Diagnosis of Raynaud's phenomenon in quarrymen's traumatic vasospastic disease

An epidemiologic and clinical study of traumatic vasospastic disease (TVD) was carried out involving 18 workers in a granite quarry. The prevalence of TVD was found to be 72% (95% confidence limits 47-90%) estimated from the combined information from a questionnaire and a clinical interview. The fingers of the hand contralateral to the preferred working hand were the most frequently affected. A newly developed cold provocation test measuring reduction in finger systolic blood pressure during combined body and finger cooling was applied to the quarrymen and to 20 age-matched men in a reference group. Raynaud's phenomenon with digital arterial closure was verified by the measurement of zero pressure in the test finger at 15 or 6 degrees C in 12 of 13 quarrymen with anamnestic and clinical evidence of TVD. The test showed an abnormal response as compared to that of the reference group in all the workers having used vibrating hand tools for more than five years. The precision, estimated as 95% confidence limits from double determinations, was 18.7%. The cold provocation test can be employed diagnostically, and it can also be used to observe the effects of prophylactic measures.