Occupational Health & Industrial
Hygiene Management
FFBL – HSE Seminar
Dr. Tahir Baig Barlas
OHSE - Consultant
Barlas HSE Solutions, Systems
Certification & CSR Consultancy
Services
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
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.
DRIVERS OF OCCUPATIONAL
HEALTH PROGRAM
LOCAL LAGISLATION
Goal of no harm to People
HSE POLICY
HSE-MS
HEALTH
HEMP / MHMS
OHSAS 18001/ ISO14001
MHMS
Manage all HSE Risks
HRA of HSE Critical Activities
Implementation of Standards
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!
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.
Focus of Occupational Health
Focus of Occupational Health
1. The maintenance and promotion of worker’s health
and working capacity
2. The improvement of the working environment and
work to become conducive to safety and health
3. 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
HRA
Leadership and Commitment
Policy and Strategic Obj.
Org., Resp., Resources
Standards. & Doc.
Hazard and Effects Management
IDENTIFY
ASSESS
HEMP
HEMP
RECOVER
CONTROL
Hazard and Effects
Management Process
Planning & Procedures
Corrective
Action
Implementation
Monitoring
Audit
Corrective Action &
Improvement
Management Review
Corrective Action &
Improvement
HSE Management System
Structure of HEMP
Hazards and Effects Management (HEMP)
Identify
Assess
Control
Recover
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 ?
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 ?
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
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
“ Health is too important to leave it to
the Doctors ”
A Few General Thoughts
 Occupational health involves predicting vulnerabilities,
promoting good 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 illhealth 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
Health Risk Assessment
A structured approach to identifying evaluating and
controlling health hazards in the workplace
IDENTIFY
ASSESS
HEMP
HRA
CONTROLHEMP RECOVER
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.
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
No Hazard = No Risk
Hazard, but No Exposure
= No Risk
Health Risk =
Hazard x Exposure
Types of Health Hazards
Noise, heat, radiation,
vibration, extreme
temperatures,
Physical
Chemical
Gases, dust, metals, solvents,
which may be present in the
working environment as gases,
vapours, mists/aerosols, fumes,
dusts, liquids or solids.
Psychological
Psychological Stress,
human interactions
workplace relationships.
Ergonomic
Workplace layout, manual
handling, body posture and
movement, micro
environment, RSI,
operations, tasks and jobs
Biological
Bacteria, fungi,
viruses, insects and
mites, moulds, yeast,
related to the
working environment
Occupational Chemical Exposure
Physical & Chemical Hazards
Welding fumes;
noise
Dust; noise
Dermatitis
Heat
Ergonomics Risks
• Manual Handling
–
–
–
–
–
–
–
Lifting
Carrying
Pushing
Pulling
Moving
Twisting
Stretching
RSI – Repetitive Strain Injuries
• Pain and discomfort
• Heaviness
• Pins - needles sensation
• Numbness
• It even disturbs sleep
• Muscle weakness
Cause and Effect
SAFETY
HEALTH
CAUSE
CAUSE
Time
Heredity
Dose
Previous
Exposures
Lifestyle
EFFECT
EFFECT
Cause and Effect of work related
injuries and diseases
Lung cancer
Cause is
hard to
see
Fume fevers
Stress
Leukaemia
Dermatitis
Musculo-skeletal disorders
Solvent
Effects
Cause is
easy to
see
Noise Induced
Hearing Loss
Welder’s Flash
Mesothelioma
Accidents
Minutes
Days
Months
Years
Decades
Key Elements of Occupational Health
Program
1. Health Risk Assessment (HRA)
2. Monitoring of Health Performance and
Incident Reporting & Investigation
3. Fitness to Work (FTW)
4. Product Stewardship
5. Local Health Facilities and Medical
Emergency Response
6. Wellness Program – Healthy Lifestyle
Workshops, Stress Management Program,
Well Women’s Clinic, Travel Health Clinic
Comprehensive Occupational Health
Program
Health Risk Assessment
Identify Health Hazards & Their Harmful
Effects
Agent
Source
Route
Harmful Effect
Silica dust (crystalline)
Refractory bricks
Inhalation
Lung disease (silicosis)
Used mineral oils
Engine oil
Skin
Dermatitis, cancer
Noise
Process noise above
85dB(A)
Hearing
Hearing Loss
Heat
Plant heat
Whole body
Heat stress, heat stroke
Legionella bacteria
Spray cooling towers
Inhalation
Legionnaire’s Disease
Repetitive movements
Workplace design
Whole or part of body
Musculo-skeletal
disorders
Routes of intake
• Routes of intake of agents into the body
–
–
–
–
–
Inhalation
Skin
Ingestion
Injection
Whole body
Basic Physiology
Ear
Lung
Liver
Eye
Nose
Mouth
Heart
Stomach
Skin
Kidneys
Biological Hazards
• Insect-borne diseases
– malaria, leptospirosis, dengue
• Water-borne diseases
– legionella
• Food borne diseases
Legionnaire’
s disease
– typhoid, dysentery, food
poisoning
• Infectious diseases
– HIV, Hepatitis
Malaria
Ergonomics & Psychological
Hazards
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”
Assigning an Agent Hazard
Rating
HAZARD RATING
0
DEFINITION in terms of potential to cause harm
No injury or damage to health
Slight health effects: Not affecting work performance or
1
causing disability - non toxic dusts (as an acute hazard)
Minor health effects: Agents capable of limited health effects
2
which are reversible, e.g. irritant agents, defatting agents, many
food poisoning bacteria
Major health effects: Agents capable of irreversible health
3
damage without loss of life, e.g. noise, poor manual handling
taks, hand/arm vibration, chemicals causing systemic effects,
sensitisers
Fatality or Permanent Total Disability: Agents capable of
4
irreversible damage with serious disability or death, e.g.
corrosives, known human carcinogens (small exposed
population), heat, cold
Multiple Fatalities: Agents with the potential to cause multiple
5
fatalities, e.g. chemicals with acute toxic effects (H2S, CO),
known human carcinogens (large exposed population)
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
Risk Assessment Matrix
Increasing Probability
Consequence
A
People
Assets
0
No
injury
No
damage
1
2
Slight
injury
Minor
injury
Slight
damage
Minor
damage
3
Major
injury
Localisd
damage
4
Single
fatality
Major
damage
Rating
5
Multiple Extensive
fatalities damage
Environment Reputation
No
effect
Slight
effect
No
impact
Slight
impact
Minor
effect
Limited
impact
Localised
effect
Considerable
impact
Major
effect
Major
national
Massive
effect
Major
international
Never
heard
of in our
Industry
B
C
Heard of Incident Happens
several
has
incident
times
occurred
in our
per
year
in
our
industry
company in Co.
D
Happens
several
times
per year
at locn.
Low
Medium
High
E
The Hierarchy of Controls
Reliability
Elimination
Substitution
Engineering
Procedural
P.P.E.
Cost
ALARP ?
•
Tolerability level
Risk to
Health
•
•
•
Legal Liability
•
•
Cost of
Control
ALARP Wasteful
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
Hazard Rating
Control Chart
EXPOSURE RATING
Very Low
Low
Medium
High
Very High
a
b
c
d
e
No Immediate
1
Third
Second
Priority
Priority
Action Required
2
Third
3
Priority
Second
Priority
First Priority
For
Action
4
5
Exposure band
< 0.1 x OEL
0.1 x OEL to 0.5 x
OEL
0.5 x OEL to 1 x
OEL
> OEL
>> OEL
Comprehensive Occupational Health
Program
Monitoring of Health Performance
and Incident Reporting &
Investigation
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
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
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
Comprehensive Occupational Health
Program
Fitness to Work (FTW)
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
Fit for
task
Detailed medical and
task assessment
Unfit
for
task
Accommodation
process
Comprehensive Occupational Health
Program
Health Facilities and Medical
Emergency Response
3 Pillars and 7 Principles of SD
Delivering Value to
Customers
Meeting
Profit
Targets
Building
Stakeholder
Relations
Respecting and
Safeguarding
People
Purpose
Earning our right
to grow
Reducing
Impact on the
Environment
Contributing
to
Communities
Using
Resources
Efficiently
Philosophy of HSE Management Systems
– Continuous Improvement!
Thank you for your attention
Any Questions!