Non binding guide to good practice for implementing Directive

ANNEX F Health Surveillance TechniquesNon binding guide to good practice for implementing Directive 2002/44/EC (Vibrations at Work)Health surveillance may consist of an evaluation of thecase history for a worker in conjunction with a physicalexamination conducted by a doctor or suitably qualifi edhealth-care professional.Questionnaires for whole-body vibration healthsurveillance are available from various sources (e.g. theVIBGUIDE section of:http://www.humanvibration.com/EU/EU_index.htm).The case historyThe case history should focus on:• family history;• social history, including smoking habit and alcoholconsumption and involvement in physical activities;• work history, including past and current occupationswith exposure to whole-body vibration, workingposture, lifting tasks and other work-related backstressors; and• personal health history.The physical examinationThe physical examination might include:• examination of the back function and evaluation ofthe effects on pain of forward and lateral fl exionand extension;• straight leg raising test;• peripheral neurological examination (knee andAchilles tendon refl exes and the sensitivity in legand foot);• signs of muscle weakness (extension quadriceps,fl exion/extension big toe/foot);• back endurance test;• Waddel’s signs of non-organic pain.98