Exposure–response relationship between work-related hand–arm vibration exposure and musculoskeletal disorders of the upper extremities: the German hand–arm vibration study

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.