High Pressure Injection Injury Treatment and Prevention: What You Need to Know About This Rare But Serious Workplace Concern

Workers in multiple industries often use high-pressure equipment as a routine component of their job duties. This type of equipment is hazardous, and injuries can and do happen due to improper use, insufficient training, or accidents. Injuries caused by high-pressure equipment typically affect the hands and can cause serious damage depending on the severity and type of material that becomes embedded within the body.

In this article, we explore what high-pressure injection injuries are, how they occur, how they're treated, and the key things workplaces need to know for high pressure injection injury prevention, including the type of personal protective equipment (PPE) that can safeguard workers against these potentially serious injuries.

What is a High-Pressure Injection Injury?

A high-pressure injection injury occurs when a substance or chemical is injected into a person's skin from a machine or piece of equipment that is operating under very high pressure. High pressure equipment is capable of delivering forces as high as 3,000 to 10,000 psi at speeds of up to 400 miles per hour. Due to their incredible power, some high-pressure equipment can inject chemicals into a person's skin even in the absence of direct bodily contact.

This sort of injury typically presents as a small puncture wound. Usually, these injuries affect a worker's hand—often his or her non-dominant hand, to be more specific. More than half of all high-pressure injection injuries involve the index finger. Other common areas of the hand affected include the thumb and palm.

High-pressure injection injuries are thought to be generally rare. According to one 2014 review published in the Journal of the American Academy of Orthopaedic Surgeons, only about 1 in 600 hand traumas presented to hospitals are high-pressure injection injuries. But despite its relative rarity, this type of occupational injury can be extremely serious and lead to life-changing or even fatal complications if not promptly treated. The initial injection injury is typically associated with inflammation and chemical irritation of underlying tissues. Chemicals can penetrate so deeply into the underlying tissue that disinfecting and cleaning out the wound can be incredibly difficult. If treatment is insufficient or delayed, then complications like secondary infections, gangrene, and compartment syndrome may develop. In severe cases, this may result in the loss or amputation of the affected digit or hand.

High-Pressure Injection Injury Causes: Industries and Workers at Risk

High-pressure equipment is often used in industries such as:

  • Construction
  • Farming and agriculture
  • Industrial, aeronautical
  • CMilitary
  • Auto
  • Manufacturing
  • Engineering

Examples of high-pressure equipment include air or liquid pumps, gas boosters, air amplifiers, and high-pressure valves, fittings, and tubing. These are often used for the administration or injection of paint thinners, water, air, paint, concrete, plastics, grease, fuel, oil, and other liquid solvents. The type of chemical or substance used influences the severity of the injury, with accidents involving oil-based paint and paint thinner usually being more severe than accidents involving grease, air, water, and even diesel.

Workers and laborers most likely to sustain a high-pressure injection are men between the ages of 21 and 59. Research suggests most of the men who sustain these injuries are usually less experienced, with 6 months or less on the job. They are often injured while attempting to clean their equipment using cloth or their own finger.

Are They Really That Serious?

Perhaps the greatest challenge with this type of workplace injury is that it often looks much more benign than it actually is. A small puncture wound from a high-powered piece of equipment might not look all that serious. The injured worker might not even feel much pain from their injury, and instead complain of only mild pressure or numbness. The initial injury might not even bleed. Unfortunately, this seemingly minor presentation can lead to a false sense of security and, unless a workplace has established specific protocols, a worker may delay seeking care.

In fact, research indicates that it takes about eight hours on average for an injured worker to seek medical attention at an emergency department after sustaining a high-pressure injection injury. Unfortunately, waiting this long for help drastically increases the risk of digit amputation. Severe injection injuries treated within six hours have an amputation rate of less than 40 percent. When time to treatment exceeds six hours, the amputation rate increases to 60 percent.

Why do these injection injuries so often result in amputated fingers? 

Beneath a high-pressure puncture wound, there is almost always extensive soft-tissue damage caused by the injected foreign substance. The substance can spread to other areas of the body via small blood vessels. Inflammation can cause swelling and increased pressure, leading to a dangerous condition known as compartment syndrome. Additionally, blood flow to the damaged tissue is often disrupted, which may lead to progressive tissue death or gangrene due to a loss of oxygen-rich blood in the area. 

For this reason, pressure injection injuries should be treated as medical emergencies, and treatment should be prompt. The sooner a person receives appropriate treatment, the less likely it is that more drastic measures like amputation will be required. 

How High-Pressure Injection Injuries Are Treated

In most cases, high pressure injection injury treatment requires surgical debridement—the removal of damaged tissues and foreign substances. During a debridement operation, surgeons make incisions in the skin surrounding the injury to expose the underlying tissue, allowing them to wash the area out with saline (irrigate) and remove as much injured tissue and toxic material as possible. Depending on the severity and nature of the injury, surgeons may delay closing (suturing) the wound and instead perform open wound packing and repeat debridements in order to save the affected finger.

When debridement is not indicated nor successful, amputation of the affected finger may be required. The injured worker may also require IV medications and other services if secondary infections or systemic effects of chemical exposure occur. Since scar tissue and loss of mobility or function is so common after these sorts of injuries, many workers require longer-term treatment such as occupational therapy or physical therapy once they are out of the acute phase of injury. 

Preventing High-Pressure Injection Injury in the Workplace

We know that high pressure injection injuries are rare. But when they do occur, these workplace injuries can be incredibly severe and costly. This is why prevention is so critical for protecting the workforce in any industry where the use of high-powered equipment is expected and commonplace.

Here are a few of the most important things you can do to prevent this injury in your workplace:

  • Ensure all workers are well-trained and educated on how to operate high-powered equipment
  • Ensure workers are well-rested, focused, and prepared for their shifts to reduce the risk of accidents
  • Perform regular maintenance and cleaning on all equipment and watch for any wear, damage, or ill-fitting connections
  • Encourage workers to call attention to any injury, no matter how small or insignificant it may seem
  • Establish and maintain good protocols for what to do when an injury occurs 
  • Use any and all high-powered equipment or machinery per the manufacturer's instructions
  • Never remove protective devices (e.g., spray gun tip guards) from equipment
  • Never attempt to stop a leak or clean a piece of equipment with a finger, hand, or other body part
  • Never attempt to feel for leaks with hands, cloths, or rags
  • Always use the trigger safety on a spray gun when the gun is not in use
  • Stay clear of high-pressure streams and sprays
  • Never aim or point high-pressure devices at oneself or others
  • Do not try to move items with high pressure spray
  • Only use approved extension cords and grounded outlets

Personal Protective Equipment (PPE) That Protects Against Pressure Injection Injuries

In addition to the above-mentioned safety protocols, workers can protect themselves from pressure injection injuries by wearing appropriate PPE. To select the appropriate PPE type and material, check with the equipment manufacturer's instructions and the safety data sheets (SDS) for the substances in use. Gloves are typically mandatory, especially ones that allow for adequate protection and do not sacrifice dexterity and grip. Depending on the solvent or chemical used, disposable gloves are often desirable, as these reduce the risk of cross-contamination. 

In addition to gloves, goggles, protective gowns, face shields, and shoe covers are also frequently used when handling high-pressure equipment. To protect both the worker and the PPE itself, workers should be well-trained in the proper donning, doffing, and storage of these protective garments. 


An injury from a high-pressure device is rare, but it can be serious and should be considered a medical emergency. Young and less experienced male workers seem to be the most likely to sustain these types of on-the-job injuries, which usually impact the fingers or hand on the non-dominant side. Treatment typically requires surgical irrigation and debridement, although amputation of the injured finger or hand might be required, especially if it takes more than six hours to receive medical attention. Fortunately, proper protocols and PPE are proven to prevent pressure injuries in a range of industries. 

If you have questions about protecting your workforce from the devastating effects of high-pressure injection injuries, contact International Enviroguard today and let us help you find affordable solutions.