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OCCUPATIONAL HEALTH [Joint ILO/WHO Committee on Occupational Health] "Occupational health should aim at: the promotion and

maintenance of the highest degree of physical, mental and social wellbeing of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to his physiological and psychological capabilities; and, to summarize, the adaptation of work to man and of each man to his job. "The main focus in occupational health is on three different objectives: (i) the maintenance and promotion of workers health and working capacity; (ii) the improvement of working environment and work to become conducive to safety and health (iii) and the 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 of the undertakings. The concept of working culture is intended in this context to mean a reflection of the essential value systems adopted by the undertaking concerned. Such a culture is reflected in practice in the managerial systems, personnel policy, principles for participation, training policies and quality management of the undertaking." IMPORTANT TERMS [based on DOLE OSHS] 1. Employer - includes any person acting directly or indirectly in the interest of an employer, in relation to an employee, and shall include government-owned or controlled corporations and institutions, as well as non-profit private institutions or organizations. Employee - means any person hired, permitted or suffered to work by an employer. Safe or Safety - shall refer to the physical or environmental conditions of work or employment, which substantially comply with the provisions of this Standards. Work Accident - shall mean an unplanned or unexpected occurrence that may or may not result in personal injury, property damage, work stoppage or interference or any combination thereof, which arises out of and in the course of employment. Work Injury - shall mean any injury or occupational illness suffered by a person, which arises out of or in the course of his employment. Occupational Illness - shall mean any illness caused by environmental factors, the exposure to which is characterized or peculiar to a particular process, trade or occupation and to which an employee or worker is not ordinarily subjected to or exposed outside of or away from such employment. Recognized Hazards - are those which do not require technical or testing devices to detect. Workplace - means the office, premises or work site, where the workers are habitually employed and shall include the office or place where the workers, who have no fixed or definite work site, regularly report for assignment in the course of their employment.

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Global Framework for Healthy Workplaces [Figure 1.1] Due to mounting social and public pressure and rising consumer expectations, enterprises are increasingly being expected to go beyond their legal requirements and act more responsibly. Creating workplaces that are healthy for their employees and that prevent illness and disease, is one way in which companies can meet these rising expectations, while also improving productivity and competitiveness. While there are a number of tools available for creating healthy workplaces at the enterprise level, most focus on specific occupational hazards, industries or sectors but no scheme for good practice exists. To provide companies with such a scheme, the World Health Organization (WHO), on the basis of the WHO Global Plan of Action on Workers Health, 2008-2017, launched the Global Framework for Healthy Workplaces in April 2010. Good practices and tools that fit the Framework are being collected for practical implementation.

[Figure 1.1]

[Continuation] A healthy workplace is one in which workers and managers collaborate to use a continual improvement process to protect and promote the health, safety and well-being of all workers and the sustainability of the workplace by considering the following, based on identified needs: Health and safety concerns in the physical work environment; Health, safety and well-being concerns in the psychosocial work environment including organization of work and workplace culture; Personal health resources in the workplace (support and encouragement of healthy lifestyles by the employer); ways of participating in the community to improve the health of workers, their families and members of the community.

Key 1: Leadership commitment and engagement Mobilize and gain commitment from major stakeholders (e.g. senior leadership, union leadership) to integrate healthy workplaces into the enterprises business goals and values Get necessary permissions, resources and support Provide key evidence of this commitment by developing and adopting a comprehensive policy that is signed by the enterprises highest authority which clearly indicates that healthy workplace initiatives are part of the organizations business strategy. Key 2: Involve workers and their representatives Workers and their representatives must not simply be consulted or informed but must be actively involved in every step of the risk assessment and management process from planning to evaluation considering their opinions and ideas It is critical that workers have some collective means of expression. Key 3: Business ethics and legality One of the most basic of universally accepted ethical principles is to do no harm to others and to ensure employees' health and safety Adhere to workers social and ethical codes as part of their role in the broader community Enforce occupational health codes and laws Take responsibility for workers, their families and the public and avoid undue risks and human suffering. Key 4: Use a systematic, comprehensive process to ensure effectiveness and continual improvement Mobilize strategic commitment to a healthy workplace Assemble the resources required Assess the current situation and the desired future Develop priorities Develop a comprehensive overall plan and specific project action plans by learning from others, for example, consult experts from a local university or ask experienced union leaders to act as mentors, visit other enterprises, consult the virtual world Implement the plan Evaluate the acceptance and effectiveness of the plan Improve when circumstances indicate it is needed. Key 5: Sustainability and integration Gain senior management commitment to use a health, safety and well-being filter for all decisions Integrate the healthy workplace initiatives into the enterprises overall strategic business plan Use cross-functional teams or matrices to reduce isolation of work groups and establish a health and safety committee and a workplace wellness committee Evaluate and continuously improve Measure not only financial performance but also customer knowledge, internal b usiness processes and employees learning and growth to develop long-term business success Maintain a comprehensive view to workplace health and safety and examine all aspects to identify a wider range of effective solutions Consider external influences such as lack of primary health care resources in the community Reinforce and recognize desired behavior through performance management systems that set behavioral standards and output targets.

HAZARDS Hazard is something that has the potential to harm the health, safety, and welfare of people at work. Risk is the likelihood that the hazard will cause injury, illness, or disease in the way that it is used or occurs in the workplace, and the severity of the injury, illness or disease that may result. Risk Assessment means the process of evaluating the probability and consequences of injury, illness or disease arising from exposure to an identified hazard or hazards. Assessment of a risk involves consideration of: The Nature of the hazard How it may affect health or safety (what type of injury, illness or disease could occur and how serious they are) How employees are exposed to the hazard Any workers affected How much, how often and for how long employees are exposed Location of the hazard THE HIERARCHY OF CONTROL MEASURES


Elimination .The job is redesigned or the substance is eliminated so as to remove the hazard. However, the alternative method should not lead to a less acceptable product or less effective process. Substitution. Replace the material or process with a less hazardous one. For example, replace mercury thermometers with spirit thermometers. Engineering controls. Install or use additional machinery such as local exhaust ventilation to control the risk. Separating the hazard from operators by methods such as enclosing or guarding dangerous items of machinery. For example, use guards on compression testing machines. Administrative controls. Reduce the time the worker is exposed to the hazard. Prohibit the eating, drinking and smoking in laboratory areas. Provide training. Perform risk assessments. Increase safety awareness signage. Personal Protective Clothing and Equipment. Only after all the previous measures have been tried and found to be ineffective in controlling the risks to a reasonably practicable level, then Personal Protective Clothing and Equipment must be used. If chosen, PPCE should be selected and fitted to the person who uses it. Workers must be trained in the function and limitation of





each item of PPCE. For example, an operator should know how long the compressed supply in a self-contained breathing apparatus will last. PPCE may be used as a temporary control measure until other alternatives are installed. IDENTIFYING, ASSESSING AND CONTROLLING HAZARDS What is a hazard? A hazard is any source of potential damage, harm or adverse health effects on something or someone under certain conditions at work. What is an occupational illness? Occupational illnesses are usually caused by health hazards. An occupational illness is a condition that results from exposure to a chemical or biological substance, a physical agent (an energy source such as noise) or other stressors (such as harassment, work demands and so forth) capable of causing harm. The time that it takes an illness to develop after exposure to a health hazard is called the latency period. What is probability? Probability is the chance that a hazard will cause harm. In risk management systems, probability is often categorized as: Frequent (workers are frequently at risk) Probable (the hazard is likely to cause harm) Occasional (workers are occasionally at risk) Remote (the hazard could cause harm, but is very unlikely to do so) Improbable (the hazard is unlikely to ever cause harm) What is severity? Severity is the seriousness of the harm that could result from contact with a hazard. It is described as: Catastrophic (death and/or severe destruction) Critical (serious injury and/or property damage) Marginal (minor injury and/or property damage) Negligible (no injury and/or property damage) What is a risk? Risk describes the odds that a hazard will cause harm. It refers to the probability and severity of potential accidents and dangerous occurrences (so called "near misses"). Risk management is a technique used to identify and control risk caused by hazards. What is risk analysis? The combination of identifying hazards and assessing their risk is called risk analysis. Risk analysis can help committee members and the employer to set priorities. Risk is calculated by using the formula: Risk = Probability x Severity. Several commercial systems assign mathematical values to probability and severity to help calculate risk ratios for hazards. Normally, hazards with the highest risk that affect the most workers should receive the greatest attention. TYPES OF HAZARDS

1. Chemical Hazards Chemicals can affect the skin by contact or the body either through the digestive system or through the lungs if air is contaminated with chemicals, vapors, mist or dust. There can be an acute (immediate) effect, or a chronic (medium to long-term) effect from the accumulation of chemicals or substances in or on the body. 2. Biological Hazards These include insects, bacteria, fungi, plants, worms, animals and viruses. For example, poultry workers exposed to bird feathers and droppings to which they are allergic can contract a medical condition. 3. Physical Hazards Physical health hazards are sources of energy strong enough to cause harm. They include noise, vibration, heat or cold and radiation. a. Noise Common noise sources include equipment, work processes, compressors, ventilation systems and power tools. Generally, if ordinary conversation cannot be understood at normal distances, noise levels are too loud. Hazard identification techniques, such as inspections, monitoring and conversations with workers will usually detect noise concerns. Vibration Vibration is a rapid back and forth or up and down motion that may affect all or part of the body. It can gradually damage nerves and circulation systems in limbs and affect internal organs. Standard hazard identification techniques can detect what jobs and workers are exposed to vibration. Monitoring and assessing vibration usually requires technical specialists. Heat and cold The health effects of too much heat include heat cramps, heat exhaustion and heat stroke. Cold can produce frostbite and hypothermia. As well as causing serious health problems, heat and cold stress disorders can reduce performance and increase the risk of accidents.



Regulations require the employer to maintain thermal conditions that are reasonable and appropriate for the work performed. If it is not reasonably practicable to adequately control indoor conditions, or where work is done outdoors, the employer must take effective measures to protect workers from heat and cold stress disorders. The employer must provide suitable monitoring equipment if workers are concerned about thermal conditions. The assessment must consider factors such as temperature, humidity, airflow, wind and work levels. d. Radiation Radiation is made up of moving particles or waves of energy. It is divided into two groups: (1) Ionizing radiation; and (2) Non-ionizing radiation. 1.) Ionizing radiation is given off by decaying radioactive elements, such as uranium. Specialized monitoring equipment is used to measure and assess radiation exposures. Radiation workers are also required to wear badges that measure the radiation dose they receive. 2.) Non-ionizing radiation includes: a. b. c. Ultraviolet radiation given off by sun lamps and welding equipment. Ultraviolet radiation can burn the skin and cause eye damage. Infrared radiation (radiated heat) used in cooking and warming equipment in food processing and industrial packaging. Lasers producing concentrated beams of light used in a variety of commercial, medical and industrial purposes. Care must be taken to ensure lasers are set up properly, adequately shielded and cannot damage the eyes or skin of workers. Microwave and high radio frequency radiation used in cooking equipment, radar as well as in high-energy radio transmission and communications equipment. If not properly shielded, some equipment may injure the skin, eyes and other organs. Long wave radiation used in radio and other communications equipment. Some equipment can heat the entire body.



e. Electrical hazards. These include the risk of injury from all forms of electrical energy. f. Lighting hazards. Inadequate lighting levels are a potential safety hazard. A common problem area is the reaction time needed for the eyes to adjust from a brightly lit to a darker environment such as a forklift driver coming indoors from bright sunlight. Temporary lighting is often inadequate. 4. Ergonomic Hazards. Ergonomics (the fit between people and their work) covers risk of injury from manual handling procedures, incorrectly designed desks or workstations, audio and visual alarms, and color coding control mechanisms. 5. Stress Hazards [http://www.who.int/occupational_health/topics/stressatwp/en/] Stress related hazards at work can be divided into work content and work context. Work contents includes - job content (monotony, under-stimulation, meaningless of tasks, lack of variety, etc) - work load and work pace (too much or too little to do, work under time pressure, etc.) - working hours (strict or inflexible, long and

unsocial, unpredictable, badly designed shift systems) - Participation and control (lack of participation in decision-making, lack of control over work processes, pace, hours, methods, and the work environment) Work context includes - career development, status and pay (job insecurity, lack of promotion opportunities, under- or overpromotion, work of 'low social value', piece rate payment schemes, unclear or unfair performance evaluation systems, being over- or under-skilled for a job) - role in the organization (unclear role, conflicting roles) - interpersonal relationships (inadequate, inconsiderate or unsupportive supervision, poor relationships with colleagues, bullying/harassment and violence, isolated or solitary work, etc.) -organizational culture (poor communication, poor leadership, lack of behavioral rule, lack of clarity about organizational objectives, structures and strategies) - work-life balance (conflicting demands of work and home, lack of support for domestic problems at work, lack of support for work problems at home, lack of organizational rules and policies to support work-life balance) SAMPLE CHECKLIST

ADDITIONAL LIST of QUESTIONS that can be ASKED What should you report and investigate in case an accident occurs? The health and safety program should specify: what is to be reported to whom it will be reported how it is reported which incidents are investigated who will investigate them what forms are used what training investigators will receive what records are to be kept what summaries and statistics are to be developed how often reports are prepared Accidents and incidents are investigated so that measures can be taken to prevent a recurrence of similar events. Investigation represents an "after-the-fact" response for any particular mishap. However, a thorough investigation may uncover hazards or problems that can be eliminated "before-the-fact" for the future. After causes have been determined, prompt follow-up action is required to achieve the purpose of the investigation. What are emergency procedures and how are they established? Emergency procedures are plans for dealing with emergencies such as fires, explosions, major releases of hazardous materials, violent occurrences, or natural hazards. When such events occur, the urgent need for rapid decisions, shortage of time, lack of resources, and trained personnel can lead to chaos. The objective of the plan is to prevent or minimize fatalities, injuries, and damage. The organization and procedures for handling these sudden and unexpected situations must be clearly defined. The development of the plan follows a logical sequence. Compile a list of the hazards (for example: fires, explosions, floods). Identify the possible major consequences of each (for example: casualties, damage). Determine the required countermeasures (for example: evacuation, rescue, firefighting). Inventory the resources needed to carry out the planned actions (for example: medical supplies, rescue equipment, training personnel).

Based on these considerations, establish the necessary emergency organization and procedures. Communication, training, and periodic drills are required to ensure adequate performance when the plan must be implemented. How do you establish medical aid and first aid programs? First aid facilities and the provision of medical aid is generally prescribed under health and safety legislation or workers' compensation legislation. The OSH program must include the following information: location of first aid stations and medical facilities identification of first aid attendants identification of other staff trained in first aid policy on pre-employment and follow-up medical examinations procedures for transporting injured employees to outside medical facilities provision of first aid training procedure for recording injuries and illnesses A policy on return to work after a lost-time accident might appropriately be included in this section of the program. The fact that "light duties" or "modified work" is a controversial issue is all the more reason for the organization to agree on a clear policy that is known by all employees. In some jurisdictions, modified work rules are covered by legislation. In general, if injured workers are offered alternative employment: The work must be suitable and productive. The worker's physician must agree that such employment will not harm the worker or slow down the recovery. The worker will pose no threat to other workers. The policy is applied to off-the-job injuries as well. Under no circumstances should the reduction of severity ratings be a reason for initiating a "modified work" program.

How do you promote employee involvement in health and safety programs? Once the health and safety program has been set in place and the program appears to be running smoothly, effort is still required to maintain enthusiasm and interest. Studies have shown that the effectiveness of health and safety educational techniques depends largely on how much importance management is seen to place on health and safety. Where management, by its actions, has shown that they are sincerely concerned, interest in the program can be maintained at a high level. Accountability for individual performance is a key motivator. Safety awareness can be enhanced by: the setting of realistic goals and monitoring progress distribution of all pertinent information individual recognition for superior performance general meetings, tailgate talks, and one-on-one coaching well-designed incentive programs The safety incentive program is probably the most controversial. Most incentive programs are based on the rationale that anything that raises safety awareness is worthwhile. However, there are those who do not share this viewpoint. They maintain that these programs lead to under-reporting of accidents and promoting of the "walking wounded" syndrome. Programs must not encourage workers to remain at work when doing so is unsafe for them due to their physical condition. Therefore, when an incentive program is launched, strict controls must be maintained to prevent this from happening. The joint health and safety committee can play a leading role in activities designed to promote the program and participation of all employees.

Should workplace specific items be included in occupational health and safety programs? The elements of OH&S programs discussed so far apply to all basic health and safety programs. In addition, specific items may be needed to address workplace specific activities. Examples of such items are: Workplace Hazardous Materials Information System (WHMIS) lock out procedures hot-work permits material handling rules plant maintenance fire safeguards vehicle safety rules off-the-job safety working alone guidelines personal protective equipment requirements engineering standards purchasing standards preventive maintenance

How do you implement occupational health and safety programs? A good health and safety program provides a clear set of guidelines for activities that, if followed rigorously, will reduce accidents and cases of occupational disease. The key to success is the manner in which the program is implemented and maintained. Senior management must demonstrate commitment and support the program by: providing resources such as time, money, and personnel ensuring that employees receive training or certification as required

making all applicable health and safety information available to all employees entitled to receive it including health and safety performance as part of employee performances appraisals at all levels attending health and safety meetings The program must be communicated to all employees. Special emphasis should be given to new workers, newly appointed supervisors, and new members of the joint health and safety committee. Revisions to policies and procedures should be publicized. The program should be available in a single written document. However, if separate manuals have been developed for various elements, such as accident investigation procedures, their use should be referred to in the main document.