Increased Interest in Express Medicals’ Tier 5 HAVS Testing

Recent press coverage for non-compliance with Hand-Arm Vibration (HAVS) regulations have highlighted the importance of regular testing to keep employees safe at work. View full article here.

Express Medicals offers all five tiers of testing for HAVS; an increasingly popular service for employers keen to avoid prosecution and/or heavy fines.

Employers have the legal duty to report confirmed cases of HAVS and vibration-induced Carpal Tunnel Syndrome (under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 RIDDOR). Affected employees have to receive a formal written diagnosis from a doctor confirming that the employee either has HAVS or carpal tunnel syndrome and that their occupation is likely to be the cause.

Furthermore, employers have to make sure that all employees who are exposed to vibration are regularly checked with Tier 1 and 2 HAVS questionnaires. If symptoms are mentioned, the HAVS 3 or 4 assessments will take place.

What is HAVS?

HAVS is a widespread hazard for employees in industries and occupations that have to work with hand-held power tools, hand-guided machinery and hand-fed machines.

Prolonged and regular exposure to this vibration can affect the operator’s health. The good news is that risks from vibration can be controlled, and employees can be protected from ill health issues. In order to protect employees, and to comply with legal requirements, employers need to assess the risks from vibration and plan how to control them.

HAVS surveillance consists of 5 Tiers:
  • Tier 1 – First questionnaire, filled out by job applicants of vibration exposed jobs for employer
  • Tier 2 – Same questionnaire as Tier 1, however completed yearly by vibration exposed employees
  • Tier 3 – If employee declares vibration-related symptoms Tier 3 assessment will be carried out by a HAVS qualified nurse. This includes taking a detailed history and physical tests that assess the vascular and the nervous system on the hands. The outcome of this process will help the nurse decide whether there is reason to believe that this could be HAVS. If so, the nurse will escalate this to a Tier 4 and recommend interim adjustment of exposure to vibration.
  • Tier 4 – This assessment will be delivered by a HAVS qualified doctor. It consists of a detailed history, assessment of symptoms and signs of HAVS. Express Medicals tests dexterity and sensation, assessing the vascular system in the hands and look at grip strength. The doctor will then decide whether to make a diagnosis of HAVS or vibration-induced Carpal Tunnel Syndrome. Furthermore, the doctor will advise on further surveillance and recommend limits to exposure.
  • Tier 5 – In addition to clinical findings from Tiers 3 and 4, we can conduct standardized tests at our clinic in London. Any employee that has signs or symptoms of HAVS should get access to a quantitative assessment, which is compared to ‘normal’ data. After testing the final diagnosis however still depends upon the judgement of the doctor.

After all tiers a detailed report will be sent to the employer, recommending further surveillance and professional advice.

For further information about Express Medical’s range of occupational health services, visit