title: The relationship between hand-arm vibration and lower extremity clinical manifestations: a review of the literature.
abstract: OBJECTIVE
  To assess the current literature supporting a relationship between hand-arm vibration (HAV) and lower extremity clinical effects.
  
  
  METHODS
  An initial review of the literature identified lower extremity vascular and neurological effects reported in association with HAV. A second literature review was performed with explicit search and evaluation strategies. It focused on analytical studies and looked for epidemiological evidence supporting the relationship between HAV and lower extremity effects.
  
  
  RESULTS
  Eight analytical studies which met all of the initial inclusion/exclusion criteria were identified. All of these had serious validity deficiencies with respect to selection bias, response rates and lack of examination of confounders.
  
  
  CONCLUSIONS
  There was consistency with respect to an association between those exposed who were diagnosed with hand-arm vibration syndrome (HAVS) and vascular symptoms in the lower extremities. There was no evidence that hand-held vibration exposure independent of the diagnosis of HAVS was associated with lower extremity vascular symptoms. There was no evidence to suggest that HAV was associated with clinically significant lower extremity neurological symptoms.
authors.affiliation: Occupational Health Services Program, St Michael's Hospital, University of Toronto, Canada. m.schweigert@utoronto.ca
authors.forename: Michael
authors.initials: M
authors.lastname: Schweigert
mesh_terms: D001132:Arm / Q000098:blood supply*; D006225:Hand / Q000098:blood supply*; D006801:Humans; D007866:Leg / Q000503:physiopathology*; D009784:Occupational Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011928:Raynaud Disease / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014661:Vasoconstriction / Q000502:physiology; D014732:Vibration / Q000009:adverse effects*