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Hand Arm Vibration Surveillance

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Jane Coombs
Jane Coombs

A presentation on preventing vibration white finger and hand arm vibration for workers who use hand held tools

1 of 27
Introduction to Hand Arm Vibration in an Occupational Setting jane.coombs@working-well-solutions.com
Contents • Introduction • What is vibration? • How is vibration measured? • Hand-arm vibration syndrome • Regulations • Control of Vibration at Work Regulations 2005 • Employers legal duties • Health surveillance guidance • Further Reading
Introduction Hand-arm vibration (HAV) widespread hazard for employees in many industries and occupationse.g. construction/demolition, mining, quarrying, forestry, shipbuilding/repair, foundries, public utilities, railways and aircraft manufacture • Percussive tools • Caulking tools • Riveting tools • Road breakers • Rotary tools • Grinders • Sanders • Burring tools • Forest and garden tools • Chain saws • Motor mowers • Others • shoe-pounding machines • Motorcycles handle bars
Introduction • Prolonged and regular exposure to vibration can affect the operators health • 5,000,000 employees exposed • 2,000,000 employees have clear risk of developing disease (HSE 2005) • Risks from vibration can be controlled and employees protected • To protect employees and to comply with the Vibration Regulations, employers need to assess the risks from vibration and control them.
What is vibration? • Vibrations arise when a body oscillates due to external and internal forces • the handle of a machine or the surface of a work piece vibrates rapidly • this motion is transmitted into the hand and arm
What is vibration? Vibration is defined by the • magnitude - acceleration (m/s2 r.m.s) • frequency (Hz)
What is vibration? Vibration is measured in three planes: X Y Z The axes are dependent on the position of the hand relative to the vibrating object – so should always be noted
How is vibration measured? • Instrumentation: • HAV measuring equipment should comply with the EN ISO 8041:2005 specifications for hand-arm vibration measuring equipment • Calibrate and monitor instrumentation for over-loading (e.g. vibration transducers). • Measurement method • Methods defined in EN ISO 5349-1:2001 • Carefully select mounting method as outlined in EN ISO 5349-2:2001
Hand-arm vibration syndrome • Neurological disorders • Numbness • Tingling • Loss of manual dexterity • Vascular disorders • VWF • secondary Raynaud’s phenomenon • Musculo-skeletal disorders • Reduced grip strength • Bone disorders • Other - Carpal tunnel syndrome
Symptoms Mild HAVS • Episodic blanching • Numbness • Tingling Severe HAVS • Cyanosis • Skin necrosis • Gangrene
A hand during an episode of blanching
Regulations • Control of Vibration at Work Regulations 2005 • European Physical Agents (Vibration) Directive (Directive 2002/44) • RIDDOR 1995
Control of Vibration at Work Regulations 2005 • Exposure action level (EAV) • ‘Daily amount of vibration exposure above which employers are required to take certain actions to control exposure’ • Greater the exposure level, greater the risk, the more action employers will need to take to reduce the risk • EAV is 2.5 m/s2 A(8)
Control of Vibration at Work Regulations 2005 • Exposure limit value (ELV) • The ‘maximum amount of vibration an employee may be exposed to on any single day’ • ELV is 5 m/s2 A(8) • It represents a high risk above which employees should not be exposed.
Control of Vibration at Work Regulations 2005 • Employers legal duties: • Assess the vibration risk to employees • Decide if employees are likely to be exposed above the daily EAV • If yes, introduce programme of controls to eliminate risk • Provide health surveillance to those regularly exposed above the EAV or at risk
Control of Vibration at Work Regulations 2005 • Decide if employees are likely to be exposed above the daily ELV • If yes, take immediate action to reduce their exposure below the limit value • Refer to publications on strategies to reduce vibration exposure e.g. alternative work methods, equipment selection, purchasing policy for replacing old tools, work schedules, clothing, workstation design, maintenance.
Employers legal duties: • Information and training on health risks • Keep a record of risk assessment and control actions • Keep health records for employees under health surveillance • Review and update risk assessments regularly • Consult employee rep. on proposals to control risk and provide health surveillance
Control of Vibration at Work Regulations 2005 L140 Guidance • Part 3: Practical control of vibration exposure and risk • Eliminate vibration exposure in the work process • Reduce exposure by mechanisation • Select equipment for reduced vibration exposure • Manage vibration exposure • Maintain tools and equipment • Reduce the level of exposure to the hand • Reduce the period of exposure • Gloves and warm clothing • Information and training for operators and supervisors • Obtaining competent advice or a consultant
Part 5: Tiered approach to health surveillance for HAVS Optional Standardised tests Not part of routine health surveillance Useful for studying progression of disease RIDDOR report / fitness to work recommendations Initial or baseline assessment Simple self-administered questionnaire returned to responsible person or qualified person Formal Diagnosis Doctor Targeted assessment Qualified person (OHN or doctor) A presumptive diagnosis can be made Tier 1 Tier 3 3 yearly assessment if no symptoms reported by questionnaire If symptoms reported or suffers from relevant vascular or neurological disorder No symptoms Fit to work Annual (screening) questionnaire Tier 2
Health Surveillance • Questionnaire screening • Diagnosis • History of symptoms • Exclude primary Raynaud’s phenomenon • Exclude other known causes of secondary Raynaud's phenomenon • Establish that sufficient vibration exposure has occurred • NB not helped by smoking
Problems • Episodic nature of attacks • Subjective history of symptoms • Subjective history of vibration exposure • Primary Raynaud’s phenomenon and other causes of secondary Raynaud’s phenomenon Solution • Stockholm staging • Griffin scoring • Objective tests: • Specific • Sensitive
Objective measurement Vascular tests • Finger systolic blood pressures • Rewarming time Neurological tests • Thermal thresholds • Vibro tactile thresholds • Clinical tactile threshold tests • Nerve conduction velocity
Finger systolic blood pressure Multi-Channel Plethysmograph
Finger rewarming test Channel Temperature Monitor
Vibrotactile thresholds test Vibrotactile Perception Meter
Thermal thresholds test Thermal Aesthesiometer
Further Reading Guidance and advice from the HSE at http://www.hse.gov.uk/vibration/ • As part of the package which supports the Control of Vibration at Work Regulations 2005 the HSE have also produced a calculator to assist in calculating exposures for hand-arm vibration. Hand-arm vibration at work: A brief guide (INDG175) Guide to using the hand-arm vibration calculator Hand-arm vibration calculator [Excel 48KB] Healthy working lives (Scotland) http://www.healthyworkinglives.com/

More Related Content

Hand Arm Vibration Surveillance

  • 1. Introduction to Hand Arm Vibration in an Occupational Setting jane.coombs@working-well-solutions.com
  • 2. Contents • Introduction • What is vibration? • How is vibration measured? • Hand-arm vibration syndrome • Regulations • Control of Vibration at Work Regulations 2005 • Employers legal duties • Health surveillance guidance • Further Reading
  • 3. Introduction Hand-arm vibration (HAV) widespread hazard for employees in many industries and occupationse.g. construction/demolition, mining, quarrying, forestry, shipbuilding/repair, foundries, public utilities, railways and aircraft manufacture • Percussive tools • Caulking tools • Riveting tools • Road breakers • Rotary tools • Grinders • Sanders • Burring tools • Forest and garden tools • Chain saws • Motor mowers • Others • shoe-pounding machines • Motorcycles handle bars
  • 4. Introduction • Prolonged and regular exposure to vibration can affect the operators health • 5,000,000 employees exposed • 2,000,000 employees have clear risk of developing disease (HSE 2005) • Risks from vibration can be controlled and employees protected • To protect employees and to comply with the Vibration Regulations, employers need to assess the risks from vibration and control them.
  • 5. What is vibration? • Vibrations arise when a body oscillates due to external and internal forces • the handle of a machine or the surface of a work piece vibrates rapidly • this motion is transmitted into the hand and arm
  • 6. What is vibration? Vibration is defined by the • magnitude - acceleration (m/s2 r.m.s) • frequency (Hz)
  • 7. What is vibration? Vibration is measured in three planes: X Y Z The axes are dependent on the position of the hand relative to the vibrating object – so should always be noted
  • 8. How is vibration measured? • Instrumentation: • HAV measuring equipment should comply with the EN ISO 8041:2005 specifications for hand-arm vibration measuring equipment • Calibrate and monitor instrumentation for over-loading (e.g. vibration transducers). • Measurement method • Methods defined in EN ISO 5349-1:2001 • Carefully select mounting method as outlined in EN ISO 5349-2:2001
  • 9. Hand-arm vibration syndrome • Neurological disorders • Numbness • Tingling • Loss of manual dexterity • Vascular disorders • VWF • secondary Raynaud’s phenomenon • Musculo-skeletal disorders • Reduced grip strength • Bone disorders • Other - Carpal tunnel syndrome
  • 10. Symptoms Mild HAVS • Episodic blanching • Numbness • Tingling Severe HAVS • Cyanosis • Skin necrosis • Gangrene
  • 11. A hand during an episode of blanching
  • 12. Regulations • Control of Vibration at Work Regulations 2005 • European Physical Agents (Vibration) Directive (Directive 2002/44) • RIDDOR 1995
  • 13. Control of Vibration at Work Regulations 2005 • Exposure action level (EAV) • ‘Daily amount of vibration exposure above which employers are required to take certain actions to control exposure’ • Greater the exposure level, greater the risk, the more action employers will need to take to reduce the risk • EAV is 2.5 m/s2 A(8)
  • 14. Control of Vibration at Work Regulations 2005 • Exposure limit value (ELV) • The ‘maximum amount of vibration an employee may be exposed to on any single day’ • ELV is 5 m/s2 A(8) • It represents a high risk above which employees should not be exposed.
  • 15. Control of Vibration at Work Regulations 2005 • Employers legal duties: • Assess the vibration risk to employees • Decide if employees are likely to be exposed above the daily EAV • If yes, introduce programme of controls to eliminate risk • Provide health surveillance to those regularly exposed above the EAV or at risk
  • 16. Control of Vibration at Work Regulations 2005 • Decide if employees are likely to be exposed above the daily ELV • If yes, take immediate action to reduce their exposure below the limit value • Refer to publications on strategies to reduce vibration exposure e.g. alternative work methods, equipment selection, purchasing policy for replacing old tools, work schedules, clothing, workstation design, maintenance.
  • 17. Employers legal duties: • Information and training on health risks • Keep a record of risk assessment and control actions • Keep health records for employees under health surveillance • Review and update risk assessments regularly • Consult employee rep. on proposals to control risk and provide health surveillance
  • 18. Control of Vibration at Work Regulations 2005 L140 Guidance • Part 3: Practical control of vibration exposure and risk • Eliminate vibration exposure in the work process • Reduce exposure by mechanisation • Select equipment for reduced vibration exposure • Manage vibration exposure • Maintain tools and equipment • Reduce the level of exposure to the hand • Reduce the period of exposure • Gloves and warm clothing • Information and training for operators and supervisors • Obtaining competent advice or a consultant
  • 19. Part 5: Tiered approach to health surveillance for HAVS Optional Standardised tests Not part of routine health surveillance Useful for studying progression of disease RIDDOR report / fitness to work recommendations Initial or baseline assessment Simple self-administered questionnaire returned to responsible person or qualified person Formal Diagnosis Doctor Targeted assessment Qualified person (OHN or doctor) A presumptive diagnosis can be made Tier 1 Tier 3 3 yearly assessment if no symptoms reported by questionnaire If symptoms reported or suffers from relevant vascular or neurological disorder No symptoms Fit to work Annual (screening) questionnaire Tier 2
  • 20. Health Surveillance • Questionnaire screening • Diagnosis • History of symptoms • Exclude primary Raynaud’s phenomenon • Exclude other known causes of secondary Raynaud's phenomenon • Establish that sufficient vibration exposure has occurred • NB not helped by smoking
  • 21. Problems • Episodic nature of attacks • Subjective history of symptoms • Subjective history of vibration exposure • Primary Raynaud’s phenomenon and other causes of secondary Raynaud’s phenomenon Solution • Stockholm staging • Griffin scoring • Objective tests: • Specific • Sensitive
  • 22. Objective measurement Vascular tests • Finger systolic blood pressures • Rewarming time Neurological tests • Thermal thresholds • Vibro tactile thresholds • Clinical tactile threshold tests • Nerve conduction velocity
  • 23. Finger systolic blood pressure Multi-Channel Plethysmograph
  • 24. Finger rewarming test Channel Temperature Monitor
  • 25. Vibrotactile thresholds test Vibrotactile Perception Meter
  • 26. Thermal thresholds test Thermal Aesthesiometer
  • 27. Further Reading Guidance and advice from the HSE at http://www.hse.gov.uk/vibration/ • As part of the package which supports the Control of Vibration at Work Regulations 2005 the HSE have also produced a calculator to assist in calculating exposures for hand-arm vibration. Hand-arm vibration at work: A brief guide (INDG175) Guide to using the hand-arm vibration calculator Hand-arm vibration calculator [Excel 48KB] Healthy working lives (Scotland) http://www.healthyworkinglives.com/