Assessment of vibration white finger syndrome.

The degree of Raynaud's phenomenon due to the use of vibrating tools is difficult to assess because of the episodic nature of the attacks and the paucity of vascular and neurologic signs between attacks. Ninety-two loggers, miners and other workers using vibrating tools and experiencing Raynaud's phenomenon were examined at the Vancouver General Hospital between 1982 and 1985. Details of history, symptoms and occupation were obtained. The majority of workers had loss of sensation in their hands to pinprick, and the extent of this correlated closely with the severity of symptoms, a correlation not previously described. In 16 subjects the loss of sensation was proximal to the level of symptoms, in 50 at the same level and in 23 distal. In three the correlation was unknown. The severity of the vibration white finger syndrome was assessed using the classification of Taylor. Four workers were placed in stage 1 (occasional blanching of fingertips, with or without tingling or numbness), 30 in stage 2 (blanching of one or more fingers with numbness in cold weather), 36 in stage 3 (frequent finger blanching affecting most digits) and 22 in stage 4 (as stage 3 but symptoms so severe that manual work is difficult and vibrating tools cannot be used). The correlation of symptoms with loss of sensation to pinprick was useful in assessing the severity of the syndrome and in the classifying of claimants for Workers' Compensation Boards.