The combined use of capillaroscopy and skin thermometry in health surveillance of workers exposed to hand-arm vibration

The use of nailfold capillaroscopy combined with skin thermometry in the study of microcirculation of the hands in workers exposed to hand-arm vibration is assessed. Fifty-eight subjects were studied; 40 asymptomatic forestry workers exposed to hand-arm vibration, 13 forestry workers exposed to hand-arm vibration with Raynaud-like symptoms confirmed by skin thermometry; 5 controls. Reduction of capillary density was observed in workers exposed to vibrating tools with respect to controls. Tortuosity of capillary loops was significantly more frequent in subjects exposed to vibrating tools than in controls. No statistically significant difference in capillary vessels of the hands was found between asymptomatic exposed subjects and workers affected by Raynaud-like symptoms. In our sample nailfold capillaroscopy shows good sensibilty and specificity in detecting capillary modifications secondary to exposure to hand-vibration. Weaker evidence is instead given in order to actual disturbances of hands circulation in chronic exposure to vibrating tools.