Cold-stress tests involving finger skin temperature measurement for evaluation of vascular disorders in hand-arm vibration syndrome: review of the literature.

Cold-stress tests are used for evaluating vascular disorders in the hand-arm vibration syndrome, and the value of such tests based on finger skin temperature measurement has been investigated. However, there is a wide difference in the test conditions among countries and researchers. Standardization of the cold-stress tests is currently under discussion within the International Organization for Standardization. We reviewed various aspects of the cold-stress tests involving finger skin temperature measurement, including water temperature, hand immersion time and other test conditions, and evaluated their diagnostic significance. Water temperature varied from 0 degrees C to 15 degrees C and hand immersion time varied from 0.5 min to 20 min. The cold-stress tests are associated with relatively severe suffering, thus, higher temperature of cold water and shorter time of immersion are desirable. To date, however, there has not been sufficient data indicating diagnostic value in a test method involving cold water at around 15 degrees C. Diagnostic value is also influenced by other test conditions, such as room temperature, season, use of ischemia during immersion. For standardization of the cold-stress test involving finger skin temperature measurement, these factors must be considered together with water temperature and immersion time.