Harnesses can become deadly whenever a worker is suspended for durations over five minutes in an upright posture. It is called suspension trauma. This can occur in many different situations in industry. A carpenter working alone is caught in mid-fall by his safety harness, only to die 15 minutes later from this suspension trauma. Another example is a worker being lowered into a shaft. After five minutes he will be unconscious and in 15 minutes later a dead body will be hauled out. Fall protection researchers have recognized this phenomenon for decades. Most users of fall protection equipment, rescue personnel, and safety and health professionals remain unaware of the hazard.
Suspension trauma death is caused by orthostatic incompetence; it can occur any time a person is required to stand quietly for prolonged periods and may be worsened by heat and dehydration. It is most commonly encountered in military parades where soldiers must stand at attention for prolonged periods. Supervisors can prevent it by training soldiers to keep their knees slightly bent and not locked.
How orthostatic incompetence occurs is that the legs are immobile with a worker in an upright posture. Gravity pulls blood into the lower legs, which have a very large storage capacity. Enough blood eventually accumulates so that return blood flow to the right chamber of the heart is reduced. The heart can only pump the blood available, so the heart's output begins to fall. The heart speeds up to maintain sufficient blood flow to the brain, but if the blood supply to the heart is restricted enough, beating faster is ineffective, and the body abruptly slows the heart.
In most instances this solves the problem by causing the worker to faint. After fainting and slumping, blood can now be returned to the heart and the person typically recovers quickly. In a harness, however, the person can't fall into a horizontal posture, so the reduced heart rate causes the brain's blood supply to fall below the critical level.
Orthostatic incompetence doesn't occur often because it requires that the legs remain relaxed, straight, and below heart level. If the leg muscles are contracting in order to maintain balance and support the body, the muscles press against the leg veins allowing for normal blood flow. In suspension trauma, several unfortunate things occur that aggravate the problem. First, the worker is suspended in an upright posture with legs dangling. Second, the safety harness straps exert pressure on leg veins, compressing them and reducing blood flow back to the heart. Third, the harness keeps the worker in an upright position, regardless of loss of consciousness, which is what kills workers.
A planned rescue policy will need to be implemented for people requiring to wear fall arrest harnesses. The equipment used to save the life from a fall can also be the danger that can kill them.
The death of a Maroubra man from a fall related accident last month provides a chilling reminder of the importance of safety harnesses and a Height Safety management plan. The news footage was eerie as the camera shows one man hanging safely by his safety harness, whilst they summise that the other man fell as a result of not wearing a safety harness.
Fall hazards are the construction industry's main cause of death from traumatic injuries with 18 deaths having occurred in 2003 in Australia and New Zealand. They are also construction industry workers second largest cause of non-fatal workplace injuries. In Australia alone between 1997 and 2001, the construction industry generated around 1,600 fall-related workers' compensation claims each year. This represents approximately 12% of all construction workers' compensation claims.*
Under the Occupational Health and Safety Act 1989, employers, persons in control of a workplace and self-employed persons must take all reasonably practicable steps to ensure that persons at or near the workplace are not exposed to health and safety risks. Preventing injury from falls is also a requirement under the Scaffolding and Lifts act 1912.
What can you do to prevent falls? There is a three step risk management approach that can be implemented into any workplace. The first step is to identify the hazards, the second is to assess the risk and the third step is controlling the risk.
Controlling the risk can involve such measures as eliminating the hazard, by working on the ground as much as is practicable; substituting with a safer surface such as constructing temporary work platforms; remove workers from the hazard by using guardrails as physical barriers; and the use of personal protective equipment such as a hard hat which can minimise the risk of head injuries and safety harnesses which are secured into an anchor point or a safety line at the work site.
If your workplace engages contractors to undertake work, it is important to remember that there is a shared responsibility for health and safety and this requires cooperation and communication regarding risks associated with the work. You can not "contract out" your safety responsibilities for work or a workplace that you control.
The state Workcover websites can provide further information on both the rights and responsibilities for employers and employees. There is a large amount of information as well as the up to date legislative requirements.
* Information sourced from the HWSA Joint Compliance Project Report: Falls Prevention in Construction 2004 - Part One found at http://www.workcover.tas.gov.au/workcoverpublish/attach/inspfalls1.pdf and from Workcover ACT's IB0314 - Prevention of Falls on Construction Sites found at http://www.workcover.act.gov.au/pdfs/IB0314-Falls_Prevention.pdf
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