After the Fall: Why Fall Protection Isn't Always Enough

Your workers must know two things: how to delay orthostatic shock and how to rescue their fellow crew members quickly.

FALL protection equipment and training in the construction industry have come a long way in the past 50 years. Today, by law, any worker exposed to an unprotected fall of 6 feet or more must wear--and companies must provide--appropriate fall protection equipment. In addition, construction companies now hold accountable workers who refuse to take the proper precautions.

But fatalities can still occur even when all fall arrest equipment is used, and functions, properly. Falls from heights continue to be a major source of injuries and fatalities for the industry; in 2004, they still accounted for 36 percent of all construction industry fatalities, according to the Bureau of Labor Statistics.

Some of these fatalities occur because contractors fail to plan for what to do after a fall. And those first few minutes, when a worker is dangling in midair from a harness, can literally make the difference between life and death.

A U.S. Air Force/OSHA study of prolonged suspension concluded that test subjects could hang motionless in a full-body harness for an average of 14.4 minutes before experiencing nausea, tingling, or numbness. That leaves you with just under 15 minutes to avoid the potential of the suspended worker's going into orthostatic shock, or suspension trauma. There is not enough time to call 911 and wait for someone else to perform the rescue. Your workers must know two things: how to delay orthostatic shock and how to rescue their fellow crew members quickly. In addition to basic pre-planning and clear instruction about who does what when a fall occurs, here are a few more things you can do to improve first response.

Prepare Your Crew for the Worst
Being prepared for a worst-case scenario is critical. Even before a job starts, the project superintendent and site supervisors should establish a basic plan tailored to the specific requirements of the job. The plan should include: * Management commitment. Include rescue pre-planning in your company's written safety policies, and have top management communicate its support. The rest of the company will dismiss pre-planning as a safety gimmick if management is not committed to it. The human and business costs of such an oversight could be devastating.

* Frequent meetings with the crew. Hold daily meetings with the site crew to review--or even practice--rescue procedures. As jobs change, revise your plans as appropriate and review again.

* Proper equipment availability. Have on site the right rescue equipment for the type of hazards present. This could include ladders, aerial lifts, self-rescue harnesses, controlled-descent arrest systems, and extra fall protection equipment, in the event that a rescue worker needs it.

* Coordination with local authorities. Before a job begins, contact the local fire department to determine its capabilities and response times and explain the type of work performed and exposures present.

* Assigned accountability. Assign responsibility for planning and executing the rescue plan to one or more qualified workers. Charge them with inspecting safety harnesses and other fall protection/rescue equipment for accessibility and reliability.

* Accessible rescue equipment. Rescue equipment must be readily accessible to those who are responsible for the rescue plan. No time should ever be wasted looking for a carabiner, rope, or other rescue device.

Most importantly, make your plan dynamic to accommodate the ever-changing needs and conditions on a work site. While essential plan elements such as accountability, management commitment, and rescue protocol may stay constant, the actual procedures and equipment needed vary from phase to phase in a project. Conditions differ when working on a foundation versus working on the structure itself versus working on the roof, and each requires specific responses. The same holds true for variations in weather, location, and job tasks.

Educate Your Crew
Employees who understand the problems that develop in the minutes following an arrested fall respond faster. Train workers on how and when to use fall protection. Demonstrate what to do and not do if workers find themselves hanging suspended from a height. Demonstrate what to do and not do when rescuing a suspended worker.

Here are some basics:

* Self-rescue. With appropriate equipment and training, an employee may be able to reach a supporting surface, but this should never be the only rescue option.

* Never work alone. Two or more workers should always work in close proximity. That way, if a fall occurs, one person will be available to initiate the rescue plan.

* Keep moving. When suspended, the worker needs to keep his or her legs moving to reduce venous pooling that can lead to shock. If at all possible, he should try to move into an upright position.

* Do not recline a rescued worker. Upon rescue, a worker should never be reclined to the horizontal position. The release of pooled blood from the lower extremities could overstrain the heart and cause death. Instead, raise the upper body to a seated, squatted, or crouched position.

Preventing falls in the first place should always be your primary course of action. But no matter how thorough your fall prevention program, there is always the chance that a fatal fall can occur. The company that is prepared for the worst-case scenario through pre-planning and training may turn a fatality into a no-lost-time incident.

This article appeared in the March 2006 issue of Occupational Health & Safety.

This article originally appeared in the March 2006 issue of Occupational Health & Safety.

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