Putting your best foot forward

According to podiatrist, Lynley Keynes, President of the South Australian Podiatry Association, "Nearly 20% of all workplace injuries occur to the feet and lower limbs, yet workplace foot health is still a neglected area. The most frequent types of foot injury are fractures, contusions and crush injuries, sprains and strains of joints and muscles."

Statistics show that the industries with the highest number of foot injuries are:

• Manufacturing (22%)
• Construction (11%)
• Transport and storage (8%)
• Retail trade (8%)
• Property and business services (7%)

Workers with the highest number of foot injuries are labourers and related workers (42%), tradespeople (19%), plant and machine operators, drivers (13%) and salespeople and personal service workers (8%), including child-care workers, enrolled nurses and dental nurses.

Female workers whose jobs demand the wearing of fashion footwear have a high incidence of acquired foot deformities at a fairly young age, as do teachers, hairdressers and retail assistants.

Figures from the Occupational Health and Safety Commission show that, on average, foot and toe injuries result in seven weeks off work with a cost per injury of $5,000.

Changing work practices and longer working hours are also taking a toll on the feet of Australian workers.

"More people now work shifts up to 12 hours instead of nine to five. In many sectors, employees will spend most of those 12 hours on their feet, standing in the same position on a very hard surface. In addition, many people in the corporate, retail and hospitality sectors wear dress shoes which are hard on the feet at the best of times," Keynes says.

Standing on hard surfaces, walking in slippery or unstable environments, jumping on and off machinery or in and out of cars and trucks, all put stress on the feet.

"When you consider that during normal walking our feet absorb 1.5-2 times our body weight and up to three times our body weight during more intense activities, it is clear that feet are under enormous pressure in the workplace," she says.

In response to these findings, West Australian safety footwear manufacturer, Footwear Industries has recently achieved a world first with its Steel Blue range of footwear. Steel Blue was independently tested by the Shoe and Allied Trades Research Association (SATRA) in the UK under its Comfort Index test and achieved the highest comfort rating ever given to a steel toe safety shoe. The Steel Blue safety boots were subjected to some of the toughest tests available and awarded a highly impressive Comfort Index of 75.

SATRA was formed over 80 years ago by a group of visionary industrialists and is the world's leading research and technology organisation of consumer goods industries. Their laboratories are accredited for a wide range of tests and procedures and their test reports are accepted and respected worldwide.

The SATRA panel concluded that the Steel Blue boot had a good appearance and feel, combined with excellent quality seams, stitching and linings. Shock absorption properties in both the heel and forepart are comparable with those expected from performance sports footwear.

Keynes considered that the foam-backed insock in the heel and substantial soling combine to provide the wearer with the perception of a high level of cushioning, which absorbs shock and reduces pressure on the feet. Safety boots should ideally be manufactured from a material that breathes, as fungal infections such as tinea love a warm, moist environment. Steel Blue boots are manufactured using 'A' grade cowhide leather and the internal linings are made with Combat SuperKint, a hydrophobic polymer that quickly wicks perspiration away from the foot, leaving the skin cool and dry.

"Foot problems caused by inappropriate footwear or ill-fitting safety shoes also cost time and money. At least half the foot problems presented to podiatrists are related to ill-fitting footwear. Price is an important issue for employers when selecting safety boots, but in the long term the costs related to foot injuries and lost time at work far exceed any savings from choosing cheaper and inappropriate footwear," Keynes says.

"Legislation mandates that employees in certain industries wear safety shoes but many employees are given poorly fitted shoes. Because of the pressure on feet in the workplace, even small irritations can restrict a person's mobility and reduce productivity," she says.

The Australian Podiatry Association welcomes Footwear Industries' proactive approach in having its safety boots assessed and believes that it would benefit employers in appropriate selection of footwear for their employees if all footwear were rated by SATRA.

Keynes has recommended that professional assessment should be sought if chronic fatigue or injury is experienced. A podiatrist can provide advice and information on:

1. Employee education on the importance of appropriate footwear, safety footwear and self-care as prevention.
2. Raising the awareness of common foot conditions related to the occupation - at an individual public health, union and occupational safety level.
3. Initiating early rehabilitative intervention to prevent long-term chronic disablement and secondary problems arising from injury.
4. Providing foot screenings to establish if modified footwear and/or insoles or orthoses are required to improve foot function.
5. Assessment of injury and sequelae for workers compensation claims.

South Australian podiatrist Adam Swalling, who wrote a discussion paper on footwear in the workplace, concurs with Keynes and makes the following suggestions to assist in selecting well-fitting footwear:

1. Always try on shoes standing up
2. Measure both feet and fit to the largest foot
3. Always measure the longest toe in the shoe (anatomically this may be the second toe)
4. There should be a 1cm gap between the longest toe and the end of the toe box
5. Never buy shoes that need breaking in, shoes should be comfortable immediately
6. Try on the shoes at the end of the day - postural oedema makes feet largest at the end of the day
7. Go for a substantial walk (5-10 minutes) around the shop to test for any possible areas of pain or irritation.