Tiered approach to assessing signs of HAVS

Nov 10, 2017

By Simon Jukes, Deputy Chief Occupational Health Advisor, MOHS Workplace Health


Where employees are exposed to hand transmitted vibration above the action value of 2.5m/s2 (8) or 100 points, they will require health surveillance. This is in line with The Control of Vibration at Work Regulations 2005 and the guidance found in HSE document L140.

Surveillance is broken down into a number of tiered assessments (1 to 5).

  • Tier 1 - A short and simple pre-assessment designed to identify employees that may be suffering from symptoms. Can be self-administered and should be completed prior to first exposure.
  • Tier 2 - The same short and simple screening assessment, completed annually for exposed employees (without symptoms). Again, may be self-administered.

Note that Tier 1 & 2 Assessments are simple screening tools. The symptoms that they are designed to identify are complex. This can lead to spurious positive answers when self-completed.

Positive answers trigger a longer Tier 3 assessment by an OH Advisor and spurious positive results add unnecessary cost. It may be better to employ an OH Provider to conduct Tier 1 & 2 pre-assessments, ensuring that only employees with likely symptoms go on to the third tier of assessment.

  • Tier 3 – A much more in depth assessment designed to identify possible symptoms. It looks at past and present exposure, medical and family histories. It must be undertaken by a trained and competent practitioner and may take up to 45 minutes to complete. Where HAVS symptoms are suspected, the employee must be referred for Tier (4) of assessment with an OH Physician.
  • Tier 4 - Assessed by a competent (trained) doctor or physician. It should result in a written diagnosis with a description symptoms and advice on future exposure. The employer will be advised to inform the HSE of the case, under RIDDOR.
  • Tier 5 - specialised testing to confirm symptoms in support of a HAVS diagnosis. (Most cases stop at Tier 4).

For more information about HAVS, please email simonjukes@mohs.co.uk


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