Vibration Injuries

Carpal tunnel syndrome, or CTS, is a painful condition of the hand and fingers caused by compression of a major nerve where it passed over the carpal bones at the front of the wrist. It causes pins and needles, numbness, and weakness of the hand or fingers.

Read more about this condition here in our resource.

People most at risk are those with jobs or activities that involve repetitive finger use, especially those associated with high-force, long-term use, extreme wrist motions, and vibrations.

Jobs that involve repetitive wrist movement include:

• Assembly line work
• Construction
• Manufacturing

Symptoms usually begin slowly and can occur at any time. Early symptoms include numbness at night, tingling, and/or pain in the fingers.

Common daytime symptoms are tingling and decreased feeling in the fingertips. Patients also report difficulty handling small objects, grasping the steering wheel to drive, holding a book to read, writing, or using a computer keyboard, etc.

It is diagnosed using a combination of your personal history, a physical examination, and tests called Nerve Conduction studies.

A physical examination includes a detailed evaluation of your hand, wrist, shoulder, and neck to check for any other causes of nerve pressure. Your doctor will look at your wrist for signs of tenderness and any deformities.

Nerve Conduction Tests (NCT) are diagnostic tests that can measure the conduction speed of your nerve impulses. If the nerve impulse is slower than normal as the nerve passes into the hand, you may have carpal tunnel syndrome.

Treatment of Carpal Tunnel Syndrome depends on its severity. Nonsurgical options include:

• Avoiding positions that overextend your wrist
• Wrist splints that hold your hand in a neutral position
• Steroid injections into your carpal tunnel to reduce inflammation

Surgery may be necessary if there is severe damage to your median nerve. This involves cutting the band of tissue in the wrist that crosses the median nerve so as to lessen the pressure on your nerve. Factors that determine success or failure are the age of the patient and the duration of symptoms.

The outcome of surgery is normally very good.

Your employer has general common law duties to ensure you have a safe place of work, safe plant or machinery and a safe system of work. If the Defendant breaches these duties there will be a claim in negligence against them.

A breach of these common law duties can be shown/proven by identifying breaches in statutory requirements the Defendants have to comply with. Some of these are as follows:

Health and Safety Act 1974

• Every employer has a duty so far as is reasonably practicable, to ensure the safety and welfare of employees.

Management of Health and Safety at Work Regulations 1999

• Duty to undertake adequate risk assessment (Reg. 3)
• The requirement to undertake health surveillance (Reg. 6)

The value of your claim will depend on the severity of the injuries linked with the work. The court will be guided by the Judicial Studies Board (JSB) guidelines, which set out the levels for different awards.

Typical awards can be as follows:

• Continuing bilateral disability with surgery – £19,210 – £20,280.
• Continuing, but fluctuating and unilateral symptoms – £13,080 – £14,330.
• Symptoms resolving in the course of up to 3 years – £7,580 – £9430.
• Complete recovery within a short period (a few months) – £1,930–£3,090.

On top of the figures above you will also be able to claim for any specific financial/out-of-pocket losses, such as loss of earnings or medication costs that have been directly incurred by the condition.

In 2003, the HSE referred to a report which estimated that around five million people are exposed to hand-arm vibration at work, and of those, as many as two million might be exposed to levels of vibration that risked injury.

For many years, the awareness of the effects of hand-arm vibration was limited and the consequences of exposure were not regarded as particularly serious.

The date of ‘guilty knowledge’ of Vibration White Finger (VW) probably began in the mid-1970s. This was following the publication of the British Standard ‘Vibration White Finger in Industry’. In the case of Armstrong and other –v– British Coal, the date of knowledge was put as 1973.

In the case of Doherty –v– Rugby Joinery(UK) Ltd, the Court of Appeal held that in the woodwork industry, the Defendant’s employer was under no duty to assess and monitor its employees for symptoms of VWF before 1991/1992.

A Guide to HAVS/Hand Arm Vibration Syndrome

Vibration white finger and hand-arm vibration syndrome describe a selection of symptoms with an underlying pathology. Workers regularly exposed to vibration may suffer from symptoms due to effects on the vascular system, nervous system, muscles, and other tissues.

Three Components of symptoms:

• Neurological component – Numbness, tingling, reduced sensation (touch and temperature), reduced dexterity.
• Vascular component – Episodic blanching of fingers (typical trigger is exposure to cold). Vibration does not precipitate symptoms, despite causing condition initially in tips of fingers (rarely thumbs, except in more extreme cases) – spreading into the whole finger and palm. This is often followed by redness and pain in fingers.
• Pain/stiffness in hand and arm.

You do not have to have the full range of symptoms to be diagnosed as suffering from HAVS. Neurological symptoms often occur first, but this is not a set rule.

More information about these two conditions can be found here in our resource.

Difficulties can occur because symptoms constituting the syndrome can arise for constitutional reasons and there is no objective test to establish the presence of the syndrome. Diagnosis, therefore, involves a three-stage process:

• Excluding other medical causes (such a Raynaud’s phenomenon).
• Assessing work history and history of exposure.
• An appropriate description of symptoms by the Claimant consistent with vibration white finger.

Under the 1974 Health and Safety at Work Act, every employer has a duty so far as is reasonably practicable, to ensure the safety and welfare of employees.

In 1975, a British Standards Institution Draft development publication referred to vibration magnitudes of below 1.0 ms2 as ‘acceptable vibration magnitudes’, and magnitudes above 10m/s2 as ‘unacceptable vibration magnitudes’.

In 1994, the HSE published guidelines that referred to a standard based on an action level of A8 of 2.8 m/s. The 2.8m/s is the average vibration level over the course of an eight hour day. At that level, ten percent of people exposed for eight hours a day for eight years would experience symptoms of finger blanching, and the exposure would be foreseeable.

Work with vibrating tools is rarely continuous, and as such the time of exposure (‘trigger time’) must be considered.

In 2005, the statute the Control of Vibration at work Regulations 2005 was passed and implemented from the 6^th of July 2005. This act set two exposure limits:

Limit 1 – Exposure Action Value ( EAV) – 2.5 m/s (Reg 4(1)(b))

Limit 2 – Exposure Limit Value (ELV) – 5 m/s2 (Reg 4(1)(a))

The EAV is the maximum amount of vibration an employee may be exposed to before an employer is required to take certain action to reduce exposure. These actions may include (Reg 6):

• Undertaking a review of the design/layout of the workplace.
• Job rotation to eliminate or reduce vibration.
• Provide suitable training and information to employees.
• Appropriate work schedules with adequate work schedules.

The ELV is the maximum amount of vibration an employee may be exposed to in any single day (Reg 6 (4))

Example:

On a daily working basis, Mr. A will use a demolition hammer for half an hour, followed by hammer drills for three hours.

Demolition hammers: levels likely – 15 m/s exposure from this work for half an hour = 225 points.

Hammer drills: levels likely – 6m/s exposure from this work for three hours = 215 points.

The number of points together would exceed 400, and therefore it is likely the ELV is being exceeded or likely to be exceeded. This is an extremely useful tool to undertake an initial assessment on the level of daily vibration.

If you have read the above and feel that you may be suffering from any symptoms whilst exposed to repetitive tasks at work, call Oakwood Solicitors Ltd to speak to our dedicated Industrial Disease team and ask about our ‘No-Win, No-Fee’ agreement.

In order to run the majority of personal injury claims, you have to have started the claim within three years of the injury. However, with Industrial Disease claims it may be that the injury started over a period of time and was only diagnosed within the last three years. We will be able to clarify this for you.

If you are still working for the Defendants they can not dismiss you for making or proposing to make a claim. If your employer attempts to do so when you are likely able to make a successful unfair dismissal claim.

Generally, in our experience, the high majority of insurers understand their duties owed to you and the right you have to pursue a claim if this duty has been breached.

In the high majority of matters, the claim will normally be transferred from the Defendants directly to their insurers and it will be the insurers who will deal with the Defending of the action.

The length of time for a case can vary and can strongly depend on how Defendants and their insurers want to defend the action. Initially, it may be that we request certain documents from the Defendants/their insurers, such as risk assessments/job sheets to fully assess the claim before any formal claim is made.

Generally, these cases can take anywhere from twelve months up to three years to reach a conclusion.

We have a very experienced and dedicated Industrial Disease team. They are able to identify whether a claim is likely to be viable at an early stage and give advice.

The team works with an extensive network of orthopedic surgeons and hand surgeons. They have dealt with a number of claims in all areas of Industrial Disease and have achieved some excellent results. If there are no risk assessments and the Defendants argue that the risk to your health was foreseeable (should have been known) a report from an Ergonomist may be required.

These experts would consider the systems in place and whether they were reasonable in all the circumstances. If required, this is something that we will arrange for in your claim.