Effective Dermal Protection

The standard hierarchy of controls applies: elimination of the hazard, engineering and administrative controls, and finally, PPE.

• By Fred Elliott
• Jan 01, 2003

THERE'S a lot of protection contained inside a glove these days. Corrosive or toxic material exposures, cuts, abrasions, and vibration are typical hazards these deceptively simple products ward off for employees.

Effective hand protection begins with task analysis. Establish the duties and hazards for every position at your facility, then devise your injury prevention strategy. The standard hierarchy of controls applies: elimination of the hazard, engineering and administrative controls, and finally, PPE.

A good place to begin researching a particular workplace hazard is OSHA's Web site, which has grown into an essential online tool for the safety and health professional. While OSHA's site pays less attention to the topic of hand protection than some other subjects--respiratory hazards, for example--its Technical Links page (www.osha.gov/SLTC/index.html) includes a useful "Dermal Exposure" link to get you started.

Interestingly, however, NIOSH's National Occupational Research Agenda has listed contact dermatitis as the second most common occupational disease in the United States, after hearing loss. Dermatitis accounts for 15 to 20 percent of all reported occupational diseases, the two agencies agree.

The Dermal Exposure page discusses chemicals that can cause dermatitis or otherwise damage the skin, as well as substances that can enter the body through intact skin and cause toxic effects. Related links explore latex allergy and personal protective equipment effective to prevent skin exposures.

Exposure can result from direct contact (either by splash or immersion), indirect contact from a contaminated surface, or vapor or large-diameter aerosols. Based on the health effects that result from exposure, dermal hazards are classified in one of four ways: as primary irritants, allergic sensitizers, photosensitizers, or skin carcinogens.

"Substitution to a less toxic chemical is almost always a good option, unless the alternative chemical is much more volatile," OSHA observes. "Consideration should be given to re-designing the work process to avoid splashes or immersion. Where that is not feasible, personal protection in the form of chemical protective gloves, an apron, or clothing should be selected. Good housekeeping can avoid the accumulation of stable, low volatility, dermally toxic contaminants on horizontal surfaces. Enclosure and isolation may be feasible for both liquid and solid large aerosols. Personal protection is a last option or a supplemental option to help control all of the above exposure mechanisms. The process of selecting appropriate personal protective clothing is more than a trivial activity; some OSHA guidance may be found in 29 CFR 1915 Subpart I App A."

Training and good communication with both glove distributors and employees are crucial to making a hand protection program work effectively. As the following checklist indicates, employers have a duty to inform their exposed workers about proper care and use of all PPE, including protective gloves. They must be educated on the hazards in their own workplace and how those hazards should be mitigated.

Editor's note: This checklist was prepared by former Occupational Health & Safety Technical Editor Linda F. Johnson. A checklist is not a substitute for a comprehensive safety program, but rather is one audit tool to be used in conjunction with an experienced staff and assessment of the hazards at your job site.

Injury Prevention Tips

A hand therapist is an occupational or physical therapist who, through five years of advanced study, specializes in rehabilitating patients with conditions affecting the hands and upper extremity. The therapist's high degree of specialization requires continuing education and, most often, advanced certification. This enables the hand therapist to work with patients, hastening their return to a productive lifestyle.

In addition to providing postoperative and general rehabilitation, hand therapists may consult with various industries to establish preventive programs for workers with cumulative trauma disorders. Hand therapists recommend modifications of workstations and alternative work methods to help ensure healthy work practices for all employees.

Work-related strain or other repetitive injuries can result in reduced productivity and increased worker's compensation costs. Just as machines need preventive maintenance to operate at full capacity, physical job duties must be evaluated to prevent injuries and ensure your staff is performing optimally. Follow these suggestions to help prevent strain and repetitive injuries in your facility.

• Take 30-second breaks every 30 minutes when performing repetitive activities. Use this time to stretch the muscles in the opposite direction from your working pattern.
• If possible, break up your day with different activities to avoid over-repetition with one activity.
• If you do injure yourself, see a hand medical doctor and get proper treatment. A small injury to the hand or arm can become a serious long-term disability if neglected. If you have a repetitive motion injury, have your doctor refer you to a hand therapist to keep you working without pain.
• Arrange for a local therapist to make a site visit to assess your work settings. The therapist can identify high-risk areas and recommend alternate configurations to reduce employee risk.
• Sometimes different tools are needed. If workers themselves start to add padding or modify how they are doing something, examine the tools they are using.

The incidence of carpal tunnel syndrome (CTS) is higher in office settings than in most other professions. CTS occurs when tendons or ligaments in the wrist become enlarged after being aggravated. Help prevent CTS by following these guidelines:

• The height of many computer keyboards creates tension in the wrists because you must bend your wrists to hit all of the keys. When using the computer, use a padded wrist rest so your wrists sit comfortably on the table in front of the keyboard.
• Stop typing every 30 minutes and stretch your hands and wrists. Spread your hands and fingers wide and then ball them up into a fist. Repeat this five times. Rotate your wrists five times in one direction, then five times in the alternate direction. These exercises will keep your hands and wrists flexible and decrease the chances of acquiring CTS.
• Holding the telephone all day with your wrist extended can cause undue stress. If you spend much of your day on the telephone, you should switch to a headset. Not only will the headset help prevent CTS, but it can also alleviate neck and upper back pain.
• When performing repetitive gripping activities, make every effort to keep your wrists straight. Stop every 30 minutes and stretch your fingers and wrist backward five to 10 times.

• If you have numbness and tingling in the hands, decreased feeling in your fingers, or the presence of an electric-like shock in your hands, you may have CTS. Get proper treatment.

SOURCE: American Society of Hand Therapists (ASHT), www.asht.org.

This article originally appeared in the January 2003 issue of Occupational Health & Safety.