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Risk assessment of vibration exposure and white fingers among platers
Authors:Tohr Nilsson  Lage Burström  Mats Hagberg
Affiliation:(1) Department of Occupational Medicine, S-85186 Sundsvall, Sweden;(2) National Institute of Occupational Health, S-90006 Umeå, Sweden;(3) Division of Work and Environmental Physiology, National Institute of Occupational Health, S-17184 Solna, Sweden
Abstract:Summary The dose-response relationship between vibration exposure and vascular disorders in the hands was examined in platers. The study was based on a cross section of 89 platers and 61 office workers divided according to exposure to vibration into four groups. Vibration exposure was assessed by measuring the acceleration intensity on a sample of tools, together with both subjective rating and objective measurements of the exposure time. The frequency-weighted energy equivalent acceleration for 4 h was 4.6–4.7 m/s2. The point prevalence of white fingers was 42% for the plater category currently exposed with an odds ratio of 85. The time laps before contraction of white fingers (latency time) was four years for the 10th percentile, and was shorter than predicted according to the ISO-5349 standard. The prevalence of white finger symptoms staged according to the Taylor-Pelmear scale was comparable to the prevalences according to the Stockholm Workshop Scale. Vibration exposure was the dominant source of white fingers and each year of vibration exposure increased the odds ratio for white fingers by 11%. Distal circulation in the hands was assessed by a timed Allen test. The odds ratio for a positive Allen test was higher for the workers exposed to vibration compared to the non-exposed workers. The use of the timed Allen test is suggested in the clinical examination for vibration white fingers. The observed high risk for contracting white fingers could be prevented by exposure level reduction and/or restriction of exposure duration.
Keywords:Hand-arm vibration syndrome  White fingers  Allen test  Symptom staging  Dose-response
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