Hands in many ways defines our humanity. The opposable thumb is thought to have been a development that defined our evolution. The ability to fashion tools, create works of art, sense and feel things and to write creates our culture, communication and identity as a species. Ultimately, manufacturing, a word derived from the Latin word for hand, is defined by manual dexterity.
As a body part, it is complex. It comes toward the top of the body’s league for the number of bones and joints, skin surface area, nerve endings and ability to change shape and exert variable pressure or sense compared to other bodily structures.
But, the things that make the hand remarkable, also make it vulnerable. Its role as a multi-tool to enable everything from expressing love to providing defence, mean damage to hands results in real loss in quality of life. The body does its part to build in resilience, but it is no match for many of the challenges placed on it.
Hand-held or hand-guided power tools, when used even for more than a few hours each day, or even used a little, but inappropriately, can permanently damage muscles, bones, blood vessels and nerves. Whatever the business end of a tool is delivering in terms of damage is a representation of the damage that is happening internally within the hand that holds it.
Hand Arm Vibration Syndrome (HAVS) caused by exposure to vibration at work is preventable, but once the damage is done it is permanent and for this reason the Control of Vibration at Work Regulations 2005 were introduced.
“damage to hands results in real loss in quality of life”
Invariably, a hand tool not only uses the hand to guide and control, but also to provide support, act as a shock absorber, to provide resistance and even additional force. Users of hand-held tools will know it and feel energy being vibrated through their bodies and force being exerted on muscles. This is energy and force the body was never evolved to cope with.
It’s likely that for the use of hammer action tools for more than about 15 minutes per day, or rotating and vibrating tools for more than about one hour per day, your body will simply not be able to resist the force or repair the damage.
Nerve overload resulting in tingling and numbness in the fingers (which may disrupt your sleep) can arise. Numbness and loss of strength as nerves fail to properly communicate with muscles and your brain. Fingers may go white and red in the cold and rain (symptoms of vibration white finger). It’s not just builders and those working in manufacturing who are at risk, but also people working as grounds people, in farming, agriculture and even in the arts. I knew a brilliant dentist whose hands went because of the use of dental tools.
There is always a temptation to reach for a hand tool because our hands are so adept, but for any regular usage, hand tools should be avoided and machinery-mounted tools used instead. More and more tools are designed to reduce vibration effects, so when buying tools, sheer power (which can also cause more noise and dust, which have their own significant risks) needs to be balanced with efficiency. Mounted tools, precision components and higher quality tool materials are likely to make a job quicker, better, more precise and less harmful to health. So the right tool for the job is essential as is its maintenance. Old tools and work out consumables like bits, blades and tips make the job more expensive, slower, but also can cost you your health.
If you are having to use your strength to make the tool work, it’s the wrong tool for the job. Power tools don’t like the wet and the cold and neither do your hands. Avoid using power tools in cold and wet conditions. Obviously, wear suitable gloves and work in bursts with breaks, but not smoke breaks as smoking affects your blood flow and makes your hands more vulnerable. You also need to be alert to the symptoms.
“as well as any guidance and monitoring, be vigilant and respond to symptoms”
If you still feel sensations in your body when you are no longer using tools, things have already started to go too far. It’s important to remember that no two people are built the same, so as well as any guidance and monitoring, everyone has to be vigilant and respond to symptoms. Tolerance also changes with age and other factors, including women’s menstrual cycles.
HSE’s free leaflet ‘Hand-arm vibration – Advice for employees (INDG296)’ (pocket card contains notes on good practice which you may find helpful) and HSE’s free leaflet ‘Control the risks from hand-arm vibration – Advice for employers on the Control of Vibration at Work Regulations 2005’ (INDG175 – rev2) are great reference points.
Computer-based and other jobs can be similarly challenging to the hands. Repetitive strain injuries and diseases such as carpal tunnel injuries can arise through the repetitious use of keyboard or operation of other machinery, which may not vibrate, but which require hands to be in certain positions or repeat certain movements. It’s contributed to heavily by the absence of breaks and by awkward working conditions, the cold, and inappropriate siting of machinery.
The impact can be very serious and long-lasting and again, it’s vital that early signs of discomfort and odd sensations in the hands or other parts of the upper body are not ignored. It’s not just the hands, of course, because if there is an awkward position requiring limitations on hands, then it puts a strain on the rest of the body.
With increased home-working, often in cold environments because of the fuel crisis, we sadly can expect to see a lot more instances of such hand injuries having progressed further undetected than before. If you work with your hands in any circumstances and begin to feel pain, discomfort or irritation, then don’t ignore it. You need to get more appropriate equipment in terms of support and protection, better workstation set up, better management of work demands and ensure that you ave early monitoring from a health professional of any symptoms to stop it turning into an illness that limits your quality of life
or require painful operations.
The hands have a really large skin to volume ratio, much of that skin is highly specialised and well-serviced with nerves and blood supply to enable it to do the amazing things it can do in terms of touch. However, it is easy to neglect this organ. It may seem obvious but substances from soil, through to cement and hand-wash gel can rob the skin of its natural oils which act as a protective barrier to disease or, even worse, have an abrasive or caustic effect.
Infections can be acquired through damaged skin or by transfer from skin to mouth or other vulnerable body parts. The skin is the body’s barrier PPE, but designed with a compromise that it also needs to be advanced sensing equipment.
“wearing permeable gloves can end up concentrating the negative effects of harmful substances”
Avoiding contact between hands and harmful substances through the selection of the right tools, or designing better work processes is the best first step, before even considering PPE. If you consider you are using your hands in direct contact or contact with something, ask yourself whether you would want that substance or object to be in direct contact with your loved-ones. It’s a helpful behavioural test, although not science.
If you do need to work with something, then having the right kind of gloves is vital. Sweat from prolonged use of gloves can cause skin problems and potentially promote infections. Wearing the same gloves for long periods of time can create a home for harmful material. Wearing permeable gloves can end up concentrating the negative effects of harmful substances. Heavy duty gloves can chaff and create strain.
Never ignore signs of irritation or pain on your skin and try and maintain appropriate levels of moisturisation and exposure to the air.
“it is our duty to avoid the ravages of work on our hands”
When I started this article, I had the strains of “You need hands…” running through my head. I look at my own hands and think that I hardly treat them with the respect they deserve. My hands have fed me, they have given me joy in play as a child and frustration in poor play as a guitarist. They have comforted and cherished my loved ones, they have shaped my home, been the tool of my trade and their quick and agile skills have saved my life on a few occasions.
I have treated them with less care. They have changed shape to accommodate the strain I place on them, hardened and scarred, their skin tells my age and the story of less care. I could have looked after them better and vow as I write this to do so. I recall being told the story of Albrecht Durer’s “Hands” that is a study of how the abused and rough hands in his picture are those of his brother whose life of hard manual labour enabled Durer to become the great artist that he became.
In those times, there simply was neither the opportunity nor the knowledge to prevent the hands from telling the story of hard work. These days we can avoid the ravages of work and it is the legal duty of the employer to ensure that this happens. Look after your hands and those of the people for whom you have responsibility. You never know when you may need their help.