title: Cold provocation testing and hand-arm vibration syndrome--an audit of the results of the Department of Trade and Industry scheme for the evaluation of miners.
abstract: BACKGROUND
  Hand-arm vibration syndrome (HAVS) is a major industrial disease that causes considerable morbidity among workers exposed to vibration. Compensation is paid to those affected in civil claims against employers and (in the UK) in claims made under Social Security legislation rules for Prescribed Disease A11. Diagnostic tests have been proposed but most are not objective. The cold provocation test (CPT), which is objective, is often included in the evaluation of HAVS.
  
  
  METHODS
  A continuous audit was made of the findings recorded at the 18 HAVS test centres in the UK established to evaluate miners. The audit, and its outcome, were monitored by the Medical Reference Panel who advise the Department of Trade and Industry. This audit report constitutes the second analysis of the findings relating to the CPT.
  
  
  RESULTS
  The CPT, with measurement of digital rewarming times, is of no value in assessing vibration-induced damage to the hands.
  
  
  CONCLUSIONS
  In its present format, the CPT should not be used for evaluating the vascular component of HAVS.
authors.affiliation: Medical Reference Panel of the Department of Trade and Industry (UK), HAVS Compensation Scheme, PO Box 31, Derby DE24 8BJ, UK. george@g-proud-frcs.demon.co.uk
authors.forename: G
authors.initials: G
authors.lastname: Proud
authors.forename: F
authors.initials: F
authors.lastname: Burke
authors.forename: I J
authors.initials: IJ
authors.lastname: Lawson
authors.forename: K L
authors.initials: KL
authors.lastname: McGeoch
authors.forename: J N V
authors.initials: JN
authors.lastname: Miles
mesh_terms: D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply; D015331:Cohort Studies; D003080:Cold Temperature; D006225:Hand / Q000098:blood supply; D006801:Humans; D008485:Medical Audit; D008875:Middle Aged; D008906:Mining; D009784:Occupational Diseases / Q000175:diagnosis* / Q000209:etiology; D010292:Paresthesia / Q000175:diagnosis* / Q000209:etiology; D012678:Sensation Disorders / Q000175:diagnosis* / Q000209:etiology; D013577:Syndrome; D014652:Vascular Diseases / Q000175:diagnosis* / Q000209:etiology; D014732:Vibration / Q000009:adverse effects*