Page 98 - OHS, October 2023

BREAKTHROUGH STRATEGIES BY ROBERT PATER Getting a Better Handle on Hand Safety Hand injuries can be, well, a handful. As I write this col- umn, I have received inquiries for help in preventing ongoing hand injuries within the last two days. These re- quests came from an “upstream” oil industry company in the United States and from the Brazilian business unit of a global manufacturer. While more prevalent in some industries, hand injuries can affect almost everyone. And these are notoriously difficult to get a handle on for good reasons. We’ve found that it’s relatively easy to make sizable and lasting improvements in soft-tissue injuries (strains and sprains), followed by not-quite-as-eye-popping re- ductions in slips/trips and falls. However, hand injuries are the most challenging to reduce. Why? It’s a matter of number of exposures. In our experience, many people lift/push/pull/carry/use tools on the order of tens or sometimes hundreds of times a day (soft-tissue injury expo- sures.) Many take thousands of steps daily (risks of slips/trips/ falls.) But people likely make tens of thousands of finger/hand/ wrist/arm motions during their day. And because the hands are most in contact with tools and equipment, these have increased first-acting and first-responder acute injury risks — not to men- tion the buildup of cumulative trauma. For example, have you seen issues like these: ■ Someone immediately and unconsciously reaching — dan- gerously — for something that has fallen or “gone wrong” (maybe a falling heavy or sharp object or a tool that is jammed? Reflexive- ly reaching out a hand to “protect” the rest of their body from im- pact, a cutting edge, or other hazard after even a slight stumble? ■ Cumulative, even-somewhat-misaligned motions that build into discomfort, pain and weakness, and that in turn can cascade into a seemingly “acute” incident? ■ Loss of attention of being misdirected or distracted, day- dreaming, or focused on an area of discomfort? ■ Someone overusing their dominant hand so that their off-hand can be almost “out of sight, out of mind” and therefore overly vulnerable? ■ Overuse of the dominant hand to the point that force over- concentrates in one limb — and then in one side of the body? ■ Bracing when fatigued — but in a “wrong” (and thus a high-risk) place or position? Yet, after doing what they can to shield their workers from hand injury exposures — a critical first step — many companies that still see concerning injuries then seem to “throw up their hands,” being at a loss of what to do. Admonishing workers can result. For example, when working with an oil industry client in Ma- racaibo, Venezuela, I noticed a poster made of an actual worker’s right hand, with four fingertips separated by space from the re- mainder of his other joints, amputated during an industrial acci- dent. I asked numerous workers what they thought of this poster and whether it helped remind or inspire them to work differently. Almost all vehemently said “no.” Many averted their attention to the picture; others expressed dismay or anger that the company would use this worker’s terrible accident to make a point. How- ever, few acknowledged its value for preventing injuries. What should companies do in- stead? 1. Chart the different kinds of hand injuries in your organization. Don’t lump together all hand, finger, wrist, hand, or upper limb injuries. What are the trends? Are you seeing bruises, pinches, lacerations, abra- sions, and strains? And what are the results, amputation, disloca- tion, carpal tunnel syndrome, Raynaud’s Disease, etc.? Seeing the actual problems can lead to more targeted solutions. 2. Widen the scope of the breadth of problems. Go beyond solely focusing on the hands. Discern how the entire body affects what happens to the hands. For example, if a person’s base (e.g., lower body position) doesn’t adequately support the work of the hands, are they overreaching? Do they experience a loss of po- tential grasping strength? Is there dexterity minimized? Are the upper limbs having to work overly hard, with less control, and thusly at greater risk? Seeing hand injury problems from a broader perspective can lead to identifying and designing out previously hidden risks and also toward applying more effective human factors prevention methods. 3. Consider possible psychosocial contributors to hand inju- ries. There’s recently been a raft of published research on such mental, social and cultural influences that either contribute or lead to soft-tissue injuries. Reflect on whether Safety leadership/ culture/policies/procedures etc., might have any impacts on the incidence of these. Gloves provided that either don’t fit snugly or aren’t appropriate for the range of tasks? Overly challenging LOTO procedures that workers wind up going around? Insuffi- cient machine maintenance? Mixed messages where Safety and production are at odds? 5. Understand the mental component and gauge how strongly lack of attention affects hand injuries. The very volume of finger and hand movements can potentially lull any of us into compla- cency. An overly narrow attention focus on hand work can go against seeing — and then simply modifying other contributing factors to lessen risk. Design and procedure in ways that encour- age workers’ freshly shifting attention in a safe manner. Transfer practical attention control training methods that almost anyone can learn and quickly apply. 6. Take a skills-based approach that transfers practical mental and physical skillsets that workers can arm themselves with to overcome some of their challenging exposures to hand injuries. There is no question that hand injuries can be among the more difficult Safety problems to reduce. However, the right “different” approaches have been shown in many companies to lead to differ- ent, better results on many levels. Robert Pater is the Managing Director and creator of the MoveSMART® system for preventing strains/sprains, slips/trips/ falls, hand injuries implemented in over 60 countries. Their empha- sis is on “Energizing, Engaging Expertise” to simultaneously elevate safety performance, leadership and culture. 98 Occupational Health & Safety | OCTOBER 2023 www.ohsonline.com