Evaluation of the risk of development of vibration-induced white finger amongst users of hand-held road drills. A review of the literature

Vibration White Finger (VWF) is the commonest disorder associated with the use of vibrating tools. The clinical features are caused by episodic peripheral vasospasm which is usually provoked by a fall in environmental temperature. The mechanism by which vibration exposure produces this cold-provoked vasospasm is not fully understood.During the early stages of VWF the symptoms are often trivial and consist of intermittent numbness and tingling of the fingers; during the later stages blanching of the fingers occurs and may be followed in advanced cases by tissue necrosis.A number of physiological tests for the diagnosis and assessment of the severity of VWF have been developed but none has proved entirely satisfactory and there is no single widely accepted diagnostic test.VWF is associated with the use of a wide range of vibrating tools and in the reported surveys its prevalence varies considerably, depending on the industry and country in which the survey has been carried out. The most hazardous vibrations are those in the frequency range below l6Hz but there are a number of other variables which influence the risk of development of VWF.There are no reports of epidemic logical surveys amongst users of hand-held road drills and the prevalence of VWF among these workers is unknown. There have been isolated case reports of VWF in users of road breaking tools and indications that the vibration characteristics of these tools could be hazardous. It is suggested that there is a need for an epidemic logical survey to determine the prevalence of VWF among users of hand-held road drills.