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Kara Ludlow, BScOT, CHT, OT Reg. (Ont.)
Department of Plastic and Reconstructive Surgery
Hand Therapy Service
University Hospital - London Health Sciences Centre
London, Ontario, Canada
Do No Harm............Including To Ourselves - the Investigation of Personal Safety during a Common Clinical Practice
Ludlow, K, Renaud, P, Townsend, ML Wyllie-Naftel, C, Rahm, C
Introduction: The concept of "do no harm" to the health and safety of our clients is indisputable and of paramount importance. But, so too is ensuring the health of hand therapists in the workplace. The heating of thermoplastic splinting materials with a heat gun is an exceedingly common clinical practice in inpatient, outpatient and home based hand therapy settings. This method is valued for it's efficacy and speed as well as the ability to isolate and heat precise aspects such as curved or rounded edges. There is however credible reason for concern from experts in the field regarding our occupational exposure to the offgassing of these materials. Thermal desoprtion and head space testing has been initiated.
Objectives: This paper synopsizes the unexpectedly lengthy and surprisingly complicated journey associated with answering what originally appeared to be the simplest of questions - "is the inhalation of fumes generated from the heating of thermoplastic splinting material with a heat gun safe for therapists and patients to breathe?"
Approach: This paper will present a progress report regarding our findings to date. It will briefly chronicle several years of contacts and correspondence with dozens of individuals, provincial and federal ministries and both Canadian and American agencies in the quest to answer this question. A status update regarding the very recent role that Health Canada is now playing in this investigation will be highlighted. Unforeseen complications and exigent obstacles such as resistance to disclosure encountered along the way will be reviewed.
Practice Implications: Study findings available by the time of presentation will be reviewed. Proposed protocols for enhanced safety will be presented using a somewhat analogous surgical scenario. Strategies for addressing similar occupational health and safety related concerns within a hand therapy context will be discussed, for example the oven heating of thermoplastic foams. The concept of procurement options will be raised.
Conclusion: Hand therapists are encouraged to look at the available science and then examine the risk/benefit ratio of an extremely common clinical procedure utilized in the fabrication of thermoplastic splints. The responsibility we bear and the assumptions we make regarding our own personal safety while performing duties within a hand therapy context are challenged. The suggestion is proposed that as health care professionals endeavouring to improve the lives of our clients, it behooves us to ensure that we are utilizing safe practice in order to protect our own health.