Abstract | BACKGROUND: Accurate diagnosis and staging of hand-arm vibration syndrome (HAVS) is important in health surveillance of vibration-exposed workers and the substantial number of related medico-legal cases. The measurement of the rewarming rate of fingers after cold provocation to the hands ( CPT) has been suggested as a useful test in diagnosing HAVS. AIM: To investigate the diagnostic value of a standardized version of the CPT test using a 15 degrees C cold challenge for 5 min applied in the recent compensation assessment of UK miners. METHODS: Analysis of a subset of UK miners assessed at our unit, together with data from a small repeatability study of the standardized CPT in normal subjects. RESULTS:
Rewarming time in the CPT was significantly lower in those subjects classified as vascular Stockholm stage 0 compared with Stockholm stages 1-3 combined, but did not discriminate between the stages of abnormality. Using the suggested cut-off in the CPT test, the sensitivity and specificity were calculated as 43 and 78%, respectively. Receiver operator characteristic analysis suggested that the rewarming time of highest accuracy gave a sensitivity of 66% and specificity of 59%. In 10 miners who reported unilateral hand blanching, there was no significant difference in CPT measurements between blanching and non-blanching hands. Repeat CPT measurements in normal subjects suggested mean differences of 52 and 107 s for each hand, and the Bland-Altman coefficient of repeatability was approximately 600 s for all fingers. CONCLUSION: Single application of this standardized CPT test may have limited value in diagnosing the vascular component of HAVS in an individual.
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Authors | H J Mason, K Poole, J Saxton |
Journal | Occupational medicine (Oxford, England)
(Occup Med (Lond))
Vol. 53
Issue 5
Pg. 325-30
(Aug 2003)
ISSN: 0962-7480 [Print] England |
PMID | 12890832
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Arm Injuries
(complications, diagnosis)
- Coal Mining
- Cold Temperature
- Cumulative Trauma Disorders
(complications, diagnosis)
- Diagnostic Tests, Routine
(methods)
- Fingers
- Hand Injuries
(complications, diagnosis)
- Hot Temperature
- Humans
- Male
- Middle Aged
- Occupational Diseases
(diagnosis)
- Peripheral Vascular Diseases
(diagnosis, etiology)
- Raynaud Disease
(diagnosis)
- Sensitivity and Specificity
- Syndrome
- United Kingdom
- Vibration
(adverse effects)
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