1. Physical hazards
Dr Majid Golabadi

2. OCCUPATIONAL HEALTH HAZARDS
Physical
Chemical
Biological
Ergonomic
Psychosocial

3. PHYSICAL HAZARDS Noise Temperature Vibration Radiation
Atmospheric pressure

4. Temperature
Heat
Cold

5. Noise
Hearing loss

6. Vibration
Whole body
Hand arm

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

8. Atmospheric pressure
Compress
Decompression (caisson )

9. Vibration

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

11. Injury
Loss of equilibrium
Nausea
HAVS
CTS

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

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

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

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

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

17. Vibration induced white finger (HAVS)

18. Ranging from Hz
Usually Hz
Cumulative trauma: at least 2000 hours and usually over 8000 hours.

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

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

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

22. 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.

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

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

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

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

28. 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