Amputations at work: What do we know about it?

Fatimah Mohd Kamil

WSH InstituteA Leading Institute for WSH Knowledge and Innovations

© 2017 Singapore Workplace Safety and Health Institute. All Rights Reserved

• An average of 130workplace major injuriesper year resulting inamputations

• Amputation is the secondhighest type of majorinjury, after Crushing,Fracture and Dislocation

Amputation injuries a cause of concern at the workplace,

with average of one incident every three days

Amputation cases from 2013 to 2017

Types of workplace major injuries2

Food

Manufacturing

(7%)Metalworking

(15%)

Marine

(8%)

Construction

(31%)

61% of amputation injuries from 2012-2016 were from these sectors

3

Main causes for amputation injuries

Mechanised Cutting Tools - Grinder, Cutter

Cutting Machines

Band saw Machines/Meat Slicers

Pinch-points of Lifting Components

The machine at the top of the list contributes the most to amputation cases

4

Top 3 work activities prone to causing amputation

injuries in Construction sector

Cutting

Lifting

Manual

Handling

• Handheld Cutter

• Handheld Grinder

• Cutting Machine

• Crane

• Excavator

-

• Rebar

• Wood

• Metals

• Rebar

• Beams

• Metals

• Beams

• Panels

Work Activities Machineries/Tools Involved Materials Involved

5

Repair &

Maintenance

Cutting

Manual

Handling

• Various

Machineries/

Mechanised tools

• Cutting Machines

• Mechanised Cutting

Tools

-

• Rebar

• Wood

• Metals

• Rebar

• Beams

• Metals

• Pipes

Work Activities Machineries/Tools Involved Materials Involved

6

Top 3 work activities prone to causing amputation

injuries in Metalworking sector

Clearing

Jammed

Machine

Cutting

Mincing

• Variety of

Machineries

• Bandsaw machine

• Knife

• Meat slicer

• Mincing Machine

Work Activities Machineries/Tools Involved

7

Top 3 work activities prone to causing amputation

injuries in Food Manufacturing sector

Manual

Handling

Lifting

Cutting

-

• Crane

• Forklift

• Cutting machines

• Mechanised cutting

tools

• Pipes

• Wood

• Metals

• Wood

• Metals

• Pipes

Work Activities Machineries/Tools involved Materials involved

8

Top 3 work activities prone to causing amputation

injuries in Marine sector

Contributory Factors of Amputation Injuries

Unsafe workplace or inadequate

safety provisions (55%)

These include unguarded

machines, improper equipment, or lack

of safe work procedures.

Unsafe acts by workers (36%)

Unaware of amputation risk,

putting their body in harm’s way

Eg: clearing chokes while machine is

running,

Eg: doing last minute adjustments

during lifting operations

9

Gathering Further Insights

Data Analysis

Focus Group Discussion (FGD)

Deeper insights needed

to understand causes

and come up with

possible solutions

10

Focus Group Discussion: Through the eyes of the participants

Note: Study aims to gather insights and identify possible solutions and is not a prevalence study

• WSH Institute Solutioning Session on Preventing Amputations at Work

• Date: 24 May 2017

• Venue: Ministry of Manpower (MOM) Services Centre

Details

18organisations

Organisation

•25 participants

•Represented by

•Management

•WSH professionals

•Union members

•WSH course trainers from the four sectors

•Members of the WSHC (Metalworking) Committee and WSHC Crane Taskforce

Participants

•Construction

•Metalworking and manufacturing

•Food and Beverage

•Marine

Sectors

11

Potential Causes of Amputations

12

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

Potential Causes of Amputations

13

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

Potential Causes of Amputations

14

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

Potential Causes of Amputations

15

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

Potential Causes of Amputations

16

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

Potential Causes of Amputations

17

Management

Weak Risk Management

Focus on business targets

Lack of Communication on amputation

risk

Poor supervision

Man

Unsafe Behaviours

Ineffective training

Distractions and

carelessness

Machine

Unguarded machine

Poor machine design

Poor machine maintenance

Lack of consideration

on man-machine

compatibility

Method

Inappropriate material handling

Inappropriate use of PPE

Wrong tool

Material

Slippery to handle

Irregular surface or size

Poor grip

• Not to use gloves when working with moving machine parts• Use gloves of correct material e.g. chainmail when operating

cutting machines

• Companies purchase machines with safety features to prevent amputation injuries

• Automate to reduce manual handling

• Good supervision to ensure compliance with safe work procedures (SWPs)

• Ensure workers are aware of amputation risk• Provide effective training to ensure safe work• Review Risk assessment and SWPs• Sufficient resources to prevent fatigue and workers taking

shortcuts

18

Possible Solutions to Prevent Amputations

Elimination

Substitution

Engineering

Controls

Administ-

rative

Controls

PPE

Most

Effective

Least Effective

Hierarchy of Controls

• Use guarded machines• Processes which reduce man-machine interaction

or crushing by objects• Change from text heavy SWPs to pictorial SWPs

Possible Root causes of Amputations and Solutions to prevent them

19

Root Causes Possible Solutions

Lack of compliance of Safe Work Procedures(SWP)

Improve supervision Involve workers in Risk Assessment (RA) and

development of SWPs Incentives and penalties

Ineffective training Training should be contextualized to the

workplace and worker profile

Unguarded machines

Purchase machines with safety features Manufacturers incentivize through pricing e.g.

small price differential between unguarded and guarded machines

Poor identification of amputation hazard

To identify amputation risk contributed by work activity, human and organizational factors

Mind-set that accidents would not happen

Sharing of amputation cases to workers and employers

Report will be made available

on the WSH Institute website

Focus Group Discussion Report

A Leading Institute for WSH Knowledge and Innovations

© 2017 Singapore Workplace Safety and Health Institute. All Rights Reserved