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Definition of Hand-arm vibration syndrome

Hand-arm vibration syndrome: A disorder resulting from prolonged exposure to vibration, specifically to the hands and forearms while using vibrating tools. Symptoms include numbness, tingling, and loss of nerve sensitivity. The hand-arm vibration syndrome (HAVS) is a painful and potentially disabling condition of the fingers, hands, and arms due to vibration. There is initially a tingling sensation with numbness in the fingers. The fingers then become white and swollen when cold and then red and painful when warmed up again. Cold or wet weather may aggravate the condition. Picking up objects such as pins or nails becomes difficult as the feeling in the fingers diminishes and there is loss of strength and grip in the hands. The pain , tingling, and numbness in the arms, wrists and hands may interfere with sleep. Also know as a type of 'Raynauds disease' which can occur without vibration exposure (Mainly in females).

Sources of vibration that can cause HAVS are very varied and include pneumatic drills, jackhammers, asphalt breakers, power chain saws, chipping tools, concrete vibrators and levelers, needle guns and scabblers, polishers, power jigsaws, sanders and angle grinders, riveters, compactors, power lawnmowers and even electronic games in which the hand controls vibrate.

HAVS was first widely recognized as a potential occupational hazard in the mid-1980s. It was first known as "vibration white finger."

Following the introduction of the European Physical Agents (Vibration) Directive 2002/44/EC, employers now have a 'duty of care' to ensure their workers are not exposed to potentially harmful vibration levels.

Links:  HAVS Links:           

The following information and illustrations have been sourced from research and publications by Donald E. Wasserman, MSEE, MBA*, Human Vibration Consultant, Cincinnati, Ohio and may be subject to copyright laws.


HAVS must be differentially diagnosed form Raynaud's Disease of other causation by a qualified physician because:

a) Primary Raynaud's occurs for unknown reasons in a small number of non-vibration cold exposed persons (mostly females).

b) Raynaud's can occur as a so-called "presenting condition" in diseases such as: scleroderma, lupus, and other connective tissue diseases as well as from exposure to vinyl chloride (acro-osteolysis); and various obstructive arterial diseases.

c) In its early tingling and numbness stages of HAVS Raynaud's can be confounded/confused with Carpal Tunnel Syndrome (CTS). (Note: Both HAVS and CTS can occur when using vibrating tools.)

The medical severity scale for HAVS uses the so-called Stockholm system (modified Taylor-Pelmear system) where the patient is examined for both neurological and peripheral vascular impairment and each hand is separately assessed into impairment stages. Unfortunately, HAVS is for the most part irreversible unless it is detected in the very earliest of finger blanching stages and the vibration exposure ceases. Fig. 1 shows a Stage 3 case HAVS for a pneumatic tool operator; Fig. 2 shows a rare case of Stage 4, tissue necrosis/gangrene unfortunately required digit amputation for this pneumatic tool operator.

Figure1: A vibrating pneumatic hand-tool operator in the later stages of Hand-Arm Vibration Syndrome (HAVS)

Figure 2: A rare case of tissue necrosis/gangrene in a vibrating pneumatic hand-tool operator at the terminal stage of Hand-Arm Vibration Syndrome (HAVS).