Results of independent medical interview and examination in the diagnosis and assessment of hand-arm vibration syndrome.

In the UK the use of the Stockholm Classification has been recommended by the Health and Safety Executive and by the Working Party of the Faculty of Occupational Medicine. The Stockholm Workshop 1994 did not recommend any changes to the existing classification but considered the variety of screening and diagnostic tests suitable for the staging of HAVS. Thirty one males claiming to be suffering from HAVS were interviewed and examined by each of the authors independently. The examination of each patient included detailed occupational and medical histories, standard physical examination with the additional tests of the rewarm time and aesthesiometry. Thermal neutral zone test (TNZ), vibrotactile thresholds and grip strength were also performed by McGeoch. All patients were classified by the Taylor/Pelmear and Stockholm Classifications. Both authors agreed that all the patients were suffering from HAVS. Agreement to within one stage was high for both the vascular and neurological elements. The additional neurological tests used by McGeoch appeared to result the raising of the neurological staging. The results indicate that independent interview plus objective tests performed by experienced physicians allow for reliable diagnosis and staging of claimants. Standardisation of tests is urgently required.