Physiological methods used in Japan for the diagnosis of suspected hand-arm vibration syndrome

In the pathogenesis of hand-arm vibration syndrome, vibration affects the peripheral system, especially the circulatory, nervous, and musculoskeletal systems. Medical questionnaires, physical examinations, and laboratory tests are used to diagnose the hand-arm vibration syndrome. The laboratory tests are satisfactory diagnostic aids for detecting slight disorders of the peripheral circulatory, nervous, and musculoskeletal systems. Peripheral circulatory function tests include skin temperature measured by a thermistor under specific temperature conditions, the nail compression test, and the cold provocation test (10-min immersion in cold water at 5 or 10 degrees C). To assess peripheral nervous function, tests for the pain and vibration senses are included. Peripheral musculoskeletal function tests consist of grip strength, pinch strength and tapping counts. These physiological tests are applied in worker screening twice a year. These tests have been authorized by the Ministry of Labour since 1973. Several criteria for the tests, although not authorized, are widely used. The diagnostic implication of each separate test may be low. Consequently, some laboratory tests should be evaluated, along with medical questionnaires and physical examinations, in the diagnosis of suspected hand-arm vibration syndrome.