The diagnostic value of finger systolic blood pressure and cold-provocation testing for the vascular component of hand-arm vibration syndrome in health surveillance

Poole, K.; Elms, J; Mason, H. J.

doi:10.1093/occmed/kqh108

Cited by 24 publications

(16 citation statements)

References 31 publications

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“…The most commonly applied methods in the assessment of abnormal vascular response to cold in HAVS are the measurements of finger skin temperature and finger systolic blood pressure after subjecting fingers or hands to cold exposure. It has been reported that the skin temperature rewarming test may lack the necessary sensitivity and specificity for distinguishing between regular vascular reactivity and cold-induced vasospasm [28][29][30] . The diagnostic value of the finger systolic pressure test can be difficult to define, as there has been a variation in both the nature of the cooling procedure and the outcome parameter used [31][32][33] .…”

Section: Discussionmentioning

confidence: 99%

“…This result suggests that the method may offer information on both aspects of the vascular reflection to cold, namely, the vasoconstrictive response to cold exposure and that following vasodilatation. In this regards, a number of researchers have reported that the finger systolic pressure test constantly shows high specificity but somewhat lower sensitivity 29,35,38) . Among the blood perfusion variables determined in this study, the false-positive cases appeared to be fewer when the value of the immersion phase was used rather than the other variables.…”

Section: Discussionmentioning

confidence: 99%

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Laser Doppler Imaging of Skin Blood Flow for Assessing Peripheral Vascular Impairment in Hand-Arm Vibration Syndrome

et al. 2007

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The objective of this study was to evaluate the usefulness of laser Doppler imaging (LDPI) of the skin blood flow for assessing peripheral vascular impairment in the hand-arm vibration syndrome (HAVS). The subjects were 46 male patients with HAVS, aged 50 to 69 yr, and 31 healthy male volunteers of similar age as controls. A cold provocation test was carried out by immersing a subject's hand on his more severely affected side into cold water at a temperature of 10°C for 10 min. Repeated image scanning of skin blood flow of the index, middle, and ring fingers was performed every 2 min before, during, and after the cold water immersion using a PMI-II laser Doppler perfusion imager. The mean blood perfusion values in the distal phalanx area of the fingers were calculated on each image. The patients suffering from vibration-induced white finger (VWF, n=20) demonstrated significantly lower skin blood perfusion at each interval of the test as compared with those without VWF (n=26) and the controls (p<0.01, ANOVA). The blood perfusions in the HAVS patients were associated with the severity of the symptoms as classified by the Stockholm Workshop scale for vascular staging. When a subject was considered to be positive if any of the tested fingers showing a decreased blood perfusion and/or a delayed recovery pattern, the sensitivity was 80.0%, and the specificity was 84.6% and 93.5% for patients without VWF and the controls, respectively. These results suggest that the LDPI technique could provide detailed and accurate information that may help detect the existence of impaired vascular regulation to cold exposure in the fingers of workers exposed to hand-transmitted vibration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laser Doppler Imaging of Skin Blood Flow for Assessing Peripheral Vascular Impairment in Hand-Arm Vibration Syndrome

et al. 2007

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“…Poole et al reported a comparatively low sensitivity and high specificity: the sensitivity was between 44 and 61%, and the specificity was between 91 and 95% 51) . On the other hand, Thompson et al reported a comparatively high sensitivity (94%) and low specificity (15%) 54) .…”

Section: Strain Gauge Plethysmography (Arterial Occlusion)mentioning

confidence: 99%

“…In the investigation undertaken by Suizu and Harada, the ISO 14835-1 test method with measurement of FST by thermistors was found repeatable 20) . The reported sensitivity and specificity from several studies involving thermometry 10,[21][22][23][24][25][26][27][28][29] and thermography [29][30][31] with a cold water immersion test in distinguishing VWF patients from controls are presented in Table 2, which indicates that the diagnostic ability of FST measurements with cold provocation is inconsistent. In the study of Coughlin et al, the researchers investigated the potential of cold provocation thermography with a water temperature of 5°C for 1 min as an objective test to diagnose the digital vasospasm in HAVS patients 31) .…”

Section: Thermometry and Thermographymentioning

confidence: 99%

“…For assessment of digital vascular function by measuring FSBP in subjects exposed to hand-arm vibration, the ISO has standardized the test conditions for optimal provocation, which includes reference measurement at 30°C followed by finger cooling for a period of 5 min at 15 and 10°C without or with additional body cooling 38) . Reported sensitivities and specificities of the local cooling tests with FSBP measurement by plethysmography from different studies are presented in Table 3 6, 25, 39, [43][44][45][46][47][48][49][50][51][52] . Among those reports, a good number of studies demonstrated the sensitivity and specificity of the local cooling test with FSBP measurement to be more than 80%, without additional body cooling, indicating satisfactory diagnostic performance of this method.…”

Section: Strain Gauge Plethysmography (Arterial Occlusion)mentioning

confidence: 99%

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Review of Different Quantification Methods for the Diagnosis of Digital Vascular Abnormalities in Hand‐arm Vibration Syndrome

Mahbub

Harada

2011

Journal of Occupational Health

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This study was undertaken to review the diagnostic ability of different quantification methods in the assessment of vibration-induced white finger (VWF), the typical clinical manifestation of vascular injuries in Hand-arm Vibration Syndrome (HAVS). Methods: A literature search of original and major review articles related to the quantification techniques for diagnosing vascular injuries in HAVS was performed. Relevant data from the publications were extracted and included in this study for reporting and discussion. Results: Few studies were available to substantiate the diagnostic techniques using the nail press test and nailfold capillaroscopy. Also, few studies were found to conclusively demonstrate the diagnostic ability using thermometry and thermography incorporated with cold provocation. Some recent reports raised the question regarding the diagnostic ability of finger plethysmography; but by virtue of its comparable assessment parameters and better diagnostic performance, plethysmography appears to be a suitable diagnostic method. In noninvasive quantification of vascular injuries, diagnostic techniques like laser Doppler perfusion imaging and nailfold capillaroscopy require further evaluation in future studies. Conclusions: For a reliable objective diagnosis of VWF at present, quantification of vascular responses using a test battery including established methods like thermometry or thermography and strain gauge plethysmography appears to be useful. (J Occup Health 2011; 53: 241-249)

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The Challenge of Hand Arm Vibration Syndrome (HAVS)

Katz

2007

AMA Guides® Newsletter

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Hand arm vibration syndrome (HAVS) has been defined as a constellation of vascular, neurological, and musculoskeletal signs and symptoms in workers who use hand-held vibrating tools (eg, drills, grinders, saws, or jackhammers); pathological features affect primarily vascular, neurological, and muscle tissues. Researchers have hypothesized changes in central nervous system processing, but no significant somatotopic cortical changes have been found using functional magnetic resonance imaging. Differential diagnosis of HAVS includes a variety of anatomical, circulatory, and vasospastic disorders and was standardized in the Stockholm Workshop classification scale (1987). Available laboratory tests generally are incapable of grading the severity of individual cases, and no protocol reliably distinguishes between psychogenic and organic abnormalities. Some proposed tests are impractical, and multimodality testing is confounded by statistical fallacies. Vascular tests, including the cold provocation tests, correlate poorly with disease staging according to the Stockholm Scale, and plethysmography before and after cold provocation, were found to be unsatisfactory. Job tasks that involve vibrating machines are associated with musculoskeletal symptoms but sorting out the roles and latency periods of vibration, repetitive movements, grip and push factors, and worker postures is imprecise. The AMA Guides to the Evaluation of Permanent Impairment, does not provide directions about rating impairment associated with HAVS, but evaluators can use Chapter 16 The Upper Extremities, basing the rating on motion, neurological, and/or vascular deficits.

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The diagnostic value of finger systolic blood pressure and cold-provocation testing for the vascular component of hand-arm vibration syndrome in health surveillance

Cited by 24 publications

References 31 publications

Laser Doppler Imaging of Skin Blood Flow for Assessing Peripheral Vascular Impairment in Hand-Arm Vibration Syndrome

Laser Doppler Imaging of Skin Blood Flow for Assessing Peripheral Vascular Impairment in Hand-Arm Vibration Syndrome

Review of Different Quantification Methods for the Diagnosis of Digital Vascular Abnormalities in Hand‐arm Vibration Syndrome

The Challenge of Hand Arm Vibration Syndrome (HAVS)

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