Australian standards governing the manufacture of mobile garbage bins should be altered to include a simple safety feature that researchers say could prevent hand injuries in elderly people.
Given the hand injuries included in the review resulted in significant use of hospital resources, including admission, surgery, follow-up and hand therapy, “resources could be potentially saved by effective prevention”.
The team of orthopaedic surgeons from Royal North Shore Hospital in Sydney found injuries to the backs of the hands of 11 elderly patients who were treated after accidents with wheelie bins at Royal North Shore and Dubbo Base Hospital between 2006 and 2010. Eight of the patients required surgery for their injuries.
“Manoeuvring of mobile garbage bins can be dangerous, particularly for older, frail citizens,” the researchers wrote in the latest issue of the Medical Journal of Australia. “Those who live in the community may not receive the assistance needed to manoeuvre mobile garbage bins to the kerbside for weekly or fortnightly council pickup. This seems unreasonable when the larger 240 litre wheelie bins are rated to carry a load of 96 kilograms, which might be double the bodyweight of a frail older person.”
The researchers found that patients over-tilted their wheelie bins to reduce the pushing or pulling force required to move them. “If the weight of the bin exceeded the strength of the patient, especially on a downward slope, the bin pulled away from the patient. Patients typically fell while still gripping the bin handle.”
Abrasions and injuries
Because of the current design of the bin handle, the patient’s hand would hit the ground first and then be dragged along the ground by the momentum of the sliding bin. This resulted in abrasions and associated injuries to underlying bone and soft tissue structures, including open tendon and joint injuries.
The researchers, who were led by Dr Rui Niu, said that altering the design of the wheelie bins could largely prevent this kind of injury. “We suggest incorporating a plastic flange on both ends of the handlebars. Provided this flange is more prominent than a gripped hand, these injuries would not occur.”
Above: The researchers propose a simple modification to the wheelie bin to prevent injuries. Source: MJA article.
This simple design modification “would ensure no such hand injury results from accidental bin overloading and incorrect handling,” they said.
In addition, the researchers recommended that local councils provide more assistance for older residents, including increasing the frequency of garbage removal to decrease the loads in wheelie bins. They noted that Launceston City Council provides assistance for older or disabled people who are having difficulty handling their mobile garbage bins. “Some of these injuries could be prevented if other local governments adopted a similar service, or increased the frequency of garbage collections to reduce the weight of bins.”
Lack of awareness
The researchers noted there was “no published literature linking hand injuries to mobile garbage bins”. There was “a lack of awareness among both manufacturers and regulatory bodies of this mechanism of injury.” The key goal of the study, therefore, was to highlight this pattern of injury, they said.
While their patient review found that finger injuries from accidents related to the wheelie bins were not uncommon, the researchers acknowledged it was unlikely their search methods captured all of the relevant cases, “and this pattern and mechanism of injury may be more common than we were able to show”.
Most patients in the series achieved satisfactory recovery of hand function, although many required significant use of hospital resources, including hospital admission, surgery, extensive clinical follow-up and hand therapy, they wrote. “These resources could potentially be saved by effective prevention.”
Read the paper, Mobile garbage bins and hand injuries in older people