Tips for Fitting the Masses

Proper fitting is an extremely important factor in gaining the full benefit of footwear's protection, as well as improved compliance and comfort.

ALTHOUGH there are many employees who are compliant and wear safety shoes, far too often the employee does not truly understand the importance and value of the shoe. Ultimately, it is incumbent on the employer to direct the employee to footwear that will provide an adequate level of protection in relation to the job hazards he or she may encounter.

A valid concern is that employees will make a selection based the lowest price or what they find at a discount store, instead of the appropriate safety criteria to match their workplace hazards. To provide the occupational health and safety staff some control over proper selection, the employer should provide the employee with a specific list of performance features the shoe/boot must have. If the company offers reimbursement, it should be contingent upon the footwear's meeting the specifications.

Allowing employees to go out and "just find something" removes the employer's control. Another option is giving mobile shoe vendors the job specifications and limiting sales to footwear that meets the criteria. This option provides a professional fitting, convenience for the employee, and more control by ensuring the appropriate footwear is sold.

Local retailers who can provide all hazard-specific brands are important. Another useful criterion when selecting a supplier is how many brands and styles are available, as well as the range of sizes it carries. The odds of a successful fitting increase with a greater selection of footwear.

Interest has grown in recent years in lighter materials and more fashionable styling; manufacturers are responding. Footwear qualities of interest also depend on age. Younger employees are interested in lifestyle and image brands. Middle-aged employees are more interested in comfort and durability. Older employees also want ergonomic properties. Not only has performance been improved, but lighter composites for toe protection have made shoes more stylish and more acceptable in appearance to employees. (Besides offering a slightly lighter composite toe, the shoe will not set off metal detectors.) The disadvantage of the composite toe is that while metal toe guards will bend inward during an impact and then pop back out, a composite withstands the blow but tends to crack and will need to be replaced.

Guidelines for Proper Fitting, Replacement
Proper fitting is an extremely important factor in gaining the full benefit of footwear's protection, as well as improved compliance and comfort. Slipping is one of the most common hazards for an employee who doesn't wear properly fitting work shoes. Whether the problems are work-related or not, the American Academy of Orthopaedic Surgeons in 2000 reported that one in every six Americans will have foot trouble--usually because of shoes that were not fitted properly.

Offer these six additional recommendations for an accurate fit to employees:

1. Always try on both shoes and walk around in them for a few minutes.

2. Buy footwear that is comfortable from the beginning; never buy shoes with the intent of breaking them in.

3. The ball of the foot should fit comfortably into the widest part of the shoe/boot.

4. Wear socks of the same weight and that will be worn with the shoes/boots.

5. Measure foot size with each new purchase, because a person's feet change with age.

6. Fit during the end of the day when feet are at their largest, and fit to the larger foot (most people have one foot slightly larger than the other, the academy reports).

Replacements should not be determined by the calendar, but by the condition of the footwear. The condition of the soles, the leather upper, and the tread should be the determinant for replacement. If the tread pattern is worn down, separation between the upper and the sole is apparent, excessive wear is visible, or permeability has changed, you should replace the footwear.

Inside components often break down faster than the outside components. Therefore, using only the exterior condition as a guide for replacement decisions is not adequate.

Training and Education
Providing education is typically a forte and a common component of occupational health nursing. As with any PPE, providing safety footwear requires education and training to ensure appropriate selection, usage, and maintenance.

As a minimum, training should encompass the rationale and circumstances that require safety wear, the benefits and limitations, proper maintenance, inspection, and when to replace. Educational content should include the fact that protective footwear must always be worn in hazard areas, the consequences of injury, and the company?s disciplinary policy for failure to comply.

Also, it is necessary to educate employees on the facility's policy for availability of required footwear and any financial contribution that may be made by the employer within a specified timeframe. Additional training is required for high-traction footwear (studs, spikes) on how to prevent accidents and how to prolong the equipment's life.

Although some shoe/boot information is specific to the model, there are some rules that apply to all footwear.

First, employees should inspect footwear regularly for loss in integrity. The seams, sole/heel, inside components, and upper materials must be intact for maximum protection. Heavily worn treads or damaged footwear must be replaced, not repaired. Second, footwear must be clean and free of debris. Chemicals may shorten the life of footwear or reduce its protective function. Soil or particulate in the tread may reduce slip resistance.

Third, inserts or insoles added after the purchase may reduce or eliminate the effectiveness of the footwear.

Finally, the manufacturer's recommended usage and care guidelines should always be followed.

A Recipe for Compliance
How can your organization start on the road to compliance and safety? As part of a compliance policy, the occupational health nurse or safety professional should perform and document all of the following:

1. Complete (and document) a hazard analysis for the facility, recognizing hazards by location or job task.

2. Match the identified hazards with the forms of protection offered by examining the footwear's ratings.

3. Write a policy for the required specifications of footwear that is appropriate to the hazards. The footwear required should meet requirements for the worst-case scenario, even if the employee only infrequently encounters the hazard.

4. Educate employees on the types of safety footwear they are required to wear, benefits as well as the limitations, proper care and inspection, and how to obtain replacements (as it relates to your facility's policy). If applicable, educate employees on the facility's process for obtaining required footwear and any payment contribution that may be made by the employer within a stipulated period of time.

5. Arrange for a wide variety of styles, sizes, and rating types required in the facility to be made available. One of the easiest ways of doing this, while maintaining some quality control and promoting convenience to the employees, is to select a mobile safety footwear vendor. Provide the vendor(s) with the list of ratings that you require for all locations or job classes. When employees visit and identify their hazard exposures, the salesperson can direct them to the correct footwear for their needs.

6. Establish a timeframe in which the program will be re-evaluated. Determine whether the hazards have changed, assess the degree of compliance you're getting, and get feedback from the employees. Understanding both positive and negative comments from employees may help to strengthen compliance or decrease barriers to use.

7. Review and investigate foot-related injuries to determine root causes and prevention strategies, making changes in policy if necessary.

Having a Major Impact
The impact of having proper occupational footwear is often underappreciated or overlooked. Moreover, even when the need is appreciated, appropriate selection may be confusing because there are so many choices and safety features available. Unfortunately, there is no such thing as an all-in-one "super shoe."

It is the responsibility of the employer to designate the proper foot protection and ensure it is worn. Therefore, making a proper selection has to begin with a site hazard assessment. Failing to assess, use that data to make appropriate selections, and then teach employees about proper use may become costly--not only because of insurance expenses and decreased productivity, but also from OSHA citations for non-compliance if injuries occur.

Wearing protective footwear cannot guarantee an injury will not occur, but it may significantly decrease its severity. Finally, protective footwear should never be used as a substitute for proper housekeeping, engineering controls, or common-sense administrative policies.

This article originally appeared in the September 2004 issue of Occupational Health & Safety.

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