What is HAVS?
Hand-arm vibration syndrome (HAVS), is a secondary form of Raynaud's syndrome and causes symptoms in fingers, hands and arms as a result of using vibrating tools. It used to be called vibration white finger. The name was changed to HAVS, as other symptoms may occur in addition to white fingers.

HAVS is caused by repeated and frequent use of hand-held vibrating tools - for example, power drills, chainsaws, pneumatic drills, powered lawnmowers etc. It may also be caused by holding or working with machinery that vibrates.

Jobs requiring regular and frequent use of vibrating tools and equipment and handling of vibrating materials are found in a wide range of industries, for example; building and maintenance of roads and railways; construction; estate management; forestry; foundries; heavy engineering; manufacturing concrete products; mines and quarries; motor vehicle manufacture and repair; public utilities and shipbuilding and repair.

HAVS is preventable, but once the damage is done it is permanent. It is serious and disabling. Damage from HAVS can include the inability to do fine work and cold can trigger painful finger blanching attacks.

Symptoms
Identifying signs and symptoms at an early stage is important. It will allow you, as the employer, to take action to prevent the health effects from becoming serious for your employee. The symptoms include any combination of:

• Loss of feeling (numbness) and or pins and needles (tingling) in the fingers; this may initially be only at the tips of the fingers and may come and go;
• Not being able to feel things properly;
• Loss of strength in the hands;
• Minor damage to the muscles, joints and bones which may cause aches and pains in the hands and lower arm. The strength of your grip may be weakened.
• Fingers going white (blanching) and becoming red and painful on recovery (particularly in the cold and wet, and probably only in the tips at first). Some people do not have the full classic colour changes but still develop bouts of uncomfortable, pale, cold fingers. The duration of each bout of symptoms can last from minutes to hours. The amount of pain or discomfort varies between people. Symptoms usually go after each bout but one or more bluish fingers may persist in severe cases.

For some people, symptoms may appear after only a few months of exposure, but for others they may take a few years. They are likely to get worse with continued exposure to vibration.

As the condition develops, numbness becomes permanent. This leads to muscle weakness and wasting. In some cases the symptoms develop months or years after finishing working with vibrating tools.

The effects on people include:

• pain, distress and sleep disturbance;
• inability to do fine work such as assembling small components or everyday tasks such as fastening buttons;
• reduced ability to work in cold or damp conditions (ie. most outdoor work) which would trigger painful finger blanching attacks;
• reduced grip strength, which might affect the ability to do work safely.

These effects can severely limit the jobs an affected person is able to do, as well as many social activities.

What to do as an employer
The costs to employees and to employers of inaction could be high. British Airways has recently been fined £6,500 for breaching regulation 5(1) of the Control of Vibration at Work Regulations 2005. The Health and Safety Executive (HSE) revealed that the company had not sufficiently risk assessed the effect of exposure by staff at Glasgow airport to drills, impact hammers and sanders, thus putting them at risk of developing the condition.
 
There are simple and cost-effective ways to eliminate risk of HAVS. The Control of Vibration at Work Regulations 2005 focuses on the elimination or control of vibration exposure. The long-term aim is to prevent new cases of HAVS occurring and enable workers to remain at work without disability.

The most efficient and effective way of controlling exposure to hand-arm vibration is to look for new or alternative work methods which eliminate or reduce exposure to vibration. This might include;

• holding tools as loosely as possible and in varying positions;

• ensuring that tools are well maintained;
• ensuring correct usage of tools and using the right tool for the job - the aim is not to have to use excessive grip, nor to use a tool for longer than necessary;
• taking regular breaks of at least 10 minutes away from the tool - short bursts of work are better than long periods of work without a break;
• keeping warm while at work - especially your hands;
• not smoking - the chemicals in tobacco can affect blood flow.

Health surveillance is vital to detect and respond to early signs of damage.

Health surveillance
Staff at risk should undergo regular health surveillance. The assessment may involve a questionnaire, a physical examination, a discussion about symptoms and various simple tests. The tests may include checking grip strength, ability to perform fine hand movements and the response of the fingers to cold.

Your risk assessments should help you determine which employees are at risk.
This will depend on whether your employees regularly and frequently work with vibrating tools and equipment and/or handle vibrating materials. It will also depend on how long your employees are exposed to vibration and at what level. As a simple guide, you will probably need to do something about vibration exposures if you answer yes to any of the following questions:

• Do your employees complain of tingling and numbness in their hands or fingers after using vibrating tools?
• Do your employees hold work pieces, which vibrate while being processed by powered machinery such as pedestal grinders?
• Do your employees regularly use hand-held or hand guided power tools and machines such as:
• concrete breakers, concrete pokers;
• sanders, grinders, disc cutters;
• hammer drills;
• chipping hammers;
• chainsaws, brush cutters, hedge trimmers, strimmers;
• powered mowers;
• scabblers or needle guns;
• concrete breakers/road breakers;
• cut-off saws (for stone etc);
• hand-held grinders;
• impact wrenches;
• jigsaws;
• needle scalers;
• pedestal grinders;
• polishers;
• power hammers and chisels;
• powered lawn mowers;
• powered sanders;
• Do your employees regularly operate:
• hammer action tools for more than about 15 minutes per day; or
• some rotary and other action tools for more than about one hour per day?
• Do you work in an industry where exposures to vibration are particularly high, such as construction, foundries, or heavy steel fabrication/shipyards?

References:
http://patient.info/health/hand-arm-vibration-syndrome-leaflet
http://www.hse.gov.uk/vibration/hav/