Occupational Health & Industrial Hygiene Management FFBL – HSE Seminar

1. Occupational Health & Industrial Hygiene ManagementFFBL – HSE Seminar Dr. Tahir Baig Barlas OHSE - Consultant Barlas HSE Solutions, Systems Certification & CSR Consultancy Services

2. WHO AM I ? • Ex – Corporate HSE Manager Azgard9 Group • (Pak American Fertilizers & Textile Business) • Ex – GM HSE PIA • EX- Country Corporate HSE Manager Shell Companies in Pakistan • Ex- Occupational Health Physician ICI Pakistan • Visiting HSE Consultant PSTD • OHS Training Resource – ILO Turin Italy

3. What HSE is all ABOUT! Harry, age 16, 1908. Pulled into machinery in a factory. His arm was ripped off at the shoulder and his leg broken.

4. LOCAL LAGISLATION HSE POLICY Goal of no harm to People HSE-MS Manage all HSE Risks HEALTH HEMP / MHMS HRA of HSE Critical Activities OHSAS 18001/ ISO14001 MHMS Implementation of Standards DRIVERS OF OCCUPATIONAL HEALTH PROGRAM

5. Aims of Occupational Health • Promote and maintain highest degree of physical, mental and social well-being of workers in all occupations; • Prevent among workers all departures from Health caused by their working condition; • Protect workers in their employment from risks resulting from factors adverse to health; and, • Place and maintain the worker in an occupational environment adapted to his physiological and psychological capacity. • Prediction of health outcomes!

6. Occupational Health Perspectives There are generally two adopted views on Occupational Health: • Restricted or workplace focused • Wider view to include the workplace and the communities in and around the work site.

7. Focus of Occupational Health Focus of Occupational Health • The maintenance and promotion of worker’s health and working capacity • The improvement of the working environment and work to become conducive to safety and health • Development of work organizations and working cultures in a direction which supports health and safety at work and in doing so also promotes a positive social climate and smooth operation and may enhance productivity

8. Leadership and Commitment Policy and Strategic Obj. Org., Resp., Resources Standards. & Doc. HazardandEffectsManagement Corrective Action Planning & Procedures Monitoring Implementation Corrective Action & Audit Improvement Corrective Action & Management Review Improvement HRA ASSESS IDENTIFY HEMP CONTROL RECOVER HEMP HSE Management System Hazard and Effects Management Process

9. Structure of HEMP Hazards and Effects Management (HEMP) Identify Are people, environment or assets exposed to potential harm ? What are the causes and consequences ? How likely is loss of control ? What is the risk and is it ALARP ? Assess Control Can the causes be eliminated ? What controls/barriers are needed ? How effective are the controls/barriers ? Can the potential consequences or effects be mitigated ? What recovery measures are needed ? Are recovery capabilities suitable and sufficient ? Recover

10. What is Health? • Health is defined as: • “Health is more than the absence of sickness! It is a state of spiritual, mental and physical well-being, which enables a person to face any crisis in life” • Pericles, 430 B.C. Health is a state of spiritual, mental and physical well being

11. What Determines Your Health? • Who you are(PREDICT) • your genes • Your Lifestyle(PROMOTE) • diet - stress - smoking - exercise - alcohol - drugs • Your Environment(PROTECT) • domestic - workplace - leisure

13. “ Health is too important to leave it to the Doctors ”

14. A Few General Thoughts • Occupational health involves predicting vulnerabilities, promotinggood health and protecting the workforce. • Exposure levels in the workplace can be much higher than those in general environment. • Occupational health deserves more focus because ill-health effects may not manifest for a long period of time. • The Health Risk Assessment identifies, evaluates and seek ways to control the impact of occupational hazards to the worker; hence preventing illnesses acquired through such direct workplace exposures • A responsible company goes beyond occupational health to promote general health and well-being

15. Health Risk Assessment A structured approach to identifying evaluating and controlling health hazards in the workplace

16. IDENTIFY ASSESS HRA HEMP CONTROL RECOVER HEMP HEALTH HEMP The 4 steps of HEMP when applied through the HRA tool identify and assess health risks, and specify appropriate exposure control and recovery measures. It addresses full range of health effects and takes account of both probability and level of exposure to health hazards.

17. No Hazard = No Risk Hazard, but No Exposure = No Risk Health Risk = Hazard x Exposure Hazards and Risks • Hazard • Potential to cause harm • Exposure (Contact with hazard) • How much? • How long? • How frequent? • Risk • Likelihood that a hazard will cause harm • Hazard x Exposure

18. Types of Health Hazards Psychological Ergonomic Physical Chemical Biological Psychological Stress, human interactions workplace relationships. Noise, heat, radiation, vibration, extreme temperatures, Workplace layout, manual handling, body posture and movement, micro environment, RSI, operations, tasks and jobs Gases, dust, metals, solvents, which may be present in the working environment as gases, vapours, mists/aerosols, fumes, dusts, liquids or solids. Bacteria, fungi, viruses, insects and mites, moulds, yeast, related to the working environment

19. Occupational Chemical Exposure

20. Physical & Chemical Hazards Welding fumes; noise Heat Dermatitis Dust; noise

21. Ergonomics Risks • Manual Handling • Lifting • Carrying • Pushing • Pulling • Moving • Twisting • Stretching

22. RSI – Repetitive Strain Injuries • Pain and discomfort • Heaviness • Pins - needles sensation • Numbness • It even disturbs sleep • Muscle weakness

23. Cause and Effect SAFETY HEALTH CAUSE CAUSE Time Heredity Dose PreviousExposures Lifestyle EFFECT EFFECT

24. Cause and Effect of work related injuries and diseases Lung cancer Cause ishard to see Fume fevers Stress Leukaemia Dermatitis Musculo-skeletal disorders SolventEffects Noise Induced Hearing Loss Welder’s Flash Cause is easy to see Mesothelioma Accidents Minutes Days Months Years Decades

25. Key Elements of Occupational Health Program • Health Risk Assessment (HRA) • Monitoring of Health Performance and Incident Reporting & Investigation • Fitness to Work (FTW) • Product Stewardship • Local Health Facilities and Medical Emergency Response • Wellness Program – Healthy Lifestyle Workshops, Stress Management Program, Well Women’s Clinic, Travel Health Clinic

26. Comprehensive Occupational Health ProgramHealth Risk Assessment

27. Identify Health Hazards & 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

28. Routes of intake • Routes of intake of agents into the body • Inhalation • Skin • Ingestion • Injection • Whole body

29. Basic Physiology Eye Ear Nose Mouth Lung Heart Liver Stomach Skin Kidneys

30. Biological Hazards • Insect-borne diseases • malaria, leptospirosis, dengue • Water-borne diseases • legionella • Food borne diseases • typhoid, dysentery, food poisoning • Infectious diseases • HIV, Hepatitis Legionnaire’s disease Malaria

31. Ergonomics & Psychological Hazards

32. WORKLIFE BALANCE “You spend half your life sacrificing your health to earn money And the other half of your life spending the money you have earned to regain your health”

33. HAZARD RATING DEFINITION in terms of potential to cause harm 0 No injury or damage to health Slight health effects: Not affecting work performance or causing disability - non toxic dusts (as an acute hazard) 1 2 Minor health effects: Agents capable of limited health effects which are reversible, e.g. irritant agents, defatting agents, many food poisoning bacteria 3 Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling taks, hand/arm vibration, chemicals causing systemic effects, sensitisers 4 Fatality or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), heat, cold 5 Multiple Fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (H2S, CO), known human carcinogens (large exposed population) Assigning an Agent Hazard Rating

34. Assigning an Exposure Rating EXPOSURE RATING DEFINITION VERY LOW (A) Exposures are negligible LOW (B) Exposures are controlled and likely to remain so in accordance with screening and performance criteria MEDIUM (C) Exposures are currently controlled to meet screening and performance criteria but control cannot be assured HIGH (D) Exposures are not adequately controlled to meet screening and performance criteria and continuously/regularly exceed Occupational Exposure Limits VERY HIGH (E) Exposures are excessive and will almost certainly result in health damage to persons exposed

35. Risk Assessment Matrix Increasing Probability Consequence A B C D E Happens several times per year in Co. Happens several times per year at locn. Incident has occurred in our company Heard of incident in our industry Never heard of in our Industry People Assets Environment Reputation Rating Noinjury No damage No effect No impact 0 Slight effect Slight impact Slight damage Slight injury 1 Low Minor damage Minor injury Minor effect Limitedimpact 2 Major injury Localised effect Considerable impact Localisd damage 3 Medium Major effect Single fatality Major damage Major national 4 High Multiple fatalities Extensive damage Massive effect Major international 5

36. The Hierarchy of Controls

37. • Tolerability level Risk to Health Cost of Control • • • • • Legal Liability ALARP Wasteful ALARP ?

38. What is ALARP ? • As Low As Reasonably Practicable • Five factors to consider • COST- The amount of money required to combat a slight possibility of risk is limited • OBVIOUSNESS - The more obvious the risk the greater the potential liability • INHERENT RISK - All work carries risk to some extent which is irreducible or irremovable and for which the employer cannot be held liable • LIKELIHOOD OF INJURY - The greater the risk, the greater the liability • SERIOUSNESS OF INJURY- The more serious the consequence the more precautions should be taken

39. Control Chart Third Priority Second Priority No Immediate Action Required First Priority For Action Second Priority Third Priority

40. Comprehensive Occupational Health ProgramMonitoring of Health Performance and Incident Reporting & Investigation

41. Exposure Measurement • Baseline Survey • May include worst case • Detailed Survey • To define the degree and pattern of exposure • Routine Exposure Monitoring • Monitoring as a control/barrier in its own right • Competence

42. When to Measure Exposure ? • An agent has irreversible effects (e.g. carcinogens) • Justification for additional control measures • Choice of control measures (e.g. for noise control) • Verification of the efficiency of control measures • Employee concerns are expressed • Legal / Customer requirements • Epidemiological studies

43. Health Surveillance • Audiometry Program • Spirometry Program • Biological Monitoring Program • Drugs & Alcohol Abuse Program • keep records on individual exposures • Develop Work History of Employee Exposure • use medical or biological procedures to identify significant abnormalities as early as possible • consider appropriateness of test procedures

44. Comprehensive Occupational Health ProgramFitness to Work (FTW)

45. Fitness to Work (FTW) Employee selected for position for which fitness to work medical evaluation is required Periodic review Initial screening evaluation With cause evaluation Further evaluation required No medical concerns Detailed medical and task assessment Unfit for task Accommodation process Fit for task

46. Comprehensive Occupational Health ProgramHealth Facilities and Medical Emergency Response

47. 3 Pillars and 7 Principles of SD Delivering Value toCustomers Meeting ProfitTargets Respecting and SafeguardingPeople Purpose Earning our right to grow Contributing toCommunities Building StakeholderRelations Reducing Impact on theEnvironment Using ResourcesEfficiently

48. Philosophy of HSE Management Systems – Continuous Improvement!

49. Thank you for your attentionAny Questions!