Harnesses Can Kill You? Part 1

October 10, 2003

Will Your Safety Harness Kill You?

By: Bill Weems and Phil Bishop

Harness-Induced Death
Workers requiring fall protection or entering confined spaces try to protect themselves through the use of safety harnesses, belts, and seats. What is little known however, is that these harnesses can also kill.

Harnesses can become deadly whenever a worker is suspended for durations over five minutes in an upright posture, with the legs relaxed straight beneath the body. This can occur in many different situations in industry.

A carpenter working alone is caught in mid-fall by his safety harness, only to die 15 minutes later from suspension trauma. An electrical worker is lowered into a shaft after testing for toxic gases. He is lowered on a cable and is positioned at the right level to repair a junction box. After five minutes he is unconscious--but his buddies tending the line don't realize it, and 15 minutes later a dead body is hauled out.

The cause of this problem is called "suspension trauma." Fall protection researchers have recognized this phenomenon for decades. Despite this, data have not been collected on the extent of the problem; most users of fall protection equipment, rescue personnel, and safety and health professionals remain unaware of the hazard.

Suspension Trauma
Suspension trauma death is caused by orthostatic incompetence (also called orthostatic intolerance). Orthostatic incompetence can occur any time a person is required to stand quietly for prolonged periods and may be worsened by heat and dehydration.

What happens in orthostatic incompetence is that the legs are immobile with a worker in an upright posture. Gravity pulls blood into the lower legs, which have a very large storage capacity. Enough blood eventually accumulates so that return blood flow to the right chamber of the heart is reduced.

The heart can only pump the blood available, so the heart's output begins to fall. The heart speeds up to maintain sufficient blood flow to the brain, but if the blood supply to the heart is restricted enough, beating faster is ineffective, and the body abruptly slows the heart.

In most instances this solves the problem by causing the worker to faint, which typically results in slumping to the ground where the legs, the heart, and the brain are on the same level. Blood is now returned to the heart and the worker typically recovers quickly. In a harness, however, the worker can't fall into a horizontal posture, so the reduced heart rate causes the brain's blood supply to fall below the critical level.

Orthostatic incompetence doesn't occur to us very often because it requires that the legs remain relaxed, straight, and below heart level. If the leg muscles are contracting in order to maintain balance and support the body, the muscles press against the leg veins.

This compression, together with well-placed one-way valves, helps pump blood back to the heart. If the upper-legs are horizontal, as when we sit quietly, the vertical pumping distance is greatly reduced, so there are no problems.

In suspension trauma, several unfortunate things occur that aggravate the problem. First, the worker is suspended in an upright posture with legs dangling. Second, the safety harness straps exert pressure on leg veins, compressing them and reducing blood flow back to the heart. Third, the harness keeps the worker in an upright position, regardless of loss of consciousness, which is what kills workers.

Reprinted with permission from the March 2003 issue of Occupational Health & Safety, (c) Stevens Publishing Corporation.

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