[The hand-arm vibration syndrome: (II). The diagnostic aspects and fitness criteria].

Part II of this paper reviews the clinical and laboratory methods to diagnose the neurological, vascular and osteoarticular components of the hand-arm vibration syndrome. The prognosis and reversibility of vibration-induced neurological and vascular disorders after cessation of vibration exposure or the introduction of powered tools equipped with vibration isolation systems are discussed on the basis of the results of follow-up clinical investigations and longitudinal epidemiologic studies. Finally, the review debates some of the methodological aspects connected with the health surveillance of vibration-exposed workers and considers the possible medical contra-indications for prolonged exposure to hand-transmitted vibration.