Hand arm vibration syndrome (HAVS) is a significant occupational health issue that affects workers exposed to vibrating tools and machinery.
According to the Health and Safety Executive (HSE), there were 215 new cases of hand arm vibration syndrome in 2023. It is believed there are 2 million workers at risk and at least 300,000 people currently suffering from advanced stages of the condition today.
In this comprehensive guide we discuss hand arm vibration syndrome symptoms, how to prevent it and treatment options.
What is hand arm vibration syndrome?
Hand arm vibration syndrome (HAVS) develops due to prolonged exposure to vibration transmitted from tools and machinery to workers’ hands and arms. Most at risk are people who use power tools such as drills, chainsaws, and hammers.
What are the symptoms of hand arm vibration syndrome?
By recognising the symptoms of hand arm vibration syndrome early, affected workers can seek appropriate medical evaluation and treatment, potentially preventing long-term complications.
Symptoms of hand arm vibration syndrome vary, because HAVS is a range of conditions which include:
Vibration white finger (VWF)
VWF is the most well-known condition, characterised by intermittent episodes of blanching (whitening) of the fingers due to restricted blood flow. It is caused by prolonged use of vibrating tools which damage blood vessels, leading to poor circulation in the fingers.
Symptoms:
- Fingers may turn white or blue in cold conditions or when stressed.
- Pain, numbness, and tingling during or after exposure to vibration.
- In severe cases, it can lead to permanent damage, making manual dexterity tasks difficult.
Hand-arm vibration neurological symptoms (HAVNS)
HAVNS refers to the neurological effects of vibration exposure, affecting the nerves in the hands and arms. The condition is caused by long-term vibration exposure which damages the sensory and motor nerves in the hands.
Symptoms:
- Loss of sensation or numbness in fingers and hands.
- Tingling or “pins and needles.”
- Weak grip strength, which can impair the ability to hold tools or objects securely.
- Difficulty in performing tasks that require fine motor skills, such as buttoning clothes.
Musculoskeletal disorders
Musculoskeletal disorders affect the muscles, tendons, bones, and joints in the hands and arms due to prolonged vibration. Vibration-induced stress and repetitive motions from tool use can lead to inflammation and wear-and-tear injuries.
Symptoms:
- Joint pain or stiffness, especially in the wrists and elbows.
- Swelling and reduced range of motion.
- Chronic muscle fatigue and weakness, which can hinder everyday activities.
Carpal tunnel syndrome
Carpal tunnel syndrome is a common condition associated with prolonged vibration exposure. It occurs when the median nerve, which runs through the carpal tunnel in the wrist, becomes compressed or irritated due to repetitive strain and vibration-induced swelling.
Symptoms:
- Numbness, tingling, or burning sensation in the thumb, index, middle, and ring fingers.
- Weakness in the hand, making it difficult to grip or hold objects securely.
- Pain that may radiate from the wrist to the forearm and, in severe cases, up to the shoulder.
- Symptoms often worsen at night, potentially disturbing sleep.
Dupuytren’s contracture
Dupuytren’s contracture is a condition where the connective tissue under the skin of the palm thickens and tightens, leading to the progressive curling of one or more fingers towards the palm. Although the exact link with vibration exposure is not fully understood, it is more commonly observed in workers using vibrating tools.
Symptoms:
- Nodules or lumps in the palm, usually near the base of the fingers.
- Thickening and tightening of the skin over time, leading to reduced flexibility.
- Fingers, typically the ring and little fingers, become bent and difficult to straighten.
- In advanced stages, it can severely restrict hand movement and impair the ability to perform tasks requiring an open palm or extended fingers.
Hand arm vibration syndrome causes and risk factors
HAVS is caused by vibration energy transmitted from tools and machinery into workers’ hands and arms. Several factors contribute to its onset:
Magnitude and duration of exposure
Tools and machinery that produce high levels of vibration pose a greater risk. This includes equipment like chainsaws, grinders, and pneumatic drills, which transmit significant vibration energy into the hands and arms.
The length of time an individual is exposed to vibration plays a critical role. Regular, long-term use of vibrating equipment without adequate breaks significantly increases the likelihood of developing HAVS.
Individual susceptibility
People vary in their sensitivity to vibration, which can be influenced by genetic, physiological, and health factors. Some people may develop HAVS even with relatively lower exposure levels due to their unique predisposition.
High grip forces and cold environments
Holding tools tightly or exerting significant effort during operation amplifies the transmission of vibration into the hands and arms, increasing the risk of damage.
Low temperatures cause blood vessels to constrict, reducing circulation in the hands and arms. This exacerbates the effects of vibration and accelerates the onset of HAVS symptoms, such as numbness and tingling.
Smoking and pre-existing vascular conditions
Nicotine restricts blood flow by narrowing blood vessels, compounding the vascular damage caused by vibration exposure. Smokers are more prone to developing HAVS due to this reduced circulation.
Individuals with underlying conditions such as Raynaud’s disease, diabetes, or hypertension are at greater risk. These conditions impair blood flow and make the vascular system more vulnerable to the effects of vibration.
Hand arm vibration syndrome treatment
Hand arm vibration syndrome treatment aims to manage symptoms, alleviate discomfort, and prevent the condition from worsening.
While there is no definitive cure for HAVS once it has developed, a combination of lifestyle adjustments, medical interventions, and preventative measures can significantly improve quality of life and functionality.
Here are some approaches to treating HAVS:
- Reduce exposure to vibrating tools. Stop or significantly limit exposure to vibrating tools and machinery. Reassign affected employees to non-vibration roles or provide tools with lower vibration levels.
- Physiotherapy to improve mobility and strength. Stretching and strengthening exercises maintain dexterity and reduce discomfort. Regular physiotherapy sessions, combined with self-directed exercises, support long-term hand and arm function.
- Medication for vascular symptoms in advanced cases. Drugs like calcium channel blockers can enhance circulation and alleviate symptoms such as finger blanching and pain. Medications targeting nerve pain can help with symptoms like tingling or numbness.
What legislation is in place to protect employees?
In the UK, several pieces of legislation are in place to protect employees from hand arm vibration syndrome and ensure their health and safety in the workplace. These laws impose clear responsibilities on employers to identify, manage, and mitigate risks associated with vibration exposure.
Health and Safety at Work Act 1974 (HSWA)
The Health and Safety at Work Act 1974 (HSWA) is the framework for workplace health and safety.
This legislation places a legal duty on employers to ensure, as far as is reasonably practicable, the health, safety, and welfare of their employees while they are at work. This includes implementing measures to minimise risks associated with vibration exposure.
Employers are required to assess workplace hazards, including those from vibrating tools and machinery, and put in place safe systems of work, adequate training, and appropriate supervision. They must maintain tools and equipment in safe working condition.
Control of Vibration at Work Regulations 2005
The Control of Vibration at Work Regulations 2005 establish legal limits for vibration exposure and require employers to implement measures to protect their workers.
Employers must conduct risk assessments to evaluate the levels of vibration their employees are exposed to and identify tasks or equipment that could lead to HAVS.
The regulations set exposure action values (EAV) and exposure limit values (ELV) to guide employers to manage these risks.
Employers are also required to implement control measures, such as using low-vibration tools, scheduling rest periods, and rotating workers to minimise individual exposure. Employees must receive information about the risks of vibration and training on how to work safely.
Health surveillance is mandatory for workers at risk, enabling early detection and management of HAVS.
Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 2013 (RIDDOR)
Under the Reporting of Injuries, Diseases, and Dangerous Occurrences Regulations 2013 (RIDDOR), employers are legally obligated to report cases of HAVS diagnosed by a medical professional.
Employers must provide detailed information about the employee’s role, exposure history, and the preventive measures in place.
How can employers prevent HAVs in the workplace?
Preventing hand arm vibration syndrome requires a proactive and holistic approach that combines effective risk management, engineering and administrative controls, personal protective equipment (PPE), training, and health surveillance.
1. Conduct risk assessments
Comprehensive risk assessments are the foundation of HAVS prevention. Employers must identify tasks with vibrating tools and machinery, understand the magnitude and frequency of vibration transmitted to workers’ hands, and assess how long employees are exposed to such vibration daily.
Risk assessments should also consider individual susceptibility to HAVS, including pre-existing health conditions and environmental factors like cold conditions.
These assessments, guided by industry standards like the Control of Vibration at Work Regulations, enable employers to evaluate the risks and implement appropriate controls.
2. Implement control measures
Eliminate the risk
The most effective way to manage vibration hazards is by eliminating the risk altogether. This can be achieved by redesigning processes to remove the need for vibration-inducing activities. For example, remote-controlled or automated machinery can be used to perform tasks that would otherwise expose workers to vibration.
Also, replacing high-vibration equipment with alternatives that do not generate harmful levels of vibration is another key strategy.
Engineering controls
Engineering controls are essential for reducing vibration exposure at its source. For example, ensuring employees are provided with low-vibration tools that are regularly maintained and replaced when necessary.
Tools with anti-vibration handles, pads, or mounts help to absorb and dampen vibration energy. Incorporating vibration-damping materials in workstations or tool components can further minimise vibration.
Administrative controls
Administrative controls focus on managing and limiting employees’ exposure to vibration through effective planning.
Implementing job rotation can ensure tasks involving vibration are distributed across multiple employees, reducing the exposure duration for individuals. Scheduled rest breaks provide workers with recovery time, while work schedules should avoid prolonged or repetitive tasks with high vibration levels in a single shift.
Training employees in proper ergonomic practices, such as correct tool handling, grip force reduction, and maintaining good posture, further mitigates the impact of vibration.
PPE
When engineering and administrative measures cannot fully eliminate vibration risks, PPE must be provided.
Anti-vibration gloves, designed to reduce the transmission of vibration to the hands, can provide additional protection. Similarly, tool attachments such as vibration-damping grips or sleeves can further decrease the impact of vibration.
However, PPE should always be considered as a last line of defence, not a standalone solution.
3. Provide training
Training and awareness programmes are critical to ensure employees can proactively prevent HAVS.
Employees should be trained to recognise early hand arm vibration syndrome symptoms, such as tingling, numbness, or blanching in the fingers, and to use tools correctly, avoiding excessive grip force and adopting proper posture.
Employees should also be encouraged to report faulty tools and follow maintenance and care guidelines to ensure they remain in good condition and generate minimal vibration.
4. Provide health surveillance
Health surveillance is crucial for preventing and managing HAVS. Regular medical assessments for employees exposed to vibration risks enable early detection of hand arm vibration syndrome symptoms and timely intervention.
Organisations should implement clear reporting procedures so workers can flag any symptoms promptly, and cases should be closely monitored to track progression and prevent further exposure. Adjusting work duties for affected employees is also essential to minimise the risk of worsening their condition.
Risk Assessment Training
Our IOSH Approved Risk Assessment Training provides participants with the knowledge and skills to carry out risk assessments, including vibration risks. Participants discover how to assess hazards and allocate precious resources most effectively to prevent hand arm vibration syndrome symptoms.
Understanding and applying risk assessment principles is not only a legal requirement but also essential for enabling managers and employees to implement your organisation’s safety policies and procedures.
Find out about Risk Assessment Training on our website or contact our friendly team on 0203 011 4242/ info@praxis42.com to find out how we can tailor training to your organisation, roles and activities.
Adam Clarke
Managing Director (Consulting)
