Simply crushing

A crush injury occurs when force or pressure is put on a body part. This type of injury most often happens when part of the body is squeezed between two heavy objects. Simple safety measures can dramatically reduce the risk of crush injures to yourself and other workers.

Crushed hand
by Onsite Paramedic

Two workers were moving large steel beams using a forklift and a truck. The forklift operator picked up the steel beam load and placed them on the back of the truck. There was one more steel beam left so the forklift operator picked it up and approached the truck to place it down. The truck driver signaled and stopped the forklift operator so he could reposition to the side of the tray to remove the beam off the tines of the forklift to prevent the steel from falling off the trucks tray and onto the ground. As the truck driver did this, he miscalculated the speed and caught his fingers between the steel and the truck bed. This resulted in the truck driver crushing both his index and middle fingers, causing multiple fingertip fractures.

Crush incidents such as this happen too often as people don’t take the necessary time to put the correct control measures in place, and importantly, wear the correct protective equipment.

Because of this incident, a review of a glove matrix pre-start was undertaken as well as a review of the incident site-wide to raise awareness of ‘line-of-fire’ hazards.

Incidents such as this can be avoided by ensuring workers complete risk assessments whenever there is a change in process, as well as always considering the energy sources, particularly gravity when undertaking a task that involves shifting loads.

It won’t happen to me

'It won't happen to me' is a common phrase that passes through someone’s mind just before they sustain a serious injury. Here are a few examples of how this line of thinking has got people into trouble.

Don't use your hand as a hammer! Hypothena Hammer Syndrome
by Dr Toby Cohen MB. BCH BAO MA MSC FRACS (Vas) Vascular and Endovascular Surgeon QLD Vascular and Director of The Vascular Lab

Our hands perform many important roles when we're at work, but one of them is not a hammer. While it's rare, we have seen cases where people have used their hands to hammer an object into place such as a piece of wood or a metal bar. Using the base of your hand in this way can lead to serious problems.

At the base of your hand, you've got two important arteries, one on the inside called the Ulnar Artery that supplies blood to the hand, and one the outside called the Radial Artery that completes the blood supply to the hand When someone subjects these arteries to a blunt force, such as hammering something into place, it brings the Ulnar Artery close to the skin, causing a potential long-term injury such as a small aneurysm. These aneurysms can then go on to form clots which travel into the fingers, resulting in the possible loss of the finger. This is called Hypothena Hammer Syndrome.

Regardless of where you work, it's important to use the correct tools to get the job done. And it's certainly no different here. Use a hammer and not your hand.

Hand Vibration Syndrome
by Dr Toby Cohen MB. BCH BAO MA MSC FRACS (Vas) Vascular and Endovascular Surgeon QLD Vascular and Director of The Vascular Lab

A common exposure in many work environments is vibration caused by heavy machinery use. When operating trucks, diggers or dozers people need to remember to wear protective equipment on their hands to minimize vibration damage. Long-term use of heavy machinery without such protection can result in 'Hand Vibration Syndrome'.

Hand Vibration Syndrome is caused by damage to the nerves, vessels and muscles in the finger due to vibration exposure. Symptoms range from tingling and numbness, cold fingers, tendonitis and arthritis.

Although this condition is rare, it's a good reminder why it's important to wear protective hand-equipment while at work.

Ruptured Right Biceps Tendon
by Sonic HealthPlus Injury Management Team

A Supervisor working for on a remote mine site for a resource company was assisting a colleague manoeuvre a refrigerator through a doorway to position into a different room. The Supervisor’s right arm was placed under strain and subsequently suffered a complete distal tear of his right bicep tendon requiring surgical intervention.

The Supervisor underwent surgery and recovered within the expected time frames, returning to full duties after careful collaboration from the approved rehabilitation provider and the employer.

It is common knowledge that companies have policies and procedures in place which should be implemented before a task is performed in order to identify the risks and determine if it is safe to perform the task at all. The individuals involved would have simply thought "we are just moving a small fridge, we'll be fine" and made the decision not to consider the consequences of the task, as it appeared straight forward.

The message associated with this injury is to NOT disregard seemingly simple tasks and the possible injuries you can sustain whilst performing them, essentially think before you act and not adopt the mentality of "it won't happen to me".

Exercise caution

A favourite pastime of many FIFO workers is exercising at the gym. While it's a great way to keep fit and healthy, it's also an easy way to get injured. Here are two examples of workers who have sustained injury due to the incorrect use of gym equipment.

Partially Dislocated AC Joint
by Sonic HealthPlus Injury Management Team

A FIFO worker on a remote mine site was utilising the gym facility after his shift. The worker was performing chest flys on a bench when he overextended his shoulder and experienced acute pain to his right shoulder. The cause of the over extension was a combination of the worker selecting a weight which caused rapid muscle fatigue and as a result, he couldn't control the weight eccentrically.

The worker was assessed by the onsite Emergency Management Officer and was flown offsite the next morning to consult with a doctor. The worker underwent an MRI to his right shoulder, which revealed he had partially dislocated his right AC joint. Surgical intervention is often not performed for partial dislocations due to the nature of the joint. The worker participated in a vigorous exercise rehabilitation program to strengthen his rotator cuff muscles and improve his current restricted shoulder range of motion.

This injury could have been avoided if the worker actively engaged with the health and wellness officer or gym coordinator to receive instruction on correct exercise programming techniques.

Lower Back Muscle Spasms
by Sonic HealthPlus Injury Management Team

A FIFO worker on a remote mine site was utilising the gym facility after his shift. The worker was performing a 200kg dead lift and felt a "twinge" in his lower back. The worker woke up the next morning unable to move due to sharp pain caused by muscle spasms in his lower back. The worker's Supervisor was informed; the EMO attended to assess the worker's injury and the decision was made to fly the worker offsite to be reviewed by his doctor.

The worker could not return to work for his next swing due to residual muscle tightness to his lower back and associated pain. The worker underwent Physiotherapy treatment to the area and was eventually certified fit to return to full duties.

Reports from surrounding individuals in the gym stated that the worker was performing the dead lift in a forward flexed position, most likely due to muscle fatigue and the attempt to repeatedly lift 200kg, poor knowledge on correct dead lift technique, selecting a weight beyond the individual's physical capability.

Once again, the worker could have utilised the health and wellness officer or gym coordinator to advise on correct lifting technique and exercise programming

Handle with care

Causing around 8,400 hospital admissions each year, hand and wrist injuries are the most common work-related injury in the Australian workforce. Injuries can range from being relatively minor to very severe, most commonly involving the fingers. Here are a few common examples that can be avoided by implementing some simple practices and techniques.

De Quervain's tenosynovitis
by Joy Hanna, EKCO Hand Therapy Manager

De Quervain’s tenosynovitis is a painful condition affecting the tendons on the thumb side of the wrist. It's usually caused by chronic overuse of the wrist such as gripping, grasping, clenching, pinching and hammering.

When we do a high volume of repetitive or sustained gripping we force these tendons to move and rub in a section of the wrist called the first dorsal compartment. This compartment is like a tunnel, so when the tendon becomes inflamed from overuse they struggle to fit into the tunnel. The continual rubbing of the tendons causes the tunnel to enlarge and makes the space inside the tunnel even smaller, which creates pain as the thumb tendons continue to move through it.

Over time the irritation in and around the tunnel can become so severe that any thumb or wrist movement causes pain. This condition is common in tradesmen, new mothers and occupations that require high volumes of thumb use such as dental assistants, lab technicians and phlebotomists.

To avoid this injury, refrain from sustained repetitive activities using the thumb, such as clicking a keyboard or picking something up using an outstretched thumb. Make sure you regularly change the task, or introduce a variety of tasks at the workstation.

Joy Hanna
Manager EKCO Hand Therapy

Joy is the Manager of Brisbane's leading hand therapy rehabilitation organisation, EKCO Hand Therapy and has over 15 years experience in hand and upper limb rehabilitation.

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Dr Toby Cohen
MB. BCH. BAO. MA. MSC FRACSVascular Surgeon

Dr Toby Cohen is a Brisbane based Vascular Surgeon whose focus is to encourage early diagnosis and minimally invasive treatment. Dr Cohen specialises in using a variety of treatment options for diseases of the arteries, veins and lymphatic systems.

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