Nailfold capillary morphological characteristics of hand-arm vibration syndrome: a cross-sectional study

BMJ Open. 2016 Nov 25;6(11):e012983. doi: 10.1136/bmjopen-2016-012983.

Abstract

Objective: The purpose of this study was to investigate the characteristics of nailfold capillaroscopy associated with hand-arm vibration syndrome (HAVS).

Methods: In total, 113 male gold miners were recruited: 35 workers who were chronically exposed to vibration and developed vibration-induced white finger were defined as the HAVS group, 39 workers who were exposed to vibration but did not have HAVS were classified as the vibration-exposed controls (VEC) group, and 39 workers without vibration exposure were categorised as the non-VEC (NVEC) group. Video capillaroscopy was used to capture images of the 2nd, 3rd and 4th fingers of both hands. The following nailfold capillary characteristics were included: number of capillaries/mm, avascular areas, haemorrhages and enlarged capillaries. The experiments were carried out in the same winter. All characteristics were evaluated under blinded conditions.

Results: Significant differences in all morphological characteristics existed between the groups (p<0.05). Avascular areas in the HAVS, VEC and NVEC groups appeared in 74.3%, 43.6% and 25.0% of participants, respectively. A higher percentage of participants had haemorrhages in the HAVS group (65.7%) compared with the other groups (VEC: 7.7% and NVEC: 7.5%). The number of capillaries/mm, input limb width, output limb width, apical width, and ratio of output limb and input limb all had more than 70% sensitivity or specificity of their cut-off value.

Conclusions: Nailfold capillary characteristics, especially the number of capillaries/mm, avascular areas, haemorrhages, output limb width, input limb width and apical width alterations, revealed significant associations with HAVS.

Keywords: Hand-arm vibration syndrome; Nailfold capillaroscopy; Vibration-induced white finger; vascular injuries.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Alcohol Drinking / epidemiology
  • Case-Control Studies
  • China
  • Cross-Sectional Studies
  • Fingers / blood supply*
  • Fingers / diagnostic imaging
  • Hand-Arm Vibration Syndrome / diagnostic imaging*
  • Humans
  • Logistic Models
  • Male
  • Microscopic Angioscopy
  • Middle Aged
  • Mining
  • Nails / blood supply*
  • Nails / diagnostic imaging
  • Occupational Diseases / etiology
  • Occupational Exposure / adverse effects*
  • Sensitivity and Specificity
  • Smoking / epidemiology
  • Vibration / adverse effects*