March 28, 2001

Protecting Your Feet

By Maureen Alvarez, CIH, CSP

Your ability to use your feet safely, with ease and comfort, is vital if you are to remain a valuable and productive worker.   When your job requires you to stand on your feet for long periods, work in potentially hazardous areas or with potentially hazardous materials, you have some risk of foot injury.  However, you can do a lot to prevent injuries by keeping your feet healthy and following safe work practices. 

In any given year, there are about 120,000 job-related foot injuries, one-third of them are toe injuries, according to the National Safety Council.  You can't take your feet for granted!  And your concern for them cannot be divided; it should continue off the job, as well as at work.

The human foot is a biological masterpiece.  It's strong, flexible, and functional design enables it to do its job well and without complaint — as long as you take care of your feet.

The foot can be compared to a finely tuned race car, or a space shuttle, vehicles whose function dictates their design and structure.  And like them, the human foot is complex, containing within its relatively small size 26 bones (the two feet contain a quarter of all the bones in the body), 33 joints, and a network of more than 100 tendons, muscles, and ligaments, to say nothing of blood vessels and nerves.

Tons of Pressure

The components of your feet work together, sharing the tremendous pressures of daily living.  An average day of walking, for example, brings a force equal to several hundred tons to bear on the feet.  This helps explain why your feet are more subject to injury than any other part of your body.

Foot ailments are among the most common of our health problems.  Although some can be traced to heredity, many stem from the cumulative impact of a lifetime of abuse and neglect.  Studies show that 75 percent of Americans experience foot problems of a greater or lesser degree of seriousness at some time in their lives; nowhere near that many seek medical treatment, apparently because they mistakenly believe that discomfort and pain are normal and expectable.

On-the-Job

It is important for you to develop safe work habits and attitudes at work.  Here are a few important points to remember:

• Be aware of the hazards of your job and the proper protective measures to take.
• Don't take chances or unnecessary risks. Take time to do your job right.
• Be alert. Watch for hidden hazards.
• Be considerate. Watch out for other workers' safety.
• Follow the rules. Don't cut corners. Use your equipment as specified.
• Concentrate on the job. Inattention can lead to accidents.
• Pace yourself. Work steadily at a comfortable speed.
• Keep your work area clean and your tools in their place.

Off-the-Job

There are a few simple things you should do off the job and at home too for foot safety:

• Bathe your feet daily; dry them thoroughly.
• Check your feet frequently for corns, calluses, cracks.
• Keep your feet warm.
• Trim your toenails straight across, slightly longer than the end of the toe.
• Prevent foot problems by visiting your podiatrist as part of your annual health check-up.
• Wear protective footwear when using lawnmowers, chain-saws, and moving heavy objects.

Protective footwear is essential to ensure safe and healthy feet.  Safety shoes and boots protect your feet, help prevent injuries to them, and reduce the severity of injuries that do occur in the workplace.

Only one out of four victims of job-related foot injury wear any type of safety shoe or boot, according to the National Safety Council. The remaining three either are unaware of the benefits of protective footwear or complain about it.

Safety footwear is comfortable, flexible, stylish, and still provides protection from injury.

The foot is the most valuable part of your body subjected to injury in industry.  Because of the many potential work hazards, it is important that you discuss with your supervisor the safety shoe, boot, or other protective equipment that you need for your protection.

OSHA Requirement

The OSHA requirements for protective footwear are found within 29 CFR 1910.136.  The General requirements of this regulation are that the employer shall ensure that each affected employee use protective footwear when working in areas where there is a danger of foot injuries due to falling or rolling objects, or objects piercing the sole, and where such employee's feet are exposed to electrical hazards.

Protective footwear purchased after July 5, 1994 shall comply with ANSI Z41-1991, "American National Standard for Personal Protection-Protective Footwear," which is incorporated by reference as specified in Sec. 1910.6, or shall be demonstrated by the employer to be equally effective.

Protective footwear purchased before July 5, 1994 shall comply with the ANSI standard "USA Standard for Men's Safety-Toe Footwear," Z41.1-1967, which is incorporated by reference as specified in Sec. 1910.6, or shall be demonstrated by the employer to be equally effective.

For a complete copy of the OSHA regulation, go to www.osha.gov.

The following is a list of the types of foot hazards that might be encountered in the work place along with some recommended protective footwear.

HAZARD: falling and rolling objects, cuts and punctures
PROTECTION: steel-toe safety shoes; add-on devices: metatarsal guards, metal foot guards, puncture-proof inserts, shin guards.

HAZARD: chemicals, solvents
PROTECTION: footwear with synthetic stitching, and made of rubber, vinyl or plastic.

HAZARD: electric current
PROTECTION: shoes or boots with rubber soles, and heels, no metal parts and insulated steel toes.

HAZARD: extreme cold
PROTECTION: shoes or boots with moisture- or oil-resistant insulation, and that can repel water (if this is a problem); insulated socks.

HAZARD: extreme heat and direct flame
PROTECTION: overshoes or boots of fire-resistant materials with wooden soles.

HAZARD: high voltage
PROTECTION: shoes with rubber or cork heels and soles, and no exposed metal parts.

HAZARD: hot surfaces
PROTECTION: safety shoes with wooden or other heat-resistant soles; wooden sandals overshoes.

HAZARD: sanitation contamination
PROTECTION: special plastic booties or overshoes; paper or wood shower sandals.

HAZARD: slips and skids (from wet, oily shoes with wooden soles or cleated, surfaces)
PROTECTION: non-slip rubber or neoprene soles; non-skid sandals that slip over shoes; strap-on cleats for icy surfaces.

HAZARD: sparking (from metal shoe parts)
PROTECTION: safety shoes with no metal parts and non-sparking material.

HAZARD: sparks, molten metal splashes
PROTECTION: foundry boots with elastic sides or (that get inside shoes) quick-release buckles for speedy removal.

HAZARD: static electricity
PROTECTION: shoes or boots with heels and soles of cork or leather.

HAZARD: wetness
PROTECTION: lined rubber shoes or boots; rubbers or shoes of silicone-treated leather.

Specialized Care

Your feet, like other specialized structures, require specialized care. A doctor of podiatric medicine can make an important contribution to your total health, whether it is regular preventive care or surgery to correct a deformity.

In order to keep your feet healthy, you should be familiar with the most common ills that affect them. Remember, though, that self treatment can often turn a minor problem into a major one, and is generally not advisable. You should see a podiatric physician when any of the following conditions occur or persist.

Athlete’s foot is a skin disease, usually starting between the toes or on the bottom of the feet, which can spread to other parts of the body.  It is caused by a fungus that commonly attacks the feet, because the wearing of shoes and hosiery fosters fungus growth.  The signs of athlete’s foot are dry scaly skin, itching, inflammation, and blisters.

You can help prevent infection by washing your feet daily with soap and warm water; drying carefully, especially between the toes; and changing shoes and hose regularly to decrease moisture. Athlete’s foot is not the only infection, fungal and otherwise, which afflicts the foot, and other dry skin/dermatitis conditions can be good reasons to see a doctor of podiatric medicine if a suspicious condition persists.

Blisters are caused by skin friction. Don’t pop them. Apply moleskin or an adhesive bandage over a blister, and leave it on until it falls off naturally in the bath or shower. Keep your feet dry and always wear socks as a cushion between your feet and shoes. If a blister breaks on its own, wash the area, apply an antiseptic, and cover with a sterile bandage.

Bunions are misaligned big toe joints which can become swollen and tender. The deformity causes the first joint of the big toe to slant outward, and the big toe to angle toward the other toes.  Bunions tend to run in families, but the tendency can be aggravated by shoes that are too narrow in the forefoot and toe.  There are conservative and preventive steps that can minimize the discomfort of a bunion, but surgery is frequently recommended to correct the problem.

Corns and calluses are protective layers of compacted, dead skin cells. They are caused by repeated friction and pressure from skin rubbing against bony areas or against an irregularity in a shoe.  Corns ordinarily form on the toes and calluses on the soles of the feet.  The friction and pressure can burn or otherwise be painful and may be relieved by moleskin or padding on the affected areas.  Never cut corns or calluses with any instrument, and never apply home remedies, except under a podiatrist’s instructions.

Foot odor results from excessive perspiration from the more than 250,000 sweat glands in the foot. Daily hygiene is essential. Change your shoes daily to let each pair air out, and change your socks, perhaps even more frequently than daily.  Foot powders and antiperspirants, and soaking in vinegar and water, can help lessen odor.

Hammertoe is a condition in which any of the toes are bent in a claw-like position. It occurs most frequently with the second toe, often when a bunion slants the big toe toward and under it, but any of the other three smaller toes can be affected. Although the condition usually stems from muscle imbalance, it is often aggravated by ill-fitting shoes or socks that cramp the toes. Avoid pressure on the toes as much as possible. Surgery may be necessary to realign the toes to their proper position.

Heel pain can generally be traced to faulty biomechanics which place too much stress on the heel bone, ligaments, or nerves in the area. Stress could result while walking or jumping on hard surfaces, or from poorly made footwear.  Overweight is also a major contributing factor.  Some general health conditions—arthritis, gout, and circulatory problems, for example— also cause heel pain.

Heel spurs are growths of bone on the underside of the heel bone. They can occur without pain; pain may result when inflammation develops at the point where the spur forms. Both heel pain and heel spurs are often associated with plantar fasciitis, an inflammation of the long band of connective tissue running from the heel to the ball of the foot. Treatments may range from exercise and custom-made orthotics to anti-inflammatory medication or cortisone injections.

Ingrown nails are nails whose corners or sides dig painfully into the skin, often causing infection.  They are frequently caused by improper nail trimming, but also by shoe pressure, injury, fungus infection, heredity, and poor foot structure.  Toenails should be trimmed straight across, slightly longer than the end of the toe, with toenail clippers. If painful or infected, your podiatric physician may remove the ingrown portion of the nail; if the condition reoccurs frequently, your podiatrist may permanently remove the nail.

Warts are caused by a virus, which enters the skin through small cuts and infects the skin.  Children, especially teenagers, tend to be more susceptible to warts than adults. Most warts are harmless and benign, even though painful and unsightly.  Warts often come from walking barefooted on dirty surfaces or littered ground.  There are several simple procedures which your podiatric physician might use to remove warts.

For more information regarding footcare and health, please visit the American Podiatric Medical Association at www.apma.org.

Copyright © 2001 by WorkCare™ All Rights Reserved

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