Vibration-induced white finger and cold response of digital arterial vessels in occupational groups with various patterns of exposure to hand-transmitted vibration
研究了使用振动工具工人的振动暴露与白指患病率及指动脉冷反应的关系，发现指动脉冷反应测试对白指诊断敏感且特异，且与暴露水平定量相关。
OBJECTIVE: This study investigated the relation between vibration exposure, the prevalence of white fingers, and the cold response of digital arterial vessels in workers using vibrating tools. METHODS: The change in finger systolic blood pressure (FSBP) at 15 and 10 degrees C as the percentage of the pressure at 30 degrees C (FSBP%) was measured in 455 healthy referents and 822 workers exposed to hand-transmitted vibration. Exposure to hand-transmitted vibration was assessed in terms of 8-hour energy-equivalent frequency-weighted acceleration [A(8)] and total operating time with vibrating tools. RESULTS: The prevalence of white fingers was 1.1% for the referents and ranged from 9.0% to 51.6% for the vibration-exposed groups. The estimated mean value of A(8) ranged between 1.6 (referents) and 8.3 (quarry drillers) m/s2. After adjustment for age, smoking, and drinking habits, the FSBP% was significantly lower in the vibration-exposed groups than in the reference group. Groupwise, the FSBP%(10 degrees) was inversely related to the prevalence of white fingers, the estimated A(8), and total operating time. With FSBP%(10 degrees) <70% or <60% as the lower normal limit, the sensitivity of the cold test varied from 86% to 100%, with a specificity of 90% to 94%, and a positive predictive value of 68% to 74%. CONCLUSIONS: FSBP measurement during cold provocation is a useful laboratory test for white fingers. A quantitative relationship between cold-induced digital arterial hyperresponsiveness and occupational exposure to hand-transmitted vibration was suggested.