Occupational health and safety in hospitals

Loss Prevention PolicySaudi Aramco will conduct its business in a manner which prevents incidents or accidents which cause loss of life, bodily injury or illness, or damage to property, assets or the environment. As reflected in Saudi Aramco’s Corporate Values, the Company will continuously maintain the highest standards of safety, security, health and environmental protection.Accordingly, the Company will:• Advise all employees and contractors of their loss prevention responsibilities and regularly measure their

performance;• Evaluate, identify and eliminate or manage safety risks prior to beginning any new operation or activity and

continue to review such risks, complying with all applicable laws and regulations;• Communicate loss prevention objectives and procedures regularly to employees and all affected parties; • Train employees and provide resources to maintain job competencies, including loss prevention responsibility

and accountability;• Design and construct Company facilities utilizing recognized best technology and practices to safeguard

property and people;• Operate and maintain Company facilities to ensure safe operations;• Require that contractors, suppliers and others adhere to the Company’s loss prevention policies, procedures and

goals;• Prepare for emergencies and other contingencies and respond promptly and effectively to any incidents or

accidents resulting from operations;• Report all incidents, review performance and communicate progress;• Promote off-the-job safety and community awareness, and • Review and improve the Company’s loss prevention program and performance continuously.

PM SMSElement 1 – Leadership and Accountability: Promotes visible management leadership and overall accountability for safety as a line management function. Summarizes the safety responsibilities for managers, employees, and contactors.

Element 2 – Risk Assessment and Management: Outlines risk assessment and management activities to protect people and preserve company assets.

Element 3 – Communications: Presents methods of communicating safety and loss prevention information within each department.

Element 4 – Competency and Training: Presents competency and training requirements for staff to perform their work in compliance with standards for loss prevention covering safety, health, the environment, quality, and production.

Element 5 – Asset Integrity: Describes life cycle management processes for the integrity of the company’s widely varied assets – the hardware side of loss prevention.

Element 6 – Safe Operations: Reflects the various steps, programs, and processes to achieve world-class safe operations - Primarily the behavioral safety of loss prevention.

PM SMS (cont.)Element 7 – Contractors, Suppliers, and Others: Delineates the management expectations for the third-party activities, which increasingly affect company operations and profitability. Third party includes contractors and suppliers of products and equipment but also joint venture with others.

Element 8 – Emergency Preparedness: Involves assessment and preparation for proper response to unplanned events.

Element 9 – Incident Reporting Awareness and Analysis: Outlines incident reporting and investigation requirements for analysis and improvement.

Element 10 – Community Awareness and Off-the-Job Safety: Describes Saudi Aramco’s historic and ongoing commitment to the related issues of community involvement and off-the-job safety.

Element 11 – Continuous Improvement: - Provides the framework necessary to continually improve the SMS through periodic measurement and review.

Fuel

Any combustible material – solid, liquid or gas

Oxygen

The air we breathe is about 21% oxygen – fire

needs only 16% oxygen

Heat

The energy necessary to increase the temperature of

fuel to where sufficient vapors are given off for ignition to

occur

Each of these three elements must be present at the same time to have a fire. A fire will burn until

one or more of the elements is removed.

There are 4 classes of fire:

Class AOrdinary combustibles or fibrous material, such as wood, paper, cloth, rubber, and some plastics.

Class BFlammable or combustible liquids such as gasoline,

kerosene, paint, paint thinners and propane.Class CEnergized electrical equipment, such as appliances, switches, panel boxes and power tools.

Class DCertain combustible metals, such as magnesium,

titanium, potassium, and sodium.

Class Ordinary Combustibles:

To Prevent Fires

• Keep storage and working areas free of trash.

• Place oily rags in covered containers.

Class Flammable liquids or gases:

Don’t refuel gasoline-powered equipment in a confined space, in the presence of an open flame, or while the equipment is hot.

Keep flammable liquids stored in a tightly closed container and away from spark producing sources.

Use flammable liquids only in well ventilated areas.

Class Electrical Equipment:

Never install a fuse rated higher than specified for the circuit.

Investigate any appliance or electrical equipment that smells strange. Unusual odors can be the first sign of a potential fire.

Utility lights should always have some type of wire guard over them.

Class Flammable metals:

• Knowledge of the properties of the metals and using good judgment and common sense will assist you in controlling or avoiding potential fires/reactions.

• Check the location of fire alarms and know how they work. • Learn your building evacuation plan. • Know where your two nearest exits are located.

Learn how doors swing and where stairs lead.

• Make sure nothing blocks fire pulls, extinguishers and emergency exits.

• Learn the sound of your building fire alarm.

• Post emergency numbers (including security and first aid) near your telephone.

• Make sure you know what to do if the fire alarm sounds. Plan your escape.

Be prepared for a fire emergency

When you hear the fire alarm:

· Leave at once, taking direction fromthe emergency warden.

· Do not delay yourself by gathering personal items. Your safety always comes first.

· Before you open any door, feel the door with the back of your hand. If the door is cold, slowly open it a crack.

· If there is no smoke in hallways or stairwells, follow your building’s evacuation plan. Get out quickly using designated fire exits.

After a fire emergency:

· Once you are out of the building, STAY OUT! Do not go back inside for any reason.

· Report to your warden for roll call at your designated assembly point.

· Tell the fire department via your warden if you know of anyone trapped inside the building.

· Only re-enter if and when the fire department tells you it is safe to do so.

SAPMT Office Muster Points

Fire sprinkler system piping

Safety observation index

Report Incidents, Unsafe Acts & Conditions• Immediately report all work related injuries/illnesses or vehicle collisions, no matter how

small, to your supervisor.• Immediately report any near miss, or incident you see to the site HSE Team.• If you see any unsafe Acts or any unsafe condition, take corrective action, report it to the site

HSE Team and follow this up by filling in a SBOI Card in the PMT Office.

Safety ResponsibilitiesManager/Supervisor Responsibilities• Establish and communicate safety rules and standards to all employees and contractors.• Provide appropriate resources, tools, and training for employees.• Conduct and document safety meetings.• Correct unsafe acts and conditions promptly.• Conduct routine safety and environmental inspections and tours.• Maintain facility emergency plans and conduct regular emergency drills.• Investigate injuries, spills, and other incidents and promptly provide corrective actions.• Review organization and employee safety performance periodically and provide feedback.

Employee Responsibilities• Comply with applicable rules, standards, and safe work practices.• Communicate safety rules and standards to contractors and co-workers.• Maintain knowledge of safety requirements, including emergency response action.• Participate in safety meetings.• Inspect, and maintain the project site in a safe condition.• Report injuries, spills, unsafe conditions, near misses, and incidents immediately.• Assist in incident investigations as necessary.

Contractor Responsibilities• Ensure that contractor employees and their subcontractors are trained in SA safety rules and

are competent in their craft or skill.• Comply with all SA rules, policies, and procedures.• Report injuries, spills, unsafe acts and conditions, near misses, and incidents immediately.• Hold pre-job meetings and other safety meetings during the job.• Assist in incident investigations as necessary.

Basic Safety Rules to think about when on siteFollow Safe Practices• Operators of vehicles shall comply with all traffic requirements, particularly speed limits.• All persons in vehicles shall wear seat belts at all times.• When ascending or descending stairways, use the handrail and take only one step at a time.• Erect barricades/flagging around hazardous work areas, such as holes in decking and floor

surfaces, trenches, road crossings, and overhead hazardous work.• Use only proper tools and equipment maintained in a safe working condition. Homemade

tools are prohibited.• Maintain good housekeeping in your work area at all times.• Smoking is permitted in designated areas only. • Eating or resting is permitted in designated areas only.• Use proper manual lifting techniques, or obtain assistance or mechanical lifting aids when

lifting loads.• All operating machinery and electrical switchgear shall have all safety guards, switches, and

alarms in place and functional.• All fire extinguishers and other emergency equipment shall be in good condition, inspected

regularly, and kept clear of any obstruction.

Avoid Unsafe Activities• Climbing or standing on equipment, piping, valves, or unstable surfaces (e.g., chairs or

barrels) to perform work is prohibited.• Approved fall protection measures (e.g., safety harnesses or scaffolding) shall be used if the

working height is greater than 1.8 m (6 ft) from floor or platform level.• Running in work areas is prohibited, except during emergencies.• Finger rings, wristwatches, jewelry, loose clothing, unsecured long hair, and other loose

accessories shall not be worn within an arm’s reach of rotating equipment or electrical switchgear.

• Do not apply compressed air or other gases to yourself or others.• Operating equipment having a “DANGER, DO NOT OPERATE” (hold) tag is prohibited.• Horseplay or fighting on SA premises is prohibited.

Protect Yourself (PPE)When on site you are required to wear the minimum PPE noted below• Hard Hat• Safety Glasses (some may require over glasses if wearing prescription glasses)• Yellow fluorescent vest• Gloves• Toe capped boots with protection to the sole to prevent nail penetration• Proper personal protective equipment (PPE) prescribed by the Chemical Hazard Bulletin

(CHB) or Material Safety Data Sheet (MSDS) shall be worn when handling chemicals or hazardous materials.

• Approved hearing protection shall be worn in high noise areas (i.e., 85 decibels [dBA] or higher).

In some areas there are signs like the one to the right which require additional PPE due to specific hazards which may be present.

Permit ProcessesGeneral discussion as to what to expect at site:• Hot Work Permit • Cold Work Permit • Confined Space Entry Permit • Excavation and Trenching • Isolations

Confined SpaceThe purpose of the Confined Space Entry (CSE) Permit process is to ensure:• Proper preparation of confined spaces/vessels to be entered.• Safe entry by personnel, including plans for rescue.• Restoration of confined spaces.

A CSE Permit (SA Form #924-4 GREEN) shall be used to protect personnel from CSE hazards. CSE is the entry of personnel into any space or structure (e.g., tank, vessel, duct, or vault) not normally intended for human occupancy, in which entry, movement within or exit is restricted. Any part of the body passing through the opening isconsidered entry. Examples include:• Vessel cleaning.• Tank internal inspection.• Work in sewers, sump pits, or valve boxes.• Excavations or trenches deeper than 1.2 m (4 ft) that meet the definition of a

confined space.

المواد مع اآلمن التعاملالكيميائية

Safety in chemicals

A hazardous chemical is any chemical which is classified as a:

Physical hazardHealth hazardSimple asphyxiantCombustible dustPyrophoric gasHazard not otherwise classified

Physical hazards are chemicals that can cause:

FireExplosionViolent reaction

Health HazardsHealth hazards are chemicals that are harmful to your health and cancause:

Short-term (acute)health problemsLong term (chronic)health problems

Health Hazards, continued…

• OSHA considers a health hazard to be any chemical which:– Is toxic– Is corrosive to the skin or eyes– Is a respiratory sensitizer– May cause cancer, birth defects or reproductive issues– Attacks specific organs– Is harmful or deadly when inhaled

Five Employer Requirements

The HazCom Chain

•Chemists classify and categorize the chemical•Safety data sheets and labels are created•Safety data sheets and labels are passed along to each company and person who handles the chemical

HazCom starts at

the chemical

manufacturing plant:

1. Chemical Inventory

• When a chemical arrives at your company, hazard information is passed along with it.

• This information is added to your company’s chemical inventory.

• OSHA requires thateach company keepan inventory on all itshazardous chemicals.

2. Safety Data Sheets

• Explain what you need to know to safely work with a chemical

• Must have the GHS-specified 16 section format• Must include certain types of information in each section• Help ensure that employers and employees understand

the chemical• Must be readily accessible to employees in the work

area during each work shift

3. Labels

Pictograms

Re-Labeling

• Re-labeling can take place when:– Your employer chooses to use an OSHA-

approved label in your workplace.– A large quantity of a

chemical is brokendown into smallerones to use indifferent areas.

Staying safe, continued…

• Other simple actions:– Know where the nearest eyewash station or

emergency shower is located– Dispose of hazardous chemicals properly– Know how to deal with

spills and leaks– Know how to respond in

an emergency

ExcavationThe purpose of the Excavation and Trenching process is to ensure proper planning and design of excavation and trenching operations, including entry of personnel. An Excavation Safety Checklist is required for:• All excavations 1.2 m (4 ft) and deeper.• Excavations deeper than 30 cm (1 ft) where buried pipelines or cables may be present.• Excavations 1.2 m (4 ft) and deeper may also require a CSE Permit as outlined in Safety

Process 3, “Confined Space Entry Permit.”• The slope of an excavation will depend on the soil type and the depth of the excavation.

Scaffolding• Scaffolding is a temporary, field erected structure used for working at an elevated

height. Because it is temporary and field erected, it is subject to wear and abuse, improper assembly, and unauthorized changes.

• Construction standards require that a "competent person" inspect scaffolds for defects before every work shift.

• Scaffolding must be erected on firm footing capable of carrying the maximum intended load. Boxes, barrels, loose concrete blocks or brick must not be used to support the structure.

• Consideration must be given to the weight the scaffold is to carry. It must be capable of supporting, without failure, four times the maximum intended load. The load includes not only the weight of the people on the scaffold but also any supplies and equipment being used.

• Scaffolding is naturally unstable because it is usually a tall structure with a narrow base. To counteract this, the scaffold must be braced or tied off to a stable structure

Safe to use Unsafe to use

Fall Protection• Approved fall protection measures (e.g., personal fall arrest systems and scaffolding)

shall be used if the working height is greater than 1.8 m (6 ft) from floor or platform level.

Traffic & Vehicle SafetyDrivers shall: • Abide by all Saudi Arabia Government (SAG) traffic regulations and Saudi Aramco traffic

requirements at all times.• Wear seat belts at all times and ensure that all passengers are wearing their seat belts. • Report any damage to the vehicle immediately to your supervisor. • Perform a 360-degree walk around before getting into the vehicle.• Ensure the vehicle is safe to operate and contains all required safety equipment. • Do Not exceed the posted speed limit at any time.• DO Not use a cell phone, eat or drink while driving. • Do Not transport more passengers than the number of seat belts provided in the vehicle. • Do Not transport passengers in the rear of pickups or on truck beds. • Vehicles should be reverse parked

Visitors• To report to Site office and sign Visitors Register.• All visitors shall receive Induction training prior to entrance to construction site.• Visitors shall not be permitted to wonder off by themselves, they will be accompanied

at all times• Full Site Specific PPE to be used – Will not be issued on site.

Smoking• Smoking is only permitted in designated areas.• At the PMT Office there is a designated room for smoking• At the refinery site there are outdoor smoking shelters

Hospital Risk Assessment

Technological

1.Electrical failure2.Transportation emergency3.Water emergency4.HVAC failure5.Structural damage6.Fire7.HAZMAT exposure (internal)

Components of Risk

Probability?A. Highly likely?B. Likely?C. Possible?D. Unlikely?

Impact?1.Marginal 2.Serious3.Critical 4.Catastrophic

by

Mohammad ahmad alqadi

Weal bahr shibli

Dr . Tamer Sharakyi

Thank you