Treatment of Vibration Syndrome in Finland

Abstract

Vibration syndrome, or traumatic vasospastic disease, arose in Finland in the 1960s; when chain saws became lighter and more effective, and a whole day of exposure was possible. Vibration exposed workers have been studied since 1972 in Finland, and there has been a change in the prevalence and severity of vibration induced symptoms among forest workers (Pyykkö et al. 1986). As the vibration syndrome does not develop by only one mechanism (Färkkilä, 1978), the treatment and prevention is dependent on the factors causing the symptoms. In Finland the patient with vibration syndrome is compensated only when the following criteria are fulfilled : 1) he has been exposed to vibration long enough to develop the syndrome, and 2) all other diseases have been excluded, such as primary Raynaud's disease, collagen diseases, injuries and thoracic outlet syndromes. The patient with vibration syndrome is compensated only, when there are findings in at least two different tissues or organs, like white fingers as a sign of vasospastic disease, and EMG changes as a sign of neuropathy. The impairment from vibration induced white fingers or numbness is considered mild, and the estimated degree of invalidity is only 10-20 per cent. The patient is expected to work in professions without vibration exposure. In Finland autonomic symptoms and neck and shoulder symptoms are considered considered to be due to strenuous muscle work, temporary reversible stress and not linked to vibration exposure. Most patients are treated by general practioners who recommend lighter work, physiotherapy or drugs without compensation. If the patient fullfills the above criteria, the insurance company will pay for the treatment of symptoms which are definitely due to vibration exposure. All vibration exposed workers have had compulsory annual health examinations for hearing loss and hand arm symptoms paid for by the employer. © 1990, Kurume University School of Medicine. All rights reserved.