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\title{Lecture Notes in Occupational Health and Safety}



\author[1]{Arindam Basu}%
\affil[1]{University of Canterbury}%


\vspace{-1em}



  
  \date{May 08, 2024}


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\subsection*{What is meant by occupational
health}

{\label{465648}}

\subsection*{}

{\label{465648}}

Occupational health refers to the study of health issues that affect
people who are engaged in work or health effects and illnesses that
occur in workplaces among workers or professionals who are engaged in
work and therefore are exposed to specific hazards and exposure
variables that are characteristic of their workplaces.~In Env/Occ
health, the term hazard denotes a situation or health condition that
occurs at a certain point in time with the likelihood or chance that it
has not occurred up until that time. For example, falling debris from a
building under construction is a hazard (which is why you see so much
restrictions being placed on people's movement in construction sites
with hard hats to be worn). Falling debris can injure a person, and this
is a hazard that a healthy person who has not suffered can become
injured in an instant.

\href{http://www.aware365.com.au/news-and-information/the-invisible-risks-spotting-the-hazards-in-your-workplace}{Hazardous
exposures are everywhere} and works in every profession or every
occupation. For example, a gardener who uses a hedge trimmer is exposed
to noise, vibration, and slippage of the cutting edge and cut himself.
An electrician is exposed to electric shock as a hazard. A plumber for
example is exposed to hot water splash or toxic fumes and other
chemicals in the workplace; a doctor is exposed to biological agents and
infectious agents that get transmitted from the patients; a surgeon is
exposed to hot water in the operation room theatre and sharp objects. A
teacher in a school is exposed to psychosocial stress; a senior
management official in a high profile company is exposed to
psychological stresses of his daily work. The purpose of this lecture is
to introduce the concepts of occupational health and safety.

\href{https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446786/}{Bernardino
Ramazzini} is reputed to introduce the question ``what do you do for a
living'' in medical practice. ~the evaluation of patients and in medical
practice.
\href{https://eic.rsc.org/feature/percival-pott-chimney-sweeps-and-cancer/2020205.article}{The
first definitive link between occupation and cancer was by Sir Percival
Pott} when he discovered that those who worked as chimney sweeps had a
high risk of scrotal cancer.

Occupational epidemiology is used to study the health effects of workers
in occupational settings. The main methods used in occupational
epidemiology are surveillance, cross-sectional studies, prospective and
retrospective cohort studies, and case control studies. Besides, many
organisations also use intervention research to identify what works best
in occupational settings to prevent illnesses and promote health of
workers.

\par\null

\subsection*{Call to Action}

{\label{577209}}

Walk in the corridor of the ground floor of the Wheki building. You need
to identify five hazards that can impact students or staff in the
university. Can you identify four workplace hazard in this floor where
we have our class? Start with this classroom and identify major sources
of potential hazards. Also try to identify a ~material safety data sheet
anywhere in this building or other safety related advertisement or
announcement posted anywhere in this building. Take about five minutes
to go about this floor of the buildng and either take a hoto photo or
sketch such a notice or hazard that you note. We will copare th compare
the photos when you return.~

\subsection*{Principles of Occupational Safety and
Health}

{\label{532029}}

Alli et.al. (2001) writes that more than 250 million work-related
accidents every year \cite{alli2001fundamental}. Workplace hazards and exposures
cause over 160 million workers to fall ill annually, while it has been
estimated that more than 1.2 million workers die as a result of
occupational accidents and diseases. The annual losses resulting from
work-related diseases and injuries, in terms of compensation, lost
work-days, interruptions of production, training and retraining, medical
expenses, and so on, routinely amount to over 4 per cent of the total
gross national product (GNP) of all the countries in the world. There is
considerable variation in the occupational losses to life and injuries
and illnesses across the world, in general workers in developing
countries are more likely to suffer from significant losses compard with
those in the more developed countries.

Agriculture, forestry, mining, and construction work are responsible for
majority of occupational injuries and diseases. Tropical logging
accidents cause 300 deaths per 100,000 workers. Small workplaces,
defined as workplaces with less than 50 employees fare worse than larger
workplaces. In general, women, those who work from home, those who work
part-time jobs, and drivers of vehicles are at higher risk of
occupational injuries and diseases.

The International Labour Organisation (ILO) is an international agency
and this agency is ratified for its functions by different countries in
the world. ILO has set up documents and have advised on international
and national policies to the governments. These policies are of two
types: conventions and recommendations. Conventions are based on
international conference of governments and the decisions and rules
adopted in conventions are binding to the member states.
Recommmendations, on the other hand, are guidelines issued to the
governments and agencies. While the governments and non-governmental
agencies implement and review these guidelines, there is no expectations
that such recommendations have to be enforced. The conventions and
guidelines include the following five types of information: - Principles
of Occupational Health - Protection measures applicable to general cases
- Protection measures applied to industries or workplaces - Protection
measures applied to guard against specific risks - Protection measures
applied for specific workers and occupations - Measures applied for
organisations as such

The core principle of occupational safety is that, every human being and
every worker deserves a safe workplace where he or she should be
protected against harm, and his work must ensure that he should enjoy
physical, mental, and social well-being beyond freedom from disability
or illnesses. The government of a country has responsibility to ensure
that occupational health and safety practices are followed. In New
Zealand such an agency is the Accidents Compensation commission (ACC).
In general, the occupational safety and health approaches include the
following:

\begin{itemize}
\tightlist
\item
  The government must formulate laws, codes, and regulations
\item
  They must set up agencies or authorities who would enforce or
  implement these principles and laws
\item
  These activities must be coordinated so that management of the
  workplace, the owners and the workers or their representatives must
  coordinate to develop a safe workplace for all
\item
  There should be education and training for the workers and people at
  all stages of education so that workplace safety is ensured
\end{itemize}

A range of policies and practices are framed. However, it is best to
formulate general terms and rest the responsibiity with a representative
group to monitor and see that such policies are put into practice and
the practices are followed by the workers. In order to do this, a
competent authority is set up (such as ACC and Worksafe in New Zealand).
Such a competent authority should:

\begin{itemize}
\tightlist
\item
  Review policies
\item
  Issue or approve regulations
\item
  Study latest evidence and commission studies were needed
\item
  Provide specific preventive measures
\item
  Disseminate information
\item
  See that the regulations are followed
\item
  Follow or see that best practices and latest international standards
  are followed
\end{itemize}

Education and training are important components of occupational safety
and health. In particular, trainings on safe work practices and safety
practices should be incorporated at all stages of training. As Alli
et.al. state,

\begin{quote}
If people are to be taught how to earn their living, they should also be
taught how to protect their lives.
\end{quote}

The responsibility of proper training of the employees about not just
productivity or how to use machinery or tools or processes like with the
owners of the enterprise or the management. This should be instituted on
an ongoing basis and the education and training should be repeated and
made contextual, that is, just in time.

Organisational principles of maintaing occupational safety and health
depends on the coordination between the worker, the mangement and the
owner of the enterprise /  \selectlanguage{english}The OSH policy must be written and displayed in
a prominent place and must be conveyed to ALL wokers and every
stakeholder. The language of that policy must be clear and easy to
understand. People must be delegated responsibility to see that the
policy is followed. The policy must be enforced and followed by actions
such as regular cleaning and maintanance of the tools and equipments.
There should be a regular review process so that new knowledge or new
regulations are captured and actions taken.

An effective way to develop a culture of occupational safety in the
workplaces is to establish joint committees. These committees are
jointly set up between management and the workers/representatives, and
they help to disseminate knowledge about risks and benefits of taking
action to the workers and also help to negotiate establishment of safety
protocols and commitment from the management. Empirical evidence suggest
that such joint committees help to prevent injuries and workplace
related harm; such joint committees will have the right and
responsibility to inspect all areas within the workplace and the must be
able to take remedial measures, monitor, and discuss with the management
about dismissal on grounds of OSH.

In summary, the roles of the management and workers are as follows:

\begin{itemize}
\tightlist
\item
  Establish principles and practices so that the workers' health are
  protected
\item
  Management has the primary responsibility to ensure that the safety
  procedures are made available, and safety protocols are placed
  prominently, and the workers get trained
\item
  The practices must be embedded or incorporated within the business
  practices as usual, and not as something separate or isolated in some
  ways
\item
  Workers must follow the processes as well to protect themselves
\end{itemize}

It is helpful to implement the guidelines for safe workplace practices
using a stepwise approach where the best or the easiest or the most
effective approaches are first introduced and then, over time, more
complex or demanding processes are introduced. Those procedures that
produce rapid results in reducing injuries or illnesses must be placed
first. There should be continuous monitoring and record keeping as to
where accidents have happened and acordingly actions must be taken

Once the occupational safety rules, and procedures are drafted, the
question would still be how to enforce or make sure that the management
and the workers follow the principles and the practices. There are two
ways according to Alli et.al.: usin legislation and a body who will
monitor (such as labour inspectors), and using collective agreements.
Governmental legislation can create bodies or agencies or professionals
such as labour inspectors whose job would be to visit the respective
industries and factories and test that the safety and health procedures
are used. The inspectors would not only conduct field visits and
interviews and debriefings, they would also be needed to suggest
procedures that would enhance the safety and precautions. However, in
many countries, there are inadequate number of such inspectors, and
these officers also have to work under difficult circumstances. In many
situations, the officers or the inspectors do not wield enough power.
Hence collective agreements between workers or their lobbyists or their
bodies and the management provide another mechanism that can ensure that
all safety procedures and health activities are followed.

Collective agreements or collective bargaining is useful as these help
to localise the problems (that is, they help to understand the
particular factory or the particular shop floor or the professional or
occupational demands and solutions where needed). These are also useful
because these can identify the local solutions and best optimised for
the factory or the shop floor and better representative of the
interestes of both the owner or management and the workers. Works best
for small enterprises where 50 of fewer people are employed.

Workplace surveillance and walk through surveys are used to monitor
health status and exposure status of the workers. Workplace surveillance
practices are based on precautionary principle. Precautionary principle
is defined as ``the need to foresee and forestall damaging human
activities before science delivers irrefutable proof'' that a certain
exposure is associated with a specific disease. For example, even if
there is no ``proof'' that environmental tobacco smoke is associated
with lung cancer, it is still useful to conduct a survey and take stock
of ETS in workplaces and run campaigns to reduce second hand smoking.
This is an application of the precautionary principle.

Occupational health surveys are defined as investigations of
environmental conditions in the workplace, conducted primarily to
determine the nature and extent of any condition that may adversely
affect the well-being of persons engaged there. These surveys and
surveillance are conducted at various stages: before employment or
deployment of a worker to an assigned task, during the time period when
he or she is working, and after the assignment. Pre-employment
examinations are health examinations where the fitness of a worker to
the job so that the person will not be put at risk, nor he or she will
present a risk to the others are conducted. While much of the
pre-employment checks are based on biological facts around effects of
chemicals, physical agents, ergonomic factors, or psycho-social
variables on the particular job type, there is no hard evidence that
pre-employment screening works to prevent industrial accidents and
injuries to the workers themselves. On the other hand, it is possible
that use of preemployment checks can be used to discriminate workers on
medical grounds and lead to expensive procedures and loss of efficiency.

Hazard surveillance involves identification of possible health hazards
to the workers. Hazard is defined as a substance that can pose risk or
it has the potential to pose risk to the workers. A hazard becomes a
risk when it ishown that it IS a risk. Hazard surveillance is through
using walk-through to the various units to identify whether a particular
process is hazardous.

\subsection*{Ocupational safety and health
services}\label{ocupational-safety-and-health-services}

\begin{itemize}
\tightlist
\item
  Services that ensures that workers are able to work in a safe working
  environment, and a service that ensures that work is matched to the
  workers.
\item
  It ensures that a programme of monitoring for hazards and risks,
  watching for new and possible hazards are put in place. Also
  preventive activities and education are disseminated; workplace
  surveillance wherever needed are established;
\item
  OSH covers between 5 - 90 \% workplaces depending on the country
  covered.
\item
  They should not only be based on primary prevention of services such
  as first aid, and preventive services, but also should provide
  seocndary cover where needed
\item
  They should provide services for special needs people such as
  pregnants and those with disability
\item
  OSH for its success needs cooperation from all sectors and
  particularly from the employers and the workers themselves.
\end{itemize}

Once a hazard has been identified, the authorities must take action
about it. In general, there are three classes of actions: - engineering
controls (this is the first step and should always be done whenever
possible), - substitution of a harmful substance with a relatively
harmless substance. A classic example of subsitution is substitution of
lead with anti-knocking agents such as benzene in petrol. Lead was
harmful and would result in neurological diseases. While benzene was
relatively harmless compared with lead, it is also associated with
health hazards such as aplastic anaemia. - Personal Protective
Equipment. -- The third recourse, when neither engineering control nor
substitution is effective or feasible, is to use personal protective
equipments to contain hazards. Personal protective equipments as
preventive steps for hazard control is least preferred as this involves
individual action and sometimes behavioural intervention. Not everyone
can be trusted to wear hard hats or gloves as these are open to human
follies and forgetfulness. Sometimes, specialised equipments such as
jumpsuits and other wearable devices can be uncomfortable and does not
allow flexible work practices (such as thick gloves are difficult to use
while operating machines such as chain saws, but they must be worn).

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