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HAVS Tier 3 & 4 Assessment

Clinical assessment by a qualified occupational health professional (Tier 3), escalating to formal diagnosis and staging by a doctor (Tier 4) where indicated โ€” for workers whose Tier 1/2 questionnaire shows new or worsening symptoms.

Tier 3 is a hands-on clinical assessment carried out by a qualified occupational health professional, triggered when a Tier 1 or Tier 2 questionnaire response indicates new or worsening symptoms. It looks at grip strength, sensory function and reported symptoms in more detail than the questionnaire alone allows.

Tier 4 is a formal diagnostic examination by a doctor, used where Tier 3 findings need a clinical diagnosis and staging against the modified Stockholm Workshop Scale. This is also the tier used to give an opinion on fitness for continued vibration-exposed work once a diagnosis has been made.

Who this is for

  • Workers flagged by a Tier 1/2 questionnaire for new or worsening symptoms
  • Workers already diagnosed with HAVS or vibration white finger, needing continued surveillance
  • Employers needing a documented clinical opinion before deciding on a worker's continued vibration exposure

What's included

Tier 3: a clinical assessment of grip strength, sensory function and symptom history, carried out by a qualified occupational health professional. Tier 4, where indicated: a formal examination and diagnosis by a doctor, staged against the modified Stockholm Workshop Scale, with a written opinion on fitness for continued vibration work and any recommended controls or restrictions.

Health surveillance vs risk assessment
Health surveillance monitors individual worker health. A HAVS risk assessment evaluates workplace vibration exposure and is what determines whether surveillance is needed. The two are not interchangeable.
Questions

HAVS Tier 3 & 4 Assessment FAQs.

What triggers a Tier 3 or Tier 4 assessment?
A Tier 1 or Tier 2 questionnaire response indicating new or worsening symptoms, or a worker with an existing HAVS/vibration white finger diagnosis continuing under surveillance.
Who carries out Tier 4?
A doctor, giving a formal diagnosis and staging findings against the modified Stockholm Workshop Scale, distinct from the clinical assessment carried out at Tier 3 by a qualified occupational health professional.
What is the Stockholm Workshop Scale?
A clinical staging system for HAVS, scoring the sensorineural and vascular components of the condition separately for each hand. It stages the disease itself, distinct from the Tier 1โ€“5 surveillance process used to decide when someone needs assessing.
Will I get a fitness-for-work opinion afterwards?
Where a diagnosis is made at Tier 4, you receive a written opinion on the worker's fitness for continued vibration-exposed work and any recommended controls or restrictions, for your employer records.
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