by Sally Colby
Our hands are a critical part of what we’re able to accomplish every day, and we use them every day to complete routine tasks and precision movements.
“Whether it’s raking a pill out of a small pill bottle or putting nuts and bolts together, it’s an amazing engineering marvel that’s made up of about 27 bones,” said Carla Wilhite, assistant professor of occupational therapy at University of New Mexico. “Then there are attachments like ligaments, tendons, nerves and an incredible blood vessel supply.”
OSHA statistics from 2007 report more than one million hand injuries in the workplace annually, and hand injuries account for 20 percent of disabling work injuries. The Bureau of Labor Statistic says 205,000 injuries to wrists, hands or fingers resulted in days away from work.
“It’s the versatility of the hand that subjects it to many kinds of injuries,” said Wilhite. “We have strains, sprains from excessive forces, excessive repetitive motions, we often work in awkward positions and try to fit our bodies to the workspace. We often have contact with surface conditions that are less than optimal for hand health, whether it’s a hard surface, a sharp edge, something cold or too hot, or rough surface conditions where we abrade our hands.”
One of five adults have some degree of arthritis, which is exacerbated by putting force on the joints. Modify the activity, take frequent breaks and if pain lasts longer than one hour after the activity or includes joint swelling, the activity was too stressful and should be broken into smaller segments or redesigned by an occupational therapist.
Skin irritants also pose a risk to hands. Chemical burns, poisonous plants, fertilizers, herbicides, puncture injury, cuts, fractures and bites from animals or insects are common; and at the extreme, accidental amputations. Puncture wounds from bites and other sources can be problematic. “Puncture wounds can be especially problematic because some of the foreign material is left deep in the wound and it can become infected,” said Wilhite. “Crushing or tearing wounds can be the result of being stepped on or crushed during a task.”
Basic skin care for hands includes limiting exposure to irritants and using protective creams when necessary. Always wash hands immediately after exposure to harmful substances. Use cotton gloves as a liner under rubber gloves to limit the effects of sweating. Wilhite says rubber gloves lined with flocking are worse than not wearing a cotton liner.
Harsh substances for hand washing can be harmful and Wilhite says the Society for Dermatology recommends soap-free cleansers for hands. “Make sure you have cleanser in numerous locations,” she said. “Then apply an after-work conditioning cream to increase the moisture in your skin so you don’t get painful cracks. After work, look for cuts, rashes, abrasions and get medical attention if necessary. Clean and bandage cuts, get splinters and grit out of wounds. Minimize hand sweating. Jewelry, including rings, watches and other items that pose a catch risk should be removed.”
Farm machinery creates numerous opportunities for hand and arm injuries. Augers, belts, chains, saws, hitches, hydraulic leaks and burns from mufflers are some of the most common sources of injuries. Wounds range from bruises and minor cuts to major tears, fractures and amputations. Even something seemingly minor, such as hydraulic fluid being injected into the hand at high pressure, will move with force throughout the hand and continue through the arm. “The hand has to be decompressed so the foreign material can be removed from the fingers,” said Wilhite. “It creates an extensive and very dirty wound that’s prone to developing gangrene.”
Preventing hand injuries is up to the individual. One important factor is fitting each person’s body size to the task. “There’s no such thing as average,” said Wilhite. “There are three basic work positions: lying, sitting and standing, but we know there are all kinds of positions that happen between those postures and are often very asymmetrical postures that are so awkward that they predispose us to injury. There’s also the need to stoop, squat or kneel in the workplace to orient our hand to what the work task is demanding.”
Hand tools can help make a task easier but should be used properly. “The purpose of the handle is to hold the tool and maintain secure control,” said Wilhite. “But the tool handle should fit the contours of the hand. This is where women often have a problem because tools are made for an ‘average’ size and the grips are too large. Tool handles should fit in your ‘okay’ sign.”
Is the tool made for right or left hand, and does it require a precision grip or a power grip? “Consider the transmission of energy between the tool handle and the hand,” said Wilhite. “When I’m hammering on something and the energy is transferred through the wood handle, I’m feeling that upstream from where I’m hammering. Tool handles each have benefits and limitations — some people are more susceptible to the vibratory injury that occurs with vibratory tools.”
Tools should be kept in good condition and stored properly. Use the right tool for the right job. Examine each tool for damage prior to use. “Don’t use damaged tools,” said Wilhite. “Tag as ‘do not use’ and get them out of the workplace so they aren’t accidentally used.”
Wilhite stresses the importance of using the correct personal protective equipment (PPE) which fits properly for the job. Gloves are made from a variety of materials, and each is designed for a specific use in the workplace. Make sure you choose the correct gloves for each use, and they fit properly.
“Don’t wear gloves near machine gears or other devices that could grab and pull you into the machinery,” said Wilhite. “Keep guards in place and keep sharp blades pointed away from the body. Cut away from the body. Use push sticks with table saws.” It’s important workers take breaks, divide tasks into shorter sessions, store tools properly, avoid sustained gripping of tools and arrange workspaces so tools are easy to access.
Be aware of hazards in the shop and take care when using tools for routine repairs. “Secure work with the proper clamps or vises, and don’t pull on cords and don’t carry tools by their cords,” said Wilhite. “Direct tools [away] from others and be aware of others in the work area. Don’t use electrical tools in a damp or wet area unless the tool is specifically approved for that use.”
A safe tool shop helps keep hands safe. Oil on the floor, tools not put away and general disarray in the shop is hazardous. “The most effective control is to engineer out risk of injury,” said Wilhite. “When the risk can’t be designed out, doing things that increase safety is absolutely essential.”
Watch your hands!
by Sally Colby