1. ZDRAVSTVENI UČINCI FIZIKALNIH ŠTETNOSTI: VIBRACIJE
Dr.sc. Milan Milošević, dr.med.

2. Kratka povijest izloženosti vibracijama
Pneumatic tools were first used in French mines
Primary Raynaud's Phenomenon (Raynaud's Disease) identified.
Professor Loriga first described vascular spasm in the hands of Italian miners using pneumatic tools.
Alice Hamilton studied miners using drills in limestone quarries describing spastic anaemia of the hands.
s - Cases of white finger were identified studies in fettlers, riveters, boot and shoe industry workers and users of electrical powered rotating tools
1950s - Research links signs and symptoms in nerves, bones, joints and muscles with vibrating tools.
After years of continuous chain saw use widespread complaints of VWF in operators.
Scale for assessing the extent of vascular injury associated with vibration white finger published by Taylor-Pelmear
Stockholm scale for assessment of VWF published. Standard for measurement of vibration published in BS 6842.
1988 – UK HSE research on exposure to HAV in a number of industries in Great Britain published.
EC Machinery Directive adopted; includes requirements on HAV.
1992 – UK HSE produce guidance on VWF in Foundries
1994 – UK HSE publish generic guidance on HAV
1997 – UK HSE publish a book of vibration-reduction case studies.
30 September 1997 UK High Court awards £127,000 compensation for VWF to 7 miners, 12,500 more cases in the pipeline
Directive 2002/44/EC on the minimum health and safety requirements regarding the expo-sure of workers to the risks arising from physical agents (vibration) was published in the Official Journal of the European Communities. Member States have 3 Years from 6 July 2002 to imple-ment the Directive.

3. Što su to vibracije?
Frekvencija (Hz)
Amplituda (m)
Ubrzanje (m/s2)

4. Vibracije Vibracije su definirane amplitudom i frekvencijom
Jačina vibracije može biti definirana:
Vibracijskim odmakom (u metrima)
Brzinom vibracije (u m/s)
Ubrzanjem vibracije (m/s²).

5. Izloženost vibracijama
Doticaj s izvorom vibracija:
segmentalne vibracije
‘dio tijela’ poput ruke ili šake (hand-arm vibration ili HAV)
vibracije cijelog tijela
Vibracije koje se prenose cijelim tijelom (whole-body vibration or WBV).

6. Zdravstveni učinci vibracija
Izvor vibracija
HAV
WBV
Učinci na kosti, zglobove, mišiće i probleme s cirkulacijom.

7. Aktivnosti i zanimanja u kojima se vibracije prenose na ruke:

15. Aktivnosti i zanimanja u kojima se vibracije prenose na cijelo tijelo
Prijevoz

16. Transportation

17. Vojska i policija

18. Poljoprivreda

19. Industrija

20. Construction workers

21. Construction workers

22. Broj izloženih radnika
Nizozemska UK
USA
1,7 - 3,6% - EU
11% ili Hrvatska

24. HAV Kada je segmentalna izloženost najopasnija?
Redovita i česta izloženost vibracijama od Hz izaziva trajno oštećenje tkiva.
Ovo je najvjerojatnije kada je izvor vibracija obavezan alat u svakodnevnom poslu.

25. HAV Kakva oštećenja čine segmentalne vibracije?
Pogoršavaju cirkulaciju („bijeli prsti”, Raynaudov fenomen)
Polineuropatije
Oštećenje mišića
Oštećenje kostiju (ciste i pseudociste, osteomalacija)
Utječu na zglobove i vezivno tkivo

27. HAVS

28. HAVS

29. Dupuytrenova kontraktura

30. HAVS
Sindrom karpalnog tunela

31. HAV Simptomi: Ove promjene se mogu kvantificirati:
Blijeda koža na prstima kada se izlažu hladnoći i vlazi
Trnci i gubitak osjeta u prstima („osjećaj stranog tijela”)
Gubitak nježnog osjeta
Bolovi i hladnoća u prstima
Slabljenje snage stiska šake
Koštane ciste
Ove promjene se mogu kvantificirati:
Stockholmska ljestvica

32. Vibracije cijelog tijela
Rezonantne frekvencije su puno niže u usporedbi s segmentalnim vibracijama:
Trup 5 Hz
Glava 20 Hz
Ramena 4-5 Hz
Slabinska kralješnica Hz
Frekvencije ispod 1 Hz se očituju mučninom

33. Kako dijagnosticirati vibracijsku bolest:
Pletizmografija
RTG
EMNG
Vibrotaktilno testiranje

34. Prevencija?

37. Occupational Vibration Control Standards
For Hand Arm Vibration:
The daily exposure limit value standardized to an eight-hour reference period shall be 5 m/s 2.
The daily exposure action value standardized to an eight-hour reference period shall be 2,5 m/s 2.

39. UK HSE HAV Exposure Ready-Reckoner
All values are
exposure points
• Colours show
exposures re.
EAV & ELV

40. Hand-Arm Vibration How vibration level and duration affect exposure
What is the exposure action value?
The exposure action value (EAV) is a daily amount of vibration exposure above which employers are required to take action to control exposure. The greater the exposure level, the greater the risk and the more action employers will need to take to reduce the risk. For hand-arm vibration the EAV is a daily exposure of 2.5 m/s2 A(8).
What is the exposure limit value?
The exposure limit value (ELV) is the maximum amount of vibration an employee may be exposed to on any single day. For hand-arm vibration the ELV is a daily exposure of 5 m/s2 A(8). It represents a high risk above which employees should not be exposed.
How vibration level and duration affect exposure

41. Pneumatski čekić:16m/s2 dozvoljeno najviše 30 min /u 8h

42. Umjesto zaključka Vibracijska bolest se može spriječiti!
To je ozbiljna bolest i pripada u skupinu profesionalnih bolesti!
Utječe na sposobnost preciznog rada i može biti bolna!
Postoje jeftini i jednostavni načini kojima se utjecaj vibracija na tijelo i organe može smanjiti!

43. „Measures” Maintenance - keep tools well maintained
�Exercise hands during work periods
�Always report any symptoms
�Smoking - don't smoke, especially before using tools
�Use the right tool for the job in the right way (ergonomics)
�Report faulty, ineffective or poorly maintained tools
�Ensure you keep your hands as warm as possible
�Short breaks - multiple short breaks better than long ones

44. Pitanja?
Links to information including vibration databases on occupational
vibration available at: