Keep your head

A new study from Oxford University, which found that head injuries triple the long-term risk of early death, brings home how essential it is that adequate and suitable head protection is provided in the workplace. 

The investigation found that traumatic brain injury (TBI) is associated with substantially elevated risks of premature mortality (defined as death before age 56) – the rates are three-fold for those who survived six months after a TBI. Those who suffer TBIs are more likely to go on to kill themselves, or to be involved in fatal accidents, since the injuries may damage parts of the brain responsible for judgement, decision-making and risk taking. 

 

This is a very important study on a subject on which there has been little available information up to now.  Researchers from Oxford University and the Stockholm Karolinska Institute examined Swedish medical records on over 200,000 people who had suffered a TBI over 41 years between 1969 and 2009. 

A TBI is defined by the authors of the study as a blow to the head that leads to a skull fracture, internal bleeding, loss of consciousness for longer than an hour, or a combination of these symptoms. Michael Schumacher’s recent terrible skiing injury is an example of a TBI.

The seriousness of a head trauma is better understood today. For example, concussion experienced on the sports field now requires a mandatory layoff in many sports. But sometimes head traumas can be difficult to detect, and even the incidence of what seems a relatively innocuous trauma can have very serious consequences. This is tragically illustrated by the case of Natasha Richardson, who had an apparently minor fall during a skiing lesson, but rapidly deteriorated and was put on life support as a result of the swelling on her brain caused by the impact of the collision, when her head hit a rock. She later died from her injury.

 

In the workplace, proper risk assessment must be carried out and where possible the hazard should be removed, or at least limited.  When not possible to eradicate the hazard, individuals entering a hazard area must be properly trained and must use appropriate personal protective equipment.  

In an industrial environment, there are three standards for head protection:

 

EN812 (industrial bump caps) – protection against bumping or scraping the head, dating back to BS 4033 in 1966 and updated significantly in 2002;

EN397 (industrial safety helmets) – a standard based on crown impact that has not fundamentally changed since BS 2826 in 1957;

EN14052 (high performance industrial helmets)- a standard requiring twice the crown impact performance and also side impact protection, released in 2005.

 

The introduction of the high performance EN14052 standard was the biggest step forward in industrial head protection in 48 years.  It reflects the need for increased protection performance in modern workplace environments where there is greater use of heavy machinery and equipment. Tunnelling, demolition, where objects are falling in open environments, items swinging on drilling platforms in the oil and gas industries, and offshore fishing in high seas, are examples of such extreme environments. 

 

There is a fine balance between compliance and performance, making specification of the right helmet for the right situation crucial. Different helmets perform at different levels, some of which are more appropriate than others. Over-specification is never the right approach and can be as dangerous as under-specification, but nevertheless, wearing the correct level of head protection in dangerous environments is essential.  It is the employer’s responsibility to determine this by looking at both the hazard that the equipment provides protection from, and the environment in which it is used.

Sadly, TBIs are far too common. In 2012/13 there were 196,766 head injuries requiring hospital visits in England alone, of which 125,822 (almost two-thirds) led to TBIs. Around 1.7 million people in the United States and one million people in Europe are hospitalised after TBIs each year2.

And in the workplace, the latest available HSE statistics (2012/13) show there were 25 deaths resulting from head and neck injuries in Great Britain, as well as 1,706 major head injuries and 5,359 head injuries requiring more than seven days off work, representing a huge total of preventable hurt and suffering.

The study by Oxford University only serves to re-emphasise the devastating effects of head injury and the necessity of preventing it.