Significance of finger coldness in hand-arm vibration syndrome.

OBJECTIVES To evaluate the relationship between subjective symptoms of coldness in fingers and peripheral circulation in patients with hand-arm vibration syndrome (HAVS). METHODS Thirty-five male patients confirmed to have HAVS as an occupational disease took part in this study. Their mean age was 62 years (SD 5) and all were chain-saw operators exposed to vibration for an average of 25 years. Their annual health examination included the history of their daily habits (smoking, drinking, and therapeutic exercise), report of subjective symptoms such as coldness, numbness and tingling in the fingers, and a physical examination; laboratory tests consisted of skin temperature measurement, and pain and vibration perception under conditions of cold provocation. A frequently used method of cold provocation, immersion of the left hand up to the wrist in water of 10°C for 10 min, was used. RESULTS Finger coldness was classified into 3 groups according to its severity: mild group (n=8), moderate group (n=17) and severe group (n=10). There was no significant difference in age or occupational background between the groups. A significant association was found between finger coldness and prevalence of Raynaud's pheno menon (p<001, χ(2)). The mean skin temperature was significantly lower with the severity of finger coldness (ANOVA, p<0.05). In the cold provocation test, there was no significant difference between skin temperature and coldness at 5 min and 10 min after immersion, though a difference was observed immediately after immersion. No significant difference was observed in the relationship between finger coldness and vibrotactile threshold before, during or after the cold provocation test. CONCLUSIONS The severity of coldness in the fingers is significantly related to skin temperature. The severity of finger coldness reflects the extent of peripheral circulatory vasoconstriction. Coldness in the fingers may be a good warning of potential problems in peripheral, circulatory function.