ABSTRACT
The prolonged use of vibrating tools and equipment can lead to a number of pathological effects primarily in the peripheral neurological, vascular and musculoskeletal systems. The resulting symptom complex is now internationally known as the hand-arm vibration syndrome or HAVS.1 The relative importance of the two main components, vascular (a Raynaud’s phenomenon) and sensorineural (a peripheral neuropathy), has shifted since the condition was first recognized at the beginning of the last century. In Alice Hamilton’s biography,2 in a chapter entitled ‘Dead fingers’, she described the presentation in limestone cutters working in Bedford, Indiana in 1918:
The men call the condition ‘dead fingers’ and it is a good name, for the fingers do look like those of a corpse, a yellowish-greyish white and shrunken. There is a clear line of demarcation between the dead part and the normal part.
