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Minor hand injuries can become major if infected

May 7, 2013
KEYWORDS hand injuries
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Have you ever thought about what it would be like to lose a finger? A thumb? A hand? Both hands?

Your arms and hands are the tools you need to do a variety of tasks, both job-related and personal. Without the use of these tools, many everyday tasks would be difficult or impossible to perform. Some may require extensive therapy and training to relearn. The wrists and hands are complex and extremely difficult to repair.1 Consequently, it is very important to control or provide good protection from hazards that present a threat to fingers, hands, and arms. It only takes a second for a life-changing event to occur.

According to the Bureau of Labor Statistics, about 250,000 serious injuries to fingers, hands, and wrists occur every year in private industry alone, with around 8,000 of those being amputations.2

Commonwealth of Virginia agencies have averaged almost 3,000 finger, thumb, hand, wrist, and lower arm injuries per year for the past five fiscal years (2002-2006), resulting in an average annual totaled incurred cost of over $3 million over the five-year period.

On any given day, agency employees are exposed to hazards that may result in injuries ranging from a minor cut to amputation. These injuries may include:

  • Cuts/lacerations, punctures
  • Fractures, crushing, and amputations
  • Chemical, thermal, and electrical burns
  • Abrasions
  • Bruises
  • Skin irritations (dermatitis)
  • Absorption of hazardous materials (through the skin)

It is important to remember that even a minor injury can become serious if it becomes infected. Even a paper cut could ultimately result in amputation.

The OSHA/VOSH hand protection standard, 29 CFR 1910.138, of 1910 Subpart I, Personal Protective Equipment (PPE) states, “Employers shall select and require employees to use appropriate hand protection when employees' hands are exposed to hazards such as those from skin absorption of harmful substances; severe cuts or lacerations; severe abrasions; punctures; chemical burns; thermal burns; and harmful temperature extremes.”3

Paragraph 1910.132(d) (1) of the general requirements for PPE mandates that, “The employer shall assess the workplace to determine if hazards are present, or are likely to be present, which necessitate the use of personal protective equipment (PPE).” The standard continues under 1910.132 (d) (1) (i), “If such hazards are present, or likely to be present, the employer shall select, and have each affected employee use the types of PPE that will protect the affected employee from the hazards identified in the hazard assessment.” In sum, workplace hazard assessments must be done to identify dangers that cause hand injuries and to help determine what steps can be taken to eliminate, control, or protect against them.4

Engineering and work practice controls

Before assuming that PPE is needed to control an identified hazard, employers should investigate possible engineering and work practice controls to remove or isolate the hazards. With engineering controls, the employer may physically change the machine or work environment to prevent exposure to hazards, such as:

  • Changing the process
  • Substitution of less harmful material
  • Install guarding: enclosure of the process
  • Install other types of barriers: isolation of the process5

For instance, a properly installed and functioning guard on a miter saw may prevent an employee from contacting the moving blade. For additional information related to machine and process guarding, refer to the Workers' Compensation Services - Loss Control web article titled, “Machine Guarding” (January 2006)

With work practice controls, the employer changes the way the job is done. This can include such steps as:

  • Establishing basic rules (e.g. never wear gloves, jewelry, or loose clothing while operating moving machinery)
  • Job rotation of workers
  • Personal hygiene
  • Housekeeping and maintenance
  • Tool and equipment selection and inspections

Personal protective equipment

However, if engineering or work practice controls are not feasible or cannot eliminate or adequately control potential hazards, then employers are responsible for:

  • Identifying and selecting appropriate PPE
  • Training employees in the use and care of the PPE
  • Enforcing the proper use of PPE
  • Periodically reviewing, updating, and evaluating the effectiveness of the PPE program6
  • The most common PPE for hand protection are gloves. There are many different types of gloves of various materials, sizes, and lengths for a wide variety of uses and levels of protection. Because there is no single glove that provides protection from all types of hand injuries, selection is based on performance characteristics of the gloves in relation to the task being performed. The nature of the hazard and operation determines the type of glove needed, such as:
  • Type of chemicals handled
  • Nature of contact
  • Duration of contact
  • Area to be protected (fingers, hands, wrists, and arms)
  • Grip requirements, dexterity needed (e.g. picking up small items)
  • Thermal protection
  • Size and comfort
  • Abrasion/resistance requirements7

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