Health Risk Assessment

1. Health Risk Assessment Controlling health risks at work

2. What is HRA ?

3. Identifying and Assessing Health Hazards • Selection of team • Identifying and assessing Health Hazards • Identifying Control Standards • Identifying nature and degree of Exposure • Evaluating Risk to Health • Deciding on Remedial Action

4. Selection of team The selection and expertise of the Health Risk Assessment Team will be dictated by: • Size and complexity of the Assessment Unit or activity being assessed e.g. Platform, Gas Plant • Nature and severity of of the hazards and risks involved • Familiarity of the activities

5. Selection of team • Team Leader / Asset owner–Line manager such as OIM, plant manager or representative of facility being assessed • Team Member –Individuals such as operational staff, line supervisor familiar with plant operation and process • Local Advisor –Individuals such as medic/OH nurse, HSE advisor, who can advise on the HRA process and exposure controls • Specialist Staff –Occupational hygienist, OH physician, toxicologist, ergonomist

6. Selection of team To gather necessary information team members must be able to: • Observe the activity being performed • Predict any potential departure from observed practice • Ask supervisors, staff etc. the relevant questions • Undertake simple diagnostic tests • Identify and review relevant technical literature • Gather the information systematically • Form valid, justifiable conclusions about exposures and risks

7. Selection of team To gather necessary information team members must be able to: • Follow up fundamental questions about any exposures to occur. • Appreciatethe range and limitations of possible control measures and their relative reliability • Look critically at existing arrangements • Specify the type of control measures needed • Ask for specialist assistance if required

8. Selection of Team The required level of skill and level of competency for the team: Team Leader Awareness - Working knowledge Team Member Working knowledge - Skilled Local Advisor Skilled Specialist Mastery

9. Competent Persons • ‘ .. a man who has the knowledge to know what he is looking for and the experience to recognise it when he sees it ...’ • Competence is a function of: • Knowledge • Skill • Experience

10. Gathering Information • How to select Assessment Units • Identify Health Hazards • Identify harmful effects • Assign Hazard Rating (RAM Consequence)

11. How to select Assessment Units • The assessment unit is what is within the boundaries of the HRA • Assessment units should be self-contained, either physically or as a process • It should cover all aspects of the working environment • The nature and the severity of the hazards and risks involved, the familiarity of the task, available resources and country-specific requirements should be taken into account

12. Organisation and Preparation Do not forget to: • Set a realistic time frame to actually carry out an HRA • Conduct an HRA according to a mutually agreed program • Use standardized HRA formats • Provide sufficient time for report writing, sharing comments and feedback • Keep ownership of HRA with the Business Unit

13. Organisation and Preparation Collect pre reading material and references such as: • Plans and drawings for plant specifications • Incident / injury reports (incl. occupational illnesses) and incident investigations • Plant and equipment fault reports • Maintenance records for control measures • Records of health surveillance and sickness absence • Occupational hygiene surveys, health and safety surveys • Minutes of health and safety committee meetings

14. Additional sources of information Collect pre reading material and references such as: • Relevant Shell HSE publications • Business Health Hazard Inventories • Company standards • National legal standards • Local health regulations • (Inter)national guidelines and standards (WHO, ISO) • Industry standards, manufacturers/suppliers data

15. What are Health Hazards • A Health Hazard has the potential to cause harm to health • Health hazards may be divided into the following groups: • chemical • biological • physical • ergonomic • psychological

16. Health hazards of primary concern • Cause fatalities in the short or long term • e.g. infectious diseases (short term), carcinogenic substances (long term) • Expose the company to substantial future social and monetary liabilities • e.g. noise induced hearing loss, repetitive strain injury, psychological stress • Cause minor health effects which could cause severe business disruption • e.g. major food poisoning outbreak

17. How to identify Health Hazards • Walk through surveys • Looking, smelling, talking, listening; use your senses! • Refer to Health Hazard Inventories • Use HRA Yellow Guide, appendix 2 • Look at Records • incident/fault reports, inspections, maintenance, sickness absence, hygiene surveys, operating procedures • Use experience from elsewhere

18. Chemical Physical Biological Ergonomic Psychological Practical ExerciseIdentify Health Hazards

19. Identify Harmful Effects • The harmful effects potentially caused by a hazard need to be identified • Examples of harmful effects: • Death • Acute or chronic illnesses • Disability • Reduced job performance • Reduced health • Concern

20. Types of Effects • Acute, immediate • Lung, skin or eye damage from corrosive liquid • Acute, late onset • Sick building syndrome • Chronic, intermittent / on-off • Repetitive Strain Injury • Chronic permanent • Lung cancer

21. Identification of Effects • Datasheets, labels, manuals • Guidance material, e.g Health Hazard Inventories • Occupational health advisors • Journals and reference literature • National competent bodies and institutes • Governmental bodies • NGOs

22. Identify Health Hazards and their Harmful Effects Hazard Source Route Harmful Effect

23. Identify Health Hazards and their harmful Effects Agent Source Route Harmful Effect Silica dust (crystalline) Used mineral oils Noise Heat Legionella bacteria Repetitive movements Refractory bricks Engine oil Process noise above 85dB(A) Plant heat Spray cooling towers Workplace design Inhalation Skin Hearing Whole body Inhalation Whole or part of body Lung disease (silicosis) Dermatitis, cancer Hearing Loss Heat stress, heat stroke Legionnaire’s Disease Musculo-skeletal disorders

24. Factors influencing the Relationship between Hazard and Risk • Cumulative exposure • Individual susceptibility • Threshold levels • Knowledge gaps • Workstyle changes • Real world practices

25. Assigning Hazard Ratings

26. Hazard Ratings Consider Harm to: • People • Assets • Reputation Select the category with the highest consequence rating!

27. Practical Exercise - Assigning Hazard Ratings • Assign hazard ratings to the selection of health hazards identified • Discuss in open forum

28. Risk Assessment Matrix The Risk Assessment Matrix (RAM) is the tool which allows assessment of the risk to the business from each identified health hazard It will assist you in prioritizing potential health risks and determine which risks need documented demonstration of controls Ensure that health risks are assessed properly by taking into account acute and chronic harmful health effects

29. Health Risk = Consequences X Probability (Likelihood) Likelihood Acute - Estimated on the basis of experience and or evidence that a certain outcome has previously occurred Chronic - Estimated based on the historical evidence that excess exposure has occurred Consequence Estimate of what could happen (acute and chronic)

30. Risk Assessment Matrix Manage for continuous improvement Incorporate risk reduction measures Intolerable – investigate alternatives

31. Health Hazard Examples of situations or activities in which the health hazard may occur Harmful health effects from over exposure (Consequences) Consequence Category (harm to people) - C Likelihood - L RAM Risk Rating (C x L) Chemical Hazards Asbestos Materials containing asbestos, for example, gaskets, ceiling tiles, partitians, insulation Acute: Mildly Irritating to eyes and respiratory tract Chronic: Category 1 carcinogen Cat 1 Carcinogen: 4/5 C 5C - High Benzene Processing, handling and distribution of benzene containing process streams and products, e.g. naphthas, platformate, condensate, gasoline. Acute: Irritant to eyes and respiratory tract; narcotic to CNS. Chronic: Category 1 carcinogen Cat 1 Carcinogen: 4/5 B 5B - Medium Ethylene oxide Shell chemicals marketed product and process material Acute: cold burns to skin and eyes. Shortness of breath, dizziness and drowsiness on inhalation. May cause pulmonary oedema. Chronic: Category 2 carcinogen and mutagen Cat 2 Carcinogen: 4/5 B 4B - Medium Epoxy Resins Contained in some adhesives (maintenance) Acute: Irritant to skin and eyes Chronic: skin sensitiser Sensitiser: 3 C 3C - Medium Hydrogen sulphide Waste gas stream; sour crude oil; condensates; bitumen and fuel oil tank head spaces Acute: Chemical asphyxiant causing respiratory paralysis. Chronic: n/a Chemical asphyxiant: 5 C 5C - High Generic RAM HRA outcomes

32. Low RAM Ratings • Manage for continuous improvement • via standard procedures and competences in HSE-MS (ensure these are adequate) • ensure Exposure Limits and other control standards are met

33. Medium and High RAM Ratings • Detailed review of controls • Standards of control • Who is exposed and when • Estimate or measure exposure • Compare existing controls against standards (are OELs met and risks As Low As Reasonably Practicable - ALARP?) • Consider need for routine exposure monitoring and/or health surveillance • For risks assessed as High • give serious consideration to alternative ways of carrying out the operation

34. Control and Recovery • Identify exposure • Hierarchy of controls • Control standards • Use of control chart for individual risk • Apply ALARP principle • Exposure measurements • Health Surveillance

35. What is exposure? Exposure is defined as: The amount of the hazard to which a person has been exposed(dose). This is a combination of the magnitude, frequency and duration of exposure

36. Exposure • Duration • Frequency • Magnitude (extent of exposure) is affected by: • Concentration/intensity of the agent • Work practices • Agent’s physical characteristic impacting on the exposure route • Existing controls

37. Exposure routes Eye Ear Nose Mouth Lung Musculo-skeletal Skin Whole body

38. Hazards and Exposure routes

39. Target Organs Central nervous system Eye Nose Ear Mouth Lung Heart Musculo-skeletal system Liver Digestive tract Skin Kidneys Reproductive system

40. Hazard, exposure route and target organ

41. Factors Affecting Intake for chemical and biological agents • Physical form • Gas/vapour/liquid/solid • Particle size • Particle shape • Solubility • Carriers • Breathing rate

42. How to identify exposure • Identify who is exposed: • Divide workforce into groups (Job Types) with expected similar exposures • Estimate the exposure level: • Identify and review tasks involving potential exposure • Base estimate on a combination of qualitative and quantitative assessments of exposure, as needed • Establish the effectiveness of existing controls

43. Identify who is exposed • Typical Job Types • Plant Operators - divided by operational group • Road Tanker Drivers - divided by product group • Maintenance Staff - mechanical, electrical, vehicle etc. • Cleaning Staff - plant and/or office • Laboratory Technicians - sub-divide as appropriate • Administrators - office based with minimal plant exposure • Field Staff - geologists

44. Estimate exposure level • Identify tasks: • Use workplace experience • Review historical records • Discuss with staff involved in doing the task • Visit work area/walk through survey • Include tasks involved in: • Normal operations • Maintenance • Abnormal conditions and foreseeable emergencies

45. Estimate exposure level • What is a ‘task’ ? • An activity which a competent person can be instructed to do in a single sentence • A plant operator could be asked to take a process stream sample • A plant cleaner could be asked to deal with a spillage • A fitter could be asked to take a pump out of service • A laboratory technician could be asked to analyse a sample for benzene content

46. Estimate exposure level • Review tasks • Frequency, duration and estimates of concentration/intensity of exposure • Work practices and existing controls • Effectiveness of existing control measures • Compare existing controls against relevant control standards • Who else is exposed? • Employees, contractors, third parties

47. Estimate exposure level-without exposure measurement • Exposure may be acceptable when: • evidently so • operations are in accordance with suppliers’ documented procedures • previous measurements under similar or worst case conditions indicate low exposure • process operated in accordance with recognised guidance on good practice

48. Estimate exposure level-without exposure measurement • Exposure may be unacceptable when: • there is evidence of fine dust deposits • fume or particles are visible in light beams • there are broken, defective or poorly maintained controls • the process is not operated in accordance with recognised guidance on good practice • complaints are made of discomfort or excessive odour • ill-health related to exposure is detected

49. Hierarchy of controls • The hierarchy of controls is a list in preferential order of the means by which exposure to health hazards can be controlled • Elimination • Substitution (alternatives) • Engineering (plant and equipment) • Procedural • Personal protective equipment

50. Types of controls • Elimination and substitution • Engineering (plant and equipment): • Equipment/processes designed to prevent or minimize release of the hazard • Examples: containment (enclosure), exhaust ventilation, remote venting/vapor recovery systems