Pathophysiology of hand-arm vibration syndrome and exposure limit for prevention

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Vibration exposure guidelines for prevention of the hand arm vibration syndrome are proposed by the International Organization for Standardization (ISO) . The guidelines are based on the latent interval of Raynaud's phenomenon among Caucasians exposed to vibration, however the evidences are not enough.Acute vibration exposure experiment form 8 Hz to 1000 Hz indicated the following results ; circulatory function of fingers exposed increased due to direct effect of vibration and that of the opposite side fingers decreased due to indirect effect via the autonomic nervous system.Acute stress test in hand-arm vibration syndrome patients using urinary catecholamines indicated the sympathoadrenal medullary response to psychological stressors increased especially in hand-arm vibration syndrome patients with Raynaud's phenomenon in higher frequency.Epidemiological investigation in Japanese general population indicated that the prevalence rates were lower than those in Caucasians. Difference of susceptibility to circulatory disturbance between races as well as pathogenesis of Raynaud's phenomenon induced vibration exposure should be considered for vibration exposure guidelines.