Hand muscle strength was compared between workers regularly exposed to hand-held vibrating tools (n=81) and a non-exposed control group (n=45). Maximal voluntary strengths of hand grip, thumb pinch, thumb palmar abduction and index and little finger abduction were measured. The exposed workers had significantly weaker extrinsic (7%, P<0.01) and intrinsic (19%, P<0.0001) muscles than the controls. Reduced vibration perception was noted in nine vibration-exposed workers who presented with symptoms of hand muscle weakness (P<0.01). Cold intolerance following vibration exposure was found to precede sensorineural and vasospastic symptoms. We therefore postulate that cold intolerance may be a valuable marker for early detection of the adverse effects of vibration. This study emphasizes the need for tests of intrinsic muscle strength in order to evaluate the impairment of hand function observed in vibration-exposed workers.