title: Cold-provocation testing for the vascular component of hand-arm vibration syndrome in health surveillance.
abstract: The aim was to investigate whether the use of infra-red thermography (I-R) and measurement of temperature gradients along the finger could improve the diagnostic accuracy of cold-provocation testing (15 degrees C for 5 min) in vascular hand-arm vibration syndrome (HAVS). Twenty-one controls and 33 individuals with stages 2/3V HAVS were studied. The standard measurement of time to rewarm by 4 degrees C (T4 degrees C) and temperature gradients between the finger tip, base and middle (measured using I-R) were calculated. Receiver Operating Characteristics (ROC) analysis to distinguish between the two groups revealed that for T4 degrees C the area under the ROC curve was not statistically significantly different from 0.5 (0.64 95% confidence interval 0.49-0.76). The difference between the tip and middle portion of the finger during the sixth minute of recovery was the most promising gradient with an area of 0.76 (95% confidence interval 0.62-0.87), and sensitivity and specificity of 57.6% and 85.7% respectively. However, this was not significantly different from that for the time to rewarm by 4 degrees C. In conclusion, the cold-provocation test used in this study does not appear to discriminate between individuals with stage 2/3V HAVS and controls and this is not improved by the measurement of temperature gradients along the fingers using I-R.
authors.affiliation: Health and Safety Laboratory, Buxton, Derbyshire, UK.
authors.forename: Kerry
authors.initials: K
authors.lastname: Poole
authors.forename: Joanne
authors.initials: J
authors.lastname: Elms
authors.forename: Howard
authors.initials: H
authors.lastname: Mason
mesh_terms: D000328:Adult; D001132:Arm / Q000503:physiopathology*; D016022:Case-Control Studies; D003080:Cold Temperature; D006225:Hand / Q000503:physiopathology*; D053421:Hand-Arm Vibration Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D006987:Hypesthesia / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D012881:Skin Temperature / Q000502:physiology*; D013817:Thermography; D006113:United Kingdom; D014661:Vasoconstriction / Q000502:physiology*