Prevention is a key factor for any organization seeking continual improvement in its occupational health and safety performance. Prevention is also the principal objective within the world’s first occupational health and safety management system standard, ISO 45001, published in March 2018.

Calculations by the International Labor Organization in 2017 show that 2.78 million fatal accidents occur at work each year – equivalent to almost 7,700 deaths per day due to work-related diseases or injuries.

In addition, there are 374 million non-fatal work-related injuries and illnesses per year, many resulting in extended absences. The aim of ISO 45001 is to reduce these sobering statistics.

No less sobering is the economic cost of these injuries, estimated by the National Safety Council to be $142 billion in the US alone. The UK’s Health and Safety Executive revealed that injuries and illness in the workplace cost the UK economy £14.1 billion in 2014/15, a sum borne by employees, employers and society at large.

A non-fatal injury costs the UK economy an average of £7,400, a fatal injury no less than £1.6 million. These sums are replicated worldwide. Work-related injury and disease cost the Australian economy $61.8 billion in 2012-13, equivalent to 4.1 percent of GDP. Australia’s employers directly bore five percent of this cost – an eye-watering $3.09 billion.

The costs are both direct, such as compensation payments by employers; and indirect, including lost productivity, loss of current and future earnings, lost potential output and the cost of providing social welfare programs. Society also suffers, with lost hours of labour reducing national productivity.

Graphic showing the economic cost of workplace injury and illness

How, though, are occupational injuries and illnesses most effectively reduced or prevented in competitive business environments where the best-managed companies require clear return on investment (ROI) or return on prevention (ROP) justifications for spend?

In its simplest form, prevention of occupational injury or illness begins with the Job Safety Analysis (JSA). For each job step, what are the hazards and how is each hazard controlled?

In the hierarchy of controls, elimination of the hazard comes first, and the last line of defense is proper use of personal protective equipment (PPE). Continual improvement of PPE has been ongoing for decades. Each improvement brings the opportunity for further prevention of injury and illness.

Vulnerable hands

The hands are a frequently injured part of the body. The Bureau of Labor Statistics reports around 300,000 cases annually of injuries or illnesses affecting the upper extremities, of which 42 percent were injuries to the hand.

In 2015, more than 40 percent of all recordable incidents in the oil and gas industry affected the hands, according to the International Association of Drilling Contractors (IADC).

The bones and tissues in the back of the hand are vulnerable to impact injuries, which are common in the offshore oil and gas, construction, mining, manufacturing, warehousing and transport industries.

Impact-related injuries range from a bruise to the knuckles to pinching fingers between two pieces of equipment to a severe bone fracture. IADC figures for 2016 show the fingers to be the most vulnerable part of the body in terms of both lost time – 20 percent of the total – and recordable injuries, accounting for one-third.

Performance standards are available for cut and puncture, chemical and heat resistance in gloves. There has long been a gap, however, with no performance standard for back-of-hand (dorsal) impact.

This has now changed with the publication by the International Safety Equipment Association of a new voluntary standard, ANSI/ISEA 138, American national standard for performance and classification for impact resistant hand protection.

Why is ANSI/ISEA 138 important?

Knowing the true performance of PPE is critical to prevent injury or illness. As a Certified Industrial Hygienist consultant, I’m often asked by clients to help specify the proper respirator and clothing when an employee may have exposure to chemicals.

Qualified references are readily available to help me specify the appropriate PPE. Likewise, as a Certified Safety Professional, I often assist clients to identify the most appropriate cut and puncture resistance gloves, such as when cutting tools are handled by employees. Again, performance criteria for cut and puncture resistant gloves are available to help me offer the best PPE advice.

What’s the most appropriate glove for back-of-hand impact protection? Until now, I have not been able to definitively answer the question. It normally boils down to trial and error: obtain a variety of gloves that are advertised as offering impact protection, have employees try them out, get feedback and go with the gloves most preferred by the end users.

And what often happens after this? It’s called trial and error for a reason. Eventually, an employee will inadvertently drop a tool on their hand and sustain an impact injury.

The cycle of field-testing and finding the most preferable gloves as ranked by employees starts all over again. That is not prevention and it is a poor way to allocate resources.

ANSI/ISEA 138 helps eliminate trial and error. The best protection, neither over-nor under-protection, is more easily identified. The standard is a win for Occupational Health and Safety (OH&S) professionals.

The simplified approach of the standard, with performance levels identified by pictograms on the gloves, makes choosing the most appropriate protection a much more precise exercise.

Return on prevention

Can the return on occupational injury or illness prevention through more effective and targeted use of PPE be calculated? There is no certain answer to this question. Direct costs for an injury or illness may be known by an employer. Indirect costs, however, vary from employer to employer and industry to industry.

Nevertheless, the Occupational Safety and Health Administration (OSHA)’s Safety Pays program, available free online, uses a ‘company’s profit margin, the average costs of an injury or illness, and an indirect cost multiplier to project the amount of sales a company would need to cover those costs’.

Bar graph displaying percentage of injuries involving days away from work

The resulting calculation is often a huge, eye-opening number. ISO 45001:2018 provides new requirements that will change the thinking of OH&S value. As adoption of ISO 45001 grows, and standard requirements are better understood even among non adopters, a much wider ROP perspective can be expected.

For example, a sub-clause under A.4.1 Understanding the organization and its context states that employers are required to understand ‘relationships with, as well as perceptions and values of, its external interested parties’.

How might this be interpreted? An example is if a suitably qualified person applying for a job – i.e. an ‘external interested party’ – perceives an employer to be lax on safety, perhaps by not supplying appropriate PPE, that person may turn the job down.

With record low unemployment across much of the United States, a good safety reputation may help land the best applicant. How should this context be factored into an ROP?

Another sub-clause requires employers to acquire ‘new knowledge on products and their effect on health and safety’. Employers therefore need to understand ANSI/ISEA 138.

Reassessing risks

ANSI/ISEA 138 and ISO 45001 are two major examples of continual OH&S performance improvements. The primary OH&S performance improvement for injury and illness prevention, however, begins with the basic Job Safety Analysis.

Every job at a worksite should have a JSA, updated as necessary. The final publication of ANSI/ISEA 138 may be the trigger for a number of JSA updates. Specifically, each JSA should re-consider back of hand hazards, including exposure to fingers and knuckles.

The most basic JSA simply considers ‘hazard and control’. Updated JSAs should include a risk component, such as ‘how often is the hazard encountered?’ The greater the frequency of the hazard, such as striking a hammer to nail X times or opening/closing a rail-car door X times, the greater the risk.

ANSI/ISEA 138 allows for another JSA risk consideration: ‘What is the potential impact force of the hazard?’ With a little online research, specifiers can obtain a reasonable estimate of impact force. To be certain, specifiers should consult an industrial hygienist or other qualified safety professional.

Other risk considerations, such as the temperature of the work environment, the required level of dexterity, or lighting – bright, dark or shadows, for example – and how these hazards may alter impact energies, could be added depending upon employer OH&S objectives.

The point is, most employers have a good appreciation of risk management. ISO 31000 Risk management – Guidelines was updated in February 2018. The American Association of Safety Professionals, the oldest and largest OH&S member organization in the United States, has been strongly encouraging its members over the past several years to upgrade their risk competency.

Application of ANSI/ISEA 138 at the worksite will involve risk decisions to choose the most appropriate performance level of gloves. This new standard was made practicable because of material advances, such as D3O® Impact Additive that has revolutionized back-of-hand impact performance.

Material advances, and the innovation to apply these advances, is another example of OH&S continual improvement. Employers, employees and even ‘external interested parties’ should be monitoring these improvements and seeking ways to continually improve their performance in injury and illness prevention. The effects of doing so will quickly become apparent in their company’s bottom line.


Dan Markiewicz MS CIH CSP CHMM is an independent environmental health and safety consultant and regular contributor to Industrial Safety & Hygiene News (ISHN).