In The Netherlands damage to health due to occupational exposure to shock and vibration is seldom reported. A survey was therefore made of the nature, extent and severity of exposure to shock and vibration. This paper presents the results of an epidemiological study, by questionnaire, among workers using impact power tools. Data were collected about exposure time, symptoms and the subjective workload. A prevalence rate of 17% for symptoms of white finger was found. In the logistic regression symptoms of back pain showed an increased prevalence with increasing total time exposed to vibration. This study shows that exposure to vibration due to working with impact power tools, either alone or in combination with ergonomically bad working conditions, probably contributes to these symptoms. An estimate of the population at risk showed that over 30,000 workers in The Netherlands who use impact power tools are exposed to a vibration intensity of 10-40 m s-2. This intensity exceeds the standards advocated in draft standards in the U.K. (BSI, 1987) and U.S.A. (ACGIH, 1984). The results also provide evidence that in The Netherlands exposure to hand-arm vibration damages health. It is suggested that damage to health due to occupational exposure to vibration is underestimated by the Dutch occupational health services. It was concluded that more investigation is needed to evaluate the precise nature of occupational exposure to vibration in order to provide a basis for its reduction or elimination.

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Impact power tools are still widely used by many professions. Users of these tools are exposed to high levels of both vibration and shock. Reported health effects due to hand-arm vibration are 'hand-arm vibration syndrome' (HAVS) and bone and joint injuries and disorders. In the construction industry a case study was conducted on one specific activity: removing concrete from the head of foundation piles. Pile heads are removed to allow the reinforcement rods to be connected to the rest of the foundation. Factors determining the vibration exposure were measured and the type and size of other occupational hazards were assessed qualitatively. The results showed that there was excessive exposure to vibration from the widely used hand-operated pneumatic drill as well as high exposure to other occupational hazards. The age of the drill, the make, the working pressure and the presence of a buffer ring have measurable effects on the level of vibration. But these adjustments only have a limited effect on the total workload. Instead of an exposure-oriented solution the present workload requires aource-oriented solutions. which are expected to be more effective. A systematic approach towards the generation of possible solutions was adopted following the individual steps of the 'problemsolving cycle', in combination with the design analysis technique. Design analysis is a method which can generate different types of solutions resulting in a reduction of the various hazards to an acceptable level.

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