Autonomic stimulation and cardiovascular reflex activity in the hand-arm vibration syndrome.

Two experiments were carried out to investigate the cardiovascular responses of vibration-exposed workers to autonomic stimulation. In the first experiment blood pressures, heart rate and systolic time intervals (STI) were measured during a cold test in 63 vibration-exposed foundry workers and 41 controls. STI, such as total electromechanical systole (QS2I) and left ventricular ejection time index (LVETI), were found to be shorter in the vibration-exposed workers with and without vibration white finger (VWF) than in the controls, both at rest and during cold provocation and recovery (p less than 0.001). A significant inverse relationship between urinary excretion of free catecholamines and the duration of STI was observed under resting conditions (0.001 less than p less than 0.03). In the second experiment, the above mentioned cardiovascular parameters were measured in 11 grinding operators with VWF and 11 controls during a hand grip test, an arithmetic test and an orthostatic test. Finger systolic pressures (FSP) during local cooling to 30, 15 and 10 degrees C were also measured. QS2I and LVETI were more abbreviated in the VWF subjects than in the controls at rest and during both the circulatory stress tests and the recovery periods (0.001 less than p less than 0.05). The reduction in FSP by local cooling from 30 degrees C to 15 and 10 degrees C was greater in the VWF workers than in the controls (p less than 0.001). Significant correlations were observed between the reduction in FSP at 15 and 10 degrees C and the duration of STI during circulatory stress activities (p less than 0.01). A multiple regression analysis pointed out that vibration exposure was the major determinant of STI during circulatory stress, while the importance of age and smoking and drinking habits in predicting STI was negligible. The findings of these studies suggest that the level of cardiac sympathetic activity is increased in VWF workers in comparison with controls. These experimental results are consistent with those of other investigators, indicating that excessive sympathetic reflex activity plays an important role in the pathogenesis of VWF.