Ramazzini; Blog on work and health by Annet Lenderink

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HAVS at your feet? Vibration-white foot

At the Netherlands Center of Occupational Diseases earlier this year a question was asked about complaints of back and legs in a construction worker exposed to vibration through his feet. At that time no relevant literature was found in an initial search, now there is this interesting  case-report of a 54-year-old miner presented with a chief complaint of blanching and pain in his toes. He had a history of foot-transmitted vibration exposure over 18 years. The complaints at his feet were analogous to complaints of hand arm vibration syndrome (HAVS) occurring at the hands of workers handling vibrating tools.

Vibration-white foot: a case report
A. M. S. Thompson, R. House, K. Krajnak and T. Eger
Occupational Medicine Volume 60, Issue 7 Pp. 572-574

Background
Hand–arm vibration syndrome (HAVS) refers to the neurological, vascular and musculoskeletal problems that may arise due to exposure to segmental vibration to the hands. An analogous syndrome may occur in the lower extremities of workers exposed to foot-transmitted vibration.  

Aims:  This report describes the case of a worker with a history of foot-transmitted vibration exposure presenting with cold intolerance in the feet and blanching in the toes.  

Case report:
 A 54-year-old miner presented with a chief complaint of blanching and pain in his toes. The worker had a history of foot-transmitted vibration exposure over his 18 year career as a miner, primarily from the operation of vehicle-mounted bolting machines. Cold provocation digital plethysmography showed cold-induced vasospastic disease in the feet, but not in the hands.

Conclusions This case illustrates a condition descriptively termed ‘vibration-white foot’: a disease analogous to HAVS arising after segmental vibration exposure to the feet. Further research is required to increase awareness of, and direct preventive efforts for, this potentially debilitating condition.

Filed under: Occupational exposure, Physical agents, Vibration, ,

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