A study on the vibration-dose limit for Japanese workers exposed to hand-arm vibration.

To obtain a vibration-dose limit for Japanese workers exposed to hand-arm vibration, the prevalences of vibration-induced white finger (VWF) and numbness of the hand were studied in 5 different groups of workers exposed to segmental vibration. In addition, the prevalence of primary Raynaud's phenomenon (PRP) in the general population without occupational vibration exposure was computed. The vibration levels in the exposed groups (except chain saw operators) ranged from 124.1-129.2 dB (reference value, 10(-6) m/s2). The prevalence of VWF in these groups was 2.2-4.8%. This value was not statistically significant (p greater than 0.05) when compared to the prevalence of PRP in the general Japanese population (2.7-2.9% in our study and 0.5-4.6% in other surveys in Japan). Although the prevalence of numbness of the hands fluctuated among the groups, no significant differences could be demonstrated. Our results were then compared to those of previous reports by literature study [319 papers on hand-arm vibration syndrome (HAVS) and 25 reports on PRP]. At a glance the Japanese population showed a lower prevalence for PRP compared to other countries, which suggested that exposure to cold and biological abilities should also be considered to assess vibration syndrome. A comparison of the vibration characteristics of different tools and the occurrence of VWF in the hands of workers in the literature with those of our data suggested that a daily hand-arm vibration exposure at a level lower than 2.5 m/s2 (128 dB, reference value 10(-6) m/s2) could possibly decrease the risk of VWF among workers exposed to segmental vibration.     

Vibration-induced multifocal neuropathy in forestry workers: electrophysiological findings in relation to vibration exposure and finger circulation

Objectives: To investigate neural conduction in the upper limbs of symptomatic forestry workers with and without exposure to hand-transmitted vibration. A further aim was to assess the possible relationships between vibration exposure, nerve conduction and finger circulation in the forestry workers who used chain saws. Methods: A detailed neurophysiological investigation was performed on the upper extremities of 20 chain saw workers, 20 forestry operators with heavy manual work but without vibration exposure, and 20 healthy male controls. All subjects were screened to exclude polyneuropathy. Measurements of sensory and motor nerve conduction (velocity and amplitude) were obtained bilaterally from the median, ulnar and radial nerves. To assess peripheral vascular function, the forestry workers underwent a cold test with plethysmographic measurement of finger systolic blood pressure (FSBP). In the chain saw operators, vibration exposure was evaluated according to the International Standard ISO 5349. Indices of daily vibration exposure and lifetime cumulative vibration dose were estimated for each chain saw operator. Results: Sensory nerve conduction in several segments of the median and radial nerves was significantly reduced in the chain saw operators compared with that in the workers doing heavy manual work and the controls. The neurophysiological pattern more frequently observed in the chain saw operators was a multifocal nerve conduction impairment to several neural segments with predominant involvement of sensory rather than motor fibres. Sensory nerve conduction velocities in the hands of the chain saw operators were inversely related to both daily and lifetime cumulative vibration exposures. In the vibration-exposed forestry workers, neither were sensori-motor complaints associated with vascular symptoms (finger whiteness) nor were electrophysiological data related to cold-induced changes in FSBP. Conclusions: Exposure to hand-transmitted vibration, in addition to ergonomic stress factors, can contribute to peripheral nerve disorders occurring in forestry workers who operate chain saws. The findings of this study suggest the existence of an exposure-effect relationship for vibration-induced neuropathy. Different underlying mechanisms are likely to be involved in the pathogenesis of the neurological and vascular components of the hand-arm vibration syndrome. Received: 18 November 1999 / Accepted: 25 April 2000     

Hand arm vibration syndrome among quarry workers in Vietnam

Few studies have focused on the health effects of vibrating tools on workers in the tropical area. Work conditions and health effects related to rock drill operation were studied in 102 quarry workers, including 73 rock drill operators in Vietnam. We aimed to clarify (1) risk of vibration exposure, (2) occurrence of vibration-induced white finger (VWF), and (3) characteristics of hand-arm vibration syndrome (HAVS). Total weighted r.m.s. acceleration of the Chinese -or Russian-made rock drills, was 45-55 m/s(2). According to work observation studies, daily exposure time to vibration was 160-210 min. ISO5349 predicted that this exposure level would be associated with a high risk of HAVS in workers. We found no clear evidence of VWF. There may be several reasons why no worker exhibited VWF: (1) warmer work conditions, (2) younger and less experienced workers, (3) seasonal changes in work operations, and (4) healthy worker effect. On the other hand, 5-10% of rock drill operators might be suffering from moderate HAVS which was sensori-neural type dominant. There may be some characteristic features of HAVS among quarry workers in the tropical area.     

Cold response of digital arteries in chain saw operators

ABSTRACT In a study of vibration-induced white finger (VWF) 39 chain saw operators, being representative of 365 lumberjacks according to a completed questionnaire, underwent clinical investigation. In a medical interview 13 of the 39 had VWF and 26 were without finger symptoms. In the subjects with VWF both hands were equally affected, the third and fourth finger most frequently; the thumbs were always normal. A cold provocation test, measuring the finger systolic blood pressure with a cuff technique during combined body cooling and finger cooling to 30, 15, and 6°C, was applied to the 39 chain saw operators and to 20 age-matched outdoor workers who had not used vibrating hand tools. The finger most often showing Raynaud's phenomenon was cold provoked, and a non-affected finger was used as a reference. The systolic pressure gradient measured at 30°C from the upper arm to the cooled finger was increased in the chain sawyers most severely affected by VWF compared with the control group and with the chain sawyers without VWF (p <0·02). Raynaud's phenomenon was verified by digital arterial closure (zero pressure in the finger) at 15 or 6°C in 12 of 13 chain sawyers having anamnestic and clinical evidence of VWF. Chain sawyers without VWF had an increased digital arterial response to cold at 15 and 6°C compared with the control group (p <0·05) and had a decreased cold response compared with chain sawyers with VWF (p <0·05). In chain sawyers without VWF 13 subjects with an exposure period of 10-23 years had an increased cold response at 6°C compared with 13 subjects with an exposure period of one to three years (p <0·05). Only one of 38 chain saws did not exceed the exposure limit proposed by the International Standardisation Organisation. The results of the present study indicate that vibrations induce hyperresponsiveness to cold in the exposed arteries, even in chain sawyers without finger symptoms. The exposure to vibration therefore should be reduced to eliminate this damage. The presented cold provocation test may be used to diagnose Raynaud's phenomenon and to disclose an abnormal digital arterial cold response before subjective symptoms have appeared.     

Dose-response relation for vascular disorders induced by vibration in the fingers of forestry workers.

OBJECTIVES--To study the relation between the prevalence of vascular disorders (white finger) and vibration exposure in a group of 222 forestry workers, of whom 164 (73.9%) had work experience limited to antivibration (AV) chain saws only and 58 (26.1%) had operated both non-AV and AV chain saws. METHODS--The chain saw operators and 195 control workers never exposed to hand transmitted vibration were interviewed with health and workplace assessment questionnaires. The diagnosis of vibration induced white finger (VWF) was made on the basis of subjective symptoms of finger blanching and the results of a cold test with plethysmographic measurement of systolic blood pressure of the finger. Vibration was measured on a representative sample of AV and non-AV chain saws. Daily vibration exposure was assessed as eight hour energy equivalent frequency weighted acceleration (A(8)). A lifetime vibration dose was estimated for each of the forestry workers. RESULTS--The overall prevalence of VWF among the forestry workers was 23.4%. The diagnosis of VWF was made in 13.4% of the forestry workers who handled only AV chain saws and in 51.7% of those who had also operated non-AV chain saws in the past. Raynaud's phenomenon was found in 2.6% of the controls. In the forestry workers, the risk for VWF showed positive increments with each increment of vibration dose, suggesting a monotonic dose-response relation. The responsiveness to cold in the digital arteries of the forestry workers was also found to increase with increasing vibration dose and severity of VWF. The estimated relation between VWF and vibration exposure showed that the expected prevalence of VWF increased almost linearly to either A(8) (with exposure duration unchanged) or the number of years of exposure (with equivalent acceleration unchanged). CONCLUSIONS--In this study of VWF among forestry workers, the estimated dose-response relation showed that if the magnitude of vibration acceleration is doubled, the total duration of exposure should be halved to produce an equivalent effect. On the basis of the assessment of vibration exposure, the estimated risk for VWF in the study population was found to be lower than that predicted by the international standard ISO 5349. These findings suggest a revision of the risk estimates for VWF currently provided by ISO 5349.     

Hand-arm vibration syndrome with use of anti-vibration chain saws: 19-year follow-up study of forestry workers

Objectives: Hand-arm vibration syndrome (HAVS) consists of vascular and neurological component. Musculoskeletal component has not been delineated yet. In the present follow-up study, we evaluated the prevalence of HAVS and the cumulative exposure to vibration among a cohort of forestry workers. Special interest was given to numbness and musculoskeletal disorders of upper extremity and neck in forestry workers. Methods: A follow-up study starting from 1976 was conducted among forestry workers in Suomussalmi in Finland. Total exposure of hand-arm vibration was recorded during 11 cross-sectional surveys. The last study was carried out in 1995. The lifetime dose of vibration energy was calculated. A cohort of 52 forest workers participated to all 11 cross-sectional surveys 1976–1995. HAVS and musculoskeletal disorders were evaluated. Results: The prevalence of active vibration white finger (VWF) decreased from 13 to 4% in the cross-sectional study. In the cohort VWF decreased from 17 to 8% and numbness increased from 23 to 40%. Rotator cuff syndrome (P=0.034) and epicondylitis (P=0.004) associated with numbness. Regional neck pain was diagnosed in 38% of workers and associated with low back pain. In modeling VWF, the lifelong vibration energy (OR 1.03, CI 1.01–1.05), and smoking (OR 7.36, CI 1.07–50.76) were significant. Numbness was modeled by pain in upper extremities (OR 12.43, CI 2.42–63.80) and neck pain (5.97, CI 1.25–28.39), not by lifelong vibration energy. Right rotator cuff syndrome was modeled by age (OR 2.58, CI 1.04–6.41) and lifelong vibration energy (OR 1.04, CI 1.00–1.07). Conclusions: The prevalence of VWF constantly decreased. Numbness did not follow the vibration exposure profile. Numbness also associated with upper extremity musculoskeletal disorders. Hand-arm vibration associated with the right rotator cuff syndrome in forestry workers.     

Normative data for neuromuscular assessment of the hand–arm vibration syndrome and its retrospective applications in Korean male workers

Purpose

The purpose of this study was to describe normative data for the neuromuscular assessments of the hand–arm vibration syndrome (HAVS) in Korean.

Methods

Data for the vibrotactile perception threshold (VPT) at three frequencies (31.5, 125, and 250 Hz), the hand grip strength (HGS), the finger pinch strength (FPS), the finger tapping test, and the Purdue pegboard tests were collected from 120 male office workers aged 30–59 years with no prior history of regular use of handheld vibrating tools. The collected data were compared with the results of a similar study of shipbuilding workers in order to investigate the diagnostic utility of clinical test for HAVS.

Results

The mean VPT values indicate that no significant differences were observed between the dominant and non-dominant hands or between the index and little fingers. The age group of 30s was highly sensitive to vibration input with a peak in sensitivity at 125 Hz among all age groups. In neuromuscular performance, dominant hands are usually more accurate, dexterous, and functionally quicker than non-dominant hands. The index finger was superior to the little finger in the finger tapping counts (p < 0.05). Also, FPS was greater in the index finger than in the middle finger (p < 0.05). The HGS of dominant hands was significantly stronger than that of non-dominant hands (p < 0.05). When the normative data were compared with the data of shipyard workers exposed to vibration, there were statistically significant differences in VPT and neuromuscular functions.

Conclusions

The current data can be used to evaluate HAVS in Korean male workers. Age is an important factor for VPT.     

A longitudinal study of finger systolic blood pressure and exposure to hand-transmitted vibration

Objectives

To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools.

Methods

Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: $ \text{dose} = \sum a_i^m t_iObjectives To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools. Methods Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: , where a _i is the acceleration magnitude on tool i, t _i is the lifetime exposure duration for tool i, and m = 0, 1, 2 or 4. Results Among the HTV workers, the initial prevalence and the 1-year incidence of VWF were 18.1 and 1.7%, respectively. At the first examination, the HTV workers with moderate or severe score for VWF showed a significantly increased cold reaction in the fingers when compared with the controls and the HTV workers with no vascular symptoms. At the follow-up, the controls, the asymptomatic HTV workers, and the prevalent cases of VWF did not show significant changes in the cold response of digital arteries. A deterioration of cold-induced digital vasoconstriction was found in the incident cases of VWF. In the HTV workers, vibration doses with high powers of acceleration (i.e., with m > 1) were major predictors of the vasoconstrictor response to cold at the follow-up examination. Conclusions The measurement of FSBP after local cooling may be a helpful objective test to monitor prospectively the change in vibration-induced vascular symptoms. The findings of this longitudinal study suggest a dose–effect relationship between cold-induced digital arterial hyperresponsiveness over time and measures of cumulative vibration exposure. In the controls, the cold response of the digital arteries was stable over 1-year follow-up period. Work presented at the second International Workshop 2006 on Diagnosis of Hand–Arm Vibration Syndrome in G?teborg, Sweden.     

Vibration injuries in Norwegian forest workers

Hellstrm, B., and Lange Andersen, K. (1972).Brit. J. industr. Med.,29, 255-263. Vibration injuries in Norwegian forest workers. A free medical examination with compensation for lost earnings was offered to the forest workers in three areas of eastern Norway. Sixty-six per cent attended (413 workers, of whom 296 used chain saws). The prevalence of Raynaud's phenomenon (RP) was 47% in chain saw operators, 14% in forest workers not exposed to vibration, and 9% in 302 indoor workers not exposed to vibration. The high prevalence of RP in chain saw operators was attributed to a traumatic vasospastic disease (TVD). The average time of latency was eight years. The standard symptoms of TVD were attacks of blanching and numbness. Cyanosis and pain occurred rarely. In subsamples, measurements of tactile two-point discrimination and maximal isometric muscle strength (hand grip and finger pressure) as well as x-ray examinations of the wrists and the hands gave no evidence of vibration injury to peripheral nerves, muscles, bones, or joints.     

Diagnosis of vascular injuries caused by hand-transmitted vibration

Objective

For a reliable objective diagnosis of vascular injuries in hand-arm vibration syndrome (HAVS), the standardized cold provocation tests—finger skin temperature measurement during hand(s) immersion in cold water (FST test) and finger systolic blood pressure measurement during local cold exposure (FSBP test)—are widely used. In recent years there is a growing controversy regarding the diagnostic value of these tests. The aim of this study was to describe particularly the diagnostic performance of FST and FSBP tests, and also to focus on the problems and uncertainties regarding the test conditions and results, in the laboratory diagnosis of vascular injuries caused by hand-transmitted vibration.

Method

A review of pertinent published English- and Japanese-language articles and conference proceedings (between 1976 and 2006) was conducted.

Results

From the reports with regard to diagnostic significance of the FSBP test, it seems to be an important laboratory test for diagnosing vibration-induced white finger (VWF). On the other hand, despite a large number of research studies with the FST test, there is a lack of data for the standardized FST test, which can confirm the value of it in diagnosing VWF. Moreover, there is no agreement on effective parameter/s to quantify and compare the responses in FST induced by immersion in cold water. While assessing and staging vascular injuries in HAVS, inquiry regarding finger coldness appears to be useful.

Conclusions

As there is no single test with satisfactory diagnostic ability for VWF, at present it is reasonable to use the cold provocation tests as a part of the comprehensive approach to evaluate HAVS patients. In addition to the objective methods, the index of finger coldness may be useful while diagnosing the vascular component of HAVS.

     

Follow up study of vibration induced white finger in chain saw operators

The current status of subjects with vibration induced white finger (VWF) was observed in order to follow up the natural course of VWF after the use of chain saws had ceased. The prevalence rate of VWF after the use of chain saws had ceased in all time periods fell to 50.2% after more than 12 years' observation. There was a pronounced tendency for the percentage prevalence to rise as the vibration exposure periods after VWF occurred increased, and a similar pattern was observed concerning the exposure periods before VWF occurred. Numbness of hands and arms takes longer to recover than VWF.     

Follow up study of vibration induced white finger in chain saw operators.

The current status of subjects with vibration induced white finger (VWF) was observed in order to follow up the natural course of VWF after the use of chain saws had ceased. The prevalence rate of VWF after the use of chain saws had ceased in all time periods fell to 50.2% after more than 12 years' observation. There was a pronounced tendency for the percentage prevalence to rise as the vibration exposure periods after VWF occurred increased, and a similar pattern was observed concerning the exposure periods before VWF occurred. Numbness of hands and arms takes longer to recover than VWF.     

A prospective study of the cold response of digital vessels in forestry workers exposed to saw vibration

Objectives: To investigate the occurrence of vibration-induced white finger (VWF) and the cold response of digital vessels in a group of 68 forestry workers who underwent a first clinical examination in 1990 and were then reexamined in 1995. Methods: The forestry workers were divided into three groups: group A (n = 27), active workers who did not have VWF in␣1990 and continued to use chain saws; group B (n = 29), workers who did not have VWF in 1990 and retired before 1995; and group C (n = 12), active or retired workers who had VWF in 1990. The subjects underwent a medical interview, a complete physical examination, and a cold provocation test, which were performed by the same physicians at both surveys. The cold test consisted of measurement of the finger systolic blood pressure (FSBP) after local cooling to 10 °C, expressed as a percentage of the pressure recorded at 30 °C (FSBP%_10°). Results: Three new cases of VWF occurred during the follow-up period among workers who had used only antivibration (AV) chain saws. The vasoconstrictor response to cold was unchanged in group A and improved in group B (P < 0.001). A significant decrease in VWF symptoms and abnormal response to cold was observed in group C (P < 0.05). As a result of preventive measures curtailing saw usage time in the VWF workers, the daily vibration exposure in group C was lower in 1995 than in 1990 (P = 0.02). In the retired workers, FSBP%_10° was positively related to the time since the cessation of work with chain saws (P < 0.01). Conclusions: The findings of this follow-up study indicate that a reduction in or cessation of exposure to vibration has a beneficial effect on finger-blanching symptoms and the cold response of digital vessels. The occurrence of new cases of VWF in subjects whose work experience was limited to AV chain saws argues for the maintenance of health surveillance in these workers. Received: 16 March 1998 / Accepted: 12 June 1998     

接振时间与作业工人手部症状及振动性白指之间相互关系的研究

按照实际接振时间，将３５例振动性白指患者和１８１各接振作业工人进行了分组，分别统计和比较各组手部症状的发五率。结果表明，接振组随接振时间的延长，各项手部症状逐涟增多，在接振时间为５００１－７５００ｈ时增多最为显著，而此时正是振动性白指的高发时段；随着接振时间的延长，白指组与接震组各手部症状发生率的差异逐渐减小。     

Prevalence of vibration-induced white finger and assessment of vibration exposure among travertine workers in Italy

Summary Among 76 stonedrillers and stonecutters/chippers working in the Rapolano travertine quarries (Tuscany, Italy), 27 subjects (35.5%) were affected with vibration-induced white finger (VWF). The median latent period for VWF was ten years (range 0.1–26 years). A VWF prevalence of 8% was found among 60 comparable controls (P < 0.0001). Vibration measurements showed that the frequency-weighted accelerations for two rock-drills and two small chipping hammers ranged from 19.7 to 36.4 m/s². Weighted accelerations between 2.4 and 4.1 m/s². were measured on the handles of a vertical grinder and a hand cutter. Vibration data, daily exposure time and total duration of exposure period were used to calculate two indicators of vibration dose such as the four-hour, energy-equivalent, frequency-weighted acceleration (m/s²) and the vibration exposure level (dB). A significant association between the vibration exposure level and the severity of VWF stages was observed among the travertine operators. The dose-effect relationship proposed by ISO 5349 was not suitable for the data of the present study because it overestimates the risk due to hand-transmitted vibration in the travertine workers. Finally, the results of a cold test indicated that the rewarming time of fingertips to room temperature was more prolonged in the operators with VAT than in those without VWF and in the controls.     

A follow up study of vascular disorders in vibration-exposed forestry workers

Objectives To investigate the occurrence of vibration-induced white finger (VWF) and the cold response of digital arteries in a group of forestry workers, most of whom had used anti-vibration (AV) chain saws solely. Methods One hundred and twenty-eight forestry workers underwent initially a medical examination and a standardized cold test with measurement of the change in finger systolic blood pressure after finger cooling from 30 to 10°C (FSBP%_10°). They were re-examined two or three times over the calendar period 1990–1999. Seventy-one forestry workers were active over the entire follow up period, while 57 retired after 1–8 years from the initial investigation. Results The initial prevalence and the cumulative incidence of VWF over the follow up period were 26.6 and 11.7%, respectively. In the retired workers, the new cases of VWF occurred before their retirement, that is when they were still active. There were no significant changes in FSBP%_10° in the active forestry workers over the follow up period. A significant increased in FSBP%_10° (i.e. improvement) was observed in the retired workers at the end of the follow up. FSBP%_10° at the cross-sectional investigation was significantly lower in the forestry workers who developed VWF during the follow up than in those who never experienced finger blanching over the study period. Conclusion The findings of this follow up study suggest that forestry workers with work experience limited to AV chain saws are still at risk of developing VWF. Cessation of vibration exposure in the retired workers was associated with a beneficial effect on the cold response of digital arteries. Cold-induced digital arterial hyperresponsiveness at the initial investigation was a predictive factor for the onset of VWF over time.     

A follow up study of vibration induced white finger in compensation claimants

Aims: To follow up vibration induced white finger (VWF) in a selected group of 73 vibration exposed workers who claimed unsuccessfully for VWF compensation at a first examination.

Methods: The VWF claimants were sent to our unit by the National Insurance Institute. The basic compensatory criteria included a positive history of VWF and abnormal cold response of the digital arteries. Following the first unsuccessful examination, over a mean time period of 4.1 (range 1–11) years the National Insurance Institute requested a second examination for all 73 claimants and a third examination for 29. During the follow up period, all subjects continued to work with vibratory tools.

Results: There were 14 new cases who reported white finger during the follow up period. In the new VWF cases, finger blanching attacks became visible after about 3.5 years since the first examination. All incident cases of anamnestic VWF showed an abnormal cold response in the digital arteries and obtained compensation according to the basic compensatory criteria. In the entire sample of VWF claimants, there was a discrepancy between positive history of VWF symptoms at medical interview (55%) and abnormal cold provocation outcomes (19%). Digital arterial hyperresponsiveness to cold was associated with both VWF symptoms and the duration of vibration exposure since the first examination. Over the follow up period, a significant increase in the vasoconstrictor response to cold was observed in the vibration exposed workers with no symptoms of finger whiteness. Abnormal cold response was not associated with either age or smoking habit.

Conclusions: Cold test measuring finger systolic blood pressure may be considered a useful laboratory method to confirm objectively VWF symptoms and to disclose abnormal cold induced vasoconstrictor response in vibration exposed workers with a negative history of VWF. Medical interview outcomes should be interpreted with caution in medicolegal situations involving VWF claimants.

     

A case-control study on the prognosis of vibration syndrome

A case-control study was undertaken to evaluate some factors affecting the prognosis of vibration-induced white finger (VWF), 286 workers, who had used a chain saw in forests and had showed some symptoms and signs that were suspected to be vibration syndrome during some of the years from 1956 to 1980, were selected by medical examinations from a total of 612 forestry workers, and were divided into four groups according to the prognosis of the VWF based on a twenty-year follow-up. The study shows an association between the prognosis of VWF and vibration components, particularly vibration levels, severity of the syndromes not only in peripheral circulation but also in peripheral neuropathy before exposure to vibration ceased. There are also significant associations between the prognosis of peripheral neuromuscular symptoms and the factors of aging and duration of exposure. The study suggests that smoking habits and history of heart failure and diabetes had no effect on the prognosis of VWF.     

Preliminary evaluation of dose-effect relationships for vibration induced white finger in Japan

Summary Habitual use of many vibrating tools has been found to be connected with the appearance of various disorders affecting the blood vessels, nerves, bones, joints, muscles or connective tissues of the hand and forearm. The vibration exposures required to cause these diseases are not known exactly, either with respect to vibration intensity and the vibration frequency spectrum, or with respect to daily exposure time and total exposure period. The purpose of this study is to investigate available data on the physical conditions in Japan that have caused vibration induced white finger (VWF) and attempt to establish approximate relationships between vibration conditions and prevalence of VWF. The vibration conditions were evaluated using the method of vibration assessment recommended by the International Standardized Organization, which uses the weighted vibration level of the frequency weighted, dominant, single axis component of vibration directed into the hand. A clear correlation between level, prevalence of VWF and exposure period can be found. The results also suggest the relationship between the weighted levels and latent intervals. These dose-effect relationships enable the prediction of the average latent interval for a population group and the range of progression of the disorders—all from a measurement of the vibration entering the hands. In Japanese cases, 4, 8, and 15% of VWF prevalence correspond with 10, 20, and 40% of VWF prevalence in the Draft International Standard ISO/DIS 5349 (1982) within the weighted vibration level range of 2 to 50m · s^¨.     

Occupational hand–arm vibration syndrome in Korea

Objectives: It is suspected that there is a large number of patients suffering from hand–arm vibration syndrome (HAVS) in Korea. However, no cases have been reported since 1992. This study was conducted to identify HAVS cases and determine the characteristics of the syndrome. Methods: In April 2001, the Busan, Ulsan, and Gyeong-Nam Province Occupational Disease Surveillance System (BUGODSS) was established to identify work-related HAVS and other occupational diseases. In the 2 years of this project, occupational physicians from five hospitals in these provinces collected information by way of interviews and questionnaires during mandatory occupational medical examinations. Among the initial 189 suspected HAVS cases, 58 volunteers were given cold-water provocation tests in order to diagnose the vascular component of the disorder. Results: One hundred fifty-four approximately occupational HAVS cases were identified from ca. 21,000 workers. One hundred fifty about of these cases were male. The cases were most often found in workers from the shipbuilding industry, and the grinder was the most common source of vibration exposure. Cases of sensorineural disorder (SD) were more common than cases of vascular disorder (VD). The mean values of the finger skin temperature and its recovery rate at 5 min and 10 min after cold-water provocation were significantly lower in the group with the VD than in the group with the SD. Conclusions: We identified 154 occupational HAVS cases, although no cases have been reported during the occupational medical examinations mandated by the state. The majority of the cases were in workers that used grinders in the shipbuilding industry. We determined that peripheral VD and peripheral SD can progress independently of each other. We conclude that exposure to hand-transmitted vibration (HTV) and HAVS cases are common in shipbuilding industry in Korea. The recovery rate of finger skin temperature after cold-water provocation is one of the useful methods for diagnosing the vascular component of HAVS.