By Art Torres
Falls are the number one cause of fatalities in the construction industry. Of the 1224 deaths in construction in 2004, 441 (36%) were from falls. Many thousands more are injured each year in falls.
These are serious statistics for the American worker. Federal OSHA and Cal-OSHA have implemented statutes to help reduce these injuries.
That brings us face to face with another problem, which occurs when an individual falls while wearing a fall restraint harness. Yes, the harness may keep the worker from impacting the ground, but it leaves the worker suspended. This new problem we face is called suspension trauma or orthostatic intolerance.
Following a fall, a worker may remain suspended in a harness. The sustained immobility may lead to a state of unconsciousness. Depending on the length of time the suspended worker is unconscious/immobile and the level of venous pooling, the resulting orthostatic intolerance may lead to death.
Such fatalities are sometimes referred to as “harness-induced pathology or “suspension trauma.”
Unconscious/immobile workers suspended in their harness will not be able to move their legs and will not fall into a horizontal position, as they would if they fainted while standing. During the static upright position, venous pooling is likely to occur and cause orthostatic intolerance, especially if the suspended worker is left in place for some time.
Venous pooling and orthostatic intolerance can be exacerbated by other circumstances related to the fall. For example: shock or the experience of the event that caused the fall, other injuries, the fit/positioning of the harness, the environmental conditions, and the worker’s psychological state. All of these may increase the onset and severity of the pooling and orthostatic intolerance and could result in serious or fatal injury, as the brain, kidneys and other organs are deprived of oxygen.
The amount of time spent in this position, with the legs below the heart, affects the manner in which the worker should be rescued. Moving the worker quickly into a horizontal position, a natural reaction, is likely to cause a large volume of deoxygenated blood to move to the heart if the worker has been suspended for an extended period. The heart may be unable to cope with the abrupt increase in blood flow, causing cardiac arrest. Rescue procedures must take this into account.
Additional information is available at www.osha.gov/dts/shib/shib032404.html.
Bring up the topic of suspension trauma/orthostatic intolerance at your next safety meeting. If you have a joint labor-management safety committee, bring it up there also. This new problem that we are facing can be manageable with the proper training, the proper equipment and the motivation of union members to make it work.
Art Torres is a member of the IBEW Local 1245 Safety Committee.
November 26, 2007