The Clinical Features of Hand-arm Vibration
Syndrome in a Warm Environment—A Review
of the Literature: Anselm Ting SU, et al. Centre for
Occupational and Environmental Health, University
of Malaya, Malaysia—The internationally accepted limit
values and the health effects of hand-transmitted vibration
exposure have been described extensively in the
literature from temperate climate countries but not from
a tropical climate environment. Objectives: We
conducted a systematic review of the health effects of
hand-transmitted vibration exposure in tropical countries
to determine the characteristics of hand-arm vibration
syndrome in a warm environment and compared the
findings with the results of the systematic reviews
published by the US NIOSH. Methods: We searched
major medical databases including MEDLINE, PubMed,
Embase, CINAHL, Ovid and Cochrane based on the
terms “hand arm vibration syndrome,” “hand transmitted
vibration,” “vibration white finger” and “Raynaud” up to
January 2011. Only studies conducted in a tropical or
subtropical environment were selected for the review.
The quality of the selected papers was assessed independently
by two investigators using predefined criteria.
A standard set of information was abstracted from the
papers for review. Results: Only six papers from
tropical countries and three papers from subtropical
countries were available in the literature. No vibration
white finger was reported in the tropical countries.
Neurological symptoms were prevalent in the vibrationexposed
workers. Finger coldness seems to be an
important surrogate for vascular disorder in a tropical
environment. Meta-analysis could not be performed
due to inadequacy of the information reported in these
papers. Conclusions: The current dose-response
relationship in ISO5349-1 for hand-transmitted vibration
exposure is not applicable to a tropical environment.
Further studies on hand-arm vibration syndromes in
tropical countries are needed.