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Procedia Manufacturing 2 (2015) 87 – 91

2nd International Materials, Industrial, and Manufacturing Engineering Conference, MIMEC2015,

4-6 February 2015, Bali Indonesia

Effect of Hand Arm Vibration on the Development of Vibration

Induce Disorder among Grass Cutter Workers
N.A. Azmira, M.I. Ghazalia, M.N. Yahyaa, M.H. Alib & J.I. Songc
a
Deparment of Engineering Mechanics, Faculty of Mechanical & Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia (UTHM),
86400 Parit Raja, Batu Pahat, Johor, Malaysia
b
OSH Management Division, Consultation, Research & Development Deparment, National Institute Occupational Safety & Health (NIOSH),
43650 Bandar Baru Bangi, Selangor, Malaysia
c
Department of Mechanical Engineering, Changwon National University, 20Changwondaehak-ro, Uichang-gu Changwon-si, Gyeongsangnam-
do 641-773, South Korea

Abstract

Objectives: Prolonged exposures to hand arm vibration among hand held machine user revealed caused development of vibration
induce disability. The present study was to determine the effect of hand transmitted vibration by using hand numerical scoring
and hand grip strength force assessment. Methods: A case study using adopted HAVS questionnaire and physical observation
was investigated to a subject of 204 male workers from grass maintenance contractor. Two health effect assessments was done in
this work comprises of severity stage of vascular and sensori-neural for both hand as well as the hand grip strength force. The
correlation of workers experience between tow health effects was analyzed. Results: More than 90% of worker has been
experience at risk hand grip stage for the both hand. Above stage 2 there were 172 workers (84.3%) with vascular disorder in the
left hand while 163 workers (79.9%) with vascular disorder in the right hand. As for sensori-neural disorder, numbers of workers
above stage 2 were 169 (82.8%) and 162 (79.4%) respectively. Conclusion: The results suggest that chronic health surveillance
for hand arm vibration is under diagnosed in agriculture sector.
©
© 2015 The Authors.
2015 Published Published
by Elsevier byThis
B.V. Elsevier B.V. access article under the CC BY-NC-ND license
is an open
Selection and Peer-review under responsibility of the Scientific Committee of MIMEC2015.
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Selection and Peer-review under responsibility of the Scientific Committee of MIMEC2015
Keywords:Hand Arm Vibration ; Grass Cutter Workers ; Hand Grip Strength ; Hand Numerical Scoring

1. Introduction

The petrol hand-held grass cutter machines is commonly used in Malaysia due to maintenance of grass growth
along the roadside, highways and general landscaping work [1]. The machine consists of petrol engine, handle shaft
and grass cutter uses nylon or metal blade. The vibration energy produce by the combustion inside of the operated

2351-9789 © 2015 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
Selection and Peer-review under responsibility of the Scientific Committee of MIMEC2015
doi:10.1016/j.promfg.2015.07.015
88 N.A. Azmir et al. / Procedia Manufacturing 2 (2015) 87 – 91

engine have produce the rotation energy to the grass cutter. Prolong hand arm vibration exposure from grass cutter
machine may cause a different hand disorder symptoms called as hand arm vibration syndrome, HAVS [2]. The
HAVS is used to determine the collective physical hazard that considered link to the hand transmission vibration.
However, there is less awareness in these occupational diseases especially in the agricultural services involved with
the foreign workers.
In line with the occupational safety and health study, factor such as ergonomics and repetitive of working
activities as well as the vibration exposure has been cited as the factor of chronic nerve diseases [3] and may
experience vascular symptoms in the hands or fingers [4]. There are been various reported case on the disease of
HAVS in developed countries. In 2005, in South Korea, 154 workers from shipbuilding industries with the
symptoms of HAVS findings were identified from 21,000 workers due to vibration exposure [5]. In the Vietnam, 5-
10% of the rock drill operators works in the quarry industry have been suffering from moderate HAVS [6]. In
Malaysia, cross sectional study in the construction industry depict the prevalence of HAVS was 18% and there is
significant sign relation with vibration exposure [7]. To our knowledge, no case study has reviewed the effect of
hand held grass cutter work in agriculture industry on hand function due to hand transmitted vibration.
There are several examination techniques to diagnose HAVS used by medical practitioner. However, the
techniques have not been clearly established to investigate the cause from vibrating tools. The observation
examinations through colour changes at fingers phalange have been used by previous researcher [8]. In addition,
hand numerical scoring for vascular and sensori-neural stages disorder assessment have been developed as one of the
technique for health surveillance monitoring [9]. Besides that, hand grip strength force due to vibration disease has
been investigated in past and show disability of hand grip after working with vibrating equipment [10].
The objective of this case study was to determine the effect of hand arm vibration among hand held grass cutter
workers in Malaysia by using hand numerical scoring and hand grip strength force assessment. Information about the
subject participated in HAVS study was collected through onsite observation and measurement. The relation
significant of working experience induce to HAVS was also determined.

2. Material and Methods

2.1. Subject, HAVS Questionnaire & Physical Observation

The subjects with the age between 20-70 years were selected through the subcontractor of leading highway
maintenance company and district council in south region of peninsular Malaysia. The observation, measurement
and interview (in 2013), 204 hand held grass cutter workers participated in an examination between August 2013 to
December 2013. Workers involved in the study were voluntary for occupational safety and health research under
each contractor responsibility.
The HAVS questionnaires developed based on the adoption approach questions in vibration injury network
association. Part of the question was asked about workers ages and working experience in grass cutter activity. The
information obtain is important to investigate the disability at hand due to grass cutting operation based on working
duration. During physical observation, author looked for colour changes in the fingers phalanges and any skin
abnormalities at hand palm before workers started their work.

2.2. Effect Assessment & Data Analysis

A dynamometer was used to determine the worker hand grip strength force before and after operating the hand
held grass cutter machine. Grip strength was measured in kilogram (kg) units. Workers were instructed to grasp the
handle of dynamometer for 5 seconds and perform the total action for 3 times before and after worker. The data
were record manually in the HAVS questionnaires. The mean and total value of grip force for both hands was
obtained and used for comparison between workers age. This assessment was based on Canadian Society for
Exercise Physiology.
The numerical scoring of vascular and sensori-neural assessment was performed by observation through colour
changes at fingers phalanges. Each fingers phalange has its own numerical value and total summation of the
numerical value for each hand is 33. The distal phalanges numerical are 1, middle phalanges are 2 and proximal
 N.A. Azmir et al. / Procedia Manufacturing 2 (2015) 87 – 91 89

phalanges are 3. The total numerical scoring for each hand will represent the severity stage of vascular and sensori-
neural diseases. The severity stage is in the form of a numerical number with its greater and smaller stage 3 and 0,
respectively for both hands. This assessment was based on the Stockholm Workshop scale for the classification of
HAVS according to grading system.
SPSS v19.0 software were used to calculate the frequencies and means for the hand grip strength as well as hand
numerical scoring values associated with different variables. The data were analyzed using the Pearson correlation
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perform the Chi-square test.

3. Results & Discussion

The personal identification characteristics of 204 hand held grass cutter workers are shown in Table 1. There
were working at two different locations which are highway main line and building facilities. These two groups
indicate that high risk exposure group and low-moderate risk exposure group based on the hand transmitted
vibration duration, respectively. Workers working at highway area are 124 (60.8%) while workers maintaining grass
at facilities area are 80 (39.2%). The majority of workers were in their 20s (50.0%) and 30s (29.4%). Most of the
workers are from foreign country such as Indonesia, Bangladesh and Pakistan. Hundred and thirteen workers had
been exposed to hand arm vibration for less than 2 years. Fifty workers had been exposed to hand transmitted
vibration for more than 4 years, and 41 workers hand been exposed more than 25 months and fewer than 48 months.
Total of two hundred and four workers were working in the landscape and grass maintenance operation services.

Table 1.Personal identification characteristics of workers

Variables Number (%)
Age (years) 20-29 102 (50.0)
30-39 60 (29.4)
40-49 27 (13.2)
50-59 13 (6.4)
60-69 2 (1.0)
Working Location Highway 124 (60.8)
Facilities 80 (39.2)
Working Experience (years) 0-9 191 (93.6)
10-19 10 (4.9)
20-29 3 (1.5)

The hand grip strength force for workers has been classified through worker’s age as shown in Table 2. The right
hand grip force is higher compared to left hand grip force, before and after work indicates the strength of dominant
hand. The group of 20-29 ages has higher grip force since they have been less exposure to hand transmitted
vibration in past while the group of 50-59 ages shows lesser grip force. In addition, the mean total grip force before
work is higher than mean total grip force after work for all the group ages except group 60-69 age. The percentage
of reducing the hand grip force after operation hour is in the range of 5%. In depth, based on the classification of
hand rating associated to grip force and age of workers, it is found that, 92.6% of worker has been experience at risk
hand grip stage (before work). This percentage was increased about 3% after expose to hand transmitted vibration
(after work).

Table 2.The hand grip strength assessment using dynamometer

Before Work (Mean) After Work (Mean)
Age Left (kg) Right (kg) Total (%) Left (kg) Right (kg) Total (%)
20-29 35.39 37.68 73.06 33.43 35.62 69.07
30-39 32.62 34.83 67.47 31.37 32.12 63.47
40-49 31.93 32.48 64.41 27.85 29.93 57.81
90 N.A. Azmir et al. / Procedia Manufacturing 2 (2015) 87 – 91

50-59 25.38 27.08 52.62 25.23 25.31 50.62

60-69 26.50 28.50 55.00 28.50 27.00 55.50
Vascular disorder and sensori-neural disorder were determined by the hand numerical scoring using the
Stockholm Workshop Scale, as shown in Table 3. Above stage 2 there were 172 workers (84.3%) with vascular
disorder in the left hand while 163 workers (79.9%) with vascular disorder in the right hand. As for sensori-neural
disorder, number of workers above stage 2 were 169 (82.8%) and 162 (79.4%) respectively. However, there were
statistical differences between the both hands for the hand numerical scoring data (chi-square test, P < 0.05). The
Pearson correlation of left hand was -0.1 and right hand was -0.26, respectively indicate that is negative relation
between numerical scoring and hand grip strength after work among hand held grass cutter workers.

Table 3.Stockholm workshop scale of HAVS among hand held grass cutter workers
Vascular disorder Sensori-neural disorder
Stage Left (%) Right (%) Stage Left (%) Right (%)
0v 7 (3.4) 7 (3.4) 0 sn 24 (11.8) 27 (13.2)
1v 25 (12.3) 34 (16.7) 1 sn 11 (5.4) 15 (7.4)
2 v (early) 114 (55.9) 97 (47.5) 2 sn (early) 55 (27.0) 52 (25.5)
2 v (late) 55 (27.0) 60 (29.4) 2 sn (late) 111 (54.4) 104 (51.0)
3v 3 (1.5) 6 (2.9) 3 sn 3 (1.5) 6 (2.9)

Prolong vibration exposure due to operation of hand held grass cutter was induced to loss of hand grip strength,
fingers blanching and numbness. This vibration occupational disease supported by the case study result. More than
90% of the workers have at risk stage of hand grip strength according to assessment done. However, there are many
specific cause of this vibration disability due to grass cutting operation such as forcefulness and repetitive of
movement [3]. The hand numerical scoring for vascular disease are at stage 2v (late) indicate frequent attacks of
whiteness effecting the distal and middle (rarely also proximal) phalanges of one or more fingers and usually a
numerical score of 10-16, while for sensori-neural stage 2sn (late) depict persistence numbness or tingling and
reduce sensory perception [9]. It usually an sensori-neural score between 9-16. Furthermore, the correlation between
numerical scoring and grip force are negative, shows no significant between these two effect variables similar to
previous result [10].

4. Conclusion

In conclusion, the numerical scoring and hand grip strength assessment can be used to monitor the health of
worker regarding on the occupational hand transmitted vibration. The grass cutter workers had been exposed to high
severity of vibration that induce to hand disorder. The chronic health effect should be considered when evaluating
the hand disability for industry risk.

Acknowledgements

The authors would like to express special thanks to the Universiti Tun Hussein Onn Malaysia, leading highway
Maintenance Company in Malaysia and National Institute of Occupational Safety & Health, Malaysia for their
assistance support throughout this research.

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