title: A longitudinal study of vibration white finger, cold response of digital arteries, and measures of daily vibration exposure.
abstract: OBJECTIVE
  To investigate prospectively the relation between vibration-induced vascular disorders and measures of daily exposure to hand-transmitted vibration (HTV).
  
  
  METHODS
  Two hundred and forty-nine HTV workers and 138 control men of the same companies participated in a 3-year follow-up study. The diagnosis of vibration induced white finger (VWF) in the HTV workers and that of Raynaud's phenomenon in the controls was based on the medical history, the administration of color charts and the results of a cold test with measurement of finger systolic blood pressures. Vibration magnitudes from the tools were measured as r.m.s acceleration, frequency weighted according to international standard ISO 5349-1, and also unweighted over the frequency range 6.3-1,250 Hz. Daily vibration exposure was expressed in terms of daily exposure duration and frequency-weighted or unweighted r.m.s. acceleration normalized to a reference period of 8 h (Aw(8) or Auw(8), respectively).
  
  
  RESULTS
  The incidence of VWF varied from 5 to 6% in the HTV workers versus 0-1.5% for Raynaud's phenomenon in the controls. After adjusting for potential confounders, Auw(8) gave better predictions of the incidence of VWF and the cold response of the digital arteries over time than Aw(8) or daily exposure duration. These findings were observed in the entire sample of HTV workers, in those with no VWF at the initial investigation, and in those with normal cold test results at baseline.
  
  
  CONCLUSIONS
  The findings of this longitudinal study suggest that a measure of daily vibration exposure calculated from unweighted r.m.s. acceleration over the frequency range 6.3-1,250 Hz performs better for the prediction of vascular disorders in users of vibratory tools than a measure derived from r.m.s. acceleration frequency weighted according to ISO 5349-1. This study provides epidemiological evidence that more weight should be given to intermediate and high-frequency vibration for evaluating the severity of hand-transmitted vibration.
authors.affiliation: Unità Clinica Operativa di Medicina del Lavoro, Dipartimento di Scienze di Medicina Pubblica, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Trieste, Università di Trieste, Centro Tumori, Trieste, Italy. bovenzi@units.it
authors.forename: Massimo
authors.initials: M
authors.lastname: Bovenzi
mesh_terms: D000328:Adult; D003080:Cold Temperature; D003430:Cross-Sectional Studies; D005385:Fingers / Q000098:blood supply*; D016468:Forestry; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D011446:Prospective Studies; D014732:Vibration / Q000009:adverse effects*