For the diagnosis of the hand-arm vibration syndrome, cold-stress tests using different water temperatures and periods of hand immersion have been investigated in Europe, North America, and Japan. In recent years, peripheral circulation and sensory tests, including finger-skin temperature measurement involving immersion of one hand in cold water at 10 degrees C for 10 min, have been widely accepted in Japan. On the other hand, standardization of the vascular assessment method is under discussion at the International Organization of Standardization. We reviewed research findings from Japan concerning finger-skin temperature measurement during the cold-stress test, especially factors influencing the test results and the diagnostic significance. For establishment of the cold-stress test for epidemiology studies of the hand-arm vibration syndrome, standardization of the environmental factors influencing the test results and reporting of its sensitivity and specificity are needed.