The objective diagnosis of vibration-induced vascular injury.

Arneklo-Nobin, Birgitta; Johansen, Kristina; Sjöberg, Trygve

doi:10.5271/sjweh.2031

Cited by 20 publications

(7 citation statements)

References 15 publications

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“…The mechanism through which exposure to vibration and use of tobacco may interact is not known, but there are several findings that suggest a mechanism and pathways for further investigation. Arneklo-Nobin et al 24 found that smokers with symptomatic Raynaud's disease induced by vibration and comparably exposed and symptomatic non-smokers both experienced a significant drop in FSBP% on cold challenge. The mechanism differed: smokers had both an arterial vasoconstrictor and peripheral cutaneous response; non-smokers only had reduction in skin circulation; and controls had neither, regardless of whether they smoked or not.…”

Section: Discussionmentioning

confidence: 99%

Vibration exposure, smoking, and vascular dysfunction

Cherniack

Clive²,

Seidner³

2000

Occup Environ Med

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Objectives-Vibration white finger (VWF), also known as "occupational Raynaud's phenomenon", is marked by arterial hyperresponsiveness and vasoconstriction during cold stimulation. The impact of tobacco use, and by extension stopping smoking, on the long term course of the disease has been inconclusively characterised. The objectives of this study included assessment of the impact of tobacco use on symptoms and on objective tests in shipyard workers exposed to vibration, and in gauging the natural history of the disorder after stopping exposure and changing smoking patterns. Methods-In a cross sectional investigation, 601 current and former users of pneumatic tools were evaluated subjectively for cold related vascular symptoms, and tested by cold challenge plethysmography. There was follow up and subsequent testing of 199 members of the severely eVected subgroup of smokers and non-smokers, many of whom had stopped smoking in the interval between tests. EVects of smoking and stopping smoking on symptoms and plethsymographic results were assessed. Results-Symptoms and measured abnormal vascular responses related to cold were more severe in smokers than in nonsmokers. Follow up of 199 severely eVected members of the cohort, all removed from exposure for 2 years, indicated that smokers were almost twice as likely to have more severe vasospasm (test finger/ control finger systolic blood pressure% (FSBP%) <30) than were non-smokers (−32.2% v 17.4%). 53 Subjects who stopped smoking during the interval between tests improved, and were indistinguishable from non-smokers similarly exposed to vibration. Additional physiological benefits of stopping smoking were still apparent at further follow up examination, 1 year later. Improvements evident on plethysmography were not accompanied by improvements in symptoms, which were unaVected by smoking. Conclusions-Smoking seems to delay physiological improvement in response to cold challenge in workers with VWF, after the end of exposure to vibration. Symptoms were less likely to improve over time than digital blood pressure, and were less aVected by smoking.(Occup Environ Med 2000;57:341-347)

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Section: Discussionmentioning

confidence: 99%

Vibration exposure, smoking, and vascular dysfunction

Cherniack

Clive²,

Seidner³

2000

Occup Environ Med

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“…All patients had RP and organic vessel changes as measured by finger pressure by finger cooling. 8 Seventeen patients with increased systolic pulmonary artery pressure (PAPsyst) were consecutive patients in whom increased PAPsyst was noticed when they were assessed for suspected PH. Twelve patients with normal PAPsyst were consecutive patients referred to our department during a period when pulmonary pressure was measured in all patients.…”

Section: Patientsmentioning

confidence: 99%

Correlation between plasma concentrations of calcitonin gene related peptide and pulmonary pressure in patients with systemic sclerosis

Bartosik

Eskilsson

Ekman

et al. 2002

Annals of the Rheumatic Diseases

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“…An even more accelerated rewarming rate (,5.0˚C/min) was described for control subjects cooled with a dual inlet cuff, similar to that used in these trials. 13 Aneklo-Noblin and colleagues 13 made similar cross sectional observations that delayed skin temperature recovery was far more common than abnormal finger systolic blood pressure in symptomatic subjects. They posited that for many VWF cases, injuries were restricted to skin and its blood vessels, rather than to digital arteries.…”

Section: Discussionmentioning

confidence: 91%

Skin temperature recovery from cold provocation in workers exposed to vibration: a longitudinal study

et al. 2003

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Background: Vibration white finger (VWF) is characterised by arterial hyperresponsiveness and vasoconstriction following cold provocation. Several years after of removal from exposure, most subjects show improved finger systolic blood pressure (FSBP) under conditions of cold challenge, but continue to report cold hands and finger blanching. Aims: To assess the underlying reasons for the persistence of cold symptoms. Methods: A total of 204 former users of pneumatic tools with cold related hand symptoms were evaluated and then re-evaluated a year later. Symptoms were evaluated using the Stockholm Workshop Scale. Finger systolic blood pressure per cent (FSBP%) was assessed by comparing digital blood pressure in a cold provoked and normalised state. Fingertip skin temperature was measured during cooling and occlusion and during rewarming and recovery. Results: There were dramatic improvements in FSBP% (14.3 mm Hg %), modest improvement in recovered skin temperature (0.86˚C), and no change in symptom stage. When the most symptomatic subjects (n = 75) were compared with the less symptomatic subjects (n = 129), there were similar inter-test improvements in FSBP%. Skin temperature recovery improved in the less symptomatic (+1.49˚C), but did not change in the most symptomatic group (20.12˚C). However, the more symptomatic group had higher temperatures at the initial test, thus qualifying the result. Conclusions: Skin temperature recovery after cold challenge in subjects with VWF remains reduced in the symptomatic subjects several years after exposure removal. This is evident even when blood pressure has increased in the setting of cold provocation. Results suggest that in VWF, the dermal circulation remains impaired, even after the restoration of arterial blood pressure in the digits.

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The objective diagnosis of vibration-induced vascular injury.

Cited by 20 publications

References 15 publications

Vibration exposure, smoking, and vascular dysfunction

Vibration exposure, smoking, and vascular dysfunction

Correlation between plasma concentrations of calcitonin gene related peptide and pulmonary pressure in patients with systemic sclerosis

Skin temperature recovery from cold provocation in workers exposed to vibration: a longitudinal study

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