What's the Impact of Safety Footwear on Workers Concerning Foot-Related Problems? A Systematic Review

Background: This study aims to assess the impact of safety footwear (SF) on workers concerning foot-related problems, especially regarding discomfort, foot pain, and skin lesions. Methods: A literature search of PubMed, Embase, Scopus, and Cochrane databases was performed according to PRISMA guidelines. Studies reporting foot-related problems in workers wearing SF were included. Exclusion criteria included non-English papers, reviews, laboratory and animal studies, expert opinions, letters to the editor, and grey literature. The quality assessment was performed using the Newcastle-Ottawa Scale. Descriptive statistic was used to present data. Result: The initial search results yielded 483 articles; 7 articles were included in the review process. Despite the extensive variety of SF, all studies consistently reported symptomatic discomfort and pain. The discomfort factors included heat, sweating, heaviness, and footwear flexibility, with primary issues in the toes, toecaps, or metatarsal-toe crease region. The pain prevalence ranged from 42.3% to 60.8% in various anatomical regions. Irritant Contact Dermatitis was the most common (97.9%) foot dermatosis, but other foot lesions were reported: dry skin (30.2%), calluses (30%), hard nails (28%), corns (27%), and blisters. Conclusions: Current SFs are designed to comply with safety regulations but are influenced by the frequent occurrence of discomfort and foot problems. The literature review identified weaknesses in certain design features. Recommendations have been proposed to improve SF development. These include addressing issues such as the selection of specific types and designs of SF based on task performance and the working environment, footwear weight, and breathable materials for moisture permeation. Considerations should also encompass distinct sizing for an optimal fit, insole application, especially for prolonged standing users, and education programs to prevent foot-related issues.