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Of all non-fatal workplace injuries, head injuries are among the most serious. In this article, Mariaan Smit addresses the causes of workplace injuries and how to protect against them.
Seventh February 2018 started as a normal workday for Mr Ackerman, who is employed at a heavy engineering company as a rigger. After attending the 15-minute toolbox talk, he went out of the training office and whilst walking in the demarcated walkway, slipped on the grease stained floor, lost his balance and fell. A co-worker witnessing him falling noticed that he did not get up from the ground, and rushed over to find out what was going on. When arriving at the scene he noticed that Mr Ackerman was vomiting and bleeding from the left side of his head, between his left eye and left ear. He immediately called for help and Mr Ackerman was transported to hospital by ambulance. He was unconscious by the time that the paramedics arrived on the scene and passed away in hospital the following morning, following a temporal lobe skull fracture. He was wearing the correct head protection on the day of the incident. The incident analysis revealed that the causative factor of the fatal incident was bad housekeeping as it was slipping on the grease stained floor that caused him to hit his head against a work bench, resulting in the skull fracture that lead to his death.
Non-fatal head injuries are among the most serious types of non-fatal injuries in the workplace as they have the potential to result in a permanent disability case, or for such an employee to accept that he cannot return to his old occupation and need to make some serious adjustments in his life after the injury. Permanent complications following a head injury that may prevent an employee to return to his normal work after recovery may be: difficulty in concentration and communication problems, seizures, behaviour changes, depression, sleep disturbances, and dizziness, to name but a few.
There are different causes of workplace related head injuries and the use of head protection will not always protect an employee from sustaining a serious head injury. Examples of potential causative head injury factors may be a motor vehicle accident; slips, trips or falls; explosions where the initial blast wave throws a person or even flying debris can cause injury; impact injuries, i.e. a crane operator not controlling the load and the load smashing into someone; objects falling from above, etc. Falls are one of the leading causes of traumatic brain injuries and a common cause of head injuries in general. In case of severe head injury, the injured person may present with signs of brain injury immediately, like loss of consciousness and vomiting. However, most people will not immediately realise that they sustained a head injury and the signs and symptoms may only become visible after a few hours or even days. It is therefore best practice to always consult a doctor immediately after sustaining a head injury even if the person does not complain. Such a person should be admitted to hospital for at least 24 hours following the head injury for monitoring.
First aiders should be trained in identifying the signs and symptoms of traumatic brain injuries. Some symptoms include:
Some signs or symptoms may appear immediately following the trauma, others may appear hours, days or even weeks later. It is therefore good practice to take any person who sustained a head injury for a check-up by a physician and to issue a family member of such a person with a list of signs and symptoms to watch out for. Should the family member notice any such signs or symptoms, the person must be taken to a doctor for a check-up without delay.
The American National Standards Institute (ANSI) and the American Industrial Hygiene Association ANSI/AIHA Z10- 2012 Occupational Health and Safety Management Systems Standard, has six levels of control other than the five levels of control normally found in safety training manuals. These six levels are:
One can, however, have all the control mechanisms in place, and a work accident can still take place. One of the reasons for this is the human involvement in the workplace and the interaction of human factors within the work area. Every individual employee should firstly take responsibility for his or her own health and safety, and then the health and safety of all co-workers – be your brother’s keeper. Three human factors need to be taken into consideration when trying to prevent head injuries in the workplace: people, the workplace and management. Under these factors are a list of elements that have the potential to contribute to workplace accidents and each element needs to be evaluated during the risk assessment to eliminate or reduce the risk of a head injury.
The elements are listed under each of the following three factors: people, workplace, and management.
Workplace design elements:
Equipment design elements:
Work environment elements:
Systems organisations management elements:
Job design elements:
Information transfer elements:
The focus of any head protection should firstly be on the hazard, rather than on the type of head protection: chemical or molten metal splash, welding and grinding sparks, impact from flying fragments or particles, etc. Therefore, the risk assessment should always first be carried out, prior to the selection of the personal protective equipment. Things to consider during the risk assessment are the following:
The primary function of a hard hat is to protect workers from sustaining a head injury where there is a risk of falling or projectile objects. It is designed to protect the head and brain by absorbing the force of impact when an object hits a person’s head. It can also provide protection against electrical shock and burns depending on the hazards in the workplace.
Hard hats are divided into two types and three industrial classes:
What is important to bear in mind when purchasing a hard hat, is that the hard hat should bear a label inside the shell that stipulates the following:
Bump caps do not offer protection against falling or flying objects, like in the instance of hard hats, but they do provide protection against accidental impact with fixed objects, for example a beam. Bump caps can only be worn where there are low overhead hazards. The advantage of bump caps is that they can be used when head protection is preferred but not required, since they are made from lightweight plastic and only protect the head from minor bumps and abrasions. Bump caps are not ANSI compliant and should the work hazards indicate fall protection, the employer should revert to hard hats.
Faceshields and headgear are not classified under head protection, but still form an important part of the risk assessment and selection of personal protective equipment in protecting the head and face. They should be used when there is a risk of flying debris, electrical sparks, or chemical or biohazardous splashes. It is important to remember that when a faceshield is required, the employee should also use appropriate safety goggles with it to protect the eyes.
Hard hat accessories are available as the parts of the hard hat can wear out or become damaged over time. Examples are sweatbands, brow pads, hat suspensions, slots for ear muffs and safety glasses. Employees should ensure that their hard hats, bump caps or other head protection equipment are always in optimal working condition and that they inspect it daily before using it. Should any parts be defective, is should be reported to the supervisor on shift and replaced immediately. Other accessories to add to the hard hat include peel-off visor covers, lamp attachments, dielectric brackets and so on.
Hard hat suspensions come in four, six or eight points and the wearer should ensure that all the points fit securely into the slots. The more points the suspension has, the better the force deflection. Suspensions should be replaced at least once a year. The shock-absorbing lining that incorporates a head band and straps with the hard hat should suspend the shell from 2.54 cm to 3.18 cm (or 1 to 1.25 inches) away from the head.
Hard hat shades can be used to protect the neck from working in the sun. Examples of hard hat accessories to prevent the head from sweating are sweat bandanas, knit cap liners and thermos-cooling skull doo-rags.
Firefighters’ helmets are specifically designed to be multifunctional and protect the wearer from falling debris and extremely hot temperatures. The helmet is made of thermoset resin composites or thermoplastics, providing greater impact and penetration resistance compared to fibreglass, and they will hold up through repeated thermal exposures.
Multifunctional rescue helmets are designed for firefighting, traffic accidents, rescue from heights, water rescue and other technical rescue assistance.
Welding helmets do not reside under the category of head protection, but rather face and eye protection, as they are designed to protect the eyes against radiant energy produced during the welding process. It can also be used for protection against sparks caused by grinding, cutting and other hot work.
The care and storage of employees’ hard hats should form part of the tool box talks and general safety communication with employees. The communication should at least contain the following information:
It should always be top priority of employers to promote a safe working environment. One should alert employees that safety starts with the individual: if they think safely, they can work safely. This attitude leads to a proactive rather than a reactive approach towards safety in the workplace.
Safety training should focus on at least six fundamental elements to promote an exceptionally good attitude towards safer work habits:
Managing head safety and fitness to work starts with:
An Article by Mariaan Smit
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