Approaches to preventing head injuries
Every year more than one million people in the UK attend hospital with a head injury. A percentage of these injuries happens in the workplace, often the result of an object falling onto the injured person’s head.
Being hit by falling or flying objects accounts for approximately 500 to 600 reported injuries and approximately 15 construction industry fatalities per year in the UK.
Consequences of head injury
The brain is the control centre of the human body and a head injury can be a very serious thing. The consequences of a head injury can be difficult to determine and predict. Common effects on the brain can include the following:
• Poor memory • Poor planning and problem solving skills • Inability to understand and communicate • Poor concentration • Poor perception, recognition and judgement • Inappropriate behaviour • Slowed response times • Lack of initiative • Loss of physical sensations • Personality changes • Loss of skills, management and day to day affairs • Loss of drive/motivation
Relatively mild or moderate injuries to the brain can have serious effects. This can be very debilitating for the individual. A concussion, for example, one of the most common traumatic brain injuries, can take months and possibly years for the effects to disappear. Even a mild concussion can be problematic, as often it does not show upon physical examination.
Of course ultimately there can be very serious consequences from a blow to the head and some people never fully recover.
The following describes an actual occurrence and is based on personal experience.
One Saturday afternoon in the summer of 2005 I was working in the capacity of Inventory Control Manager at one of the UK’s biggest fishing companies. During the operation of landing fish that had previously been frozen at sea, an accident occurred in one of the ship’s holds.
One of the team, who was responsible for attaching the hoist and safety netting to the palletised boxes of frozen fish, had been struck on the head. The weather was warm and the work was quite physical and in this instance he had removed his safety helmet.
It transpired later that the whole team had removed their helmets.
The net that secured the boxes of fish as they were hoisted out of the hold and onto the dockside had slipped. Several boxes fell from hoist and hit the stacked fish below that was waiting to be removed.
There was very little room to manoeuvre around the hold and men scattered trying to reach a place of safety. It was all over in seconds but the corner of one of the boxes struck one of the men on the head.
I received a phone call to tell me that all operations were being suspended. In fact, it would be a number of days before they would resume. Not only did they stop unloading our vessels, of which there were two, but all operations ceased at this site.
The men returned to the factory despondent at the injury that had befallen their work colleague. I spoke to the two supervisors who were on site at the time of the accident – they were also downhearted but, in addition, apprehensive, as they knew they should have enforced the wearing of safety helmets.
Further to this one of the senior management team had been on site at the time of the accident and, just a short time before, had spoken to the supervisor in the hold and witnessed the fact that none were wearing head protection. He also failed to challenge this behaviour. He became particularly distressed when he realised the consequences of his error sometime later.
This is where the reality of an accident hits home. One of our men was injured quite seriously and it would be more than six months before he was fit to return to work. He was rushed to hospital unconscious, but he was lucky to be alive. There would be many months of ups and downs for him as he suffered from memory loss and headaches.
Emerging, painful truths
This is also where the classroom chart representing an accident as an iceberg with 9/10 of it underwater becomes painful reality. This is to say, spreading out from this accident was loss of production. In this case, frozen fish that was destined ultimately for other parts of the world, would now be held in the holds of the berthed vessels. The ships would be going back to sea four days late.
This time can never be recouped and the whole year’s schedule of landings and supply to our customers would be curtailed. The transport company that was moving the fish from the dockside to the freezers, some nearby, some 60 miles away would now have to stand down.
The extra forklift trucks that I had hired in for these landings would have to be paid for and rehired when operations continued.
The cost of the accident investigation, possible compensation and increased insurance costs, the possibility of litigation due to the failure to enforce the wearing of safety helmets in what was a hardhat area – all had to be countered.
Would the wearing of a helmet have reduced the injury that was sustained on that fateful day? Almost certainly, but to what degree it is difficult to ascertain exactly. The box of frozen fish had struck the unfortunate worker directly on the head – it wasn’t a glancing blow. The helmet would, however, have helped to control the energy released on impact, dissipating around the head and not directly onto the skull and brain.
I’ll admit the following isn’t a scientific assessment, but in my experience where other workers have been hit on the head by a falling object and were wearing a helmet, they came out with a sore neck and a minor headache.
One thing is for sure: the company would probably not be looking at prosecution for failure to meet its obligations with regard to the wearing of PPE (Personal Protective Equipment) under the UK’s Health and Safety at Work Act 1974, The Management of Health and Safety at Work Regulations 1999, and the Personal Protective Equipment Regulations 2002.There would, however, have been the failure of the safety net to address.
What were the underlying causes for the accident and how could they have been addressed?
The failure to understand the need for the enforcement of wearing safety headwear and PPE more broadly was a symptom of a general lack of a positive safety culture. I had steadfastly been identifying and reporting on the lack of safe systems of work, policies and procedures from the beginning of my employment nine months earlier. To give the company its due credit they had taken on board my recommendations and, ironically, I was in the process of completing my NEBOSH course prior to examination.
There was a distinct need for all levels of management to adopt a more positive attitude to health and safety. The inclusion of managers, supervisors and the workforce in the review of risk assessments, development of robust policies and the formulation and implementation of safe systems of work would have gone some way to addressing the deficiencies.
I’m a great believer in toolbox talks, too, and taking the delivery of short, sharp health and safety talks to the ‘coal face’ and making them intrinsic to every day work activities can be more effective than a robust policy in some instances.
The safety helmet
I first encountered the safety helmet back in the mid Seventies, while working on the British Steel complex in North East Britain. At that time the wearing of the safety helmet wasn’t rigidly enforced in the area where I worked.
By the mid to late Eighties, it had become compulsory to wear both safety boots and safety helmets beyond the demarcation line just north of the office complex.
For those operating mobile plant dispensation was given from wearing the helmet while inside the operator’s cab.
Safety helmets are essential in many workplaces. Forklift training centres, warehouses, construction sites, engineering and fabrication workshops, docks and steelworks are among some of the many workplaces where safety helmets can be seen.
The modern helmet is in two parts. This comprises of the outer part, or shell, and the inner part that can be described as a plastic web or skull cradle. This forms the suspension and is anchored to the helmet at various points around the inside.
Part of the plastic web was at one time made of fabric in some designs. The effect of the suspension is that in the event of an impact on the helmet the shock, or energy released, is not concentrated in one area and therefore is not transmitted directly into the skull. Helmet design varies slightly from manufacturer to manufacturer but some use a combination of ridges to reinforce the shell.
One disadvantage of wearing a safety helmet is that in effect a person’s height is increased slightly. In places where access is limited and height is restricted it is possible to catch the top of the helmet. An alternative to the safety helmet is a bump cap. This is usually used where there is the likelihood of banging your head on projections or equipment. But if there is a likelihood of an impact from a falling object it is not generally strong enough to absorb this.
The safety helmet, or to use its more common name, the hard hat, is used in workplace environments where the risk of being hit by a falling object has been identified. The risk assessment will take into consideration the probability and seriousness of being hit and the types of objects used at height in the workplace. If the hazard cannot be effectively controlled by any other means then the issue of PPE in the form of a hard hat is the next step.
Safety helmet accessories
When selecting a safety helmet for use in the workplace there are a few considerations that must be made. Will it be used in conjunction with other personal protective equipment? It may be that in your workplace you also need to use ear defenders. If this is the case make sure they are compatible with your safety headwear. Ear defenders can be purchased that are compatible with or attach to your helmet. Likewise, check that the helmet does not compromise any safety eyewear.
Other accessories include headlamps that negate the need for having to hold a torch. Chin straps can be attached so that the helmet stays on should the wearer need to bend. You can also get a padded forehead band that gives added comfort to the wearing of the helmet.
Make sure that any safety helmets that are issued are looked after, that they are stored in a clean, dry place and that they are not subject to abuse. This includes the painting and the application decals to the shell. Any paint or adhesives that are applied to the shell could cause it to degrade. This could lessen any potential protection that the helmet would give in the event of an impact.
Likewise, if the helmet has suffered an impact either as a result of an accident or mis-use it must be replaced as the shell could be compromised. Helmets carry a replacement date inside the shell and this should be adhered to. If it appears to be still in good order when it has reached its life expectancy it should be discarded nonetheless.
Always ensure the employees understand why they have to wear safety helmets and refer them to your company policy on PPE and risk assessment that identifies the need to wear a safety helmet.
Employees should be trained in the proper use of PPE, including safety helmets. The band inside should be adjusted to achieve a snug fit. The helmet must always be worn the correct way round; that is, the peak to the front.
Make observations to ensure the helmets are being used and worn in the appropriate way and challenge any incidences where this is not so. Ensure that your supervisors and managers are aware of the above and are trained to the same level. The failure by them to challenge non use, mis-use or the inappropriate use of safety helmets propagates a negative health and safety culture. Where it is deemed necessary for helmets to be worn, there must be no exceptions.
Always make sure you have additional safety helmets in the event that you have visitors to your site.
The best way to ensure that you get the right hat for the job is to contact a safety helmet manufacturer or consult your supplier.
Colours and identification
Hardhat colours can be used to signify different work roles on construction sites. These colour designations can vary from company to company and work site to work site. For instance, at one of the companies that I have worked for, all first aiders wore green helmets, operatives wore yellow, and management wore blue.
Specification and regulation
In most cases, suitable head protection means an industrial safety helmet conforming to British Standard BS EN397: 1995, or equivalent.
There are other standards depending on application. This will ensure that the hat has passed the relevant tests for adjustment, performance, impact, penetration, flame resistance, leakage and ageing. Testing will ensure that the falling object should not penetrate the outer shell, and any dent the falling object makes should not exceed the gap between the outer shell and the skull cradle that is 12mm.
For more information on standards see the HSE’s (Health and Safety Executive’s) document, European Standards and Markings For Head Protection, available for free download on the HSE’s website.
Hard hats come in many styles to suit different applications and in some cases personal preference. Variations of the standard hat are available with the options of:
• A full peak for shielding the eyes from the sun or glare from reflective surfaces • A reduced peak for when the worker is required to look up – for instance when climbing ladders • A rain gutter for additional protection against bad weather • Ventilation holes to help keep the wearer cool in hot weather • Replaceable sweat bands on the inside of the helmet • A chinstrap for extra security and fit when the wearer is climbing, stooping or working at height • A chinguard and visor to protect against potentially hazardous materials flying upwards • Built-in eye protection in the form of safety goggles or a half face visor
• Integrated hearing defenders – helmet-mounted earmuffs are particularly suitable for users wearing more than one type of PPE, such as respiratory protection and eye protection, and when the wearer is routinely climbing ladders or scaffold, or working at height generally
• Chemical and heat resistance, higher levels of electrical insulation protecting against shocks in excess of 1,000 volts AC, additional cold weather resistance to below -40° C, molten metal resistance and lateral deformation, or side impact resistance
In the UK, from April 6, 2013, the Construction (Head Protection) Regulations, requiring construction workers to wear safety helmets were revoked. This initially caused confusion in some quarters as some erroneously thought that the wearing of safety helmets was no longer enforceable. This is not so, and employers must still comply with the Personal Protective Equipment Regulations 2002. These cover the provision and use of head protection in the workplace.
Other Legislation that should be taken into consideration when considering your employees, the use of safety helmets and PPE in general is the Health and Safety at Work act 1974, sections 1 and 2. Also the Management of Health and Safety regulations 1999, where various sections are applicable.
I always carry a safety helmet in my car for site visits and they have become part of my way of life. To avoid devastating accidents of the kind described earlier in this article, I also insist on reinforcing wearer compliance in other workers, leading by example.
Always wear your hard hat where it is needed – and stay safe.
Published: 21st Oct 2013 in Health and Safety International