Cold provocation tests in the evaluation of vibration-induced white finger.

Abstract

Two types of cold provocation tests, a classical test with immersion of the hand in cold water and the evaluation of finger systolic blood pressure (FSBP) during local cooling, were administered to forest workers. Raynaud's phenomenon in the classical test correlated positively with the number of disabled phalanges, recovery time, and frequency of attacks. It did not correlate with the severity of paresthesia of the hands and arms. Repetition of the test enhanced the number of positive results. A significant reduction in the FSBP was observed in 22 and 25% of the subjects with inactive and active forms of vibration-induced white finger (VWF), respectively. In the same groups of subjects the classical cold provocation test yielded positive results in 7 and 25% of the subjects, respectively. A cold provocation test was found to produce a positive result even some years after the cessation of VWF attacks. The rather low severity of VWF among the examined subjects may explain the lack of positive test results. FSBP measurement was not superior to cold provocation by water immersion, but it is recommended because it is easier to standardize and more convenient for the test subject.