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International Archives of Occupational and Environmental Health

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01-03-2009 | Original Article

Vibration-induced white finger syndrome and carpal tunnel syndrome among Finnish metal workers

Authors: Riitta Sauni, Rauno Pääkkönen, Pauliina Virtema, Ville Jäntti, Mika Kähönen, Esko Toppila, Ilmari Pyykkö, Jukka Uitti

Published in: International Archives of Occupational and Environmental Health | Issue 4/2009

Abstract

Objective

Officially 10–26 cases of vibration-induced white fingers (VWF) have been reported annually in Finland. It has been suggested that the numbers are underestimated. The purpose of the present study was to estimate the cumulative exposure to hand–arm vibration (HAV) and the prevalence of clinically diagnosed cases of VWF and carpal tunnel syndrome (CTS) in a population of Finnish metal workers and to determine the symptoms and clinical tests that would best predict the diagnosis.

Methods

A questionnaire on vibration exposure at the workplace and symptoms of the upper extremities was sent to a sample (n = 530) of members of the local Metalworkers Union. Those who reported finger blanching, numbness or tingling of the fingers or symptoms of CTS were invited to take part in clinical examinations. Their cumulative lifelong exposure to HAV was evaluated. Those whose symptoms referred to VWF or CTS were given a cold provocation test with the measurement of finger systolic blood pressure and electroneuromyography of the upper arms.

Results

Altogether 285 metal workers (54%) responded to the questionnaire, and 24 new cases of VWF (8.4%) and 12 cases of CTS (4.2%) were diagnosed. In the group of VWF patients, seven workers had both VWF and CTS. All of the workers diagnosed as having VWF also had numbness or tingling in their fingers. Consequently, questions concerning numbness and tingling, a two-point discrimination test, Phalen’s test, and Tinell’s test had a high predicting value for VWF. The exposure time of the VWF cases did not differ significantly from that of the study group as whole, but the cumulative exposure index was significantly higher.

Conclusion

The results suggest that VWF is underdiagnosed in Finland. In screening for the health effects of HAV, sensorineural symptoms of hands should be carefully inquired about and examined in patients complaining of white fingers. More education on the recognition and evaluation of HAV exposure and its health effects is needed.

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Title: Vibration-induced white finger syndrome and carpal tunnel syndrome among Finnish metal workers
Authors: Riitta Sauni
Rauno Pääkkönen
Pauliina Virtema
Ville Jäntti
Mika Kähönen
Esko Toppila
Ilmari Pyykkö
Jukka Uitti
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 4/2009
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-008-0357-6

At a glance: The STEP trials

Springer Medicine

Vibration-induced white finger syndrome and carpal tunnel syndrome among Finnish metal workers

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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