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Keynote Presentation - Health Effects Of Vibration - The Known And The Unknown - Introduction; Proceedings Of The First American Conference On Human Vibration
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    Science involves the study of the nature and behaviour of natural things and the knowledge we obtain about them. Scientific endeavour leads to the unfolding of new knowledge and adjustments to our understanding and our behavior. To indicate that we ‘know’ something may merely mean we do not feel able to, or that we do not wish to, disagree with others who claim to know; or it may mean we have either heard about it, or studied it, or understand part of it, or accept that it is true, or have seen evidence to be convinced of its veracity. What do we ‘know’ about the health effects of vibration? There are many unknowns in the field of human responses to vibration. Not all would agree on what is known and what is unknown. This paper seeks to summarize what we know that we know, what it is sometimes claimed that we know, and what we know that we do not know about the relation between exposures to vibration and our health. It also speculates on what we do not know that we do not know. Hand-transmitted vibration What we know we know We know that exposures to hand-transmitted vibration result in various disorders of the hand, including abnormal vascular and neurological function. Not all frequencies, or magnitudes, or durations, of hand-transmitted vibration cause the same effects. What we may claim to know To enable exposures to be reported and compared, they are ‘measured’ and ‘evaluated’ using defined (e.g. standardised) procedures. This involves identifying what is to be measured and specifying how it is expressed by one (or a few) numbers. Summarising a vibration exposure in a single value involves assuming the relative importance of components within the vibration (e.g. different magnitudes, frequencies, directions, and durations), so standards define ‘weightings’ for these variables. The importance of the weighted values may also be suggested, allowing ‘assessments’ according to a criterion (e.g. the probability of a specific severity of a specific disease). Standards for the measurement and evaluation of hand-transmitted vibration define a frequency weighting and time dependencies that allow the severity of vibration exposures to be assessed and the probability of finger blanching to be predicted 1. What we do not know We do not know that the frequency weighting in current standards reflects the relative importance of different frequencies and axes of vibration in producing any specific disorder. We do not know whether the energy-based daily time-dependency inherent in A(8) reflects the relative importance of vibration magnitude and daily exposure duration. Consequently, the relation between A(8) and the years of exposure to develop finger blanching, as in an appendix to ISO 5349-1 (2001), is not well-founded. We do not know, or at least there is no consensus on, the full extent of the disorders caused by hand-transmitted vibration (e.g. vascular, neurological, muscular, articular, central), or the pathogenesis of any specific disorder caused by hand-transmitted vibration, or the roles of other factors (e.g. ergonomic factors, environmental factors, or individual factors). We know that acute

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