Riveting hammer vibration damages mechanosensory nerve endings

• Published in: Journal of the peripheral nervous system Vol. 25; no. 3; pp. 279 - 287
• Main Authors: Zimmerman, Jordan J., Bain, James L. W., Wu, Chaowen, Lindell, Hans, Grétarsson, Snævar L., Riley, Danny A.
• Format: Journal Article
• Language: English
• Published: Malden, USA Wiley Periodicals, Inc 01-09-2020; Wiley Subscription Services, Inc
• Subjects: Arm; Denervation; Etiology; Hair; Innervation; mechanosensory; Nerve endings; neurodegeneration; Occupational diseases; PGP9.5; shock wave; Vibration; vibration disease; Vibrations; shock wave; neurodegeneration; denervation; PGP9.5; mechanosensory; vibration disease
• ISSN: 1085-9489; 1529-8027; 1529-8027
• DOI: 10.1111/jns.12393

Hand‐arm vibration syndrome (HAVS) is an irreversible neurodegenerative, vasospastic, and musculoskeletal occupational disease of workers who use powered hand tools. The etiology is poorly understood. Neurological symptoms include numbness, tingling, and pain. This study examines impact hammer vibration‐induced injury and recoverability of hair mechanosensory innervation. Rat tails were vibrated 12 min/d for 5 weeks followed by 5 week recovery with synchronous non‐vibrated controls. Nerve fibers were PGP9.5 immunostained. Lanceolate complex innervation was compared quantitatively in vibrated vs sham. Vibration peak acceleration magnitudes were characterized by frequency power spectral analysis. Average magnitude (2515 m/s2, root mean squared) in kHz frequencies was 109 times that (23 m/s2) in low Hz. Percentage of hairs innervated by lanceolate complexes was 69.1% in 5‐week sham and 53.4% in 5‐week vibration generating a denervation difference of 15.7% higher in vibration. Hair innervation was 76.9% in 5‐weeks recovery sham and 62.0% in 5‐week recovery vibration producing a denervation difference 14.9% higher in recovery vibration. Lanceolate number per complex (18.4 ± 0.2) after vibration remained near sham (19.3 ± 0.3), but 44.9% of lanceolate complexes were abnormal in 5 weeks vibrated compared to 18.8% in sham. The largest vibration energies are peak kHz accelerations (approximately 100 000 m/s2) from shock waves. The existing ISO 5349‐1 standard excludes kHz vibrations, seriously underestimating vibration injury risk. The present study validates the rat tail, impact hammer vibration as a model for investigating irreversible nerve damage. Persistence of higher denervation difference after 5‐week recovery suggests repeated vibration injury destroys the capability of lanceolate nerve endings to regenerate.