Injury and Disease Prevention

Prepared by Dr. Julian Jolly

Ph.D (UK) SSIRSM (UK) IGC (NEBOSH, UK)

TTT (NIOSH)

Ministry of Health (MOH) Malaysia

Description of The Occupational Health Unit

Vision Towards a healthy nation and healthy workers through promotion of healthy environment and workplace in order to achieve sustainable basic of health for all.

Mission To promote healthy and quality of life by preventing and controlling diseases, injuries and disabilities related to the interaction between people and their working environment.

MOH Objectives

• To promote and maintain the highest possible degree of physical, mental and social wellbeing of workers in all occupations.

• To promote the safety and health at workplace which includes work environment and process.

• To increase awareness among employers, employees and communities on occupational safety and health aspects.

• To prevent occupational related health problems arising from the work environment and work process amongst workers.

• To reduce the morbidity and mortality due to occupational diseases ( injuries and poisoning).

Ministry of Human Resources Malaysia

• The Department of Occupational Safety and Health (DOSH) is under this ministry.(Jabatan Keselamatan dan Kesihatan Perkerjaan - JKKP)

• ACT 514 – Occupational Safety and Health Act 1994.

OccupationalINJURY and DISEASE

The Department of Occupational Safety and Health, Ministry of Human Resources Malaysia describes INJURY and DISEASE as follows:

1. Occupational InjuryAny injury such as a cut, fracture, sprain, amputation etc., which results from a work accident or from a single instantaneous exposure to a hazard in the work environment.

2. Occupational DiseaseA disease arising out of or in connection with work. It includes acute and chronic disease or poisoning which may be caused by inhalation, absorption, ingestion, or direct contact with a hazard at the workplace.

Notification of Accident, Dangerous Occurrence, Occupational Poisoning and Occupational Disease Regulations 2004

• The above must also be addressed as it is part and parcel of the related legal requirements of Occupational Safety and Health.

• It is known as NADOPOD Regulations

2004.

Levels of Disease

SporadicSporadic

EndemicEndemic

EpidemicEpidemic

PandemicPandemicIncreasing amount of diseaseIncreasing amount of disease

Natural History of Disease

Stage of Stage of susceptibilitysusceptibility

Stage of Stage of Subclinical Subclinical

DiseaseDisease

Stage of Stage of Clinical Disease Clinical Disease

Stage of Recovery,Stage of Recovery,Disability, or DeathDisability, or Death

ExposureExposure

Pathological Pathological ChangesChanges Onset ofOnset of

SymptomsSymptoms

Usual Time Usual Time of Diagnosisof Diagnosis

Environmental Issues and ImpactsISO14001

• Health of workers are affected by the environment.

• ISO 14000 addresses various aspects of environmental management.

• It provides practical tools for companies and organizations looking to identify and control their environmental impact and constantly improve their environmental performance.

Environmental Quality ACT, 1974Malaysia

ACT 127

It assists companies to take effective

measures to CURB, CONTROL or

ERADICATE pollution problems so as not

to be prosecuted under the Law.

Intentional and Unintentional Injuries

1. IntentionalThe term "intentional" is used to refer to injuries resulting from purposeful human action, whether directed at oneself or others. Intentional injuries include self inflicted and interpersonal acts of violence intended to cause harm.

2.UnintentionalInjuries that were unplanned or considered accidental, not intended to happen, such as motor vehicle crashes, falls, fires and drowning.

WHO International Classification of External Causes of Injury (ICECI)

Purpose/Definition

It is designed to help researchers and prevention practitioners to describe, measure and monitor the occurrence of injuries and to investigate their circumstances of occurrence using an internally agreed classification.

Criteria underlying the Classification

As a separate coding axis for each main concept, usefulness for injury prevention, usability in many types of settings in many parts of the world e.g. hospitals and other places where data are collected, and complementing the ICD-10.

Classification Structure

ICECI has a multi-axial and hierarchical structure:

1.Core module including seven items (mechanism of injury, objects/substances producing injury, place of occurrence, activity when injured, the role of human intent, use of alcohol, use of (other) psycho-active drugs) and

2.Five (5) additional modules

To enable collection of additional data on special

topics (violence, transport, place, sports,

occupational injury).

The Meaning of DISEASE

• A pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms.

• A condition or tendency, as of society, regarded as abnormal and harmful.

Classifying DiseasesThey can be divided into three (3) categories: 1. Intrinsic (non-infectious)

Coming from within the body, normally not contagious or communicable. e.g. stress related diseases, autoimmune diseases, cancers, hereditary diseases.

2. Extrinsic (infectious)Emerging from outside the body and contagious,e.g. infections derived from viruses, bacterium or parasites.

3. Unknown OriginDiseases for which there is no known cause.

Occupational Disease

An occupational disease is a health problem experienced by the worker caused by exposure to a health hazard at the workplace.

HAZARDS causing DISEASES

• dust, gases, or fumes

• noise

• toxic substances (poisons)

• vibration

• radiation

• infectious germs or viruses

• extreme hot or cold temperatures

• extremely high or low air pressure.

World Health Organization

Classifications of diseases have been developed by WHO mainly for two purposes:

(1) notification for labour safety and health surveillance &

(2) compensation.

International Classification of Diseases (ICD)/History

• ICD-10 was endorsed by the Forty-third (43rd ) World Health Assembly in May 1990.

• Came into use in WHO Member States as from 1994.• The classification is the latest in a series which has its

origins in the 1850s. • The first edition, known as the International List of

Causes of Death, was adopted by the International Statistical Institute in 1893.

• WHO took over the responsibility for the ICD at its creation in 1948 when the Sixth Revision, which included causes of morbidity for the first time, was published.

Types of ClassificationThe WHO-FIC (Family of International Classification) is comprised of:

1. Reference Classifications: Main classifications on basic parameters of health. These classifications have been prepared by the World Health Organization and approved by the Organization's governing bodies for international use- International Classification of Diseases (ICD) - International Classification of Functioning, Disability

and Health (ICF)- International Classification of Health Interventions (ICHI)

2. Derived ClassificationsDerived Classifications are based on the reference classifications( i.e. ICD and ICF).

Chapters and Titles of the ICD

IA00-B99 Certain infectious and parasitic diseasesIIC00-D48 NeoplasmsIIID50-D89 Diseases of the blood and blood-forming organs

and certain disorders involving the immune mechanism

IVE00-E90 Endocrine, nutritional and metabolic diseasesVF00-F99 Mental and behavioural disordersVIG00-G99 Diseases of the nervous systemVIIH00-H59 Diseases of the eye and adnexaVIIIH60-H95 Diseases of the ear and mastoid processIXI00-I99 Diseases of the circulatory systemXJ00-J99 Diseases of the respiratory systemXIK00-K93 Diseases of the digestive systemXIIL00-L99 Diseases of the skin and subcutaneous tissue

Chapters and Titles of the ICDXIIIM00-M99 Diseases of the musculoskeletal system and

connective tissueXIVN00-N99 Diseases of the genitourinary systemXVO00-O99 Pregnancy, childbirth and the puerperiumXVIP00-P96 Certain conditions originating in the perinatal

periodXVIIQ00-Q99 Congenital malformations, deformations and

chromosomal abnormalitiesXVIIIR00-R99 Symptoms, signs and abnormal clinical and

laboratory findings, not elsewhere classifiedXIXS00-T98 Injury, poisoning and certain other

consequences of external causesXXV01-Y98 External causes of morbidity and mortalityXXIZ00-Z99 Factors influencing health status and contact

with health servicesXXIIU00-U99 Codes for special purposes.

Workplace Health Hazards

Workplace health hazards can cause three (3) kinds of reactions in the body:• Immediate or acute reactions, like shortness of breath

or nausea, can be caused by a one-time event, (e.g. a chemical spill). These reactions are not usually permanent.

• Gradual reactions, like asthma or dermatitis (skin rashes), can get worse and persist when you are exposed over days, weeks or months. These reactions tend to last for a longer time.

• Delayed reactions or diseases that take a long time to develop, like lung cancer or loss of hearing, can be caused by long-term exposure to a substance or work activity. These reactions can be noticed long after the job is over.

Hazards are often built Into or brought Into the Workplace

Workplace Hazards

Breaking Rules – A BIG Hazard!

Chronic Respiratory Diseases

Chronic respiratory diseases are chronic diseases of the airways and other structures of the lung. Some of the most common are:

• Asthma• Chronic Obstructive Pulmonary Disease (COPD) • Respiratory Allergies• Occupational Lung Diseases and • Pulmonary Hypertension.

Do you recognize this?

ASTHMA

• Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person.

• During an asthma attack, the lining of the bronchial tubes swells, causing the airways to narrow and reducing the flow of air into and out of the lungs.

Causes of Asthma

• The causes of asthma are not completely understood. However, risk factors for developing asthma include inhaling asthma “triggers”, such as allergens, tobacco smoke and chemical irritants.

• Asthma cannot be cured, but appropriate management can control the disorder and enable people to enjoy a good quality of life.

AsthmaAsthma is a disease in which inflammation of the airways causes airflow into and out of the lungs to be restricted.

Occupational Lung Diseases• Silicosis (silica/cement dusts)

• Brucellosis (brucella bacteria)

• Anthrax (anthrax bacteria)

• Asbestosis (asbestos dust)

• Lung Cancer (viral)

• Black Lung Disease (coal dust)

• Occupational Bronchitis (allergens/bacteria)

• Pneumonia (viral/chemicals/dusts)

Healthy Lungs

Destroyed Lungs (cancer)

Anthrax Bacteria or Bacillus anthracis

CRD Risk Factors

The most important risk factors for preventable chronic respiratorydiseases are:

• Tobacco smoking • Indoor air pollution • Outdoor pollution • Allergens • Occupational risks and vulnerability.

AIR POLLUTION (Indoors)

• Indoor air pollution is contamination of the air inside buildings.

• The most common cause is smoke from open fires or stoves that burn solid fuels, such as coal, wood, dung or crop waste.

• This smoke contains a range of health-damaging pollutants, in particular fine particles.

• It can lead to respiratory diseases and chronic obstructive pulmonary disease in adults.

Examples of Indoor Air Pollution (the “Sick-Building” syndrome)

RADON Gas

Radon is a radioactive gas that occurs naturally in the environment. It comes from the natural breakdown of uranium in soils and rocks.

In the open air, the amount of radon gas is very small and does not pose a health risk.

In some confined spaces like basements and underground mines, radon can accumulate to relatively high levels and become a health hazard.

RADON Gas

After smoking, radon is the next leading cause of lung cancer.

Radon gas can move through small spaces in the soil and rock upon which a house is built. It can seep into a home through dirt floors, cracks in concrete, sumps, joints, basement drains, under the furnace base and jack posts if the base is buried in the floor.

Concrete-block walls are particularly porous to radon and radon trapped in water from wells can be released into the air when the water is used.

Blood borne Pathogens

Blood borne Pathogens are pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B virus (HBV) and Human Immunodeficiency virus (HIV).

Blood borne Pathogens

The Blood borne Pathogens Standard based on the U.S. Department of Labour, OSHA Regulations 29CFR, provides requirements to protect employees from exposure to blood or other potentially infectious materials that may contain blood borne pathogens.

Blood borne Pathogens

There are many blood borne pathogens, but the main infections that pose the greatest risk to workers are the Human Immunodeficiency virus (HIV), Hepatitis B virus (HBV), and Hepatitis C virus (HCV).

Costs of Occupational Injury or Illness

Work-related accidents or diseases are very costlyand can have many serious direct and indirecteffects on the lives of workers and their families.

For workers some of the direct costs of an injury or illness are: • the pain and suffering of the injury or illness• the loss of income• the possible loss of a job• health-care costs.

Costs of Occupational Injury or Illness

For employers, some of the direct costs are: • payment for work not performed• medical and compensation payments• repair or replacement of damaged machinery

and equipment• reduction or a temporary halt in production• increased training expenses and administration

costs• possible reduction in the quality of work• negative effect on morale in other workers.

Costs of Occupational Injury or Illness

Some of the indirect costs for employers are: • the injured/ill worker has to be replaced• a new worker has to be trained and given time to

adjust• it takes time before the new worker is producing

at the rate of the original worker• time must be devoted to obligatory investigations,

to the writing of reports and filling out of forms

Costs of Occupational Injury or Illness

• accidents often arouse the concern of fellow workers and influence labour relations in a negative way.

• poor health and safety conditions in the workplace can also result in poor public relation.

Worker’s Compensation Act 1952(covering foreign workers)

This Act provides for the compensation payment to an injured employee or worker arising out of and in the course of employment or contracting occupational disease.

Important Information on the ACT• Where the employee or worker dies in the event

of fatal accident or contracting an occupational disease or in the course and arising out of performing his duty or work, the Workmen's Compensation Act 1952 provides for the compensation payment to the worker's dependants.

• This Act is administered by the Department of Labour and applies throughout Malaysia.

• Only foreign workers are covered under this Act.• Effective from 1st July 1992, local workers are

covered under the Employees Social Security Act 1969.

Social Security Organization(for Malaysian workers only)

The Social Security Organization (SOCSO)

is an organization set up to administer,

enforce and implement the following:

The Employees' Social Security Act, 1969

and The Employees' Social Security (General) Regulations 1971

More about SOCSO

• It is commonly known in the Malay term as PERKESO or Pertubuhan Keselamatan Sosial.

• The Social Security Organization provides social security protection by social insurance including medical and cash benefits, provision of artificial aids and rehabilitation to employees to reduce the sufferings and to provide financial guarantees and protection to the family.

Who is compulsory to contribute to SOSCO?

• An employee employed under a contract of service or apprenticeship and earning a monthly wages of RM2,500 and below must compulsorily register and contribute to SOCSO regardless of the employment status whether it is permanent, temporary or casual in nature.

• An employee must be registered with the SOCSO irrespective of the age.

SOCSO does NOT cover the following categories of persons

• A person whose wages exceed RM2,000 a month and has never been covered before.

• Government employees. • Domestic servants employed to work in a private

dwelling house which includes a cook, gardeners, house servants, watchman, washer woman and driver.

• Employees who have attained the age of 55 only for purposes of invalidity but if they continue to work they should be covered under the Employment Injuries Scheme.

• Self-employed persons. • Foreign workers.

Compensation and Claims

SOCSO provides coverage to eligible employees through two (2) Schemes namely:

1.Employment Injury Insurance Scheme2. Invalidity Pension Scheme.

These schemes provide the benefits of,

• Invalidity pension• invalidity grant survivors • pension rehabilitation• funeral benefit, • constant attendance allowance and • educational loan.

Compensation and Claims

These schemes are classified into 2 categories :

• First Category - Employment Injury Insurance Scheme and Invalidity Pension Scheme. The contribution payment is made by both the employer and employee

• Second Category - Employment Injury Insurance Scheme Only. The contribution is paid by the employer only. An employee who is not eligible for coverage under the Invalidity Pension Scheme is protected under this category.

LEGISLATIVE FRAMEWORKin Malaysia

Occupational and Safety Health Act 1994ACT 514

(Exercise – via the INTERNET/Download the ACT 514 and report on your findings.)

Some Points we ought to know about the OSHA Act

• All employers (in Malaysia) with more than 5 employees are required by the legislation to formulate a written Safety and Health Policy.

• The object of the Safety and Health Policy is to demonstrate the company's commitment and concern to ensure safety and health at place of work.

• Among the provisions of the OSHA Act 1994 is the establishment of the safety and health committee, the appointment of a safety and health officer and the enforcement, investigation and offenses.

OSHA Standards (often referred to as the General Duty Clause)

(a) Each employer -- (1) shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or are likely to cause death or serious physical harm to his employees(2) shall comply with occupational safety and health standards promulgated under the Act

(b) Each employee shall comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to the Act which are applicable to his own actions and conduct.

HEALTH and SAFETY PROGRAM

The best Safety and Health Programs involve every level of the organization, instilling or promoting a safety culture that reduces accidents for workers and improves the bottom line for managers. When Safety and Health are part of the organization and a way of life, everyone wins.

The First OBJECTIVE

Overview of System Components

• A system is an established arrangement of components that work together to attain a certain objective, in this case to

prevent injuries and illnesses in the workplace.

• Within a system, all parts are interconnected and affect each other.

The four (4) main Components

1. Worksite Analysis (involving thorough inspection)

2. Hazard Prevention and Control

3. Management Leadership and Employee Involvement

4. Safety and Health Training

In reality we are talking of Workplace Safety For ALL

Hazards must be identified

Worksite Analysis Worksite analysis involves a variety of

worksite examinations to identify not only existing hazards, but also conditions and operations in which changes might create hazards.

Effective management actively analyzes the work and the worksite, to anticipate and prevent harmful occurrences. The next slide is an acceptable plan to identify all worksite hazards:

Plan to Identify Worksite Hazards

Identify the Hazards

HAZARD IDENTIFICATION demonstrates a simple but effective way to eliminate or control safety hazards. By highlighting unsafe workplaces, processes, and machinery, it shows you how to list the hazards thus RECONIZING them, eliminate those you are responsible for, and request action to remove those hazards outside your authority.

Major Action Points

1. Conduct a comprehensive, baseline survey for safety and health and ensure periodic surveys are carried out as well to monitor any new facility, processes, materials, and equipment.

2. Perform routine job hazard analysis.

3. Develop and introduce new controls and update inventories (in line with new technologies).

4. Conduct periodic and daily safety and health inspections of the workplace.

.

What we are looking for is -

Actions to form the basis from which good hazard prevention and control can be developed.

Hazard and Prevention ControlAfter detection, all current and potential hazards must be prevented, corrected or controlled. Systems used toprevent and control hazards include:

• Engineering Controls • Safe Work Practices• Administrative Controls • Personal Protective Equipment (PPE) • Systems to Track Hazard Correction • Preventive Maintenance Systems • Emergency Preparation • Medical Programs

Engineering Controls

• The first and best strategy is to control the hazard at its source.

Engineering controls do this, unlike other controls that generally focus on the employee exposed to the hazard. The basic concept behind engineering

controls is that, to the extent feasible, the work environment and the job itself should be designed to eliminate hazards or reduce exposure to hazards.

Engineering Control

Safe Work PracticesSafe work practices include the company’s general workplace rules and other operation-specific rules. Through established safe work practices, employee exposure to hazards can be further reduced.

Some of these specific areas include:

• Respiratory Protection • Lockout/Tagout • Confined Space Entry• Hazard Communication• Blood borne Pathogens• Hearing Conservation• Laboratory Chemical Hygiene

Work Safely (use PPE)

Administrative Controls While safe work practices can be considered

forms of administrative controls, OSHA uses the term administrative controls to mean other measures aimed at reducing employee exposure to hazards.

These measures include additional relief workers, exercise breaks and rotation of workers. These types of controls are normally used in conjunction with other controls that more directly prevent or control exposure to the hazard.

Keep Records

Personal Protective Equipment When exposure to hazards cannot be engineered

completely out of normal operations or maintenance work, and when safe work practices and other forms of administrative controls cannot provide sufficient additional protection, a supplementary method of control is the use of protective clothing or equipment. This is collectively called personal protective equipment, or PPE.

PPE may also be appropriate for controlling hazards while engineering and work practice controls are being installed.

Personal Protective Equipment

Systems to Track Hazard Correction An essential part of any safety and health

system is the correction of hazards that occur despite the overall prevention and control program.

Many companies use the form that documents the original discovery of a hazard to track its correction.

Frequently, companies will computerize their hazard tracking system which can be as simple as adding a few items to an existing database, such as work order tracking.

Preventive Maintenance Systems

Good preventive maintenance plays a major role in ensuring that hazard controls continue to function effectively. It also keeps new hazards from arising due to equipment malfunction.

Reliable scheduling and documentation of maintenance activity is necessary. The scheduling depends on knowledge of what needs maintenance and how often. The point of preventive maintenance is to get the work done before repairs or replacement is needed. Documentation is not only a good idea, but is a necessity in larger companies. Certain OSHA standards also require that preventive maintenance be done.

Emergency PreparationDuring emergencies, hazards that normally are not found in the workplace, may appear. These may be the result of natural causes (floods, typhoons, etc.), events caused by humans but beyond control (train or plane accidents, terrorist activities, etc.), or those within an organization’s own systems.

We must become aware of possible emergencies and plan the best way to control or prevent the hazards they present. Some of the steps in emergency planning include: • Survey of possible emergencies• Planning actions to reduce impact on the workplace• Employee information and training• Emergency drills as needed.

Medical Programs

A company’s medical program is an important part of the safety and health system. It can deliver services that prevent hazards which may cause illness and injury, recognize and treat illness and injury, and limit the severity of work-related injury and illness. The size and complexity of a medical program will depend on many factors, including the:

• Type of processes and materials and the related hazards• Type of facilities• Number of workers• Characteristics of the workforce• Location of each operation and its proximity to a health

care facility.

Medical Programs• May consist of everything from a basic

First Aid to CPR response.

• Either in-house or through arrangements made with a local medical clinic (GH).

• It is important to use medical specialists with occupational health training.

(Note: CPR or Cardiopulmonary Resuscitation is a technique designed to temporarily circulate oxygenated blood through the body of a person whose heart has stopped.)

Administering CPR

Cardiopulmonary Resuscitation

Management Leadership

• Management leadership and employee involvement are complementary.

• Management leadership provides the motivating force and the resources for organizing and controlling activities within the organization.

• Management regards worker safety and health as a fundamental value.

• Employer involvement provides the means through which workers express their own commitment to safety and health, for themselves and their fellow workers.

Visible Leadership from Managers

Successful top managers use a variety of techniques that visibly involve them in the safety and health protection of their workers. Managers should look for methods that fit their style and workplace. Some methods include:

• Getting out where you can be seen, informally or through formal inspections.

• Being accessible.

• Being an example, by knowing and following the rules employees are expected to follow.

• Being involved by participating on the workplace Safety and Health Committee.

Employee Involvement

OSHA is aware that the growing recognition of the value of employee involvement and the increasing number and variety of employee participation arrangements can raise legal concerns. It makes good sense to consult your labor relations advisor (or HR Dept) to ensure that any employee involvement program conforms to current legal requirements.

Why should employees be involved?

• Rank and file workers are the persons most in contact with potential safety and health hazards. They have a vested interest in effective protection programs.

• Group decisions have the advantage of the group’s wider range of experience.

• Employees are more likely to support and use programs in which they have input.

What can employees do to be involved?

Examples of employee participation include: • Participating on joint labor-management

committees and other advisory or specific purpose committees.

• Conducting site inspections.• Analyzing routine hazards in each step of a job or

process, and preparing safe work practices or controls to eliminate or reduce exposure.

• Developing and revising the site safety and health rules.

• Training both current and newly hired employees. • Providing programs and presentations at safety

and health meetings.

What can employees do to be involved?

• Conducting accident/incident investigations. • Reporting hazards. • Fixing hazards within your control. • Supporting your fellow workers by providing

feedback on risks and assisting them in eliminating hazards.

• Participating in accident/incident investigations. • Performing a pre-use or change analysis for new

equipment or processes in order to identify hazards up front before use.

Accountability from Managers and Employees

When managers and employees are held accountable for their safety and health responsibilities, they are more likely to press for solutions to safety and health problems than to present barriers. By implementing an accountability system, positive involvement in the safety and health program is created.

Accountability – Making it Effective

Any accountability system should have the following elements to be effective:

• Established standards in the form of company policies, procedures or rules that clearly convey standards of performance in safety and health to employees.

• Resources needed to meet the standards, such as a safe and healthful workplace, effective training, and adequate oversight of work operations.

• A measurement system which specifies acceptable performance e.g. consequences, both positive and negative.

• Application at all levels.

Review of Program Operations

• The last action recommended under management leadership and employee involvement is an annual review of program operations to evaluate success in meeting the goal and objectives.

• A comprehensive program audit is needed to evaluate the safety and health management means, methods, and processes, to ensure they are protecting against worksite hazards.

Review of Program Operations

• The audit determines whether the policies and procedures are implemented as planned and whether they have met the objectives set for the program. This allows for the identification of opportunities for improvement and can drive the following year's planning process.

Employee Recognition Program

In the US, the Department of Labor operates an

Employee Recognition Program to encourage

employees to participate fully in improving

operations and to recognize and reward

employees whose contributions and day-to-day

input merit special attention. OSHA fully endorses

this program and encourages maximum

participation of all personnel.

Letters of Commendation

Commendation of employees via letters of

recognition for excellent compliance to

safety and health or some other matters

related to safety at workplace can also be

made by management to all levels of

employees as a gesture of work well done.

Safety and Health Training

We cannot assume that everyone in the workplace knows the hazards around them. Some of the QUESTIONS asked are:

• What are the workplace plan in case of a fire or other emergency?

• When and where PPE is required? • What are the types of chemicals used in the

workplace? • What are the precautions when handling them? • Can Training help to develop the knowledge and

skills needed to understand workplace hazards and safe procedures?

OSHA considers Safety and Health Training vital to every workplace

It is most effective when integrated into a company’s overall training in performance requirements and job practices.

Identification of needs is an important early step in training design. Involving everyone in this process and in the subsequent teaching can be highly effective.

The Five (5) PrinciplesThe five (5) principles of teaching and learning should be followed to maximize program effectiveness. They are:

• Trainees should understand the purpose of the training. • Information should be organized to maximize

effectiveness. • People learn best when they can immediately practice

and apply newly acquired knowledge and skills. • As trainees practice, they should get feedback. • People learn in different ways, so an effective program

will incorporate a variety of training methods.

Who needs Training?Training should target new hires, contract workers, employees who wear personal protective equipment, and workers in high risk areas.

Managers and supervisors should also be included in the training plan. Training for managers should emphasize the importance of their role in visibly supporting the safety and health program and setting a good example. Supervisors should receive training in company policies and procedures, as well as hazard detection and control, accident investigation, handling of emergencies, and how to train and reinforce training.

The long-term worker whose job changes as a result of new processes or materials should not be overlooked. And the entire workforce needs periodic refresher training in responding to emergencies.

Plan to EVALUATE the Training

If the evaluation is done right, it can identify your program’s strengths and weaknesses, and provide a basis for future program changes.

Keeping training records will help ensure that everyone who should get training does. A simple form can document the training record for each employee.

OSHA has developed voluntary training guidelines to assist in the design and implementation of effective training programs.

Types of Training• Orientation Training for site workers and contract

personnel. • JSAs (Joint Service Agreement), SOPs

(Standard Operating Procedures), and other hazard recognition training.

• Training required by OSHA standards, including the Process Safety Management standard.

• Training for emergency response people. • Accident investigation training.• Emergency drills.

PPE Hazard Assessment and Training

The basic element of any management program for PPE should be an in depth evaluation of the equipment needed to protect against the hazards at the workplace. The evaluation should be used to set a standard operating procedure for personnel, then train employees on the protective limitations of the PPE, and on its proper use and maintenance.

Using PPE requires hazard awareness and training on the part of the user. Employees must be aware that the equipment does not eliminate the hazard. If the equipment fails, exposure will occur. To reduce the possibility of failure, equipment must be properly fitted and maintained in a clean and serviceable condition.

MITIGATIONMitigation is any sustained action taken to reduce

or eliminate long-term risk to life and property from

a hazard event. This process has four (4) steps:

1. Organizing resources.

2. Assessing risks.

3. Developing a mitigation plan.

4. Implementing the plan and monitoring progress.

Safety InspectionSafety Inspection of workplaces (The Walk Round – look andcheck at/for) must be carried out on a periodical basis i.e. regularly. A Safety Inspection Check list must be used and the following should be included:

1. Poor housekeeping causing hazards e.g. trips, obstructions, fire risks

2. Trip hazards - wires, cables, damaged flooring, items stored on floor

3. Electrical equipment - not PAT tested, defective, unauthorized fires, toasters etc, overloaded sockets, extension leads and adaptors.

4. Safety signage - missing damaged, obscured5. Fire and/or office- damaged, gaps in, missing closers, not closing

properly;6. Smoking - in no smoking areas7. Fire extinguishers - missing, used, not checked in last 12 months8. Junk in fire escape routes9. Ladders - check for any defects - bends, bashes, missing feet or

rungs, wobbly etc. 10. Staff complaints/comments - ask staff if they have any.11. First Aid - are all boxes reasonably stocked?

Unscheduled Safety Inspection

• In addition to scheduled safety inspections, it is useful for senior members of an organization to undertake periodic unscheduled safety tours to ensure that, for example, standards of house-keeping are acceptable, fire protection precautions are being maintained and that personal protective equipment is being correctly used. In addition to being a useful extra check, this will demonstrate their commitment to safety.

• The term "safety audit" should be reserved for the systematic critical examination of all areas of an organization's activities, including for example management policy, attitudes, training, processes, personal protection needs and emergency procedures, with the object of minimizing injury and loss.

Accident Reporting

Reasons to investigate a workplace accident include: • most importantly, to find out the cause of

accidents and to prevent similar accidents in the future.

• to fulfill any legal requirements.• to determine the cost of an accident.• to determine compliance with applicable safety

regulations.• to process workers' compensation claims.

The ProcessThe accident investigation process involves thefollowing steps: • Report the accident occurrence to a designated person

within the organization • Provide first aid and medical care to injured person(s)

and prevent further injuries or damage• Investigate the accident• Identify the causes• Report the findings• Develop a plan for corrective action • Implement the plan• Evaluate the effectiveness of the corrective action• Make changes for continuous improvement.

Accident reporting

A preliminary investigation includes noting

information such as the following: – - Where did the accident or incident occur? – - What time did it occur? – - What people were present? – - What was the employee doing at the time of

the accident or incident? – - What happened during the accident or

incident?

Accident Causation Models

• Many models of accident causation have been proposed, ranging from Heinrich's Domino Theory to the sophisticated Management Oversight and Risk Tree (MORT).

• The causes of any accident can be grouped into five categories - task, material, environment, personnel, and management.

Accident Causation

The Five (5) categories

1. Task – e.g. work procedure, appropriate tools, safety devices.

2. Material – e.g. equipment failure, materials used, use of PPE.

3. Environment – e.g. weather conditions, poor housekeeping, noise.

4. Personnel – e.g. training, status of health, stress.

5. Management – e.g. safety rules, adequate supervision, regular safety inspection.

Occupational EPIDEMIOLOGY

• Occupational epidemiology involves the application of epidemiologic methods to populations of workers.

• Occupational epidemiologic studies may involve looking at workers exposed to a variety of chemical, biological or physical (e.g. noise, heat, radiation) agents to determine if the exposures result in the risk of adverse health outcomes.

• Alternatively, epidemiologic studies may involve the evaluation of workers with a common adverse health outcome to determine if an agent or set of agents may explain their disease.

The Epidemiologic Triangle (Triad)

• Disease is the result of complex interactions (imbalance) between the triad of the agent (toxic or infectious), the host and the environment.

• Recognizing the different components of this triad is important because they are the source of opportunities to reduce disease at multiple points in the transmission cycle.

• A common mistake is to focus on only one aspect of the triad for disease control or prevention and to overlook the others.

Epidemiologic Triad

AgentAgent

HostHost EnvironmentEnvironment

Agent Factor Examples

– Dose– Environmental hardiness– Virulence (microbial)– Infectivity (microbial)– Toxicity (poisons).

Host Factor Examples

– Innate resistance (e.g. gastric barrier, mucocilliary transport mechanism)

– Previous exposure– Vaccination status and response– Age– Gender– Behavior (e.g. mutual grooming, dominance)– Production status (e.g., lactating vs. non-lactating)– Reproductive status (e.g., pregnant vs. non-pregnant

sterile vs. intact)– Genetics – Intrinsic (non-changeable in the individual).

When evacuating the Building(Egress)

1.Leave by the nearest staircase. DO NOT use the elevators unless under police or fire department supervision. Floor plans should be posted at various areas around the building for route of quickest egress.

2.Assemble at least 100 feet away from the building for a head count conducted by your local Fire Marshall or Warden. Quickly identify any individuals whom you suspect might still be in the building and alert fire or police department personnel.

When evacuating the Building(Egress)

3.Disabled Occupants - If a disabled occupant is unable to exit the building unassisted, the Fire Marshall or Warden must notify the emergency response personnel of the person's location. Transporting of disabled individuals up or down stairwells should be avoided until emergency response personnel have arrived.

OCCUPATIONAL HEALTH AND SAFETY COORDINATOR (Officer)

TASKS and RESPONSIBILITIES:

• plans, organizes, directs and coordinates the Occupational Health and Safety Program.

• plans, develops, implements, and monitors programs, policies and procedures to ensure compliance of workplace safety and health laws and regulations.

• identifies program needs and sets program priorities.• conducts field (workplace) inspections. • distributes pertinent safety information to employees and

management.• requests for technical assistance e.g. training where

required.

Safety Monitors (Wardens)

The Safety Monitors are responsible for:

• Familiarizing personnel with emergency procedures.

• Acting as liaison between management and their work area.

• Ensuring that occupants have vacated the premise in the event of an evacuation, and for checking assigned areas.

• Knowing where their Designated Meeting Site is and for communicating this information to occupants.

Safety Monitors (Wardens)

• Having a list of personnel in their area of coverage, so a head count can be made at the assembly point.

• Ensuring that disabled persons and visitors are assisted in evacuating the building.

• Evaluating and reporting problems to the Emergency Coordinator after an emergency event.

• Posting the "Area Evacuation Plan" in their work areas, communicating plan to occupants, and updating the plan annually.

Biostatistics(Useful information)

1. The science of statistics applied to the analysis of biological or medical data.

2.Biostatistics in the public health context consists primarily of developing descriptive statistics describing the overall health and well being of a population.

Exercise via InternetBiostatistics

Look up for Biostatistics and report your findings in the next class. Group discussion.

WHAT IS HAPPENING HERE?

Responsibility of anOSHA personnel

Do NOT compromise on SAFETY,

it is your duty to ensure a

SAFE and HEALTHY

work environment!