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Pitting speed against safety, Anthony Dimeck uses case studies to highlight the potentially devastating outcomes of doing a job quickly instead of doing a job well.
According to research by the Qatar National Health Strategy, hand and finger injuries account for more time lost in the construction industry than any other type of injury. And yet, year after year, hand injuries are among the leading causes of missed workdays and emergency room visits, costing employers millions of dollars in compensation costs and lost productivity. A hand injury can have a debilitating effect on a worker. Once a thumb or forefinger is amputated, simple everyday tasks that we take for granted like holding a cup of tea or tying a shoe lace suddenly become extremely challenging – let alone leisure activities such as driving, fishing or playing darts. Hand injuries, like the vast majority of workplace injuries, are preventable.
Case study
A construction worker was using a portable, power driven circular handsaw to cut sheet metal when the machine kicked back at him, severing his wrist. Doctors were able to re-attach his hand, but the father of two young children lost almost all use of it. The safety guard had been removed from the saw because it made the job faster.
The hands
The hands are valuable and are one of the most complex parts of your body, but they are also one of your most vulnerable extremities. They enable us to execute simple or complex tasks that cannot be performed by any other part of the body. Without our hands, it would be extremely difficult to complete even those routine chores that we take for granted every day.
Hazard exposure
In the construction industry the hands are exposed to the following hazards.
Skin absorption of harmful substances Allergic contact dermatitis is caused by direct hand exposure to chemicals, resulting in a sore, itchy rash. It can be treated by avoiding the triggering chemical, but constant exposure can de-sensitise the skin and result in long term damage.
Cuts or lacerations Workers regularly use utility knives to score and slice through heavy plastic panels and other materials. If distracted or rushing, pointed objects like screwdrivers can slip, puncturing a worker’s hand. A minor laceration typically only affects the outer layer of skin and is usually just treated with simple cleaning, bandages and/or stitches. A major laceration is a cut deep into the hand, often severing important nerves, muscles or tendons, with surgery frequently needed to repair this damage. After surgery physio-therapy is often necessary, but even then the injured person’s hand will not return to its pre-injury condition. Sometimes the laceration will be so severe that amputation is necessary. This is a devastating outcome resulting in permanent disability.
Severe abrasions or punctures Building materials can shear the skin off palms and fingers. Minor abrasions can be treated with dressings and antiseptic, whereas deep abrasions may in some cases require skin transplantation.
Chemical or thermal burns Some chemicals, such as caustics, acids, adhesives and paint strippers will burn the hands when they come into contact with substances.
Harmful temperature extremes Exposure to steam pipes and equipment in the workplace can cause severe burns.
Vibrations Using vibratory tools such as jackhammers, hand grinders, breakers and drills may result in Hand Arm Vibration Syndrome (HAVS). This irreversible condition produces extreme pain in the tips of the fingers of the affected person, reducing a person’s ability to carry out fine work.
Impact and blunt force Workers’ hands can be drawn into rotating equipment or be hit by a hammer causing major lacerations and crushing injuries, which dependent on severity, may result in fractured bones. In some cases, complications may arise from serious fractures.
Preventing hand injuries A hand safety programme begins with tracking injuries and analysing the data to identify any trends.
We should not look at just the types of hand injuries that are occurring, it is also important to establish the tasks workers are carrying out and the conditions and surrounding environment in which they hurt their hands. Trends may identify, for example, the particular area of operations in which hand injuries occur, or that most injuries occur while workers operate tools and equipment. From this it is possible to draw conclusions from the hand injury trends, see where the issues are and concentrate the focus and resources in that particular area.
Case study
A sheet metal worker was marking out a pattern at his workbench using a craft knife when he was distracted by a colleague asking him a question. The craft knife slipped, cutting two fingers almost to the bone. This injury resulted in 18 stitches.
The results of the trend analysis and hazard assessment will help to determine the types of engineering, administrative controls and Personal Protective Equipment (PPE) needed to protect workers hands.
Hand protection
In a study for construction workers conducted by the Occupational Safety and Health Administration (OSHA), statistics revealed that 45% of the workers who suffered hand injuries were not wearing gloves, another 30% of hand injuries occurred because hand protection was inadequate, damaged or misapplied.
The results of this study would seem to indicate that a high percentage of workers either have not been sufficiently trained on the proper use of hand protection, or the glove product that was supplied to them does not meet the requirements for the job.
Common problems include:
• Incorrect gloves for the task to be undertaken – sometimes employers will choose the type of glove based on cost
• Wearer comfort – one size fits all
• Lack of storage facilities
Case study
A mason was unloading some concrete blocks from the back of a pick-up truck when one of the blocks slipped from his grasp. As he tried to stop it from falling his right forefinger jammed between the body of the pick-up truck and the block, fracturing his finger. He was unable to work for three weeks.
Several factors contribute to glove comfort, including fit, flexibility, tactile sensitivity and dexterity. Dexterity is a big issue as many injuries occur when workers carrying out detailed work remove their gloves because of a lack of dexterity. Each of these factors will directly impact on a worker’s acceptance of PPE and how well the individual can perform his or her job tasks. Gloves that are bulky or too loose impair the worker’s dexterity and can be hazardous when worn near certain equipment, such as rotating equipment e.g. electric drills, where workers’ hands can be drawn into the equipment.
The correct glove for the task will be designed specifically for the application. Gloves are available, for example, with special patterns or embossed designs to improve grip on wet, smooth or slippery objects. Gloves are also offered that provide high levels of cut resistance and protection from extremes of heat and cold, chemicals and electric shock.
Glove manufacturers, if given the opportunity, will provide solutions for a particular task. For example, they will provide alternative materials that offer greater comfort and a higher level of protection. Gloves are on the market that incorporate KEVLAR Stretch Armour Technology, combining lightweight construction with superior cut resistance and outstanding dexterity to protect construction workers from glass, metal and plastic hazards.
Providing workers with gloves that are comfortable and designed for the task will not only keep them safe, but will reduce the potential costs resulting from hand injuries. These can be direct costs, such as medical expenses, or indirect costs such as lost time and decreased productivity.
As a first step in the programme to reduce hand injuries, construction companies should thoroughly assess their operations and examine glove usage throughout their projects to determine possible opportunities for improvement. The assessment process, which may be conducted in conjunction with a glove provider partner, may also help the company to identify best practices that can be implemented across multiple sites.
Hand safety goes beyond workers just putting gloves on. It involves identifying critical application factors, training employees in proper glove use, providing workers with adequate access to gloves and considering how any changes will impact safe operations.
Training
Training is vital to every worker involved in the construction process. Whether employees are wearing gloves, protective clothing, eye protection or working with hand tools, training will significantly impact upon how well and how safely they perform their jobs.
Resources may be as simple as material safety data sheets or project glove boards, which typically display the types of hazard to be found on site and the corresponding gloves to be worn. Training should also be made available for cross-site and best practice implementation. Some companies, for example, have successfully created web based training programmes that are offered to workers at multiple sites.
Training programmes must be continuous, with regular refreshers and presented to all new employees as well as those involved with any process changes. Establishing an on-going training programme will help to reduce operational risks for employees and the organisation overall.
Selecting tools
As detailed in the following sections, tool selection and use can make a substantial difference to the number of hand injuries within an organisation.
Retractable craft knifes Craft knives are used extensively in the construction industry, but if used incorrectly or indiscriminately they can cause serious deep lacerations to the hands. Most of these knives are now manufactured with blades that retract when not being used. Wrenches and spanners with jaws that are worn can cause severe damage to the hands including muscle sprains, strains and tendon damage should they slip when being used due to the force exerted by the user.
Electric sheet metal rollers Workshop machinery can be the source of many hazards to the hands, such as drawing in or entanglement. Operator training and experience is essential for the operation of each machine. Electric sheet metal rollers present a particular problem regarding hand injuries, as there is a need to handle sheet metal that is fed into the machine, but the use of gloves is frowned upon due to the potential of gloves being trapped within the rollers and subsequently drawing the fingers into the danger area.
Concrete breakers Concrete breakers are used at length on construction sites. They produce a manual handling problem, but they present a far greater hazard in the form of vibration. Exposure to high levels of vibration can cause Vibration White Finger (VWF), which can have long term debilitating effects on the functionality of the hands.
Exposure to vibration can be diminished through the following control measures:
• Consider if there is a reasonably practicable method to do the task with zero, or less, vibration exposure – elimination/reduced time exposure on the hierarchy of control
• Ensure equipment is suitable for the job and well maintained
• Reduce exposure time – job rotation may be suitable
• Ensure workers receive suitable information, instruction and training
Monitoring the hand safety programme
Training the workers on the guidelines of the hand safety programme and why they are needed is important; however, following up and reinforcing the message is just as important.
In conjunction with verbally reinforcing the message, emphasis can also be placed on written communication, such as posters, fliers and banners to make it visible around the workplace.
We should not overlook the compliance and follow-up elements of the hand safety programme. Tools we could use include safety alerts, checklists and specific focused hand injury audits. It is important to remember when engaged in monitoring activities that people don’t hurt their hands deliberately, so rather than implementing punitive actions we can consider coaching and persuasion.
Line of fire
‘Line of fire’ incidents account for a large percentage of hand injuries – especially within the construction industry. Basically, a ‘line of fire’ injury is where a worker puts his body in a danger area. In a construction scenario, this will predominantly involve the hands.
Case study
A rigger needed to use an overhead crane to lift some materials – he was in a hurry and was trying to free the hook from another load. He attempted to lower the hook with one hand while trying to free it with the other. When he accidentally hit the up button instead of the down his finger got caught and was severed between the hook and the sling.
We have already stated that people don’t want to hurt themselves deliberately, so why then do workers constantly expose their hands to these hazards? This question has been posed time after time with a meaningful answer hard to find – possibly because we are delving into the realms of human behaviour. On construction projects, therefore, a constant emphasis on ‘line of fire’ hand hazards is necessary. This normally comes in the form of a toolbox talk delivered to the work party by their supervisor.
The following is a typical ‘line of fire’ toolbox talk: A key aspect of hand safety is to look out for hazards related to tools and the work environment.
Think about the hand tools you are using. Your task may involve making equipment adjustments. Your focus may be on the bolt or gauge that you need to work. You may not be thinking about the condition of the tool, overlooking worn jaws on a wrench, a cracked wooden handle on a file, or another tool defect that could put your hand at risk.
When working around hot services or steam hazards you may be climbing a scaffold, scoping a task or reading equipment. Your work may not directly involve the hot surface or steam, but you cannot ignore the potential thermal burn hazard if it is near to the work you are performing.
General environmental or weather conditions may also affect hand safety. A normal dry surface may become slick if it becomes wet with rain. When you apply force to an object in this unexpected condition, you may lose your grip and jam your hand. When planning the job, consider the hazards of the task itself. Consider ‘line of fire’, pinch points and hand position. Ensure that you are using the correct gloves for the hazards.
Some construction companies acknowledge that hand injuries are inevitable and accept them as part of business, but we must try to change this attitude. All hand injuries are preventable.
Published: 29th Oct 2014 in Health and Safety Middle East
