Prevention Of Occupational Injuries And Illnesses Flashcards
Recognition
The process of detecting workplace hazards
First two steps in a worksite program to prevent illness or injury of workers
- Recognition/anticipation of hazards
2. Clear identification of hazards
Anticipation
The foresight to recognize and eliminate hazards in equipment and processes during the planning, process review and design stages
Identification
The process of defining, describing, and classifying hazards
Hazard
The potential for harm or damage to people, property or the environment
Classes of workplace hazards
- Physical
- Chemical
- Biologic
- Environmental/mechanical
- Psychosocial
Knowledge required to recognize and identify hazards
Knowledge of
- Workers
- Worksite
- Work practices and processes
- Industrial materials
Sources of information regarding hazards
- Knowledgable company representatives
- Health and safety professionals
- Professional publications and courses
- Direct observation of production processes and workers activities
Overall goal of a prevention program
To recognize and identify hazards, evaluate and analyze these hazards, and select and implement preventative and control measures as a continual process
Site survey or walk-through
Worksite inspection not related to any particular incident, work area or piece of equipment
Purpose of the site survey
To identify unsafe conditions and practices, including items not in compliance with local, state and federal regulations, such as OSHA standards
Examples of what to inspect during a site survey
- Atmospheric conditions
- Illumination
- First aid and emergency units
- Containers
- Supplies and materials
- Buildings and structures
- Electrical hazards
- Fire fighting equipment
- Machinery
- Material handling
- Personal protective equipment
- Work practices
Atmospheric conditions to observe during a site survey
- Dusts
- Vapors
- Odors
Illumination to observe during a site survey
- General
2. Workstations
First aid and emergency units to observe during a site survey
- Eye wash stations
2. Deluge showers
Containers to observe during a site survey
- Labeling
- Flammable liquid
- Waste
Supplies and materials to observe during a site survey
- Caustics
- Acids
- Poisons
- Compressed gases
- Cryogenics
- Oxidizers
- Flammable or spontaneously combustible materials
Buildings and structures to observe during a site survey
- Windows
- Aisles
- Floors
- Stairs
- Exit signs
Electrical hazards to observe during a site survey
- Extension cords
- Outlet usage
- Cord conditions
- Electric gear clearance
- Shock hazards
Fire fighting equipment to observe during a site survey
- Fire extinguishers
- Sprinkler systems
- Standpipes
- Accessibility
- Alarms
- Testing procedures
Machinery to observe during a site survey
- Guarding of moving parts and pinch points
- Barrier safety shields
- Proximity switches
- Automatic shutoffs
Material handling to observe during a site survey
- Lifting devices
- Conveyors
- Lift truck operations
- Crane
- Hoists
Personal protective equipment to observe during a site survey
- Clothing
- Safety glasses
- Chemical goggles
- Gloves
- Safety shoes
- Hard hats
Work practices to observe during a site survey
- Eating at the work station
- Personal hygiene
- Adherence to safe operating procedures
- Housekeeping
Types of walk-through inspections
- Informal inspection
- Formal inspection
- General inspection
Informal inspection
Focuses on routine work, such as inspecting and testing equipment at the beginning of each shift
Formal inspection
- Performed periodically by a team of occupational health and safety professionals
- Scheduled at convenient times
- Includes a written report of findings
General inspection
May be conducted to ensure compliance with legal requirements or for insurance purposes, corporate or union audits and fire code compliance
A site survey follows ——— from the beginning to end
Flow of work
A ——- is used to guide site survey inspection
Checklist
Inspection checklists should be….
Site specific
Pre-inspection activities may include the following:
- Determination of inspection time
- Meeting with managers and supervisors
- Review of previous inspection and accident reports, material safety data sheets, and other relevant records and reports
- Gathering of essential personal protective equipment needed at site
- Gathering of checklists, sampling devices, and other items needed for inspection
Inspection activities may include the following:
- Explanation of procedure to supervisors at inspection site
- Observation of employees’ work practices
- Recording of unsafe conditions and practices, including items out of compliance with OSHA standards
- Identification of problems and their causes
- Commendation of supervisor and workers when conditions are noted to be safe
- Corrective action if an immediate danger, such as a blocked exit is noted
Post inspection activities may include:
- Meeting with managers and supervisors
- Conducting a long term analysis based on data from both current and previous inspections
- Preparing appropriate reports
- Circulating reports, which should include recommendations for possible solutions and correction priorities
A ——- to periodically check for corrected and unresolved problems should be established
Audit system
Resource for example of a walk-through program
AAOHN’s Foundation Block: Worksite Safety Walkthrough Program
Focused inspections are conducted periodically for the following purposes:
- To inspect specific processes, equipment or areas
- To investigate an accident
- To evaluate a reported health or safety hazard
- To respond to complaints of such things as a strange odor or loud noise
Who should conduct the focused inspection?
Individuals or multidisciplinary teams with in-depth knowledge of the process or area
Critical parts that require more frequent inspection
- Light switches
- Safety valves
- Cables
- Belts
- Fire extinguishers
- Eyewash stations
- Exhaust hoods
Legally mandated focused inspections
- Elevators
- Autoclaves
- Boilers
Records review
Can be done alone or as a supplement to other methods of hazard identification
Purposes of record audits
- Identify work site hazards
- Better acquaint the occupational and environmental health nurse with the site
- Provide historical data for trend analysis and epidemiologic study
- Ensure compliance with OSHA standards
Focused checklist for electric forklift
- Obvious damage/leaks
- Tire condition
- Battery plug connect
- Warning lights
- Battery discharge meter
- Horn
- Steering
- Foot brake
- Parking brake
- Hydraulic controls
- Fork operation
- Battery water level
- Seat belts
- Fire extinguisher
- Repairs needed
Records that may be helpful in a records review
- Records concerning production and quality control problems
- Workers compensation claims
- Employee assistance program utilization reports
- Personnel records, including absentee records and job histories
- Written hazard control programs, training records and records concerning fit testing and distribution of PPE
- Safety surveys, inspection reports, and exposure monitoring reports
- Machine and equipment maintenance logs
- Emission and process records
- System monitoring and alarm test records
- Plans for disaster preparedness and emergency response
- Designs and reviews of new or planned facilities, processes, materials or equipment
- Written complaints from withers and minutes of the safety committee meetings
- OSHA record keeping forms
- Other site specific records that can be identified and examined if deemed appropriate
Job hazard analysis
- aka job safety analysis
- the process of studying and recording each step of a job to identify existing and potential health and safety hazards and to determine the best way to perform the job to reduce or eliminate the hazards
The conduct of a job hazard analysis requires the following steps:
- Set priorities
- Assess the general conditions under which the job is performed
- Recommend safety procedures and corrections
- Repeat and revise the job hazard/ job safety analysis periodically and after an accident or injury
Priority areas for job hazard analysis
- Jobs with the highest rates of accident and disabling injuries
- Jobs where close calls have occurred
- New jobs
- Jobs where changes have been made in processes and procedures
Steps to take after assessing general conditions under which a job is performed
- List each step of the job in order of occurrence
- Examine each step to determine the existing or potential hazards
- Repeat job observation as often as needed until all hazards have been identified
- Review each hazard with the worker to determine weather the job could be performed in a safer way or weather safety equipment and precautions are needed
- List exactly each new step or method and identify what the worker needs to know
Recommended safety procedures and corrections include:
- Developing a training program
- Redesigning equipment, changing tools, adding guards, improving ventilation or using personal protective equipment
- Reducing the necessity or frequency of performing the job
- Avoid general earnings such as “be careful”
Job hazard/ job safety analysis provides the following benefits
- Improves worker hazard awareness
- Increases worker safety training and supervisor/worker communication
- Enhances identification of root causes of incidents
- Serves as a valuable tool for ergonomic studies
- Increases the thoroughness of machine inspections
- Helps train new supervisors in unfamiliar jobs
- Determines physical and mental requirements necessary for job performance
When is determining physical and mental requirements necessary for job performance a necessity?
When evaluating job candidates with disabilities
Incident analyses
Fact finding procedures to identify the pertinent factors that allow accidents or near misses to occur so similar future incidents can be prevented
Near miss
An incident that could have resulted in injury or property damage under different circumstances
Why should near misses be evaluated?
To prevent recurrence and a more serious outcome
First step in incident analysis
Identify immediate causes
Methods of identifying immediate causes
- Interviewing workers and collecting physical evidence
- Inspecting the scene of the accident or near miss
- Interviewing witnesses in private
- Being alert to the possibility of attempts to hide injuries or facts
- Use company’s incident investigation form to avoid omitting information
- Trying to quote workers statements on their own words
- Staying objective and avoiding biased statements or questions
Examples of physical evidence to be collected post accident
- Drug screening
2. Alcohol testing
How should you record the relevant details when inspecting the scene post accident?
- Photographs
- Drawings
- Measurements
Why would workers attempt to hide injuries or facts?
Fear of:
- Reprisal
- Poor evaluations
- Ruining safety records
- Discovery of substance abuse
- Embarrassment
- Implicating others
Examples of root causes of incidents
- Lack of management support for safety
- Failure to positively reinforce or reward safe behaviors
- Lack of preventive maintenance programs
- Production output stressed over safety
- Low worker morale
- Unqualified trainers
- Lack of job safety analysis
- No assigned responsibility for a function
- Unsafe work behaviors without accident experience
- Peer values
- Poor example set by supervisors/managers
Workplace factors that often contribute to incidents
- Procedures
- Facilities
- Communication patterns
- Behaviors
Examples of types of procedures that are immediate causes of incidents
- Nonexistent
- Not followed
- Not trained in
- Not understood
- Not accurate
- Impossible to follow
Examples of types of facilities/tools/equipment that are immediate causes of incidents
- Personal protective equipment failure
- Improper design
- Nonergonomic design
- Wear/deterioration
- Lack of proper equipment
- Poor housekeeping
- Process equipment failure
- Missing guards or safety devices
Examples of types of hazards that are immediate causes of incidents
- Man made
- Natural source
- Documented but not repaired
- Unidentified
- Identified but accepted
- Inadequately repaired
- Presenting a “challenge” to workers
Examples of types of communication that are immediate causes of incidents
- Inadequate planning
- Breakdown in communication between co-workers, between workers and supervisors, or between contractor and company
- Confused communications
- Lack of warning signs
- Language barriers
- Illiteracy
Examples of types of behavior that are immediate causes of incidents
- Rushed by supervision
- Co-worker competition
- Motivation to finish early
- Taking shortcuts
- No teamwork
- Heavy client workload
- Bonus incentives
- Medication effects
- Boredom
- Fatalistic “it can’t happen to me” attitude
- Unauthorized smoking/eating
- Inattention/distraction
- Fear of asking for help
Examples of types of training that are immediate causes of incidents
- None
- Insufficient
- Safe work practices not addressed in training
- Training applied incorrectly
- No hands on training
- Inadequate follow-up
- Need for refresher training
- Training not site specific
Examples of types of other factors that are immediate causes of incidents
- Fatigue
- Lack of sleep
- Illness
- Physical stress
- Repetitive motion
- Fright
- Physical incapability
- Disrupted circadian rhythms because of shift work
Benefits derived from an incident analysis
- Increases health and safety awareness for workers and supervisors
- Establishes better rapport between the occupational and environmental health nurse, supervisor and ill or injured worker
- Provides data that can be used for an overall safety program evaluation and prevention of future incidents
- Provides essential facts for workers compensation, OSHA record keeping and insurance claims
Incident historical review
The compilation and analysis of incidents and near misses that have occurred over a selected period of time
Categories of incidents in an incident historical review
- Incidents related to specific seasons
- Incidents occurring on a particular shift
- Incidents occurring to a specific group of workers
- Incidents occupying at a specific location or within a specific process
Incident historical review begins with an analysis of incidents and trends in incidents through review of the following records:
- OSHA forms
- Safety committee minutes
- Accident, incident or near miss reports
- Log of daily health service visits
- Other periodic reports and records of the health and safety service
- Comparison of incident rates with those in similar industries
The following factors should be considered when evaluating incident trends
- Workers attitudes and behaviors
- Management attitudes and behavior
- Work environment deficiencies
Worker attitudes and behaviors to consider when evaluating incident trends
- Impatience
- Boredom
- Recklessness
- Feeling rushed (ie those paid for piecework)
- Insufficient training
- Upset by shift work
Management attitudes and behaviors to consider when evaluating incident trends
- Emphasis on production over safety
- Failure to identify hazards and perform corrective action
- Failure to enforce safe behavior
Work environment deficiencies to consider when evaluating incident trends
- Poor lighting
- Inadequate ventilation
- Obsolete equipment
Items that provide critical safety information for workers and employers
- Chemical inventories
2. Material safety data sheets
Chemical inventories and material safety data sheets are required by…..
OSHA 29 CFR 1910.1200 Hazard Communication Standard
Similar OSHA standard for certain laboratories
OSHA 29 CFR 1910.1450
Chemical inventories and material safety data sheets are useful for…..
Estimating potential hazards associated with raw materials, products and other hazardous substances present in the facility
Incidence rate calculation
Incidence rate= (number of new cases/ year x 200,000 work hours per facility) / (number of hours worked at facility/year)
Alternate method for calculating incidence rate
Incidence rate= (number of new cases/ year x 200,000 work hours) / (number of people at facility x 2000 hours)
Employee perception surveys/questionnaires
Involve workers directly in hazard recognition and identification
Why is worker involvement in hazard recognition and identification important?
Because the worker is most directly involved with the work process and often provides an insight not otherwise obtained
Information obtained from surveys and questionnaires is most accurate when collected by….
An independent, unbiased third party
Surveys and questionnaires should consist of questions that have been…
Researched and field tested for reliability
Why should survey results be shared with workers?
- So that all workers can benefit from their coworkers insight
- Workers may wish to clarify, modify or otherwise add information contained in the results
Process safety reviews
Consist if evaluations performed on activities involving chemicals, including use, storing, manufacturing, handling or moving chemicals at the site
In a process safety review information is gathered on the hazards of the chemicals, technology and equipment used in the process which allows health and safety professionals to…
- Identify the hazards of new and changed processes
- Evaluate the processes reviewed in the last 5yrs
- Review processes related to incidents that had a potential for catastrophic consequences
Process safety reviews serve as a means of….
Determining what could go wrong and what safeguards must be implemented to prevent hazardous chemical releases
Process safety reviews are mandated by:
- EPA 40 CFR Part 68: “Worst Case Scenario” section
2. OSHA 29 CFR 1910.119: “Process Safety Management of Highly Hazardous Chemicals
Process safety reviews are mandated by EPA and OSHA for industries
- Using more than 130 chemicals in listed quantities
2. Using flammable liquid and gases in quantities of 10,000 pounds or more
Methods to determine and evaluate the consequences of the failure of engineering and administrative controls include the following:
- What if
- Checklists
- Hazard operability study (HAZOP)
- Failure mode and effects analysis (FMEA)
- Fault tree analysis
What if method
A method of thinking in which failure potentials are brainstormed and their causes and effects analyzed
Checklist method
Identifies major hazards and nuisances associated with a particular material
Hazard operability study
HAZOP
A formal systematic study of a newly designed facility or operation to assess the potential of individual equipment components to fail, resulting in consequential effects on the overall facility
Failure mode and effects analysis
FMEA
A “bottom up” technique in which the failure of a particular process component is assessed for its effects on other components and on the process system as a potential source for accidents
Fault tree analysis
A formalized deductive technique that works backward from a defined accident to identify and graphically display the combination of equipment failures and operational errors that could have led up to the accident
Worker health and safety information for chemicals includes
- Health effects of chemicals
- Possible need for specific exposure monitoring
- First aid planning
Ergonomic analysis
Evaluates stresses related to the performance of work so strategies for prevention can be developed
NIOSH Equation for Manual Lifting
Can be used to identify tasks having a risk of overexertion injuries and low back pain because of lifting and lowering activities
NIOSH Equation for Manual Lifting is an equation based on the following variables
- Horizontal distance
- Vertical distance
- Distance of lift
- Asymmetry of lift
- Coupling
- Frequency of lifting
Goal of NIOSH Equation for Manual Lifting
To design the task so the lifting index is at or below 1.0
Examples of prevention strategies from ergonomic analysis
- Redesigning workstations and work equipment
- Improving work environment
- Designing warning signs for hazardous equipment and locations
Effective ergonomics programs include the following:
- Surveillance strategies to assess patterns of exertion injuries
- Job hazard analysis/ job safety analysis to identify workers at risk
- Job design or redesign that considers ergonomic factors
- Management and worker training related to the recognition and control of biochemical hazards
- Protocol management of injured workers
Ultimate purpose of hazard evaluation and analysis
To control all hazards, existing and potential
Hazards that warrant a greater priority when control measures are implemented
Hazards that present a high probability of severe injury or illness
Hazard evaluation and analysis serves as an ongoing tool to determine….
- What is working well
- What isn’t working well
- What deserves commendation
- What needs constructive correction
————- serve as guides for program implementation
Analysis and evaluation strategies
When exposure monitoring indicates that agent action levels have been reached…..
A worker health surveillance program should be implemented
When worker health data suggests adverse work site exposures….
Exposure monitoring may be indicated
Environmental or biologic monitoring results that suggest elevated exposure may indicate the need for…..
Additional engineering or administrative control measures or for additional training in the proper use of personal protective equipment
Industry standards provide
A guide for evaluating and analyzing hazards
Two types of industry standards
- Mandatory standards
2. Consensus standards
Mandatory standards
- Establish minimum safety program requirements and maximum levels of permitted exposure
- enforced by government agencies
Examples of government agencies that enforce mandatory standards
- OSHA
2. EPA
Consensus standards
Voluntary industry standards adopted by agreement among participating members
Standards can serve as professional yardsticks against which to measure….
Hazard identification and prevention activities
Occasionally mandatory standards quote —— as their requirements
Consensus standards
Example of a mandatory standard that quotes a consensus standard as its requirement
State fire regulations that reference the National Fire Protection Association (NFPA) recommendations
Standards can carry heavy weight in such issues as:
- Insurance company coverage
- Legal actions
- Grant funding
- Other issues in which competency and compliance issues are involved
Example of how standards can carry hevy weight on competency and compliance issues
The evaluation process and ratings of JCAHO as a condition for third party reimbursement
Places that might have certification or compliance requirements that industry can use as a yardstick for hazards and preventative measures
- Trade associations
- Scientific and technical societies
- Insurance companies
Example of an association/society/company that have certification or compliance requirements to use as a yardstick
The standard for laboratory ventilation provided by the American National Standards Institute (ANSI)
International associations that promulgate consensus standards, often as a part of environmental treaties and quality initiatives are:
- The International Labour Organization
2. International Organization for Standardization
Some standards are inadequate for the following reasons:
- May conflict with each other in their requirements
- Standards in the United States may differ from those of other countries
- Standards may not address an organization’s principle risk
Example of conflict requirements
Labeling requirements for the DOT versus those of OSHA
——— has issued a series of directives intended to ensure harmonization of requirements for the health and safety of individuals
The Council of the European Union
The European Directives set out a common framework, for member countries to implement at the national level of —-, —–, and —— necessary to comply with their requirements
- Laws
- Regulations
- Administrative procedures
The European legal instruments can be put into five categories:
- Regulations
- Directives
- Decisions
- Recommendations and opinions
- Action programs
Regulations (European directives)
Binding on all member states and introduced
Directives (European Directives)
Establish principles that are binding on all member states and implemented in accordance with member states arrangements
Decisions (European Directives)
Binding on those to whom they are addressed
Recommendations and opinions (European Directives)
Not binding, but encourage good practice
Action programs (European Directives)
Adopted by the Council; indicative of the Council’s intention to take measures to achieve its objectives
Other countries (aside from US and Europe) also have regulations associated with occupational health and safety issues. Name several of those countries
- China
- Australia
- Japan
Occupational health and safety regulations in China
- has significant number of regulations associated with occupational health and safety
- regulations vary in different provinces
- can be quite complex
- many local rules
Number of laws, regulations, standards and rules applicable to Shanghai City
807
Occupational health and safety regulations in Australia
- standards are determined by individual states and territories
- major initiative is self-regulation via “code of practice”
Code of practice in Australia
Places a broad duty of care on employers to provide a safe and risk free work environment
Examples of groups that determine Australian occupational helth and safety standards
- Queensland Division of Workplace Health and Safety
2. Victoria Health and Safety Organization
Occupational health and safety regulations in Japan
- regulations are determined centrally
- unusual feature is that industrial law requires that a person undergo a prescribed occupational medical examination each year
Who determines Japanese occupational health and safety regulations?
Labor Standards Bureau of the Ministry of Labor
How differing standards affect international corporations
- The processes that are followed, the participants and their extent of involvement and the legal structures embracing these standards are different than in the US
- Essential that judgements of other countries not be based on what we have experienced in the US
Resource that provides a template that can be used for standards in general industry and manufacturing settings
AAOHN’s Foundation Block- A Safety Action Plan Template
In the occupational setting, risk analysis is……
An interdisciplinary science that evaluates health and environmental hazards and risks that result from work related activities
Low numbers of incidents and injuries do not necessarily mean…..
A hazard free worksite
A hazardous event may be rated as:
- Catastrophic
- Critical
- Marginal
- Negligible
Hazardous event rating categories are subjective categories based on:
- Fatalities
- Injury severity
- Financial damage
The likelihood of a hazardous event is estimated subjectively as:
- Frequent
- Probable
- Occasional
- Remote
- Improbable
Risk analysis shoud consider both….
The probability of an incident occurring and the expected severity of adverse results, thus ranking the risks
A formula for estimating risk score
R= S x E x P
Risk score= severity x exposure x probability
Risk analysis should define the following items that identified hazards may affect:
- People
- Property
- Environment
To be meaningful, the results of risk analyses must be communicated to the people they affect:
- Worker
- Health and safety professionals
- Management