Initial screening questionnaire - vibration

Use our questionnaire to establish whether your employees are at risk from hand-arm vibration syndrome.

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 working with:

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

How should you use it?

An initial screening questionnaire checks on the employee’s previous exposure to vibration risk and identifies any existing symtoms. The completed forms must be treated confidentially and the information only read by those who need it.

If the answers include a “yes”, you should refer the individual to an occupational health nurse or doctor for a face-to-face medical assessment.

Seek HR advice before introducing the form.

Note. Our form is based on one published by the HSE so you can be assured that this is the accepted approach.