Hand-Arm Vibration (NIOSH Criteria) questions for the ASP

Question 1

An occupational health nurse reviews nerve conduction tests for a quarry worker who uses a hand-held rock drill every day and reports numb fingers. Testing shows slowed conduction in the median nerve but a normal ulnar nerve in the same hand. The nurse is deciding whether vibration alone can be assumed to explain the finding. Based on the guidance, what is the best interpretation?

1. AThe result suggests a cause other than direct vibration effects, because both nerves would be expected to be affected in users of hand-held vibrating tools
2. BThe result confirms HAVS Stage 3, because single-nerve slowing is the defining sign of that stage
3. CThe result is consistent with vibration exposure, because only the nerve nearest the tool handle would be expected to be affected
4. DThe result rules out any neural involvement, because vibration injury never produces slowed nerve conduction

Question 2

A foundry left its pneumatic chipping hammer operators in a vibration-exposure program that includes periodic medical examinations. Eighteen months after leaving the company, a former operator develops numbness and blanching in his fingers. He sends the foundry a signed written consent naming his private physician and asks that the physician be given his preplacement and periodic medical examination records. The HR manager says the company has no duty to release records to a non-employee or to an outside doctor. What is the correct response under the recommended standard?

1. AProvide the records on request for examination and copying to the physician, because the former worker gave specific written consent
2. BRelease only a one-page summary of the findings, because full copies are limited to compliance officers
3. CRelease the records only to the former worker personally, because an outside physician is a third party even with written consent
4. DRefuse, because only current workers are entitled to examine their medical records

Question 3

A machine shop hires a worker with no prior vibrating-tool experience and no hand or circulation complaints. The job requires daily use of an impact wrench and a pneumatic grinder. The shop manager proposes giving the worker no medical exam until the first annual periodic exam, saying a healthy new hire has nothing to compare against. Which response is consistent with the NIOSH recommended standard?

1. ASkip the preplacement exam because the worker is asymptomatic and has no prior vibration exposure, and start with the annual exam
2. BConduct a preplacement medical examination for this worker before the job starts, because the results become the baseline for comparing later periodic exams
3. CDelay the first exam until the worker reports numbness, tingling, or finger blanching, since a baseline is only useful when symptoms exist
4. DLimit preplacement exams to workers who report prior vibrating-tool use, since only they have exposure history to document