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Mobile garbage bins and hand injuries in older people

Rui Niu, Adam B Woodbridge, Belinda J Smith, Stephen J Ruff and Richard D Lawson
Med J Aust 2013; 199 (7): 491-492. || doi: 10.5694/mja13.10212
Published online: 7 October 2013

Injuries to the extensor tendon complex at the level of the proximal interphalangeal (PIP) joint are common and may result in stiffness, deformity and loss of hand function.1,2 A number of older patients have presented to our hand surgery unit with open central slip extensor tendon injuries acquired while manoeuvring mobile garbage bins, commonly known as wheelie bins.3

Mobile garbage bins are rectangular bins with two wheels, made from injection-moulded high-density polyethylene. Since being invented in Germany in 1975, mobile garbage bins have largely replaced conventional household garbage bins in Australia, as they have greater storage capacity, increased durability, and can be lifted mechanically.3 The most commonly used residential wheelie bins hold a volume of 240 L and weigh 13 kg when empty. According to Australian Standards, a 240 L mobile garbage bin is designed to hold a load of 96 kg, with a maximum pulling force of 60 newtons on a flat surface when the bin is tilted to an angle requiring a vertical lifting force of 20% extra of the load. The forces required to manoeuvre these bins increase considerably on slopes, steps, uneven ground and textured surfaces.4,5

There is no published literature linking hand injuries to mobile garbage bins, and there is a lack of awareness among both manufacturers and regulatory bodies of this mechanism of injury. Our primary goal in this study is to highlight this pattern of injury.

Although these injuries could be prevented by simple measures such as using smaller bins, reducing loading, and having council-assisted bin handling, we present a simple design modification for the type of bins currently in use that would ensure no such hand injury results from accidental bin overloading and incorrect handling.

Discussion

Our retrospective chart review shows that finger injuries from accidents related to manual handling of mobile garbage bins are not uncommon. Because prohibitively large numbers of hand injuries are reported, we restricted our search to ICD-10 codes similar to those allocated in previous known cases of dorsal finger injuries resulting from accidents with mobile garbage bins. However, without a specific medical record code for this type of injury, it is unlikely that our 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.

Manoeuvring of mobile garbage bins can be dangerous, particularly for older, frail citizens. Those that 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 L wheelie bins are rated to carry a load of 96 kg, which might be double the bodyweight of a frail older person.

Launceston City Council provides assistance for older or disabled people who are having difficulty handling their mobile garbage bins.6 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.

However, altering the design of mobile garbage bins could largely prevent this mode of injury. We suggest incorporating a plastic flange on both ends of the handlebars (Box 2). Provided this flange is more prominent than a gripped hand, these injuries would not occur by the mechanism described. We recommend that the Australian standards for mobile garbage bin manufacture should be altered to include this simple safety feature.

Most patients in our 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. These resources could potentially be saved by effective prevention.

Received 18 February 2013, accepted 3 July 2013

  • Rui Niu1,2
  • Adam B Woodbridge1
  • Belinda J Smith1,2
  • Stephen J Ruff1,2
  • Richard D Lawson1



Correspondence: 

Competing interests:

No relevant disclosures.

  • 1. Freiberg A, Pollard BA, Macdonald MR, Duncan MJ. Management of proximal interphalangeal joint injuries. Hand Clin 2006; 22: 235-242.
  • 2. Pratt AL, Burr N, Grobbelaar AO. A prospective review of open central slip laceration repair and rehabilitation. J Hand Surg Br 2002; 27: 530-534.
  • 3. Sulo Environmental Technology. About us. Somersby, NSW: Sulo. http://www.sulo.com.au/articles/About_Us/3 (accessed Oct 2010).
  • 4. Committee PL-047. Mobile waste containers. Part 1: Containers with two wheels and a capacity up to 400 L for lifting devices dimensions and design. Australian Standard 4123.1-2008: 1-20.
  • 5. Committee PL-047. Mobile waste containers. Part 5: Performance requirements and test methods. Australian Standard 4123.5-2008: 1-28.
  • 6. Launceston City Council. Are you are having difficulties handling your bin? Tasmania, Australia: Launceston City Council. http://www.launceston.tas.gov.au/lcc/index.php?c=392 (accessed Mar 2012).

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