Diagnosis of whole-body vibration related health problems in occupational medicine

Occupational whole-body vibration (WBV) exposed workers may report nonspecific health complaints or debilitating physical disorders. Health care providers and safety professionals may not recognize such occupational injuries and be unfamiliar with appropriate exposure assessment. Method: Review of peer-reviewed clinical studies and publications, medical evidence, differential diagnostic evaluation protocols, surveillance programs, national and international standards, and intervention recommendations regarding WBV. Results: There are well-designed epidemiological studies showing that prolonged and increasing exposures to WBV can primarily result in musculoskeletal or neurological disorders of the spine. Less frequent and weaker evidence exist for organ damage that include intestinal organs, vascular system and other body parts. In some countries spinal injury caused by long-term occupational WBV exposure is compensable. Many physicians and occupational safety experts seem to be unfamiliar with the wide spectrum of health complaints and the proper evaluation of WBV-exposed patients following expert reviews and international guidelines/standards. Detailed protective regulations and provisions exist primarily in highly industrialized countries with good occupational health systems. The causal diagnosis should be based on medical findings, a differential diagnostic methodology and adequate work exposure assessment and documentation of WBV. Conclusion: A proper WBV-related injury diagnosis includes a critical review of the work history, exposure data assessment and the clinical differential diagnostic evaluation. Many health care providers receive little or no training in the recognition of WBV-related injuries and case management. WBV health surveillance should assess the health status of WBV-exposed workers and address preventive measures for employers and employees.