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Transcript of Institut universitaire romand de Santé au Travail IST, rue du Bugnon 19, CH-1005 Lausanne Education...
Institut universitaire romandde Santé au Travail
IST, rue du Bugnon 19, CH-1005 Lausanne http://www.iurst.ch
Education of Occupational Health professionals in risk evaluation, analyses and prevention
Brigitta Danuser, Angela Ensslin, David Vernez
2
Identifying key factors
Company: Risk assessment and management
Society
OH have do deal with a potential open circle of persons!
3
Identifying key factors: Modes of collaborative work
Multidisciplinary:…..bringing a number of different disciplines together to work discretly on different aspects of a problem
Interdisciplinary:……bringing disciplines together to work on the same problem
Transdisciplinary:…..cutting across disciplines through use of a common conceptual framework to adress a particular problem, blending together concepts and theories (Rosenfield 2003)
4
Identifying key factors
Education in risk evaluation and management is basically formation in interdisciplinary work!
5
Identifying key factors
Intellectual and institutional factors characterizing disciplines:
Symbolic generalizations Models Exemplars
6
Identifying key factors
Establishing an interdisciplinary approach means foremost:
establishing a common language second establishing common models and requires
social competencies
7
Identifying key factors
Interdisciplinary education has to balance:
Integration of symbolic disciplinary systems
Interdisciplinary model
Translation of symbols
Proper disciplinary models
8
Identifying key factors
Interdisciplinary work has to have a common goal:
FIOH: We promote health and safety at work as part of a good full life!
9
Identifying key factors: Risk assessment and risk management
S E V E R i T Y
P R OB A B I L I T Y
Non acceptable
Acceptable
ALARP
Classical approach:
Risk = f(probability and severity)
Maximal Threshold: there exists an upper limit above which the risks are not acceptable
Mininmal threshold: there exists a lower limit under which no measures have to be taken
ALARP = As low as reasonably possible!
10
Identifying key factors: Risk assessment and risk management
Measurements of fatality risks (Slovic 2001): Deaths per million people in the population Deaths per million people within x miles of the
source of exposure Deaths per unit of concentration Deaths per facility Deaths per ton of air toxic released Deaths per ton of air toxic absorbed by people Deaths per ton of chemical produced Deaths per million dollars of product produced Loss of life expectancy associated with the
exposure to the hazard
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Non Acceptable Threshold
G R A V I T E
P R OB A B I L I T E
Inacceptables
Acceptables
UncertaintiesPrincipally set for adultes in good healthHealthy worker effectNew technologies – no experienceTLV for 600 substances but 60’000 in useNo reliable strategy for mixtures / interactions
13
Acceptable – Non Acceptable
1,0E-03
1,0E-02
1,0E-01
1,0E+00
1,0E+01
1,0E+02
1,0E+03
1,0E+04
0,1 1 10 100 1000
f [Hz]
B [
mT
]
ENV (travailleurs) ENV (public)ÖNORM (public) ICNIRP (public)ICNIRP (travailleurs)
Public health threshold: lower than professional threshold: principle of precaution
Electromag-netic fields
14
Acceptable – Non Acceptable
500 µT
1 µT
Electromagnetic fields of 50 HZ
• Professionnel exposure
• The source is part of the working process
• Based on scientific data
• Public exposure
• Precaution limit (Swiss)
• New installations
“grey zone”
15
The grey zone
The acceptable risk limit is decreasing!
According to the Swiss regulations of major hazards: risks in the grey zone are considered acceptable or not acceptable according to the protection required by the population concerned and the environment as well as by public interests!
The grey zone is a zone of negotioation!
16
Influences on perception and acceptance of risks
Risk category Individual involvement severity
Risk measurement Relative; absolute «psycho - political»
Communication repulsion; attraction authority; experts
Context Other risks Cost-benefice
Equity Risk distribution Social groups
Politics-society Cultural values Law
17
Influence of individual choice / control
Individual freedom of choice /control
Example Individual acceptable risks
total High risk sports 10-2 – 10-3
partial work 10-3 – 10-4
low Collective transportation
10-4 – 10-5
zero Atmospheric pollution
10-5 – 10-6
18
OH risk matrix
GRAVITE V IV III II I
A
B
C
D
E
PR
O
B
A
B
I
L
I
T
E
Catégorie Critères Qantitatifs
Très élevé A 1/mois
Elevé B 1/an à < 1/mois
Modéré C 1/5 ans à < 1/an
Négligeable D 1/20 ans à < 1/5 ans
Quasi-impossible
E 1/100 ans à < 1/20 ans
Catégorie Critères Qantitatifs
Très grave I décès
Grave I I Invalidité grave
Moyenne I I I Invalidité légère
Faible IV Blessure ave arrêt de travail
Très faible V Blessure sans arrêt de travail
19
Risk assessment GRAVITE
V IV III II I
A 0.1.2, 1.3.2, 3.1.3, 3.4.4, 5.1.1, 5.5.1
0.1.4, 1.1.1, 1.3.1, 3.2.3,
B 0.1.5, 0.1.7, 1.2.1, 2.1.2, 3.1.5, 3.2.11, 3.4.1
0.1.1, 0.1.6, 1.2.2, 1.4.2, 1.4.3, 1.4.4, 1.5.1, 2.2.3, 2.2.4, 2.3.2, 2.3.3, 2.4.1, 2.4.2, 2.4.3, 2.4.4, 3.1.1, 3.1.2, 3.1.4, 3.4.2, 3.4.3, 5.3.7, 0.1.8
3.2.1 a, 3.2.5, 3.3.3, 5.3.3,
C 3.2.13, 5.4.1 0.1.3, 2.1.1, 3.1.4, , 3.2.9, 3.2.15, 5.3.2, 5.3.5, 5.3.6
1.1.2, 1.4.1, 1.4.5 a, 2.2.1 a, 2.2.2, 2.3.1, 3.2.2 a, 3.2.4 a, 3.2.7, 3.3.2 a, 5.5.3
3.2.1 b, 5.3.1,
D 5.2.1, 5.2.2, 5.3.2 3.2.6, 5.3.8, 5.4.2, 3.2.14
1.4.5 b, 2.2.1 b, 3.2.2 b, 3.2.4 b, 3.2.10, 3.3.2 b, 5.3.4,
E 3.2.8 3.2.12 3.3.1,
PR
O
B
A
B
I
L
I
T
E
A
BC
Risk analyses in an emergency departement
A: chronic annoyances: stress, fatigue
B: mecanic accidents, agressions
C: sever accidents, virus contagion
20
Individual – collectiv risks
Estimatedindividual risk
HIV conversion
Hepatitis conversion
PC screen work
Mecanic accidents
Organisational risks
Noise
Client relationship
Estimated collective risks
HIV conversion
PC screen work
Mecanic accidents
Noise
Client relationship
21
How to deal with the grey zone
1. reducing the individual risk above the non acceptable threshold!
2. Applying cost-benefice criteria for the collective – collective wheigted risks, ev. Cost-benefit of measures
3. Participative approach to set priorities
22
Identifying key factors
To elucidate the subjective nature of risk assessment, OH specialists have to be conscious about their system of values.
To communicate risks and to discuss values
To include our clients and partners (participative approach)
23
FIOH strategy 2006-2010
We promote health and safety at work as a part of a good full life
- we create solutions for improving occupational health, safety and well being together with our clients and partners
- By applying our solutions, our clients can learn new things, improve their operatons, and succeed in the changing environment
- We learn from our clients about their needs in work life.
24
Interdisciplinary Approach in the MAS W+H
Interdisciplinary features in the MAS Work + Health:
- Large common education of Occupational physicians, Occupational Hygienists and Ergonomics Professionals
- Block II dedicated to communication, social competencies, negotiation and company environment
- Large proportion of project oriented learning - Interdisciplinary group work in a company (2
weeks duration) - Topic oriented learning
26
Block I
Block I Professional basics
Basics necessary for the understanding of the three disciplines
Law and legal issues
to find a common language!
27
Block II
Block II Management and company environment
Managerial aspects of OH
Communication, understanding
Social competencies
Client orientation
28
Block III
Block III training in the three disciplines
Separately for:
Occupational physicians
Ergonomics
Occupational Hygienists
29
Block IV
Block IV Corporate Health
Sociology, epidemiology, public health, economics, corporate organisation
2 weeks project work in an interdisciplinary group
30
Ongoing evaluation
Over the last 10 years due to an ongoing evaluation process we have:
Trippled the workplace visits Doubled the interdisciplinary group
work Added training in mangerial and
economic competencies
31
New: Topic oriented learning
Goals: Integration and overview of
knowledge Building of knowledge maps Identification of missing teaching
links
32
Topic orientied learning
Group work Each group has one theme (Chemistry
workplaces, hospital personnel) At the end of the modules the groupes
work one hour on: Which are the relevant aspect for our workplaces learned during the modul? What do they mean, how do the new facts interact with previous learned one’s?