Simultaneous observation of zero-value of FSBP% and Raynaud's phenomenon during cold provocation in vibration syndrome.

Many workers using vibratory tools suffer from handarm vibration syndrome. Among symptoms of the syndrome, blanching attack is the most typical. In terms of medico-legal aspects, objective recognition of Raynaud’s phenomenon is considered to be most important in judging the syndrome as an occupational disease. Measurement of finger systolic blood pressure test (FSBP%) in the laboratory has recently been introduced in Europe to confirm the occurrence of vibration-induced white finger. During the epidemiological study at the Stockholm Workshop 1994, the following points were agreed upon in making a confirmation of the occurrence of blanching attack: recognition of white finger during a doctor’s inspection, color pictures of the hands photographed together with the patient’s face and measurement of zero-value of FSBP%. Even if workers complain of blanching attacks in the fingers, if Raynaud’s phenomenon cannot be confirmed under these criteria, registration of these cases must be judged as cases of unidentified phenomenon. However, it is very difficult to confirm Raynaud’s phenomenon under direct inspection by a doctor or with color photographs because of the rapid disappearance of attacks. In addition, it is rare that FSBP% shows zero-value in a laboratory. Theoretically, a zero-value of FSBP% indicates complete closure of the digital arteries resulting in a blanching attack. We report the simultaneous observation of both zero-value of FSBP% and blanching attack during cold provocation test.