title: Is skull sawing by autopsy assistants overlooked as a cause of vibration-induced white fingers?
abstract: BACKGROUND
  Workers using vibrating tools have an increased prevalence of vibration-induced white fingers. One example of such workers is autopsy assistants, who use vibration for skull sawing.
  
  
  METHODS
  A previously healthy 42-year-old Swedish male smoker had worked as an autopsy assistant at a forensic department between 1977 and 1991. He prepared corpses for autopsy, including sawing the skulls with an electric saw. Beginning in 1983, his right index finger blanched in cold. During subsequent years the blanching spread to the other fingers on the right hand, except for the thumb. The findings in the physical examination and the results of blood tests were normal. Digital blood pressure after cooling showed a severe vasospastic reaction in both middle fingers. Vibration measurements during skull sawing showed a frequency-weighted acceleration level of 8.9 m.s-2. QUESTIONNAIRE SURVEY: A questionnaire was mailed to all assistants (N = 17) preparing autopsies and to all medical examiners, as referents (N = 18), at the Swedish Institutes of Forensic Medicine. It was answered by 13 assistants (76%), 1 woman and 12 men, and 16 medical examiners (89%), 3 women and 13 men. Eleven of the assistants (85%), including one woman, and one of the physicians (6%), a men, reported a history of blanching fingers provoked by chill (difference 79%, P = 0.00003, Fisher's exact test).
  
  
  CONCLUSIONS
  Autopsy assistants at forensic departments seem to have an increased prevalence of self-reported blanching fingers, which may be an effect of exposure to high levels of vibration.
authors.affiliation: Institute of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Torén
authors.forename: P
authors.initials: P
authors.lastname: Jonsson
mesh_terms: D000328:Adult; D001344:Autopsy; D001696:Biomechanical Phenomena; D003251:Constriction, Pathologic; D003430:Cross-Sectional Studies; D012090:Cumulative Trauma Disorders / Q000209:etiology*; D005260:Female; D005385:Fingers / Q000098:blood supply*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D014732:Vibration / Q000009:adverse effects*