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Preventing Respiratory Diseases

Published: 10th Jan 2012

Every year, hundreds of thousands of workers across the globe are made ill by hazardous substances. They suffer lung diseases including asthma and cancer - diseases which can cost millions of pounds each year in the form of compensation to the individual and their family, for the loss to industry to replace the worker and to society more generally in terms of disabled allowances and medicines.

Unlike many hazards, the risks associated with chemicals in the workplace cannot be seen and are often not recognised until the damage to an individual (or individuals) has been done. The respiratory system is a target organ for many hazardous substances.

Unlike head or foot injuries, respiratory injuries may not be readily apparent. It may take several years, or may not be until workers retire before an individual displays symptoms as a result of exposure to hazards in an atmosphere.

Chemicals in the workplace can create pollution from tiny particles in the air that can enter the respiratory system in the form of mists, vapours, fumes, dust or fibres that cannot be seen.

Harmful substances

There is a high volume of hazards present in the workplace that are harmful to the respiratory system. Dusty or fume-laden air can cause lung diseases and workers commonly affected include welders, quarry workers or woodworkers.

Metalworking fluids can grow bacteria and fungi, which can cause dermatitis and asthma. The agriculture and horticulture industries have risks associated with harvesting, flowers, bulbs, fruit and vegetables, while the catering industry has chemicals around hot oils and cleaning products, and Benzene in crude oil can cause leukaemia.

Other hazards can come from vapours (solvents, detergents, paints, adhesives), gases (chlorine, carbon monoxide) and oxygen deficient atmospheres.

In addition to the fumes are the hazards associated with liquid chemicals and skin damage; for example, when a dangerous acid is spilled onto an open area of the body.

The risks can result in both immediate short term health issues to fatalities - from conditions such as difficulty in breathing caused by fumes and dusts, through to long term, life threatening risks such as cancer caused by breathing asbestos fibres. Inhalation also provides the quickest and most direct path of entry for hazardous materials into the body. Exposure to respiratory hazards may cause various health effects such as damage to the respiratory system, permanent damage to other target organs due to inhaled substances making their way to such organs, acute and chronic illnesses, other disabilities, or even death.

In the UK, there were 2,997 instances of work related respiratory illness in 2006/7 and it is now a requirement that all persons working with, for example, lead or asbestos are fit-tested. In 2005, 373 death certificates included work related asbestosis as the cause or underlying cause of death.

It is imperative that a business conducts a suitable and sufficient risk assessment to identify if there are any hazards around respiratory issues and implements a plan to minimise the risks for people carrying out the activities, and anyone who may be affected by the workplace activities. By doing this the risk to occupational related lung disease and other adverse health affects will be reduced. The concern here is not simply about issuing Respiratory

Protective Equipment (RPE) - it is about so much more.

Outlined below is a process to help in dealing with respiratory hazards and controlling the exposure to work related respiratory illness: 1. Conduct a risk assessment. 2. Change processes or materials if possible. 3. Control exposure levels using engineering controls. 4. Choose the right respiratory protective equipment. 5. Provide respiratory protective equipment that not only meets the appropriate standards, but also fits the user. 6. Fit RPE properly to the user. 7. Maintain your RPE equipment. 8. Communicate the dangers. 9. Train people how to use the equipment. 10. Review, maintain records, conduct ongoing risk assessments.

Conduct a risk assessment

As with dealing with other hazards in the workplace, it is imperative to conduct a formal risk assessment. A risk assessment is not merely a paper exercise; it is about taking sensible steps to prevent ill health. Identify and evaluate the potential respiratory hazards to people at work and people affected by workplace activities.

There is a need to assess: • Workplace conditions that people operate in such as a very hot, cluttered, busy environment. How well is the area ventilated with natural air?

• What form is the hazard? For example, is it gas, lack of oxygen, dust, vapour or mist?

• Degree of exposure to respiratory hazards considering the levels with and without any protective equipment

• What are the rules and recommendations of dealing with specific chemical substances? What is the permissible exposure limit to a particular airborne substance? Is this being adhered to? Can the exposure time be reduced?

• What is the worst-case scenario? How would an emergency situation impact on the wider workforce and on the local community?

• What is the protection provided, is it being worn properly, is it cleaned correctly? Is it really protecting the worker? Is it correctly maintained?

• Is there sufficient communication to warn about the dangers and the hazards?

Ill health caused by the various substances used at work is preventable. It is important to understand the dangerous properties of each substance. They may be flammable; for example, solvent-based products. Other products will give off vapour or clouds of dust, which cannot easily be seen, but can explode if ignited.

Employers are expected to fully understand the substances involved and assess in what ways they are harmful. There are a wide range of sources available to assess in what ways a product is harmful, but at least always check the safety data sheet from the manufacturers for more information.

When assessing the tasks of individuals in the workplace it is important to understand how the substance might be harmful and how might the workers be exposed. Is it from breathing in gases, fumes, mist or dust? Other hazards which might affect the employee could include contact with the skin, swallowing, contact with the eyes and skin puncture.

Once inhaled, some substances can attack the nose, throat or lungs, while others get into the body through the lungs where they can then harm other parts of the body; for example, the liver, which, due to it’s filtering role, is the target organ for many substances.

Change processes or materials if possible

Having conducted a risk assessment, the safety professional needs to consider, in conjunction with the senior operational management, what changes in processes or materials could be implemented to help reduce hazards.

Employers must accept that merely providing protective equipment and respirators is not an answer to developing and implementing different work practices and processes. It is imperative to eliminate or reduce respiratory hazards to the lowest feasible levels through improved work practices and controls.

Areas which employers should consider include the potential of employees working fewer hours in such a hazardous environment and changing a product to one with fewer hazardous properties or one with, for example, a lower evaporation rate. Additionally, we could consider improved ventilation by opening up walls with natural air or providing fans to help circulation of air.

We might also think what processes, methods and techniques could be implemented to reduce the levels of risk; for example, hand rolling adhesive or paint rather than spraying? Or, can a control room, enclosure or exhaust hood be built to distance employees from emissions?

Control exposure levels

What more is an employer able to do to limit the exposure levels of people at work and others who may be affected by work activities? Controlling measures is a mixture of using different equipment and processes and providing a standard operating procedure to combine the right equipment with the right way of working. An employer needs to implement control measures that work and continue to work all day, every day.

Our primary approach must always be to try and provide a safe place of work if at all possible; that is, to control emissions and exposure wherever possible.

Having exhausted all engineering and similar controls, however, we should also consider options including rotating staff on a particular task to minimise the length of time exposed to a particular hazard. Also, consider if it is possible to reduce the volume of several harmful chemical substances simultaneously.

Having tried to create the safe place of work as far as we can, additional examples of control measures around hazardous substances include providing personal respiratory protective equipment.

Provide respiratory protective equipment

Despite management controls and improved processes it may not always be possible to eliminate respiratory hazards entirely. In these instances employee protection must be achieved through the use of protective equipment.

The various forms of RPE (Respiratory Protective Equipment) protect users from inhaling airborne contaminants that are generally unseen and therefore unnoticed. Some people might believe that RPE is simply a multi-purpose mask, but there is a range of different products designed for respiratory protection in various industries.

The correct form of RPE depends on the hazards the user faces. The level of protection required is dependent on the work being carried out in different environments. The primary question is: is there sufficient oxygen to support life?

If the answer is no, and we must still enter the working environment, then we have to use breathing apparatus, which in essence provides us with a supply of breathable air via either a self contained system or a line-fed system.

If there is sufficient oxygen, then we can consider a respirator, which filters out harmful substances, but relies on there being sufficient breathable air once the impurities are removed.

Whether it is working with dust, gas or chemicals it is vitally important that a risk assessment is conducted in order to identify the appropriate form of RPE needed.

Dr Bob Rajan, from the UK’s Health and Safety Executive Chemical Risk Assessment and Control Group has stated: “Every year in the UK, industry spends around £250 million on RPE, but a sizeable portion of this money is wasted because the equipment selected is not right for the job or used wrongly. This can result in RPE wearers being exposed to avoidable hazards to their health or even life.”

It is therefore imperative that workers are provided with suitable RPE that matches the associated risks. Failure to provide necessary protection can cause preventable damage to workers’ health.

In summary, it is vital that any RPE issued by an employer not only meets the appropriate standards to protect against the specific hazards, but also fits the user.

Choosing the right RPE

There are also a number of additional factors that need to be considered when choosing RPE. When considering which respirator, the employer needs to consider the appropriate type of RPE required and the specific model from the various types available.

The person selecting RPE must thoroughly understand the options and the types of equipment available. They must be familiar with the tasks the user is carrying out, the risks involved and the equipment’s capabilities, including the degree of protection it can provide, and its limitations.

Additionally, they must consider the affects that other PPE being used may have on the effectiveness of the RPE, and vice versa, and both the efficiency and comfort of the user.

For example, in an oxygen-deficient atmosphere the user will require breathing apparatus as opposed to a respirator. The breathing apparatus will supply air from a cylinder or compressor, whereas as a respirator is used to filter harmful contaminants.

It is also important for the user to feel comfortable wearing the respirator, allowing users to communicate freely without interference or irritation while performing physical work. Remember to select any RPE in conjunction with employees as they are the people at risk and the ones who will have to wear the equipment.

Getting a proper fit

Care must be taken to ensure that the user is wearing the device properly. Any selection of equipment must be around a testing of the individual with a correctly fitting facepiece. If there is any change to the individual’s characteristics, for example weight gain or loss, then the model should be re-fitted by a competent person to check it is being worn properly.

There are two forms of ‘fit-testing’ which should be considered as relevant to protect against the specific hazards. Qualitative fit-testing is used for disposable filter face pieces and half masks and is based on the user’s own assessment of the fit and any leakage.

For full-face masks and in areas where hazards and exposure can result in significant risks a full-face mask is recommended using a quantitative fit testing method. This approach provides a numerical measure known as the fit factor, giving an objective measure of face fit. It requires specialised equipment and is more complicated to carry out.

Any reputable RPE supplier should be able to advise on what equipment and testing is required to protect from your specific hazards.

Maintaining RPE

Employers should ensure there is a regime in place to maintain equipment in line with the manufacturer’s guidelines. Maintenance should take place at least once every three months with the air quality checked and valves, face seals or worn parts being replaced. It is sensible to keep a small stock of replacement parts to ensure there is no ‘down time’ if they need to be replaced.

The equipment should be stored in a safe place away from possible contamination and ensure a log of any expiry dates on equipment is kept and monitored.

Regular cleaning must also be undertaken and, with suitable training and facilities, this is something that many users are able to undertake themselves as and when required.

Communicate the dangers

As with any health and safety risk in the workplace it is important that staff understand the issues and dangers they are faced with. Employers have a duty to notify employees who are or may be exposed to any respiratory hazards.

Employees should have clear guidelines of permissible exposure limits, gained from manufacturers’ materials, safety data sheets and elsewhere.

In addition, employees should be aware of the action they should take in reducing their exposure to the hazards, including use of RPE, or personal hygiene.

As with all forms of communication and particularly with health and safety issues, it is important to ensure that individuals have received and understood the messages. It should not be a case of employers telling employees with a letter or a notice; there needs to be a level of feedback to ensure complete understanding of the hazards and the actions they should take to minimise the risks.

We recommend that individuals not only participate in a formal training session as part of a group, but that regular notices are posted in suitable locations to reinforce the messages.

Train in equipment use

Respiratory conditions are serious as permanent damage can happen instantly from a single breath, (acute effects), or slowly through inhaling a contaminant over a long period of time, (chronic effects). Either way, through entering the body via the respiratory system these hazards can be devastating to a worker in future years.

Communicate with your employees

Ongoing communication is important in managing risks with employees, but it is also vital that employees are trained in how to use the various pieces of RPE.

It has already been highlighted that the effect of wearing RPE incorrectly can result in serious harm to the individual. Employees need initial training to ensure they understand the risks and the reasons for needing RPE and in how to ensure their equipment fits to protect them properly.

During any training session it is helpful to reinforce:

• That some people might believe that RPE is simply a multi-purpose mask, but there is in fact a range of different products designed for respiratory protection in various industries

• The various forms of RPE protect users from inhaling airborne contaminants that are generally unseen and therefore unnoticed

• That users are aware of how to check their equipment to ensure it is working properly and that it fits properly on their face

• Employees should feel empowered to stop working and leave the area of danger if their RPE is not working properly

Training should be on an ongoing basis to ensure bad habits are not developed and best practice is maintained. We would recommend group training sessions as well as one on one induction training.

Also, ensure topics are covered under regular health and safety meetings. Users should always check the airflow every time they use any RPE. RPE suppliers can often help with training to employees.

Employers may need to conduct medical assessments to ensure their staff are physically able to perform the tasks while wearing respirators.

Important paperwork

Remember to review, maintain records and conduct ongoing risk assessments. It is important to constantly assess the workplace from a health and safety perspective.

Questions to ask yourself are:

• Are the hazards still at the same level?

• Are processes being adhered to?

• Are people wearing the respirators properly?

• Does any protective equipment need replacing - are there any signs of wear and tear?

• When was training last received?

• How effective is the training?

In summary

There are many hazards in the workplace and as with managing other aspects of health and safety issues, a professional approach can reduce the potential for risk. Conducting a meaningful risk assessment, acting on the findings, improving processes, providing relevant protective equipment, training and communication, and maintaining an ongoing review and action approach, can minimise any risks to the individuals or people affected by work activities.

Author

Ann Goodwin, Corporate Communications, British Safety Services

British Safety Services (BSS) is an international consultancy offering advice and training on health and safety issues. Established in 1990, BSS has gained an international reputation as a major provider of high quality safety training that gets results. The team at BSS also provides guidance on all aspects of public safety, specialising in workplace legislation and best practice.

BSS advise clients on their health and safety strategy and policy, and assist in implementing procedures as required. By conducting training needs analysis, BSS help clients identify skills gaps in their workforce and then develop and deliver bespoke training programmes to meet these gaps, to improve safety awareness and performance in the workplace. BSS have been successfully providing these services to companies throughout the world for almost 20 years.

BSS has its Head Office in Birmingham, UK, and has regional offices in Qatar, Dubai, Yemen, China, Libya and Algeria. With a team of specialist staff grounded in a detailed understanding of each country’s cultural issues, as well as specific industry and country safety requirements, instructors are all qualified to NEBOSH standards and have a minimum of 15 years of experience.

Most clients are in high risk sectors such as construction, the nuclear industry, oil and gas, together with many service industries including schools and food. Clients include, Qatar Petroleum, Al Futtaim Carillion, Readymix Qatar, PDO, Sabic, Conoco Phillips, Canadian Nexan, Weatherford, Inpex Libya, Al Mansoori, Petro Bras and Misco Libya.

For more information visit www.bssukhse.co.uk or email Pat.McLoughlin@bssukhse.com

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Published: 10th Jan 2012 in Health and Safety Middle East

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Ann Goodwin, Corporate Communications British Safety Services