Objectives 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°C as the percentage of the pressure at 30°C (FSBP%) was measured in 455 healthy referents and 822 workers exposed to hand-transmitted vibration. Vibration measurements were performed on a representative sample of the hand-held tools, and 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) was 8.3 m/s2 for the quarry drillers, ranged between 2.8 and 4.7 m/s2 for the construction workers, caulkers, foundry workers and forestry workers, and was <2 m/s2 for the grinders, mechanics and shipyard workers. 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° was inversely related to the prevalence of white fingers, the estimated A(8), and total operating time. With FSBP%10° <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%.

Conclusion 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.

Key terms cold provocation test; exposure-response relationship; finger systolic blood pressure; predictive value; sensitivity; specificity; vibrating tool