Annual screening questionnaire - vibration

Use our questionnaire to check whether your employees are at risk from hand-arm vibration syndrome on an on-going basis.

When should you use it?

To comply with the Control of Vibration at Work Regulations 2005, you need to carry out health surveillance when a worker begins a job which exposes them to work with:

• hand-held vibrating tools
• hand-guided vibrating machines; or
• hand-fed vibrating machines.

The first form to use is our Initial Screening Questionnaire - Vibration. It includes detailed questions about occupational history and past symptoms. Then on an annual basis you should follow up with the Annual Screening Questionnaire - Vibration.

How should you use it?

Consult with staff before introducing the process.

If the returns to your questionnaires include a “yes” to any of the symptoms described, you should refer the individual to an occupational health nurse or doctor for a face-to-face medical assessment.

The completed forms must be treated confidentially and the information only read by those who need it. They must also be stored confidentially. The standard time period for retaining medical records is 40 years. This may be difficult to achieve within your organisation but do the best you can -  records might be needed many years later to defend a claim.

Note. Our form is based on one published by the HSE so you can rest assured that this is the expected approach to take.