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Occupational Medicine Advance Access originally published online on July 26, 2007
Occupational Medicine 2007 57(7):512-517; doi:10.1093/occmed/kqm076
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Assessment of the hand–arm vibration syndrome: thermometry, plethysmography and the Stockholm Workshop Scale

Aaron Thompson, Ron House and Michael Manno

Department of Occupational and Environmental Health, St Michael's Hospital, Toronto, Ontario, Canada

Background The Stockholm Workshop Scale (SWS) provides a staging scheme for hand–arm vibration syndrome (HAVS) based on subjective history. Cold provocation finger thermometry and plethysmography are commonly used objective tests for the vascular component of HAVS.

Aim To examine the correlation between the cold provocation tests and SWS vascular stage. A secondary goal was to evaluate the correlation between cold provocation finger plethysmography and thermometry testing.

Methods Patients investigated for HAVS at St Michael's Hospital, Toronto, Ontario, were subjected to the same protocol including a questionnaire, clinical assessment and objective testing. Spearman correlation coefficients were calculated for the vascular tests with the SWS and for the vascular tests themselves. Logistic regression models controlled for age, smoking, use of vasoactive medications and time since last vibration exposure.

Results One hundred and thirty-nine patients investigated for HAVS consented to participate in the study. The correlation coefficients for plethysmography ({rho} = 0.14) and thermometry ({rho} = 0.18) with the SWS were not statistically significant. Plethysmography and thermometry results were significantly correlated ({rho} = 0.47, P < 0.001). Logistic regression showed plethysmography and thermometry to weakly predict SWS vascular stage (OR 1.5 and 1.3, respectively). None of the potential confounders had a significant effect in the models.

Conclusion The results of plethysmography and thermometry did not significantly correlate with SWS vascular stage in this study. The objective tests did correlate with each other, suggesting that they are reliable measures of similar phenomena likely related to underlying vascular pathology.

Keywords      Cold provocation tests; hand–arm vibration syndrome; photocell plethysmography; Stockholm Workshop Scale; thermometry

Correspondence to: Aaron Thompson, Occupational Health Services Program, St Michael's Hospital, 61 Queen Street East, 8th Floor, Toronto, Ontario, Canada M5B 1W8. Tel: +416 426 9174; e-mail: aaron.thompson{at}utoronto.ca


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A. Adisesh and K. Poole
Re: Thompson A, House R, Manno M. Assessment of the hand-arm vibration syndrome: thermometry, plethysmography and the Stockholm Workshop Scale
Occup. Med., May 1, 2008; 58(3): 223 - 224.
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