A Follow Up Study of Vibration-Induced White Finger in Compensation Claimants

The aim of this follow up clinical study was to investigate the changes in vascular symptoms and the cold response of digital vessels in 73 vibration-exposed workers claiming for VWF compensation. The subjects were followed up over a mean time period of 4.1 (range 1-11) years. They underwent a medical interview, a physical examination and a standardised cold test with measurement of finger systolic blood pressure. During the follow up period, all subjects continued to work with vibratory tools. At the first examination, 29 vibration-exposed workers had a positive history of VWF. There were 14 new cases of VWF during the follow up period (p<0.05). On a group basis, a significant increase in the vasoconstrictor response to cold was observed over the follow up time in both the incident cases of VWF and the workers with no symptoms of finger whiteness. Abnormal cold response was not associated with either age or smoking habit. These findings suggest that impairment to digital vasculature can develop over a short time in workers with current exposure to hand-transmitted vibration. That a few extra years of continued work with vibratory tools have caused a significant increase in the occurrence of VWF among currently active workers argues for the implementation of preventive measures as required by the European Directive on mechanical vibration (2002/44/EC)