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<p>The scientific justification provided by the BMAS for a new occupational disease, ‘lesion of the rotator cuff of the shoulder due to long-term and intensive strain from overhead work, repetitive movements in the shoulder joint, exertion of force in the shoulder area from lifting loads or hand-arm vibrations,’ includes damage caused by hand-arm vibrations (HAV). This is based on epidemiological studies. There are no human or animal studies on the effect of HAV on shoulder joint structures and no pathogenetic explanations.</p><p>A systematic review (Seidler et&#xa0;al. [<CitationRef CitationID="CR15">15</CitationRef>]) is cited as a basis. It refers in particular to van der Molen et al. [<CitationRef CitationID="CR23">23</CitationRef>].</p><p>The threshold for HAV for occupational disease recognition of rotator cuff lesions is not comprehensible. It does not appear to be consistent with the primary literature: The cohort study by Dalbøge et&#xa0;al. [<CitationRef CitationID="CR4">4</CitationRef>] estimates a doubling of risk with moderate vibration acceleration. Taking other studies into account, the risk was OR = 1.6 (1.4–1.8), and in van der Molen et&#xa0;al. [<CitationRef CitationID="CR23">23</CitationRef>] it was OR&#xa0;1.34 (1.01–1.77). The case-control study (Seidler et&#xa0;al. [<CitationRef CitationID="CR14">14</CitationRef>]) showed the highest risk OR = 3.20 (1.72–5.96).</p><p>The energy transfer from the hands to the rotator cuff, which weakens considerably along its course, is not discussed (Xu et&#xa0;al. [<CitationRef CitationID="CR27">27</CitationRef>]). Only about a quarter of the vibration energy reaches the shoulder from the measuring point on the hand.</p><p>Insufficiently substantiated causes and inadequate quantification of risks are leading primary prevention for the prevention of occupational diseases in the wrong direction.</p>

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Zur wissenschaftlichen Begründung des Ärztlichen Sachverständigenbeirats zur Läsion der Rotatorenmanschette durch Hand-Arm-Vibrationen

  • 期刊论文

  • 发表日期：

    2025年10月28日

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  • Bernd Hartmann,
  • Gunter Spahn,
  • Michael Spallek,
  • Michael Meyer-Clement

摘要

The scientific justification provided by the BMAS for a new occupational disease, ‘lesion of the rotator cuff of the shoulder due to long-term and intensive strain from overhead work, repetitive movements in the shoulder joint, exertion of force in the shoulder area from lifting loads or hand-arm vibrations,’ includes damage caused by hand-arm vibrations (HAV). This is based on epidemiological studies. There are no human or animal studies on the effect of HAV on shoulder joint structures and no pathogenetic explanations.

A systematic review (Seidler et al. [15]) is cited as a basis. It refers in particular to van der Molen et al. [23].

The threshold for HAV for occupational disease recognition of rotator cuff lesions is not comprehensible. It does not appear to be consistent with the primary literature: The cohort study by Dalbøge et al. [4] estimates a doubling of risk with moderate vibration acceleration. Taking other studies into account, the risk was OR = 1.6 (1.4–1.8), and in van der Molen et al. [23] it was OR 1.34 (1.01–1.77). The case-control study (Seidler et al. [14]) showed the highest risk OR = 3.20 (1.72–5.96).

The energy transfer from the hands to the rotator cuff, which weakens considerably along its course, is not discussed (Xu et al. [27]). Only about a quarter of the vibration energy reaches the shoulder from the measuring point on the hand.

Insufficiently substantiated causes and inadequate quantification of risks are leading primary prevention for the prevention of occupational diseases in the wrong direction.