Occupational Hazards

Occupational Hazards

The word hazardous pertains to a condition or mixture of factors that lead to considerable risk or crisis by causing damage to persons or goods. It is characteristically used to explain materials and elements that are harmful, which include inflammables, irritants, combustibles sensitizers, and corrosives, even when these materials might be comparatively non-toxic in weak concentrations.

It is important to study occupational hazards in order to:

• Make all the workers aware of the dangers of most kinds of jobs or professions
  
  
• Check whether workers can adapt to the dangers of a profession or not
  
  
• Help workers in making appropriate job choices

Physical Hazards

Physical hazards include those hazards, which physically harm an individual. These include noise nuisance, vibrations and blow, glare, radiations, excessive heat, ventilation, water contamination, etc. Such exposures can result in disorders like redness in eyes, genetic problems, risk of cancer, infertility, loss of hearing, nerve damage, and many other problems. The different hazards can cause different problems.

Heat

Direct effects of heat are:

• Burn: Can cause disfiguration or even death
  
  
• Heat exhaustion: Symptoms are headache, muscle weakness, and so on.
  
  
• Heat syncope or blacking out: Results from physical exhaustion at high temperatures, causing the blood vessels to widen, which causes reduced blood flow to the brain.
  
  
• Heat cramps: Muscle fit resulting from excessive loss of salt and water because of excessive activity.

Indirect effects of heat are: (a) Decreased efficiency (b) Increased lethargy

Cold

• Chills
• Erythrocyanosis Crurum
• Frostbite in the feet and hands due to cutaneous vasoconstriction
• Hypothermia.

Light

The intense impact of low illumination are:

• Strain in the eyes
• Headache
• Congestion over the cornea
• Eye fatigue

Occupational cataract is often observed in individuals, working with radiation and x-ray beams (radiologists). Miner’s Nystagmus is an occupational problem occurring among coal excavators, usually in middle aged or older workers, who have been working for over 25 to 30 years in coal mines.

The physical side effects include poor visibility in low light, extreme sensitivity to glare, and rhythmic oscillation of the eyeballs. This might result in defective perception about nearby objects and lead to poor judgment of surroundings.

Associated visual side effects are cerebral pains and wooziness, especially while stooping or bending, and the advancement of psychoneurotic side effects in later stages of disease. If the problem is not diagnosed timely, the nervous disorder may lead to total disability.

Noise

Noise relates to sound-related impacts on an individual like:

• Temporary or irreversible hearing loss
• Nervousness
• Lethargy
• Reduced efficiency
• Irritation

Ionizing radiations

Radiation dangers include:

• Genetic changes
• Malformation
• Leukemia
• Ulceration
• Infertility

The preventive measures that can be adopted to fight against the above-mentioned hazards are:

• Continuous use of appropriate overalls and safety gear (gloves, ear sleeves, scarf, caps, and so on)
• Proper ventilation
• The temperature in the working place must be regularly monitored
• Regular medical check-ups
• Employees should be trained, according to their working conditions
• Footwear (shoes, socks, and boots) should be washed/cleaned routinely
• Hot beverages should be accessible
• More protein and fat intake in diet
• Foot gear should be impervious to water
• Avoid contact with cold metals with bare skin
• Keep a thermometer
• Bring covers and sheets, if somebody feels excessively cold
• Use gas or electrical radiators if required.

Physical hazards depend on the characteristic state of the compound. Later these are sub-isolated into various classes based on the level of threat used to categorize them. There are five primary classes of physical dangers.

Explosives

These are prone to blast, whenever exposed to flame, heat, shock, friction.

One could avoid it by:

• Avoid burning objects (flashes, blazes, heat, etc.)
• Wear protective gear

Flammables

These are the unstable substances that are prone to catch fire (sparks, heat). Some flammable materials may even produce combustible gases on contact with water. The preventive measures, one could adopt is:

• Keep away from ignition sources (flashes, flares, heat)
• Maintain distance
• Use protective gear while working

Oxidising chemicals

These are the chemicals that can catch fire even in the absence of air or can ignite unstable/flammable substances. The preventive measures, one could adopt are:

• Stay away from combustible sources (sparks, flares, heat)
• Use protective gear

Gases stored at high pressure

The gases that are discharged might be extremely cold. Gas vessel may blast whenever heated. It is important to adopt the following preventive measures:

• Never heat gas vessels
• Keep away from eyes and skin

Corrosives

These are the substances that may erode metals. One could avoid metals.

Chemical Hazards

A chemical hazard is an exposure to chemicals in a working environment, which can result in acute or long term health issues. Repeated exposure to chemicals like silica dust, engine smoke, and smoking leads to increased chances of cardiovascular disease, stroke, and hypertension.

Chemical compounds can be classified into risk classes causing threat to both, physical condition and overall health. It is to be noted that these chemicals can cause more than one or multiple integrated hazards.

Numerous factors influence how the chemical will cause the response and how extreme it will be. The common chemicals materials like fluorine, ammonia, ethylene oxide, ozone, hydrocarbons (HC), sulphuric acid (H2SO4), tannic acid, limes and alkalis harm the workers, when they come into contact with the skin, inhaled, or ingested.

Laborers may experience the ill effects of respiratory illnesses, skin sicknesses, sensitivity, coronary illness, malignancy, and neurological issue or some other problems. These diseases might be temporary or long standing. Generally, a disease may be difficult to diagnose because the symptoms may start after a long span of latent period or may not start at all.

The effects of chemical hazards could be:

• Skin inflammation
• Eczema/Atopic Dermatitis
• Ulcer/open sore
• Malignant growth by irritant

It is usually caused by inhalation of following:

• Dust: Dust particles are ‘barely divided solid particles with size ranging from 0.1 to 150 microns’. Dust grains bigger than 10µ settle at the ground from the air quickly, while the particles smaller than 5µ are straightaway drawn into lungs and can cause pneumoconiosis/occupational lung disease. Dust can be classified into:
  • Organic and inorganic
  • Soluble and insoluble
    
    
• Gases:
  • Simple gases (Oxygen)
  • Suffocating gases (eg Nitrogen, Helium, Sulfur Dioxide)
  • Anesthetic gases (eg Isoflurane, Chloroform, Nitrous Oxide)
    
    
• Ingestion: Occupational diseases are also caused by ingestion of chemicals such as lead, mercury, arsenic, zinc, chromium, phosphorus, etc.

Control of chemical hazards

It is done by risk-management action, implementation of control measures and monitoring their efficiency. Until and unless the hazardous chemical is eliminated, a set of control measures is necessary to minimise the risk and implementation of an effective series of defences to control their exposure.

Following are the steps for control:

• Elimination: Efficacious and dependable control measure is elimination of the hazardous chemical.
  
  
• Substitution: Replacement of the chemical agent by a less harmful chemical agent is the next choice for control. However, care should be taken that the new chemical should not expose workers to new risks. The new chemical should be used in a form, which is less harmful (for example, use of chemical in pellet form, instead of powder).
  
  
• Isolation: Isolation of the chemical agent in time or space from those conceivably unprotected is an effective method for control (like shifting individuals in a secured control room, putting a buffer region around a chemical reactor, making use of the chemical when people are not in that area, etc.).
  
  
• Engineering controls: Designing controls reduces the exposure at the source (carrying out the process in pipes or using an exhaust for ventilation). Avoiding unrestrained discharge is crucial and can be achieved by using strategies like quantity limiting, segregation, safe storage, and temperature control.

Biological Hazards

Hazards caused by biological substances that are dangerous for the health of a living organism, mainly, humans, are called biological hazards. The perpetrators include microorganisms, viruses, toxins, etc. There are three main pathways for microorganisms to enter our body:

• Via respiratory tract
• Ingress by contact with body liquids of an infected person
• Infected objects

These harmful interactions may result in three outcomes in humans- infections, allergies, and poisoning. Professions and work environments, where people might be exposed to such threats are as follows:

• Medical staff, housekeeping staff, and lab worker in medical field
• Healthcare providers
• Housekeeping department
• Management of material
• Workers dealing with environmental waste like fluid waste and trash accumulation and disposal
• Horticulture, veterinary care, and building factories that utilise flora or fauna derived raw material, for example, paper items, textiles, fur, leather, and other items

Indoor working environments like clubs, eateries, and restaurants, where staff by and large work in encompassed places with central air conditioning, a microbe can multiply inside the conditioning system. In an office setting, the carpets, rugs, plants, or places that are moist can harbour microorganisms. Preventing and controlling measures for biological hazards are:

• Removal of the source of infection is the first step to control biological hazards.
  
  
• Engineering techniques like improving ventilation, partial segregation of the infection source, establishing negative air gradient and independent ventilation and air cooling system (wards for infectious diseases), and use of UV lamps to avoid spread of infectious agents.
  
  
• A worker must always use personnel protection equipment and maintain personal hygiene.
  
  
• The PPE includes face mask, gloves, protective overalls, eye protection, head, and shoe covers.

Respiratory system safety includes:

• Use of proper protective gear to avoid contact with biological hazards. Respiratory protective equipment includes:
  • Surgical masks comprises three layers of non-woven material, which act as a barrier.
    
  • N95 or superior respirator strains out particulates and fluid droplets, thereby providing safety from inhaling airborne microbes and aerosols.
    
    
• Correct selection of particulate respirators should be done considering its filtration efficiency. In a healthcare centre, respirator of N series with filtration up to 95% (type 95) or 99% (Type N-100) is suitable. When there are considerable amount of oil mists present in the environment, then, the R-series is utilised; R95 (where, R represents resistance to oil) or series P95/P99 respirator or P100 (where, P represents oil verification) are utilised.
  
  
• Powered Air Purifying Respirator (PAPR) makes use of an electric blower to transmit air from the filter to the user, making it more pleasant.
  
  
• Air providing respirators, which condense the air or provide clean air through a high pressure vessel using hose.
  
  
• The suitable type of respiratory protection is chosen on the basis of the type of biological hazard and the working environment. The workers should be properly trained for using PAPR and air supplying respirators for their own safety. It is mandatory to abide by the manufacturer’s instructions properly.
  
  It is crucial that the respirator must fit snugly on the wearer to form a satisfactory seal and a seal check should be performed to ensure effective protection.
  
  
• The disposable surgical mask act as a barrier and protect from inhaling possibly infectious droplets. It is essential to wear them properly. They should be replaced, if they get soiled, wet, or if its surface is touched or coughed on frequently. They should be carefully wrapped before they are destroyed. Hands should be thoroughly washed later. Important points to remember while wearing a surgical mask are:
  
  • The masks should fit softly on the face
    
    
  • Coloured side should be worn outwards with the metal strip lying on the upper side
    
    
  • Elastic handles should keep the mask firmly in place
    
    
  • Mask should cover the nose, mouth, and chin o Metallic band is pressed on either side of the nose bridge to keep the mask relaxed over the face.
    
    
  • Effort should be made to not touch the mask while wearing it. Hands should be thoroughly washed, before contacting the cover.
    
    
  • Under routine circumstances, a surgical mask needs to be changed every day.
    
    
• N95 masks are used in departments such as casualty department, ICUs, radiology department (Chest X-Ray units), and physiotherapy department. Medical staff that deal with high-risk patients or assist high-risk treatments choose N95 or high level respirators. Important points to remember while wearing the N95 mask are:
  
  
  • While wearing N-95 mask, the face-piece should fit snugly. Evaluate the size of various brands to get the best and comfortable fit.
    
    
  • Follow guidelines given by the manufacturer, while wearing the mask
    
    
  • For reusing the N95 mask, it must be placed in a paper bag, when not in use.
    
    
  • N95 mask should be immediately replaced, if soiled or damaged.
    
    
  • N95 mask cannot be shared with anybody or taken outside hospital premises.
    
    
  • Inappropriate use of mask will decrease its effectiveness.
    
    
  • N95 masks should not be used by:
    • Person having respiratory problems like emphysema and asthma.
      
      
    • Person having trouble while breathing or feeling dizzy while using it.

Protective clothing

Protective clothing is a defensive cover with a hood, having an overall gown and head and shoe covers. Protective gear should be impervious to fluids to safeguard our body from contamination via body fluids, droplets, open injuries, or employee’s own clothing; this diminishes the likelihood of cross infection or pathogen spread.

Important points to remember while wearing the protective clothing are:

• Protective gear is generally disposable, although can be reused after disinfection
  
  
• Good quality protective gear should be chosen
  
  
• Protective wear should fit properly, without limiting movement
  
  
• Protective gear should be examined before use and changed if damaged
  
  
• Biologically infected clothing should be disposed of in a specially designated container, which should be sealed with ‘biological hazard’ label

Goggles or face shields

Important points to remember while wearing the goggles or face shields are:

• Safety eyewear/glasses and face shields protect eyes from contacting microbes carrying blood, droplets or other body fluids, which may ingress the body through mucosa
  
  
• Standard goggles should be selected (EU EN 166, U.S. ANSI Z87.1- 1989)
  
  
• Glasses, with side shields should be used because they provide protection to the front side as well as the sides from liquid splash Goggles fit easily and are better than glasses for eye protection
  
  
• If needed, face shield can be used to protect entire face
  
  
• Face-shields and eye wear should be washed with liquid soap frequently. In case of contamination by blood, they must be soaked in 1:49 diluted liquid bleach and then, kept in clean water. They should be kept in plastic bags after they are dry and stored in a cabinet
  
  
• Check routinely and replace, if they get out of shape, get cracked or get scratches

Gloves

Important points to remember while wearing the gloves are:

• Gloves save and cover the hands from coming in contact with blood, droplets, body fluids and body tissue of the contaminated, or microbe-infected objects and protect from infection while touching the face. Gloves also prevent contamination of open wounds by pathogens.
  
  
• Most gloves have to be disposed after use
  
  
• Good quality gloves should be selected (EU EN 374; U.S. ASTM F1670, ASTM F1671)
  
• Substance used should be resistant to chemicals.
  
  
• Gloves should fit comfortably and not limit a person’s movement
  
  
• Always keep short nails to avoid tearing of gloves
  
  
• Two pairs are worn while handling dangerous substances
  
  
• Always wash hands rigorously before and after use
  
  
• Check for any tearing before use
  
  
• Contaminated gloves should be disposed of immediately in a container, sealed with ‘Biological hazard’ warning and label.

Shoe covers

Important points to remember while wearing the shoe covers are:

• Shoe covering prevent microbes from being carried outside the working area
  
  
• Shoe gear is generally disposable
  
  
• Boot covers provide extended security. Cover the boots with the trousers to stop microbes from getting inside the boots
  
  
• Shoe covers should be impervious to water
  
  
• Size should be suitable so that the movement of a person does not get slowed down.
  
  
• Personal protective equipment needs the right selection and use, along with proper preservation and storage. Equipment, which is to be reused should be cleaned and sterilised properly before being used again. Damaged pieces should be returned.
  
  
• While using the entire set, medical personnel should strictly follow hospital protocols on infection control. Gloves should be disposed of so that there won’t be any skin contact with the external surface of gloves, which will prevent cross-contamination.

Sterilisation

Sterilisation is a method, which utilises high heat or high pressure to eliminate micro-organisms, or by using bactericide to kill microbes, including spore forms. A total sterilisation method should include sanitising the infected area and vigorous removal of any remaining harmful material to guarantee that workers won’t be harmed in the hazard area.

Appropriate sanitisation is decided based on the strain and quantity of microbes, virulence of the organism, the time period, temperature, and concentration of the steriliser used. Sterilisation should be done by abiding to safety instructions carefully to provide safety to the staff. There are numerous types of sterilising agents, the most well-known ones are rubbing alcohol and liquid bleach. Hands should be washed properly after removing any sort of protective gear.

Personal hygiene

Personal cleanliness starts with washing hands with fluid cleanser. It is the most basic and easy way to stay away from contamination. Nonetheless, it is often ignored. Always wash hands right before or after wearing protective gear, outfits, or gloves to reduce the likelihood of disease.

Psychosocial Hazards

Psychosocial hazard is an occupational hazard, which harms the psycho-social wellbeing of the workforce, including their capability to engage in the working environment with other workers. These hazards are recognised by the manner in which work is planned, organised, directed, and coordinated, along with financial as well as community context of the job and are associated with psychiatric, psychological, or physical damage. Related to psychosocial threats are problems like occupational tension and work pressure, which are of great concern to health and safety.

A psychological hazard is a hazard that affects the mental health of the worker substantially and requires coping techniques. Industrial/job stress caused by different stressors such as task and job demands, leadership, lack of unity, intergroup and interpersonal problems, career alterations, etc., lead to significant distraction, which further leads to lethargy and demotivation.

All of this affect the health of workers. ‘Psychosocial’ pertains to the interrelationships between a person’s ideas and behaviours, and their social surrounding. This term always relates to social circumstances such as family of origin, socio-economic standing, and extent of education. While it is necessary to be familiar with persons and non- work related psychosocial factors, psychosocial hazards generally refer to hazards caused only by work and working environment.

Occupational stress

The word ‘stress’ has been a much discussed and debated topic. The term supports a diverse range of meanings, it is now possible to conclude different statements together to summarise the characteristics of occupational stress. There are three key factors, which needs to be examined:

• Firstly, it is vital to know that response to stress is multifactorial. It could be a physiological, mental, or emotional response to a set of factors that can translate into ill health.
  
  
• Secondly, it is not a disease per say, but a path that can affect health either mentally or physically. The poor health pathway starts, when there is a noticeable ‘imbalance’ between the demands made from an individual and the ways that they cope up with them.
  
  
• Lastly, the individual’s perception of their work attributes (which include their opinions of their coping ability and how essential it is for them to deal with it) is an important part of stress equation.

Psychosocial risk factors

There are certain factors, which increases the risk of psychosocial hazards in a working environment:

• Time pressure: When one requires to work very hard and at fast pace to meet key performance indicators decided for a role, then that is referred to as the time pressure. The pressure can occur from impractical deadlines or insufficient resources to complete the given task. Work performed quickly by machines and electronic monitoring of performance create time pressure, if not well designed and executed.
  
  
• Cognitive needs: Cognitive needs associated with a job can be various, however, there are two main cognitive needs, which can negatively affect the psychological and physical wellbeing, and lead to reduced outcomes. These are activities with high concentration and activities requiring low mental demands.
  
  
  The former require continuous undivided attention, focus, and a lot of decision making, for example, Anaesthetist. Then, there are tasks that require very little cognitive thinking (for e.g. sorting things, stacking material, etc.). Monotonous tasks with few variations can be exhausting, stressful, and prone to error.
  
  
  Emotional demands: Work-related emotional load includes jobs requiring workers to exhibit false demonstration of emotions like being happy or wish to please, even in a state when the worker is feeling angry or dissatisfied. The control of negative feelings leads to adverse effects on the worker’s wellbeing, for example, flight crew and shop retailer. Workers who are exposed to mentally distressing situations are associated with an increased probability of illness (police officers and firefighters are exposed to such risks).
  
  
• Hours of work: Hours of work, including poorly designed work schedule, can cause risk to health and safety by two means:
  • Exposure time defined as ‘how long workers are exposed to psychosocial hazards in a given working week and accordingly directly influence the level of risk’.
    
    
  • Fatigue caused by long working hours and shift schedule can lead to mishaps at work
    
    
• Work roles: Role conflicts and obscurity refers to employees’ comprehension of their role in the organisation and whether the organisation maintains distinction and avoids conflict between any two roles. This means that people having an incomplete understanding of job expectations and position responsibilities, because of repeated or erratic changes in roles, lead to overlapping of roles with others’ roles.
  
  
• Conflict: Interpersonal disputes at workplace has been reported to be among the causes of stress at work. Facts suggest that job related interpersonal disputes are associated with compromised psychological and physical performance. In addition to psychological disturbance, age, stressful work incidents, stressful life incidents, and support from work also play a major role.

Decreasing and preventing psychological hazards

Possibilities to advance the well-being of employees and prevent occupational stress depend on the specific institution, organisation of work, employees’ expectations and characteristics, existing resources, and much more, but the rule of thumb for shaping a positive psychosocial working environment is to involve employees in decisions about them, open information exchange, optimal workload, and zero tolerance of occupational violence (including any signs of bullying and harassment).

When one is planning activities to improve the psychosocial working environment, it should be remembered that it is always more efficient and cheaper to prevent the problem on the organisation level through good management and work organisation. In case, where risks cannot be fully avoided, it might help to apply measures directed for supporting the risk groups or to rehabilitate employees who have already suffered due to work pressure.

Examples of organisation-level measures are:

• Clear determination of employee’s responsibilities and corresponding authorisation
  
  
• Determining clear principles and guidelines for coping with workplace bullying and harassment
  
  
• Transparent personnel politics
  
  
• Enabling a flexible work organisation
  
  
• If risks cannot be completely eliminated, for example, due to type of job (night-time job, a job that requires lot of communication), stress relief measures should be directed to risk groups
  
  
• Organising training for employees on coping in tense situations
  
  
• Offering training for middle managers on how to cope with the stress of subordinates and to help them
  
  
• Encouraging healthy lifestyle in employees (e.g. movement habit)
  
  
• Regardless of all applied measures, there are always employees who do suffer from occupational stress due to one reason or other. To support these individuals, the employer could:
  • Offer the employees some psychological counselling and help
    
    
  • Enable training to improvise job-related skills
    
    
  • Develop supportive systems to integrate employees back to work who have been absent from work for a longer period of time (e.g. on a sick list)

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Prevention and Control of Hazards

Sound-induced hearing loss is, at present, untreatable and permanent, however, it can be controlled. Thus, the implementation of an effective preventive programme is important. Specific steps for the elimination and control of exposure to noise should not be implemented temporarily, but as part of an inclusive strategy.

The above-mentioned example illustrate the aim of prevention and control of hazards, which is to discuss basic principles for prevention and control, their management, and incorporating them in the elimination or control of all kinds of hazards.

A programme is for taking care of employees from the harmful effects of physical/ chemical/biological/psychosocial hazards in the workplace. Hazard programmes should be planned to cater to needs of every scenario, existing hazards, and other factors that distinguish a workplace, moreover, programme should be opened to developments in technology and scientific discoveries, and to changes in the socio- economic factors.

Usually, national legislation requires the implementation of all kinds of measures in order to achieve the lowest possible levels of exposure to harmful elements, taking into account:

• The state of the art on the topic of technical progress;
• Possibilities to reduce hazards from the source
• The planning should be appropriate

Requirements for efficient programmes

• Political support and decision-making procedure
• Support from the top management
• Clear and well-designed policy
• Precise and distinct aim and objectives
• Adequate human and economic resources
• Technical awareness and exposure
• Founding of multidisciplinary team
• Continuous development of the programmes

Every hazard prevention and control programme requires measures associated with the working condition and the workforce. Proficient control measures generally depend on a mix of engineering (technical) control and personal actions (e.g., work practices). Control measures should be able to meet the needs of every situation and perspectives such as effectiveness, cost, technical feasibility, and socio-cultural aspects.