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What is hand arm vibration syndrome (HAVS)?

Workers who are regularly exposed to hand-arm vibration can suffer from a range of conditions known as Hand Arm Vibration Syndrome (HAVS) which includes vibration white finger and carpal tunnel syndrome.

This is due to pathological effects on the peripheral vascular system, peripheral nervous system, muscles and other tissues of the hand and arm.

Neurological symptoms of HAVS include numbness and tingling in the fingers, and a reduced sense of touch and temperature. This nerve damage can be disabling, making it difficult to feel, and to work with, small objects.

Vascular symptoms include episodic finger blanching (the tip of one or more fingers temporarily blanches) which is characteristic. This is sometimes known as 'vibration white finger', 'dead finger' or 'dead hand'. The main trigger for this is exposure to the cold, for example being outdoors early on a winter's morning. The symptoms can also be triggered by localised or general body cooling in otherwise warm environments. Although vibration causes the condition, it does not precipitate the symptoms.

After initial blanching indicating vasospasm, the circulation is restored, either spontaneously or after rewarming the fingers. Tissue ischaemia occurs during the period of spasm. This leads to an exaggerated return of blood flow and painful red throbbing fingers (reactive hyperaemia).

During attacks the sufferer may complain of numbness, pain and cold as well as reduced manual dexterity. Effects are seen initially in the tips of the affected fingers, if exposure to vibration continues then changes may occur with the spreading up the fingers; The thumb may also be affected. As the condition progresses, the frequency of attack will increase. Rarely, in very severe cases, blood circulation may be permanently impaired.

Affected workers may also complain of joint pain and stiffness in the hand and arm. Grip strength can be reduced due to nerve and muscle damage.

An individual worker suffering from HAVS may not experience the complete range of symptoms, for example symptoms related to the neurological component can be present in the absence of vascular problems and vice versa. Neurological symptoms generally appear earlier than finger blanching.

Employees suffering from HAVS can experience difficulty in carrying out tasks in the workplace involving fine work or manipulative work and have a reduced ability to work in cold conditions. The disease may also have an impact on social and family life. Periodic attacks of "white finger" will take place not only at work, but also during activities such as car washing or watching outdoor sports. Everyday tasks, for example fastening small buttons on clothes, may become difficult.
When is health surveillance required?

Regulation 7 of the Control of Vibration at Work Regulations 2005 requires employers to provide suitable health surveillance where the risk assessment indicates a risk to workers' health. In any case, workers likely to be exposed in excess of the daily exposure action value of 2.5 m/s2 A(8) should be under suitable health surveillance.
Health surveillance should be instituted for:

• employees who are likely to be regularly exposed above the exposure action value;
• employees likely to be occasionally exposed above the exposure action value where the risk assessment identifies that the frequency and severity of exposure may pose a risk to health;
• employees who have a diagnosis of HAVS (even when exposed below the exposure action value).

Competency and training

It is essential that health professionals involved in health surveillance for HAVS can demonstrate that they have the necessary expertise for the required testing (level 3 or level 4).

Contact us now on 01925 838350 and speak to one of our consultants for further advice on your company's needs.
Tel: (01925) 838350 - Fax: (01925) 838351 - Email: office@soundadviceltd.co.uk