Hand Injuries

The importance of our hands cannot be over emphasised. It is generally believed that the brain retains 10% of what we read, 20% of what we hear, 30% of what we see, 50% of what we see and hear, 70% of what we discuss with others, 80% of what we experience, and 95% of what we teach to someone.

Could you imagine someone writing without a thumb, eating without two middle fingers, or knotting a tie without a forearm? One important thing to remember is that the hands and wrists are a complex system of bones, tendons, ligaments, muscles, blood vessels and nerves protected by the strata of skin. The physiology of our hands is such that a total of 27 bones in the hands and wrist are connected to the muscles by tendons. Ligaments link the bones together and hold the joints in place. Blood vessels supply nourishment to all these parts. Nerves help to transport sensations and control hand and finger movements. Hand injuries are considered the most frequently occurring body injuries, the treatment of which is of long duration and great community expense. It is therefore very important to protect hands from avoidable risk that could easily become catastrophic.

Hand protection philosophy

The Hand Protection Standard has been designed to protect employees from hand injury during the course of their work. Affected employees will wear hand protection that meets the BTEC standard performance criteria. Employees are encouraged to practice hand safety both on and off the job. The selection of personal protective equipment will be based on a hazard evaluation of the area and the type of job, standard operating procedures, and materials of the task being conducted. The correct PPE will be chosen and personnel trained in the following areas: use, limitations, adjustments, cleaning, and storage.

The most effective means of preventing skin exposure is by substitution of less hazardous substances or by redesign of the experimental setup; however, in the research environment often the wearing of gloves is by far the most commonly used form of personal protection. Finger and hand injuries are some of the most prevalent accidents encountered in the workplace. Some injuries occur as a result of the employee not wearing hand protection. Others happen because the wrong glove is used for a particular job, giving the employee a false sense of protection. Due to these facts, before a glove is selected one should first review the appropriate MSDS and evaluate the concerns for the material being used. The type and style of gloves used for protection, the procedures being performed and the materials involved should be considered in choosing the proper glove.

Factors to consider

The following factors will affect which is the best glove for a given task. Comfort and fitness for purpose, physical conditions and chemical resistance.

Comfortability and fitness

There are numerous cuff styles available, which serve important safety functions. The four most common types are:

• Knit wrist – a snug fitting style found on cotton gloves
• Band top – an easy on and off that admits ventilation
• Safety cuff – a slit opening on the side allows the wearer to throw off from any angle
• Gauntlet – an easy on and off that holds a tucked sleeve to protect the forearm

Besides choosing the right style of glove for the job, it is important that the glove fits properly. In some instances, such as neoprene gloves for bulk acid work, the glove should fit loosely to enable it to be thrown off the hand in case of an accident. Some jobs, however, may require a higher degree of dexterity and so a glove that fits tightly is desirable. Consequently, determining the proper glove size is an important step in choosing protective gloves.

To determine the proper glove size, measure the width of your palm from the thumb crotch straight across to the outside of the hand. Doubling the measurement will give you the proper glove size; i.e. a four-inch measurement equals size 8 glove. Keep in mind, however, that unlined gloves will be more comfortable if you select them one half size larger than this measurement. The length of a glove is determined by measuring from the tip of the longest finger lengthwise to the end of the glove. A glove 10 to 11 inches long offers protection up to the wrist. A gauntlet style glove 14 inches long is recommended for wrist protection. To protect the forearm, you need to wear an 18-inch elbow length glove.

Physical conditions

Glove materials must be strong enough to withstand mechanical stresses during their use. This includes abrasions, punctures, cuts and temperature variations. The heavier work gloves, textile and leather offer good protection from cuts and abrasions, but they are normally porous and can absorb and hold chemicals against the skin. Proper selection of chemical resistant gloves that are strong enough to withstand the physical conditions of a job are necessary.

Alternatively, thinner chemical resistant gloves worn underneath a general purpose glove may be an acceptable combination to afford cut and abrasion resistance as well as affording protection from chemicals. In operations such as a dry box a thin cotton or polyethylene liner may be worn inside the gloves of the dry box to protect against abrasion or perspiration from movement of the arms inside the thicker chemical resistant gloves.

Chemical resistance

Chemical resistance of gloves materials must always be considered when making glove selection. Solvents may dissolve certain types of glove materials and others may not provide an adequate barrier to prevent exposure. Based on chemical resistance, choose the glove type with the highest rating for the chemical and physical conditions to which you may be exposed. Select gloves without linings if extra dexterity and a sense of touch is needed. It’s worth noting that thinner gloves will have lower ratings than the tested gloves and permeation breakthrough at a shorter exposure time. Choose the glove size or sizes that will assure optimum wear, dexterity, working ease, and comfort.

Once the glove type is selected, the actual glove used must be checked for imperfections, cracks or pinholes. Dispose of the glove after contamination has occurred and wash hands thoroughly. It’s best to keep in mind that gloves are not impervious to all chemicals and their resistance to permeation drops with time. In some cases, ‘double gloving’ (either two of the same type or two different types) will be needed to provide optimum protection. Always remember that latex gloves are not chemical resistant and must not be used when handling chemicals.

How bad could it be?

The following are case studies of injuries sustained in the workplace.

A case of an incident in my workplace further revealed the nature of the incident that can so easily occur if you do not properly protect the hands. A colleague placed his left hand on the bathroom door frame while with his right hand turning on the hot tap. The bathroom door swung back due to sudden movement of the vessel caused by sea swell and slammed his left hand against the door frame. He sustained internal injury, requiring a surgical procedure to insert a titanium plate to support his fingers and was restricted to some kind of jobs. Statistic have shown that in the world, among the working population about 50% of the hand injuries do occur at the workplace.

Amputation and complicated lacerations were the costliest, resulting in additional days lost at work. Injuries at work result in greater costs because they involve more serious injuries, and because workers that require manual skills would need a higher level of hand rehabilitation to return to work. Unless the labour costs are taken into perspective, the real impact of hand injuries is greatly underestimated.

Preventing injury

Many companies take the approach of using protection processes or implementing engineering, administrative controls that protects the hands of their employees while at work, which is in line with OSHA’s hierarchy of controls. Despite these efforts, hand injuries still occur. One of the key ways of protecting workers is through the use of personal protective equipment (PPE). For hand protection this means using gloves to prevent risk of injury, but it’s absolutely essential to use gloves appropriate to the task at hand. It is important to select the right gloves, keeping in mind the nature of the job, the glove material and the duration of contact with the chemical or harmful substance.

Proper selection

The first factors in glove selection depend on the application for which the glove is used and the protection required. It is good to determine the physical conditions to which the glove will be subjected (temperature, cutting, puncturing, abrasion, exposure). Consider the glove features required to perform the work (dexterity, protection, grip, liquid repellence, insulation). Choose the style that provides the best combination of features and resistance to physical conditions.

The following is a guide to the most common types of protective work gloves and the types of hazards they can guard against.

Disposable gloves

Disposable gloves, usually made of lightweight plastic, can help guard against mild irritants.

Fabric gloves

Made of cotton or fabric blends are generally used to improve grip when handling slippery objects. They also help insulate hands from mild heat or cold.

Leather gloves

These gloves are used to guard against injuries from sparks or scraping against rough surfaces.

Metal mesh/Kevlar gloves

These gloves are used to protect the hands from accidental cuts and scratches. They are used most commonly by persons working with cutting tools or other sharp instruments.

Aluminised gloves

Gloves made of aluminised fabric are designed to insulate hands from intense heat. These gloves are most commonly used by persons working with molten materials.

Chemical resistance gloves

These gloves may be made of rubber, neoprene, polyvinyl alcohol or vinyl, etc. The gloves protect hands from corrosives, oils, and solvents. When selecting chemical resistant gloves, be sure to consult the manufacturers’ recommendations, especially if the gloved hand will be immersed in the chemical.

Nitrile coated cloth gloves

These most times offer a low cost and effective solution during manual handling activities.

Glove usage

Employers must make available at the workplace important safety information on the use of gloves as follows:

1. All personnel shall carry a pair of appropriate gloves whenever they enter an Operating Area at the Pilot Plants.
2. Personnel shall be encouraged to wear their gloves at all times while in the Pilot Plants, laboratories, conducting work in shops, and moving material.
3. Site approved gloves are those that are in Storehouse stock or specified in the SOP for the task after review and approval by IH/Safety.
4. Inspect gloves before each use for holes, cracking, discolouration, abrasions, scrapes, general condition, etc.
5. Insure that the gloves to be used are not contaminated. Non- contaminated gloves may be disposed of as normal trash, while contaminated gloves should be disposed of as hazardous waste. “make use of hand protection when exposed to harmful substance, cuts, abrasions, burns, and harmful temperature extremes” 
6. Disposable gloves should be used once and replaced. Other gloves should be replaced when they are contaminated or otherwise unfit for use.

“make use of hand protection when exposed to harmful substances, cuts, abrasions, burns, and harmful extreme temperatures”

During tasks involving asbestos, rigger and Nitrile coated cloth gloves are mostly used because they are a low cost and very effective solution. There are various kinds of it and when recommended for use must be single usage, disposable ones and must be a suitable pack for hazardous waste. There are various sizes available and would depend on the type of works being carried out, various sizes and standards are available. The above table shows the required hand protection while the chart overleaf shows the types, advantages and disadvantages.

Hand protection standards

According to OSHA’s Standard 29 CFR 1910.138: “Employers shall select and require employees to make use of appropriate hand protections whenever hands are exposed to hazards of absorption of harmful substance such as cuts, lacerations, abrasions, burns, and harmful temperature extremes.” In terms of selection: “Employers shall base their selection criteria for appropriate hand protection on evaluation of performance characteristics in relation to the task(s) to be performed. It is important to note the three basic standards for the gloves; chemical, mechanical and heat.

No matter the situation, the glove must meet the relevant standard. Under EN 388, EN 374 and EN 407 gloves shall be tested against mechanical hazards, cut, abrasion, chemical resistance and heat protection respectively. The higher the number, the better the resistance.

Conclusion

The hands are engaged in almost all activities. They account for about 80% of all occupational injuries, therefore, it is very important to protect them. Gloves enable tasks to be executed safely and prevent cuts, burns infections and abrasions.

By selecting the right glove, with the right protection level and monitoring, there will be less down time and lower worker absence, ultimately giving rise to injury free workplaces. Gloves must be regularly inspected and replaced in case of worn out pieces. A very important precaution to always take is to wear approved safety gloves. Although not all gloves will protect you from all hand injuries, they could still reduce the impact. It is necessary to check the appropriateness of the type of glove prior to use for a task. In addition, certain precautions must still be taken to reduce the level of danger during execution of a task involving the hands.