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  • Hand / Arm Vibration Assessment Form

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    Moniki Covrigaria
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    This hand/arm vibration assessment form collects information about tool use, environmental conditions, symptoms experienced, and control measures. It records what tools are used, how long they are used each day, their vibration magnitude, and whether vibration is continuous or intermittent. It also notes if any workers have complained of numbness, tingling, pain or other symptoms in their hands or arms after using vibrating tools. If tools causing vibration are used and symptoms are reported, it indicates vibration exposure may exceed limits and control measures should be implemented.

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    Original Title

    7. HAV Checklist

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    This hand/arm vibration assessment form collects information about tool use, environmental conditions, symptoms experienced, and control measures. It records what tools are used, how long they are used each day, their vibration magnitude, and whether vibration is continuous or intermittent. It also notes if any workers have complained of numbness, tingling, pain or other symptoms in their hands or arms after using vibrating tools. If tools causing vibration are used and symptoms are reported, it indicates vibration exposure may exceed limits and control measures should be implemented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    24 views2 pages

    Hand / Arm Vibration Assessment Form

    Uploaded by

    Moniki Covrigaria
    This hand/arm vibration assessment form collects information about tool use, environmental conditions, symptoms experienced, and control measures. It records what tools are used, how long they are used each day, their vibration magnitude, and whether vibration is continuous or intermittent. It also notes if any workers have complained of numbness, tingling, pain or other symptoms in their hands or arms after using vibrating tools. If tools causing vibration are used and symptoms are reported, it indicates vibration exposure may exceed limits and control measures should be implemented.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 2

    HAND / ARM VIBRATION ASSESSMENT FORM

    Date: Review Date:


    Project Name:

    Address:

    Assessors Name: Signed:

    Environmental
    Conditions:
    Part 1 - Tools
    Are any of the Yes No If yes, state make Duration Vibration Maximum
    and model of activity Magnitude Exposure
    following tools
    time (Per
    used? 8 Hours)
    Angle
    Grinders
    Pneumatic
    Hammers
    Impact
    Wrenches
    Needle
    Guns
    Hammer
    Drills
    Percussion
    Chisels
    Jack
    Hammers
    Chipping
    Hammers
    Rotary
    Tools
    Other
    (Specify):

    Type of Vibration
    Continuous Intermittent Structural
    Part 2 -
    Symptoms

    Has any person complained Yes No


    about the following after using a Numbness
    vibrating tool? Pins & Needles
    Aches in the fingers
    Pain in the hands
    Cramps in the fingers
    Incapacitation of the fingers
    Other symptoms considered attributable to
    vibration (please state)
    If you have answered yes to Part 1 and Part 2 your personnel may be exposed to vibration levels in
    excess of the recommended exposure levels. Modifications to the work and a vibration control
    programme need to be considered.

    Control measures are detailed within the specific work operations Risk Assessments
    Description of the work:

    Comments:

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