PUBLISHED DOCUMENT PD 12349:

1997

Mechanical vibration —
Guide to the health
effects of vibration on
the human body

ICS 13.160
PD 12349:1997

Committees responsible for this

Published Document

The preparation of this Published Document was entrusted by Technical

Committee GME/21, Mechanical vibration and shock, to Subcommittee
GME/21/6, Human exposure to mechanical vibration and shock, upon which
the following bodies were represented:

Imperial College of Science and Technology

Institute of Sound and Vibration Research
Institution of Mechanical Engineers
Lloyd’s Register of Shipping
Ministry of Defence
Open University
Power Generation Contractors’ Association [PGCA (BEAMA Ltd.)]
Railway Industry Association of Great Britain
Society of British Aerospace Companies Limited
Society of Environmental Engineers

The following bodies were also represented in the drafting of the standard,
through subcommittees and panels:

British Compressed Air Society

British Gas plc
British Industrial Truck Association
British Railways Board
Forestry Commission
Health and Safety Executive
Institute of Explosives Engineers
Institute of Naval Medicine
Motor Industry Research Association
Portable Electric Tool Manufacturers’ Association
Society of Motor Manufacturers and Traders Limited
University College of Wales
University of Salford

This Published Document, having

been prepared under the
direction of the Engineering
Sector Board, was published
under the authority of the
Standards Board and comes into Amendments issued since publication
effect on
15 March 1997 Amd. No. Date Comments
© BSI 03-1999

The following BSI reference

relates to the work on this
publication:
Committee reference GME/21/6

ISBN 0 580 26664 8

 PD 12349:1997

Contents

Page
Committees responsible Inside front cover
National foreword ii
Foreword 2
Text of CR 12349 3

© BSI 03-1999 i
PD 12349:1997

National foreword

This Published Document has been prepared by Subcommittee GME/21/6, and is

the English language version of CR 12349:1996, published by the European
Committee for Standardization (CEN).
This Published Document is not to be regarded as a British Standard.

Summary of pages
This document comprises a front cover, an inside front cover, pages i and ii,
the CR title page, pages 2 to 10, an inside back cover and a back cover.
This standard has been updated (see copyright date) and may have had
amendments incorporated. This will be indicated in the amendment table on
the inside front cover.

ii © BSI 03-1999
REPORT CR 12349
RAPPORT
June 1996
BERICHT

English version

Mechanical vibration — Guide to the health effects

of vibration on the human body

Vibrations mécaniques — Guide Mechanische Schwingungen —

concernant les effets des vibrations Leitfaden über die Wirkung von
sur la santé du corps humain Schwingungen auf die Gesundheit
des Menschen

This CEN REPORT has been prepared by Technical Committee CEN/TC 231
“Mechanical vibration and shock” and has been approved by CEN
on 1996-05-24.
CEN members are the national standards bodies of Austria, Belgium,
Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy,
Luxembourg, Netherlands, Norway, Portugal, Spain, Sweden, Switzerland,
United Kingdom.

CEN
European Committee for Standardization
Comité Européen de Normalisation
Europäisches Komitee für Normung
Rue de Stassart 36, B-1050 Brussels

© CEN 1995 All rights of reproduction and communication in any form and by any means reserved in all
countries to CEN and its members
Ref. no. CR 12349:1996 E
CR 12349:1996

Foreword Contents
Page
This CEN report has been drawn up by Technical
Committee CEN/TC 231 “Mechanical vibration and Foreword 2
shock”, working group 5 “Vibration effects”. 1 Scope 3
Annex A and Annex B are informative. 2 Normative references 3
3 Hand-transmitted vibration 3
4 Whole-body vibration 7
Annex A (Informative) Bibliography 10
Annex B (informative) Glossary Inside back cover
Table 1 — The Stockholm Workshop scale for
staging cold-induced Raynaud’s phenomenon
in the hand-arm vibration syndrome 5
Table 2 — Sensorineural stages of the hand-arm
vibration syndrome according to the Stockholm
Workshop scale 5

2 © BSI 03-1999
 CR 12349:1996

Introduction CR 1030-1, Hand-arm vibration — Guidelines for

vibration hazards reduction — Part 1: Engineering
This CEN report provides a short overview of the
methods by design of machinery.
current knowledge of the possible effects of
vibration on the human body. It is an informative CR 1030-2, Hand-arm vibration — Guidelines for
document which presents general background vibration hazards reduction — Part 2: Management
information for the user of the different European measures at the workplace.
Standards on vibration. prEN 1299, Vibration isolation of machines —
Mechanical vibration arises from a wide variety of Information for the application of source isolation.
processes and operations performed in industry, ENV 25349, Mechanical vibration — Guidelines for
forestry and agriculture, and public utilities. the measurement and the assessment of human
Vibration caused by vehicles, powered processes, exposure to hand-transmitted vibration.
hand-held and hand-guided tools, or workpieces can (ISO 5349:1986)
greatly influence the human body. Exposure to EN 30326-1, Mechanical vibration — Laboratory
harmful vibration can induce several complaints method for evaluating vehicle seat vibration —
and health disorders, mainly at the upper limbs and Part 1: Basic requirements. (ISO 10326-1:1992)
the lower back. A comprehensive knowledge of the
prEN ISO 10819, Mechanical vibration and shock —
unwanted effects of vibration on the body is
Hand-arm vibration — Method for the measurement
essential to implement appropriate administrative,
and evaluation of the vibration transmissibility of
technical and medical preventive measures.
gloves at the palm of the hand.
(ISO/DIS 10819:1995)
1 Scope
The aim of this CEN report is to provide information 3 Hand-transmitted vibration
on the possible adverse health effects caused by
3.1 General
exposure to vibration at work. The report addresses
manufacturers as well as employers and employees Powered processes and tools which expose
using vibrating machinery in order to improve their operators’ hands to vibration are widespread in
understanding of the possible health problems several industrial activities. Occupational exposure
arising from occupational exposure to vibration. to hand-transmitted vibration can arise from
This CEN report is limited to the effects on health rotating and percussive hand-held power tools used
and does not cover the potential effects of vibration in the manufacturing industry, quarrying, mining
and construction, forestry and agriculture, and
on comfort, human performance or vibration
public utilities. Exposure to hand-transmitted
perception. Most of the information on whole-body
vibration can also occur from vibrating workpieces
vibration in this CEN report is based upon data
held in the hands of the operator, and from
available from research on human response to
hand-held vibrating controls such as motorcycle
vibration of seated persons. There are only few data
on the effects of vibration on persons in standing, bars or vehicle steering wheels.
reclining or recumbent positions. The information Excessive exposure to hand-transmitted vibration
on both hand-transmitted vibration and whole-body may include disturbances in finger blood flow, and
vibration is based upon data from laboratory in neurological and locomotor functions of the hand
research on acute effects as well as upon data from and arm. It has been estimated that 1,7 to 3,6 % of
epidemiologic studies. the workers in the European countries and the
Additional information may be obtained from the U.S.A. are exposed to potentially harmful
scientific literature (see Annex A). hand-transmitted vibration.
The term hand-arm vibration (HAV) syndrome is
2 Normative references commonly used to refer to the complex of peripheral
vascular, neurological and musculoskeletal
This CEN report incorporates by dated or undated disorders associated with exposure to
reference, provisions from other publications. These hand-transmitted vibration. Workers exposed to
normative references are cited at the appropriate hand-transmitted vibration may be affected with
places in the text and the publications are listed neurological and/or vascular disorders separately or
hereafter. For dated references, subsequent simultaneously. Vascular disorders and bone and
amendments to or revisions of any of these joints abnormalities caused by hand-transmitted
publications apply to this CEN report only when vibration are compensated occupational diseases in
incorporated in it by amendment or revision. For several countries. These disorders are also included
undated references, the latest edition of the in an European schedule of recognized occupational
publication referred to applies. diseases.

© BSI 03-1999 3
CR 12349:1996

3.2 Vascular disorders Several laboratory tests are used to diagnose white
Workers exposed to hand-transmitted vibration finger objectively. Most of these tests are based on
may complain of episodes of pale or white finger cold provocation and the measurement of finger skin
usually triggered by cold exposure. This disorder, temperature or digital blood flow and pressure
due to temporary abolition of blood circulation to the before, during and after cooling of the fingers and
fingers, is called Raynaud’s phenomenon (after hands.
Maurice Raynaud, a French physician who first Epidemiologic studies have demonstrated that the
described it in 1862). It is believed that vibration prevalence of VWF varies widely, from 0 to 100 %.
can disturb the digital circulation making it more It appears that the probability and severity of white
sensitive to the vasoconstrictive action of cold. finger symptoms is influenced by several factors
To explain cold-induced Raynaud’s phenomenon in such as the characteristics of vibration exposure
vibration-exposed workers, some investigators (frequency, magnitude, direction, impulsiveness,
invoke an exaggerated central vosoconstrictor reflex duration), the type of tool and work process, the
caused by prolonged exposure to harmful vibration, environmental conditions (temperature, air flow,
while others tend to emphasize the role of humidity, noise), some biodynamic and ergonomic
vibration-induced local changes in the digital factors (grip force, push force, arm position), and
vessels. various individual characteristics (susceptibility,
diseases and agents, e.g. smoking and certain
Various synonyms have been used to describe medicines, affecting the peripheral circulation).
vibration-induced vascular disorders: dead or Thus, there is a complex relationship between
white finger, Raynaud’s phenomenon of vibration exposure and the development of white
occupational origin, traumatic vasospastic disease, finger symptoms. Epidemiologic studies suggest
and, more recently, vibration-induced white finger that the occurence of VWF increases with increasing
(VWF). VWF is a prescribed disease in many duration of vibration exposure. There is some
countries. evidence that the cumulative exposure before the
Initially attacks of blanching involve the tips at one appearance of finger blanching is approximately
or more fingers, but, with continued exposure to inversely proportional to the magnitude of the
vibration, the blanching can extend to the base of vibration exposure (i.e. if the vibration magnitudes
the fingers. Sometimes, an attack of blanching is are doubled, a halving of the years of exposure is
followed by cyanosis, i.e. a bluish discoloration of required to produce the same effect).
the affected fingers due to increased extraction of Since the late 1970s a decrease in the incidence of
oxygen from the sluggish digital circulation. In the VWF has been reported among active forestry
recovery phase, commonly accelerated by warmth or workers in both Europe and Japan after the
local massage, redness, eventually associated with introduction of anti-vibration chain saws and
pain, may appear in the affected fingers as a result administrative measures curtailing the saw usage
of a reactive increase of blood flow in the cutaneous time together with endeavours to reduce exposure to
vessels. The blanching attacks are more common in other harmful work environment (e.g. cold, and
winter than in summer and last from a few minutes physical stress). Recovery from VWF has also been
to more than one hour. The duration varies with the reported among retired forestry workers. Similar
intensity of the triggering stimuli, the attack is findings are not yet available for tools of other type.
usually ending when the entire body is warmed.
If vibration exposure continues, the blanching
attacks become more frequent and may occur all
year around. In the rare advanced cases, repeated
and severe finger blanching attacks can lead to
trophic changes (ulceration or gangrene) in the skin
of the fingertips. During the attack the affected
workers can experience a complete loss of touch
sensation and manipulative dexterity, which can
interfere with work activity increasing the risk for
acute injuries due to accidents. In occupational
medicine various staging systems for the
classification of VWF have been developed.
A grading scale proposed at the Stockholm
Workshop 86 is reported in Table 1.

4 © BSI 03-1999
 CR 12349:1996

Table 1 — The Stockholm Workshop scale for Vibration-exposed workers may sometimes show
staging cold-induced Raynaud’s phenomenon signs and symptoms of entrapment neuropathies,
in the hand-arm vibration syndrome such as carpal tunnel syndrome (CTS), a disorder
Stage Grade Symptoms
due to compression of the median nerve as it passes
through an anatomical tunnel in the wrist. CTS
0 — No attacks seems to be a common disorder in some occupational
1 Mild Occasional attacks affecting groups using vibrating tools such as rock-drillers,
only the tips of one or more platers and forestry workers. It is believed that
fingers ergonomic stressors acting on the hand and wrist
(repetitive movements, forceful gripping, awkward
2 Moderate Occasional attacks affecting
postures), in combination with vibration can cause
distal and middle (rarely also CTS in workers handling vibrating tools.
proximal) phalanges of one o
more fingers Table 2 — Sensorineural stages of the
hand-arm vibration syndrome according to
3 Severe Frequent attacks affecting all the Stockholm Workshop scale
phalanges of most fingers
Stage Signs and symptoms
4 Very severe As in stage 3, with trophic skin
changes in the fingertips 0SN Exposed to vibration but no symptoms
1SN Intermittent numbness, with or without
3.3 Neurological disorders tingling
Workers exposed to hand-transmitted vibration 2SN Intermittent or persistent numbness,
may experience tingling and numbness in their reduced sensory perception
fingers and hands. If vibration exposure continues,
these symptoms tend to worsen and can interfere 3SN Intermittent or persistent numbness,
with work capacity and life activities. reduced tactile discrimination and/or
Vibration-exposed workers may exhibit a reduction manipulative dexterity
in the normal sense of touch and temperature as
3.4 Musculoskeletal disorders
well as an impairment of manual dexterity at the
clinical examination. As an effect of 3.4.1 Skeletal
hand-transmitted vibration, also a reduction of the Vibration-induced bone and joint disorders are a
vibration sensitivity of the skin of the fingertips controversial matter. Early radiological
may be found. Epidemiologic surveys of investigations revealed a high prevalence of bone
vibration-exposed workers show that the prevalence vacuoles and cysts in the hands and wrists of
of peripheral neurological disorders varies from a vibration-exposed workers, but more recent studies
few percent to more than 80 %, and that sensory have shown no significant increase with respect to
loss affects users of a wide range of tool type. It manual workers not exposed to vibration. Excess
seems that sensorineural disturbances may develop occurrence of wrist and elbow osteoarthrosis as well
independently of other vibration-induced disorders, as ossifications at the sites of tendon insertion,
probably reflecting different pathological mostly at the elbow, have been found in miners,
mechanisms. road construction workers and metal-working
A classification for the neurological component of operators exposed to shock and low-frequency
the HAV syndrome was proposed at the Stockholm vibration (< 50 Hz) of high magnitude from
Workshop 86, consisting of three stages according to pneumatic percussive tools. An excess prevalence of
the symptoms complained and the results of clinical Kienböck’s disease (lunate malacia) and
neurological examination and psychophysical pseudoarthrosis of the scaphoid bone in the wrist
testing methods such as tactile discrimination, has also been reported by a few investigators.
vibrotactile perception, and precision manipulation
(see Table 2).

© BSI 03-1999 5
CR 12349:1996

There is little evidence of an increased prevalence of In addition to peripheral disorders, other adverse
degenerative bone and joint disorders in the upper health effects involving the endocrine and central
limbs of workers exposed to mid- or high-frequency nervous system of vibration-exposed workers have
vibration arising from chain saws or grinding been reported by Russian and Japanese
operation. Heavy physical effort, forceful gripping investigators. The clinical picture, called “vibration
and various biomechanical factors may account for disease”, includes signs and symptoms related to
the higher occurrence of skeletal injuries found in dysfunction of the higher centres of the brain
workers operating percussive tools. Local pain, (e.g. persistent fatigue, headache, irritability, sleep
swelling, and joint stiffness and deformities may be disturbances, impotence, electroencephalographic
associated with radiological findings of bone and abnormalities These findings should be interpreted
joint degeneration. In some countries (e.g. France, with caution and further carefully designed
Germany, Italy), bone and joint disorders occurring epidemiologic and clinical research work is needed
in workers using hand-held vibrating tools are to confirm the hypothesis of an association between
considered to be an occupational disease and the disorders of the central nervous system and
affected workers are compensated. exposure to hand-transmitted vibration.
3.4.2 Muscular 3.6 Prevention
Workers with prolonged exposure to vibration may The prevention of injuries or disorders caused by
complain of muscular weakness, pain in the hands hand-transmitted vibration requires the
and arms, and diminished muscle force. Vibration implementation of administrative, technical and
exposure has also been found to be associated with medical procedures. Guidelines on preventive
a reduction of hand-grip strength. In some procedures are included in CR 1030-1, CR 1030-2
individuals muscle fatigue can cause disability. and ENV 25349. Prevention includes technical
Direct mechanical injury or peripheral nerve measures aimed at elimination or reduction of
damage have been suggested as possible etiologic hand-transmitted vibration at the source,
factors for muscle symptoms. Other work-related appropriate information and advice to employers
disorders have been reported in vibration-exposed and employees, instruction to adopt safe and correct
workers, such as tendinitis and tenosynovitis work practices, and medical preventive guidance.
(i.e. inflammation of tendons and their sheaths) in No adequate personal protective equipment against
the upper limbs, and Dupuytren’s contracture, a hand-transmitted vibration is presently available.
disease of the fascial tissues of the palm of the hand. Gloves are useful to protect the fingers and hands
These disorders seem to be related to ergonomic from traumas and to maintain them warm. To be
stress factors arising from heavy manual work, and effective at attenuating vibration gloves shall
the association with hand-transmitted vibration is succeed the test required by prEN ISO 10819.
not conclusive. Heating systems for hand grips of motor chain saws
3.5 Other disorders have been proved to be a very effective prevention
measure in forestry work. Since continuous
Some studies indicate that in workers affected with
exposure to vibration is believed to increase
VWF, hearing loss is greater than that expected on
vibration hazard, work schedules should be
the basis of ageing and noise exposure from
vibrating tools. It has been suggested that VWF arranged to include rest periods. A 10 min rest
subjects may have an additional risk of hearing break for each hour of continuous vibration
exposure as well as the use of warm rest rooms or
impairment due to vibration-induced
cabins have been suggested as preventive measures.
vasoconstriction of the blood vessels supplying the
inner ear.

6 © BSI 03-1999
 CR 12349:1996

The aims of health surveillance are to inform the 4 Whole-body vibration

worker on the potential risk associated with
4.1 General
vibration exposure, to assess health status and to
diagnose vibration-induced disorders at an early The mechanical vibration transmitted by the seat or
stage. Pre-employment medical screening and by the feet in vehicles (land, air, water), on ships
periodic clinical examinations at regular intervals and vibrating surfaces is called whole-body
should be performed on vibration-exposed workers. vibration (WBV). In the society, exposure to WBV is
At the first screening examination the subject’s a widespread occupational factor that may cause
personal, work and medical history should be adverse effects on health. According to estimates
carefully recorded. Particular attention should be conducted in some European countries, 4 to 7 % of
paid to any condition which may be aggravated by all employees are exposed to potentially harmful
exposure to vibration (e.g. constitutional tendency WBV. Important high-risk groups are drivers of
to white-finger disease, some forms of secondary off-road vehicles (e.g. earth-moving, forestry and
Raynaud’s phenomenon, past injuries to the upper agricultural machines), drivers of industrial trucks
limbs causing circulatory disturbances or deformity and busses, crane-operators, helicopter pilots, and
of bones and joints, neurological disorders). The use ship crews.
of some drugs which can affect peripheral This WBV is often complex, contains many
circulation (e.g. ¶-blocking agents) should be frequencies, occurs in several directions and
recorded. A complete neurological, vascular and changes over time. The transmission of vibration to
osteoarticular physical examination should be the body is also dependent on body posture. The
performed by a qualified physician. The worker effects of vibration may therefore be complex.
should be advised to wear adequate clothing to keep Exposure to WBV causes a distribution of motions
the entire body warm, and to avoid or minimize the and forces within the human body. There can be
smoking of tobacco. large biological variations between subjects with
The pre-employment examination shall be followed respect to effects. WBV may cause sensations
by periodic health re-assessment with a regular (e.g. discomfort or annoyance), influence human
interval (e.g. every 1 or 2 years). At subsequent performance capability and/or present a health and
screening examination, any illness occurred since safety risk. Low-frequency vibration of the body
the last examination and any symptom related to (with a frequency generally below 0,5 Hz) can cause
vibration exposure should be recorded. The findings motion sickness.
of the physical examination should be also reported. Most of the research on effects of WBV on the
Specific diagnostic tests (assessment of digital human body has concentrated on acute effects,
circulation after local cooling, neurophysiological discomfort or decreased performance. Less is known
investigations) should be decided by the physician about health effects of long-term exposure.
on the basis of the worker’s symptoms and the However, biodynamic research as well as
results of clinical examination. The diagnostic tests epidemiologic studies have given evidence for an
should be selected and performed by specialists. elevated risk of health impairment due to long-term
Observation of finger blanching is an important exposure to WBV. Mainly the lumbar spine and the
diagnostic marker. Vibration-exposed workers connected nervous system may be affected. With a
should be instructed to report and demonstrate lower probability, the neck-shoulder, the digestive
finger blanching when it first occurs or if there is system, the female reproductive organs, the
deterioration. Physicians and their staff should peripheral veins, and the vestibular system are
record these pathological events. Avoidance or affected by WBV.
reduction of vibration exposure for the affected
worker should be decided after considering the
severity of symptoms, the characteristics of the
entire working process, and other aspects related to
the company’s medical policy and the legislation of
the country. However, it is recommended that
exposure to hand-transmitted vibration should be
avoided for workers who reach stage 2 vascular on
the Stockholm Workshop scale.

© BSI 03-1999 7
CR 12349:1996

4.2 Low-back pain and back disorders Driving of vehicles does not only involve exposure to
Long-term exposure to occupational WBV is WBV but also to several other back-straining
strongly associated with low-back trouble. Most of factors. The most important being prolonged sitting
the research on adverse health effects from WBV in often constrained and poor postures (e.g. frequent
deals with the musculoskeletal system, in twisting of the spine), frequent lifting and material
particular, the lumbar spine. From epidemiologic handling (e.g. drivers of delivery trucks), traumatic
research there is positive evidence that WBV can be injuries, unexpected movements, and unfavourable
harmful to the spinal system. The results of climatic conditions.
epidemiologic studies show a higher prevalence rate In some countries (e.g. Belgium, Germany) back
of low-back pain, herniated disc and early disorders occurring in workers exposed to WBV are,
degeneration (spondylosis deformans, under certain conditions regarding intensity and
osteochondrosis intervertebralis, arthrosis duration of exposure, considered to be an
deformans) of the spine in exposed groups. There is occupational disease which is compensable.
a trend to higher risks with exposure to higher 4.3 Other disorders
intensity levels. Increased duration of the vibration
and increased intensity are assumed to increase the 4.3.1 Neck-shoulder disorders
risk, while periods of rest reduce the risk. There is WBV containing frequencies within the
also some indication that transient (shock-type) fundamental resonance frequency of the body may
vertical WBV exposure may present an elevated cause severe motion of the shoulders. This leads to
risk. increased response from the muscles in the body
Based on available epidemiologic data, firm region. Many drivers complain about disorders in
conclusions on an exposure-response relationship the neck-shoulder. Several ergonomic factors may
cannot be drawn. For this purpose reliable data on be suspected to give raise to these complaints,
vibration exposure, the exposure time history, e.g. twisted head postures, hand-lever
selection of the study population and the manoeuvring, stress and WBV. However, heretofore
contributing occupational environment are often not the few epidemiologic studies which have been
available. Besides, the reported effects are not performed have only shown a weaker relationship
specific for vibration exposure and there are many between neck-shoulder disorders and WBV.
contributing and/or effect-modifying factors in this 4.3.2 Digestive disorders
relationship. From experimental research on acute effects it is
Both epidemiologic and experimental researchs are known that exposure to WBV may lead to increased
still going on to clarify the exact working gastro-intestinal activity. Several studies have been
mechanism by which WBV leads to adverse health undertaken to determine the long-term effects of
effects on the spine. Although several hypotheses on WBV on the digestive system. In some studies an
working mechanisms have been proposed, the increased prevalence of gastro-intestinal
hypothesis that the mechanical overloading due to complaints, peptic ulcer and gastritis was found in
vibration leads to premature degeneration of the drivers of vibrating vehicles. Some other studies did
lumbar spine has been generally accepted during not find adverse effects. However, the few “positive”
the last years. Recent biomechanical data have also epidemiologic studies only showed slight
provided cooperating mechanisms: muscle fatigue, associations, even for the populations which were
reduced disc height and bending of the spinal most exposed, and some of these studies failed to
column may be regarded as “conditioning effects” control for important possible confounders
leading to a high strain on the vertebral column. If (e.g. smoking, alcohol, dietary habits, shift work,
the exposure is high (peak values) or continued stress). The question whether exposure to WBV may
during longer time without sufficient recovery, this lead to digestive disorders therefore remains open;
may result in a “direct (mechanical) effect”: fatigue it is likely to be at most a minor effect.
failure and impaired nutrition of the disc. Several
data show that in particular the combination of
prolonged sitting and exposure to WBV (which is
often the case in vehicles) may increase the risk of
spinal damage. In this development other
individual factors may play a role: working posture,
anthropometric characteristics, muscle tone,
physical workload, and individual susceptibility
(age, pre-existing disorders, muscle force, etc.).

8 © BSI 03-1999
 CR 12349:1996

4.3.3 Reproductive effects In addition to technical measures, improvement of

Vibration, may be, has some specific effects on the ergonomic lay-out, in particular the forced
women. Disorders of menstruation, internal working posture, and of climatic factors, limitation
inflammation and abnormal childbirth in women of the vibration exposure duration and medical
exposed to 40 to 55 Hz vibration in the guidance are important tools for prevention.
concrete-industry were reported, but the studies Appropriate information and advice to employers
were not very informative. In a large study of and employees and instruction in safe and correct
spontaneous abortion and stillbirth without work practices should be given. As personal
congenital defect it was found that there was a protective equipment against WBV is not available,
greater than expected incidence of stillbirth among information, knowledge and tools enabling
women exposed to vibration in the transport sector. employees to cope with risk factors and early effects
Further research is needed. are basic in the maintenance of health and safety at
the workplace.
4.3.4 Circulatory disorders
Medical guidance (surveillance of health) is needed
In the literature a relation between WBV and the for all workers who will be exposed to occupational
occurrence of varicose veins and hemorrhoids is WBV. This guidance shall be given by occupational
suggested. In this relationship, WBV seems to be health physicians conversant with possible effects of
rather an additional factor that acts in combination mechanical vibration and shock on human subjects.
with the long-term sitting posture of drivers. An Any worker who will be exposed to WBV shall be
elevated intra-abdominal pressure is assumed to informed of the possible adverse effects on health
play a role in the pathogenic mechanism. The prior to employment. This information comprises
evidence is however weak. also the possible preventive measures to be taken by
4.3.5 Cochleo-vestibular effects the employee.
Long-term exposure to WBV is supposed to A pre-employment medical examination shall
potentiate noise-induced hearing loss. comprise: a work history with special reference to
Simultaneous noise and vibration exposure show exposure to WBV in the past and to other
higher temporary threshold shifts of hearing in the work-related risk factors of low-back pain, a medical
higher frequencies (6 kHz to 10 kHz) than exposure history and a physical examination with special
to noise separately. The pathogenic mechanism for reference to the musculoskeletal system. The
this effect has not yet been clarified. A decreased pre-employment examination shall be followed by
vestibular excitability and a higher prevalence of periodical health examination with a regular
multiple vestibular disturbances were found in interval (e.g. every 2 or 4 years). Consultation of the
WBV exposed workers but a causal link remains occupational health physician by exposed workers
dubious since WBV with very low and high who have symptoms or disorders, or who are
intensities was linked with an increase of vestibular otherwise concerned about their health, shall be
disorders, whereas workers exposed to WBV of recommended.
medium intensity did not exhibit impairments. The following medical conditions are considered to
4.4 Prevention increase the risk of WBV exposure: recurrent
episodes of chronic back pain, distinct premature
On many workplaces exposure to WBV is still not (not related to age) degenerative changes of the
recognized as a serious problem and many spine, intervertebral disc disorders, increased
occupational health and safety services have a lack stiffness of the spine (e.g. after surgical treatment),
of experience in prevention of adverse health effects. a history of spinal injury with fracture of vertebrae,
Different elements of prevention can be chronic gastritis and/or peptic ulcers, pregnancy.
distinguished: technical prevention aimed at These conditions may be considered as
elimination or reduction of WBV (procedures to contra-indications to further severe exposure.
select suspension seats according to the dynamic
characteristics of the vehicle or to isolate machines
are given in EN 30326-1 and prEN 1299),
organizational changes in the work, personal
protection and medical prevention. In most cases
only a combination of preventive actions will lead to
a successful reduction in vibration exposure.

© BSI 03-1999 9
CR 12349:1996

Annex A (Informative)
Bibliography
Bongers, P.; Boshuizen, H.: Back disorders and whole-body vibration at work. Thesis University of
Amsterdam, Amsterdam, 1990, ISBN 90-9003668-7.
Bovenzi, M.: Medical aspects of the hand-arm vibration syndrome. International Journal of Industrial
Ergonomics, 6, 1990, pp. 61-73.
Christ, E. et al.: Vibration at work (ISSA brochure). Published by the International section Research of
ISSA, Institut National de Recherche et de Sécurité (INRS), 30, rue Olivier-Noyer, F-75680
Paris Cedex 14, 1989.
Dupuis, H.; Zerlett, G.: The effects of whole-body vibration. Springer-Verlag, Berlin, Heidelberg, New York,
Tokyo, 1986, ISBN 0-387-16584-3.
Griffin, M.J.: Handbook of human vibration. Academic Press, London, 1990,
ISBN 0-12-303040-4.
Hulshof, C.T.J.; Veldhuijzen van Zanten, O.B.A.: Whole-body vibration and low-back pain — A review of
epidemiological studies. International Archives of Occupational and Environmental Health, 59, 1987,
pp. 205-220.
Pelmear, P.L.; Taylor, W.; Wasserman, D.E. (eds.): Hand-arm vibration — A comprehensive guide for
occupational health professionals. Van Nostrand Reinhold, New York, 1992, ISBN 0-442-01250-0.
Seidel, H.: Selected health risk caused by long-term whole-body vibration. American Journal of Industrial
Medicine, 23, 1993, pp. 589-604.
Stockholm Workshop 86, Symptomatology and diagnostic methods in the hand-arm vibration syndrome.
Scandinavian Journal of Work, Environment & Health, 4, 1987, pp. 271-388.

10 © BSI 03-1999
 CR 12349:1996

Annex B (Informative)
Glossary
Arthrosis deformans: degeneration of a joint leading to deformation
Bone cyst: an abnormal cavity in the bone structure
Carpal tunnel syndrome: symptoms of numbness, tingling, or burning pain on the palmar surfaces of the
thumb, index, middle, and ring fingers, occurring mostly at night, caused by compression or irritation of
the median nerve as it passes through a tunnel formed by the wrist (carpal) bones. Signs of impaired hand
function and disability may develop.
Cochleo-vestibular effects: effects on the cochlea and the vestibular system; components of the inner ear
CTS: carpal tunnel syndrome
Cyanosis: bluish discoloration of the skin due to deficient oxygenation of the blood
Dupuytren’s contracture: thickening of the fibrous lining of the palm of the hand preventing the
straightening of the fingers, mainly the ring and little finger
Epidemiology: the study of the occurrence — prevalence and incidence — of diseases or disorders in a
population. Occupational epidemiology investigates the relation between exposure to work risk factors and
their possible adverse health effects.
Gastritis: inflammation of the stomach
Hand-arm vibration syndrome: the complex of symptoms and signs (neurological, vascular, and
musculoskeletal) associated with disorders produced by hand-transmitted vibration
HAV: hand-arm vibration
Herniated disc: a protrusion of the nucleus pulposus of the intervertebral disc in the vertebral canal; this
may exert pressure on the spinal cord or on nerve fibres
Kienböck’s disease: a disorder of mineralization (malacia) of the lunate bone in the wrist
Incidence: the number of new cases of a disease or disorder in a population over a specified period of time
Intervertebral disc: flexible pads between the vertebrae with a soft jelly-like core, the nucleus pulposus and
the annulus fibrosus: a ring of fibre which forms the circumference
Motion sickness: vomiting, nausea or malaise provoked by actual or perceived motion of the body or its
surroundings
Osteoarthrosis: bone and joint degeneration
Osteochondrosis intervertebralis: degeneration of the joints and the bony surroundings between the
vertebrae
Peptic ulcers: ulcers of the stomach or the first part of the small intestine
Prevalence: the number of existing cases of disease or disorder in a given population at a specified time
Raynaud’s phenomenon: attacks of finger blanching due to insufficient circulation of blood as a result of
digital vasoconstriction usually triggered by cold or emotion. (Primary Raynaud’s disease, when the
symptom of finger blanching cannot be attributed to any specific cause. Secondary Raynaud’s phenomenon,
when some causes can be identified. Vibration-induced white finger, a secondary form of Raynaud’s
phenomenon caused by exposure to hand-transmitted vibration)
Sensorineural disorders: abnormalities in the sensation of light touch, pain, temperature, vibration and
deep pressure; impairment of discriminative sensory function (two-point discrimination, appreciation of
texture, size, and shape)
Tendinitis: inflammation of a tendon
Tenosynovitis: inflammation of a tendon and its sheat
Vasoconstriction: narrowing of the lumen of blood vessels, especially as a result of an increased contraction
of the muscle wall of the blood vessel
VWF: vibration-induced white finger (see Raynaud’s phenomenon)
WBV: whole-body vibration

© BSI 03-1999
PD 12349:
1997
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