Hand-Arm Vibration (HAV) is a widespread disease in many industries and occupations. HAV exposure at work can arise from the use of hand-held power tools, hand-guided machinery and hand-fed machines. Prolonged and regular exposure to this vibration can affect the operator’s health. The survey in 1997-98 gave a prevalence estimate of 288 000 sufferers from vibration white finger in Great Britain (255 000 males and 33 000 females respectively). The number of new cases of Vibration White identified was 7,373 in the period 2007-2016, similarly 3615 cases of Carpel Tunnel Syndrome(CTS).

The Control of Vibration at Work Regulations 2005 requires all employers to have Health Surveillance in place where people are at risk. Health Surveillance must be in place for employees who are exposed above the action value (2.5m/s A (8)) and for employees who are sensitive to vibration to minimise the risk of the disease progression.

Health Surveillance for HAVS

Health surveillance for HAVS should be carried out by competent persons and who received training in HAVS assessments. Karen Shea has completed and passed the Faculty of Occupational Medicine examination and attends regular refresher courses.

Health surveillance encompasses a “tiered approach”.

Tier One

This comprises of a HAVS questionnaire to be completed by employees who it is proposed will commence working with vibrating tools. If the resulting questionnaire indicates a HAVS condition, this would be a contraindication to employment with Vibrating Tools.

Tier Two: Annual (screening) questionnaire

In the absence of HAVS health issues being declared at Tier One and the individual working with Vibrating Tools, a HAVS questionnaire should be administered at twelve monthly intervals, however once every three years it is advised that the employee should have a tier three assessment.

Tier Three: Assessment by a qualified person

This involves a HAVS health assessment by a suitably qualified Occupational Health Professional, i.e. Occupational Health Nurse who has passed the FOM HAV examination. A further questionnaire is completed by the employee at this stage which asks relevant questions regarding their medical history, social/leisure pursuits and family health issues. The person may then have some basic examinations undertaken such as Blood pressure, bilateral pulses, grip strength, assessment of manual dexterity etc This is assessed and if the results indicate a likelihood of HAVS signs and symptoms, then a referral to an Occupational Health Physician at Tier Four, is recommended.

Tier Four: Formal diagnosis

The employee will be seen and examined by an Occupational Health Physician, again who successfully has completed the FOM HAV examination. A formal diagnosis may be made at this stage, indicating the extent of the condition by “staging” under the Stockholm Workshop Scale of 0 to 3. It is at this stage, depending on the diagnosis and staging that reporting under the RIDDOR 1995 regulations will be recommended. A “Fitness for Work” recommendation will be made.

Tier Five: Use of standardised tests (optional)

The Occupational Health Physician may recommend that a referral for Objective Testing is made. This will include such things as Vibrotactile and Thermal Perception Threshold Estimation.

Shea OH Ltd Hand Arm Vibration Health Surveillance includes:

  • Explaining how to assess the risks in tools and showing how to reduce risk
  • Performing Vibration risk assessments
  • Providing appropriate Health Surveillance at Tier 1-5
  • Confidential data management and reporting, with employee consent
  • Worker education at time of test
  • Permanently retained records (40 years)
  • Completed COSHH report for each individual to be kept at your company to demonstrate to regulators that you are compliant with the law
  • Running a training course on Hand-Arm Vibration.

Associated Documents:

Hand/Arm Vibration Factsheet
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