Hand‑Arm Vibration Syndrome

Understand and Prevent HAVS

A comprehensive patient and worker guide to Hand-Arm Vibration Syndrome, a serious yet preventable occupational disease affecting hands, wrists, and arms from prolonged tool vibration.

What is HAVS?

Hand-Arm Vibration Syndrome (HAVS) is a long-term health condition caused by repeated exposure to vibrating tools or machinery. It can damage nerves, blood vessels, muscles, and joints of the upper limbs. Once symptoms develop, the condition often becomes permanent without early intervention.

Symptoms typically start mild—like finger tingling or cold sensitivity—but may progress to chronic pain, numbness, or loss of hand function. Early detection and avoidance of further vibration are essential.

Who Is at Risk?

People working with power tools or vibrating machinery are most at risk. This includes:

• Construction workers(e.g. drill, breaker, grinder operators)
• Miners and quarry workers
• Forestry workers(e.g. chainsaw operators)
• Engineers and steelworkers
• Road maintenance crews
• Groundskeepers and gardenersusing strimmers or brush cutters

Factors that increase risk:

• Prolonged tool usewithout breaks
• High-vibration equipment
• Cold, wet working conditions
• Poor tool maintenance
• Tight tool grip
• Smoking
• Previous hand injury or certain health conditions

What are the Symptoms?

HAVS symptoms can be divided into three main categories:

1. Vascular Symptoms (Vibration White Finger):

• Fingers turnwhite or blue in the cold
• Followed bypainful redness and throbbing when rewarmed
• Often affects the dominant hand first
• Can lead tofingertip tissue damage in severe cases

2. Neurological Symptoms:

• Tingling,numbness, or pins and needles
• Loss offinger sensation or dexterity
• Difficulty performing fine tasks (e.g. fastening buttons)

3. Musculoskeletal Symptoms:

• Aching, stiffness, or painin hands or forearms
• Reduced grip strength
• In some cases, conditions likeKienböck’s disease or Dupuytren’s contracture

Progression and Severity

The Stockholm Workshop Scale classifies HAVS into stages:

• Stage 1:Occasional white finger attacks or tingling
• Stage 2:More frequent symptoms, loss of sensation
• Stage 3:Persistent numbness, poor hand function
• Stage 4:Permanent tissue damage and disability

Diagnosis: What to Expect

There is no single test for HAVS. Diagnosis involves:

• Detailed work history
• Symptom description
• Physical exam(nerve tests, grip strength)
• Cold provocation or Doppler studies
• Nerve conduction studies, especially if Carpal Tunnel Syndrome is suspected

Other conditions like diabetes, arthritis, or autoimmune disease may need to be ruled out.

Treatment and Prognosis

There is no cure for HAVS. However, early action can halt or slow progression.

Key Treatment Steps:

• Stop using vibrating tools
• Stop smoking
• Keep hands warm and dry
• Avoid medications that restrict circulation (e.g. beta blockers)
• Redeploy to a vibration-free roleif possible
• Some may benefit fromcalcium channel blockers (e.g. nifedipine) for vascular symptoms

Prevention: What Employers Must Do

Under the Control of Vibration at Work Regulations 2005, UK employers must:

• Assess riskand monitor exposure
• Keep exposure below legal thresholds (EAV and ELV)
• Provide safe equipment and protective clothing
• Train staffon safe tool use
• Offer health surveillanceand act on early symptoms
• Maintain equipmentto reduce excess vibration

Failure to comply may result in legal and financial penalties.

Mental Health Impact

HAVS can have serious psychological consequences including:

• Depression and anxiety
• Loss of work identity
• Embarrassmentdue to disability
• Social withdrawal

Mental health support and occupational health services should be offered where appropriate.

FAQs

Can HAVS be reversed?
Early stages may improve with prompt action. In advanced cases, the damage is usually permanent.

How do I know if I have HAVS or Carpal Tunnel Syndrome?
HAVS affects fingertips and is triggered by cold. CTS affects the wrist, may cause waking at night, and causes different sensory changes. A doctor can help differentiate.

Is HAVS a recognised disability?
Yes. Severe HAVS is a prescribed industrial disease (PD A11). Workers may be entitled to Industrial Injuries Disablement Benefit (IIDB) or compensation.

Clinical Pearls / Key Points

• HAVS ispreventable but often irreversible
• It can affectvascular, nerve, and musculoskeletal systems
• Cold triggersRaynaud-like attacks
• Smokingworsens symptoms
• Symptoms may appearmonths or years after exposure begins
• Regulartool maintenance and breaks reduce risk
• Early reportingof symptoms improves outcomes

Call to Action

Experiencing symptoms?
Contact your GP or occupational health provider immediately.
Employers must act if symptoms are reported.

Need advice or a specialist consultation?
Visit www.TheArmDoc.co.uk or call 020 3384 5588
Email: Info@TheArmDoc.co.uk

Disclaimer

This leaflet is for general information only and does not replace medical advice. Always consult a healthcare professional if you have symptoms or concerns.