Vibration white finger – hand arm vibration syndrome

Author: Susan Ford BSc (Hons) Occupational Health, 2012.

What is vibration white finger?

Vibration white finger, also known as hand-arm vibration syndrome, is one of the causes of Raynaud phenomenon. The syndrome affects the blood vessels, nerves, muscles, joints and connective tissue of the hand, wrist and arm. It is not uncommon, with many developed countries publishing regulatory documentation on frequency (Hz) exposure limits, effects and control.

Who is affected by vibration white finger?

Workers who use hand-held or hand-guided power tools for more than a few hours each day are at risk of vibration white finger. The period of time between exposure to vibration and development of symptoms is variable, ranging from months to years. The risk of developing hand-arm vibration syndrome increases with the intensity and duration of exposure to vibration, and continued exposure results in worsening symptoms. It is recommended that individuals that suffer from certain vascular or neurological disorders affecting the hand or arm, e.g. Raynaud disease or carpal tunnel syndrome, are not exposed to vibration at work.

What causes vibration white finger?

Vibration white finger may occur in those using handheld vibrating tools such as sanding tools, hammer drills, jackhammers and chain saws. It may also be caused by holding or working with machinery that vibrates. Vibration promotes vasoconstriction through arterial smooth muscle hypertrophy, and damage to the endothelial cell walls; there is an increase in the release of vasoconstricting chemicals such as serotonin and thromboxane. Nerve damage also occurs.

Clinical features of vibration white finger

There are some specific features and symptoms of vibration white finger:

What can be done to improve the vibration white finger?

General advice:

Work place advice:

Standard tests used to diagnose vibration white finger include:

It is appropriate to rule out Raynaud’s disease, or secondary Raynaud’s phenomenon due to other causes.

Treatment of vibration white finger

If a worker has developed vibration white finger, management may include:

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