New Standard Criteria for Cold Provocation Test With Hand Immersion for Cases of HAVS in Japan

In Japan, physicians diagnose hand-arm vibration syndrome (HAVS), a peripheral circulatory disorder, with a cold provocation test (Harada et al, 1999). However, there are no standard protocols for the performance of this test although several standards have been proposed and used for diagnosis of HAVS. The inconsistencies have led to confusion among practitioners who treat patients with HAVS, and there is demand for a national standard. ISO 14835-1:2005 recommends that the cold provocation test be performed with 12 degree C water and immersion of the hands for 5 min. However, there is extensive data in Japan where the cold-water provocation test is performed in 10 degree C water for 10 min. This study aimed to establish a national standard for cold-water provocation tests based on an analysis of Japanese multi-institutional data.