Hand-arm vibration syndrome: reducing risks to workers
Submitting InstitutionUniversity of Southampton
Unit of AssessmentGeneral Engineering
Summary Impact TypeHealth
Research Subject Area(s)
Medical and Health Sciences: Clinical Sciences, Neurosciences, Public Health and Health Services
Summary of the impact
Multidisciplinary research by the University of Southampton has been
pivotal to tackling the problem of Hand-Arm Vibration Syndrome, HAVS, a
major compensated industrial disease with more than 1.2 million workers at
foreseeable risk in the UK and many millions with symptoms around the
globe. Work by the Human Factors Research Unit, part of the University's
Institute of Sound and Vibration Research, has had a major impact on
understanding and controlling the disorder, shaping guidance that is used
in national and international standards, governmental legislation, law
courts and compensation schemes both nationally and internationally. The
advances arising from the Southampton research are recognised by
policymakers, industry, and peer groups.
Phenomenal growth in the use of powered tools during the past 100 years
has resulted in widespread exposure to hand-transmitted vibration and,
consequently, the development of the `hand-arm vibration syndrome', HAVS,
a disease affecting blood vessels, nerves, muscles and joints of the hand,
wrist and arm. Failure across industry, government, and the legal system
to comprehend the complexities of the disease left workers at risk.
Recognising that a combination of engineering, epidemiological,
experimental, and clinical studies was required, multidisciplinary
research aimed at bringing HAVS under control has been conducted by the
Human Factors Research Unit (HFRU), part of the University of
Southampton's Institute of Sound and Vibration Research. Comprising 70
refereed journal publications, research led by Professor Michael Griffin
(HFRU head: 1972 to present) has investigated the causes of HAVS and its
consequences so as to improve vibratory tools, the diagnosis of disorders,
and provide practical advice to industry and policymakers. Medical
research included substantial collaboration with the University of
Southampton MRC Lifecourse Epidemiology.
Early research at Southampton by Griffin and colleagues identified that
hand-transmitted vibration caused both vascular and neurological disorders
in the hands, with the disorders developing independently, and this is now
widelty accepted [3.1].
Together with the MRC Lifecourse Epidemiology Unit (Professor Coggon,
1980 - present; and Professor Palmer, 1994 - present), the HFRU undertook
the largest survey (1997-1998) of the causes and consequences of exposure
to hand-transmitted vibration, involving 12,907 participants. It was found
that 4.2 million men and 667,000 women in Great Britain were exposed to
hand- transmitted vibration at work and that 1.2 million men and 44,000
women had foreseeable risk of injury with exposures to vibration exceeding
the Health and Safety Executive daily action level. The Southampton
findings prompted a call for international action from policymakers.
In 2002, research for the HSE by Griffin and Lindsell (Research
Assistant, 1995 - 2002) established reliable means of measuring vibration
thresholds, thermal thresholds, and systolic blood pressures in the
fingers and criteria for establishing abnormalities in vibration-exposed
An epidemiological study of 1,200 dockyard workers completed in 2003
showed HAVS was related to the duration of exposure and that an improved
vibration frequency weighting was needed to control the disorder [3.2].
HFRU psychophysical research showed for the first time (with Morioka in
2006) the dependence of frequency weightings on vibration magnitude [3.3].
In the engineering field, methods of assessing exposures to
hand-transmitted vibration were critically reviewed by Griffin (1997), who
also assessed the vibration isolation efficiency of gloves (Griffin, 1998)
and later showed how contact conditions with a source of vibration had a
great influence of the vibration modes (Concettoni and Griffin, 2009). All
these studies challenged the frequency weighting and frequency range for
predicting vibration disorders [3.6].
Research in Southampton from 1995 to 2013 was key to the international
development of methods for diagnosing HAVS, largely with PhD research in
the Human Factors Research Unit. The First International Workshop on the
diagnosis of disorders caused by hand-transmitted vibration was held in
Southampton in 2002. The HFRU developed a set of CE-marked HVLab
diagnostic tools, among them a tactile vibrometer, a thermal
aesthesiometer, and a multi-channel plethysmograph (to measure finger
blood pressure and finger blood flow). The Unit continues to improve on
the established methods and equipment for measuring neurological and
vascular dysfunction associated with HAVS [3.4].
The multi-channel plethysmograph also made it possible to undertake
unique experimental studies of the physiological response to vibration,
revealing the mechanisms causing vibration-induced reductions in finger
blood flow [3.5].
References to the research
(the best 3 are starred)
3.1. Griffin,M.J., Bovenzi,M. (2002) The diagnosis of disorders caused by
hand-transmitted vibration: Southampton Workshop 2000. International
Archives of Occupational and Environmental Health, 75, (1-2), 1-5.
3.2. *Griffin,M.J., Bovenzi,M., Nelson,C.M. (2003) Dose-response patterns
for vibration-induced white finger. Occupational and Environmental
3.3. *Morioka,M., Griffin,M.J. (2006) Magnitude dependence of equivalent
comfort contours for fore-and-aft, lateral and vertical hand-transmitted
vibration. Journal of Sound and Vibration 295 633-648.
3.4. Griffin,M.J. (2008) Measurement, evaluation, and assessment of
peripheral neurological disorders caused by hand-transmitted vibration. International
Archives of Occupational and Environmental Health, 81(5), 559-573.
3.5. *Ye,Y., Griffin,M.J. (2011) Reductions in finger blood flow in males
and females induced by 125-Hz vibration: association with vibration
perception thresholds. Journal of Applied Physiology, 111,
3.6. Griffin,M.J. (2012) Frequency-dependence of psychophysical and
physiological responses to hand-transmitted vibration. Industrial
Health 50, 354-369. [Invited paper at 12th International
Hand-Arm Vibration Conference, Ottawa, June 2012].
Details of the impact
Southampton's long research into hand-arm vibration syndrome has
influenced company practice around the world, demonstrated the need to
tackle the disease and raised its profile on the policy agenda, provided
health services with more effective diagnostic tools, and helped control
the risks for millions of workers, of whom more than 1.2 million are at
risk in the UK.
The EU Physical Agents (vibration) Directive (2002/44/EC) published in
2002 required member states to start implementing measures to control the
risks of hand-transmitted vibration by 2005. With the Europe-wide policy
legally binding for every employer in the European Union, Griffin led the
preparation of the EU Guide to Good Practice on Hand-Arm Vibration,
published in 22 languages by the European Commission [5.1]. The
guide shows member countries how to implement the EU Physical Agents
(vibration) Directive, and is also widely used outside the EU.
The HFRU has been in the vanguard of the development of standards related
to on human responses to vibration. Griffin is chair of the BSI
sub-committee on human responses to vibration. The hand-transmitted
vibration research of Professor Griffin is cited in ISO 5349-1:2001,
ISO/DIS 10819:2011, ISO 13091-1:2001, ISO 14835-1:2005, ISO 14835-2:2005,
ISO PD 12349:1997. These standards are the basis of the EU Physical Agents
(vibration) Directive, the EU Machinery Safety Directive, and means of
controlling exposures to hand-transmitted vibration and diagnosing
disorders. They are in constant use by industry and government.
The HVLab instruments developed and produced in the ISVR are in
use in England, Scotland, Northern Ireland, Italy, Sweden, Finland, USA,
Japan, and South Africa to decide whether workers have HAVS, assess the
adequacy of preventative measures, decide on the termination of work with
vibratory tools, and assist courts in ruling on compensation. Initially,
it was necessary to standardise the methodology and determine normal
values for the measures — values that are now used to decide on future
employment and the compensation of workers [5.2]. Having
established their validity in fundamental research, the HFRU obtained
certification to ISO 13485 so the HVLab instruments could be
CE-marked and sold for diagnosis in hospitals by occupational health
physicians [5.3]. The HFRU, which is also certified to ISO 9001,
sells the specialist HVLab diagnostic instruments world-wide,
including to hospitals in Japan with more stringent medical
instrumentation standards [5.4]. More than 150 units have been
sold in the past 10 years to the approximate value of £1.25 million
(excluding accessories, upgrades, and servicing) with revenues used to
fund related PhD research at the ISVR. The HVLab vibrometer and
thermal aesthesiometer are in current use by the Department of Work and
Pensions, DWP, at 41 sites run by Atos Healthcare across the UK to assess
compensation of prescribed disease A11 in British workers [5.5].
Previously, HVLab instruments were used to decide on compensation
for HAVS among more than ½ million coal miners [5.6].
The range of HVLab instruments — vibrometer, thermal
aesthesiometer, and plethysmograph — is also used in research centres that
combine research with the clinical assessment of patients, including the
UK Health and Safety Laboratory in Buxton, the Human Factors Research
Unit, the University Hospital in Trieste (Italy), and Yamaguchi University
School of Medicine (Japan). Such international collaboration with clinical
researchers is needed to agree on diagnostic methods in an area where
there are many affected workers but few UK experts. The specialised nature
of the equipment and the current state of understanding mean that many
involved in the diagnosis of HAVS require more support than is available
from a solely commercial organisation, so the HFRU provides on-going
training in the diagnosis of HAVS for users of the instrumentation and
operates a telephone support system for nurses and physicians using HVLab
equipment. The experience gained from users provides additional experience
of industrial applications of the diagnostic methods, leading to improved
techniques, developments of the relevant international standards (ISO
13091-1, ISO 14835-1, and ISO 14835-2), and advice to the government's
Industrial Injuries Advisory Council on the appropriateness of the
Research at Southampton has increased awareness (within industry, policy,
and legal circles) of the disease, leading to a considerable rise in the
number of workers receiving compensation following the first significant
HAVS compensation court case in the 1980s. Subsequent pressure from
insurance companies — compensation for loss of earnings to highly skilled
young workers can reach up to half a million pounds — has ensured
employers set in place measures to reduce the likelihood of HAVS.
Following some confusion in the courts, Griffin reviewed the alternative
methods of deciding on compensation and defined a fairer means of deciding
on employer negligence [5.7].
HFRU research into vibration discomfort (with Morioka 1999 - 2013) led to
the development of the only frequency weightings suitable for predicting
the discomfort caused by hand-transmitted vibration over a range of
vibration magnitudes. It was first used in US motorbike industry and is
now used more widely in the transport industries where it remains the only
Since its inception in 1972, the HFRU has played a leading role in the
organisation and promotion of the `International Conference on Hand-Arm
Vibration', which brings together industry, governments, and academia
every four years. This is the only international forum for engineers,
scientists, and medical researchers. In invited plenary presentations, the
HFRU has raised the importance of HAVS in developing countries and was
instrumental in the Chinese government offering to host the 2015
conference. In 2013, Griffin is advising a large group of Chinese
companies that recently experienced an outbreak of the HAVS with major
consequences to production. Efforts have also been made to raise the
profile of the disease in Africa, collaborating with the University of
Pretoria on studies in goldmines and advising local industry, in a country
where awareness was very low. The HFRU's international efforts led to the
Taylor Award by the International Advisory Committee on Hand-Arm Vibration
at the International Conference on Hand-Arm Vibration in Ottawa in 2011 —
recognising that the HFRU research had advanced understanding in such a
way as to assist the prevention of the effects of hand-arm vibration,
influencing tool design, anti-vibration devices and the recognition and
diagnosis of the HAVS. The citation states: "The Human Factors Research
Unit has been at the forefront of research and development for almost
half a century. Their contributions over the years to the understanding
of human response to hand-arm vibration have been wide-ranging and
comprehensive, and the excellence of their work has been acknowledged
internationally. The impact of this leading centre for teaching,
research and consultancy on hand-arm vibration is manifest world-wide".
Sources to corroborate the impact
[5.1] Griffin,M.J., Howarth,H.V.C., Pitts,P.M., Fischer,S., Kaulbars,U.,
Donati,P.M. and Brereton,P.F. (2006) Guide to good practice on hand-arm
vibration. Non-binding guide to good practice with a view to
implementation of Directive 2002/44/EC on the minimum health and safety
requirements regarding the exposure of workers to the risks arising from
physical agents (vibrations). Luxembourg, European Commission, 61pp.
(Translated into 22 official languages of the EU: http://bookshop.europa.eu/is-bin/INTERSHOP.enfinity/WFS/EU-Bookshop-Site/en_GB/-/EUR/ViewPublication-Start?PublicationKey=KE7007108).
[5.2] Lindsell,C.J., Griffin,M.J. (2002) Normative data for vascular and
neurological tests of the hand-arm vibration syndrome. Int. Arch Occup.
Environ Health 75:43-54.
HVLab Diagnostic instruments for disorders caused by
Japanese agent selling HVLab diagnostic equipment in Japan.
[5.5] Provision of diagnostic equipment to Atos Health Care to provide
diagnostic facility at 41 centres in UK for the DWP: Dr Colin
[5.6] Lawson,I.J, and McGeoch,K.L. (2003) A medical assessment process
for a large volume of medico-legal compensation claims for hand-arm
vibration syndrome. Occupational Medicine, 53, 302-308.
[5.7] Griffin,M.J. (2008) Negligent exposures to hand-transmitted
vibration. International Archives of Occupational and Environmental
Health, 81 (5), 645-659.