Monkeypox virus (MPXV) is a re-emerging zoonotic poxvirus responsible for producing skin lesions in humans. Endemic in sub-Saharan Africa, the 2022 outbreak with a clade IIb strain has resulted in ongoing sustained transmission of the virus worldwide. MPXV has a relatively wide host range, with infections reported in rodent and non-human primate species. However, the susceptibility of many domestic livestock species remains unknown. Here, we report on a susceptibility/transmission study in domestic pigs that were experimentally inoculated with a 2022 MPXV clade IIb isolate or served as sentinel contact control animals. Several principal-infected and sentinel contact control pigs developed minor lesions near the lips and nose starting at day 12 through 18 days post-challenge (DPC). No virus was isolated or viral DNA was detected from the lesions; however, MPXV antigen was detected by IHC in tissue from a pustule of a principal infected pig. Viral DNA and infectious virus were detected in nasal and oral swabs up to 14 DPC, with peak titers observed at 7 DPC. Viral DNA was also detected in nasal tissues or skin collected from two principal-infected animals at 7 DPC post-mortem. Furthermore, all principal-infected and sentinel control animals enrolled in the study seroconverted. In conclusion, we provide the first evidence that domestic pigs are susceptible to experimental MPXV infection and can transmit the virus to contact animals.

PURPOSE: Database linkage between cancer registries and clinical trial consortia has the potential to elucidate referral patterns of children and adolescents with newly diagnosed cancer, including enrollment into cancer clinical trials. This study's primary objective was to assess the feasibility of this linkage approach. METHODS: Patients younger than 20 years diagnosed with incident cancer during 2012-2017 in the Kentucky Cancer Registry (KCR) were linked with patients enrolled in a Children's Oncology Group (COG) study. Matched patients between databases were described by sex, age, race and ethnicity, geographical location when diagnosed, and cancer type. Logistic regression modeling identified factors associated with COG study enrollment. Timeliness of patient identification by KCR was reported through the Centers for Disease Control and Prevention's Early Case Capture (ECC) program. RESULTS: Of 1,357 patients reported to KCR, 47% were determined by matching to be enrolled in a COG study. Patients had greater odds of enrollment if they were age 0-4 years (v 15-19 years), reported from a COG-affiliated institution, and had renal cancer, neuroblastoma, or leukemia. Patients had lower odds of enrollment if Hispanic (v non-Hispanic White) or had epithelial (eg, thyroid, melanoma) cancer. Most (59%) patients were reported to KCR within 10 days of pathologic diagnosis. CONCLUSION: Linkage of clinical trial data with cancer registries is a feasible approach for tracking patient referral and clinical trial enrollment patterns. Adolescents had lower enrollment compared with younger age groups, independent of cancer type. Population-based early case capture could guide interventions designed to increase cancer clinical trial enrollment.

Several invasive mosquito species that are nuisances or of medical and veterinary importance have been introduced into the Southeastern region of the USA, posing a threat to other species and the local ecosystems and/or increasing the risk of pathogen transmission to people, livestock, and domestic pets. Prompt and effective monitoring and control of invasive species is essential to prevent them from spreading and causing harmful effects. However, the capacity for invasive mosquito species surveillance is highly variable among mosquito control programs in the Southeast, depending on a combination of factors such as regional geography and climate, access to resources, and the ability to interact with other programs. To facilitate the development of invasive mosquito surveillance in the region, we, the Mosquito BEACONS (Biodiversity Enhancement and Control of Non-native Species) working group, conducted a survey on the capacities of various public health agencies and pest control agencies engaged in mosquito surveillance and control in seven Southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Ninety control programs completed the survey, representing an overall response rate of 25.8%. We report key findings from our survey, emphasizing the training and resource needs, and discuss their implications for future invasive mosquito surveillance and control capacity building. By increasing communication and collaboration opportunities (e.g., real-time sharing of collection records, coordinated multistate programs), the establishment of Mosquito BEACONS and the implementation of this survey can accelerate knowledge transfer and improve decision support capacity in response to or in preparation for invasive mosquito surveillance and can establish infrastructure that can be used to inform programs around the world.

Prolonged and intensive vibration exposures during the grinding of handheld workpieces may cause hand-arm vibration syndrome. The objectives of this study are to develop an on-the-hand method for evaluating vibration-reducing (VR) gloves, and to determine whether VR gloves can significantly reduce the vibration exposures. A worker holding and pressing a typical workpiece (golf club head) against a grinding wheel or belt in order to shape the workpiece was simulated, and the input vibration and those on the workpiece and hand-arm system were measured. Ten human subjects participated in the experiment. The results demonstrate that VR gloves significantly reduced the vibrations at the palm, hand dorsum, and wrist. The grinding interface condition and hand feed force did not substantially affect glove effectiveness. The use of gloves slightly increased the workpiece resonant response, but the resonant response did not significantly affect glove effectiveness. This study concluded that the use of VR gloves can help control vibration exposures of workers performing grinding of handheld workpieces.

Middle East respiratory syndrome-related coronavirus (MERS-CoV) is a persistent zoonotic pathogen with frequent spillover from dromedary camels to humans in the Arabian Peninsula, resulting in limited outbreaks of MERS with a high case-fatality rate. Full genome sequence data from camel-derived MERS-CoV variants show diverse lineages circulating in domestic camels with frequent recombination. More than 90% of the available full MERS-CoV genome sequences derived from camels are from just two countries, the Kingdom of Saudi Arabia (KSA) and United Arab Emirates (UAE). In this study, we employ a novel method to amplify and sequence the partial MERS-CoV genome with high sensitivity from nasal swabs of infected camels. We recovered more than 99% of the MERS-CoV genome from field-collected samples with greater than 500 TCID(50) equivalent per nasal swab from camel herds sampled in Jordan in May 2016. Our subsequent analyses of 14 camel-derived MERS-CoV genomes show a striking lack of genetic diversity circulating in Jordan camels relative to MERS-CoV genome sequences derived from large camel markets in KSA and UAE. The low genetic diversity detected in Jordan camels during our study is consistent with a lack of endemic circulation in these camel herds and reflective of data from MERS outbreaks in humans dominated by nosocomial transmission following a single introduction as reported during the 2015 MERS outbreak in South Korea. Our data suggest transmission of MERS-CoV among two camel herds in Jordan in 2016 following a single introduction event.

BACKGROUND: In 2019, the World Health Organization released guidelines reflecting major changes in multidrug-resistant tuberculosis (MDR-TB) management-prioritizing fluoroquinolones, bedaquiline, and linezolid (LZD) while de-emphasizing previously favored injectable agents. In some cases, linezolid use is associated with gastrointestinal intolerance, mitochondrial toxicity, and significant drug interactions. CDC's Division of Tuberculosis Elimination supports a network of regional TB Centers of Excellence, which provide medical consultation to healthcare providers. Consultations are documented in a medical consultation database (MCD) enabling evaluation of management questions and recommendations. We describe the scope of clinical inquiries and responses specific to linezolid use for MDR-TB in the US. RESEARCH QUESTION: What are the major themes of provider and patient challenges regarding the use of linezolid for the treatment of MDR-TB in the US? METHODS: We queried MCD consults categorized as "MDR/XDR-TB" from 1/1/2013 to 12/31/2018. Only linezolid-specific consultations were included; incomplete and duplicate entries were excluded as were those citing linezolid historically or theoretically. Subgroup characteristics were assessed (e.g., Center, year, provider type). A descriptive coding scheme was developed through inductive thematic analysis. RESULTS: In 2013-2018 of the 1889 consults regarding MDR/XDR-TB, 934 MDR-TB consults referenced linezolid; 137 met inclusion criteria, representing between 4 and 10% of MDR-TB consults annually. Four main themes emerged: adverse effects (71.5%); concerns about linezolid use due to co-morbidities or concurrent medication use (15.3%); dosing adjustments (8.8%); and monitoring and maintenance logistics (4.4%). INTERPRETATIONS: Linezolid consults consistently exceeded 4% of all consults annually over the 6-year period, suggesting a need for access to expert opinion for providers using linezolid to manage MDR-TB. While only a snapshot of MDR-TB in the US, this evaluation summarizes major provider concerns regarding particular adverse effects, and highlights a need for evidence-based guidance regarding linezolid dosing and toxicity management.

BACKGROUND: Persons living with human immunodeficiency virus (HIV) are at a greater risk of developing tuberculosis (TB) compared to people without HIV and of developing complications due to the complexity of TB/HIV coinfection management. METHODS: During 2013-2017, the Centers for Disease Control and Prevention (CDC) funded 5 TB Regional Training and Medical Consultation Centers (RTMCCs) (now known as TB Centers of Excellence or COEs) to provide medical consultation to providers for TB disease and latent TB infection (LTBI), with data entered into a Medical Consultation Database (MCD). Descriptive analyses of TB/HIV-related consultations were conducted using SAS® software, version [9.4] to determine the distribution of year of consultation, medical setting and provider type, frequency of consultations regarding a pediatric (<18 years) patient, and to categorize key concepts and themes arising within consultation queries and medical consultant responses. RESULTS: Of 14,586 consultations captured by the MCD in 2013-2017, 544 (4%) were categorized as TB/HIV-related, with 100 (18%) received in 2013, 129 (24%) in 2014, 104 (19%) in 2015, 117 (22%) in 2016, and 94 (17%) in 2017. Most TB/HIV consultations came from nurses (54%) or physicians (43%) and from local (65%) or state health departments (10%). Only 17 (3%) of HIV-related consultations involved pediatric cases. Off the 544 TB/HIV consultations, 347 (64%) concerned the appropriate treatment regimen for TB/HIV or LTBI/HIV for a patient on or not on antiretroviral therapy (ART). CONCLUSIONS: The data support a clear and ongoing gap in areas of specialized HIV knowledge by TB experts that could be supplemented with proactive educational outreach. The specific categories of TB/HIV inquiries captured by this analysis are strategically informing future targeted training and educational activities planned by the CDC TB Centers of Excellence, as well as guiding HIV educational efforts at regional and national TB meetings.

The objective of this study is to characterize the vibration responses of a handheld workpiece and the handarm system, which is an important step toward identifying and developing effective methods and technologies for controlling the vibration exposures to workers performing the grinding of handheld workpieces. This study established a method for measuring the vibration responses of the entire workpiecehandarm system; the vibration exposure of a worker holding and pressing a typical workpiece against a sanding belt or grinding wheel in order to shape the workpiece was simulated. This method was applied to measure the apparent mass and vibration transmissibility of the system under two different feed forces (15 N and 30 N) and six simulated grinding interfaces with different stiffness values. A major resonance was observed in each transmissibility spectrum of the workpiece, which was correlated with the major resonance of the impedance of the entire system. This resonant frequency depended primarily on the workpiece mass and the grinding interface stiffness, but the handarm system could substantially affect the resonance magnitude. The feed force also significantly affected the resonance frequency and magnitude. While increasing the feed force increased the overall vibration transmissibility on the handarm system, the transmissibility with respect to the workpiece was not significantly affected by the interface conditions. The implications of the results are discussed.

The objective of this study is to identify effective engineering methods for controlling handheld workpiece vibration during grinding processes. Prolonged and intensive exposures to such vibration can cause hand-arm vibration syndrome among workers performing workpiece grinding, but how to effectively control these exposures remains an important issue. This study developed a methodology for performing their analyses and evaluations based on a model of the entire grinding machine-workpiece-hand-arm system. The model can simulate the vibration responses of a workpiece held in the worker's hands and pressed against a grinding wheel in order to shape the workpiece in the major frequency range of concern (6.3-1600 Hz). The methodology was evaluated using available experimental data. The results suggest that the methodology is acceptable for these analyses and evaluations. The results also suggest that the workpiece vibration resulting from the machine vibration generally depends on two mechanisms or pathways: (1) the direct vibration transmission from the grinding machine; and (2) the indirect transmission that depends on both the machine vibration transmission to the workpiece and the interface excitation transformation to the workpiece vibration. The methodology was applied to explore and/or analyze various engineering methods for controlling workpiece vibrations. The modeling results suggest that while these intervention methods have different advantages and limitations, some of their combinations can effectively reduce the vibration exposures of grinding workers. These findings can be used as guidance for selecting and developing more effective technologies to control handheld workpiece vibration exposures.

PURPOSE: Linkage of cancer registry data with complementary data sources can be an informative way to expand what is known about patients and their treatment and improve delivery of care. The purpose of this study was to explore whether patient smoking status and smoking-cessation modalities data in the Kentucky Cancer Registry (KCR) could be augmented by linkage with health claims data. METHODS: The KCR conducted a data linkage with health claims data from Medicare, Medicaid, state employee insurance, Humana, and Anthem. Smoking status was defined as documentation of personal history of tobacco use (International Classification of Diseases, Ninth Revision [ICD-9] code V15.82) or tobacco use disorder (ICD-9 305.1) before and after a cancer diagnosis. Use of smoking-cessation treatments before and after the cancer diagnosis was defined as documentation of smoking-cessation counseling (Healthcare Common Procedure Coding System codes 99406, 99407, G0375, and G0376) or pharmacotherapy (eg, nicotine replacement therapy, bupropion, varenicline). RESULTS: From 2007 to 2011, among 23,703 patients in the KCR, we discerned a valid prediagnosis smoking status for 78%. KCR data only (72%), claims data only (6%), and a combination of both data sources (22%) were used to determine valid smoking status. Approximately 4% of patients with cancer identified as smokers (n = 11,968) and were provided smoking-cessation counseling, and 3% were prescribed pharmacotherapy for smoking cessation. CONCLUSION: Augmenting KCR data with medical claims data increased capture of smoking status and use of smoking-cessation modalities. Cancer registries interested in exploring smoking status to influence treatment and research activities could consider a similar approach, particularly if their registry does not capture smoking status for a majority of patients.

PURPOSE: To examine smoking and use of smoking cessation aids among tobacco-associated cancer (TAC) or non-tobacco-associated cancer (nTAC) survivors. Understanding when and if specific types of cessation resources are used can help with planning interventions to more effectively decrease smoking among all cancer survivors, but there is a lack of research on smoking cessation modalities used among cancer survivors. METHODS: Kentucky Cancer Registry data on incident lung, colorectal, pancreatic, breast, ovarian, and prostate cancer cases diagnosed 2007-2011, were linked with health administrative claims data (Medicaid, Medicare, private insurers) to examine the prevalence of smoking and use of smoking cessation aids 1 year prior and 1 year following the cancer diagnosis. TACs included colorectal, pancreatic, and lung cancers; nTAC included breast, ovarian, and prostate cancers. RESULTS: There were 10,033 TAC and 13,670 nTAC survivors. Smoking before diagnosis was significantly higher among TAC survivors (p < 0.0001). Among TAC survivors, smoking before diagnosis was significantly higher among persons who: were males (83%), aged 45-64 (83%), of unknown marital status (84%), had very low education (78%), had public insurance (89%), Medicaid (85%) or were uninsured (84%). Smoking cessation counseling and pharmacotherapy were more common among TAC than nTAC survivors (p < 0.01 and p = 0.05, respectively). DISCUSSION: While smoking cessation counseling and pharmacotherapy were higher among TAC survivors, reducing smoking among all cancer survivors remains a priority, given cancer survivors are at increased risk for subsequent chronic diseases, including cancer. Tobacco cessation among all cancer survivors (not just those with TAC) can help improve prognosis, quality of life and reduce the risk of further disease. Health care providers can recommend for individual, group and telephone counseling and/or pharmacotherapy recommendations. These could also be included in survivorship care plans.

The objective of this study was to develop a convenient and reliable adapter method for testing and evaluating vibration-reducing (VR) gloves and VR materials at the fingers. The general requirements and technical specifications for the design of the new adapter were based on our previous studies of hand-held adapters for vibration measurement and a conceptual model of the fingers-adapter-glove-handle system developed in this study. Two thicknesses (2 mm and 3 mm) of the adapter beam were fabricated using a 3-D printer. Each adapter is a thin beam equipped with a miniature tri-axial accelerometer (1.1 g) mounted at its center, with a total weight ≤ 2.2 g. To measure glove vibration transmissibility, the adapter is held with two gloved fingers; a finger is positioned on each side of the accelerometer. Each end of the adapter beam is slotted between the glove material and the finger. A series of experiments was conducted to evaluate this two-fingers-held adapter method by measuring the transmissibility of typical VR gloves and a sample VR material. The experimental results indicate that the major resonant frequency of the lightweight adapter on the VR material (≥800 Hz) is much higher than the resonant frequencies of the gloved fingers grasping a cylindrical handle (≤300 Hz). The experimental results were repeatable across the test treatments. The basic characteristics of the measured glove vibration transmissibility are consistent with the theoretical predictions based on the biodynamics of the gloved fingers-hand-arm system. The results suggest that VR glove fingers can effectively reduce only high-frequency vibration, and VR effectiveness can be increased by reducing the finger contact force. This study also demonstrated that the finger adapter method can be combined with the palm adapter method prescribed in the standardized glove test, which can double the test efficiency without substantially increasing the expense of the test.

In January 2017, two local health departments notified the California Department of Public Health (CDPH) of three cases of coccidioidomycosis among workers constructing a solar power installation (solar farm) in southeastern Monterey County. Coccidioidomycosis, or Valley fever, is an infection caused by inhalation of the soil-dwelling fungus Coccidioides, which is endemic in the southwestern United States, including California. After a 1-3 week incubation period, coccidioidomycosis most often causes influenza-like symptoms or pneumonia, but rarely can lead to severe disseminated disease or death (1). Persons living, working, or traveling in areas where Coccidioides is endemic can inhale fungal spores; workers who are performing soil-disturbing activities are particularly at risk. CDPH previously investigated one outbreak among solar farm construction workers that started in 2011 and made recommendations for reducing risk for infection, including worker education, dust suppression, and use of personal protective equipment (2,3). For the current outbreak, the CDPH, in collaboration with Monterey County and San Luis Obispo County public health departments, conducted an investigation that identified nine laboratory-confirmed cases of coccidioidomycosis among 2,410 solar farm employees and calculated a worksite-specific incidence rate that was substantially higher than background county rates, suggesting that illness was work-related. The investigation assessed risk factors for potential occupational exposures to identify methods to prevent further workplace illness.

The objective of this study was to develop a vibration model of a grinding machine-workpiece-hand-arm system. A lumped-parameter model structure of the system was proposed, and its major parameters were determined using the mechanical impedance measured at the grinding point of a typical workpiece (golf club head) held by two hands and referenced to the vibration transmissibility spectra measured at the wrist and on the upper arm of human subjects. The model reasonably predicted the vibration transmissibility spectra measured on the club head and the driving-point response function when the grinding contact stiffness was below a certain value. This suggests that the model is acceptable not only to enhance the understanding of the system responses, but also to explore some engineering methods for controlling vibration exposures during the grinding process. The identified model parameters reveal that the major resonance of the handheld workpiece depends primarily on its mass and grinding contact stiffness. The feed force applied in the grinding process can substantially affect the grinding contact stiffness; as a result, it can significantly influence the resonance. Vibration-reducing gloves can marginally increase the workpiece resonance, but these gloves can reduce some vibration transmitted to the hand-arm system. This study also clarified an important mechanism for the prediction errors of linear human vibration models, which is useful to further improve human vibration modeling.

Percussive riveting is the primary process for attaching the outer sheet metal “skins” of an aircraft to its airframe. Workers using manually-operated riveting tools (riveting hammers and rivet bucking bars) are exposed to significant levels of hand-transmitted vibration (HTV) and are at risk of developing components of hand-arm vibration syndrome (HAVS). To protect workers, employers can assess and select riveting tools that produce reduced HTV exposures. Researchers at the National Institute for Occupational Safety & Health (NIOSH) have developed a laboratory-based apparatus and methodology to evaluate the vibrations of rivet bucking bars. Using this simulated riveting approach, this study investigated the effects of feed force on the vibrations of several typical rivet bucking bars and that transmitted to the bucking bar operator's wrist. Five bucking bar models were assessed under three levels of feed force. The study results demonstrate that the feed force can be a major influencing factor on bucking bar vibrations. Similar feed force effects were observed at the bucking bar operator's wrist. This study also shows that different bucking bar designs will respond differently to variations in feed force. Some bucking bar designs may offer reduced vibration exposures to the bar operator's fingers while providing little attenuation of wrist acceleration. Knowledge of how rivet bucking bar models respond to riveting hammer vibrations can be important for making informed bucking bar selections. The study results indicate that, to help in the appropriate selection of bucking bars, candidate bar models should be evaluated at multiple feed force levels. The results also indicate that the bucking bar model, feed force level, or the bucking bar operator have no meaningful effects on the vibration excitation (riveting hammer), which further suggests that the test apparatus proposed by NIOSH researchers meets the basic requirements for a stable vibration source in laboratory-based bucking bar vibration assessments. This study provides relevant information that can be used to help develop a standardized laboratory-based bucking bar evaluation methodology and to help in the selection of appropriate bucking bars for various workplace riveting applications. Relevance to Industry: Because the feed force level can affect HTV exposures to bucking bar operators, the feed force required for specific riveting operations should be an important consideration when selecting bucking bar models. This study provides useful information about bucking bar responses to riveting hammer vibrations; this knowledge can improve bucking bar selections.

Background: Prostate cancer patients' needs for information and support have been previously addressed by both mentoring and interactive services. Objective: To determine whether combining computer-based support with a human cancer mentor would benefit prostate cancer patients more than either intervention alone. Methods: Newly diagnosed prostate cancer patients from 3 centers were randomly assigned to receive either: a web-based system of information and support; or telephone and e-mail support from a trained cancer information mentor; or both interventions. Results: The combined condition improved several quality-of-life outcomes more than the individual interventions alone, but these results were few and scattered. Limitations: Offering Internet (computer) access to all potential subjects may have made some computer nonusers less likely to participate, biasing the sample toward relatively advantaged men. Conclusions: Combining human and computer-based interventions did not produce the expected much stronger benefits to patients. Given the costs involved, the computer-based system alone is likely preferable. Funding/sponsorship Grant R01CA114539 from the National Cancer Institute.

This study conducted two series of experiments to investigate the relationships between hand coupling force and biodynamic responses of the hand-arm system. In the first experiment, the vibration transmissibility on the system was measured as a continuous function of grip force while the hand was subjected to discrete sinusoidal excitations. In the second experiment, the biodynamic responses of the system subjected to a broadband random vibration were measured under five levels of grip forces and a combination of grip and push forces. This study found that the transmissibility at each given frequency increased with the increase in the grip force before reaching a maximum level. The transmissibility then tended to plateau or decrease when the grip force was further increased. This threshold force increased with an increase in the vibration frequency. These relationships remained the same for both types of vibrations. The implications of the experimental results are discussed. Practitioner Summary Shocks and vibrations transmitted to the hand-arm system may cause injuries and disorders of the system. How to take hand coupling force into account in the risk assessment of vibration exposure remains an important issue for further studies. This study is designed and conducted to help resolve this issue.

It is known that the vibration characteristics of the fingers and hand and the level of grip action interacts when operating a power tool. In the current study, we developed a hybrid finger model to simulate the vibrations of the hand-finger system when gripping a vibrating handle covered with soft materials. The hybrid finger model combines the characteristics of conventional finite element (FE) models, multi-body musculoskeletal models, and lumped mass models. The distal, middle, and proximal finger segments were constructed using FE models, the finger segments were connected via three flexible joint linkages (i.e., distal interphalangeal joint (DIP), proximal interphalangeal joint (PIP), and metacarpophalangeal (MCP) joint), and the MCP joint was connected to the ground and handle via lumped parameter elements. The effects of the active muscle forces were accounted for via the joint moments. The bone, nail, and hard connective tissues were assumed to be linearly elastic whereas the soft tissues, which include the skin and subcutaneous tissues, were considered as hyperelastic and viscoelastic. The general trends of the model predictions agree well with the previous experimental measurements in that the resonant frequency increased from proximal to the middle and to the distal finger segments for the same grip force, that the resonant frequency tends to increase with increasing grip force for the same finger segment, especially for the distal segment, and that the magnitude of vibration transmissibility tends to increase with increasing grip force, especially for the proximal segment. The advantage of the proposed model over the traditional vibration models is that it can predict the local vibration behavior of the finger to a tissue level, while taking into account the effects of the active musculoskeletal force, the effects of the contact conditions on vibrations, the global vibration characteristics.

Some powered hand tools can generate significant vibration at frequencies below 25 Hz. It is not clear whether such vibration can be effectively transmitted to the upper arm, shoulder, neck, and head and cause adverse effects in these substructures. The objective of this study is to investigate the vibration transmission from the human hands to these substructures. Eight human subjects participated in the experiment, which was conducted on a 1-D vibration test system. Unlike many vibration transmission studies, both the right and left hand-arm systems were simultaneously exposed to the vibration to simulate a working posture in the experiment. A laser vibrometer and three accelerometers were used to measure the vibration transmitted to the substructures. The apparent mass at the palm of each hand was also measured to help in understanding the transmitted vibration and biodynamic response. This study found that the upper arm resonance frequency was 7-12 Hz, the shoulder resonance was 7-9 Hz, and the back and neck resonances were 6-7 Hz. The responses were affected by the hand-arm posture, applied hand force, and vibration magnitude. The transmissibility measured on the upper arm had a trend similar to that of the apparent mass measured at the palm in their major resonant frequency ranges. The implications of the results are discussed. Relevance to industry: Musculoskeletal disorders (MSDs) of the shoulder and neck are important issues among many workers. Many of these workers use heavy-duty powered hand tools. The combined mechanical loads and vibration exposures are among the major factors contributing to the development of MSDs. The vibration characteristics of the body segments examined in this study can be used to help understand MSDs and to help develop more effective intervention methods. © 2016.

BACKGROUND: Fingers-transmitted vibration can cause vibration-induced white finger. The effectiveness of vibration reducing (VR) gloves for reducing hand transmitted vibration to the fingers has not been sufficiently examined. OBJECTIVE: The objective of this study is to examine tool-specific performance of VR gloves for reducing finger-transmitted vibrations in three orthogonal directions (3D) from powered hand tools. METHODS: A transfer function method was used to estimate the tool-specific effectiveness of four typical VR gloves. The transfer functions of the VR glove fingers in three directions were either measured in this study or during a previous study using a 3D laser vibrometer. More than seventy vibration spectra of various tools or machines were used in the estimations. RESULTS: When assessed based on frequency-weighted acceleration, the gloves provided little vibration reduction. In some cases, the gloves amplified the vibration by more than 10%, especially the neoprene glove. However, the neoprene glove did the best when the assessment was based on unweighted acceleration. The neoprene glove was able to reduce the vibration by 10% or more of the unweighted vibration for 27 out of the 79 tools. If the dominant vibration of a tool handle or workpiece was in the shear direction relative to the fingers, as observed in the operation of needle scalers, hammer chisels, and bucking bars, the gloves did not reduce the vibration but increased it. CONCLUSIONS: This study confirmed that the effectiveness for reducing vibration varied with the gloves and the vibration reduction of each glove depended on tool, vibration direction to the fingers, and finger location. VR gloves, including certified anti-vibration gloves do not provide much vibration reduction when judged based on frequency-weighted acceleration. However, some of the VR gloves can provide more than 10% reduction of the unweighted vibration for some tools or workpieces. Tools and gloves can be matched for better effectiveness for protecting the fingers.

Anyone seeking to control the risks from vibration transmitted to the hands and arms may contemplate the use of anti-vibration gloves. To make an informed decision about any type of personal protective equipment, it is necessary to have performance data that allow the degree of protection to be estimated. The information provided with an anti-vibration glove may not be easy to understand without some background knowledge of how gloves are tested and does not provide any clear route for estimating likely protection. Some of the factors that influence the potential efficacy of an anti-vibration glove include how risks from handarm vibration exposure are assessed, how the standard test for a glove is carried out, the frequency range and direction of the vibration for which protection is sought, how much hand contact force or pressure is applied and the physical limitations due to glove material and construction. This paper reviews some of the background issues that are useful for potential purchasers of anti-vibration gloves. Ultimately, anti-vibration gloves cannot be relied on to provide sufficient and consistent protection to the wearer and before their use is contemplated all other available means of vibration control ought first to be implemented. 2016, The Author(s).

Mechanical arm systems are commonly used to support powered hand tools to alleviate ergonomic stressors related to the development of workplace musculoskeletal disorders. However, the use of these systems can increase exposure times to other potentially harmful agents such as hand-transmitted vibration. To examine how these tool support systems affect tool vibration, the primary objectives of this study were to characterize the vibration emissions of typical portable pneumatic grinders used for surface grinding with and without a mechanical arm support system at a workplace and to estimate the potential risk of the increased vibration exposure time afforded by the use of these mechanical arm systems. This study also developed a laboratory-based simulated grinding task based on the ISO 28927-1 (2009) standard for assessing grinder vibrations; the simulated grinding vibrations were compared with those measured during actual workplace grinder operations. The results of this study demonstrate that use of the mechanical arm may provide a health benefit by reducing the forces required to lift and maneuver the tools and by decreasing hand-transmitted vibration exposure. However, the arm does not substantially change the basic characteristics of grinder vibration spectra. The mechanical arm reduced the average frequency-weighted acceleration by about 24% in the workplace and by about 7% in the laboratory. Because use of the mechanical arm system can increase daily time-on-task by 50% or more, the use of such systems may actually increase daily time-weighted hand-transmitted vibration exposures in some cases. The laboratory acceleration measurements were substantially lower than the workplace measurements, and the laboratory tool rankings based on acceleration were considerably different than those from the workplace. Thus, it is doubtful that ISO 28927-1 is useful for estimating workplace grinder vibration exposures or for predicting workplace grinder acceleration rank orders.

Coccidioidomycosis is associated with soil-disruptive work in Coccidioides-endemic areas of the southwestern United States. Among 3,572 workers constructing 2 solar power-generating facilities in San Luis Obispo County, California, USA, we identified 44 patients with symptom onset during October 2011-April 2014 (attack rate 1.2 cases/100 workers). Of these 44 patients, 20 resided in California outside San Luis Obispo County and 10 resided in another state; 9 were hospitalized (median 3 days), 34 missed work (median 22 days), and 2 had disseminated disease. Of the 25 patients who frequently performed soil-disruptive work, 6 reported frequent use of respiratory protection. As solar farm construction in Coccidioides-endemic areas increases, additional workers will probably be exposed and infected unless awareness is emphasized and effective exposure reduction measures implemented, including limiting dust generation and providing respiratory protection. Medical providers, including those in non-Coccidioides-endemic areas, should suspect coccidioidomycosis in workers with compatible illness and report cases to their local health department.

The hand coordinate systems for measuring vibration exposures and biodynamic responses have been standardized, but they are not actually used in many studies. This contradicts the purpose of the standardization. The objectives of this study were to identify the major sources of this problem, and to help define or identify better coordinate systems for the standardization. This study systematically reviewed the principles and definition methods, and evaluated typical hand coordinate systems. This study confirms that, as accelerometers remain the major technology for vibration measurement, it is reasonable to standardize two types of coordinate systems: a tool-based basicentric (BC) system and an anatomically based biodynamic (BD) system. However, these coordinate systems are not well defined in the current standard. Definition of the standard BC system is confusing, and it can be interpreted differently; as a result, it has been inconsistently applied in various standards and studies. The standard hand BD system is defined using the orientation of the third metacarpal bone. It is neither convenient nor defined based on important biological or biodynamic features. This explains why it is rarely used in practice. To resolve these inconsistencies and deficiencies, we proposed a revised method for defining the realistic handle BC system and an alternative method for defining the hand BD system. A fingertip-based BD system for measuring the principal grip force is also proposed based on an important feature of the grip force confirmed in this study.

While simulations of the measured biodynamic responses of the whole human body or body segments to vibration are conventionally interpreted as summaries of biodynamic measurements, and the resulting models are considered quantitative, this study looked at these simulations from a different angle: model calibration. The specific aims of this study are to review and clarify the theoretical basis for model calibration, to help formulate the criteria for calibration validation, and to help appropriately select and apply calibration methods. In addition to established vibration theory, a novel theorem of mechanical vibration is also used to enhance the understanding of the mathematical and physical principles of the calibration. Based on this enhanced understanding, a set of criteria was proposed and used to systematically examine the calibration methods. Besides theoretical analyses, a numerical testing method is also used in the examination. This study identified the basic requirements for each calibration method to obtain a unique calibration solution. This study also confirmed that the solution becomes more robust if more than sufficient calibration references are provided. Practically, however, as more references are used, more inconsistencies can arise among the measured data for representing the biodynamic properties. To help account for the relative reliabilities of the references, a baseline weighting scheme is proposed. The analyses suggest that the best choice of calibration method depends on the modeling purpose, the model structure, and the availability and reliability of representative reference data.

The objective of this study is to evaluate an adapter method for measuring the vibration on the human arms. Four instrumented adapters with different weights were used to measure the vibration transmitted to the wrist, forearm, and upper arm of each subject. Each adapter was attached at each location on the subjects using an elastic cloth wrap. Two laser vibrometers were also used to measure the transmitted vibration at each location to evaluate the validity of the adapter method. The apparent mass at the palm of the hand along the forearm direction was also measured to enhance the evaluation. This study found that the adapter and laser-measured transmissibility spectra were comparable with some systematic differences. While increasing the adapter mass reduced the resonant frequency at the measurement location, increasing the tightness of the adapter attachment increased the resonant frequency. However, the use of lightweight (15 g) adapters under medium attachment tightness did not change the basic trends of the transmissibility spectrum. The resonant features observed in the transmissibility spectra were also correlated with those observed in the apparent mass spectra. Because the local coordinate systems of the adapters may be significantly misaligned relative to the global coordinates of the vibration test systems, large errors were observed for the adapter-measured transmissibility in some individual orthogonal directions. This study, however, also demonstrated that the misalignment issue can be resolved by either using the total vibration transmissibility or by measuring the misalignment angles to correct the errors. Therefore, the adapter method is acceptable for understanding the basic characteristics of the vibration transmission in the human arms, and the adapter-measured data are acceptable for approximately modeling the system.

The objective of this study is to enhance the understanding of the vibration transmission in the hand-arm system in three orthogonal directions (X, Y, and Z). For the first time, the transmitted vibrations distributed on the entire hand-arm system exposed in the three orthogonal directions via a 3-D vibration test system were measured using a 3-D laser vibrometer. Seven adult male subjects participated in the experiment. This study confirms that the vibration transmissibility generally decreased with the increase in distance from the hand and it varied with the vibration direction. Specifically, to the upper arm and shoulder, only moderate vibration transmission was measured in the test frequency range (16 to 500Hz), and virtually no transmission was measured in the frequency range higher than 50Hz. The resonance vibration on the forearm was primarily in the range of 16-30Hz with the peak amplitude of approximately 1.5 times of the input vibration amplitude. The major resonance on the dorsal surfaces of the hand and wrist occurred at around 30-40Hz and, in the Y direction, with peak amplitude of more than 2.5 times of the input amplitude. At higher than 50Hz, vibration transmission was effectively limited to the hand and fingers. A major finger resonance was observed at around 100Hz in the X and Y directions and around 200Hz in the Z direction. In the fingers, the resonance magnitude in the Z direction was generally the lowest, and the resonance magnitude in the Y direction was generally the highest with the resonance amplitude of 3 times the input vibration, which was similar to the transmissibility at the wrist and hand dorsum. The implications of the results are discussed. RELEVANCE TO INDUSTRY: Prolonged, intensive exposure to hand-transmitted vibration could result in hand-arm vibration syndrome. While the syndrome's precise mechanisms remain unclear, the characterization of the vibration transmissibility of the system in the three orthogonal dimensions performed in this study can help understand the syndrome and help develop improved frequency weightings for assessing the risk of the exposure for developing various components of the syndrome.

Vibration-reducing (VR) gloves have been increasingly used to help reduce vibration exposure, but it remains unclear how effective these gloves are. The purpose of this study was to estimate tool-specific performances of VR gloves for reducing the vibrations transmitted to the palm of the hand in three orthogonal directions (3-D) in an attempt to assess glove effectiveness and aid in the appropriate selection of these gloves. Four typical VR gloves were considered in this study, two of which can be classified as anti-vibration (AV) gloves according to the current AV glove test standard. The average transmissibility spectrum of each glove in each direction was synthesized based on spectra measured in this study and other spectra collected from reported studies. More than seventy vibration spectra of various tools or machines were considered in the estimations, which were also measured in this study or collected from reported studies. The glove performance assessments were based on the percent reduction of frequency-weighted acceleration as is required in the current standard for assessing the risk of vibration exposures. The estimated tool-specific vibration reductions of the gloves indicate that the VR gloves could slightly reduce (<5%) or marginally amplify (<10%) the vibrations generated from low-frequency (<25 Hz) tools or those vibrating primarily along the axis of the tool handle. With other tools, the VR gloves could reduce palm-transmitted vibrations in the range of 5%–58%, primarily depending on the specific tool and its vibration spectra in the three directions. The two AV gloves were not more effective than the other gloves with some of the tools considered in this study. The implications of the results are discussed. Relevance to industry Hand-transmitted vibration exposure may cause hand-arm vibration syndrome. Vibration-reducing gloves are considered as an alternative approach to reduce the vibration exposure. This study provides useful information on the effectiveness of the gloves when used with many tools for reducing the vibration transmitted to the palm in three directions. The results can aid in the appropriate selection and use of these gloves.

Sheet metal workers operating rivet bucking bars are at risk of developing hand and wrist musculoskeletal disorders associated with exposures to hand-transmitted vibrations and forceful exertions required to operate these hand tools. New bucking bar technologies have been introduced in efforts to reduce workplace vibration exposures to these workers. However, the efficacy of these new bucking bar designs has not been well documented. While there are standardized laboratory-based methodologies for assessing the vibration emissions of many types of powered hand tools, no such standard exists for rivet bucking bars. Therefore, this study included the development of a laboratory-based method for assessing bucking bar vibrations which utilizes a simulated riveting task. With this method, this study evaluated three traditional steel bucking bars, three similarly shaped tungsten alloy bars, and three bars featuring spring-dampeners. For comparison the bucking bar vibrations were also assessed during three typical riveting tasks at a large aircraft maintenance facility. The bucking bars were rank-ordered in terms of unweighted and frequency-weighted acceleration measured at the hand-tool interface. The results suggest that the developed laboratory method is a reasonable technique for ranking bucking bar vibration emissions; the lab-based riveting simulations produced similar rankings to the workplace rankings. However, the laboratory-based acceleration averages were considerably lower than the workplace measurements. These observations suggest that the laboratory test results are acceptable for comparing and screening bucking bars, but the laboratory measurements should not be directly used for assessing the risk of workplace bucking bar vibration exposures. The newer bucking bar technologies exhibited significantly reduced vibrations compared to the traditional steel bars. The results of this study, together with other information such as rivet quality, productivity, tool weight, comfort, worker acceptance, and initial cost can be used to make informed bucking bar selections.

For exposure to hand-transmitted vibration (HTV), personal protective equipment is sold in the form of anti-vibration (AV) gloves, but it remains unclear how much these gloves actually reduce vibration exposure or prevent the development of hand-arm vibration syndrome in the workplace. This commentary describes some of the issues that surround the classification of AV gloves, the assessment of their effectiveness and their applicability in the workplace. The available information shows that AV gloves are unreliable as devices for controlling HTV exposures. Other means of vibration control, such as using alternative production techniques, low-vibration machinery, routine preventative maintenance regimes, and controlling exposure durations are far more likely to deliver effective vibration reductions and should be implemented. Furthermore, AV gloves may introduce some adverse effects such as increasing grip force and reducing manual dexterity. Therefore, one should balance the benefits of AV gloves and their potential adverse effects if their use is considered.