Development of a vibratory white finger prevention program for shipyard workers: an exploratory study.

BACKGROUND: Vibratory White Finger (VWF) disease afflicts many shipyard workers who use vibrating tools over a period of years and can lead to a lifelong disability. Vascular symptoms include cold-induced spasms of the fingers and hands, blanching of the fingers, and atrophic skin changes in the fingertips. Sensorineural symptoms include numbness and tingling in the fingers and hands and reduced sensory perception and manipulative dexterity. The purpose of this study was to develop a screening program for shipyard workers, so that VWF disease could be identified and workers with the disease could be counseled on possible job changes involving reduced exposure to vibration.

METHOD: This study was conducted during 1993. The subjects consisted of 39 users of vibrating tools and 10 nonusers. In the shipyard, each subject received a questionnaire dealing with VWF symptoms, followed by tests for multifrequency vibration thresholds, cutaneous sensitivity, and hand and finger strength. Each subject was subsequently examined outside the shipyard by a board-certified occupational health physician.

RESULTS: Using discriminant analysis, statistical models for both the vascular and sensorineural stages of the disease were constructed. In general, there was a high level of agreement between the staging obtained from the statistical models and the outside physician's diagnoses, suggesting that the combination of questionnaire and test data was adequate for initial screening for this disease.

CONCLUSION: It is not considered practical to perform a complete physician evaluation on every shipyard worker who is at risk for VWF. By using a structured questionnaire together with a limited number of VWF-related tests, and incorporating the data into a statistical model, it is possible to identify the priority candidates for physician follow-up and possibly alter the worksite to prevent serious disability.