Review of objective tests for the hand-arm vibration syndrome.

The Health and Safety Executive has recommended health surveillance for all workers in jobs identified as giving rise to significant risk of the hand-arm vibration syndrome. Objective tests are not routinely recommended for workplace surveillance but may have a role in the assessment of accurate staging or if decisions on an individual's continuing exposure is in question. This paper covers the use of multiple objective tests, the collection of routine data, a proposed scoring system for the sensorineural component and discusses the role of cold provocation testing in the diagnosis of the vascular component.