Among 76 stonedrillers and stonecutters/chippers working in the Rapolano travertine quarries (Tuscany, Italy), 27 subjects (35.5%) were affected with vibration-induced white finger (VWF). The median latent period for VWF was ten years (range 0.1-26 years). A VWF prevalence of 8% was found among 60 comparable controls (P less than 0.0001). Vibration measurements showed that the frequency-weighted accelerations for two rock-drills and two small chipping hammers ranged from 19.7 to 36.4 m/s2. Weighted accelerations between 2.4 and 4.1 m/s2 were measured on the handles of a vertical grinder and a hand cutter. Vibration data, daily exposure time and total duration of exposure period were used to calculate two indicators of vibration dose such as the four-hour, energy-equivalent, frequency-weighted acceleration (m/s2) and the vibration exposure level (dB). A significant association between the vibration exposure level and the severity of VWF stages was observed among the travertine operators. The dose-effect relationship proposed by ISO 5349 was not suitable for the data of the present study because it overestimates the risk due to hand-transmitted vibration in the travertine workers. Finally, the results of a cold test indicated that the rewarming time of fingertips to room temperature was more prolonged in the operators with VWF than in those without VWF and in the controls.