Like many sons of prosthetists, I was in my father’s lab at a young age, and as a congenital amputee, I was probably there more frequently than most might be. One of my first tasks was learning to make “gunk.” Mixing a resin with sawdust and then “gunking” a test socket to a wood block, and ideally doing so fast enough that you weren’t standing over the resin when it finally kicked off and started to smoke. Ventilation was limited and the best way to avoid the bad smell was to walk into another room with no concerns that the smoke might be bad for you. If you happened to get any of the resin or gunk on you, it was simply cleaned off with acetone. From there I learned to sand foam for orthotic pads, break out casts of plaster, mix and pour plaster. At this point, I was laminating sockets with carbon, or Kevlar, or whatever new and exciting materials we happened to be using in the lab. Here again, it was best to be done laminating before the resin started to smoke, spills were simply cleaned with acetone, and all of the sockets were ground and finished with the router or Sutton producing limited to poor dust collection.
Such was the lab in which I grew up and I suspect that most of us have either started in or maybe still operate in such a space. Our health or awareness of health risks seemed to be non-existent or maybe we simply didn’t care. Fast forward, a few years and we settled into using carbon in all of the sockets and even in the AFOs. To combat the annoyance of the itch while finishing carbon, we upgraded to a much better dust collector that attempted to keep the carbon dust from attaching to our skin. We would also suit-up in hazmat gear to reduce the risk of the itch. Yes, that’s right! We were only worried about the itch, not the fact that carbon could get into our lungs, and once there, stay forever. This was and in many cases is the norm in prosthetics and orthotics. I would like to tell you that we had some sort of epiphany or wake-up call to the potential hazards of the materials we were using, but that just would not be true. We found healthier alternatives more by accident than by design. After developing our Summit Lock, and the urethane attachment to be glued to the liner, we found a glue that turned out to be fast-setting, easy to use, and without a dreadful, lingering scent. Remarkably compared to other glues and resins in our lab, this glue was much safer and easier for us to use. No more dodging that smoking resin!
A few years down the road, we were working on adding more flexibility and toughness to the sockets and the AFOs we were laminating. While doing so, we discovered that we could use our basalt braid in place of carbon fiber. Low and behold, it was not only tougher and more flexible, but it did not itch when ground and was not an inhalant risk. At this point…..a wakeup call! We decided to purposely look for healthier alternatives rather than just hoping to accidentally find materials that were safer to use. With this change in thinking, we began using safer resins for our laminations and strategically placed fans to help remove fumes from the lamination and gluing areas. With more research, we found a good hand-cleaner to use instead of acetone and we mandated the use of masks and eye protection. We made sure the dust collection devices were grabbing as much of the dust as possible and our Kleenaire Air Purification Systems were removing even more nasty air particles from our lab.
When I look back, it baffles me at all the absurd things we were doing and using that were serious health risks. Now as I travel the country, I am continually amazed that many of these same behaviors and practices are still employed and used. You may not notice anything right away or even for years and can happily say, “Hey, this is the way we’ve always done it.” A common theme that kept us from changing for way too many years. However, we all need to wake-up to the reality that many materials, behaviors, and practices are not good for our employees or for us. We each need to make an effort to do all that we can to reduce the number of negative factors in our labs while increasing safety and improved health-oriented behaviors.
While we have accomplished many improvements, we know there is much more to do. Every day we search for new materials, supplies, tools, and equipment to help create a safer work environment. This outlook must be continuous and ongoing. We should not have to wait for a real health issue or crisis to decide that we need a cleaner lab and a cleaner planet.