Hand-Arm Vibration in Orthopaedic Surgery

In a study to investigate the hand-arm vibration to which orthopaedic surgeons are exposed, three surgeons performed cuts onto cadaveric tibia bones using battery-operated saws[i].  The vibration magnitudes were measured in three directions, and the average vibration was calculated.

The average overall vibration was 11.3 m/s2.  This value was compared to the exposure action values (EAV) and the exposure limit values (ELV) set by the Health and Safety Executive.  The exposure action value is a daily amount exposure above which employers are required to take action to control exposure.  The exposure limit value is the maximum amount of vibration an employee may be exposed to on a single day.  The limit values are functions of both time and the size of the vibration, whereby exposure to a larger vibration will reach the limits over shorter time periods than exposure to smaller vibration.  Both values are required under the Control of Vibration at Work Regulations 2005[ii].

Figure: How vibration level and duration affect exposure (Source: HSE)


The results of the experiment suggest that a surgeon using this equipment would reach the EAV at 23 minutes and the ELV at 1 hour 33 minutes.  Depending on the amount of time surgeons spend using these saws each day, their exposure may be approaching the EAV or ELV.  The researchers conclude that further study is necessary to assess whether orthopaedic surgeons are at risk from disorders related to hand-arm vibration exposure.



[i] Mahmood, F. et al. Hand–arm vibration in orthopaedic surgery: a neglected risk. Occup Med (Lond) 67, 715–717 (2017). https://academic.oup.com/occmed/article-abstract/67/9/715/4596550?redirectedFrom=fulltext (Accessed 30 January 2018)

[ii] Employers’ responsibilities – legal duties. Health and Safety Executive. http://www.hse.gov.uk/vibration/hav/advicetoemployers/responsibilities.htm (Accessed 31 January 2018)