Application of Stockholm criteria to patients with hand-arm vibration syndrome in a follow-up study.

We applied Stockholm criterion to patients with hand-arm vibration syndrome (HAVS) for assessing the therapeutic effects in comparison with the criterion of the Ministry of Labour in Japan (MLJ). Forty male patients recognized as an occupational disease were examined in two times (mean interval periods 3.0 years). The subjects were free from vibratory tasks during the mean period of 8.3 years. The clinical examinations and some laboratory tests were conducted with the same procedures by the two same occupational physicians. The criterion of MLJ was graded more severe than Stockholm one for the vascular component at the first examination. According to Stockholm criterion, 16 patients (40%) were classified into stage 0 in the vascular component, 11 (70%) of which complained of coldness in the fingers. At the second examination, 9 of 16 patients in stage 0 had Raynaud's phenomenon (RP). On the other hand, the criterion of MLJ could reflect an improvement of symptoms, for example, coldness. The findings may indicate that Stockholm criterion for vascular component is not enough to assess the clinical changes for light stages according to the severity of RP alone. For the sensorineural (SN) component, both criteria were almost compatible. From the viewpoint of preventive medicine, it was concluded that Stockholm criterion was not suitable for evaluating their clinical severity in the early stage of HAVS.