A busca pelos artigos foi realizada nas bases de dados Medline (via PubMed), Embase, Web of Science, Scientific Eletronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs).

RESULTADOS

Sessenta e quatro artigos foram obtidos a partir da busca eletrônica, dos quais 18 cumpriram os critérios de elegibilidade. Todos os estudos discutiram sobre a exposição a vibrações localizadas em membros superiores. Em seis deles, a questão térmica foi direta ou indiretamente abordada. Nenhum estudo abordou a exposição ao cloreto de vinila.

CONCLUSÃO

De maneira geral, constatou-se maior prevalência do fenômeno de Raynaud entre operadores de ferramentas vibratórias em comparação aos não expostos, com aumento do número de casos quanto maior o nível de vibração e tempo de exposição. O frio é fator desencadeante e agravante do fenômeno de Raynaud e parece exercer papel importante para o surgimento das manifestações vasculares da síndrome de vibração de mãos e braços.

Doença de Raynaud; Doenças vasculares periféricas; Vibração; Cloreto de vinil; Temperatura baixa

First author	Year	Study design	Country	Characteristics (population)	Characteristics (occupation)	Type of exposure
Kluger⁸	2017	Transversal	Finland	1000 people invited by email; response rate: 45%, 98 women and 350 men	Tattoo artists who are members of the French Union of Tattoo Artists	Vibration: tattoo gun
Pettersson⁹	2014	Transversal	Sweden	Workers with ONIHL*; received the questionnaire: 246 men/78 women; response rate: 41%	Most common occupations: teachers, military, and welders	Vibration: questions to estimate minutes/day and years of exposure. Cold: time outdoors when working
Roquelaure¹⁰	2012	Transversal	France	3.710 workers, 2.161 men (58%) and 1.549 women (42%)	Almost all occupations except farmers, artisans, tenants, self-employed	Vibration tools (≥2hours/day): 460 workers. Cold temperature <15^oC (≥4hours/day): 220 workers
Aiba¹¹	2012	Cohort	Japan	704 workers (685 men and 19 women). Mean observation time: 10.6 ± 7.4 years	Workers using an impact wrench	Vibration: 8 vibrating tools selected to be evaluated during work. Acceleration: 4.9 - 22.6 m/s2
Inaba¹²	2010	Transversal	Japan	120 men; 74 answered a questionnaire in the winter and 83 in the summer	Electricians (construction workers)	Vibration: 95% of electricians used vibration tools. Cold: local metrological information
Burström¹³	2010	Transversal	Sweden	Cases: 19,251 men exposed to vibration of hands/arms. Controls: 3,350 office workers	Cases: construction workers with exposure to hand and arm vibration	Vibration: 0-5 scale (occupational hygienists). Cold: local metrological information
Bovenzi¹⁴	2010	Cohort	Italy	Cases: 249 workers with exposure to vibration. Controls: 138 workers without exposure	Forestry workers (chainsaws with anti-vibration device) and quarry workers	Vibration: ISO 5349. Estimation of daily exposure: direct observation for one week (chronometer)
Bovenzi¹⁵	2008	Cohort	Italy	Cohort of 128 forestry workers. At the end of the follow-up, 57 workers (44.5%) had retired	Forestry workers: chainsaw operators	Vibration: sample of 9 chainsaws during operating conditions as per ISO 5349
Bovenzi¹⁶	2008	Cohort	Italy	183 forestry workers and 33 quarry workers completed the follow-up	Forestry workers: chainsaws. Quarry workers: tools for processing marble	Vibration: measurements taken during tool operating conditions as per ISO 5349
Bovenzi¹⁷	2005	Transversal	Italy	Cases: 100 female workers using orbital sanders. Controls: 100 female office workers	G(A) orbital sanders; (B) orbital sanders/hand sanding; (C) hand sanding	Vibration: measurements performed on 9 orbital sanders. Acceleration: 6.8 m/s2
Futatsuka¹⁸	2005	Transversal	Japan	73 quarry drill operators; 29 controls: manual tasks in the same companies	Quarry drill operators (rock drill)	Vibration: ISO 5349. Acceleration (drills): 45-55 m/s2; 160-210 min/day. Temp: South of Vietnan >25oC
Barregard¹⁹	2003	Transversal	Sweden	900 car mechanics received a questionnaire; 806 replied	Mechanics of cars	Vibration: working time (average): 12 years. Exposure: 14 minutes/day. Vibration level: 3.5 m/s2
Allen²⁰	2002	Transversal	Ireland	Three groups of men (79 riveters, 52 healthy controls, and 79 claimants)	Workers: riveters. Controls: no vibration. Claimants: yard/public services	Vibration: exposure time of 0.2 - 18 years among riveters and 1.5 - 48 years among claimants
Palmer²¹	2000	Transversal	United Kingdom	Questionnaires answered by 12.907 people aged 16-64 years (6.913 men/5.994 women)	Unspecified, random selection of record lists	Vibration: exposure assessed by questionnaire
Aiba²²	1999	Cohort	Japan	383 workers (men): use of impact wrench in electric light pole factory, 1982 to 1999	Workers using an impact wrench	Vibration: ISO 5349 and JIS B 49000. Exposure: 102 to 117 minutes/day. Cold: not characterized
Palmer²³	1998	Transversal	England	153 gas distribution agents (response rate 81%). Average of 16 years using vibrating tools	Gas distribution agents (pneumatic tools)	Vibration: ISO 5349. Vibratory tools (time of use - questionnaire): 1.2 to 5.5 hours/week (on average)
Bovenzi²⁴	1998	Transversal	Italy	Cases: 822 workers exposed to vibration, Controls: 455 healthy men not exposed	Grinders, mechanics, quarry drillers, construction/forestry workers, etc.	Vibration: ISO 5349; 8.3 m/s2 (percussion); 2.8-4.7 m/s2 (percussion/rotary); <2 m/s2 (rotary hand tools)
Miyashita²⁵	1998	Transversal	Japan	4652 private forestry workers (at least 1 medical examination for VS** from 1974 to 1996)	Forestry workers exposed to hand and arm vibration (chainsaws)	Vibration: estimation of career time operating vibratory tools

First author	Evaluation of the Raynaud phenomenon	Outcome
Kluger⁸	Questionnaire by e-mail. RP*: finger whitening related to cold. No evaluation was performed by a physician	448 questionnaires: 30 reported symptoms of RP; 11 appeared after the beginning of tattooing activity. Daily work hours: association with RP
Pettersson⁹	RP* classified by the questionnaire (with image)	RP* considered in 37% of those who reported exposure to hand and arm vibration and in 15% of those who did not report the exposure
Roquelaure¹⁰	Doctor asked about RP* features (last 12 months), defined as finger whitening episodes triggered by exposure to cold	87 cases of RP* diagnosed, 56 (women) and 31 (men). Female: association with psychosocial factors. Male: association with exposure to cold
Aiba¹¹	Medical evaluation with questions about the signs/symptoms related to RP* and typical image to aid in reporting	RP: 39 workers during the period. Incidence of RP: 6.27 people per 1000 individuals-year. Prevalence: 0.6% (1982), 6.2% (1987), 4.9% (2008)
Inaba¹²	Self-administered questionnaire. “White finger in response to cold environment”. No evaluation by a physician and no picture of RP*	Prevalence of RP* among construction electricians: 43.2% (winter) and 7.2% (summer)
Burström¹³	Self-administered questionnaire. Prevalence of RP* estimated by the questionnaire, without medical evaluation	Prevalence of white fingers: 13.4% (hand/arm vibration); 8.4% (controls). Higher odds ratio: intense vibration categories and workers in the North
Bovenzi¹⁴	Criterion 1: reliable history (images of RP*). Criterion 2 (more restrictive): history of “white fingers” and cold provocation test	Prevalence of RP*: Criterion 1: 21.7% (vibration) and 7.3% (controls). Criterion 2: 10.8% (vibration) and 0.7% (controls)
Bovenzi¹⁵	Physical examination; RP* related to occupation if provoked by cold and first episode after the beginning of occupational exposure	Prevalence of RP* related to vibration (beginning of the study): 26.6%; 11 new cases during the follow-up; cumulative incidence: 11.7%
Bovenzi¹⁶	Physical examination; RP* related to occupation if provoked by cold and first episode after the beginning of occupational exposure	Prevalence of RP* related to vibration (beginning of the study): 18.1% (forest workers:14.8%; quarry workers:36.4%). Incidence:1.7% (3 cases)
Bovenzi¹⁷	Physical examination; RP* related to occupation if provoked by cold and first episode after the beginning of occupational exposure	Daily vibration: higher in group A (4.7 m / s2) than in group B (3.9 m / s2); no significant difference (RP*) between furniture sander and controls
Futatsuka¹⁸	Subjective complaints assessed by interview. Peripheral circulation and neurosensory tests	No workers suffering from “white fingers”. Hypoaesthesia, weakness, and coldness in fingers/hands: significantly higher in the drill operators
Barregard¹⁹	Diagnosis based on the history of well-marked pallor episodes on the fingers or parts of the fingers (induced by cold)	Estimated prevalence of RP* related to vibration: approximately 15% among car mechanics
Allen²⁰	Questionnaire: medical and occupational history. Vasospasm: provocative test (cold) and systolic pressure of the finger	Riveters (6.3%) and claimants (83.5%) reported RP* symptoms. Positive test for vasospasm (finger cooling): riveters (30.4%); claimants (19%)
Palmer²¹	Questionnaire considering well-marked alterations of finger coloration caused by cold conditions	Pallor of the fingers (history): 14.2%. Cold-induced: 11.8%. Clear demarcation: 4.6%. Time of exposure (vibration): associated with symptoms
Aiba²²	Questionnaire: medical and occupational history. Doctor asked about RPrelated factors (images of RP)	Prevalence of RP* related to vibration: 1.7% (1982), 4.86% (1986), disappearing in 1994. During the period: preventive measures introduced
Palmer²³	Interview with doctor or nurse, questionnaire, physical examination, and hand immersion test in cold water (2-8oC for 4 minutes)	Prevalence of pallor of the fingers: 24%. Risk increased significantly with the hours of use of vibratory tools and the level of vibration
Bovenzi²⁴	Diagnosis: positive history for pallor episodes involving at least 1 finger and occurring after exposure to localized upper limb vibration	Prevalence of RP*: 17.2% among workers exposed to vibration, ranging from 9.0% among grinders to 51.6% among foundry workers
Miyashita²⁵	Medical evaluation records	Prevalence of workers who complained of “white fingers” induced by vibration: 25.9% (1978), 25.7% (1988) and 15.1% (1996)

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E-mail: ramb@amb.org.br

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[1] CORRESPONDING AUTHOR: Rafael Alves Cordeiro. Instituto Oscar Freire Rua Teodoro Sampaio, 115 - Cerqueira César, São Paulo - SP, Brasil – 05406-000 – Phone: 55 (11) 3061-7291 Email: rafael19abc@hotmail.com