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Health Risk Assessment. Controlling health risks at work. What is HRA ?. Identifying and Assessing Health Hazards. Selection of team Identifying and assessing Health Hazards Identifying Control Standards Identifying nature and degree of Exposure Evaluating Risk to Health - PowerPoint PPT Presentation
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HRA WorkshopHRA-2 Slide 1
Health Risk Assessment
Controlling health risks at work
HRA WorkshopHRA-2 Slide 2
What is HRA ?
Identify health hazards and their harmful effects (acute/chronic)
Assess the potential risk to the Business by
Plotting each hazard on the RAM
Are Control and Recoverymeasures adequate to
control health risks to ALARP?
Medium or High Risk
Low Risk
Yes
No
Develop and Implement
Remedial Action Plan
Manage for continuous improvement
Don’t know - obtain further information
Review
Document
HRA WorkshopHRA-2 Slide 3
Identifying and Assessing Health Hazards
Selection of team
Identifying and assessing Health Hazards
Identifying Control Standards
Identifying nature and degree of Exposure
Evaluating Risk to Health
Deciding on Remedial Action
HRA WorkshopHRA-2 Slide 4
Selection of team
• Team Leader / Asset owner–Line manager such as OIM, plant manager or representative of facility being assessed
• Team Member – Individuals such as operational staff, line supervisor familiar with plant operation and process
• Local Advisor – Individuals such as medic/OH nurse, HSE advisor, who can advise on the HRA process and exposure controls
• Specialist Staff – Occupational hygienist, OH physician, toxicologist, ergonomist
HRA WorkshopHRA-2 Slide 5
Selection of team
To gather necessary information team members must be able to:
•Observe the activity being performed
•Predict any potential departure from observed practice
•Ask supervisors, staff etc. the relevant questions
•Undertake simple diagnostic tests
• Identify and review relevant technical literature
•Gather the information systematically
• Form valid, justifiable conclusions about exposures and risks
HRA WorkshopHRA-2 Slide 6
How to select Assessment Units
The assessment unit is what is within the boundaries of the HRA
Assessment units should be self-contained, either physically or as a process
It should cover all aspects of the working environment
The nature and the severity of the hazards and risks involved, the familiarity of the task, available resources and country-specific requirements should be taken into account
HRA WorkshopHRA-2 Slide 7
Organisation and Preparation
Collect pre reading material and references such as: Plans and drawings for plant specificationsIncident / injury reports (incl. occupational
illnesses) and incident investigationsPlant and equipment fault reports Maintenance records for control measuresRecords of health surveillance and sickness
absenceOccupational hygiene surveys, health and safety
surveys Minutes of health and safety committee meetings
HRA WorkshopHRA-2 Slide 8
What are Health Hazards
A Health Hazard has the potential to cause harm to health
Health hazards may be divided into the following groups: chemical biological physical ergonomic psychological
HRA WorkshopHRA-2 Slide 9
Health hazards of primary concern
Cause fatalities in the short or long term e.g. infectious diseases (short term), carcinogenic
substances (long term) Expose the company to substantial future social
and monetary liabilities e.g. noise induced hearing loss, repetitive strain injury,
psychological stress Cause minor health effects which could cause
severe business disruption e.g. major food poisoning outbreak
HRA WorkshopHRA-2 Slide 10
How to identify Health Hazards
Walk through surveys Looking, smelling, talking, listening; use your senses!
Refer to Health Hazard Inventories
Use HRA Yellow Guide, appendix 2
Look at Recordsincident/fault reports, inspections, maintenance,
sickness absence, hygiene surveys, operating procedures
Use experience from elsewhere
HRA WorkshopHRA-2 Slide 11
Types of Effects
Acute, immediate• Lung, skin or eye damage from corrosive liquid
Acute, late onset• Sick building syndrome
Chronic, intermittent / on-off• Repetitive Strain Injury
Chronic permanent• Lung cancer
HRA WorkshopHRA-2 Slide 12
Identify Health Hazards and their harmful Effects
Agent
Silica dust (crystalline)
Used mineral oils
Noise
Heat
Legionella bacteria
Repetitive movements
Source
Refractory bricks
Engine oil
Process noise above 85dB(A)
Plant heat
Spray cooling towers
Workplace design
Route
Inhalation
Skin
Hearing
Whole body
Inhalation
Whole or part of body
Harmful Effect
Lung disease (silicosis)
Dermatitis, cancer
Hearing Loss
Heat stress, heat stroke
Legionnaire’s Disease
Musculo-skeletal disorders
HRA WorkshopHRA-2 Slide 13
Cumulative exposureIndividual susceptibilityThreshold levelsKnowledge gapsWorkstyle changesReal world practices
Factors influencing the Relationship between
Hazard and Risk
HRA WorkshopHRA-2 Slide 14
Assigning Hazard Ratings
Hazard Rating Definition Consequence Category (harm to people)
1Slight health effects: Not affecting work performance or causing disability, e.g. non toxic dusts (as an acute hazard)
2Minor health effects: Agents capable of minor health effects which are reversible, e.g. irritant and defatting agents, many food poisoning bacteria
3Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling tasks, hand/arm vibration, chemicals causing systemic effects, sensitisers
41 to 3 fatalities or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), heat, cold, psychological stress
5Multiple fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (hydrogen sulphide, carbon monoxide), known human carcinogens (large exposed population)
HRA WorkshopHRA-2 Slide 15
Hazard Ratings
Consider Harm to:
PeopleAssetsReputation
Select the category with the highest
consequence rating!
HRA WorkshopHRA-2 Slide 16
Risk Assessment Matrix
The Risk Assessment Matrix (RAM) is the tool which allows assessment of the risk to the business from each identified health hazard
It will assist you in prioritizing potential health risks and determine which risks need documented demonstration of controls
Ensure that health risks are assessed properly by taking into account acute and chronic harmful health effects
HRA WorkshopHRA-2 Slide 17
Increasing Probability A B C D E Never heard of in
the world
Heard of incident in our industry
Incident has occurred in Shell
company
Happens several times per year in Shell company
Happens several times per year in
our location
1 Slight Injury/Illness
2 Minor Injury/Illness
3 Major Injury
4 1-3 fatatlities
5 Multiple Fatalities
Categories LOW MEDIUM HIGH Area 1 Area 2 Area 3
ConsequenceConsequence
Estimate of what could Estimate of what could happen (happen (acute and chronicacute and chronic))
LikelihoodLikelihood
AcuteAcute - Estimated on the - Estimated on the basis of experience and basis of experience and or evidence that a certain or evidence that a certain outcome has previously outcome has previously occurredoccurred
Chronic Chronic - Estimated - Estimated based on the historical based on the historical evidence that excess evidence that excess exposure has occurredexposure has occurred
Health Risk = Consequences X Probability (Likelihood)Health Risk = Consequences X Probability (Likelihood)
HRA WorkshopHRA-2 Slide 18
Increasing Probability
CONSEQUENCE A B C D E
HAZARD RATING
People
Assets
Reputa-
tion
Never heard of in the world
Heard of incident in our Industry
Incident has occurred in Shell company
Happens several times per year in Shell company
Happens several times per year in our location.
1 Slight health effect
Slight damage
Slight impact
LOW RISK
2 Minor health effect
Minor damage
Limited impact
3 Major health effect
Localised damage
Considerable impact
MED. RISK
4 PTD* or 1 to 3 fatalities
Major damage
Major national
HIGH RISK
5 Multiple fatalities
Extensive damage
Major int’national
* PTD = Permanent Total Disability
Note: Environment consequence column omitted
Manage for continuous improvementManage for continuous improvement
Incorporate risk reduction measuresIncorporate risk reduction measures
Intolerable – investigate alternativesIntolerable – investigate alternatives
Risk Assessment Matrix
HRA WorkshopHRA-2 Slide 19
Health Hazard Examples of situations or activities in which the health hazard may
occur
Harmful health effects from over exposure
(Consequences)
Consequence Category (harm to
people) - C
Likelihood - L
RAM Risk Rating (C x
L)
Chemical Hazards
Asbestos Materials containing asbestos, for example, gaskets, ceiling tiles, partitians, insulation
Acute: Mildly Irritating to eyes and respiratory tractChronic: Category 1 carcinogen
Cat 1 Carcinogen: 4/5
C
5C - High
Benzene Processing, handling and distribution of benzene containing process streams and products, e.g. naphthas, platformate, condensate, gasoline.
Acute: Irritant to eyes and respiratory tract; narcotic to CNS.Chronic: Category 1 carcinogen
Cat 1 Carcinogen:
4/5
B
5B - Medium
Ethylene oxide Shell chemicals marketed product and process material
Acute: cold burns to skin and eyes. Shortness of breath, dizziness and drowsiness on inhalation. May cause pulmonary oedema. Chronic: Category 2 carcinogen and mutagen
Cat 2 Carcinogen:
4/5
B
4B - Medium
Epoxy Resins Contained in some adhesives (maintenance) Acute: Irritant to skin and eyesChronic: skin sensitiser
Sensitiser: 3
C
3C - Medium
Hydrogen sulphide Waste gas stream; sour crude oil; condensates; bitumen and fuel oil tank head spaces
Acute: Chemical asphyxiant causing respiratory paralysis.Chronic: n/a
Chemical
asphyxiant: 5
C
5C - High
Generic RAM HRA outcomes
HRA WorkshopHRA-2 Slide 20
Low RAM Ratings
Manage for continuous improvementvia standard procedures and
competences in HSE-MS (ensure these are adequate)
ensure Exposure Limits and other control standards are met
HRA WorkshopHRA-2 Slide 21
Medium and High RAM Ratings
Detailed review of controlsStandards of controlWho is exposed and whenEstimate or measure exposureCompare existing controls against standards (are
OELs met and risks As Low As Reasonably Practicable - ALARP?)
Consider need for routine exposure monitoring and/or health surveillance
For risks assessed as Highgive serious consideration to alternative ways of
carrying out the operation
HRA WorkshopHRA-2 Slide 22
Control and Recovery
Identify exposureHierarchy of controlsControl standardsUse of control chart for individual riskApply ALARP principleExposure measurementsHealth Surveillance
HRA WorkshopHRA-2 Slide 23
What is exposure?
Exposure is defined as:The amount of the hazard to which a person has been exposed(dose). This is a combination of the magnitude, frequency and duration of exposure
HRA WorkshopHRA-2 Slide 24
Exposure
DurationFrequencyMagnitude (extent of exposure) is affected
by:Concentration/intensity of the agentWork practicesAgent’s physical characteristic impacting on the
exposure routeExisting controls
HRA WorkshopHRA-2 Slide 25
Lung
Ear Eye
Skin
NoseMouth
Musculo-skeletal
Whole body
Exposure routes
HRA WorkshopHRA-2 Slide 26
Hazards and Exposure routes
Hazard Exposure routeNoise ear
Chemical Liquids skin (through uptake of the skin, or through injection)Eye transferred from hand to mouth ingestion
Chemical gases, vapours and dusts nose, mouth, lungs – inhalation
Chemical dusts trapped in the nose and throat, or transferred from hand to mouth, leading to ingestion
Vibrations whole body or specific parts e.g. hands, eyes
Heavy lifting & other ergonomic hazards
muscoloskeletal system
HRA WorkshopHRA-2 Slide 27
Lung Heart
Digestive tractLiver
Kidneys
EarEye
Skin
NoseMouth
Central nervous system
Musculo-skeletal system
Reproductive system
Target Organs
HRA WorkshopHRA-2 Slide 28
Hazard, exposure route and target organ
Hazard Exposure route Target organ
Noise Ear Ear
Chemical liquids and dusts
(hazard dependent on the specific chemical)
Inhalation, skin, eye Direct contact with lungs, skin and eyes. May also be absorbed in blood stream and carried to susceptible organs: central nervous system, reproductive system, kidney, liver
Stress Mind Heart, mental impairment
HRA WorkshopHRA-2 Slide 29
Factors Affecting Intake for chemical and biological
agentsPhysical form
Gas/vapour/liquid/solid Particle size Particle shape
Solubility Carriers
Breathing rate
HRA WorkshopHRA-2 Slide 30
Identify who is exposed
Typical Job Types Plant Operators - divided by operational group
Road Tanker Drivers - divided by product group
Maintenance Staff - mechanical, electrical, vehicle etc.
Cleaning Staff - plant and/or office
Laboratory Technicians - sub-divide as appropriate
Administrators - office based with minimal plant exposure
Field Staff - geologists
HRA WorkshopHRA-2 Slide 31
Identify tasks:Use workplace experienceReview historical recordsDiscuss with staff involved in doing the taskVisit work area/walk through survey
Include tasks involved in:Normal operationsMaintenanceAbnormal conditions and foreseeable emergencies
Estimate exposure level
HRA WorkshopHRA-2 Slide 32
Estimate exposure level
What is a ‘task’ ? An activity which a competent person can be instructed to do in a single sentence
A plant operator could be asked to take a process stream sample
A plant cleaner could be asked to deal with a spillage
A fitter could be asked to take a pump out of service
A laboratory technician could be asked to analyse a sample for benzene content
HRA WorkshopHRA-2 Slide 33
Estimate exposure level
Review tasksFrequency, duration and estimates of concentration/intensity of exposure Work practices and existing controls
Effectiveness of existing control measures
Compare existing controls against relevant control standardsWho else is exposed?
Employees, contractors, third parties
HRA WorkshopHRA-2 Slide 34
Exposure may be acceptable when: evidently so operations are in accordance with suppliers’
documented procedures previous measurements under similar or worst
case conditions indicate low exposure process operated in accordance with
recognised guidance on good practice
Estimate exposure level-without exposure measurement
HRA WorkshopHRA-2 Slide 35
Exposure may be unacceptable when: there is evidence of fine dust deposits fume or particles are visible in light beams there are broken, defective or poorly maintained
controls the process is not operated in accordance with
recognised guidance on good practice complaints are made of discomfort or excessive odour ill-health related to exposure is detected
Estimate exposure level-without exposure measurement
HRA WorkshopHRA-2 Slide 36
The hierarchy of controls is a list in preferential order of the means by which exposure to health hazards can be controlledEliminationSubstitution (alternatives)Engineering (plant and equipment)ProceduralPersonal protective equipment
Hierarchy of controls
HRA WorkshopHRA-2 Slide 37
Types of controls
Elimination and substitutionEngineering (plant and equipment):
Equipment/processes designed to prevent or minimize release of the hazard
Examples: containment (enclosure), exhaust ventilation, remote venting/vapor recovery systems
HRA WorkshopHRA-2 Slide 38
Types of controls
Procedural: Safe systems of work / Permit to work system
Record systems
Staff Instruction, Information & training
Supervision, Emergency arrangements
Personal Protective Equipment (PPE): Respiratory & Skin Protection as a secondary line of defence or as the only option
HRA WorkshopHRA-2 Slide 39
Effectiveness of Controls
The types of control vary in their effectiveness according to the control hierarchy:
Elimination Most Effective
Substitution
Engineering
Procedural
PPE Least Effective
HRA WorkshopHRA-2 Slide 40
Control selection
Control selection to achieve ALARP must consider the control effectiveness and cost:
consider the most effective controls first
limit PPE to:
-infrequent tasks
-temporary use until more effective controls are in place
-as a precaution should other controls fail
HRA WorkshopHRA-2 Slide 41
Maintenance of controls
Controls are only effective if they workEngineering controls
Preventive maintenance, inspections and tests
Procedural controlsRecord systems, information and training
Effective supervision
PPERoutine maintenance, inspection and training
Emergency measuresInspections and realistic exercises
HRA WorkshopHRA-2 Slide 42
Control standards
Occupational Exposure Limits (OELs)
Specifications for control:Engineering Control Standards (SES, DEP)
Procedural (manufacturer’s/supplier’s info/industry good practice)
Personal Protective Equipment
National, Company, Group, Industry and International Standards
HRA WorkshopHRA-2 Slide 43
Chemical agentsOccupational Exposure Limits are levels of airborne
concentrations of hazardous compounds that are considered safe for the workplace
OEL’s and recommendations are set by competent national authorities
OEL’s are normally used for chemical agents, but the concept can also be applied for physical, biological and psychosocial agents and for ergonomics
What are exposure limits?
HRA WorkshopHRA-2 Slide 44
Physical Agents, e.g.Shell ‘Noise Guide’ recommended criteria
Daily Noise Dose - 85 dB(A) Leq
Design Limit - 85 dB(A) at 1 meterCold stressIonising radiationHeat stressLasersVibrations
Occupational exposure limits
HRA WorkshopHRA-2 Slide 45
Biological agentsControl to as low as reasonably practicable
Ergonomics
Include ergonomic principles to all work activities
PsychologicalRefer to specialist for evaluation and treatment
Occupational exposure limits
HRA WorkshopHRA-2 Slide 46
Engineering control standards
Face velocities of Lab Hoods should meet recognized design standardsRotating equipment mechanical seals that do not leak Transfer lines/hoses with disconnect fittings that do not leakCapture velocities for welding hoods meet recognized ventilation standardsEngineering controls are inspected regularlyEngineering controls are on a PM (preventive maintenance) schedule
HRA WorkshopHRA-2 Slide 47
Procedural standards
written procedures for tasks involving exposure (permit to work system)
procedures include work practices that minimize exposure
work practices are understood (e.g. training & validated by testing) and followed by employees (supervision, validated by auditing)
HRA WorkshopHRA-2 Slide 48
Personal Protective Equipment
respirators
gauntlets (gloves)
goggles
protective clothing
foot protection
HRA WorkshopHRA-2 Slide 49
Personal protective equipment
Adequate use of PPE includes an assessment of:
• PPE requirement for each task
• PPE selection to match the hazard
• PPE is practical & functional for the task
• PPE requirements are understood by employees (e.g. training & validated by testing)
• PPE is used correctly (e.g. training & validated by audit))
• PPE is used when required (validated by audit)
• PPE is inspected and maintained regularly (validated by audit)
HRA WorkshopHRA-2 Slide 50
Are controls meeting the control standards?
Control chart: tool for decisionsUse of information on exposures and
controlsCombining ‘hazard rating’ and
‘exposure rating’
Use of Control Chart
HRA WorkshopHRA-2 Slide 51
HAZARD RATING DEFINITION (Consequence Category: Harm to People)
1 Slight health effects: Not affecting work performance or causing disability, e.g. non toxic dusts (as an acute hazard)
2 Minor health effects: Agents capable of minor health effects which are reversible, e.g. irritant agents, defatting agents, many food poisoning bacteria
3 Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling tasks, hand/arm vibration, chemicals causing systemic effects, sensitisers
4 One to three fatalities or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), sensitisers where the onset of sensitisation threatens continuing employment, heat, cold, psychological stress
5 Multiple fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (hydrogen sulphide, carbon monoxide), known human carcinogens (large exposed population)
Hazard rating categories
HRA WorkshopHRA-2 Slide 52
Exposure Rating Exposure Band
Definition
a) Very Low < 0.1 x OEL Exposures are negligible
b) Low > 0.1 - <0.5 x OEL
Exposure are controlled well below OEL and are likely to remain so in accordance with standards
c) Medium > 0.5 – 1 x OEL
Exposures are currently controlled below OEL to meet standards but control may be reliant on less robust measures such as personal protective equipment
d) High > OEL Exposure are not adequately controlled to meet standards and continuously/regularly exceed OEL
e) Very High >> OEL Exposures are excessive and will almost certainly result in health damage to persons exposed
Exposure Rating
HRA WorkshopHRA-2 Slide 53
Exposure Rating
Hazard Rating Very Low (a)
Low (b)
Medium (c)
High (d)
Very High (e)
1 No immediate Third Second Priority
2 action required priority
3 First Priority
4 for
5 Action
Exposure Band (1)
<0.1*OEL (2) 0.1*OEL - 0.5*OEL
0.5*OEL - 1*OEL > OEL >> OEL
1. reference to exposure bands is a qualitative estimate only where no exposure data are available 2. OEL: Occupational Exposure Limit
Control Chart
HRA WorkshopHRA-2 Slide 54
Evaluate the Adequacy of Controls
What is the nature of the hazard to health ?
Use Hazard Rating (RAM Consequence Category)
What is the nature and degree of exposure for the task ?
Assign Exposure Rating
Combine in Control Chart
HRA WorkshopHRA-2 Slide 55
Remedial Action Plan
The Remedial Action Plan must cover:
Recommendations divided into four levels of action (first, second, third priority and no immediate action required)
Is recommendation agreed or not? Responsible person Due date
HRA WorkshopHRA-2 Slide 56
Actions Control Chart (1)To aid priority setting
Action 1st priority Stop the exposure; notify management immediately Identify all sources Implement immediate control improvements e.g. PPE Consider need for exposure measurement Identify and implement work practice and control
improvements Review HRA, including measurements
HRA WorkshopHRA-2 Slide 57
Actions Control Chart (2)To aid priority setting
Action 2nd priority Reduce exposure to below OEL (Hazard Ratings 1-2) Consider reducing to below 0.5 x OEL (Hazard Ratings 3-5) Identify and implement work practice and control
improvements (*) Consider need for exposure measurement (*) Review HRA, including measurements (*)
Action 3rd priority Actions with asterisk under 2nd priority
Action – No Immediate Action Required Normally no need for immediate action to improve controls.
Manage for continuous improvement
HRA WorkshopHRA-2 Slide 58
Definitions of ALARP“ balancing the reduction in risk against the time, difficulty and cost of achieving it”
This level represents the point, objectively assessed, at which the time, difficulty and cost of further reduction measures become unreasonably disproportional to the additional risk reduction obtained.
ALARP Definition
HRA WorkshopHRA-2 Slide 59
ALARP is influenced by the following factors:
risk to be avoided
sacrifice involved in taking measures to avoid the risk (money, time and trouble)
comparison of the two
ALARP
HRA WorkshopHRA-2 Slide 60
List the measures that have been taken to
reduce the risk
Go on to identify an additional option which
might be introduced to reduce the risk further
Give reasons why this additional control is not
adopted
ALARP- rule of thumb
HRA WorkshopHRA-2 Slide 61
••
••
•
•
Risk toHealth
Tolerability level
Cost ofControl
ALARPLegal Liability Wasteful
ALARP
HRA WorkshopHRA-2 Slide 62
Is risk to health ALARP?Yes, when only a small reduction in risk would require
an unreasonable amount of time, trouble, difficulty or cost.
OtherwiseSelect appropriate additional controls/barriers
consideringHierarchy of controls including recovery preparedness
measuresOther measures like: measurements, monitoring, health
surveillance, maintenance of controls, instruction & trainingPriorities for implementation
What remedial action?
HRA WorkshopHRA-2 Slide 63
Identify who may be exposed to health risksIdentify the relevant exposures to
individuals in the workplaceAssess your work environment to determine
when you need to do exposure monitoring/measurements
Exposure measurements
HRA WorkshopHRA-2 Slide 64
Verification of the efficiency of control measuresJustification for additional control measuresChoice of control measures (eg for noise
control)To establish and document historical records of
exposure levels for all workersTo ensure and demonstrate compliance with
regulatory and other exposure guidelinesEpidemiological studies or investigating
reported health effectsTo alleviate employee concerns
Purpose of exposure measurements
HRA WorkshopHRA-2 Slide 65
Baseline - to define range and distribution of exposure for defined jobs
Worst case – to identify potentially high exposure
Detailed – when baseline study provides insufficient data
Routine – periodic exposure monitoring to check that control measures remain effective
Compliance - to ensure that exposure is below regulatory and other guidelines
Objectives of exposure measurement
HRA WorkshopHRA-2 Slide 66
Personal Monitoringworker exposure with normal work procedurebreathing zone for inhalation exposurenear ear for noise exposurefull shifts / task samples
Area (Environmental) Monitoringcontaminant concentration in work areaplant conditionseffectiveness of controls
Monitoring methods
HRA WorkshopHRA-2 Slide 67
Biological MonitoringDetermine body absorption of potentially
hazardous substance from all sourcesMeasure changes in the composition of
body fluid, tissue or expired airMay be used to indicated inadequate
control, improper work procedureProvides accurate information about the
absorbed dose of a substance in the bodyNot all substances have a method or a BLV
(biological Limit Value)
Monitoring methods
HRA WorkshopHRA-2 Slide 68
Where to SampleWhen to SampleWhom to SampleHow long to SampleHow many samples to take
Sampling Strategy
HRA WorkshopHRA-2 Slide 69
Monitoring and health surveillance aims to (periodically) assess exposures and health in order to
Confirm the effectiveness of existing control measures
Collect data for the detection and evaluation of hazards to health
Confirm compliance with predetermined criteria
Required by law
Health Surveillance
HRA WorkshopHRA-2 Slide 70
Medical Surveillance selection criteria
Is there a risk to health (based on HRA)
The prevention/intervention potential ("can we do something about it?")
Can we detect it?
Are the detection methods suitable?
Medical Surveillance
HRA WorkshopHRA-2 Slide 71
Document & Review HRA
Appropriate Depth of Records
Linked with Medical Records
Informing Staff
Archiving of Records
Reviewing Records
HRA WorkshopHRA-2 Slide 72
Appropriate Documentation
Records should: be retrievable
Internal/external audits, authorities and review
meet legal requirements be detailed enough to ensure audit trail on how
conclusions were reached allow traceability from individual name via Job Type to
tasks include exposure monitoring and health surveillance
HRA WorkshopHRA-2 Slide 73
Informing Staff of Findings
Involves staff in HRA process Ensures that:
Health risks are understood Control measures are used Staff can alert assessment teams on
changes
May be a legal requirement
HRA WorkshopHRA-2 Slide 74
Archiving of Records
As required by local law and/or practice 30 - 40 years are typical
Allows for re-introduction of old processes
HRA WorkshopHRA-2 Slide 75
Reviewing HRAs
Senior management will confirm the status of HRA through HSE annual letter
Action Items Short term reviews of action items
Against target dates and responsible persons
Change in process, hazard, legislation etc Change in controls New information on the effect
Incidents, illnesses, complaints, new knowledge On an agreed cycle
Between 1 and 5 years dependent on risk