CHAPTER 4HEALTH HAZARDS

LECTURED BY:

MOHD HADRI MOHAMED NOR

SUBTOPICSUBTOPIC

4.1 Introduction to Health Hazard and Hygiene4.2 Chemical Hazards4.3 Physical Hazards 4.4 Biological Hazards

HEALTH HAZARDS

HISTORYHISTORY

• In 5th century BC, Hippocrates, a Greek doctor initiated scientific foundation to make a link between the adverse effects suffered by lead workers and their exposure to metal.

HEALTH HAZARDS

4.1 INTRODUCTION TO HEALTH HAZARD & HYGIENE

• In the 1st century AD, Pliny the Roman Elder recorded how workers refining red mercuric sulfide wore bladders over their faces to avoid inhaling dust.

• Only in 15th century that the dangers in substances such as lead, mercury and dust from mining became widely recognized and efforts were made to reduce exposures.

HEALTH HAZARDS

.

• In 18th century, Rammazini an Italian doctor also known as Father of Occupational Medicine published books on diseases related to exposures of metals, dusts and some chemical and also the importance of physician to inquire patient’s occupation.

HEALTH HAZARDS

“Occupational Health is the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs.”  [ILO/WHO 1995]

DEFINITION OF OCCUPATIONAL HEALTHDEFINITION OF OCCUPATIONAL HEALTH

HEALTH HAZARDS

• Acute• Immediate in their effects and relatively simple control.

• Chronic• Difficult to assess or identify as they may take a long time to have any

effect.

HAZARD TYPESHAZARD TYPES

HEALTH HAZARDS

• Anticipate• Identify/Recognise• Assess/Evaluate• Control• Review

PRINCIPLE OF PREVENTION AND CONTROLPRINCIPLE OF PREVENTION AND CONTROL

HEALTH HAZARDS

• Eliminate• Substitute• Isolate• Engineering control• Administrative control• PPE

HIERARCHY OF CONTROLHIERARCHY OF CONTROL

HEALTH HAZARDS

• Health surveillance is the monitoring of individuals in order to identify changes in health due to exposure to hazardous substances.

• Biological monitoring is the measurement of a hazardous substance, its metabolite or other substances like enzymes in body tissues, fluids or exhaled air.

HEALTH SURVEILLANCE AND BIOLOGICAL MONITORINGHEALTH SURVEILLANCE AND BIOLOGICAL MONITORING

HEALTH HAZARDS

• Rehabilitation includes the medical treatment which assist recovery, as well as management of the process which helps people stay at or return to work.

OCCUPATIONAL REHABILITATIONOCCUPATIONAL REHABILITATION

HEALTH HAZARDS

4.2 CHEMICAL HAZARDS

HEALTH HAZARDS

SUB-TOPICSUB-TOPIC

4.2.1 Legal Provision4.2.2 How Chemical Affect Health 4.2.3 Dangerous Situation – Increasing Risk Exposure4.3.4 Chemical Safety Data Sheet (CSDS)

• Factories and Machinery Act– Factory and Machinery (Lead) Regulations 1984– Factory and Machinery (Asbestos Process) Regulations 1986– Factory and Machinery (Mineral Dust) Regulations 1989

• Five main aspect related to this statutory– Permissible exposure limit– Exposure monitoring– Medical inspection– Control methods– Other matters such as records, penalty, etc

4.2.1 LEGAL PROVISION4.2.1 LEGAL PROVISION

HEALTH HAZARDS

• Occupational Safety and Health Act– OSH (Control of Industrial Major Accidents Hazards) Regulation

1996 Control of major disaster caused by chemical

– OSH (Classification, Packaging and Labeling of Hazardous’ Chemicals) Regulation 1997

Supply of chemicals Chemical Safety Data Sheet (CSDS)

– OSH (Prohibition of Use of Substance) Order 1999 Prohibition of dangerous chemical

– Management of chemicals, PEL, evaluating risk, medical monitoring

HEALTH HAZARDS

• Direct contact with corrosive chemical such as alkali or acid

• Irritant chemicals cause skin to flare up• Cause skin allergy example nickel

4.2.2 HOW CHEMICAL AFFECT HEALTH4.2.2 HOW CHEMICAL AFFECT HEALTH

HEALTH HAZARDS

DIRECT CONTACT

INHALATION

INGESTION

ABSORPTION

INJECTION

HEALTH HAZARDS

CHEMICAL ROUTES OF ENTRY INTO HUMAN BODY

Breathing and smoking causes us to inhale substances which enter the lungs. Substance inhaled into the lungs are readily absorbed into the blood stream.

INHALATION INGESTION ABSORPTION INJECTION

INHALATION

HEALTH HAZARDS

Swallowing a substance causes penetration into the blood stream via the stomach and small intestine.

INHALATION INGESTION ABSORPTION INJECTION

INGESTION

HEALTH HAZARDS

Entering the body through the skin causes substances to enter the blood stream at a slower rate than by inhalation or absorption. However, the resulting entry and distribution within the body is the same.

INHALATION INGESTION ABSORPTION INJECTION

ABSORPTION

HEALTH HAZARDS

Injection occurs when substances are forced through this skin. This can occur as a result of such means as compressed air, or by having the skin abraded by a penetrating object.

INHALATION INGESTION ABSORPTION INJECTION

INJECTION

HEALTH HAZARDS

• Lack of awareness on hazardous chemicals• Leakage or accidentally spillage of chemicals• Working in a enclosed area or room with poor ventilation• Doing routine that involve chemicals• Machine breakdown• Lack of safety management

4.2.3 DANGEROUS SITUATION - INCREASING RISK EXPOSURE4.2.3 DANGEROUS SITUATION - INCREASING RISK EXPOSURE

HEALTH HAZARDS

• CSDS is a brochure or informational paper containing information related to hazardous chemical which are important in the safe use and handling of chemicals at workplace.

• Objectives of CSDS– Understand the safety recommendation and their rationales– Realize the results of failure to comply to safety requirements– OSH (Prohibition of Use of Substance) Order 1999– Identify symptoms of over exposure– Obtain input for the formulation of strategies and

recommendation in the safe use of hazardous chemicals

4.2.4 CHEMICAL SAFETY DATA SHEET (CSDS)4.2.4 CHEMICAL SAFETY DATA SHEET (CSDS)

HEALTH HAZARDS

Introduction

• Regulation 9(1) of the OSH (Classification, Packaging and Labeling) Regulations 1997– Requires supplier to prepare and provide CSDS for every

hazardous chemical supplied.– Supplier is defined as the party supplying the chemical to the

user which includes formulators, manufacturers, importers or distributors.

– Supplier also required to review CSDS regularly– The information required must be with the objective to protect

the safety and health of the worker, and not for use for any reason.

HEALTH HAZARDS

Legal Provision

• There are 15 types information required– Chemical product itself and the company identification– Composition of the ingredients that clearly identifies the

hazardous chemical for the purpose of conducting a hazard evaluation.

– Hazard identification– First aid measures– Accidental release measures– Handling and storage– Exposure control and PPE– Physical and chemical properties– Stability and reactivity– Toxicology information– Ecological information

HEALTH HAZARDS

Mandatory Information

– Disposal information– Transportation information– Date of preparation of CSDS

HEALTH HAZARDS

4.3 PHYSICAL HAZARDS

HEALTH HAZARDS

SUB-TOPICSUB-TOPIC

4.3.1 Noise4.3.2 Vibration 4.3.3 Heat Stress

DEFINITIONDEFINITION

4.3.1 NOISE

• Sound– Generated by mechanical vibrations that can be detected by

human ears.– It is a force carried out through various mediums (air, water,

solids)

• Noise– Unwanted sound

HEALTH HAZARDS

• Frequency– Number of vibrations per

second– Unit Hertz (Hz)

COMPONENTSCOMPONENTS

Frequency B > Frequency A

A

B

1 cycle

Frequency

• Amplitude– Peak magnitude or maximum

movement of the sound wave.– Unit decibel (dBA)

Amplitude of B > A

A

B

x

inte

nsi

ty

HEALTH HAZARDS

• Continuous noise– Noise that has the sound intensity between maximum and

minimum less than 3 dBA.

TYPE OF NOISETYPE OF NOISE

time

am

plit

ud

e

changing of amplitude < 3 dB

HEALTH HAZARDS

• Fluctuation noise– Noise that has varying intensity levels from high to low over 3 dBA.

> 3 dB

time

am

plit

ud

e

HEALTH HAZARDS

• Impulse noise– Noise that has high intensity within a short duration such as the

sound of a bullet shot.

> 1 s

< 0.5 s

am

plit

ud

e

time

HEALTH HAZARDS

• Interval noise– Noise that occurs at certain durations and may repeat at certain

intervals

< 3 dB

< 3 dB

time

amp

litu

de

HEALTH HAZARDS

• Factories and Machinery (Noise Exposure) Regulation 1989– Permissible exposure limit.– Exposure monitoring.– Methods of compliance.– PPE for specific hearing protection.– Audiometric testing program.– Employee information and training.– Warning sign.– Record keeping– Miscellaneous

LEGAL PROVISION RELATED TO NOISELEGAL PROVISION RELATED TO NOISE

HEALTH HAZARDS

LEGAL PROVISION – PERMISSIBLE EXPOSURE LIMIT (PEL)LEGAL PROVISION – PERMISSIBLE EXPOSURE LIMIT (PEL)• Action level (AL)

– 85 dBA

• PEL– Continuous noise

For 8 hours: 90 dBA Ceiling limit: 115 dBA

– Impulse noise Ceiling limit: 140 dBA

HEALTH HAZARDS

• Mining• Quarrying• Construction • Manufacturing• Textile• Etc.

OCCUPATIONS AT RISKOCCUPATIONS AT RISK

HEALTH HAZARDS

HEALTH EFFECTHEALTH EFFECT

• Disturbed emotion and anger• Communication problem• Tinnitus • Psychology pressure• Increase of blood pressure• Damage or loss of hearing

– Conduction type Damage to the ear drum Displacement of ossicle bones in the middle ear

– Neuro-sensory Damage to the hair follicles in the inner ears Loss of hearing due to over exposure to loud noise Normal cases: both ears

HEALTH HAZARDS

CONTROL MEASURESCONTROL MEASURES

• Engineering controls– Substitution of less noisy equipment– Isolation of noisy equipment from main area

• Administrative controls– Proper risk assessment before purchase noisy equipment– Reduction of exposure to noise– Training and lectures– Have written policy to ensure safe work practice– Exposure monitoring

HEALTH HAZARDS

• Health monitoring– Once annually

Exposure PEL Initial hearing test shows that there is hearing problem Hearing Threshold Standard

– Once every 2 years for noise exposure between 85-90 dBA

HEALTH HAZARDS

Audiometric booth

audiometer

printer

AUDIOMETRIC BOOTHAUDIOMETRIC BOOTH

HEALTH HAZARDS

4.3.1 VIBRATION

DEFINITIONDEFINITION

• Vibration– Refer to movement of solids where the amplitude and frequency

produced may cause harmful to those exposed.

HEALTH HAZARDS

TYPES OF VIBRATION (IN CONTEXT OF WORKERS HEALTH)TYPES OF VIBRATION (IN CONTEXT OF WORKERS HEALTH)

• Whole body vibration (WBV)– Where the vibration usually transferred when in contact with the feet or

buttocks Vehicle operation Heavy vehicles

• Hand arm vibration (HAV)– Where the vibration usually transferred when in contact with the hand due

to use of vibrating equipment Hand drill Chainsaw Etc.

HEALTH HAZARDS

HEALTH EFFECT HEALTH EFFECT

• Whole body vibration (WBV)– Blurring eye– Nausea, vomiting, headache, back pain– Can cause lung and heart malfunction

• Hand arm vibration (HAV)– Damage blood vessel, nerve and musculoskeletal system – Pale finger, numbness and pain– Carpal tunnel syndrome

HEALTH HAZARDS

• Evaluate risk prior to purchasing a vibrating equipment

• Eliminate hazard

• Substitute: with less vibrating equipment, anti-vibration

• Reduce exposure

• Training, information, instruction

• Periodical maintenance equipment

PREVENTION AND MONITORING CONTROLPREVENTION AND MONITORING CONTROL

HEALTH HAZARDS

INTRODUCTIONINTRODUCTION

4.3.1 HEAT STRESS

Heat stress occurs when the body’s means of controlling its internal temperature starts to fail. As well as air temperature, factors such as work rate, humidity and clothing worn while working may lead to heat stress.

Workers who are exposed to extreme heat or work in hot environments may be at risk of heat stress. Exposure to extreme heat can result in occupational illnesses and injuries.

HEALTH HAZARDS

COMPILATION OF SEVERE HEAT STRESS IN BODYCOMPILATION OF SEVERE HEAT STRESS IN BODY

- Heat stroke

- Heat exhaustion

- Heat syncope

- Heat cramp

- Heat rash

HEALTH HAZARDS

Heat Stroke

- Occurs when the body becomes unable to control its temperature: the body's

temperature rises rapidly, the sweating mechanism fails, and the body is

unable to cool down.

- Can cause death.

Symptom

• Hot, dry skin or profuse sweating• Hallucinations• Chills• Throbbing headache• High body temperature• Confusion/dizziness• Slurred speech

CALL 999

First Aid

HEALTH HAZARDS

Heat Exhaustion

- Heat exhaustion is the body's response to an excessive loss of the water and

salt, usually through excessive sweating.

Symptom

• Heavy sweating• Extreme weakness or fatigue• Dizziness, confusion• Nausea• Clammy, moist skin• Pale or flushed complexion• Muscle cramps• Slightly elevated body temperature• Fast and shallow breathing

First Aid

• Have them rest in a cool, shaded or air-conditioned area. • Have them drink plenty of water or other cool, nonalcoholic beverages. • Have them take a cool shower, bath, or sponge bath.

HEALTH HAZARDS

Heat Syncope

- is a fainting/dizziness, usually occurs with prolonged standing or sudden rising

from a sitting or lying position. Factors that may contribute to heat syncope

include dehydration and lack of acclimatization.

Symptom

• Light-headedness • Dizziness • Fainting

First Aid

• Sit or lie down in a cool place when they begin to feel symptoms. • Slowly drink water, clear juice, or a sports beverage.

HEALTH HAZARDS

Heat Cramp

- Usually affect workers who sweat a lot during strenuous activity.

- Low salt levels in muscles causes painful cramps.

- May also be a symptom of heat exhaustion

Symptom

• Muscle pain or spasms usually in the abdomen, arms, or legs

First Aid

• Stop all activity, and sit in a cool place. • Drink clear juice or a sports beverage. • Do not return to strenuous work for a few hours after the cramps subside because further exertion may lead to heat exhaustion or heat stroke. • Seek medical attention if the worker has heart problems, the worker is on a low-sodium diet, the cramps do not subside within one hour.

HEALTH HAZARDS

Heat Rash

- Is a skin irritation caused by excessive sweating during hot, humid weather.

Symptom

• Heat rash looks like a red cluster of pimples or small blisters. • It is more likely to occur on the neck and upper chest, in the groin, under the breasts, and in elbow creases.

First Aid

• Try to work in a cooler, less humid environment when possible. • Keep the affected area dry. • Dusting powder may be used to increase comfort.

HEALTH HAZARDS

REDUCING THE RISKREDUCING THE RISK

- Control the temperature

- Provide mechanical aid

- Regulate the length of exposure to hot environments

- Prevent dehydration

- Provide personal protective equipment

- Provide training for your workers

- Allow workers to acclimatize to their environment and identify which workers

are acclimatized/assessed as fit to work in hot conditions.

- Identify employees who are more susceptible to heat stress

- Monitor the health of workers at risk

HEALTH HAZARDS

HEAT STRESS INDEXHEAT STRESS INDEX

HEALTH HAZARDS

Heat May Be Nature’s Deadliest Killer

HEALTH HAZARDS

4.4 BIOLOGICAL HAZARDS

HEALTH HAZARDS

INTRODUCTIONINTRODUCTION

• Community and employee awareness

• Identification of biological agents that cause Legionnaire disease, Hepatitis B and HIV

• Industries such as agriculture, health care, biotechnology, research and clinical laboratories

• Biological agent– Includes living micro-organisms such as viruses and

bacteria capable of exuding toxins, exposure to which may cause disease or death in human, animals and plants.

• Etiological agent– Agent that causes the actual contraction of disease.

• Infection– Attacks of pathogenic organism on the body, which may or

may not cause contraction of disease.

DEFINITIONSDEFINITIONS

HEALTH HAZARDS

• Bio-safety– An area of science that serve to disconnect chains of infection.

• Agent– Physical, radiological, chemical or biological entity that may cause

certain effects upon exposure.

• Host– Host where the agent is present (example: human)

• Environment– Includes living and non-living things (biosphere, atmosphere,

lithosphere and hydrosphere)

HEALTH HAZARDS

INTERACTION BETWEEN HOST, AGENT AND ENVIRONMENTINTERACTION BETWEEN HOST, AGENT AND ENVIRONMENT

Agent Host

Environment

Environment- Population density- Medical support facilities- Weather (wind, temperature)- Social, politics, ethics- Facility design

Host- Health status- Management system- Training- Health surveillance- Use of PPE- Perceptions- Reservoir

Agent- Carrier- Substitute for pathogen- Antibiotics resistance- Virulent factors- Communicability factor- Fatal factor

HEALTH HAZARDS

• Agent must be pathogenic• Presence of reservoir• Agent must be able to escape from reservoir• The ability of agent to move in the environment• There is an entry on the new host• Host is susceptible to the agent

ANOTHER FACTORS ANOTHER FACTORS

HEALTH HAZARDS

CHAIN OF INFECTIONCHAIN OF INFECTION

Takungan

Patogen

Pelepasan dari

takungan

Transmisi melalui

persekitan

Tapak kemasukan

Hos rentan

Control of infection = break any connection between chain

HEALTH HAZARDS

BIOLOGICAL SAFETY CABINET CLASSIFICATIONBIOLOGICAL SAFETY CABINET CLASSIFICATIONPotential of Bio-

HazardDescription of

AgentExample Control

Level I

Low risk

Not known whether can cause disease

Bacteria

Bacillus subtilis

E.Coli K12

Normal biological practices

Suitable isolation

Level II

May cause disease on human

Bacteria

Salmonella

Virus

Hepatitis A, B, C, D

FungersCryptococcus

Bio-hazard label

Autoclave

Medical surveillance

Level III Agent is indigenous Virus

HIV, TB

Special design

Specific LEV

Level IVAgent is dangerous

High exposure may cause risk to life

Virus

Ebola

Special design

HEALTH HAZARDS

• Bio safety program management– Identify the scope of the programme based on the risk– Develop policy and procedure– Provide training for workers, supervision and regular refresher course– Provide suitable facilities

• Administrative controls – Establish a bio-safety committee– Appoint bio-safety officer (BSO – Bio Safety Level III & IV)

• Physical containment– Based on bio-safety level

WORKING SAFELY WITH BIOLOGICAL AGENTSWORKING SAFELY WITH BIOLOGICAL AGENTS

HEALTH HAZARDS

• Disinfection and sterilization– Use of chemical or physical agent– Sterilization kill organisms in total

• Accident, spill and emergency training– Requires specific training

• Transportation of biological agent– Should be viewed from the perspective of anticipating and preventive accidents– Compliance with sea and air transport standards

• Biological risk communication– Biological communication strategy should be develop– Other than workers, should also include the public

HEALTH HAZARDS

HEALTH HAZARDS