Cement Burns

Contact with wet concrete can do serious damage to skin.

By Gwenyth Laird Pernie

Skin burns caused by direct contact with wet concrete are a routine hazard faced by precasters. Preventing these burns, which are caused by the caustic nature of cement once it is mixed with water, can be accomplished through proper training and a safe environment, both at work and at home.

In 2002 there were more than 274,000 workers in the concrete and masonry fields, and the numbers are expected to increase more than 20 percent by 2012 (U.S. Department of Labor’s Bureau of Labor Statistics (BLS)). And, according to Ed Sullivan, chief economist with the Portland Cement Association (PCA), 90 million tons of cement, which is utilized in concrete, mortar, plaster, stucco, terrazzo, tile grout and other products, was consumed in the United States in 2004.

Lost workdays due to skin problems caused by direct contact with wet concrete are significant. The BLS reports that lost workdays in the masonry fields are 2.5 times greater and in the concrete fields are seven times greater than the U.S. national average. In addition, concrete workers report four times more lost workdays for skin problems than other construction workers. Consequently, workers suffer reduced earnings, medical bills and, in cases where an allergy is diagnosed, loss of trade while employers must deal with workers’ compensation disability claims and lower productivity.

When cement is dry it contains calcium oxide, which is not particularly dangerous. However, when water is added to cement, calcium hydroxide is formed, which is extremely alkaline with a pH of 12 to 13. Normal human skin has a pH of 5.5; therefore, wet cement can produce alkaline (caustic) skin burns which progress and get worse without more exposure. A worker may have wet concrete on his or her skin for hours without feeling any discomfort; however, the cement is damaging the skin microscopically. Early identification of changes to the skin is important so steps can be taken to treat the affected area.

Don’t assume the burn will not get worse. By the time a worker becomes aware of a burn, much damage has already occurred and further damage is difficult to stop.

Cement burns frequently produce discoloration of the skin, gradually changing to a deep purple-blue color, eventually progressing to painful burns, ulcerations and, in the worst cases, amputation. Some patients report red inflamed skin near the affected area followed by severe blistering. Cement burns can also lead to allergic dermatitis.

Wet concrete has additional characteristics that are harmful to human skin: hygroscopic (draws moisture from skin); abrasive (physically damages the skin surface, making it a less effective barrier); and contains sensitizing chemicals and metals, such as hexavalent chromium (can cause allergic contact dermatitis).

Once the eyes or areas of the skin have been directly exposed to wet concrete, immediate steps should be followed to slow the burning process:

1. Remove any contaminated clothing, being careful not to touch unexposed areas. Promptly rinse clothes in clean water.
2. Gently brush any dry chemicals off the skin and flush the affected area with clean running water for at least 20 minutes. To help neutralize the alkalinity, add vinegar, citrus or a buffer to the water.
3. If the eyes are involved, rinse eyes with clean water for 20 minutes.
4. Seek professional medical attention without delay. Provide the medical personnel with a product Material Safety Data Sheet (MSDS) and a Physician Alert brochure (available from The Center to Protect Workers’ Rights), which explains the skin hazards of concrete work.

In some circumstances, when an employee suffers a cement burn, the employer is required to make a one-line entry on the Occupational Safety & Health Administration (OSHA) Form 300 (Log of Work-Related Injuries and Illnesses) and complete an OSHA Form 301 (Injury and Illness Incident Report), or equivalent form.

According to Kevin O’Barr, standards officer for North Carolina Department of Labor, these circumstances include work-related accidents that require medical treatment above first aid or that result in lost or restricted work time. All records must be kept for five years. These forms can be found on the OSHA website at  www.osha.gov/recordkeeping.

Training
Proper training on the safe handling of wet concrete both at work and at home are key to preventing cement burns.

According to experts at OSHA, prevention of cement burns begins with the front-line foreman instructing employees of the hazards associated with wet concrete and the necessary safety precautions to avoid injury.

“Hands-on experience with cement products is fundamental to educating workers on cement burn dangers and thus reducing occurrences of burns,” explained one OSHA training official. “In addition, it is important to institute workplace inspections to insure all employees are following safety precautions.”

OSHA created the Voluntary Protection Program (VPP) to encourage businesses to establish effective safety and health management systems. The VPP encourages participants to develop and implement safety plans that effectively identify, evaluate, prevent and control occupational hazards. As a result the average VPP work sites have 50 percent fewer lost workdays than others in their industries.

In 2003 Oldcastle Precast, located in Manchester, N.Y., was the first precast concrete facility to receive the OSHA Merit VPP award for commitment to safety. In 2004, it was the second precast concrete facility to receive the Star Site award – the highest VPP award available. The first to receive the Star Site award was Utility Vault, an Oldcastle facility in Auburn, Wash.

“In the precast industry, cement burns are not a major occurrence; however, they are still a concern when employees are involved in finishing work or cleaning out mixers,” said Bonita Petti, safety manager for the New York Oldcastle plant. “The success of our safety program is attributed to good training and employee commitment to ensuring a safe work environment.”

Petti attributes the employees’ positive response to safety participation to an interactive approach to safety training, where employees participate in group discussion and hands-on training. “In addition, Oldcastle Precast developed a safety training computer program which has a quiz at the end that all prospective employees must pass,” she said. “To accommodate the increasing number of Spanish speaking employees, all training materials and workplace signs are bilingual.”

Institute a safe work environment
Creating a safe work environment by minimizing skin contact with wet concrete – both directly and indirectly – from contaminated surfaces is essential to preventing cement burns.

A safe environment begins with instituting a safety plan, which includes creating a best practices checklist (such as a listing of best protective practices at home and work, a symptom checklist and a pH testing checklist) and an MSDS for each job site.

According to Tom Carter, director of environment, health and safety with PCA, an MSDS is required for each product at the job site and should include its physical and chemical properties; the physical and health hazards and roots and means of exposures associated with it; precautions of safe handling and use; emergencies and first aid procedures; and control measures to prevent exposure. Individual MSDSs for cement and cement products should be available from the vendor.

“The Portland Cement Association is in the process of revising its guidance on developing a material safety data sheet,” Carter said. “Our member companies can utilize this document as they see fit for developing their own Material Safety Data Sheet. We expect to complete the document by early fall 2005.”

Proper supplies at the job site are vital to insuring a safe environment. These items include:

• At least 5 to 7 gallons of clean running water per day
  per worker
• pH-neutral soap to help neutralize the effect of caustic cement (prohibit workplace cleaners that are caustic and abrasive or contain sensitizers like lanolin, limonene or perfume, and irritants like alcohol)
• Buffering spray or solution, such as Mason’s Hand Rinse or Neutralite to normalize surface skin pH
• Clean towels
• Full range (pH 1-14) pH indicator papers to get reasonably accurate measurements of the pH of the skin, work areas, work clothes, skin surfaces, car interior surfaces and other potential contact areas.

  It is equally important that workers be dressed appropriately in order to avoid contact with the caustic substances.

Protective equipment should include:

• Full-cover goggles or safety glasses with side shields to protect against blowing dust (the moisture in the eyes will mix with the dust, making it caustic), splattering concrete and other foreign objects
• Snug-fitting alkali-resistant gloves, such as butyl gloves or nitrite gloves
• Long-sleeve buttoned shirts taped inside gloves
• Overalls or long pants taped into water-repellent boots
• Waterproof pads to be worn between the fresh concrete surfaces and the knees, elbows and hands – the areas of the body most frequently burned.
• Remove all jewelry, watches, belts, etc., since the wet concrete can become trapped against the skin.

Workers need to be especially careful when removing gloves, boots and other work clothes so as not to contaminate themselves or other areas routinely exposed to the caustic product. Each time gloves or boots are removed, workers should wash and thoroughly dry hands with clean towels. It is crucial that gloves and boots are cleaned daily and stored in a dry place away from tools and other work or home items.

Employers should provide on-site skin inspections at regular intervals throughout the workday. Inspections should be conducted by an occupational health physician or nurse who is competent to recognize the signs and symptoms of cement burns. The responsible persons must record and report all findings.

At the end of the day, work clothes should be removed at the job site and placed in a separate container, such as a trash bag. This will help prevent contamination away from the job site, including cars, homes, etc.

Home safety
Preventing skin damage due to exposure to wet concrete doesn’t end at the job site. At home, workers should always wash with pH-neutral or acidic soaps and avoid lanolin, petroleum jelly and other skin-softening products since they can seal cement to the skin and increase the skin’s ability to absorb contaminants.

In addition, cautionary steps should be taken to avoid contamination at home. Most importantly this includes laundering work clothes separately from other clothes and keeping other items such as boots and gloves isolated from the home environment.

Routine safety procedures will greatly reduce the risk of cement burns and consequent lost workdays:

• Educate workers on the hazards of direct contact with wet concrete
• Follow procedures needed to avoid direct contact (e.g. wearing appropriate protective equipment/clothes)
• Provide proper immediate first aid when contact occurs

In addition, establishing best practice guidelines, along with routine safety inspections, should further limit injuries caused by direct contact with wet concrete.