Combined effects of cold, vibration and smoking, particularly in snowmobile users.

In a living and working environment more than one factor is usually important for physiological and psychological responses in the body. In this report the effects and combined effects of hand-arm vibration and cold, in particular their effect on frostbite, has been reviewed. As a second example is given the combined effect of vibration and smoking on vibration-induced white finger. In both cases our previous work among reindeer herders frequently using snowmobiles has been utilised as an example. Descriptive terms for combined effects have varied in previous multi-exposure studies. Here, the terminology recommended in the Saariselkä agreement has been applied, and according to that the combined effect between cold and vibration on frostbite was called synergism and between vibration and smoking on white finger Bliss synergism.