Vibration syndrome caused by hand-held vibrating tools in 14 locomotive and rolling stock plants in four regions of the People's Republic of China (south, north, middlewest, and northeast) and the influence of climatic factors on its prevalence rate were studied. For 1,028 male workers (705 riveters, 284 chippers, and 39 grinders), the prevalence rate of the syndrome was 13.4% and for a reference group of 256 workers it was 1.6%. The prevalence rate of white finger in the four regions differed and was higher in northeast and north China than in south and middlewest China. This finding suggests that cold climate and humidity may be causative factors of the vibration syndrome.