In a group of 65 Italian forestry operators using chain saws, the overall prevalence of vibration-induced white finger (VWF) was found to be 29.2%. The occurrence of VWF was higher in the chain sawyers who had operated non-antivibration (non-A/V) as well as A/V saws (46.4%) than in those with experience limited to A/V saws (16.2%). The latency time before VWF averaged 9.4 yr (SD 6.8). The mean value of the four-hour energy-equivalent frequency-weighted acceleration [(ah,w)eq(4)] was 7.2 m/s2 (SD 1.2). On the basis of the known VWF prevalence and of [(ah,w)eq(4)], a latent period before VWF of 7.1 yr was expected according to ISO 5349. The measurement of finger systolic pressure (FSP) at 15°C and 10°C by plethysmographic technique showed that the chain sawyers affected with VWF experienced a more intense digital vasospasm than a group of comparable controls and the chain sawyers without VWF. The sensitivity of the method to detect vibration-induced digital arterial hyper-responsiveness to cold was 84.2% and the specificity was 100%. The findings of this study showed a good agreement between the expected and observed latency times before VWF, even though the ISO dose-effect relationship seems to overestimate slightly the risk. The results of the cold test indicated that the measurement of FSP during local cooling is an accurate laboratory method to diagnose objectively Raynaud's phenomenon of occupational origin.
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