This Document Contains Chapters 5 to 6 CHAPTER 5 Physical Agents Essential Outcome After completing the lesson on this chapter, if nothing else, my students should be able to identify and categorize common physical agents found in the workplace, and be able to describe typical ways of managing and controlling them. Learning Outcomes After completing this chapter, students should be able to: identify common physical agents in the workplace explain how and when many of the commonly found physical agents can be considered hazardous identify methods of controlling physical agents within the workplace Key Concepts Physical agents are sources of energy that may cause harm, injury, or disease if they are not properly managed or controlled. Most physical agents fall into the categories of noise, vibration, radiation, and extremes in temperature or pressure. Noise is the most common workplace hazard, and is defined as any unwanted sound. Noise is complex to manage because situations and individuals vary greatly in terms of how noise is experienced. Human hearing response is conditional, and based on the frequency, duration, and loudness of sound, all of which may be important factors with noise. Excessive or prolonged exposure to noise can result in hearing loss, which may be physiological (conductive or sensorineural), or psychological. Noise control usually centres around the source–path–human approach, and includes reducing noise at its source, moving workers away from the path of the noise, and using personal protective equipment (PPE) such as earmuffs or earplugs. Vibration, the oscillating motion of an object such as a piece of equipment, can be low frequency or high frequency and can be experienced throughout the entire body (whole-body vibration) or only in certain parts of the body, usually the hands and arms (segmental vibration). Vibration can cause a range of health issues ranging from nausea or fatigue to more serious problems affecting muscles, joints, tissue, and bones. Vibration can be managed through engineering controls such as ergonomic features that reduce or dampen vibration at its source, administrative controls that limit exposure to vibration, or the use of PPE such as gloves, padding, or floor mats. Thermal stress involves exposure to temperature extremes—either hot or cold. The human body regulates its temperature through homeostasis, and its ability to maintain a steady temperature is affected by its exposure to external heat sources or cold sources through the process of heat transfer. Heat transfer can be the result of conduction, convection, or radiation. The effect of extreme heat or cold on the body depends partly on the individual’s physical characteristics, including overall health and fitness level, age, height, and weight, and by medical conditions such as heart disease or high blood pressure. Heat-related illnesses include edema, heat rash, cramps, fainting, heat exhaustion, and heat stroke. Engineering controls are used to reduce heat where possible, but administrative controls (such as limiting exposure to heat and ensuring proper hydration) and PPEs like hats, sunglasses, and even cooling vests are also commonly utilized. Cold environments can also be hazardous, resulting in either non-freezing injuries, such as chilblains, mild circulation problems, immersion foot, or trench foot; or freezing injuries, such as frostnip, frostbite, or hypothermia. As with heat, engineering controls (heaters), administrative controls (shut down in extreme cold), and PPEs (warm clothing) are commonly used to manage the hazards of cold. Radiation is electromagnetic energy and is classified as ionizing (e.g., X-rays or gamma rays) or non-ionizing (e.g., ultraviolet or infrared radiation or microwave radiation). Radiation is typically controlled through monitoring, shielding, job rotation, protective equipment, and extensive training. Ionizing radiation can result in cell mutation, burns, and radiation sickness. Non-ionizing radiation can result in illnesses such as burns and rashes but affects the eyes most of all. PPE use therefore often includes eye protection. Other PPE devices are used along with various engineering and administrative controls. Student Motivation Every student in the classroom will be able to relate to one or more of the physical agents discussed in this chapter, even if not specifically in the workplace. All students have experienced noise, for example, as well as the effects of temperature. Most will have some experience with radiation as well, either from the sun or perhaps from tanning beds. When they draw from these direct experiences and make the connection to the same hazards but in a workplace context, most students will find this chapter of interest. Barriers to Learning There should be relatively few learning barriers in this chapter, other than some of the terminology, which may be challenging for some students. Encourage students to write out and sound out words and terms that are unfamiliar or challenging to them (e.g., “sensorineural”). Also bear in mind that English may not be the first language for some students in your class. These students may require a little extra time to become familiar and comfortable with some of the terms. If you are using the chapter appendix, the sections on calculating noise levels and shift adjustment for noise exposure present formulas for calculating decibel levels. These formulas may be quite challenging for some students if they are expected to understand and work with them. Engagement Strategies and Lesson Plan 1. Engaging Students at the Outset Learning objective: At the completion of this activity, students will be able to relate their own direct experiences with physical agent hazards to the content discussed in the chapter. Post four flip charts around the classroom with the headings “noise,” “vibration,” thermal stress,” and “radiation.” With markers provided, invite students to post on the appropriate charts any jobs they have had where these types of hazards were (or may have been) present. Review the results with the class, asking for elaboration/clarification as necessary. Use this activity as a way of introducing the chapter and the four major types of physical agents described, and as a lead-in to Lesson Plan item A: Physical agents: Definitions. 2. Lesson Engagement Strategies a. Learning objective: At the completion of this activity, students will have experienced the sensation of hearing loss by listening to sound files of music and speech that simulate normal, mild, high frequency, moderate, and severe hearing loss conditions. As an addition to Lesson Plan item D, The Affects and Controls of Hazardous Noise, visit the website hearingcenteronline.com/sound.shtml. Play the various sound files found on this page for the class, beginning with “normal” and proceeding through the “mild,” “high frequency,” “moderate,” and “severe” hearing loss conditions. Ask students to jot down how they are feeling (e.g., frustrated, disconnected) as they experience listening to each file. Discussion can centre on the impact of hearing loss and on the need to protect against hazards that may damage hearing. b. Learning objective: At the completion of this activity, students will be able to consider and apply strategies for ensuring worker compliance in the use of PPEs. Organize students into groups of four, and have each of them assume a role within the group (facilitator, recorder, time keeper, presenter). Have students read and discuss Case 2, “Expensive Jewellery,” and expand on strategies that ensure employees wear their personal protective equipment. After 5 to 7 minutes, have the presenter from each group briefly describe their groups’ strategies to the class. Refer to Case 2 to fill in any missing strategies. c. Learning Objective: At the completion of this activity, students will have considered the importance of protecting their eyes from the effects of harmful radiation. Ask students who have sunglasses with them to take them out for examination. Have students who do not have sunglasses form small teams with students who do. Have the small teams examine the sunglasses to try to determine whether the sunglasses provide protection from harmful UV radiation, while referring to Figure 5.3, “General Absorption Properties of the Eye for Electromagnetic Radiation.” If time permits and students have Internet access on their laptops or tablets, it might be helpful for them to quickly research their sunglasses online. 3. Lesson Plan Notes and Lecture Outline * For a list of workplace hazardous noise DVD titles from WorkSafeBC Library Services, visit www.worksafebc.com/about_us/library_services/assets/pdf/videos_titles.pdf. A: Physical Agents: Definitions Use PowerPoint slides to define physical agents and then define and discuss examples of the four common physical agents encountered in industry—noise, vibrations, thermal stress, and radiation. You can incorporate examples from students’ experiences in the workplace and entertainment venues. Refer to End of Chapter Exercise 1. B: Types of Hearing Loss Use PowerPoint slides to define and discuss workplace examples of the three ways noise can affect humans: physiologically, socially, and psychologically. C: Noise Exposure Standards Ask students what hazardous noise they have experienced in the workplace. Do people have to raise their voices to be understood? Do you have ringing in your ears at the end of the workday? Do you turn the radio up on the drive home? Do you have difficulty understanding conversations in public? If any of the above statements are true, your workplace might be too noisy and a noise assessment or survey of the workplace should be undertaken. Ask the students a few more questions concerning hearing loss outside their workplace. Do you have trouble hearing in a crowd? Do you miss parts of conversations? Do you ask people to repeat themselves? Do friends and family complain that the music or TV is too loud? Do your ears ring? Do you feel you are getting used to the noise level? Ask students to form small groups and discuss Discussion Question 1 at the end of the chapter. Workers in a manufacturing division have made a formal complaint that three machines are too noisy. Noise measurements are taken: the results are 83 dB, 87 dB, and 88 dB. Do the workers have a legitimate complaint? Refer students to OH&S Notebook 5.1, “Noise Exposure Limits,” and to the CCOHS website: Noise—Occupational Exposure Limits in Canada (http://ccohs.ca/oshanswers/phys_agents/exposure_can.html). Refer to End of Chapter Discussion Question 1. D: The Effects and Control of Hazardous Noise Show the Workers’ Compensation Board of BC video/DVD The Hearing Video, www.healthandsafetycentre.org/i/hearing/TheHearingVideo_scan.jpg. This video demonstrates how ears work and the effects of hazardous noise on hearing. It also shows the proper use and maintenance of hearing protection, and how to choose the right protection, as well as what a hearing test involves. Ask students to list important facts about noise in the workplace (or answer the following questions) as they watch the video. After watching the video, engage students in a discussion on the questions below: How does the ear work? What are the effects of hazardous noise on hearing? How do you use and maintain hearing protection? How do you choose the right protection? What is a hearing test, and why do tests need to be done yearly? What are the WCB’s industrial noise regulations? Worksafe BC has several videos and publications, as well as checklists, quizzes, frequently asked questions and answers, and information with the logo HearSafe: Hear Today, Hear Tomorrow. E: Noise Control: Hearing Protection Refer to Lesson Plan B, “Noise Control, Hearing Protection and the Role of the HRM.” * An additional learning activity would be to have students discuss how earbuds isolate employees from their work environment and workplace hazards. View the WCB video clip Deaf to the Danger, which offers three short scenarios that demonstrate just some of the dangers associated with wearing earbuds on the job. A list of DVD titles can be accessed at WorkSafeBC Library Services, www.worksafebc.com/about_us/library_services/assets/pdf/videos_titles.pdf. F: Hearing Conservation Programs Ask the students to discuss Case 1, “Monty’s Problem.” Then use PowerPoint slides to describe the elements of and legal requirements for implementing a noise conservation program. Refer to End of Chapter Case 1. Hearing conservation is the prevention and reduction of occupational noise-induced hearing loss. The most effective way to control noise exposure is to implement a hearing conservation program. This would require the involvement of qualified individuals who have specialized technical knowledge and current training (e.g., an industrial audiometric technician or a contract technician). If workplace noise exceeds regulated limits (BC uses a noise standard of 85 dB (A) for eight hours and a peak noise level of 140 dBA), employers must have an effective noise control and hearing conservation program. A hearing conservation program must be written that addresses the following: Noise measurement Education and training Engineered noise control Hearing protection Posting of noise hazard area Hearing tests Annual program review The conservation program elements described above are explained in detail in the Workers’ Compensation Board of BC publication Sound Advice: A Guide to Hearing Conservation Programs, www.worksafebc.com/publications. For more information, visit the following: Hearing Conservation Check List www2.worksafebc.com/pdfs/hearing/sound_advice9.pdf Hearing Conservation Program Examples www2.worksafebc.com/PDFs/hearing/sampleprogramlarge.pdf www2.worksafebc.com/PDFs/hearing/sampleprogramsmall.pdf In summary, you may want to ask students to describe how a human resource manager can implement a hearing conservation program. G: Vibration Use PowerPoint slides to describe the three reasons why vibration is a health hazard: whole body vibration, segmental vibration, and noise. Refer to OH&S Notebook 5., “Controlling Vibration.” Use PowerPoint slides to discuss the causes, health effects, and control strategies for whole body and segmental vibration. H: Thermal Stress Use PowerPoint slides to illustrate Figure 5.2, “The Body as a Machine System.” Use the figure to define homeostasis, thermodynamic theory, thermal stress, conduction, convention, and radiation. Describe how the body controls its temperature, the focal point of thermal stress, and the core body temperature range (35C–38.5C). Ask the class if they (or someone they know) have spent a lot of time working or participating in activities outside in the summer and/or winter (e.g., construction, skiing, wilderness hiking, climbing) and what effects heat or cold had on their health. Use PowerPoint slides to describe the various heat and cold related illnesses. Access the Internet to review the health and safety regulations for outdoor work in your jurisdiction. Using WCB resources such as the Workers’ Compensation Board of BC’s “Hypothermia—Surviving the Cold” (www.worksafebc.com/publications), engage the students in a discussion of the ways in which employers can reduce the adverse consequences of working in the heat or cold. Refer to End-of-Chapter Questions—Using the Internet. * An additional learning activity would be to have students read and discuss a recent news article on heat and cold illnesses and/or deaths. For example, for hypothermia, “Survivor Recounts How Two Died in BC Kayaking Accident,” CBC News, October 8, 2007 (www.cbc.ca/canada/british-columbia/story/2007/10/08/kayak-death.html). One of the major hazards you face when working in the cold is losing your body heat. If your body becomes so cold that it can no longer produce more heat than it loses, hypothermia is occurring. What causes hypothermia? When and why does hypothermia occur? Who is at risk? How can you protect yourself and others and reduce the risks? What are the signs of the onset of hypothermia? How can you treat victims? What can employers do (and what are they are required to do by law) to reduce the adverse consequences of working in the cold? In summary, engage students in a discussion of this question: “If workers are at risk of heat-related disorders, what obligations do employers/HRM have to ensure that the workers are safe from the dangers of heat exposure?” Conduct a heat stress assessment. Implement engineering controls to reduce the level of heat. Adjust work/rest schedules to reduce exposure. Provide personal protective equipment. Ensure cool drinking water is near worksite. Limit exposure through work rotation. Install fans or air conditioning. Allow time to acclimatize. Provide drinking water. Support the use of sun hats, sunscreen, and eye protection. The prevention of heat stress at work is described in detail in the WorkSafe BC publication Preventing Heat Stress at Work (www.worksafebc.com/publications). I: Radiation Use PowerPoint slides to define, discuss examples, and describe human reactions related to ionizing and non-ionizing radiation. Discuss the management of radiation from implementing extensive specialized training and procedures for industries that encounter ionizing agents to prevention policies and programs for industries that encounter non-ionizing agents. Engage students in a discussion on the sources and health effects of nonionizing radiation. Ask students, “What is the greatest source of UV radiation?” (Answer: Sunlight. The eye is the primary organ at risk.) Ask students how often they use electronic devices, cellular phones, and computer video display terminals (VDTs). Using the Opening Vignette “Are Cellphones Safe?” and current research on VDTs, engage students in a discussion about the concerns and debates on the possible hazards related to the use of cellular phones and VDTs (i.e., fetal risk, tumors). Ask students if they know anyone who uses tanning centres. Tanning lights emit mostly UV-A radiation and must exceed guidelines in order to cause tanning. Using the OH&S Notebook 5.7, “Effects of Nonionizing Radiation,” have students form small groups to discuss sources, health effects, and the management of non-ionizing radiation in their workplaces. Have the student groups summarize their discussion with the class. For more information: www.ccohs.ca/oshanswers/phys_agents/ultravioletradiation.html. www.radiationsafety.ca www.ccohs.ca/oshanswers/phys_agents/cellular_telephones.htm Assessment Tools To quickly assess student learning against the chapter learning outcomes, at the end of the class: Refer back to the flip charts on the wall with the lists of physical hazards under the four main categories. Ask students to recall some of the listings without looking at the charts. Ask students to describe and provide examples of when the physical agents discussed may be safe versus when they might present a hazard (e.g., your cell phone vibrating in your pocket versus working all day on a vibrating piece of industrial machinery). Addressing each of the four categories, ask students to cite a few examples of how each can be controlled or managed within the workplace. Reflections on Teaching Good teaching requires ongoing self-assessment and reflection. At the completion of this lesson, you may find it helpful to reflect on the following, and consider whether you want or need to make any adjustments for subsequent lessons. What worked in this lesson? What didn’t? Were students engaged? Were they focused or did they go off on tangents? Did I take steps to adequately assess student learning? Did my assessments suggest that they understood the key concepts? What (if anything) should I do differently next time? How can I gather student feedback? How can I use this feedback for continuous improvement of my teaching? Additional Resources Weblinks Canadian Centre for Occupational Health and Safety website: Measurement of Workplace Noise, www.ccohs.ca/oshanswers/phys_agents/noise_measurement.html. HearingCentreOnLine.com website: Name That Sound—What Does Hearing Loss Sound Like? http://hearingcenteronline.com/sound.shtml. Videos A list of other DVD titles can be accessed at WorkSafeBC Library Services: www.worksafebc.com/about_us/library_services/assets/pdf/videos_titles.pdf. Suggested answers to cases and exercises Discussion Questions 1. Workers in a manufacturing division have made a formal complaint that three machines are too noisy. Noise measurements are taken: the results are 83 dB, 87 dB, and 88 dB. Do the workers have a legitimate complaint? Answer: In BC, an employer must ensure that workers are not exposed to noise levels above either of the following exposure limits: 85 dBA Lex daily noise exposure level and 140 dBA peak sound level for an eight-hour continuous period without hearing protection. These legislated standards vary slightly throughout the Canadian provinces and territories (refer to Table 5.1) and must be viewed as the maximum allowable tolerances, not as a safe level of noise exposure, as hearing loss can occur below the legislated exposure level. Another factor to consider is how long the individual is exposed to potentially hazardous noise (e.g., exposure to noise on the edge of safe limits can cause hearing damage if ongoing over a long time—for example, with a kitchen blender, 86Db). The hazard noise poses depend on three main factors: intensity (loudness), frequency (pitch), and duration (time). The Worksafe BC Publication, “How Do I Know If I Am Exposed at Work,” www2.worksafebc.com/pdfs/hearing/noise_exposure_handout.pdf, describes and gives examples of various combinations of noise levels and durations and how they all have the same risk to an exposed worker’s hearing. A noise level assessment should be conducted by the employer for all noise-exposed job classifications, and warning signs need to be immediately posted noting that hearing protection is required until a more formal hearing conservation program is implemented. When noise exceeds regulated limits, BC employers must have an effective noise control and hearing conservation program. The noise levels in this manufacturing division need to be measured to ensure the noise exposure of employees is at a safe level. The most effective way to control noise exposure and protect employees’ hearing is to implement a hearing conservation program. This is a preventive approach to potential occupational noise-induced hearing loss and addresses the expressed formal complaints of the employees. The program will work towards identifying noise sources and engineering controls and identifying workers who require hearing protection, testing, and education. If workplace noise exceeds regulated limits (BC uses a noise standard of 85 dB (A) for eight hours and a peak noise level of 140 dBA) employers must have an effective noise control and hearing conservation program. A hearing conservation programs must be written and address the following: Noise measurement Education and training Engineered noise control Hearing protection Posting of noise hazard area Hearing tests Annual program review The conservation program elements described above are explained in detail in the Workers’ Compensation Board of BC’s “Sound Advice: A Guide to Hearing Conservation Programs” (www.worksafebc.com/publications). Hearing Conservation Check List www2.worksafebc.com/pdfs/hearing/sound_advice9.pdf Hearing Conservation Program Examples www2.worksafebc.com/PDFs/hearing/sampleprogramlarge.pdf www2.worksafebc.com/PDFs/hearing/sampleprogramsmall.pdf Worksafe BC has several publications, checklists, quizzes, frequently asked questions, and answers and information using the logo “HearSafe: Hear Today, Hear Tomorrow.” For more information on noise and physical agents in the workplace, visit www.ccohs.ca. The American Conference of Governmental Industrial Hygienists (ACGIH) lists updated noise standards annually: www.acgih.org. 2. Name three sources of UV radiation in an office. Then describe the effects of UV radiation on health. Answer: Refer to Occupational Health and Safety Notebook 5.7, “Effects of Non-Ionizing Radiation.” Controlling non-ionizing radiation exposures usually includes training, isolation, and separation, limiting use, and using protective equipment. For more information: www.ccohs.ca/oshanswers/phys_agents/ultravioletradiation.htm www.radiationsafety.ca www.ccohs.ca/oshanswers/phys_agents/cellular_telephones.htm Three Sources of UV Radiation in an Office: 1. Fluorescent and halogen lights 2. Computer and monitor screens 3. Sunlight through windows Effects of UV Radiation on Health: • Skin Damage: Premature aging, sunburn, and increased risk of skin cancer. • Eye Damage: Cataracts and vision impairment. • Immune Suppression: Reduced immune function, increasing susceptibility to infections. 3. All jurisdictions in Canada have access to the same science. Yet jurisdictions vary in legislated standards. Why might different standards apply in different jurisdictions? Answer: Refer to the text pages 125–27. Different standards may apply in various Canadian jurisdictions despite access to the same science due to: 1. Local Priorities: Different regions may prioritize economic, social, or environmental factors differently based on local needs and industries. 2. Provincial Autonomy: Provinces and territories have the authority to regulate certain areas independently, leading to variations in how science is applied to policy. 3. Economic Considerations: Some jurisdictions may adjust standards to accommodate local economic conditions, balancing regulatory costs with business interests. 4. Cultural and Political Factors: Regional values, political climate, and public opinion may influence how scientific findings are translated into regulations. These factors lead to varying standards despite shared scientific knowledge. 4. Many occupations involve inherent exposure to a physical agent resulting in excessive exposure to noise, vibration, thermal conditions, etc. Outline the steps an employer can take to protect employees when avoiding the exposure is not possible. Answer: An employer/HRM would follow the source–path–human strategies to control exposure to a physical agent (noise, vibration, thermal conditions) in the workplace. The best method of dealing with these physical agents is to use engineering controls to reduce the hazard at the source. The next best strategy would be to move the worker away from the source; this may include erecting barriers, enclosing the source or worker, reducing the length of exposure, job rotation, training, and limiting use. If it is not possible to reduce exposure to a physical agent, the employer must reduce exposure to the lowest level possible, post warning signs in the hazard areas, give affected workers personal protection equipment that meets the legal standards, and ensure that personal protection equipment is worn effectively in hazard areas. Using the Internet 1. Working outside in the Canadian winter can be a hazard for many workers. Using Internet resources, determine the health and safety regulations and guidelines for outdoor work in your jurisdiction. Compare regulations across several provinces and territories. Which jurisdictions have developed the most extensive sets of guidelines for outdoor work? Answer: Legislation in BC provides employers with extensive guidelines, obligating them to pay close attention to the dangers of thermal stress. Employers must conduct heat and cold stress assessments and implement engineering and administrative controls (e.g., heat shelters) if workers are at risk of heat or cold related illnesses (exposed to conditions that would cause the body’s core temperature to fall below 36C or above 38.5C). Employers should obtain regular weather reports and ensure employees have appropriate clothing and PPE. In the colder parts of the province, workers are trained to recognize the signs of frostbite, trench foot, frostnip, and hypothermia. For more information: Saskatchewan: www.ccohs.ca/otherhsinfo/alerts/alert56.txt. Workers’ Compensation Board of BC, Worksafe Magazine, December 2004, “Working Safely In Winter,” www.worksafebc.com/publications/newsletters/worksafe_magazine/Assets/PDF/wsm_nov_dec_2004.pdf. Workers’ Compensation Board of BC, “Hypothermia—Surviving the Cold,” www.worksafebc.com/publications. Workers’ Compensation Board of BC, “Preventing Heat Stress at Work,” www.worksafebc.com/publications. Exercises 1. Occupational health and safety legislation establishes standards for exposure to various forms of physical agents in the workplace. Think of common forms of after-work entertainment (movies, bars, restaurants, malls, etc.). What physical agents are present in these settings? What risks do they pose for customers? For employees of these establishments? Answer: The following are some common forms of after-work entertainment and activities that may cause hearing loss and/or vibration, thermal stress, and radiation-related health illnesses (e.g., cancer, conjunctivitis, blurred vision, sore joints, muscle atrophy, heat stroke, hypothermia): Noise—diesel truck—85dB(A), blender—86dB(A), lawn mower—92dB(A), power saw—88dB(A), airplane taking off—120dB(A), washing machine—80dB(A), stereo headsets/I-pods, music in bars, power tools, power gardening equipment. Vibration—music in bars, power tools, driving, belt sanders, driving a tractor, truck, motor cycle, vibrating construction tools. Thermal Stress—beach volleyball/soccer tournaments in hot weather. Radiation—fluorescent lights, microwave ovens. WorkSafe BC has a series of handouts listing typical noise exposures in a variety of industries, as well as off-the-job noise levels. How Loud Is It? (Handouts) Source: WorkSafeBC Construction Fishing General Logging Municipalities Off the Job Public Schools Pulpmills Sawmills Ship Building Waste Management Cases Cases 1: Monty’s Problem Students will want to refer to the Occupational Health and Safety legislation in their provincial, territorial, or federal jurisdiction. Resolving this situation would involve collaborative discussions among all OH&S stakeholders located at the corporate office, branch plants, and personnel departments (e.g., owner, newly appointed corporate medical director, occupational health and safety nurse, senior production engineer, plant manager, general manager at corporate office). The topics of discussion should involve working together to review the current practices and legislation concerning occupational health and safety programs (described below) and hearing conservation programs (described below). The mutual goal would be to control noise exposure to prevent occupational hearing loss. The most effective way to control noise exposure would be to implement a hearing conservation program, which would require involving qualified individuals with specialized technical knowledge and who have received adequate current training (e.g., hiring an industrial audiometric technician, contract technician, or acoustical engineer). The scope of legislation differs in each Canadian jurisdiction. The following describes the major provisions and their implication for employers, owners, contractors, employees, human resource managers, and supervisors in British Columbia. Employers are responsible for ensuring the health and safety of all workers at a workplace where the employer’s work is being carried out. This involves establishing an occupational health and safety program, providing a healthy and safe working environment, and providing instruction and training to supervisors and workers. Business owners are responsible for providing and maintaining the land and premises being used as a workplace in a manner that ensures the health and safety of anyone at or near the workplace. They must ensure that employers and prime contractors at the workplaces have all the information they need to identify, eliminate, or control occupational health and safety hazards. When work areas of two or more employers overlap, the owner of the site must coordinate health and safety activities. Contractors or subcontractors must be registered with the WCB. Supervisors are responsible for ensuring the health and safety of all workers under their direct supervision. They must ensure that workers follow the requirements of the Act and Regulation and that they are aware of any health or safety hazards in the workplace. They must conduct regular staff safety meetings, workplace inspections, and incident investigations, correct unsafe acts and conditions, and ensure workers are adequately trained and qualified to safely perform their duties. Workers are responsible for protecting their own health and safety and the health and safety of other people who may be affected by the work being done. They must learn and follow safe work procedures, use and maintain personal protective equipment as required, report hazards to their supervisor or employer, and participate in workplace inspections and incident investigations as required. According to the Worker’ Compensation Act of BC an employer must meet the standard of due diligence. An ongoing occupational health and safety program that controls specific hazards in the workplace forms the basis of due diligence. The minimum occupational health and safety program elements are outlined below: Statement of Aims and Responsibilities Inspection of Premises, Equipment, and Work Written Instructions Management and Safety Committee Meetings Investigation of Accidents/Incidents Maintenance of Records and Statistics Instruction and Supervision of Workers If workplace noise exceeds regulated limits (BC uses a noise standard of 85 dB(A) for eight hours and a peak noise level of 140 dBA) employers must have an effective noise control and hearing conservation program. A hearing conservation programs must be written and address: Noise measurement Education and training Engineered noise control Hearing protection Posting of noise hazard area Hearing tests Annual program review The conservation program elements described above are explained in detail in the Workers’ Compensation Board of BC’s “Sound Advice: A Guide to Hearing Conservation Programs” (www.worksafebc.com/publications). Hearing Conservation Checklist www2.worksafebc.com/pdfs/hearing/sound_advice9.pdf Hearing Conservation Program Example www2.worksafebc.com/PDFs/hearing/sampleprogramlarge.pdf www2.worksafebc.com/PDFs/hearing/sampleprogramsmall.pdf These hearing conservation programs may contain the following elements: maintaining confidential records (privacy legislation) allowing only the WCB, audiometric technician, company physician, and/or OH&S nurse to access the hearing test records (for yearly comparisons); using experts (who have received adequate training and attend refresher courses) to conduct workplace noise surveys and measure hazardous noise; providing training for individuals involved in the hearing conservation program (e.g., coordinators, supervisors); and investigating the possibility of reducing noise at the source (engineered noise control) in order to eliminate the need for hearing protection and testing. Case 2: Expensive Jewellery The organization’s beliefs and expectations concerning occupational health and safety strongly influence whether employees act safety or not. The goal would be to have occupational health and safety as part of the business plan and a core value held by all levels of management and employees. An organization’s culture is a reflection of its leaders and their values and vision. HRM practices (e.g., hiring, orientations and training, performance evaluations) should support these organizational expectations. An organization’s occupational health and safety culture is a mix of formalized rules, control, autocratic decision making, and enforcement at one end of the continuum and a mix of self-reliance, motivation, participatory decision making, and internalized commitment on the other end of the continuum. Organizations are diverse and are made up of a mixture of enforcement and self-control processes and practices. Legislation and compliance may be needed when organizations and employees have limited understanding of or commitment to occupational health and safety. Legislation outlines what employers and employees are accountable for without moral buy-in. A strong safety program shows the company's serious commitment to safety. Self-monitoring builds employee ownership, initiative, and self-responsibility. The measure of occupational health and safety would be a delicate balance of compliance while embracing shared perceptions of the importance of safety. The performance management system should reward employees who support safety rules and procedures and apply progressive discipline to employees who do not follow their legal and organizational OH&S responsibilities. This case can be approached by initially asking some critical questions to determine the root causes of the unsafe behaviours. Some questions that can be asked are: What can the owner, management supervisors, and employees do to prevent these unsafe acts? Were the owner and management team showing due diligence and a commitment to employee safety? Was there an OH&S program (policies, procedures, inspections, health and safety committees, training, maintenance of records, and investigations are the core elements of an occupational health and safety program)? Was there an OH&S committee established to identify and resolve health and safety problems in the workplace? Did the supervisor ensure that the employee was adequately trained and aware of all the health and safety hazards? Were the employees aware of the risks and hazards involved in working with chemicals and neglecting to wear proper eye protection? Did the employee have a lack of caution, poor judgement, or inappropriate behaviour? Did the employee deviate from standard job procedures or practices that would require disciplinary action from the supervisor (e.g., fail to use personal protective equipment)? While the employer is ultimately responsible for the overall safety of all the employees, the supervisor is responsible for ensuring the OH&S of all workers under his/her supervision, and the employee is responsible for following safe workplace procedures and reporting health and safety problems to the Health and Safety committee responsible for identifying and recommending solutions. Chapter 10 provides more information on motivating safety behaviour, safety climate, and safety leadership. CHAPTER 6 Chemical and Biological Agents Essential Outcome After completing the lesson on this chapter, if nothing else, my students should be able to comprehend the terminology related to the risks and hazards of chemical and biological agents, and describe processes used to manage and control these risks in the workplace. Learning Outcomes After completing this chapter, students should be able to: define the numerous terms related to chemical and biological agents discuss the management of chemical and biological agents outline the actions of chemical and biological agents on human physiology outline control mechanisms Key Concepts Most occupational diseases are related to exposure to chemical and biological agents. Depending on factors such as the type, circumstances, and duration of exposure, the result can be as minor as a skin irritation, or as serious as death. Chemical agents are the creation of one or a combination of a large number of chemicals and their physical reactions. In North America alone, more than 70,000 different chemicals are in use, with hundreds more being added to the list each year. Contaminants can be either chemically produced (such as vapour from paint thinners), or mechanically produced (such as dust from sanding or grinding). The seven types of contaminants are dust, fume, smoke, mist, vapour, gas, and liquid. The hazard that a chemical agent poses is defined by its likelihood of causing injury and by the potential seriousness of its toxicity. Chemicals may enter the body by one of four means: respiration (inhalation), skin absorption, ingestion, or skin penetration. Of these, respiration is the most common means of contamination and may present the greatest risk in many workplaces. Solvents may be organic or inorganic, and present various risks, which depend in part on their characteristics and properties, such as their heat of vaporization, flammability, and volatility. Biological agents are sometimes referred to as biohazards and include things like mould, fungus, bacteria, and viruses. They are natural organisms or products of organisms that present a risk to humans. Biohazards are categorized by Biosafety Level, ranging from Level 1 to Level 4, with Level 4 being the most dangerous and requiring highly specialized containment facilities, equipment, and expertise. All employees must be properly trained in identifying and handling dangerous substances, and policies and procedures for their safe handling and use must be in place along with good housekeeping practices and record keeping. Other administrative controls include the use of appropriate personal protective equipment (PPE), good personal hygiene practices (such as proper washing before entering rest areas or lunchrooms), and diligent record keeping, including medical surveillance. Student Motivation At some level, most people fear the types of hazards described in this chapter. This should arouse interest and curiosity to learn more about chemical and biological agents and their safe handling. Many students will have some prior awareness of the dangers of chemicals in the workplace, even if they have not had direct experience with them. Likewise, most students will be aware of biological hazards such as highly contagious viruses, and will have some appreciation of the serious health threat they represent. Barriers to Learning This chapter deals with some technical and scientific terminology that may be unfamiliar or challenging to some students, especially those without some previous science background (such as biology or chemistry), or those whose first language is not English. So it may be necessary to provide some extra time to review these terms. Engagement Strategies and Lesson Plan 1. Engaging Students at the Outset Learning objective: At the completion of this activity, students will be able to list and identify chemical and biological agents with which they may have come into contact. Working in pairs, have students list various substances they have had contact with, either in their work or in their personal lives. Once they have a list, ask them to mark either a “C” for chemical or “B” for biological beside each substance. Ask for a few examples, and use these as a way of introducing the chapter indicating that everyone has had some exposure to chemical and biological agents, representing various degrees of hazard to our health. 2. Lesson Engagement Strategies a. Learning objective: At the completion of this activity, students will have related the risk of exposure to chemical and biological hazards to the actual workplace, by using the workplace examples described in the text. Working in triads, ask students to read and discuss OH&S Notebook 6.1, “Deadly Fires Burning: Firefighters at High Risk for Occupational Cancer”; OH&S Today 6.3, “Occupational Asthma: The Case of Snow Crab Workers”; and OH&S Today 6.4, “Good Scents?” Each student is to take responsibility for reading a different article and summarizing its contents for the other two members of the triad. Ask them to consider the exposure risks of chemical and biological agents in each situation, and to discuss together whether these risks are reasonable and acceptable. Then invite the students to share the conclusions of their triad discussions with the class. b. Learning objective: At the completion of this activity, students will be able to list and describe basic procedures for infection control of potential biological hazards. Show the class a brief video on infection control, such as the following video on universal precautions from the Shelter Health Hep C organization in Hamilton, Ontario: www.youtube.com/watch?v=Sxbba7ECCXc. Ask them to take notes while watching the video. At the completion of the video, ask them to pair up and compare their notes. Call on students at random to have them identify the seven universal precautions described in the video. c. Learning Objective: At the completion of this activity, students will have considered various perspectives dealing with the issue of environmental illness (EI) caused by exposure to fragrances and scents. Ask students to raise their hand if they are currently wearing any type of fragrance (perfume, cologne, body spray, etc.). While they keep their hands up, ask again for students to also raise their hand if today they used any sort of lotion, antiperspirant, etc., that has some sort of fragrance or scent. Now ask the students to look around the classroom to observe the number of classmates wearing some form of fragrance today. Have them put down their hands. Now, ask students to raise their hand if they experience some sort of allergy or sensitivity to scents and fragrances. Ask any other students to raise their had if they know someone with such a sensitivity or allergy. Compare the size of this group to the size of the first group, and facilitate a discussion about the issue of how to manage this issue in the workplace (using the classroom as a potential representation of a typical workplace). Refer back to OH&S Today 6.4, “Good Scents?” to illuminate the issue, with particular reference to the Canadian Human Rights Act. 3. Lesson Plan Notes and Lecture Outline Many chemical and biological agents are dealt with under WHMIS regulations. You may want to have an OHS specialist from a safety association provide a three-hour WHMIS training session as an introduction to chemical hazards. WorkSafe BC provides a booklet, “WHMIS at Work,” an instructional Video/DVD, and WHMIS information (www.worksafebc.com/publications). Other jurisdictions provide similar useful student and instructor training resources. A. Chemical and Biological Agents (Refer to Lesson Engagement Strategy a, above) B. Chemical Agents and Types of Contaminants * Just for fun, you may want to bring a few examples of classroom chemical hazards to your classroom to share with students (e.g., multipurpose correction fluids, glue, computers, felt markers, toner cartridges) as examples of the various types of chemical hazards professors and students could be exposed to in nonindustrial workplaces. This chapter lists the types of contaminants found in industrial workplaces. You will want to extend the discussion to include contaminants found in nonindustrial workplaces. Use PowerPoint slides to define (and mention their impact on workplace health hazards) several of the terms relating to chemical agents, such as these: synergistic, toxicity, aerosol, flammability, reactivity, concentration, exposure time, liquid/solid/vapour states. Use PowerPoint slides to illustrate OH&S Notebook 6.1–Types of Contaminants. 1. Dust 2. Fumes 3. Smoke 4. Mist 5. Vapour 6. Gas 7. Liquid Ask students to reflect on their earlier discussion (Lesson Plan A: “Chemical Agents: Types, Risks and Management”) and share examples of the chemical contaminants that the workers in those cases were exposed to (OH&S Notebook 6.1, “Deadly Fires Burning: Firefighters at High Risk for Occupational Cancer”; OH&S Today 6.3, “Occupational Asthma: The Case of Snow Crab Workers”; and OH&S Today 6.4, “Good Scents?”). Ask students to consider what types of chemical hazards office workers might be exposed to. Refer to the answer of End-of-Chapter Discussion Question 1 for examples. Office equipment such as photocopiers, computers, fax machines, laser printers, and ink/bubblejet printers may have ozone and hydrocarbon emissions. These must be labelled on MSDSs. Use products with low volatile organic compound emissions and use only as directed. Have students form groups of three or four to discuss one type of contaminant found in a workplace. The students will want to refer to their text, OH&S Notebook 6.1, “Types of Contaminants.” Students should define one contaminant, give an example, and describe related legislation and HRM policies that address the health and safety issues. You may want to share the following example before or after the group’s discussion. Example: Second-hand Smoke Smoke is one of the seven types of chemical contaminants found in workplaces. Smoke is an airborne respirable particulate originating from the products of combustion. Second-hand tobacco smoke should not be present in the workplace. The Workers’ Compensation Board defines second-hand smoke as a workplace hazard that requires employers to control the exposure of workers. Employees may be provided with designated smoking areas outside the building. Second-hand tobacco smoke contains many different toxic chemicals, including some that are cancer-causing, such as benxoapyrene and formaldehyde. Health experts have not established a safe level of exposure to second-hand smoke. Employers may offer worksite health promotion interventions ranging from smoking cessation programs, which typically involve a combination of education, group support, counselling, and behavioural change techniques, to wellness programs and health benefits. For online information on second-hand tobacco smoke, visit one of the following: www2.worksafebc.com/Topics/IndoorAir/SecondhandSmoke.asp www.worksafebc.com/news_room/campaigns/ets/default.asp www.bchealthguide.org/healthfiles www.tobaccofacts.org www.hc-sc.gc.ca www.worksafebc.com www.cctc.ca www.quitnow.ca Ask a few of the student groups to summarize their discussion with the class. Share a few more examples of any of the seven contaminants that were not mentioned by the student groups, to ensure the students know the seven types of contaminants. * An alternative learning activity would be to engage students in a discussion on the growing concern about quality of air in the workplace and environmental illnesses. Students can discuss Case 1, “Mass Hysteria?” Refer to End-of-Chapter Case 1. * An additional learning activity would be to use current news articles for examples of changing laws and workplace policies related to indoor air quality and second-hand smoke. This will create a dynamic student discussion (www.cctc.ca). Most human exposure to chemicals comes from breathing contaminated (polluted) air. C. Toxicology and Routes of Entry Use PowerPoint slides to define toxicology and the four routes of entry in order of risk and normal contact: respiration, skin absorption, ingestion, and penetration. Engage students in a discussion of recent events concerning occupations with high-risk exposure to chemicals (refer to Using the Internet, Question 2). Bring several current online newspaper articles to class (e.g., Teck Cominco smelter workers exposed to thallium, Canadian fire fighters exposed to carcinogenic chemical fumes, agriculture workers exposed to pesticides). Ask students to form small groups to discuss the following: an example of an environment and/or occupation that is at a high risk of chemical exposure; how chemicals enter employees’ bodies; the actions these chemical agents have on the human body; and what employee behaviours can reduce the chemical exposure. Ask a few student groups to summarize their discussion with the class. You will want to clarify that certain chemicals can be high-risk or low-risk depending on their route of entry. For example, research supports that thallium is a dust that can affect the human nervous system, lungs, heart, and kidneys if it enters the body through respiration, ingestion, or penetration but not absorption; therefore, it requires personal hygiene, the wearing of respiratory personal protective equipment, and safe work practices. Ask students if they know of anyone who ingests iron pill supplements. Iron is not harmful if it is ingested, penetrated, or absorbed into the human body, but it can cause short-term (not long-term) respiratory problems if it enters the body through respiration. Summarize the discussion by suggesting that chemical exposures can be prevented, first, through elimination, and second, through substitution, and that if these methods are not possible, then chemical hazards need to be controlled by ensuring that employees wear PPE and that they develop good personal hygiene and safe work practices. D. Classification of Toxic Substances Divide students into small groups. Assign each group one or two of the 12 classifications of toxic substances. Have the groups define and discuss examples of the actions these biological and chemical agents have on the human body. Have the small groups present their definitions and examples to the class. Refer to OH&S Notebook 6.4, “Classification of Toxic Substances.” The twelve classifications of toxic substances are: 1. Irritants 2. Asphyxiates 3. Anesthetics and Narcotics 4. Systemic Poisons 5. Liver Toxicants 6. Kidney Toxicants 7. Neurotoxins 8. Sensitizers 9. Lung Toxicants 10. Mutagens 11. Teratogens 12. Carcinogens E. Characteristics and Properties of Solvents Solvents are the most prevalent of products that we use both at work and at home. Use PowerPoint slides to define organic and inorganic solvents, and then engage students in a discussion on the eight characteristics and properties that make solvents effective, but also hazardous and toxic. The eight general characteristics or properties that make solvents effective, but hazardous and toxic, are: 1. Low surface tension 2. High vapour pressure 3. Low boiling point 4. Low heat of vaporization 5. High volatility 6. Ability to dissolve fats 7. Flammability 8. Vaporization F. Biological Agents Use PowerPoint slides to illustrate the four biohazard classification levels outlined in the OH&S Notebook 6.5, “Classification of Biological Agents.” Give an overview of the increasing degree of risk at each level, providing workplace examples of biohazards. Engage students in a discussion of some of the biohazards they have encountered in their workplaces. Refer to Table 6.2, “Biological Agents.” G: Control of Biological Agents (Infection Control) Refer to Lesson Engagement Strategy b, above. * An additional or alternative activity would be to have students form small groups to discuss Using the Internet Question 1. You can have students access websites, or you can bring in newspaper articles, hospital guidelines/policies, and/or other publications on workplace procedures that have been implemented to minimize exposure and reaction to SARS. Ask the student groups to summarize their discussion with the class. Refer to End-of-Chapter Using the Internet Question 1. H. Control of Exposures Have students form seven small groups to discuss one of the seven ways of controlling the potential adverse effects of exposure to chemical and biological agents. Ask the seven student groups to summarize their discussion with the class. Refer to the answer for End-of-Chapter Discussion Question 3. Use PowerPoint slides to illustrate Figure 6.2. Give an overview of engineering, work practices, PPE, personal hygiene practices, good housekeeping, medical surveillance, and record-keeping controls. Assessment Tools To quickly assess student learning against the chapter learning outcomes, at the end of the class: Ask students to compare and contrast chemical and biological agents, giving examples of each. Use OH&S Notebook 6.1, “Types of Contaminants”; and Table 6.2, “Biological Agents” as references. Ask students to write a “minute paper” identifying (1) one key learning point they are taking away from the class, and (2) one aspect they find confusing or requiring more study. Collect and use the information to help assess material; this may require revisiting either at the beginning of the next class, or during study review for a mid-term test. Reflections on Teaching Good teaching requires ongoing self-assessment and reflection. At the completion of this lesson, you may find it helpful to reflect on the following, and consider whether you want or need to make any adjustments for subsequent lessons. What worked in this lesson? What didn’t? Were students engaged? Were they focused or did they go off on tangents? Did I take steps to adequately assess student learning? Did my assessments suggest that they understood the key concepts? What (if anything) should I do differently next time? How can I gather student feedback? How can I use this feedback for continuous improvement of my teaching? Additional Resources Weblinks Shelter Health Network website:, www.shelterhealthnetwork.ca. Videos Shelter Health Hep C organization in Hamilton, Ontario: www.youtube.com/watch?v=Sxbba7ECCXc. Suggested answers to cases and exercises Discussion Questions This chapter lists the types of contaminants found in industrial workplaces. Consider the typical office setting. What types of chemical hazards might office workers be exposed to? (You can expand this question to include the types of chemical hazards that classroom professors and students may be exposed to.) Answer: Refer to the OH&S Notebook 6.1, “Types of Contaminants,” for a list of the seven types of chemical contaminants. Some examples of chemical hazards (listed according to the seven types of contaminants) that office workers (or classroom professors and students) may be exposed to include the following: • Dust is an airborne respirable particulate—that is, solid particles generated by mechanical means. It may occur during office renovations involving sanding, or from laser printer toner. Office equipment such as photocopiers, computers, fax machines, laser printers, and ink/bubblejet printers may have ozone and hydrocarbon emissions. These must be labeled on MSDSs. • Fumes are airborne respirable particulate formed by the evaporation of solid materials, such as automobile exhaust. They may enter through the intake of air from indoor garages. • Smoke is an airborne respirable particulate originating in the products of combustion, such as second-hand tobacco smoke. • Mist is an airborne respirable particulate in the form of liquid droplets generated by condensation from the gas state, such as hair spray, spray perfume, or other personal care products. • Vapour is the airborne respirable particulate in a gaseous form of any substances that are normally in the solid or liquid state at room temperature and pressure, such as multipurpose correction fluids, glue, felt markers paints, lacquers, varnishes, drapes, and carpets. • Gas is an airborne respirable particulate that is one of the three states of matter where temperature is above the boiling point, such as elevated levels of carbon dioxide in small workspaces. • Liquid can come in contact with the skin and/or eyes through chemical splashes or spills. Examples include office, lunchroom, and bathroom cleaning solvents. www2.worksafebc.com/Topics/IndoorAir/Home.asp. “Tools for Schools Action Kit for Canadian Schools 2003”: www.osha.gov/dts/osta/otm/otm_iii/otm_iii_2.html#2. “Investigation”: www.hc-sc.gc.ca/ewh-semt/pubs/air/tools_school-outils_ecoles/index_e.html. “A Guide for Building Owners, Managers, and Occupants”: www.worksafebc.com/publications/health_and_safety/by_topic/assets/pdf/indoor_air_bk89.pdf. “BC Health Files Indoor Air Quality”: www.bchealthguide.org/healthfiles/hfile65a.stm#E7E1. Canada Mortgage and Housing Corporation: www.cmhc-schl.gc.ca/en/co. British Columbia Lung Association: www.bc.lung.ca. Health Canada: www.hc-sc.gc.ca/english/iyh/index.html. Explain the concept of a “synergistic effect” as used in this chapter. Answer: Synergistic effects occur when the outcome of two factors taken together is greater than the sum of the two. Hazards can act synergistically with other lifestyle or environmental factors, leading to a much more serious hazard. A good and familiar example is ammonia and bleach. What are the major ways of controlling the potential adverse effects of exposure to chemical and biological agents? Answer: Figure 6.2 gives an overview of engineering, work practices, PPE, personal hygiene practices, good housekeeping, medical surveillance, and record-keeping controls. Major Ways to Control Exposure to Chemical and Biological Agents: 1. Engineering Controls: Improve ventilation, use fume hoods, and implement enclosed systems to reduce airborne exposure. 2. Administrative Controls: Set safety protocols, limit exposure time, and provide proper training for handling hazardous materials. 3. Personal Protective Equipment (PPE): Use gloves, masks, respirators, and protective clothing to minimize direct contact. 4. Substitution: Replace hazardous substances with less harmful alternatives when possible. These controls help minimize risks associated with exposure to chemical and biological agents. Using the Internet 1. Using a search agent, such as Google, find reports of the SARS outbreak in Canadian cities (especially Toronto) during 2003. What procedures did workplaces (i.e., hospitals) implement to minimize exposure or reaction to this biological hazard? Answer: The WCB Prevention Magazine on Occupational Health and Safety Issues, WorkSafe (www.WorkSafebc.com) published an article, “SARS in the Workplace—Meeting the Challenge” (February 2004) that describes the challenges of protecting BC health care workers from the emerging respiratory infection called SARS (severe acute respiratory syndrome). Health care professionals or individuals living with someone with SARS had the greatest risk of contracting the disease. The hospital authorities had questions about how to protect their staff and prevent the further spread of this deadly, unknown infection. However, they had few answers. The challenge was to manage information, which required them to stay current on the constantly changing science, besides updating protocols, facilitating centralized and rapid decision making, communicating information, and addressing the concerns and fears of everyone involved, quickly, effectively, and efficiently. The WCB responded by developing an initial set of guidelines to protect workers, which it posted online at www.healthandsafetycentre.org/pdfs/safetyupdates/wcb_sars_1.pdf. A SARS Scientific Committee was formed to develop evidence-based safe work procedures for health care workers. Containing the spread of SARs involved many people, organizations, laws, guidelines, and standards. Some of these organizations and laws are listed below: Public Health Act (communicable diseases are covered by public health legislation, which protects the public from reportable diseases). BC Workers’ Compensation Act / BC OH&S Regulations (provides the following rights to employees: job-protected leave, no penalties for emergency leave, payment for those not working because of quarantines, and work refusal processes. BC Centre for Disease Control. Occupational Health and Safety Agency for Health Care. BC Nurses’ Union (and other unions). Health Employers Association of BC. BC Health Authorities. Occupational Health Specialists. Office of the Provincial Health Officer, Ministry of Health. Health Canada Laboratory Centre for Disease Control (agency that prepares MSDSs). Emergency Operation Centres. Infection control protocols and respiratory protection programs are legislated and in place in BC health care facilities. The challenge was to provide a higher level of protection and to maintain rigorous infection control practices because of the limited information about the disease. Employers with workers who can reasonably expect to be exposed to blood and certain body fluids must comply with the OH&S regulation sections on biohazardous materials in Part 6 of the Occupational Health and Safety Regulation (Substance Specific Requirements—Biohazardous Materials). Visit www2.worksafebc.com/publications/OHSRegulation/Part6.asp#SectionNumber:6.33. These sections typically require employers to develop and implement an exposure control plan to address the specific risks and hazards faced by workers in these settings. The HRM may be involved in keeping records of all job classifications and identifying (risk identification) all tasks and procedures in which there is the potential for occupational exposure to a biohazardous material. The HRM will also be involved in initiating action plans to deal with sick employees, quarantined employees, and frightened employees, communicating with unions, health and safety committees, and health care professionals, implementing immediate training and hiring processes, establishing immediate communication channels (e.g., families and staff forums where employees can talk about these concerns), clarifying compensation policies (e.g., commitment to maintain the wages of workers in quarantine), clarifying limited rights to refuse work for nursing staff www2.worksafebc.com/publications/OHSRegulation/Part3.asp#SectionNumber:3.12, providing PPE training, educating and training employees on how communicable diseases are and are not spread, the health effects of the diseases caused by these viruses, and examples of safe work practices, implementing an exposure control plan, ensuring that universal precautions are taken, and following relevant legislation from employment contracts to privacy and human rights. Where exposure incidents involving blood and certain body fluids have or may occur in the workplace, employers must implement exposure control plans and procedures, which must include the following: a statement of purpose and responsibilities, identification of workers at risk, assessment of the degree of risk, and identification of how the risk will be controlled. Controls may include these: engineering and work practice controls, housekeeping practices to keep the workplace clean and free from spills, work procedures that ensure contaminated laundry is isolated, the use of WHMIS Labels and MSDS, education and training to inform and instruct workers on how to eliminate or reduce the risk of contact with blood and certain body fluids, conducting of immediate medical evaluations if an incident occurs, ensuring that work practices eliminate or minimize the risk of unforeseen contact, development of ways to address chance encounters with blood and certain body fluids, providing workers with the equipment, tools, and PPE they need to deal with unforeseen contact, monitoring of the workplace to ensure that safeguards are used and that safe work practices are followed, ensuring prompt, easy access to first aid and that medical attention is available, investigating and developing ways to prevent future incidents from occurring. Online Information on SARS: World Health Organization, www.who.int/csr/sars/en. 2. Cases of environmental illness or environmental sensitivity seem to be becoming more common. Search out contemporary cases in which employees have been exposed to chemical or biological agents with long-term consequences. Could these exposures have been prevented? Could the workers have been protected? Answer: One case example occurred in Trail, BC, on August 30, 2001. Dozens of workers were exposed to thallium while working at the Teck Cominco smelter. There was uncertainty regarding how much information the workers, contractors, or public had concerning the presence of thallium at the worksite. Pure thallium is a bluish-white metal found in trace amounts in the earth's crust. Thallium is used mainly to manufacture electronic devices, switches, and closures, primarily in the semiconductor industry. It also has limited use in the manufacture of special glass and for certain medical procedures. Exposure to high levels of thallium can result in numbness of fingers and toes, vomiting, durries, and temporary hair loss, and can have harmful health effects on the human nervous system, lungs, heart, liver, and kidneys. It has caused death. It is not known what the effects of exposure to low levels of thallium are over a long period of time. Research supports that thallium dust can enter the body through respiration, ingestion, or penetration; thus, it requires good personal hygiene, safe work practices, and the wearing of respiratory PPE. Chemical exposures can be prevented first through elimination, and second through substitution. If these methods are not possible, then chemical hazards need to be controlled by ensuring that employees wear PPE and develop good personal hygiene and safe work practices. Online Information on Teck Cominco Smelter and Thallium: www.cbc.ca/news/background/environment/thallium.html www.cbc.ca/canada/story/2001/09/06/cominco_010906.html www.atsdr.cdc.gov/tfacts54.html www.atsdr.cdc.gov/toxprofiles/tp.asp?id=309&tid=49 Exercises Although exposure to various workplace hazards is never a good thing, some individuals may be more sensitive to some exposures than others. For example, pregnant women may be more at risk when exposed to certain chemicals than are other employees. To what extent can we use HR tools such as selection and placement to offset this problem? Is it appropriate to refuse to hire women of childbearing age to work in environments where exposures are possible? Sex is one of the 13 prohibited grounds of discrimination defined in the BC Human Rights Code (www.bchrt.bc.ca), which is enforced by the BC Human Rights Tribunal. The BC Human Rights Code defines discrimination as the denial of opportunity to a person or class of person based on the following list of 13 group characteristics. Discrimination occurs if a distinction is made that imposes disadvantages not imposed on others. Employers must not discriminate on the basis of gender, either male or female, or on the basis of pregnancy or sexual harassment. 1. Age 2. Ancestry 3. Colour 4. Unrelated criminal conviction 5. Family status 6. Marital status 7. Physical or mental disability 8. Place of origin 9. Race 10. Religion 11. Political belief 12. Sex 13. Sexual orientation Employers have to be careful not to have human resource practices that globally discriminate against women of childbearing years (BC Human Rights Code). Employers must also ensure that all employees and their unborn children work in a safe and healthy environment (BC Workers’ Compensation Act). Employers must show due diligence by having an OH&S program that incorporates WHMIS. Hazardous information must be listed on MSDSs (including information about the hazards to pregnant women and their unborn baby, although not all the effects are known about certain chemical exposures to a developing fetus), and controls must be in place. When an employer does not know beyond a reasonable doubt about the risks and protective practices about chemical exposure to pregnant women, they should ensure rigorous, aggressive, high level protection. Cases Case 1: Mass Hysteria? New building construction has become more energy efficient, which in turn has reduced the amount of outside air intake. This can lead to sick building syndrome or building-related illnesses, which can range from headaches and vomiting to eye and skin irritations. This case is an example of the very real increase in public concerns about indoor air quality, concerns that have increased with energy conservation measures that limit the influx of outside air, and with the increased use of synthetic building materials and office equipment and supplies that give off fumes. Indoor air quality problems can cause symptoms such as headaches, nausea, fatigue, itching or burning eyes, and skin or throat irritation, as described in the case. The factors that could be affecting indoor air quality can include these: poorly designed or maintained ventilation and temperature control systems, microbial and fungal matter (e.g., bacteria and moulds), carbon monoxide (e.g., from second-hand tobacco smoke, incomplete burning of fuels, and vehicle exhaust near air intakes), formaldehyde (e.g., building materials, insulation, carpets), and volatile organic compounds (e.g., office printer/photocopiers and paint/glue/cleaning materials). Indoor air quality can be controlled in several ways: workplace design; proper use and maintenance of heating, ventilation, and air conditioning (HVAC) systems to control temperature, humidity, and odours and to remove air pollutants; controlling pressure differences between rooms to isolate pollutants; and establishing policies to restrict or prevent the introduction of pollutants into office environments. HRMs can ensure healthy indoor air quality by making sure these control measures are in place, which can range from adequate ventilation systems to implementing policies and procedures restricting or preventing air pollutants. There are three basic ways to improve indoor air quality: Remove the source of pollution or reduce the level of the emissions. Improve ventilation by increasing the amount of outdoor air coming indoors. Use air cleaners to control the source and improve ventilation. Refer to Occupational Health and Safety Today 6.3, “Good Scents,” and to your local legislation. Online Information on Indoor Air Quality www2.worksafebc.com/Topics/IndoorAir/Home.asp “Tools for Schools Action Kit for Canadian Schools 2003”: www.osha.gov/dts/osta/otm/otm_iii/otm_iii_2.html#2. “Investigation”: www.hc-sc.gc.ca/ewh-semt/pubs/air/tools_school-outils_ecoles/index_e.html. “A Guide for Building Owners, Managers, and Occupants”: www.worksafebc.com/publications/health_and_safety/by_topic/assets/pdf/indoor_air_bk89.pdf. “BC Health Files Indoor Air Quality”: www.bchealthguide.org/healthfiles/hfile65a.stm#E7E1. Canada Mortgage and Housing Corporation: www.cmhc-schl.gc.ca/en/co. British Columbia Lung Association: www.bc.lung.ca. Health Canada: www.hc-sc.gc.ca/english/iyh/index.html. Case 2: Unexpected Gas? Students can approach this case from an investigation point of view and develop a list of critical questions (5 W’s and How) to determine the root cause of the accident and what can be done to ensure that similar accidents do not occur in the future. Ask students to identify what questions will help recognize the root causes of the accident. Was there an effective inventory management program? Were the employees trained in WHMIS (i.e., did they know the hazards, how to protect themselves, how to handle the emergency, and where to get product information)? Important points for discussion include ensuring that the organization has good management of its products from an effective inventory control program to an occupational health and safety program that incorporates WHMIS and the labelling and identification of all materials. Waste products should be appropriately disposed of and not be left onsite. Unused waste products should not be left sealed, but rather rinsed and stored open to let oxygen cycle through. WHMIS labels, Material Safety Data Sheets (MSDS), and worker education and training must all be provided. There need to be labels on controlled products to alert workers to potentially hazardous products. MSDSs need to be provided to workers; these provide detailed hazardous ingredient and safe handling of the product information. Education is needed to provide employees with the information and practices that they need to know to work safety with controlled products. All other products should also have been labelled. Solution Manual for Management of Occupational Health and Safety Kevin E. Kelloway, Lori Francis, Bernadette Gatien 9780176532161, 9780176657178
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