Vibration white finger (HAVS): symptoms, causes and prevention at work

HSE explains that prolonged, regular exposure to vibration can damage the nerves, blood supply, joints and muscles of the hands and arms. These disorders are collectively called hand-arm vibration syndrome, or HAVS. The best known of them is vibration white finger, caused by the effects of vibration on the body’s blood circulation.

Vibration white finger is a form of Raynaud’s phenomenon that is triggered by work. The NHS says Raynaud’s is where blood stops flowing properly to the fingers and toes, causing them to change colour, and that it is sometimes caused by working with vibrating tools for a long time. HSE adds that there is also evidence that vibration may cause carpal tunnel syndrome.

HSE’s message to employers is that regular and frequent exposure can lead to permanent health effects, most likely when contact with a vibrating tool or process is a regular part of someone’s job. Occasional or infrequent low exposure is unlikely to cause ill health.

HSE lists the early signs a worker should look out for. These often start in the fingertips and in cold or wet conditions.

• Tingling and numbness in the fingers, which can disturb sleep.

• Not being able to feel things properly with your fingers.

• Loss of strength in your hands, so you are less able to pick up or hold heavy objects.

• In the cold and wet, the tips of the fingers going white, then red and painful on recovery (vibration white finger).

HSE says that if people carry on using high-vibration tools the symptoms will probably get worse. The numbness can become permanent so that you cannot feel things at all, picking up small objects such as screws or nails becomes difficult, and the white finger attacks can happen more often and affect more fingers.

The effects HSE lists 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 that trigger attacks, and reduced grip strength that might affect the ability to work safely. HSE’s case histories show how this can affect hobbies and independence as well as employment.

HSE says you are at risk if you regularly use hand-held or hand-guided power tools and machines for more than a few hours each day, or hold workpieces that vibrate while being processed by powered machinery. It says you are particularly at risk if you 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.

The industries HSE names include construction, building and maintenance of roads and railways, forestry, foundries, heavy engineering, mines and quarries, motor vehicle manufacture and repair, public utilities and shipbuilding.

HSE advises workers to report any symptoms promptly to their employer or to the person who does their health checks, and says a company doctor, occupational health professional or your GP can also help. Employers who identify a risk are expected to provide health surveillance for workers who need it.

Where a GP is involved, the NHS advises seeing a GP if Raynaud’s symptoms are very bad, getting worse or affecting daily life, or if symptoms are only on one side of the body. A GP may prescribe a medicine to improve circulation, and it may arrange tests if there might be an underlying condition.

HSE says it is the employer’s responsibility to protect workers, but workers can help by asking whether the job could be done a different way without vibrating tools. If it cannot, HSE suggests the measures below.

• Ask to use suitable low-vibration tools and always use the right tool for the job.

• Check tools are properly maintained and cutting tools kept sharp.

• Reduce the amount of time you use a tool in one go by doing other jobs in between.

• Avoid gripping or forcing a tool or workpiece more than you have to.

• Store tools so that the handles are not very cold when next used.

• Keep warm and dry, wearing gloves and waterproofs where needed, and give up or cut down smoking because it reduces blood flow.

• Massage and exercise your fingers during work breaks.

Because damage can be permanent, the aim is to stop it progressing. Reducing exposure early gives the best chance of avoiding further harm, which is why HSE puts so much emphasis on early reporting. The NHS notes that people with Raynaud’s can often ease symptoms by keeping warm, not smoking and limiting caffeine.

Vibration white finger can affect a person’s ability to continue in their trade. Employers are responsible for control measures, and workers with a diagnosed work-related condition may be able to seek advice from their trade union or from occupational health about reporting and any further support.