Hand Arm Vibration: Interview with Michelle Tew

Welcome to Health and Safety to Go, a production of the Canadian Centre for Occupational Health and Safety.


CCOHS: Hello and thank you for joining us. Today we’re talking to Michelle Tew, Occupational Health Nurse at the Occupational Health Clinics for Ontario Workers – also known as OHCOW. Today, Michelle is talking to us about hand arm vibration syndrome – what is it, and way to prevent it. Thanks for being here today Michelle!


Michelle: Thank you for having me.


CCOHS: What is hand arm vibration syndrome and how common is it?


Michelle: Hand arm vibration syndrome or HAVs is an irreversible occupational medical condition that affects workers’ fingers hands and arms.  It causes damage to blood vessels, nerves, bones, joints and muscles.    


It is very common in certain occupational groups with a lot of exposure to vibrating tools.   Exact numbers of workers affected aren’t known as it tends to be under reported and under diagnosed. On average in Ontario, the WSIB sees around 200 NEW cases each year but it is estimated that between 20 and 50% of workers in certain high risk occupational groups develop HAVS. 


CCOHS: What causes it?


Michelle: HAVS is caused by regular exposure to hand held vibrating tools or holding workpieces which vibrate while being processed - such as holding a part against a grinder.  There are hundreds of tools that fall into this category - some of the common ones include chainsaws, jack hammers, impact wrenches, jigsaws, impact hammers and  drills, as well as  powered lawnmowers, hedge trimmers and even floor polishers.


CCOHS: What are the symptoms – how do you know if you have hand arm vibration syndrome?


Michelle: Symptoms can develop over a number of years so they might creep up on you but with high exposure, symptoms can appear in as little as 2 months. 


It often starts with tingling, numbness or pins and needles in the fingers resulting in loss of sensation and dexterity.  Workers report not being able to pick up small objects or hold onto tools, or even dropping cups of coffee.  Waking at night with painful hands and fingers. 


One of the most distinguishing features is painful episodes of fingers turning white when exposed to cold and/or vibration which usually start in a couple of finger tips.  This is the vascular portion of HAVS and is called vibration white finger.


These symptoms may appear at work or outside of work.  If you have symptoms, you should see your doctor for specialized testing.

Sometimes HAVS gets mistaken for carpal tunnel syndrome, which can be caused by vibration as well but that is only part of the picture.  


CCOHS: Who does it affect?


Michelle: It affects workers of any age whose job requires regular and frequent use of vibrating tools and equipment, which are found in a wide variety of industries.  Such as construction, mining, grounds maintenance, forestry, foundries, motor vehicle manufacturing and repair, concrete products, public services and utilities. 


CCOHS: What happens if you ignore the symptoms?


Michelle: Unfortunately HAVS is irreversible and there is no effective treatment or cure.  


If a worker continues to use high-vibration tools, the symptoms will likely get worse.  The numbness in your hands could become permanent and you may lose all feeling.  One worker described his hands as dead, numb all the time.  He had difficulty picking up small things or would drop things often.  The blanching and pain in the fingers could spread to more fingers and in very severe cases, gangrene can develop. Cold weather becomes a nightmare and in Canada, that’s a problem.  Workers may not be able to do their job but they have also talked about having to give up hobbies they enjoyed such as golf, fishing, and swimming.  I remember one worker in his 50s who had played in a band all of his life and couldn’t play the guitar anymore.   He was devastated and became severely depressed. It was hard on his friends and family too.  


CCOHS: How can it be prevented?


With no effective treatment or cure, the only way to prevent this disability is to reduce exposure to vibration be implemented. 


These include efforts in four major different areas.

1.    Reduce vibration at the source or the tool

a.    Have an anti-vibration tool purchase policy.  Choose tools that are labelled as anti-vibration or AV

b.    Make sure that tools are well maintained, keeping cutting tools sharp

2.    Reducing exposure to vibration at the worker

a.    Workers should be supplied with anti-vibration gloves which are ISO/ANSI certified.

3.    Addressing work practices

a.    Ensuring workers are protected from continuous exposure by rotating tasks and/or frequent breaks.

4.    Educational programs for workers and management addressing

a.    Work practices such gripping tools as lightly as possible, storing tools so the handles aren’t cold. 

b.    Personal habits such as keeping fingers, hands and body warm. 

c.    Avoiding smoking as it constricts blood vessels

d.    Learning to recognize symptoms early and what to do about it

                                          i.    See a doctor

                                        ii.    Report it to your supervisor

                                       iii.    Tell your co-workers


Mainly it is important to take action when any worker is diagnosed with HAVS. Likely if one worker has developed HAVS, there are others at risk. 


CCOHS: Thanks for sharing this information with us Michelle. For more information on hand arm vibration syndrome and other musculoskeletal disorders please visit CCOHS.ca. Thanks for listening everybody.