Occupational Health & Industrial Hygiene ManagementFFBL – HSE Seminar

Dr. Tahir Baig Barlas

OHSE - Consultant

Barlas HSE Solutions, Systems Certification & CSR Consultancy

Services

WHO AM I ?• Ex – Corporate HSE Manager Azgard9

Group

(Pak American Fertilizers & Textile

Business)

• Ex – GM HSE PIA

• EX- Country Corporate HSE Manager

Shell Companies in Pakistan

• Ex- Occupational Health Physician ICI

Pakistan

• Visiting HSE Consultant PSTD

• OHS Training Resource – ILO Turin Italy

What HSE is all ABOUT!

Harry, age 16, 1908. Pulled into machinery in a factory. His arm was ripped off at the shoulder and his leg

broken.

Goal of no harm to People

Manage all HSE Risks

HRA of HSE Critical Activities

Implementation of Standards

LOCAL LAGISLATION

HSE POLICY

OHSAS 18001/ ISO14001

MHMS

HEALTHHEMP / MHMS

HSE-MS

DRIVERS OF OCCUPATIONAL HEALTH PROGRAM

Aims of Occupational HealthPromote and maintain highest degree of physical, mental

and social well-being of workers in all occupations;Prevent among workers all departures from Health

caused by their working condition;Protect workers in their employment from risks resulting

from factors adverse to health; and,Place and maintain the worker in an occupational

environment adapted to his physiological and psychological capacity.

Prediction of health outcomes!

There are generally two adopted views on Occupational Health:

Restricted or workplace focused Wider view to include the

workplace and the communities in and around the work site.

Occupational Health Perspectives

Focus of Occupational Health

1. The maintenance and promotion of worker’s health and working capacity

2. The improvement of the working environment and work to become conducive to safety and health

3. Development of work organizations and working cultures in a direction which supports health and safety at work and in doing so also promotes a positive social climate and smooth operation and may enhance productivity

Focus of Occupational Health

HEMPHEMP

Leadership and Commitment

Policy and Strategic Obj.

Management Review

Corrective Action &Improvement

Audit

Org., Resp., Resources Standards. & Doc.

Corrective Action &Improvement

Monitoring

Planning & Procedures

Hazard and Effects Management

Implementation

Corrective Action

HSE Management SystemHazard and Effects Management Process

HRA

IDENTIFY ASSESS

CONTROLRECOVER

HEMPHEMP

Structure of HEMP

Identify Are people, environment or assets exposed to potential harm ?

AssessWhat are the causes and consequences ?How likely is loss of control ?What is the risk and is it ALARP ?

Control Can the causes be eliminated ?What controls/barriers are needed ?How effective are the controls/barriers ?

RecoverCan the potential consequences or effects be mitigated ?What recovery measures are needed ?Are recovery capabilities suitable and sufficient ?

Hazards and Effects Management (HEMP)

What is Health?What is Health?

Health is defined as:

• “Health is more than the absence of sickness! It is a state of spiritual, mental and physical well-being, which enables a person to face any crisis in life”

• Pericles, 430 B.C.

Health is defined as:

• “Health is more than the absence of sickness! It is a state of spiritual, mental and physical well-being, which enables a person to face any crisis in life”

• Pericles, 430 B.C.

Health is a state of spiritual, mental and physical well being

What Determines Your Health?What Determines Your Health?

• Who you are (PREDICT) your genes

• Your Lifestyle (PROMOTE) diet - stress - smoking - exercise - alcohol -

drugs

• Your Environment (PROTECT) domestic - workplace - leisure

What factors affect HEALTH?

“ Health is too important to leave it to the Doctors ”

A Few General ThoughtsA Few General Thoughts Occupational health involves predicting

vulnerabilities, promoting good health and protecting the workforce.

Exposure levels in the workplace can be much higher than those in general environment.

Occupational health deserves more focus because ill-health effects may not manifest for a long period of time.

The Health Risk Assessment identifies, evaluates and seek ways to control the impact of occupational hazards to the worker; hence preventing illnesses acquired through such direct workplace exposures

A responsible company goes beyond occupational health to promote general health and well-being

Health Risk Assessment

A structured approach to identifying evaluating and controlling health hazards in the workplace

The 4 steps of HEMP when applied through the HRA tool identify and assess health risks, and specify appropriate exposure control and recovery measures.

It addresses full range of health effects and takes account of both probability and level of exposure to health hazards.

HEMPHEMP

IDENTIFY ASSESS

CONTROL RECOVER

HEMPHEMP

HRA

HEALTH HEMP

Hazards and Risks

• Hazard– Potential to cause harm

• Exposure (Contact with hazard)– How much?

– How long?

– How frequent?

• Risk– Likelihood that a hazard

will cause harm

– Hazard x Exposure

No Hazard = No Risk

Hazard, but No Exposure = No Risk

Health Risk = Hazard x Exposure

Types of Health Hazards

Chemical Biological

Ergonomic

Psychological

Physical

Noise, heat, radiation, vibration, extreme temperatures,

Noise, heat, radiation, vibration, extreme temperatures,

Gases, dust, metals, solvents, which may be present in the working environment as gases, vapours, mists/aerosols, fumes, dusts, liquids or solids.

Gases, dust, metals, solvents, which may be present in the working environment as gases, vapours, mists/aerosols, fumes, dusts, liquids or solids.

Bacteria, fungi, viruses, insects and mites, moulds, yeast, related to the working environment

Bacteria, fungi, viruses, insects and mites, moulds, yeast, related to the working environment

Workplace layout, manual handling, body posture and movement, micro environment, RSI, operations, tasks and jobs

Workplace layout, manual handling, body posture and movement, micro environment, RSI, operations, tasks and jobs

Psychological Stress, human interactions workplace relationships.

Psychological Stress, human interactions workplace relationships.

Occupational Chemical Exposure

Physical & Chemical Hazards

Welding fumes; noise

Heat

Dust; noise Dermatitis

Ergonomics Risks

• Manual Handling– Lifting

– Carrying

– Pushing

– Pulling

– Moving

– Twisting

– Stretching

RSI – Repetitive Strain Injuries

• Pain and discomfort

• Heaviness

• Pins - needles sensation

• Numbness

• It even disturbs sleep

• Muscle weakness

Cause and Effect

CAUSE

EFFECT

SAFETY

CAUSE

EFFECT

Heredity

LifestylePreviousExposures

Time

Dose

HEALTH

Cause iseasy to see

Cause ishard to see

Minutes Days Months Years Decades

Accidents

Welder’s Flash

SolventEffects

Fume fevers

Musculo-skeletal disorders

Dermatitis

Stress

Noise InducedHearing Loss

Mesothelioma

Lung cancer

Leukaemia

Cause and Effect of work related injuries and diseases

Key Elements of Occupational Health Program

1. Health Risk Assessment (HRA)

2. Monitoring of Health Performance and Incident Reporting & Investigation

3. Fitness to Work (FTW)

4. Product Stewardship

5. Local Health Facilities and Medical Emergency Response

6. Wellness Program – Healthy Lifestyle Workshops, Stress Management Program, Well Women’s Clinic, Travel Health Clinic

Comprehensive Occupational Health

Program

Health Risk Assessment

Identify Health Hazards & 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

Routes of intake

• Routes of intake of agents into the body– Inhalation– Skin– Ingestion– Injection– Whole body

Basic Physiology

Lung Heart

StomachLiver

Kidneys

Ear Eye

Skin

NoseMouth

Biological Hazards• Insect-borne diseases

– malaria, leptospirosis, dengue

• Water-borne diseases– legionella

• Food borne diseases– typhoid, dysentery, food

poisoning

• Infectious diseases– HIV, Hepatitis Malaria

Legionnaire’s disease

Ergonomics & Psychological Hazards

WORKLIFE BALANCE

“You spend half your life sacrificing your health to earn moneyAnd the other half of your life spending the money you have earned

to regain your health”

Assigning an Agent Hazard RatingHAZARD RATING

1

2

3Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling taks, hand/arm vibration, chemicals causing systemic effects, sensitisers

4Fatality 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

5Multiple Fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (H2S, CO), known human carcinogens (large exposed population)

DEFINITION in terms of potential to cause harm

0 No injury or damage to health

Slight health effects: Not affecting work performance or causing disability - non toxic dusts (as an acute hazard)

Minor health effects: Agents capable of limited health effects which are reversible, e.g. irritant agents, defatting agents, many food poisoning bacteria

Assigning an Exposure Rating

EXPOSURE RATING DEFINITION

VERY LOW (A) Exposures are negligible

LOW (B) Exposures are controlled and likely to remain so in accordance with screening and performance criteria

MEDIUM (C) Exposures are currently controlled to meet screening and performance criteria but control cannot be assured

HIGH (D)Exposures are not adequately controlled to meet screening and performance criteria and continuously/regularly exceed Occupational Exposure Limits

VERY HIGH (E) Exposures are excessive and will almost certainly result in health damage to persons exposed

Risk Assessment MatrixIncreasing ProbabilityConsequence

A B C D E

Never heard

of in our Industry

Low

Massiveeffect

Major effect

Localisedeffect

Minor effect

Environment

Extensivedamage

Majordamage

Localisddamage

Minordamage

No damage

AssetsPeople

Noinjury

Minorinjury

Majorinjury

Single fatality

Multiplefatalities

Rating

1

2

3

4

5

Heard of incident in our

industry

Incident has

occurredin our

company

Happensseveral times

per yearin Co.

Happensseveraltimes

per yearat locn.

Slight effect

0

Reputation

Slight damage

Slight injury

No effect

Major international

Considerableimpact

Limitedimpact

Slight impact

No impact

High

MediumMajor national

Reliability Cost

EliminationSubstitutionEngineeringProceduralP.P.E.

The Hierarchy of Controls

ALARP ?

••

••

•

•

Risk toHealth

Tolerability level

Cost ofControl

ALARPLegal Liability Wasteful

What is ALARP ?

• As Low As Reasonably Practicable– Five factors to consider

• COST - The amount of money required to combat a slight possibility of risk is limited

• OBVIOUSNESS - The more obvious the risk the greater the potential liability

• INHERENT RISK - All work carries risk to some extent which is irreducible or irremovable and for which the employer cannot be held liable

• LIKELIHOOD OF INJURY - The greater the risk, the greater the liability

• SERIOUSNESS OF INJURY - The more serious the consequence the more precautions should be taken

EXPOSURE RATING

Very Low Low Medium High Very High

a b c d e

1

2

3

4

5

Exposure band < 0.1 x OEL0.1 x OEL to 0.5 x

OEL0.5 x OEL to 1 x

OEL> OEL >> OEL

Haza

rd R

ating

Control ChartControl ChartControl ChartControl Chart

No Immediate

Action Required

Third

Priority

Third

Priority

Second

Priority

Second

Priority

First Priority

For

Action

Comprehensive Occupational Health

Program

Monitoring of Health Performance and Incident Reporting &

Investigation

Exposure Measurement

• Baseline Survey– May include worst case

• Detailed Survey– To define the degree and pattern of exposure

• Routine Exposure Monitoring– Monitoring as a control/barrier in its own right

• Competence

When to Measure Exposure ?• An agent has irreversible effects (e.g. carcinogens)

• Justification for additional control measures

• Choice of control measures (e.g. for noise control)

• Verification of the efficiency of control measures

• Employee concerns are expressed

• Legal / Customer requirements• Epidemiological studies

Health Surveillance• Audiometry Program• Spirometry Program• Biological Monitoring Program• Drugs & Alcohol Abuse Program

– keep records on individual exposures

– Develop Work History of Employee Exposure

• use medical or biological procedures to identify significant abnormalities as early as possible

• consider appropriateness of test procedures

Comprehensive Occupational Health

Program

Fitness to Work (FTW)

Employee selected for position for which fitness to work

medical evaluation is required

Initial screening evaluation

No medical concerns

Fit for task

Further evaluation required

Detailed medical and task assessment

Unfit for

task

Accommodation process

Periodic review

With cause evaluation

 

Fitness to Work (FTW)

Comprehensive Occupational Health

Program

Health Facilities and Medical Emergency Response

3 Pillars and 7 Principles of SD

PurposeEarning our right to grow

Meeting Profit

Targets

Delivering Value to Customers

Reducing Impact on the Environment

Using Resources Efficiently

Respecting and Safeguarding People

Contributing to Communities

Building Stakeholder

Relations

Philosophy of HSE Management Systems – Continuous Improvement!

Thank you for your attentionAny Questions!