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Ergonomics of PPE - 

Ensuring Acceptable Above the Neck Protection

Although it is widely recognised that reduction of any risk at source is to be preferred, in many workplaces Personal Protective Equipment (PPE) is used, either as the only form of protection or as an additional defence.

Taking just one form of protection as an example, research has established that 5.5 million workers are exposed to respiratory hazards in the workplace. Of these, approximately 50% wear respiratory protective equipment (RPE). However, it is also estimated that only 50% of these wear equipment that is correctly selected and fitted. It can be calculated from this that only 25% of those at risk are adequately protected which suggests that the remaining 75% could be at risk from respiratory ill health.

This article examines a range of reasons why some of that 50% don’t wear their RPE correctly - the issue of why they don’t wear the correct RPE is a different, but equally important, issue.

Right for the wearer?

Why do a high proportion of workers exposed to potential respiratory hazards not wear their RPE? There are many factors that contribute to this, which relate to the ergonomics of RPE/PPE design and use. Firstly, as well as being technically effective, PPE must not be too uncomfortable to wear, and must not get in the way of doing the work, or it will not be worn correctly (if at all).

To put it another way, as summarised by the current campaign by the British Safety Industry Federation and the Health and Safety Executive (BSIF/HSE) “Clean Air? - Take Care!”©: RPE(PPE) must be “right for the hazard; right for the task; right for the wearer.”

Clearly, using the right type of protection is important. A dust respirator provides little or no protection against chemical vapours, impact-resistant safety glasses are less effective against chemical splashes?than goggles. But, ensuring the correct protection also involves not over-protecting.

Most forms of PPE impose some load on the wearer in terms of interference or discomfort. Although not always the case, PPE providing a higher level or protection tends to be bigger, heavier or otherwise more intrusive. For example, those hearing defenders providing a higher degree of protection tend to have larger, heavier cups held firmly to the head (to form an effective seal). Research has shown that there are two factors which are major determinants of the comfort of hearing defenders: their weight and the force they exert on the side of the head (with heavier or more forceful defenders being less comfortable to wear). This creates the situation where, in the (noisy) situations where we most need hearing protection, we are less likely to find those provided to be comfortable and therefore less likely to be willing to wear them.

When a wearer is working hard, or if they have an existing respiratory problem, even the modest increase in breathing resistance imposed by RPE can be a problem. Powered respirators, in which filtered air is blown inside a mask or hood, can help to overcome this, making the RPE more acceptable. Similarly, in noisy environments but where users still need to be able to hear certain sounds, selective hearing defenders can help, again making the PPE more acceptable. In such ways, careful selection of PPE can help to ensure that those wearing it can have the right sort of protection which is appropriate for the tasks they have to perform.

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Size matters

When getting it right for the wearer, size (can) matter. With some forms of PPE, having the right size, correctly fitting the wearer, can be crucial for ensuring the correct level of protection. Even with something as simple as a hard hat, having the right size shell can be important in ensuring the correct air space inside (as well as helping to improve acceptability).

With RPE, fit is critical; and the requirement in the UK for Face-Fit testing recognises that, without a correct fit, the necessary technical performance will not be achieved. Although all are made to pass the same technical standard, RPE from different manufacturers can differ in shape and it is important to realise that one size probably doesn’t fit all when it comes to RPE. Again, where getting a fit is a particular problem, hood-type RPE can be an alternative. Even hearing defenders and ear-plugs can differ in size and shape and again, different makes might be better for some wearers than others (after all, we all come in different shapes and sizes as well).

Two’s a crowd

How many of us, when doing a DIY job such as fitting loft insulation, have found our glasses misting up on top of the dust respirator we are wearing? What have we done about it? Too often, the answer is to not wear one of the two properly, if at all.

Where two or more items of PPE are worn at the same time, they might interfere with each other, either in terms of comfort or of performance. Helmet-mounted hearing defenders should only be worn with those makes of helmet they have been tested with (this information is available from the manufacturers). Even then, however, they might not be suitable for some people where there is too little space between the helmet shell and the ear (not between the ears) for the hearing defender shell to fit correctly and comfortably. The arms of safety glasses will pass under the cushions of hearing defenders. This might cause a break in the seal (making the defenders less effective) or be pushed against the side of the head, making the two uncomfortable to wear together. Again, alternative forms of PPE can help, with ear-plugs instead of hearing defenders, or safety glasses with elastic straps instead of side arms. There are even styles of full-face respirator that can accommodate prescription glasses (which can again otherwise break the seal). Where glasses are a problem with RPE, some designs of hood-type RPE can also provide eye protection (but not all types, so check carefully).

It’s the law!

Within the EU, problems such as these have been recognised for some time and requirements to take them into account are included in?legislation. Thus Council Directive 89/656/EEC established the need for national regulation relating to the use by workers of PPE in the workplace, and Council Directive 89/686/EEC laid down further requirements on manufacturers selling PPE within the EU. In the UK, the provisions of the so-called ‘Use Directive’ have been incorporated into the Personal Equipment at Work Regulations, 1992.

Among other duties, the Directive requires all PPE to:

  • Be appropriate for the risks involved
  • Take account of ergonomic requirements
  • Fit the wearer correctly

In addition, where more than one item of PPE is required, such equipment must be compatible and continue to be effective.

Help is out there

To assist in addressing these requirements, a European Standard has been prepared (EN 13921), specifically on the Ergonomics of PPE. Although PPE is not directly tested against this standard it serves to provide guidance on the problems which can occur and could be used by employers in the same way.

In addition, within the UK, a standard specifically addressing the ergonomics of PPE ensembles for firefighters (BS 8469) has been published. Some brigades are already using the tests in this standard as part of their PPE selection process, helping to ensure that the PPE ensemble is ergonomically sound, as well as meeting technical performance requirements.

Well - if that’s your attitude!

So far, this article has concentrated on the physical aspects of the PPE, helping to ensure that employers provide the correct PPE for the hazard; select PPE which serves their workforce correctly; and selects PPE which interferes, as little as possible, either with the work or with other forms of PPE. However, no matter how carefully chosen the PPE, it will not be effective if it is not worn. Attention to the above factors can help. Potential wearers have to believe that the PPE will protect them, and PPE which gets in the way or is uncomfortable will be less likely to be worn. But this is unlikely to be enough. It takes commitment and belief both from managers and from employees for an effective PPE programme.

As well as physical constraints, attitudinal and behavioural factors are also important. Research has shown that managers at all levels in an organisation need firstly to recognise the need for PPE. It is important that those with management or supervisory responsibilities are aware of the hazards involved, know of the possible consequences of exposure, and recognise and accept the role which correctly selected and worn PPE can play in controlling such risks. This can particularly be the case where managers and supervisors themselves are ‘old hands’. Research has identified that older workers can provide a potential negative influence as they perhaps have a different perspective framed by prior experience and practice. Changing knowledge about workplace hazards also plays a part and older workers in particular might find it hard to accept that a particular chemical is now seen as hazardous, when its use was once commonplace. Of course, having seen the effects of workplace hazards on their former workmates, they can also be a positive influence in encouraging younger workers to protect themselves.

We all have a part to play

As with other workplace health and safety issues it is important for all employees, especially managers, to recognise that they have a role to play in health and safety and that their attitudes and behaviour can be a major positive (or negative) influence. Encouraging an inclusive health and safety culture, where such issues are the responsibility of all, not just a designated person, will make a valuable contribution to the subsequent effectiveness of any programme.

Get enough of the right stuff

When PPE has been selected, it must always be readily available. Some forms of PPE are relatively robust and long-lasting (such as safety helmets - although even these can deteriorate in heat or sunlight). Others, however, might be designed to be limited use (eg. disposable RPE) or might be easily soiled and made unsuitable. For example, gloves which have been heavily contaminated by whatever they are protecting from might no longer provide suitable protection. Replacement supplies must be readily and easily available or any efforts to ensure compliance will be undermined.

Knowledge is power

Intuitively, it is important that employees are made aware of the hazard and of the risks which could be associated with whatever the PPE is protecting against. In some workplaces, informing and educating is likely to be the most effective approach. However, there is some evidence, in some industries at least, that people respond better to just being told what to do. Nevertheless, some at least in the workforce are likely to respond better to a more informed approach. As well as providing information about the hazard, such training should provide an opportunity to identify and address the entrenched attitudes which engender a disproportionately low risk perception. In some instances, employees think PPE is being used as the cheap alternative to ‘proper’ protection and it is right that PPE should not be regarded as the first avenue for protection. The resultant attitude of the employers as ‘cheapskates’ is difficult to shake off - but it will help if the reasons for using PPE in preference to other approaches (or as well as other approaches) is carefully explained.

Lead by example

Whilst technically the risk associated with a brief exposure to a hazard during a short visit to a work area might well be negligible, failure to wear the correct PPE in such circumstances will undermine any efforts to maximise compliance. For example, if a manager is seen walking through a hearing protection zone without protection, then employees are more likely to see it as an example of ‘one law for us, another law for them’, rather than working out that five minutes’ exposure is less of a problem than eight hours. ‘Leading by example’ might sound trite, but it is likely to be far more effective than ‘do what I say, not what I do’.

Keep it clean

Some types of PPE, such as powered respirators, require more cleaning and maintenance than others and may well require centralised provision. Examples have been encountered where, for example, powered respirators have been provided without this ancillary provision (with predictable consequences). However, even less demanding types of PPE might nevertheless require some provisions to be made. For example, RPE which is only worn intermittently has often been seen left lying on workbenches or otherwise exposed to contamination when not being worn. Provision should be made for temporary storage facilities close at hand. Such provision should also include allowing time within the working day for such activities. If it’s left until after the end of the shift it is less likely to be carried out correctly, if at all.

What about the workers?

Many of the issues described above have parallels within the workforce. Thus, it is important that employees are made aware of the hazard involved and of the consequent risks arising. When a requirement for PPE is introduced where there has not been one previously, care should be taken to identify and counter the possible reluctance to recognise the risk, particularly amongst older workers. In some instances, there can be a reluctance to admit that the individual has been at risk, perhaps for many years (a concern which can also influence management attitudes) and it might therefore be seen by all as easier to continue to ignore the hazard.

There are many indications that involving the workers in the selection of PPE and, where possible, providing them with a degree of personal choice in which make/model of PPE to wear, helps to ensure better acceptance and compliance.

Training should seek to identify and address the entrenched attitudes which engender a disproportionately low perception of risk and result in a reluctance to wear PPE (parallels can be drawn with the attitude to smoking that says “my uncle smoked 80 a day and he lived until he was 90”). It is often difficult to get people to recognise or acknowledge a risk and get them to change their behaviour as a result. Many contributory factors can be at play here, including the ‘macho’ culture described earlier. On the positive side, there is some evidence that, initially at least, younger workers are less willing to accept conditions which their seniors regard as ‘just part of the job’ and might find PPE more acceptable as a result. It is also important to recognise that the real reason for a failure to change might not be that put forward by the employees, for example someone who ‘blames’ the physical characteristics of the RPE rather than admitting to just not wanting to wear it, or an individual not wanting to admit to experiencing feelings of claustrophobia when wearing a full-face respirator.

As stated earlier, even where the need for the use of PPE has been recognised and accepted, employees might still be reluctant to wear such equipment which is uncomfortable or intrusive. Although worker involvement in selection will help to offset this to some extent, some employees might still find the level of discomfort from a particular form of PPE unacceptable. In some cases, this might be an unavoidable consequence of the risk being protected against. If this is the case then this should be explained to the employees so that they can appreciate that these characteristics are a necessary part of providing the protection required. In other instances, however, other approaches might be effective. For example, instead of using a relatively heavy, bulky class 3 gas/vapour filter on RPE, it might be possible to use a class 1 filter, but to replace it more frequently (e.g. at breaks during the shift).

It is important to recognise that this is not just a comfort issue. If RPE is either not worn or not worn correctly, then health and ultimately the quality and duration of life can be adversely affected.

Upfront and personal

In summary, PPE should correctly be seen as the last (or temporary) resort in controlling risks from workplace hazards. However, there are times when use of PPE is unavoidable (and essential if the health and safety of the workforce is to be protected). As well as being technically right for the job (e.g. providing the correct level of protection), PPE must not be too uncomfortable to wear, and must not get in the way of doing the work, or it will not be worn correctly (if at all). Managers and supervisors have an important role to play as, unless the need for PPE is recognised in the first place, and the correct PPE chosen and made available, then worrying about fit, comfort, interference with work and all of the other factors written about will be a waste of time. Every individual worker also has a role to play - the clue is in the name: Personal Protective Equipment.

Published: 10th Jul 2010 in Health and Safety International

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Richard Graveling is Principal Ergonomics Consultant with the Institute of Occupational Medicine (IOM). Last year the IOM received the President’s Medal of the Institute of Ergonomics and Human Factors in recognition of their research and consultancy work on t...
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