HAVS Tier 4 Assessments: Bristol, South Wales & UK-wide
On-line booking, 2-day appointments
Comprehensive HAVS Tier 4 and Tier 1-3 health surveillance
HSE-accredited. Compliant with Control of Vibration at Work Regulations 2005
Clinics in Bristol and Chepstow (South Wales) and on-site services UK-wide
On-line booking. 2-day appointments
£300 pay-as-you-go; discounts for groups
What is Hand-Arm Vibration Syndrome (HAVS)?
Causes, symptoms, and prevention
Understanding HAVS
Prolonged use of hand-held power tools can permanently damage small blood vessels, nerves, and soft tissues. Early detection through health surveillance is required by the Control of Vibration at Work Regulations 2005 to prevent permanent disability.
Hand-arm Vibration Syndrome is referred to as HAVS disease, vibration white finger or “hand and arm vibration syndrome”. It may affect workers who regularly use vibrating tools (hand-held or hand-guided), e.g., in construction, manufacturing, civil engineering, or forestry. Long-term use of vibrating tools can damage small blood vessels, nerves and soft tissues in the fingers. This may cause symptoms such as finger blanching, tingling, numbness, reduced dexterity and strength. In advanced cases, untreated HAVS can result in permanent disability.
Vibration exposure may also contribute to conditions such as vibration-related carpal tunnel syndrome (vCTS), Dupuytren’s contracture and other musculoskeletal disorders.
HAVS stages and workplace adjustments
Hand-Arm Vibration Syndrome (HAVS) progresses through stages, each requiring specific interventions. The stages involve hand nerve damage (sensorineural) and artery damage (vascular) Stage 1 (mild and intermittent numbness/tingling and/or blanching) and Stage 2 early (more extensive and more persistent symptoms) demand workplace restrictions (e.g., exposure limited <2.5 m/s2 per shift, breaks, tool, task and work rotation). Stage 2b (moderate and persistent symptoms) and Stage 3 (severe, persistent symptoms) require withdrawal from working with vibrating tools to manage the symptoms and prevent further deterioration and disability.
Early detection through regular HAVS assessments is crucial and mandated by the Control of Vibration at Work Regulations 2005.
Our Tier 4 assessments provide legally defensible recommendations, ensuring compliance with UK regulations and protecting both employee health and employer liability.
HAVS Health Surveillance Service in Bristol, South Wales, and UK-wide
We support employers in Bristol, South Wales and nationwide through on-site visits
Bristol OH Clinic
Supporting Bristol Stoke, Avonmouth, Filton, Keynsham and surrounding areas
Chepstow (South Wales) OH Clinic
Serving Newport, Cardiff, Swansea, Pontypool, Cwmbran, Abergavenny
On-Site HAVS Assessments (UK-Wide)
For larger groups, we offer cost-effective on-site HAVS assessments throughout the UK. This minimizes disruption and ensures cost-effective, high-quality assessments for your entire workforce.
HAV assessment process
What to expect during HAVS Tier 4 assessment in Bristol or Chepstow
HAVS Tier 4 assessment takes approximately 45 minutes and includes a clinical review of medical and occupational history, a detailed hand examination, and a discussion of findings.
How to prepare for your HAV assessment
Please Bring a photographic ID and your current prescription, if applicable. Do not attend if you have a new cough or fever.
If you experience finger blanching (white finger), provide photographs of the affected areas.
The HAVS Tier 4 Report
Following the assessment, we provide recommendations for managing the condition and preventing further progression in keeping with vibration regulations. This may include advice on continued work with vibration, restrictions, controls or, in severe cases, recommending cessation of vibrating tool use.
Book your HAVS Tier 4 assessment online
or request more information
Learn more about the law and medical risks of hand-transmitted vibration
HAVS disease and employers’ legal obligations
The Control of Vibration at Work Regulations 2005
UK employers have a legal duty to protect employees from the risks of hand-arm vibration:
- Assess and monitor the risk from vibration exposure, control and reduce exposure as low as reasonably practicable, and provide suitable information and training on HAVS risks and prevention.
- Ensure regular health surveillance for those at risk, including Tier 1, 2,3 and Tier 4 medicals to comply with regulations.
Health surveillance for HAVS
Health surveillance plays a critical role in identifying early signs of HAVS for employers (Regulation 7):
- Likely exposed to hand-transmitted vibration at or above the Exposure Action Value (2.5 m/s² over an 8-hour shift).
- Occasionally exposed above the EAV but affected by health risks.
- Have a diagnosis of HAVS.
Understanding the HAVS health surveillance tiers: Tier 1 to Tier 4
Health surveillance for HAVS follows a tiered approach, as outlined in the Control of Vibration at Work Regulations 2005
In very complex cases, a referral for Tier 5 laboratory tests can be considered.
Our experience and expertise
10+ years of occupational medicine experience across industries
Our HSE-accredited occupational health service provides expert medical HAV assessments and HAVS health surveillance.
The assessments, conducted by HSE-accredited occupational health physicians with 10+ years of experience, include Tier 4 and Tier 3 examinations. We can also help employers set up and run Tier 1 and Tier 2 health surveillance.
Since 2015, we have delivered comprehensive Tier 1, Tier 2, Tier 3 and Tier 4 health surveillance services, supporting employers and employees across diverse sectors, including construction, manufacturing, energy, automotive, utilities, quarrying, steel production, forestry and similar in Bristol, South Wales and nationwide.
HAVS Health Surveillance: Frequently Asked Questions
• What is Hand-Arm Vibration Syndrome (HAVS), and why is it a risk in Bristol and South Wales?
HAVS, also known as vibration white finger, HAVS disease or ‘hand and arm vibration syndrome’ causes permanent damage to nerves, blood vessels, and soft tissues of the hand from prolonged vibrating tool use. In Bristol and South Wales, high-risk industries include construction, manufacturing, and utilities. All employers must comply with the Control of Vibration at Work Regulations 2005 to manage health and safety and avoid fines and claims.
• What are an employer’s legal duties for HAVS in the UK?
Employers must conduct vibration risk assessments, implement controls, monitor and review risks and provide pre-employment Tier 1 and annual Tier 2, 3 or 4 health surveillance if indicated by risk assessment. Our Bristol and South Wales clinics offer audit-ready compliance support.
• How does a Tier 4 HAVS assessment work, and how can I book one?
A Tier 4 HAVS assessment is a 45-minute clinical review by an HSE-accredited physician, covering medical and occupational history and hand exams. Book online for Bristol or Chepstow clinics with next-day appointments; occuaptional health HAVS reports are issued within 48 hours.
• Why choose on-site HAVS assessments for UK teams?
On-site HAVS assessments at £300 per person plus travel costs (volume discounts available) minimise downtime, and provide cost-effective, quick and HSE-compliant process for larger groups of employees.
• What evidence do HSE audits require for HAVS compliance?
HSE audits require Tier 1, 2, 3 and Tier 4 reports, exposure assessment and control plans, and training records. Bristol and South Wales employers can access audit-proof documentation through our clinics.
• Can employees continue working after a HAVS diagnosis?
Yes, with adjustments like reduced exposure through job, task and tool rotation, avoiding prolonged tool use, or role changes. Severe cases (stage 2b and higher) may require stopping tool use. Bristol and South Wales employers receive tailored return-to-work plans.
• How should employees prepare for a Tier 4 HAVS assessment?
Following a referral for HAVS Tier 4 assessment, an employee should bring a photo ID and photograps of finger blanching if applicable. GP referral is not required for our specialist HAV assessments in Bristol and South Wales.
