This report describes a systematic literature review on the nature of the exposure-response relationship between hand-transmitted vibration and the elements of hand-arm vibration syndrome (HAVS), ie the vascular, neurosensory and musculoskeletal components. Annex C of ISO 5349-1:2001 contains an exposure-response relationship for vascular HAVS, yet this review of the literature has not found any strong evidence of a precise quantitative relationship between exposure to vibration and health outcomes, either for vascular or neurosensory HAVS. There is some evidence that suggests possible limited reversibility of vascular HAVS after cessation of exposure. However, the limited evidence concerning neurosensory HAVS does not indicate any reversibility of the condition.
This review indicates that there are a number of unknowns with regard to the exposure-response relationships for HAVS. Despite on-going research in the area of HAVS, quantitative exposure-response relationships for HAVS remain elusive and ill-defined. It has still not been possible to establish if there is a no effect level for vibration exposure, other than the somewhat obvious zero exposure level.
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