A Perth doctor is warning of the dangers of wearing high-vis shirts in direct sunlight after what she believes is the world's first case of burns from retro-reflective tape.
In a letter to the editor of the Medical Journal of Australia published today, emergency medicine specialist Ioana Vlad explained how she treated a man for first-degree burns caused by the reflective tape on his shirt.
The 40-year-old field environmental engineer had presented at Sir Charles Gairdner Hospital's emergency department in late January 2018 complaining of a rash across his back.
In assessing the patient, Dr Vlad noticed the rash was directly underneath a reflective stripe on the high-vis shirt the man had been wearing during the day.
Although the man's injuries were not serious, he said it caused him discomfort for a few days.
He was treated with aloe vera and painkillers for the first-degree burn, which was similar in severity to a sunburn.
Dr Vlad said almost anyone wearing shirts with reflective tape was at risk of similar injuries.
"It could happen to other people as well, especially if they wear the same type of shirt and the same type of reflective tape, and especially if they work out in the sun and the sun shines directly onto the shirt," she said.
The man said the tape often became extremely hot when he was working in hot conditions and that he had to regularly change positions to ensure it did not touch his skin.
What to wear and when
Under Australian Work Health and Safety regulations, employers are left to determine when high-visibility clothing should be worn, depending on the environment workers are in.
But Standards Australia, which sets requirements for safety equipment including high-visibility clothing, said state employers were responsible for ensuring their workers were safe with UV Protection Workwear when they were exposed to direct sunlight.
Under the standards, these garments should have ultraviolet protection and have a UPF rating in the 40-50+ excellent category.
Dr Vlad said while she recommended employers not make shirts with reflective tape compulsory during the day, there were precautions workers could take to minimise their risk of being burned.
"Those people wearing them should be aware that if this tape is coming into direct contact with the skin, and they are in direct sunlight, this could happen," she said.
"They should either wear something else underneath like a t-shirt or avoid direct sunlight."
Dr Vlad said workplaces should also consider using removable vests with retro-reflective tapes instead.
The visual requirements for garments to be worn at different times of the day are specified under the Standards Australia guidelines for high-visibility clothing.
Fluorescent yellow and navy polos without tape are the recommended garments for daytime, whereas high visibility clothing for night-time use is required to have reflective tape either in an X or H pattern to increase its visibility to others.
High visibility polo shirts with reflective tape, similar to the one the man was wearing when he was burned, are permitted to be worn both during the day and night.
Call for more safety measures
Despite the effectiveness of garments required to be checked in three-month to six-month intervals, Dr Vlad said there was more manufacturers could do to keep workers safe.
"I guess it is something the manufacturers need to look at and see if they need to either make sure they put a different piece of cloth underneath this reflective tape … or maybe to limit the number of uses for this shirt," she said.
Manufacturers warned that wearing retro-reflective tape could possibly cause heat build-up around the shoulder, neck and ears.
There was also a risk that the tape could smoulder or melt when subjected to heat.
But no cases of injuries arising from retro-reflective tape had previously been published in medical literature.