought to cause adverse loading on
the lumbar disc and lumbar vertebral endplates. Adverse health
effects from a combination of both mechanical shock and vibration exposure are thought
to include an increased risk of structural and neurological injury to the lumbar spine (Hoy
et al., 2005; Bovenziet al., 2006). Disturbance to the nutrition pathways of spinal articular
segments, leading to increased degenerative and pathological processes in the lumbar
spine are also speculated (Hadjipavlou et al., 2008).
Peripheral nerves are often mechanically damaged in occupational hazards. Acute
trauma victims are easily identifiable but gradual development of sign symtoms of
peripheral nerves dysfunction can be overlooked in aworker until impaired function affect
productivity and safety. Repeated mechanical injury resulting from external forces may
cause subacute or chronic syndromes of nerve dysfunction. Compression of nerve within
a ligamentous bony canal stretching and subsequent ischemic injury by squeezing of a
nerve betwwen muscle edges during repetitive motions are mechanism for injury .
changes in design and modification in the design of ahand operated tools or afdaptation
in work procedure may prevent further damage and permit recovery.
American journal of occupation medicine 4:661-681 (1983) classical syndromes in
occupational medicine .
Peripheral nerve entrapment syndrome and ergonomic factors
Robert g feldmann, MD < rose Goldmann, MD and W Monroe Keysirling , Ph D
It was found that arm
angle in driving posture has a substantial in#uence on the dynamic behavior of tWhen a
driver sits on a vehicle seat, s/he chooses a positioning of the seat to operate the
pedals easily. The seat may be moved backwards or forwards according to the stature of
a driver in order to operate the pedals without difficulty. The spacing between the
steering
wheel and the body then becomes small. The driver has to bend the arm considerably
tohe human
body while driving. It is not clear whether the vibration of arms and legs
is an important factor or not for ride comfort. However, when a driver operates the pedals
and

the steering wheel, it is important to reduce the vibration from arms and legs in an
emergency.
When the vibration of arms and legs increases, the steering wheel and pedals cannot be
operated
to prevent an accident. It is therefore desirable to clarify the vibrational characteristics of
the
system comprising the human body and the seat, steering wheel and pedals. The
transmissibility and the resonance frequency vary with body parts. It is desirable to
reduce the vibration experienced by arms and legs in order to operate the steering wheel
and
pedals the arm angle was
observed to have a primary in#uence on the upper arm, the lower arm, the thigh, and the
shin accelerations. It became clear that resonance frequency and peak value for body
parts were di!erent . The standard deviations of both the peak acceleration ratio for
upper arm and the
resonance frequency for shin and thigh were large. The following can be said as a result:
there is considerable variability concerning the vibration characteristics of upper arm,
shin and thigh
Journal of Sound and <ibration (2000) 236(1), 1}21
doi:10.1006/jsvi.2000.2862, available online at http://www.idealibrary.com on
RESEARCH ON VIBRATION CHARACTERISTICS
BETWEEN HUMAN BODY AND SEAT, STEERING WHEEL,
AND PEDALS (EFFECTS OF SEAT POSITION ON RIDE
COMFORT)
S. NISHIYAMA AND N. UESUGI
Hiroshima City Industrial echnology Institute, 8-24 Senda-machi 3-Chome, Naka-Ku,
Hiroshima City
730-0052, Japan

T. TAKESHIMA AND Y. KANO

Delta Kogyo Company td. 1-14 Shinchi Fuchu-cho, Aki-gun, Hiroshima 735-8501,
Japan
AND
H. TOGII
Kuroishi Iron=orks Corporation td. 2-20 Minami Myoujin, Kaita-cho, Aki-gun, Hiroshima
736-0055,
Japan
(Received 28 January 1999, and in ,nal form 10 January 2000)
Excessive exposure to hand-transmitted vibration
can induce disturbances in finger blood flow,
and in neurological and motor functions of the hand
and arm. It has been estimated that 1.73.6% of the
workers in the European countries and USA are
exposed to potentially harmful hand-transmitted vibration.
Vascular disorders and joint abnormalities caused
by hand-transmitted vibration are compensated occupational
diseases in 13% of total occupational diseases in
Croatia (Kacian, 1997). These disorders are also
included in an European list of recognized occupational
diseases (ISO 5349-2001). The term hand-arm vibration
syndrome (HAVS) is commonly used to refear to
the complex of peripheral vascular, neurological and
musculoskeletal disorders associated with exposure to
hand-transmitted vibration. Even operators on
jobs that seem easy, such as tractor driver, can be

exposed to unexpected vibration. Specially unexpected

are vibration transmitted from the steering wheel to the
drivers hands. This vibration was already recognized as
a problem (Goglia and Gospodari!c, 2002
During an ordinary working day the driver spends
approximately 6.5 h in effective work. The effective
work consists of two dominant operations during which
the tractor is either idling or at full load.
vibration acceleration level transmitted from the
steering wheel to the drivers hands will produce finger
blanching in 10% of exposed persons after less than 2
years. Therefore, it is necessary that persons who are
responsible for occupational health and safety take
preventive measures. It is presumed that vibration
hazards are reduced when continuous vibration exposures
over long period are avoided. Therefore, work
schedules should be arranged to include vibration-free
periods.
Applied Ergonomics 34 (2003) 4549
Hand-transmitted vibration from the steering wheel to drivers of a
small four-wheel drive tractor
V. Gogliaa,*, Z. Gospodari!cb, S. Ko$suti!cb, D. Filipovi!cb
a Faculty of Forestry University of Zagreb, Sveto$simunska 25, 10 000 Zagreb, Croatia
b Faculty of Agronomy University of Zagreb, Sveto$simunska 25, 10 000 Zagreb,
Croatia

Received 1 February 2002; accepted 16 September 2002

Each tissue mass has its own natural frequency. Smaller structures tend to resonate at
higher frequencies and larger masses tend to resonate at lower frequencies. When the
body comes in contact with a mechanical source of vibration the tissues of the body
become displaced from their resting position. In the work setting there are basically three
types of vibration that are significant to the worker. These include whole body vibration,
segmental vibration and resonance. The most common form of whole body vibration is
vehicular vibration. In this case vibration enters the body through the buttocks and the
feet and to a lesser extent the hands.
All physical systems have their own natural frequency. When tissues of the body are
exposed to sources of vibration corresponding to their natural frequency these tissues
go into reso . When the muscles of the body are exposed to vibration, they react by
exhibiting a protective reflex. The reflex causes the muscles to contract and shorten
resulting in an increase in energy consumption. These sustained static muscle
contractions result in a rapid fatiguing of the muscle. Fatigued muscles are much more
susceptible to injury. The most significant effect is the contraction of the muscles that line
the walls of the small blood vessels. These muscles serve to regulate blood flow by
constricting and dilating the vessel size. Blood flow is cut off to the affected body part
resulting in numbness and tingling. The worker consequently looses sensation and
motor control.
11th International Research/Expert Conference
Trends in the Development of Machinery and Associated Technology
TMT 2007, Hammamet, Tunisia, 05-09 September, 2007.
CORRELATIONS BETWEEN MECHANICAL VIBRATIONS AND HUMAN HEALTH
nance.
Few environmental studies conducted to-date confi rm
that the highest levels of vibration measured at the seats
of agricultural tractors remain mainly within the range of
low frequencies (1-10 Hz), equivalent to the resonance
frequencies for various human body organs [6, 7, 18, 20].
Mechanical vibration with the above-mentioned characteristics
may cause serious disorders in the functioning of
these organs or systems,
The conducted studies of mechanical vibration exerting

a general effect on the whole body occurring on the

seats of agricultural tractors showed that the highest acceleration
values are emitted during agricultural work activities
performed with an elevated operation velocity, along a
hard surface and unequal surfaces.
PRELIMINARY RECOGNITION OF WHOLE BODY VIBRATION RISK
IN PRIVATE FARMERS WORKING ENVIRONMENT
Leszek Solecki
Department of Physical Occupational Hazards, Institute of Agricultural Medicine, Lublin,
Poland
Solecki L: Preliminary recognition of whole body vibration risk in private farmers working
environment. Ann Agric Environ Med 2007, 14, 299-304.
demonstrated vibration-induced disruption of retrograde axoplasmic transport after only
two 5-hr long periods of vibration, as well as structural changes to endothelial cells after
a single 4-hr exposure to vibration [Curry et al. 2002; Yan et al. 2005].
Curry BD, Bain JLW, Yan J-G, Zhang L-L, Yamaguchi M, Matloub HS, Riley DA [2002].
Vibration injury damages arterial endothelial cells. Muscle Nerve 25(4):527534.
Yan J-G, Matloub HS, Sanger JR, Zhang L-L, Riley DA [2005]. Vibration-induced
disruption of retrograde axoplasmic transport in peripheral nerve. Muscle
Nerve 32(4):521526.
The present study demonstrates the effect on NCV after prolonged vibration and, more
importantly, displays the ability of the rat tail nerve to recover from 7-day exposure but
not 14-day exposure. Vibration for 14 days causes a decrease in NCV that does not
return to normal after a recovery period of 60 days. Vibration for 7 days also causes a
significant decrease in NCV, but the injury, although still significant, shows some
recovery 30 days post-vibration (group D) and complete recovery 60 days following
vibration
VIBRATION-INDUCED NERVE INJURY AND RECOVERY IN A RAT TAIL MODEL
Michael A. Loffredo,1 Dennis Kao,1 Ji-Geng Yan,1 Lin-Ling Zhang,1and Hani S.
Matloub1
1Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, WI

Danny A. Riley,2
2Department of Cell Biology, Neurobiology, and Anatomy,
Proceedings of the Second American C onference on H uman V ibration
Chicago, IL June 46, 2008
Driving during the 5 years preceding the onset of symptoms seemed to increase the risk
of back pain, whereas earlier exposure did not.
Spine:
January 1992
Original Article: PDF Only
Self-Reported Back Pain in Fork-Lift Truck and Freight-Container Tractor Drivers
Exposed to Whole-Body Vibration.
BOSHUIZEN, HENDRIEK C. PhD; BONGERS, PAULIEN M. PhD; HULSHOF, CAREL T.
J. MD
Anthropometric evaluation showed abdominal girth and weight to be significantly higher
in tractor-driving farmers (P= 0.006 and 0.046, respectively),
Spine:
1 December 1999 - Volume 24 - Issue 23 - p 2506
Clinical Studies
Effect of Whole-Body Vibration on the Low Back: A Study of Tractor-Driving Farmers in
North India
Kumar, Adarsh MTech*; Varghese, Mathew MS; Mohan, Dinesh PhD; Mahajan,
Puneet PhD; Gulati, Praveen MD; Kale, Shashank MCh
The localized decrease in substance P and increased VIP seen following low frequency
vibration are compatible with results following peripheral Injury.
Spine:
May 1988
Article: PDF Only
Neuropharmacologic Effects of Vibration on the Dorsal Root Ganglion: An Animal Model.

WEINSTEIN, JAMES DO; POPE, MALCOLM PhD.; SCHMIDT, ROBERT BS;

SEROUSSI, RICHARD BS
Based on the measurement results it is quite certain
that the vibration acceleration level transmitted from the
steering wheel to the drivers hands will produce finger
blanching in 10% of exposed persons after less than 2
years
Applied Ergonomics 34 (2003) 4549
Hand-transmitted vibration from the steering wheel to drivers of a
small four-wheel drive tractor
V. Gogliaa,*, Z. Gospodari!cb, S. Ko$suti!cb, D. Filipovi!cb
Few environmental studies conducted to-date confi rm
that the highest levels of vibration measured at the seats
of agricultural tractors remain mainly within the range of
low frequencies (1-10 Hz), equivalent to the resonance
frequencies for various human body organs [6, 7, 18, 20]
Solecki L: Whole body vibration in agricultural vehicles a significant
health risk factor. In: Solecki L (Ed): Physical Hazards in Agriculture,
57-65. Institute of Agricultural Medicine, Lublin 1999 (in Polish).
Solecki L, Choina P, Wasilkowski J, Michalczuk A: Recognition of
risk due to the whole body mechanical vibration in private farmers work
environment. [Report from Project No. 2.17/05] for 2005-2006. Institute
of Agricultural Medicine, Lublin 2006 (in Polish)..
Fairley TE: Predicting the discomfort caused by tractor vibration.
Ergonomics 1995, 38, 2091-2106.

Futatsuka M, Maeda S, Inaoka T, Nagano M, Shono M, Miyakita

T: Whole-body vibration and health effects in the agricultural machinery
drivers. Ind Health 1998, 36, 127-132.
Goglia V, Gospodaric Z, Filipovic
Vibration
occurring on the handles of these machines cause
vascular, neurological and musculoskeletal changes, resulting
in vibration-induced white fi nger syndrome
Goglia V, Gospodaric Z, Filipovic D, Djukic I: Infl uence on operators
health of hand-transmitted vibrations from handles of a single-axle
tractor. Ann Agric Environ Med 2006, 13, 33-38.
Health effects
to the lower extremity (white-feet) related to standing
on vibrating surfaces have been reported in i.e. mining
Eger T, Thompson A, Leduc M et al. Vibration induced white-feet:
overview and field study of vibration exposure and reported symptoms
in workers. Work 2014; 47: 101110.
Anthropometric evaluation showed abdominal girth and weight to be significantly higher
in tractor-driving farmers
Spine:
1 December 1999 - Volume 24 - Issue 23 - p 2506
Clinical Studies
Effect of Whole-Body Vibration on the Low Back: A Study of Tractor-Driving Farmers in
North India
Kumar, Adarsh MTech*; Varghese, Mathew MS; Mohan, Dinesh PhD; Mahajan,
Puneet PhD; Gulati, Praveen MD; Kale, Shashank MCh

decreased nerve conduction velocity, sober ... dose populations such as truck drivers,
bus drivers,
heavy equipment operators, foundry workers, farm tractor drivers
The Effects of Whole-body Vibration on Health
HE von Gierke 1979
Exposure to FTV can lead to vibration white feet/toes resulting in blanching of the toes,
and tingling and numbness in the feet and toes. Operators exposed to FootTransmitted
Vibration at 40 Hz appear to be at greater risk of experiencing vibration induced injury.
Tammy Eger1, 2, Aaron Thompson3, 4, Mallorie Leduc1, Kristine Krajnak5, Katie Goggins1,
Alison Godwin1, 2, Ron House3, 4 Volume 47, Number 1 / 2014 Vibration induced white-feet:
Overview and field study of vibration exposure and reported symptoms in workers
JournalWork: A Journal of Prevention, Assessment and Rehabilitation

Reference:
Essays, UK. (November 2013). Hazards In The Development Of Carpal Tunnel?
utm_expid=309629 42.KXZ6CCs5RRCgVDyVYVWeng.0&utm_referrer=https%3A%2F
%2Fwww.ukessays.com%2Fessays%2Fhealth%2F. Retrieved from
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%2Fwww.ukessays.com%2Fessays%2Fhealth%2F?cref=1