Rubber Gloves and Chronic Injuries: Are Your Workers at Risk?

When we think about the word “consequences,” we typically consider it in terms of unwanted outcomes; consequences are “bad.” But they can also be good, the desired outcomes of specific, targeted actions. And then there are those times when an action’s consequences seem good – yet they have unexpected, adverse side effects that may go unrecognized until an injury occurs.

This is precisely the case with rubber gloves.

For two decades, I have been warning our industry that overuse of rubber gloves can result in damage to workers’ hands. I knew this was a possibility because of my own hand issues some 25 years ago. I even took a pair of Class 2 rubber gloves to my orthopedic appointment so I could ask my surgeon for his opinion. He explained to me something called the “coefficient of friction,” noting that less friction exists when a worker’s gloves are wet inside; this can cause even greater hand strain, especially in the wrists.

The coefficient is a correlation value that indicates the relationship between measured handgrip strength and another variable (e.g., gripping while wearing good-fitting leather gloves, then performing the same test wearing rubber gloves). Grip loss from the test conditions directly relates to the extra effort necessary to accomplish the task.

Armed with this information, I began examining records, counting the reported numbers of carpal tunnel syndrome (CTS) cases among those in our workforce. I then reviewed data from the American Medical Association and the U.S. Department of Health and Human Services regarding CTS case numbers in both the general population and other crafts whose workers endure hand stress similar to lineworkers. As informal as the activity was, some comparisons of the numbers indicated that lineworkers are four times more affected by CTS than other workers of the same median age.

Here’s something else that became apparent: Lineworkers are perhaps the only craft-workers with significant dexterity demands who use heavy rubber gloves. I’ve discussed this issue with various colleagues, and those discussions usually touched upon dielectric boot use as well. A common refrain I heard was, “We can’t stop using rubber gloves.” Well, of course that’s true – but can we use them in a way that’s less physically harmful to workers?

Industry Data Needs
Since then, the big issue has been a lack of testing and numbers. The industry needs research data and values to analyze the work environment and rubber glove use, with the goal of identifying opportunities to reduce hand stress.

Enter Austin Energy’s Alfred Sundqvist, D.C., a chiropractor with experience treating lineworkers.

I was introduced to Dr. Sundqvist by Wendy Ellen shortly after he joined the utility. A safety manager for Austin Energy, Ellen has the good sense not to turn down potential employees simply because they might be a little overqualified.

At the time of our introduction, Sundqvist knew little about how lineworkers complete our tasks, so I shared with him the industry’s rubber glove issue, explaining how we use the gloves and the concerns that their use could lead to chronic injury. Sundqvist immediately began a literature review. At the same time, he ordered a medical-grade handgrip dynamometer and began testing craft-workers, with Austin Energy’s support.

The initial testing of 50 craft personnel has already produced actionable results – but Sundqvist is not stopping at 50. Every Austin Energy craft employee will be assessed, and those results will be tabulated and analyzed. Thus far, some of the worst-case test results indicate a 33% coefficient loss of grip strength using Class 2 rubber gloves.

As part of his literature review, Sundqvist has found that chronic overstrain while performing gripping activities does correlate to the onset of common injuries such as tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis) and CTS. His research data may ultimately give us trends related to work types, age and time spent on the job. There is more to come from Sundqvist, and we expect to publish his study results in the future pages of Incident Prevention magazine.

The Employer’s Obligation
So, what does all this mean? It means we have an obligation to those workers who are skeptical about or haven’t considered the possibility that they could develop chronic, debilitating physical conditions due to overuse of rubber gloves – some of which may not begin their onset until after retirement. This obligation is clearly described in OSHA’s General Duty Clause, which requires employers to provide their employees with a safe and healthy workplace that is “free from recognized hazards that are causing or are likely to cause death or serious physical harm.”

OSHA had this to say in a May 2019 letter of interpretation to the American Physical Therapy Association: “… work-related injuries and illnesses involving muscles, nerves, tendons, ligaments, joints, cartilage and spinal discs would meet the general recording criteria if they involve medical treatment beyond first aid, days away from work, job transfer or restricted work” (see www.osha.gov/laws-regs/standardinterpretations/2019-05-23).

Both CTS and medial epicondylitis among craft-workers are almost certainly work-related, making them recordable injuries. So, we know prevention is in order. But where do we start?

Next Steps and Recommendations
I expect Sundqvist will eventually make recommendations for preventive exercises or programs to help reduce the risk of chronic injury from rubber glove use. In the meantime, there are other things we can do.

Our industry has seen increasing use of rubber gloves over the past two decades, and frankly, some of it is unnecessary. One example is the use of rubber gloves with hot-sticks, especially lifting and holding them. I deliver hot-stick training and have lost count of the number of times I’ve seen a lineworker maneuver the weight of a stick in rubber gloves, with the stick wedged against their body to achieve the necessary control.

I understand why employers require this, and I’m not criticizing those that do, but I will offer my qualified opinion. Hot-sticking is a mode of energized work established as a primary means of worker protection. When a hot-stick is operated from outside the minimum approach distance and with a clear minimum distance between the working end and the user, no other secondary barriers are needed to protect the worker. There is no justification for using rubber gloves with hot-sticks in either the OSHA or consensus standards. If you maintain your sticks in accordance with consensus practices, they are unlikely to leak or flash over; 75 years of historical experience has demonstrated this.

Further, rubber gloves and sleeves have no mechanical performance rating. This means the rubber may not withstand the applied voltage at some point in compression. I have not seen data to clearly define that value, but the consensus standards limit pressure on the insulating rubber as no more than normal hand pressure. Sundqvist has already discovered that once you move from an 8-foot hot-stick to a 10-foot hot-stick while wearing rubber gloves, the grip necessary to maneuver and control the hot-stick exceeds what is assumed to be normal hand pressure.

The point here is that – out of an abundance of caution and with good intentions – the industry has traded a reliable tool for an increased likelihood of chronic hand injuries. At the same time, we’ve made it riskier for workers to control hot-sticks by making them wear rubber gloves, which compromise grip strength.

Working in the Rain
“What about working in the rain?” That’s a question I hear frequently during discussions about this topic. Well, for starters, we wet-test hot-sticks at 75,000 volts per foot for good reason, and that alone adds to the reliability of hot-stick use in wet conditions. But there is a practical answer, too. If it’s raining hard enough to compromise your hot-stick, then your rainsuit, arms and rubber gloves are also wet. Unlike the waxed fiberglass hot-stick that’s been wiped with silicone, your gloves and body do not have a tested wet resistance of 75,000 volts per foot. Wet gloves and protectors are much less reliable than the hot-stick they hold.

Now, let’s talk about ground-to-ground, an evolution related to the work practices required by the Electrical Transmission & Distribution Partnership. I support the partnership’s work, and my intention here is not to disparage its role in significantly reducing serious incidents within the partnership’s companies. Cradle-to-cradle and lock-to-lock are partnership-established rubber glove best practices (see https://powerlinesafety.org/best-practices/). Ground-to-ground (climbing poles/structures) use of rubber gloves is not. Climbing in rubber gloves is likely the most stressful of all the work access modes. Cradle-to-cradle is short term. Most of the hand stress occurs while performing work, with some additional stress for the operator of the bucket controls. Lock-to-lock is the same; when the transformer is open and determined to be safe, the gloves can come off. Climbing a pole in rubber gloves means the climber is continually torquing their hands with every step up the structure. They are constantly adjusting finger-sized controls on their portable fall prevention gear. If the climber is crossing an obstruction, they must attempt to manipulate snaps, adjusters and connectors in rubber gloves.

Last is the unnecessary use of higher-class rubber gloves, such as using Class 3 on a 23-kV system when Class 2 is perfectly acceptable. I still come across employers that believe glove ratings must meet system voltage. That’s not the case if you have a good cover-up program. OSHA has clearly explained that, in three-phase exposures, if the two phases not being worked are properly covered, the exposure to the worker is phase-to-ground. Unless you are gloving 34 kV, where phase-to-ground exceeds the working rating of Class 2 rubber gloves, you need not use Class 3 gloves. Getting your personnel out of Class 3 gloves would provide huge stress relief for their hands. And for secondary work, it may be advisable to provide craft-workers with Class 00/0 gloves.

Conclusion
I know the readers of Incident Prevention magazine are serious about protecting their co-workers. Now that we have some data available, the industry has work to do when it comes to rubber glove policies. It may be that you simply decide to perform an internal analysis of wrist and elbow injuries and adopt a preventive exercise program to counter the risks. I submit that there are also opportunities to reduce the number of ill-advised policies regarding when to wear rubber gloves.

In addition to gloves, I have asked Sundqvist to think about dielectric overshoe use as well, as many industry professionals have come to believe they contribute to lower-back and hip-stress injuries in workers required to wear them every day. There is no time frame for that, but I look forward to his findings and Austin Energy’s continued contributions to industry safety through his work.

About the Authors: After 25 years as a transmission-distribution lineman and foreman, Jim Vaughn, CUSP, has devoted the last 27 years to safety and training. A noted author, trainer and lecturer, he is a senior consultant for the Institute for Safety in Powerline Construction. He can be reached at jim@ispconline.com.

Alfred Sundqvist, D.C., currently serves as occupational health and safety coordinator for Austin Energy, focusing on field operations safety as well as designing and implementing injury prevention programs. He earned his chiropractic degree in 2017 and worked clinically in the Austin, Texas, area for seven years. Prior to that, Sundqvist worked in residential and commercial construction and construction management for 13 years. He can be reached at alfred.sundqvist@austinenergy.com.