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Table of Contents   
REVIEW ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 334-340
Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review


1 Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
2 Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia

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Date of Web Publication22-Jun-2017
 

   Abstract 

Background: The traffic police force is one of the occupations that utilize motorcycles as the main mode of transport. The main ergonomic hazard with the constant use of motorcycles is exposure of riders to vibration while riding their motorcycles, which can potentially lead to work.related musculoskeletal disorders (WMSDs). Objective: This review is meant to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines. Method: This study involved comprehensive search of database from 1945 to 2015. Published research paper that reported on the vibration exposure, prevalence, and/or risk factors of WMSDs and occupational riders were assessed and reviewed. Result: The review suggests that the main factors involving vibration in motorcycles come from the motorcycles itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding motorcycles. Majority of the studies agreed that police riders had higher percentage of WMSDs especially in lower back, neck, and shoulder. Conclusion: Overall, police riders have a high incidence of WMSDs, which in combination with exposure to vibrations with prolonged sitting and static posture may increase their susceptibility to WMSDs. Further research is required to explore the level of exposure to vibrations and WMSDs among traffic police riders, its potentially consequences, and ways to reduce exposure and risk associated with vibrations and WMSDs.

Keywords: Riders, traffic policemen, vibration, work.related musculoskeletal disorders

How to cite this article:
Diyana NA, Karuppiah K, Rasdi I, Sambasivam S, Tamrin SB, Mani KK, Syahira PA, Azmi I. Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review. Ann Trop Med Public Health 2017;10:334-40

How to cite this URL:
Diyana NA, Karuppiah K, Rasdi I, Sambasivam S, Tamrin SB, Mani KK, Syahira PA, Azmi I. Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Sep 22];10:334-40. Available from: http://www.atmph.org/text.asp?2017/10/2/334/208694

   Introduction Top


Motorcycles are a common mode of transport in Malaysia. An estimated 11,000,000 motorcycles are used in Malaysia, followed by 10,000,000 cars, 62,000 buses, 99,000 taxis, and 862,000 other vehicles.[1] Although motorcycles are usually used for short‐distance transport due to the convenience and effectiveness afforded, they are also used as the main mode of transport for some occupations such as couriers, food delivery, postal delivery, and traffic police force.

Accordingly, there are three types of hazard factors that affect motorcycle riders. They are (i) environmental factors such as inadequate road network and surfaces, less physical space, overcrowded road conditions, and objects and/or obstruction on the road; (ii) human factors such as poor visual acuity, impaired hearing, physical defects, inadequate personal protective measures, psychosocial issues, addiction, and abuse of substance; and (iii) machine factors such as bad maintenance and poor monitoring.[2] In addition, the Malaysian Institute of Road Safety Malaysia (MIROS)[3] also reported that more motorcycles are involved in accidents compared with other vehicles in Malaysia.[4] However, health problems especially exposure to vibration among motorcycle riders are often overlooked, although motorcyclists make up a large number of road users in Malaysia.

In Malaysia, the traffic police are responsible for controlling traffic congestion, investigating all traffic accidents, and coordinating traffic at the time of special events. Traffic police use various types of vehicles including motorcycles for carrying out their daily duties. Most of the motorcycles used by the traffic police force are high‐powered motorcycles with the average engine power ranging between 750 and 1,300 cc. Traffic police riders may ride for many hours while on duty where their exposure to vibration becomes critical, since overexposure may cause discomfort, stress, a decrease in their performance, and even health risk including work‐related musculoskeletal disorders (WMSDs). However, there has been little research to address health problems related to vibration exposure and WMSDs issues among traffic police force in Malaysia.

Thus, the objective of this article is to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines.


   Materials and Methods Top


In order to analyze the availability of motorcycle vibration exposure and WMSDs among traffic policemen, various databases such as Springer Online, PubMed, MIROS, and Department of Statistics Malaysia[4] were accessed and searched by using the following keywords: motorcycle, hand-arm vibration (HAV), whole‐body vibration (WBV), musculoskeletal disorders, and guidelines. The search covered a span of 70 years from 1945 to 2015. According to Uibel et al., this large range was used to ensure that all possible research done in this field was covered.[5]


   Results Top


Vibration

Vibration is defined as the oscillatory motion of a system around the equilibrium position (Frank, 2006 and Chen HC 2013, The Scarecrow Press Inc., United States of America). Vibration can be found in a solid, gas, or liquid state and the oscillation motion can either be periodic or random, continuous or intermittent, or steady state or transient [Figure 1].[6] The main characteristics of vibration are magnitude, frequency, direction, and duration.[7]
Figure 1: Type of vibration (Stephan, 2008)

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The vibration magnitude known as “power” represents the acceleration and is measured in the unit of meter per second squared (m/s2).[8] However, the magnitude of acceleration is expressed as the root mean square (rms) value when the vibration does not involve shocks. Frequency, one of the main elements of vibration, is defined as the number of complete cycles per seconds and measured in Hertz (Hz).[8] In addition, it is also necessary to define a dose measure, which is related to the exposure time factor where a human's response to vibration increases with the duration of exposure.[7] Human vibration is defined as the mechanical vibration effect from the environment to the human body.[9]

Hand‐arm vibration

HAV is known as the segmented vibration in which the vibration is transferred from a tool to a worker's hands and arms. The level of vibration produced will depend on the tool's size and weight, method of propulsion, and the tool's drive mechanism.[10] However, previous studies have shown that long periods of exposure to vibrating hand tools has been linked to hand-arm vibration syndrome (HAVS).[11],[12] Prolonged periods of exposure have also been shown to produce temporary sensory impairments that require more than 20 min to recover.[13],[14],[15]

Whole‐body vibration

WBV is the transmission of vibrations to the human body in a seated position.[16] The vibration frequency in the range of 0.01‐50 Hz h for WBV can cause motion sickness, pain, discomfort, vomiting, and numbness to the skin.[17] The body is exposed to physiologic and pathologic effects because of the constant exposure to WBV.[18] Previous studies have shown that there is a moderate to strong epidemiologic evidence showing the association of WBV exposure with an increased risk of lower back pain, especially among occupational drivers, in the range of 55-65%.[19],[21]

Work‐related musculoskeletal disorders

WMSDs are defined as injury of the muscles, nerves, cartilage, ligaments, and joints that function as the supporting structures of the upper and lower limbs, neck, and lower back. This usually happens when the body is exposed to physical activities involving repetition, force, vibration, or awkward posture.[22]

In situations where repeated exposure to risk factors results in increased levels of tissue damage and symptom severity, allocation of a presenting disorder to acute injury or chronic condition can be arbitrary, especially in the earlier stages. However, most of the WMSDs cannot be often diagnosed with respect to a clinical pathology, but they may still result in physical impairment and disability.[23] Symptoms of WMSDs may include local or generalized pain, discomfort, loss or hypersensitivity of sensation to touch, heat and pressure, loss of muscle strength, and loss of the ability to perform controlled movements or balance reactions.[24]

Many previous studies have reported that the prevalence of WMSDs in various types of industries to be half or more than that in the study population. A study carried out in a rubber factory found that the prevalence of WMSDs for 12 months was 73.6%, with the highest prevalence reported in the lower back (50.2%), knees (48.5%), and upper back (38.1%) region.[25] Another study conducted by Yu et al. (2012) found that among 3479 frontline workers, half of the population suffered WMSDs for the past 12 months.[26] A study carried out among workers in a sugar‐producing factory found that the prevalence of WMSDs for the past 12 months was 87.1%, with the highest prevalence reported in the knees (58.6%) and lower back region (54.3%).[27] A study among workers in a Malaysian automotive manufacturing company revealed that the highest WMSDs prevalence occurred in the lower back, feet/ankle, and upper back of the body.[28] Another study carried out among Malaysian male commercial bus drivers concluded that the overall prevalence of WMSDs was 81.8%, with majority of complaints of lower back (58.5%).[29]

In addition, vibration can also affect the tendons, muscles, bones, joints, and nervous system. Usually, these effects are known as the HAVS.[29] HAVS is a combination of disorders in the vascular and nonvascular system of the hand due to prolonged exposure to hand‐transmitted vibration from power tools. It may contribute to various disorders of the vascular, neurologic, and musculoskeletal systems of the body.[30] Radwin et al. proved that hand tool vibration can introduce disturbance in the neuromuscular force control, which results in excessive grip exertions when holding a vibrating handle.[14] Among the areas of vibration transmitted to the human body, the HAV is the second largest problem after WBV, which also causes problems.[31]

Carpal tunnel syndrome is a type of disorder that causes pain in and weakness of the hands and wrists. It develops from problems between the nerves in the wrist.[32] The symptoms usually are pain in the hand and wrists, weak hand grip, numbness, a pins‐and‐needles sensation from the wrist to the thumb, index, middle, or ring finger that appears gradually and worsens over time. It can also result in near constant pain that often awakens the individual from sleep.[33]

Raynaud's disease was first described as a condition of loss of blood circulation, wherein the affected person sees one or more fingers becoming white and feeling cold simultaneously.[34] In 1-3% of the cases, the whitening of fingers (blanching attacks) can become progressively severe over the years, leading to blue and cold fingers where even the skin may become atrophic, ulcerated, or gangrenous.[35] Raynaud's diseases is divided into two stages. The primary Raynaud's phenomenon, originally described by Dr. Maurice Raynaud, occurs spontaneously around less than 15% of the general population, with a female‐to‐male ratio of 5:1.[36],[37] The secondary Raynaud's phenomenon has the same signs and symptoms and progresses through the same stages of severity but may be correlated with a specific cause such as other medical conditions, vinyl chloride, or vibrating hand tools.[35]

Standard guidelines of vibration

Two guidelines are commonly used in human vibration exposure: the International Organization of Standard (ISO) and the European Directive (EU Directive). ISO for human vibration is split to two standards: ISO 2631, which is used for WBV, and ISO 5349‐1, which is used for hand‐transmitted measurements. In both ISO standards, there are three types of human vibration signals that can be measured and analyzed. These are the HAV signal, WBV signal, and low‐frequency WBV signals.[38] The coordinate systems used for measuring HAV [Figure 2] and whole‐body human vibration [Figure 3] show the origins at the interface between part of the body and the vibrating surface.[39],[40]
Figure 2: The coordinate system used to measure HAV (source: ISO 5349-1, 2001)

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Figure 3: The coordinate system used to measure whole.body human vibration (source: ISO 2631-1, 1997)

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The ISO standards also provide the weighting filters that can be applied to human vibration signals in them. These weighting filters can isolate the directional components that the user is interested in and help in analyzing different types of human vibrations. Six weightings are used in ISO 2631‐1 and only one in ISO 5349‐1.[42] Wc, Wd, We, Wj, and Wk weighting filters are used for WBV signals, Wh weighting filter for HAV signal, and Wf weighting filter for low‐frequency WBV signal.[38]

ISO 2631 describes weighting filters for combinations of standing, sitting, and recumbent subjects for the analysis of health, discomfort, perception, and motion sickness. In addition, they describe how different weighting filters should be used for different axes of measurement (fore‐aft, lateral, vertical, rotational). ISO 2631 also highlights that it does not apply to the evaluation of extreme‐magnitude single shock such as vehicle accident. In order to get the total acceleration value of WBV, the below formula is used:



The evaluation of WBV with A(8), which represent 8‐h energy equivalent acceleration, is formulated as follows (ISO5349‐1, 2001):



Where

T = Total daily duration of exposure to the vibration.

T0 = The reference duration of 8 h (28,800 s).

The standard ISO 5349‐1 was developed to define the procedure in measuring the level of vibration for the hand-arm system. Mansfield (2005) stated that the International Organization for Standardization (ISO) produced new version guidelines of ISO 5349‐1:2001 to evaluate hand‐transmitted vibration and directly replace the first version of ISO 5349‐1:1986.[41] This standard recommended taking the acceleration measurement in all three directions (X‐, Y‐, Z‐axis) to evaluate the total vibration exposure (ahv). The total value of vibration is defined as the rms of the three component values:



In order to facilitate the comparisons between daily exposures of different durations, the daily vibration exposure is expressed in terms of the 8‐h energy‐equivalent frequency‐weighted vibration total value, αhv(eq, 8h), as shown in the below equation in which αhv(eq, 8h) is expressed as A(8):



Where

T = Total daily duration of exposure to the vibration.

T0 = The references duration of 8 h (28,800 s).

EU Directive 2002/44/EC was developed to guide employers for minimum health and safety requirements regarding the exposure of the vibration among employees. EU Directive is focused on exposure limits and action values for both types of vibrations. The daily exposure limit value standardized for HAV is 5.0 m/s2 and the daily exposure action value is 2.5 m/s2. Meanwhile, for the WBV, the daily exposure limit value is set at 1.15 and 0.5 m/s2. In Malaysia, guidelines on occupational vibration issued by the Department of Occupational Safety and Health formulated in the year 2003 are used to deal with vibration that may affect the human body in the terms of occupational safety and health.[42] To control HAV exposure, these guidelines have established a threshold level based on the total daily exposure duration [Table 1] and should not be exceeded. Meanwhile, guidelines for WBV is adapted from ISO 2631.
Table 1: Threshold limit values for exposure of the hand to vibration in either Xh, Yh, Zh

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Previous findings

Previous studies have investigated the prevalence of symptoms related to occupational vibration exposure among motorcycle riders. Chen and Pan (2013) suggested that vibration exposure in motorcycle was greater than in a four‐wheeled vehicle, with the WBV exposure among motorcycle riders being 0.56-1.11 m/s2 compared with taxi drivers (0.17-0.55 m/s2) and highway transport truck drivers (0.34-0.56 m/s2).[43],[44],[45] Prolonged exposure to high levels of vibration can lead to motion sickness, fatigue, and headache, since the transmission of vibration energy to the entire body causes localized effects.[46] This is also supported by Ruppe and Mucke (1993), who showed that prolonged exposure to WBV can cause strong spine disorders or injuries and chronic lower back pain.[47],[48],[49]

A study was carried out in Japan by Seyed et al. (1997) to assess HAV exposure among traffic police motorcycle riders.[50] It was reported that the prevalence of subjective symptoms in fingers or hand among motorcycle riding policemen was in the range of 0.5-19.3%, where 4.2% of the respondents suffered finger blanching and 13.4% had shoulder pain, with a computed mean value of vibration of 2.6 m/s2 rms. They also highlighted that the main factors involving vibration in motorcycles came from the motorcycle itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding the motorcycles.

According to Stefano et al. (2011), ergonomic problems arising while riding a motorcycle might be related to manual force and wrist posture (degree of flexion and extension), which can lead to strain on the rider's hands and arms.[50] In Europe, professional speedway motorcycle riders are at a risk of developing symptoms related to HAV exposure.[51] Besides, ergonomic stress factors with exposure to HAV were identified as main contributor to the development of various symptoms in the hand-arm system of postwomen riders. The researcher found that the respondents experienced finger blanching and pain when exposed to vibration.[52] The value of mean vibration dose value was high at higher speed than at lower speed (20-40 km/h).[53] These results were supported by several studies wherein a slower riding speed may lower the vibration exposure.[54],[55]

In addition, previous studies related to MSD among policemen [Table 2] have been conducted. Many of the researchers agreed that the level of MSD was high among policemen.[55],[56],[57],[58],[59] In their studies, different subjects have different levels of pain in different parts of their bodies because of different body muscles used, different level of severity of body muscle used, and working conditions.[60],[61] Lipscomb et al. (2004) found that a quarter of the respondents reported that their MSD caused them to take sick leave of up to 5 days.[62] The majority of the policemen did not experience low back pain before recruitment to the force, which proves that some factors of policing has caused the MSD among policemen.[59] Gyi and Porter (1998) concluded that traffic policemen had a high prevalence of low back pain, since they had high exposure to driving because they need to spend their shifts in the same car all day.[63] They agreed that traffic policemen experienced MSD for longer periods within the past year compared with other general duty policemen. They also found that traffic police riding motorcycles had a higher percentage of shoulder pain than the traffic policeman driving cars. Although many studies have been conducted on police and successfully identified MSD as the major concern among this community, it still does not clearly show the factors associated with a higher incidence of MSD. The combination of exposure to WBV with prolonged sitting and static posture may increase susceptibility to MSD among police drivers.[60]
Table 2: The prevalence of musculoskeletal disorders among police officers

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   Discussion Top


It is known that traffic police riders are engaged in a high‐risk occupation that exposes them to high levels of motorcycle vibration. The findings of previous studies also provide clear association between vibrations among riders or drivers with increased risk of WMSDs. However, there is very limited research that has examined the issue of vibration exposure among traffic policemen riders with WMSDs, especially in Malaysia.


   Conclusion Top


In summary, police officers including traffic police riders have a high incidence of WMSDs, which may be caused by the combination of exposure to vibration with prolonged sitting and static posture among them. However, there is relatively very little research in this area, especially in Malaysia. Thus, more research is needed to explore the level of vibration exposure specifically and WMSDs among traffic police riders, its potential consequence, ways to reduce the exposure, and the risk associated with vibration and WMSDs.

Acknowledgement

The author would like to show the gratitude to all those who were involved in this study. Appreciation also goes to Universiti Putra Malaysia for data and technical support for this review paper. This research is supported by the Ministry of Education Malaysia (MOE) Fundamental Research Grant Scheme (FRGS), Vote No: 5524770.

Ethical issues

The ethical approval of this study was obtained from Ethic Committee, Universiti Putra Malaysia (reference number: UPM/TNCPI/RMC/1.4.18.1 (JKEUPM)/F2).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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Correspondence Address:
Karmegam Karuppiah
Department of Environmental and Occupational Health, Fakulti Perubatan dan Sains Kesihatan, 43400 UPM Serdang, Selangor Darul Ehsan
Malaysia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ATMPH.ATMPH_91_17

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