Characteristic changes of finger skin temperature in cold provocation test in workers with vibration white finger / 中国职业医学

OBJECTIVE: To analyze the changes of finger skin temperature in cold provocation test( CPT) in workers with vibration white finger( VWF). METHODS: A total of 245 male workers engaged in hand arm vibration operation was selected as study subjects using random number table method. All subjects were divided into VWF group( 73 persons) and control group( 172 persons). CPT( 10 ℃,10 min) was performed and the skin temperature of 6 fingers( index finger,middle finger and ring finger of both hands) was measured at pre-CPT adaptation period( 0,10,20,30 min) and after CPT period( 0,5,10,15,20,25,30 min). RESULTS: The effect of interaction between grouping and observe time was statistically significant on finger skin temperature( P < 0. 01). In the pre-CPT adaptation period,there was no statistically significant difference on skin temperature between 10 and 30 min time point in the two groups( P > 0. 05). After CPT,the fingers skin temperature of VWF group was lower than that of control group at 5 min time point( P < 0. 05),but there were no statistically significant differences on fingers skin temperature of other time points between the two groups( P > 0. 05).In both groups,the finger skin temperature at 0 min time point after CPT were lower than other time points in the same group( P < 0. 05),and the finger skin temperature increased with time( P < 0. 01). However,the finger skin temperature at 30 min after CPT did not restore to that at 30 min time point of pre-CPT. Except the VWF group,the abnormal rewarming temperature at 5 min time point after CPT of left index finger,the right index finger and the right ring finger were higher than that of the control group( 72. 6% vs 56. 4%,75. 3% vs 57. 6%,86. 3% vs 65. 1%,P < 0. 05),but there were no statistically significant differences on the abnormal rewarming temperature at 10,30 min time points of the six fingers in the two groups( P > 0. 05). There were no statistically significant differences on the detection rate of abnormal rewarming temperature between left index finger and the right index finger,or the right index finger and the right ring finger in the VWF group( 72. 6% vs 75. 3%,75. 3% vs 86. 3%,P > 0. 05). CONCLUSION: When CPT( 10 ℃,10 min) was performed in workers engaged in hand arm vibration operation,it is recommended to measure the finger skin temperature of index finger,and adaptation time before CPT can be adjusted to 10 min.

The Relationships among Delayed Recovery in Finger Temperature, Nocturnal Dip, and Glaucoma Progression

PURPOSE: To investigate the effects of a delay in finger temperature recovery rate on the hand cold provocation test (HCPT) and a nocturnal dip greater than 10% (dipper) on the progression of glaucomatous visual field (VF) defects in open-angle glaucoma patients when the intraocular pressure (IOP) was well controlled lower than the target pressure. METHODS: 30 patients (58 eyes) with normal tension glaucoma (NTG) and 13 patients (24 eyes) with primary open angle glaucoma, and 12 normal controls (24 eyes) were retrospectively enrolled in this study. We performed HCPT, 24 hour ambulatory blood pressure monitoring (24-hr ABPM), Goldmann applanation tonometer measurements, and VF tests on all subjects. The delay in finger temperature recovery rate was defined as a delay longer than 15% of the mean finger temperature of normal controls over 2 intervals among 5, 10, 15, and 20 minutes after the immersion of cold water. We examined the relationships among the delay in finger temperature recovery rate, dipper, and the progression of glaucomatous VF defects. RESULTS: The finger temperature recovery rate in NTG patients was significantly delayed more than that of normal controls at 5, 10, and 15 minutes after the immersion. The delay in finger temperature recovery rate significantly correlated with dipper in NTG patients. Glaucomatous VF defects were significantly progressed in the presence of dipper in NTG patients. Delay in finger temperature recovery rate was significantly related to the progression of glaucomatous VF defects in NTG patients. In the binary logistic regression test, delay in finger temperature recovery rate was the only factor that was strongly related to the progression of glaucomatous visual field in NTG patients. CONCLUSIONS: When glaucomatous VF defects progressed despite the IOP being well controlled, 24-hr ABPM and HCPT for detecting vascular dysregulation might be helpful for diagnosis and treatment of glaucoma.

Standardization of finger systolic blood pressure (FSBP) cooling tests

A finger systolic blood pressure (FSBP) cooling test was introduced in 1977 and standardized during the following years for the optimal provocation and best characterization of an attack of vasospastic Raynaud's phenomenon (RP). The purpose of the present review is to compare and analyse some different techniques used in FSBP cooling tests from different countries and described in the final draft of the international standard, ISO/DIS 14835-2 (2004). The selected FSBP test results indicate to some extent that the tests are reliable and have acceptable diagnostic values despite the use of different techniques to obtain them. However, only a few studies used a zero-pressure FSBP%(0) to verify an ongoing attack of vasospastic RP. Most studies used an abnormal cold reaction FSBP%(A) located below the lower limit of controls, to make the anamnestic diagnosis of RP probable. According to the ISO draft, different types of finger cooling and body thermostating can be used together in the seated or supine position, and FSBP%(A) is indicated to be used for diagnostic purposes. Further studies are recommended to solve future standardization problems not included in the upcoming ISO standard. An international agreement on the presentation and comparison of test results is needed as a supplement to ISO/DIS 14835-2.

Diagnostic significance of cold provocation test at 12°C

In Germany, vibration-induced white finger (VWF) disease is accepted as an occupational disease (BK No. 2104 BKV), for which compensation may be paid provided that the sociolegal requirements are met in accordance with the list of occupational diseases that is valid at the time. A cold provocation test (thermometry, infrared thermography) is helpful in the diagnosis of VWF and we believe that it could contribute to the standardization of vascular assessment methods. In Germany, the approved degree of the decrease in earning power is downgraded as disease symptoms improve with time; therefore, insured individuals suffering from VWF are regularly reassessed every 1-3 years. In the context of such follow-up examinations and the assessment of reversibility of this disease, a standardized cold provocation test is of central importance. Currently, there is a lack of data that confirm the diagnostic value of this test. Further investigations on VWF patients to validate the use of the cold provocation test in obtaining sufficient data for determining the satisfactory diagnostic value of this test are required.

Diagnostic Significance of Cold Provocation Test at 12\degC

In Germany, vibration-induced white finger (VWF) disease is accepted as an occupational disease (BK No. 2104 BKV), for which compensation may be paid provided that the sociolegal requirements are met in accordance with the list of occupational diseases that is valid at the time. A cold provocation test (thermometry, infrared thermography) is helpful in the diagnosis of VWF and we believe that it could contribute to the standardization of vascular assessment methods. In Germany, the approved degree of the decrease in earning power is downgraded as disease symptoms improve with time; therefore, insured individuals suffering from VWF are regularly reassessed every 1-3 years. In the context of such follow-up examinations and the assessment of reversibility of this disease, a standardized cold provocation test is of central importance. Currently, there is a lack of data that confirm the diagnostic value of this test. Further investigations on VWF patients to validate the use of the cold provocation test in obtaining sufficient data for determining the satisfactory diagnostic value of this test are required.

Standardization of Finger Systolic Blood Pressure (FSBP) Cooling Tests

A finger systolic blood pressure (FSBP) cooling test was introduced in 1977 and standardized during the following years for the optimal provocation and best characterization of an attack of vasospastic Raynaud’s phenomenon (RP). The purpose of the present review is to compare and analyse some different techniques used in FSBP cooling tests from different countries and described in the final draft of the international standard, ISO/DIS 14835-2 (2004). The selected FSBP test results indicate to some extent that the tests are reliable and have acceptable diagnostic values despite the use of different techniques to obtain them. However, only a few studies used a zero-pressure FSBP%(0) to verify an ongoing attack of vasospastic RP. Most studies used an abnormal cold reaction FSBP%(A), located below the lower limit of controls, to make the anamnestic diagnosis of RP probable. According to the ISO draft, different types of finger cooling and body thermostating can be used together in the seated or supine position, and FSBP%(A) is indicated to be used for diagnostic purposes. Further studies are recommended to solve future standardization problems not included in the upcoming ISO standard. An international agreement on the presentation and comparison of test results is needed as a supplement to ISO/DIS 14835-2.

Evaluation of Finger Skin Temperature by Cold Provocation Test for Diagnosis of Hand-Arm Vibration Syndrome / 대한산업의학회지

OBJECTIVES: Various objective tests have been widely used worldwide for diagnosing the hand-arm vibration syndrome. Among these, the cold provocation test has been frequently used to confirm the presence of Raynaud's phenomenon. This study was carried out in order to evaluate finger skin temperature by cold provocation test(10 degrees C for 10 minute) for the diagnosis of hand-arm vibration syndrome METHODS: Fifty-eight workers who had been exposed to local vibration were examined. Information concerning age, occupation, types of vibration tools used, presence of subjective symptoms such as vibration induced white finger(VWF), and numbness and tingling were collected. The subjects were classified into three groups according to their symptoms(Vascular, Neural, and No symptom group). In order to examine the applicability of the cold provocation test using water at 10 degrees C for 10 minute, we compared finger skin temperature between the groups. RESULTS: The mean value of the finger skin temperature at 5 minutes and 10 minutes after cold provocation as well as the recovery rate in the vascular group were significantly lower than that seen in the other groups. CONCLUSIONS: The evaluation of finger skin temperature by cold provocation test is very useful method for the diagnosis of hand-arm vibration syndrome. The test results will assist in confirming the diagnosis of the hand-arm vibration syndrome.

6 Cases of Hand Arm Vibration Syndrome in Grinding Workers Exposed to Hand-arm Vibration / 대한산업의학회지

OBJECTIVES: To confirm the HAVS in workers exposed to hand-arm vibration with using the objective diagnostic methods METHODS: Several tests were used to help substantiate a clinical diagnosis of HAVS. Some other diseases were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was evaluated for considering HAVS. Peripheral vascular changes were examined by a cold provocation test. An electromyography was implemented to ascertain the peripheral neural changes. RESULTS: 8 workers with symptoms in hands & fingers, exposed to hand-arm vibration were examined. Some other diseases(primary Raynauds disease, secondary Raynauds disease in not occupational origin) were excluded by a medical interview, hematologic assessment, urinalysis, X-rays. The hand-arm vibration acceleration level of the grinder was 7. 9 m/sec2. The recovery time of a skin temperature followed finger cooling was significantly prolonged in 6 workers with HAVS. The nerve conduction velocity was reduced in 6 workers with HAVS. CONCLUSIONS: So we report 6 cases of HAVS in grinding workers exposed to hand-arm vibration diagnosed objectively by an exclusion of some other disease, handarm vibration acceleration level, cold provocation test, electromyography.