Cold provocation test results from a 1985 survey of hard-rock miners in Ontario.

The case histories of ten workers with Hand-Arm Vibration Syndrome (HAVS) indicate that their predominant vibration exposure was to impact vibration. This association, recognized previously in pedestal grinders and in multiple hand tool users, should now be identified in spot welders and press operators. This will have important implications for compensation claimants as well as prevention development.

PEL MEAR PL. Clinical evaluation of vibration-exposed complainants in field surveys. Scand J Work Environ Health 13(1987) 284-285. The time constraints on research workers in the field inevitably limit the depth and quality of evaluations, which have two essential components, a questionnaire on the medical and work history and simple clinical tests conducted within a reasonable time frame. The questionnaire should include subject identification and age, personal and family history, past and present occupational history, and past and present hand-arm symptoms. The clinical tests, following a physical examination of the neck and upper limbs, should seek to evaluate the cardiovascular and neurological systems in the hands and arms. Tests to demonstrate the patency of the major vessels, and the response of the digital vessels following immersion in cold water, are feasible and practical, as are neurological tests to determine skin sensitivity to touch and vibration. Grip strength should be evaluated, as well as hearing loss by audiometry. Some error s in diagnosis occur with the use of such screening tests, but subsequent hospital investigations have usually confirmed their overall reliability. It is concluded that with improved instrumentation the evaluation of vibration-exposed workers at initial and follow-up examinations can only improve, as will the validity of the counseling of workers and machine manufacturers to reduce the risk.

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