Physical hazards Dr Majid Golabadi

OCCUPATIONAL HEALTH HAZARDS Physical Chemical Biological Ergonomic Psychosocial

PHYSICAL HAZARDS Noise Temperature Vibration Radiation Atmospheric pressure

Temperature Heat Cold

Noise Hearing loss

Vibration Whole body Hand arm

Radiation Ionizing Non-ionizing Alpha,ß, X,gama EMF, Radiofrequency ,Microwave Infrared (IR), Visible ,Ultraviolet (UV)

Atmospheric pressure Compress Decompression (caisson )

Vibration

8-10 million workers in the USA exposed to occupational vibration. Of these 7 million: Whole Body Vibration. Others: Hand Arm Vibration.

Injury Loss of equilibrium Nausea HAVS CTS

Truck drivers & heavy equipment operators: Lumbar spinal disorders Hemorrhoids Hernia GI problems Urinary tract problems Result of extended sitting+ vibration

Resonance (amplification): Vibration of the same frequency . WBV: 5 Hz

WBV: <20 HZ Critical :3-5 Hz Discomfort:2-11 Hz Musculoskeletal, neurologic, circulatory, and digestive system disorders. Visual performance impairment: 10-25Hz

LBP ,intervertebral disc damage, spinal degeneration, intervertebral osteochondrosis, calcification of discs. Reproductive effects: SAB, congenital malformation, menstrual changes.

Vibration sickness: GI problems, decreased visual acuity, labyrintine disorders, intense musculoskeletal pain.

Vibration induced white finger (HAVS)

Ranging from 5-1500 Hz Usually 125-300 Hz Cumulative trauma: at least 2000 hours and usually over 8000 hours.

HAVS: Spasm of digital arteries (raynaud phenomenon): damage of Peripheral nerve Vascular tissue Subcutaneous tissue Bones joints

Pathology: Arterial muscle wall hypertrophy Demyelinating pripheral neuropathy Connective tissue deposition Micro vascular occlusion

Clinical findings: Severe attacks:15 minutes to 2hours remove from exposures: reversible in 50%

symptoms: Tingling then numbness then white finger in cold. Intermittent blanching of tip of one finger. Progress to tip and base of all fingers. Progress to summer season.

Advanced cases: Degeneration of bone & cartilage resulting: Joint stiffness, restriction of motion, arthralgia. Manual dexterity may decrease. Clumsiness may increase.

Diagnosis: Exposure history & response to cold. Association with Raynaud phenomenon. Exclusion of idiopathic Raynaud disease & other causes of Raynaud phenomenon.

Other causes of Raynaud phenomenon: Trauma Frostbite Occlusive vascular disease Connective tissue disorders Neurogenic disorders Drug intoxication Vinyl chloride monomer

Prevention: Wearing gloves Keep the hands warm Prevent long period of exposures Training Avoidance from: Vasoactive drugs & cigarette smoking

Treatment: Removal from exposure Massaging, shaking, placing in warm water For intractable episodes: Nifedipin 30-40mg/day Thymoxamine For more sever cases: Stanozolol PGE Biofeedback & surgical sympathectomy