We quantified the effect of vision, pressoreceptor function and proprioception on the postural stability at different ages. Altogether 212 healthy volunteers (ages from 6 to 90 years) were examined by using a computerised force platform. The sway velocity (SV) was measured with eyes open and eyes closed during quiet stance on a bare platform and a foam plastic covered surface. In addition, to study the proprioceptive system, pseudorandom vibration perturbation was applied on the calf muscles. The SV showed a U-shaped curve: the children and the oldest swayed most. Equilibrium was most stable around 50 years. The visual system was of most importance for balance control in the old. The children were sensitive of pressoreceptor and proprioceptive perturbation, indicating the importance of these systems for their postural control.

Ten competition shooters were tested during simulated race using the force platform technique to investigate the effect of training on postural stability. The shooters were tested at 30-min intervals during a race simulating actual race conditions. Sway velocity was calculated during 27-second periods. The postural stability was evaluated with and without competition clothing. The shooters had significantly better stability than untrained control subjects, when tested without supportive clothing. The competition clothing reduced the sway velocity further both in visual and nonvisual conditions. The Romberg quotient was higher in shooters than in normal controls, indicating that the shooters used to an increased amount proprioceptive and vestibular cues to stabilize their posture. The good postural stability of the shooters apparently results from assiduous training aimed to improve postural stability.

A longitudinal study of hearing loss was conducted among a group of lumberjacks in the years 1972 and 1974-8. The number of subjects increased from 72 in 1972 to 203 in 1978. They were classified according to (1) a history of vibration-induced white finger (VWF), (2) age, (3) duration of exposure, and (4) duration of ear muff usage. The hearing level at 4000 Hz was used to indicate the noise-induced permanent threshold shift (NIPTS). The lumberjacks were exposed, at their present pace of work, to noise, Leq values 96-103 dB(A), and to the vibration of a chain saw (linear acceleration 30-70 ms-2). The chain saws of the early 1960s were more hazardous, with the average noise level of 111 dB(A) and a variation acceleration of 60-180 ms2. When classified on the basis of age, the lumberjacks with VWF had about a 10 dB greater NIPTS than subjects without VWF. NIPTS increased with the duration of exposure to chain saw noise, but with equal noise exposure the NIPTS was about 10 dB greater in lumberjacks with VWF than without VWF. With the same duration of ear protection the lumberjacks with VWF consistently had about a 10 dB greater NIPTS than those without VWF. The differences in NIPTS were statistically significant. The possible reason for more advanced NIPTS in subjects with VWF is that vibration might operate in both of these disorders through a common mechanism-that is, producing a vasoconstriction in both cochlear and digital blood vessels as a result of sympathetic nervous system activity.Subjects exposed to occupational vibration are also often exposed to excessive noise levels. In laboratory experiments noise has been shown to assist the vasosconstriction produced by vibration,' probably by activating the sympathetic nervous system. Simultaneous exposure to vibration also seems to act synergistically with noise to cause a noiseinduced permanent threshold shift (NIPTS).2 3The frequency range,4 intensity,5 duration,6 and impulse characteristics of the noise7 are physical properties related to the vulnerability to noise. It has been suggested that the variability in the effect of noise on different subjects depends on differing hair cell metabolism or differing blood flow characteristics8 or middle ear mechanisms and anatomical factors9 or both.An overactive sympathetic vasoconstrictor reflex

A detailed analysis of risk factors for the development of sensory-neural hearing loss (SNHL) was carried out on 122 forest workers. These forest workers were selected from a larger group (n = 217) by restricting the age range to 30-55 years. The hearing threshold of the left ear at 4000 Hz was measured and the effect of age, exposure, systolic and diastolic blood pressure (DBP), presence of vibration-induced white finger (VWF), tobacco smoking and use of earmuffs were evaluated in multiple linear regression analysis. Robinson's nonlinear model was used to evaluate the rate of hearing loss. Aging was the major risk factor and it explained 15.4% of the variance of the SNHL. The presence of VWF was the second most important single risk factor and explained a further 5.2% of the SNHL. Elevation of DBP correlated significantly with SNHL and explained an additional 4.1% of the SNHL. These main factors were able to explain about 26% of the spread of SNHL. Additional factors in the analysis, e.g. smoking, systolic blood pressure, did not significantly contribute to the genesis of SNHL. When Robinson's model was applied to the SNHL data, on a group basis, we did not observe any exaggerated risk of hearing loss due to combination of noise and vibration. In combined exposure subjects with VWF as well as subjects with enhanced DBP will run a higher risk for SNHL.

Measurements of bone lead concentrations in the tibia, wrist, sternum, and calcaneus were performed in vivo by x ray fluorescence on active and retired lead workers from two acid battery factories, office personnel in the two factories under study, and control subjects. Altogether 171 persons were included. Lead concentrations in the tibia and ulna (representative of cortical bone) appeared to behave similarly with respect to time but the ulnar measurement was much less precise. In an analogous fashion, lead in the calcaneus and sternum (representative of trabecular bone) behaved in the same way, but sternal measurement was less precise. Groups occupationally exposed to lead were well separated from the office workers and the controls on the basis of calculated skeletal lead burdens, whereas the differences in blood lead concentrations were not as great, suggesting that the use of concentrations of lead in blood might seriously underestimate lead body burden. The exposures encountered in the study were modest, however. The mean blood lead value among active lead workers was 1-45 pmol l1 and the mean tibial lead concentration 21 1 pg (g bone mineral)-'. posure. Calcaneal lead concentration, by contrast, was strongly dependent on the intensity rather than duration of exposure. This indicated that the biological half life of lead in calcaneus was less than the seven to eight year periods into which the duration of exposure was split. Findings for retired workers clearly showed that endogenous exposure to lead arising from skeletal burdens accumulated over a working lifetime can easily produce the dominant contribution to systemic lead concentrations once occupational exposure has ceased.Lead is a widely used toxic metal that accumulates in the body. It is concentrated in bone, which contains over 90% of the body burden in adults.' Occupational exposure to lead is routinely monitored by determination of blood lead concentrations, which largely reflect recent average exposure as the half life of lead in blood is of the order of 35 days.2 Blood lead concentration has been shown to be associated with indicators of adverse effects on haem synthesis, such as free erythrocyte protoporphyrin,' and with neurophysiological4 and psychological effects.56The relation between blood lead concentration and exposure is, however, not necessarily linear7 and, in particular, it has been recognised that in a model of a skeletal subcompartment, the lead should be considered readily exchangeable and constitute an intrinsic source of lead input to the blood.