Losing a finger, hand, arm, or any part of the body, not only causes physical pain to the worker, it also severely impacts the worker’s livelihood and mental well-being. There is great importance in protecting our fingers, hands, and arms while at work, and building a culture of prevention in the workplace so that everyone can work in a safe environment. Hand, arm and finger injuries are preventable. Reducing the risk at its source is fundamental.
Forty-six workers lost their hands or fingers in amputation accidents in Singapore last year, mainly due to the unsafe use of machinery. Such injuries, which often have a lasting impact on the workers’ lives and livelihoods, are preventable, stressed Senior Minister of State for Manpower Zaqy Mohamad when he launched the 2021 Safe Hands Campaign. “We need to persevere in our efforts to ensure such incidents do not recur,” he said, as he encouraged companies to embrace a culture of reporting near misses1. The significant trend in hand and arm injuries are correlative to the use of machinery, which pose an immediate call for action by all stakeholders.
“the significant trend in hand and arm injuries are correlative to the use of machinery”
Where Should We Start?
We should start looking at hand and arm protection from the inception of each and every planning paradigm. When planning is being carried out by the HSE manager and line manager, the considerations with regards to hand and arm protection are listed below by stages:
- The 5W+1H
- General duties of person at the workplace
- Contractor’s Scope of Work
- Non-powered hand tools
- Hand and arm risk management, and management of change
- Types of hazards pertaining to hand, arm, finger
- Training for persons who could be exposed to hand, arm and finger risks
- Hand protection equipment
When we are in the planning paradigm, we should consider adopting the 5W+1H to assist us in understanding the overview of the entire process on how to prevent hand, arm and finger injuries. These are some questions which I always ask during a planning meeting:
- Who are the persons exposed to hand, arm and finger risks?
- What hazards can be identified from the job scope, method and machines that the workers are exposed to?
- Where is the PPE matrix in accordance with the Scope of Work (SoW) and hazards?
- When are we conducting training for the workers/operators?
- Who is monitoring the effectiveness of these risk control measures?
- How can we achieve zero harm on hand, arm and finger injuries?
Duty of Care
The employers, principals and self-employed persons in all workplaces exercise their due diligence as a duty of care to:
- Conduct risk assessments (RA) to identify and control WSH risks
- Provide safe work facilities and arrangements for workers
- Ensure safety in machines, equipment, substances used, and work activities carried out
- Provide adequate instruction, information, training and supervision to workers
- Implement risk control measures for dealing with emergencies
Contractor’s Scope of Work
During the pre-tender stage, the contractor will have a clear breakdown on the inventories of the Scope of Work. This Scope of Work shall be utilised to understand the specific method of work in order to plan for a Hand Arm Safety Programme. The Scope of Work can do wonders if utilised to its optimal potential, such as when looking at manpower, machines, method, material, measurement and environment (5M+1E). These are essential pieces of information needed in order to conduct a comprehensive and contextualised risk assessment.
Powered and Non-Powered Hand Tools
The ergonomic design of powered and non-powered hand tools is important to avoid awkward postures of the hand and arm, and prevent the user from experiencing excessive exertion and/or vibration. Non-powered hand tools include pliers, screwdrivers, hammers and knives.
Powered hand tools such as chainsaws and powered screwdrivers can be electric or pneumatic. The use of poorly designed hand tools, such as hand tools with small grip areas, can lead to poor hand-wrist posture and place excessive pressure on the hand.
The following are good practices for the selection and use of hand tools appropriate for the job:
- Select or design tools that can be operated with the wrist in a neutral position
- Avoid short tool handles that press into the palm of the hand
- Avoid narrow tool handles that press deeply into the hand when the tool is used
- Select or design tools that can be used with either the right or left hand
- Select or design tools that require less effort or rotational movement to use, improve posture and reduce holding time
- Select tools with handles made of slip-resistant materials
- Counterbalance or support heavy tools, e.g. by hanging heavy tools from a support
- Ensure that the hand and fingers are able to easily grasp the tool
Use of Machines
Workers who operate machines must be trained, competent, and/or suitably supervised so that they do not put themselves or others at risk while at work. Before starting an operation, it is critical to:
- Obtain the latest copy of the completed RA, understand the hazards posed by the machine and identify the control measures implemented
- Carry out pre-operation functionality checks on all machine safety devices (e.g. machine guards, presence-sensing devices, two-handed control devices, interlocking devices and an emergency stop button).
When using machines, operators are expected to:
- Ensure that the engineering control measures are in place
- Adhere to safe working practises (SWPs)
- Put on the appropriate PPE such as safety glasses or goggles if there is a risk of materials being ejected during operation
Following on from that last point, hearing protectors must be worn should there be excessive exposure to noise while working at the machine. Hand protection must be worn should there be potential risk of cutting, chemical exposure, etc.
“employers need to ensure that workers are adequately trained and competent in machine operation”
Employers need to ensure that workers are adequately trained and competent in machine operation and maintenance prior to assigning work. Training may include formal classroom training, on-the-job coaching, and specific work instructions to individuals or groups. All training should be properly documented (e.g. date of training, participant list, topics covered and assessment methods). The training should be conducted:
- During the orientation of new employees
- Periodically for existing employees
- Whenever new machines or processes are introduced
- When an employee is transferred to another department or job role
The desired outcome after receiving the training, workers should be able to:
- Follow SWPs and operate the machines safely
- Use PPE correctly
- Exercise due diligence to report accidents, incidents, near misses or any workplace hazards to their supervisors
- Carry out emergency response procedures
- Participate in engagement session to suggest safety and health feedbacks
Retraining is necessary, when:
- New machines are installed or modifications are made to existing machines
- Changes are made to SWPs
- The risk assessment is revised
Lock-Out Tag-Out (LOTO) Procedures
All energy sources (whether electrical, mechanical, pneumatic, hydraulic, or in any combination) must be securely isolated before any machine repair or maintenance is attempted. This is to ensure that the machine does not move or accidentally start up due to an unexpected release of an energy source. The steps necessary to isolate all forms of hazardous energy is termed the LOTO procedure.
Hand and Arm Risk Management
Risk assessment is followed by implementing the risk control measures and reviewing them after they are physically implemented and communicated to all personnel. These measures are also audited for conformance and periodically reviewed for their effectiveness. In the event where work-related ill-health, near misses or an accident occurs, an immediate review of the risk assessment is necessary. Otherwise, all risk assessments (RA) should be reviewed at least once every three years by default.
The risk assessment should be a comprehensive and contextualised document which consists of the information supported by 5W+1H, legal and other requirements, general duties of persons at the workplace, procurement/leasing of machines, contractor’s scope of work, non-powered hand tools, machines, types of hazards pertaining to hand, arm, finger, and training for persons who could be exposed to hand, arm and finger risks.
Risk management (RM) includes record-keeping of all relevant records (e.g. RA training sessions, RM implementation audits and RM process management reviews) for a minimum period of three years.
Management of Change
As changes to a machine or its operation may occur after the initial RA is completed (e.g. relocation of machine, new settings and operating procedures, machine modifications and upgrades), it is important to subject any changes under consideration (whether minor or major, temporary or permanent) to a risk assessment. Conducting a RA will ascertain the impact of the change on employees’ safety and health before they are implemented. Written procedures to manage changes should be established and implemented.
Considerations to be addressed prior to any change to the machine and its operation include:
- A technical basis for the proposed change
- An update of hazard communication and operating procedures required as a result of the change
- The necessary time period for the change to be affected
- An authorisation requirement for the change
All personnel whose job tasks will be affected by the change must be made aware of it and receive the necessary training to handle the change before it is implemented.
“inherently safer design means machine hazards are excluded at the source by designing out the risk”
Inherently Safe Design Measures
Inherent safety can be achieved through inherently safer design. Inherently safer design means machine hazards are excluded at the source by designing out the risks a worker faces when they work with the machine. Machines can be made safer by manufacturer design through hazard avoidance or risk reduction by choosing safe design features for the machine or minimising the interaction between man and machine. Some inherently safe design measures include:
- Introducing machine automation
- Substituting a toxic machining fluid with a less hazardous one
- Reducing the mechanical force or energy exerted by the machine
- Blocking access to moving parts
- Eliminating equipment pinch points
Risk control by safeguarding and implementing complementary protective measures. These controls are add-on protective measures put in place to reduce the likelihood of occurrence or severity of the consequence of a mishap. These include erecting a physical safeguarding barrier to interrupt the accident transmission path between a worker and a hazard. Examples of worker’s hand exposed to rotation/cutting part of a machine, physical barriers include installing a machine guard to protect workers from moving equipment parts or enclosing a noisy machine to protect the workers’ hearing.
Information for Use
These controls help to further reduce exposure to hazards by adherence to safe work procedures (SWPs) or instructions. They should be considered after risk reduction by inherently safer design measures and appropriate safeguarding or implementation of complementary protective measures. Procedure documentation should emphasise the correct steps to be taken and the administrative controls necessary to carry out the work activity safely. Information on hazards and necessary safety precautions to be taken at specific work areas, especially when working with a hazardous machine, should be communicated to workers via safety signs. In addition, information for use includes guidance on selecting the appropriate personal protective equipment (PPE) for the task at hand.
Types of Hazards Pertaining to Hand, Arm, Finger
Potential hazards to hands and arms include skin absorption of harmful substances, chemical or thermal burns, electrical arc flash burns or exposure to live parts, bruises, lacerations, abrasions, cuts, punctures, fractures or amputations.
Employers should explore all possible engineering and work practice controls to eliminate hazards and use PPE to provide additional protection against hazards that cannot be completely eliminated through other means. For example, machine guards may eliminate a hazard; installing a barrier to prevent workers from placing their hands at the point of contact between a table saw blade and the item being cut is another method.
“use PPE to provide additional protection against hazards that cannot be completely eliminated through other means”
Many machines have moving parts. Machine parts may move in a linear, reciprocating, rotary, or oscillating motion, individually or in combination. In many cases, the action of these moving parts can exert sufficient force to cause injury to workers operating the machine. A few of the possible hazards are detailed below.
Entanglement may arise in the course of work when part of a worker’s body (e.g. hand or foot) or loose items on their person (e.g. clothing or gloves) comes into direct contact with a moving machine part. In general, entanglement may involve:
- Contact with a single rotating surface such as couplings, spindles, chucks, leadscrews, mandrels, bars or any rotating work piece
- Being caught by projections or in gaps such as fan blades, spoked pulleys, chain wheels, gear wheels and flywheels, mixers and beater arms, spiked cylinders, belt fasteners, projecting keys, set screws, cotter pins on shafts or slat conveyors
- Hands being caught in between counter-rotating parts, for example, gear wheels, rolling mills, mixing rolls and calendars, or materials being drawn between two rolls
Cutting hazards are present in machines used to cut wood, metal, or other materials at the point of operation. Examples of cutting hazards include all kinds of cutting tools, milling cutters, circular saws, handsaw blades, rotary knives, disc blades, or the sharp edges of a moving sheet of material. Machines or tools with moving cutting elements are particularly dangerous as they have the capability to cause severe injury (e.g. deep cuts, amputations) due to its own momentum when they come into contact with a worker’s body.
The severity becomes magnified when the body part is trapped in a stationary position and the worker is unable to move away from the cutting element. Cutting hazards also occur when materials are ejected from a machine (e.g. flying metal chips or scrap material) and strike the machine operator.
Crushing occurs when a body part
- Between a fixed and moving part of a machine (e.g. between the bed and tool of a power press)
- Between a moving machine part and a fixed structure (e.g. between a machine counterweight and floor)
- Between two moving parts of a machine
Impact hazards relate to objects that strike the human body, but do not penetrate it. The severity of an impact hazard depends on the speed, force and inertia of the moving machine parts, materials being processed during machine operation, or upon ejection from the machine. An example of an impact hazard would be being struck by kickback materials, which often results in injuries such as abrasion and bruises.
Hand-Arm Vibration Syndrome (HAVS)
A very common hazard that transmits from the source to a worker’s hand and then up to their arm, which poses the threat of becoming a chronic condition, is Hand-Arm Vibration Syndrome (HAVS).
Vibration is the mechanical oscillation of an object about its normal stationary position. Work can potentially expose persons to hand-arm vibration or whole-body vibration.
Hand-arm vibration due to the use of vibrating hand tools (e.g. saws, grinders, drills, polishers, jack hammers, concrete vibrators and chain saws) over a long duration, and at a high intensity, could progressively damage nerves and blood vessels. If not treated or stopped, these damages could progress to MSDs such as hand-arm vibration syndrome (which includes a particular vascular disorder known as vibration-induced white finger), as well as neurological disorders (abnormal nerve conduction speeds and reduced tactile sensitivity) and vibration induced bone and joint deformation. The vibration transmitted from the tools or materials to the hands and arms could damage sensory nerves, muscles and joints, which develops into the condition we know as Hand-Arm Vibration Syndrome (HAVS).
Training for Hand, Arm and Finger Risks
The employer shall be responsible for instructing the operators and helpers as required on the hazards of the machines they are to operate or assist in operating, and the safe methods to be used. The instructions given should include, but not be limited to:
- A description of the assigned tasks
- The function of controls to be encountered in performing the assigned tasks
- The hazards associated with the assigned tasks
- The designated method of feeding
- The designated method of safeguarding
- The methods of function-testing or otherwise assuring the proper function of safeguarding means
- Responding to and reporting inconsistent performance
Hand Protection Equipment
Hand protection equipment should be carefully selected according to the type of hazards and work activities. When procuring protective gloves, employers should consider the following:
- Comfort and efficiency
- Testing and certification
- Marking and information
- Glove material
- Level of performance – resistance to water
- Hand size
- Glove sizes
- Levels of performance – finger dexterity test
- Other references for specific types of hand protection equipment
During procurement for hand protection equipment, the employer should clearly understand the typical operations, hazards or hazardous agents that are present, while the manufacturer should also provide precise product information, in order to select the correct type.