Whole-body vibration and musculoskeletal diseases in professional truck drivers

Abstract Background: Most occupational diseases do not fit the paradigm of medical interpretation of the health-disease process based on linear causality, in which it would be possible to find a single cause for each type of disease. Objectives: to conduct a systematic review in order to investigate the association between whole-body vibration (WBV) and musculoskeletal disorders (MSD) in professional truck drivers (PTD). Methods: The scientific databases of PubMed, Cochrane, Lilacs and Scielo were used to collect articles published from 2000 until the present time. Two independent reviewers adopted inclusion and quality criteria to evaluate the selected articles. Results: From adopted inclusion and quality criteria, nine articles were chosen to identify the association between MSD and WBV in PTD. The results showed that MSD seems to be closely associated to exposure to WBV in these workers, mainly due to high prevalence and symptoms of low back pain. Two cohort studies showed exposure to WBV as risk for MSD. Only one, with case-control design, did not show WBV as a significant factor. Conclusions: In this study the importance of exposure analysis of WBV in the occurrence of MSD in PTD was elucidated. This study showed the importance of WBV exposure analysis on the occurrence of MSD in PTD. There is adequate information to provide rationale for the reduction of WBV exposure to the lowest possible level, to ensure the health of these workers. Studies with a greater power of investigation, of a prospective, design, should be encouraged, supplanting those only of association.

## 摘要
### 背景
多数职业病并不契合基于线性因果关系的健康-疾病过程医学解读范式——此类范式主张每种疾病均可找到单一病因。
### 目的
开展系统综述，探究职业卡车司机（PTD）的全身振动（WBV）暴露与肌肉骨骼疾病（MSD）之间的关联。
### 方法
检索PubMed、Cochrane、Lilacs及Scielo四大科学数据库中2000年至今发表的相关文献，由2名独立评审员依据纳入标准与质量评价准则对筛选出的文献进行评估。
### 结果
依据纳入标准与质量准则，最终纳入9篇文献以分析职业卡车司机肌肉骨骼疾病与全身振动暴露的关联。结果显示，此类劳动者的肌肉骨骼疾病似乎与全身振动暴露密切相关，其中以腰痛的高患病率与典型症状最为突出。两项队列研究表明，全身振动暴露是肌肉骨骼疾病的危险因素；仅1项采用病例对照设计的研究未发现全身振动为显著影响因素。
### 结论
本研究阐明了职业卡车司机全身振动暴露分析在肌肉骨骼疾病发生中的重要性。本研究证实，为保障此类劳动者的健康，需将全身振动暴露降至尽可能低的水平，相关研究结果可为该防控举措提供理论依据。未来应鼓励开展效力更强的前瞻性研究，以替代仅关注关联分析的现有研究。