Ao se estudar as causas da perda auditiva relacionada ao trabalho, geralmente a perda auditiva induzida por ruído é a mais referida, embora a literatura especializada aponta outros agentes presentes no ambiente de trabalho que podem ser nocivos à saúde do trabalhador. Os solventes são considerados alguns desses agentes e seus efeitos sobre o sistema auditivo vêm sendo investigado por alguns pesquisadores. O uso industrial destes solventes é vasto e, normalmente as condições de trabalho presentes num grande número de indústria brasileiras expõem o trabalhador a elevadas concentrações de solventes. A convivência com as substâncias químicas nos dias atuais é, portanto, obrigatória e permanente sendo particularmente importante para os trabalhadores envolvidos em processos produtivos que direta ou indiretamente utilizem estas substâncias em razão dos danos à saúde e ao ambiente que podem resultar de sua utilização. O risco e o perigo que estão relacionados com as substâncias químicas devem ser trabalhados nas suas várias dimensões entre as quais destacamos: o potencial de dano do produto, as condições ambientais e do trabalho em que as atividades se desenvolvem e o histórico conhecido daquela realidade e de outras semelhantes a partir dos dados epidemiológicos produzidos e do conhecimento científico existente. Este estudo avaliou o perfil audiológico e caracterizou o ambiente de trabalho de frentistas de postos de combustíveis. Os procedimentos desta pesquisa foram realizados em uma clínica particular de fonoaudiologia na cidade de Bariri, e a análise laboratorial foi realizada no laboratório São José, também na cidade de Bariri. Foram utilizados audiometria convencional e de altas frequências, logoaudiometria, imitanciometria, pesquisa das emissões otoacústicas, do Potencial Evocado Auditivo de Tronco Encefálico, exames clínicos laboratoriais, assim como avaliação do ruído ambiental. Nos resultados foram encontrados limiares dentro da normalidade em todos os casos, porém, todos eles apresentaram o traçado característico da perda auditiva ocupacional em evolução, ou seja com entalhes nas frequências de 3 a 6 KHz. Houve ainda alteração nos resultados do PEATE, com aumento de latência em 20 das 32 orelhas testadas. A pressão sonora variaram entre os postos, sendo que o Posto 1 não ultrapassou 80dB, enquanto o Posto 2 apresentou picos que superaram 100dB. O Hemograma se mostrou alterado, com redução de leucócitos, em 9 dos 16 participantes. Não houveram alterações nos demais exames. Concluiu-se que esta população apresentou desencadeamento de PAIR, dentro da normalidade. Os Níveis de Pressão Sonora se apresentaram acima do previsto em lei, e a maioria dos frentistas apresentaram leucopenia, o que pode estar relacionado à exposição aos solventes em questão. Tais conclusões mostram a importância de novos estudos voltados a este ambiente e a esta população. / By studying the causes of work-related hearing loss, usually noise-induced hearing loss is the most reported, although the literature points to other agents present in the workplace that can be harmful to workers health. The solvents are considered some of these agents and their effects on the auditory system are being investigated by some researchers. The industrial use of these solvents is vast and usually working conditions present in a large number of Brazilian industry expose workers to high concentrations of solvents. Living with chemicals nowadays is therefore mandatory and permanent is particularly important for workers involved in production processes that directly or indirectly use these substances because of damage to health and the environment that may result from its use. The risk and the danger that are related to chemicals must be worked in its various dimensions among which: the product of damage potential, environmental conditions and the work in which the activities are developed and the known history of that reality and other similar produced from epidemiological data and current scientific knowledge. This study assessed the audiological profile and characterized the attendants of desktop gas stations. Were used Conventional audiometry and high frequency, speech audiometry, tympanometry, otoacoustic emissions, the brainstem auditory evoked potential brainstem, clinical laboratory tests, and assessment of environmental noise. The recognition and analysis of the risks related to chemical agents are priority activities to qualify intervention in defense of workers\' health. The results were found thresholds within normal limits in all cases, however, they all showed the typical route of occupational hearing loss in evolution. The sound pressure levels varied between the posts, and the station 1 has not exceeded 80 dB, while the station 2 showed peaks which exceed 100dB. The blood count was abnormal, with leukocyte reduction in 9 of the 16 participants. There were no changes in other tests. It was concluded that this population presented onset of NIHL, normal. The sound pressure levels presented above provided by law, and most attendants showed leukopenia, which may be related to exposure to solvents in question. These findings show the importance of new studies related to this environment and this population.

Introdução - A vida do ser humano é repleta de necessidades consideradas básicas para um desenvolvimento saudável, dentre as quais estão alimentação, cuidados com a higiene pessoal e com o corpo de uma forma geral. Para esses cuidados, há um leque cada vez maior de produtos, entre os quais estão incluídos os cosméticos que trazem em sua composição química oformaldeído, que tem sido utilizado extensivamente como alisante capilar nas denominadasescovas progressivas. Objetivo - O fato dos cabeleireiros estarem expostos a substâncias químicas, dentre eles o formaldeído, por meio do manuseio de cremes e produtos de alisamento capilar, motivou a realização desse estudo com o objetivo de quantificar a exposição ocupacional de cabeleireiros ao formaldeído comparando os resultados da exposição entre diferentes tipos de salão de beleza frente à legislação vigente brasileira (NR15) e americana (US OSHA e US NIOSH). Métodos - A população estudada foi constituída por 23 salões de beleza localizados no município de Bauru, São Paulo, representativos de áreas com diferentes vulnerabilidades sociais medidas pelo IPVS (Índice Paulista de Vulnerabilidade Social). Foram aplicados dois questionários para coleta de informações pessoais, queixas de saúde e processos de trabalho adotados pelos profissionais. Resultados - Dos 23 salões, cuja exposição dos profissionais ao formaldeído foi avaliada pelo método da National Institute for Occupational Safety and Health (NIOSH), 30% ultrapassaram o limite de concentração de formaldeído estabelecido pela NR 15 (1,6 ppm); já pelo método desenvolvido pelo IPT (Instituto de Pesquisas Tecnológicas), esse limite de tolerância foi ultrapassado em 39% dos salões. Considerando o limite de exposição ao formaldeído previsto pela Occupational Safety Health Administration (OSHA), que é de 2,0 ppm, 17% dos salões obtiveram concentrações de formaldeído acima do permitido (método NIOSH) e, pelo método IPT, 30% obtiveram valores maiores que o previsto pela legislação nas amostras analisadas. Os produtos alisantes ultrapassaram de forma significativa o limite de concentração de formaldeído permitido pela Agência Nacional de Vigilância Sanitária (ANVISA) em suas formulações, o qual é de 0,2%. Quatro formulações apresentaram de 10% a 11% de formaldeído em sua composição. Conclusões - Os resultados deste estudo mostraram que os cabeleireiros estão cronicamente expostos a altas concentrações de formaldeído em ambiente laboral, sendo que estas exposições estão associadas principalmente à ventilação do ambiente, medida por meio da abertura de portas e janelas do salão. O processo de trabalho também pode impactar na intensidade da exposição. / Introduction - The life of the human being is full of basic necessities for a healthy development, among which are food, cares for personal hygiene and the body in general. For this care, there is a growing range of products, including cosmetics that bring formaldehyde in its chemical composition, which has been used extensively as hair straightener in so-called progressive brushes. Objective - The fact that hairdressers are exposed to chemical substances, among them formaldehyde, through the handling of creams and hair straightening products, motivated the accomplishment of this study with the objective of quantifying the occupational exposure of hairdressers to formaldehyde comparing the results of (NR15) and US (US OSHA and US NIOSH) legislation. Methods - The study population consisted of 23 beauty salons located in the city of Bauru, São Paulo, representing areas with different social vulnerabilities measured by IPVS (Paulista Index of Social Vulnerability). Two questionnaires were used to collect personal information, health complaints and work processes adopted by professionals. Results - Of the 23 salons, whose exposure of professionals to formaldehyde was assessed by the National Institute for Occupational Safety and Health (NIOSH) method, 30% exceeded the formaldehyde concentration limit established by NR 15 (1.6 ppm); already by the method developed by IPT (Institute of Technological Research), this limit of tolerance was exceeded in 39% of the salons. Considering the Occupational Safety Health Administration (OSHA) exposure limit of 2.0 ppm, 17% of the salons obtained formaldehyde concentrations above the allowable level (NIOSH method), and by the IPT method 30% obtained values than those provided for by legislation in the analyzed samples. Smoothing products significantly exceeded the limit of formaldehyde concentration allowed by the National Agency for Sanitary Surveillance (ANVISA) in its formulations, which is 0.2%. Four formulations had 10% to 11% formaldehyde in their composition. Conclusions - The results of this study showed that hairdressers are chronically exposed to high concentrations of formaldehyde in the workplace, and these exposures are mainly associated with the ventilation of the environment, measured through the opening of doors and windows of the hall. The work process can also impact the intensity of exposure.

A Dylos DC1100 was evaluated to: 1. Establish relationship between low-cost DC1100 and higher-cost pDR 1200; 2. Develop a method to convert DC1100 particle number into mass concentration to compare with respirable and inhalable mass references. A Dylos DC1100 was deployed in a swine CAFO, along with a pDR-1200 and filter set to collect respirable and inhalable particles. Deployment was conducted from December 2013 through February 2014 in 24 hour intervals. The pDR-1200 and respirable mass concentration was used to convert the DC1100 particle count to mass concentration. Two methods of conversion were used, physical property method (Method 1) and regression method (Method 2). Direct measurements from the DC1100 and pDR-1200 had a coefficient of determination (R2) of 0.85. DC1100 particle number were converted to mass concentration using Method 1 and Method 2, the coefficient of determination (R2) was 0.72 and 0.73, respectively compared to pDR-1200. The slope of the best-fit line was 1.01 for Method 1 and 0.70 for Method 2. When the DC1100 daily averages were compared to respirable mass, the physical property method had an R2 of 0.64 and a slope of 1.10. Regression method had an R2 of 0.62 and a slope of 0.80. Both methods underestimated inhalable mass concentrations with slopes < 0.13. The Dylos DC1100 can be used to estimate respirable mass concentrations within a CAFO. Using expensive dust monitors to correct the number of particles into a mass concentration is needed to establish a correction factor for the DC1100. Using these methods, correction factors can be determine for many occupational environment, with the physical property method being preferred over the regression method.

Approximately 92% of the land in Iowa, 64% in Indiana, and 27% in Michigan is agricultural farmland. Nearly 77% of farmland in Iowa and Indiana, and 58% of farmland in Michigan, were treated with herbicides in 2012 (USDA). Pesticide drift, or “overspray”, is defined as any off-site movement of pesticide during its application. Exposure to this drift has the potential to damage crops and landscaping, kill aquatic animals, and cause DNA damage, cancer, and allergic wheeze in applicators. The Pesticide Bureau of the Iowa Department of Agricultural and Land Stewardship (IDALS), the Indiana State Chemist (ISC), and the Michigan Department of Agriculture and Rural Development (MDARD) investigate complaints of pesticide misuse, including reports of pesticide drift. Individual narrative reports and case summaries are available, but have not been analyzed to identify contributing factors to prevent field, worker, and community exposures; nor has the community at large been surveyed about reporting practices. The aim of this research was to (1) identify determinants of pesticide drift events in the Midwest, comparing between states; (2) whether differing state policies were associated with drift characteristics and/or reporting of incidents; and (3) determine the proportion of events that occurred due to applicators ignoring pesticide label guidance. This examination will provide guidance when developing policies and prevention efforts used to minimize the hazards associated with pesticide drift. Narrative case reports from IDALS and MDARD, and case summaries from ISC spanning 2010-2016 were analyzed. Narratives and case summaries were converted to trackable data for ease of analysis using Excel. Data analysis includes descriptive statistics on continuous variables (e.g., distance, wind speed), chi-square tests, and t-tests. Analysis includes: crop damage associations with wind speed by chemical; ratio of human exposures across aerial applications, and associations of distance to target crop and reported plant damage. Key state policies were compared and the responses from a survey concerning the reporting of drift incidents was analyzed. The proportion of cases that violated weather and distance recommendations/label directions for the five most common pesticides in each were analyzed. Between 2010 and 2015, Iowa received 471 reported drift cases; between 2011 and 2016 Indiana received 391, and between 2014 and 2016 Michigan received 91 reports. The five most common pesticides analyzed for during drift investigations varied between states, but 2,4-D, glyphosate, and atrazine were common to all states. The method of application, (i.e., aerial or ground), wind speed, and the intended target crop were significantly associated with drift events across all three states. While Iowa was the only state to contain regulatory language concerning drift to bees or livestock, all states still reported 4 to 5% of cases in which pesticides drifted onto animals. Michigan was the only state to suggest the creation and use of a drift management plan and was the only state requiring applicators to inform neighbors of drift. About 30% of confirmed drift cases involved applications within 7.62 meters of desirable vegetation, and about 40% of applications occurred in wind greater than 4.5 m/s. More education, training, and community involvement are suggested interventions to reduce drift cases.

Exposure to air contaminants is significantly associated with both short-term and long-term health effects. However, the precise mechanisms that derive such effects are not always understood. While an extensive background database from in vivo toxicological studies have been developed, most toxicity data is from oral and dermal chemical exposures rather than inhalation exposure. There is a need to explore new alternative approaches to provide toxicity information particularly on this technically demanding area. This research explores the potential of in vitro methods for toxicity assessment of workplace air contaminants. A tiered approach for in vitro toxicity testing of workplace contaminants was designed in which appropriate air sampling and exposure techniques were developed. A diversified battery of in vitro assays including the MTS (tetrazolium salt, Promega), NRU (neutral red uptake, Sigma) and ATP (adenosine triphosphate, Promega) and a multiple human cell system including: A549- lung derived cells; HepG2-liver derived cells, and skin fibroblasts were used. Primarily the application and merits of in vitro methods for prediction of toxicity of selected workplace contaminants including Ammonium hydroxide, Cadmium chloride, Cobalt chloride, Formaldehyde, Glutaraldehyde, Manganese chloride, Mercuric chloride, Sodium dichromate, Sulphureous acid and Zinc chloride was confirmed. To study the toxicity of airborne contaminants an indirect exposure method was established using air sampling techniques followed by static and dynamic direct exposure methods by culturing cells on porous membranes to reveal representative data relating to human airborne exposures. The static method enabled the measurement of an airborne IC50 (50% inhibitory concentration) value for selected volatile organic compounds (VOCs) including: Xylene (IC50 = 5,350-8,200 ppm) and Toluene (IC50 = 10,500- 16,600 ppm) after 1 hr exposure. By implementing the dynamic method, airborne IC50 values were calculated for gaseous contaminants including: NO2 (IC50 = 11 ?? 3.54 ppm; NRU), SO2 (IC50 = 48 ?? 2.83 ppm; ATP) and NH3 (IC50 = 199 ?? 1.41 ppm; MTS). A higher sensitivity of in vitro methods was observed compared to in vivo published data. A range of in vitro bioassays in conjunction with exposure techniques developed in this thesis may provide an advanced technology for a comprehensive risk assessment of workplace air contaminants.

<p>Brominated flame retardants (BFRs) are a diverse group of chemicals, which are used to slow down or inhibit the development of fires. BFRs are incorporated into a wide range of consumer products that are considered as potential fire hazards, such as TV-sets, household appliances, computers, and textiles. The production and use of BFRs is extensive and consists of mainly tetrabromobisphenol A (TBBPA), polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecan (HBCD). BFRs in general, but in particular the PBDEs, have led to both scientific and public concern since they have been found to bioaccumulate in humans and wildlife. The general population is targeted by the PBDEs due to their applications and via the food web. Occupational exposure occurs not only during direct handling of BFRs, but also during handling, repair and dismantling of flame retarded goods.</p><p>This thesis is aimed to assess occupational exposure to BFRs. It is mainly focused PBDEs and especially the PBDEs with high bromine content, such as decabromodiphenyl ether (BDE-209). The work has been accomplished by analysis of BFRs in indoor air at industries handling BFRs or flame retarded goods, and by analysis of blood drawn from workers with potential exposure to BFRs. A referent group, abattoir workers with no occupational exposure to PBDEs, was also investigated. Data from these cross-sectional investigations and from serum sampling during vacation in PBDE-exposed workers have been used for calculation of apparent halflives of hepta- to decaBDE in serum.</p><p>The results clearly show that the workers were exposed to PBDEs when handling PBDE containing products or goods. The serum PBDE levels in computer technicians were found to correlate to the estimated cumulative work hours with computers. Exceptionally high concentrations of BDE-209, almost up to 300 pmol/g lipid weight (l.w.) were observed in serum from rubber workers manufacturing or handling rubber compound that was flame retarded with a technical mixture of decabromodiphenyl ether (DecaBDE). Elevated concentrations of PBDEs with eight or nine bromine substituents were also observed. In an electronics dismantling plant, where elevated levels of PBDEs previously had been observed, reduced serum levels of some, but not all PBDE congeners were observed after industrial hygiene improvements. Notably, it was observed that the BDE-209 concentrations in referents with no occupational exposure were similar to the concentrations of 2,2’,4,4’- tetrabromodiphenyl ether (BDE-47), often referred to as the most abundant PBDE congener in humans and wildlife. Additionally, PBDEs with high bromine content were found to have a fast rate of elimination or transformation in humans, based on serum analysis. BDE-209 had an apparent half-life in serum of only 15 days.</p><p>The possibility of quantifying BFRs, such as PBDEs, in human serum at low levels of detection has been achieved by reducing the contamination of the samples and procedural blanks. Major efforts have been done to develop routines and clean up methodology to enable an almost contamination-free environment at the laboratory. The use of a clean room has decreased PBDE levels in the blanks to acceptable limits. The modifications of the original analytical method have made it possible to quantify almost all PBDE congeners of interest in one GC/MS run.</p><p>Occupational and general background exposure of BFRs to humans will continue as long as these chemicals are a part of our daily life and present as environmental contaminants. The present scientific knowledge of the potential health risks of these BFRs still needs to be further developed. It should be stressed that health effects to PBDEs have not been assessed in this work. It is the author's wish that this thesis should add another piece of knowledge to the puzzle of BFRs and BFR exposure to humans and that these data will be used in future risk assessments of PBDEs in particular.</p>

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style="font-size: 12pt / line-height: 115% / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance. <span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><o:p></o:p></span></p> <p>&nbsp / </p>

<p>Background: Health care workers, more specifically, nursing students are at increased risk of occupational injury and exposure to blood borne pathogens. Compliance with universal precautions (UP) will minimise risk or transmission of HIV and HBV (Hepatitis B virus) according to the Department of Health of South Africa. Aim: The aim of this study was to investigate the knowledge and practice of universal precautions amongst nursing students and their fear of occupational exposure to blood borne pathogens. Rationale: The rationale for the study was to investigate what the students&rsquo / knowledge and practice of UP were, to see if this could be a possible contributing factor to occupational exposure. Research design: The study was a quantitative, cross sectional survey using a questionnaire that included one open ended question. Participants: The participants for the study were the undergraduate nursing students in year levels two to four (n = 253) who and were selected by means of stratified random sampling. Procedures: A questionnaire was administered to the participants by the researcher. Analysis of the data collected was done through statistical package for social sciences (SPSS 16.0) and content analysis. Results: The researcher established that there is indeed a lack of knowledge regarding UP and that the students&rsquo / self reported practice of UP is poor. No statistically significant correlation between knowledge and practice of UP were found. There is underreporting of occupational exposures to staff at the School of Nursing. The majority of students reported a moderate to severe fear for occupational exposures and contributing factors raised by them are reality in the clinical facilities.</p>

Brominated flame retardants (BFRs) are a diverse group of chemicals, which are used to slow down or inhibit the development of fires. BFRs are incorporated into a wide range of consumer products that are considered as potential fire hazards, such as TV-sets, household appliances, computers, and textiles. The production and use of BFRs is extensive and consists of mainly tetrabromobisphenol A (TBBPA), polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecan (HBCD). BFRs in general, but in particular the PBDEs, have led to both scientific and public concern since they have been found to bioaccumulate in humans and wildlife. The general population is targeted by the PBDEs due to their applications and via the food web. Occupational exposure occurs not only during direct handling of BFRs, but also during handling, repair and dismantling of flame retarded goods. This thesis is aimed to assess occupational exposure to BFRs. It is mainly focused PBDEs and especially the PBDEs with high bromine content, such as decabromodiphenyl ether (BDE-209). The work has been accomplished by analysis of BFRs in indoor air at industries handling BFRs or flame retarded goods, and by analysis of blood drawn from workers with potential exposure to BFRs. A referent group, abattoir workers with no occupational exposure to PBDEs, was also investigated. Data from these cross-sectional investigations and from serum sampling during vacation in PBDE-exposed workers have been used for calculation of apparent halflives of hepta- to decaBDE in serum. The results clearly show that the workers were exposed to PBDEs when handling PBDE containing products or goods. The serum PBDE levels in computer technicians were found to correlate to the estimated cumulative work hours with computers. Exceptionally high concentrations of BDE-209, almost up to 300 pmol/g lipid weight (l.w.) were observed in serum from rubber workers manufacturing or handling rubber compound that was flame retarded with a technical mixture of decabromodiphenyl ether (DecaBDE). Elevated concentrations of PBDEs with eight or nine bromine substituents were also observed. In an electronics dismantling plant, where elevated levels of PBDEs previously had been observed, reduced serum levels of some, but not all PBDE congeners were observed after industrial hygiene improvements. Notably, it was observed that the BDE-209 concentrations in referents with no occupational exposure were similar to the concentrations of 2,2’,4,4’- tetrabromodiphenyl ether (BDE-47), often referred to as the most abundant PBDE congener in humans and wildlife. Additionally, PBDEs with high bromine content were found to have a fast rate of elimination or transformation in humans, based on serum analysis. BDE-209 had an apparent half-life in serum of only 15 days. The possibility of quantifying BFRs, such as PBDEs, in human serum at low levels of detection has been achieved by reducing the contamination of the samples and procedural blanks. Major efforts have been done to develop routines and clean up methodology to enable an almost contamination-free environment at the laboratory. The use of a clean room has decreased PBDE levels in the blanks to acceptable limits. The modifications of the original analytical method have made it possible to quantify almost all PBDE congeners of interest in one GC/MS run. Occupational and general background exposure of BFRs to humans will continue as long as these chemicals are a part of our daily life and present as environmental contaminants. The present scientific knowledge of the potential health risks of these BFRs still needs to be further developed. It should be stressed that health effects to PBDEs have not been assessed in this work. It is the author's wish that this thesis should add another piece of knowledge to the puzzle of BFRs and BFR exposure to humans and that these data will be used in future risk assessments of PBDEs in particular.

The purpose of this thesis was to assess the possible risk of myocardial infarction in work entailing exposure to vibration, and to study whether there is any relation between short-term exposure to vibration and cardiac regulation. Epidemiological methods were applied to investigate a possible association between occupational exposure to vibration and myocardial infarction. Two study populations were used; one case-control study (n=475) and one cohort of iron-ore miners in Kiruna and Malmberget, Sweden (n=13621). In the former, the cases were first-time myocardial infarction patients and the controls were selected to match for sex, age and hospital catchment area. Job-exposure matrixes for vibration were established for both the case-control study and the cohort study. In order to study acute effects on cardiac regulation, an experimental study was conducted on healthy subjects (n=20) who were exposed to hand-arm vibration exclusively and in combination with exposure to noise. The effect on the autonomic balance was measured by heart rate-variability. In the case-control study, an increased risk of contracting myocardial infarction was found among occupations entailing vibration exposure. The results from the cohort show an increased risk of myocardial infarction mortality compared to a reference population. The increment was higher for those younger than 60 years. Relative risks for myocardial infarction mortality increased with increasing exposure to vibration in the group at working-age and the increased risk remained after adjusting for exposure to dust. In the experimental study, exposure to hand-arm vibration was found to acutely affect the autonomic nervous system as the total heart-rate variability decreased during exposure to hand-arm vibration. To conclude: work entailing exposure to vibration is a risk factor for myocardial infarction, increased myocardial infarction mortality attributed to exposure to vibration seems to be mainly observed at working-age, and exposure to hand-arm vibration acutely decreases heart-rate variability and thus affects heart-rate regulation.