Bringing Health To Work

Bringing health to work a workshop by Canadian Centre for Occupational Health and Safety In association with www.ThailandHotelier.com

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Healthy Employees + Healthy Organizations = Healthy Workplaces There is a strong connection between the health and well being of people and their work environments. When people feel valued, respected and satisfied in their jobs and work in safe, healthy environments, they are more likely to be more productive and committed to their work. When the workplace is unsafe, stressful or unhealthy, ultimately both the organization and the employees are hurt. Everyone can benefit from a healthy workplace. The goal of this workshop is to make information, tools and resources easily available that will help employees, employers and practitioners participate in making their workplaces healthy and safe. Bringing Health to Work...helping all to thrive and benefit - employees, employers, families, communities and governments.

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Cook What does a cook do? The main duties of cooks in restaurants, hotels, healthcare facilities and schools include the following: • • • • •

Plan and prepare menus, and determine food portions and quantities needed. Pay attention to special dietary needs, if applicable. Monitor and order supplies. Clean up kitchen or work area. Supervise kitchen staff.

What are some health and safety issues for cooks? Working with food presents its own unique set of potential hazards. Some of the main ones are: • • • • • • • • • • •

Handling raw meat and poultry. Exposure to cleaning products, pest control products, or other chemicals. Working in awkward positions or performing repetitive manual tasks. (Appendix 1) Lifting or carrying heavy trays. (Appendix 2) Risk of accidental radiation leaks from microwave ovens. (Appendix 3) Working in extreme temperatures. (Appendix 4) Working with knives, mincers, and other dangerous tools or equipment. Risk of burns or fire from ovens, deep-fat fryers, and steam from pots. Slips, trips and falls. Appendix 5) Stress. (Appendix 6) Working alone. (Appendix 7)

What are some preventive measures for cooks? • • • • •

Wash hands frequently. (Appendix 8) Learn safe lifting techniques. Know how to work with all equipment and tools required for the job. Wear appropriate personal protective equipment, including safety shoes with non-skid soles, and eye protection. Know how to report hazards. (Appendix 9)

What are some good general safe work practices? • • • • • •

Practice safe lifting techniques. (Appendix 2) Exercise caution when working with knives and other sharp equipment. Use, maintain and store personal protective equipment according to manufacturers' recommendations. Follow company safety rules. Follow good housekeeping procedures. (Appendix 10) Read the material safety data sheet (MSDS) for any hazardous product that you use and follow recommended safety precautions.

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Food and Beverage servers What does a server do? The duties of servers, table wait staff, hostesses, "bus-boys," and other food and hospitality personnel vary according to the workplace. The following is a general summary of duties these people have in common: • • • • • •

Greet customers. Take orders and relay them to kitchen and bar staff. Pay attention to customers' special menu and dietary needs or restrictions, when applicable. Serve food or drinks to customers. Clean up tables or kitchen. What are some health and safety issues of servers? Work environments such as restaurants, hotels and bars, where food and beverages are served, present a unique set of hazards. The main health and safety issues for servers include:

• • • • • • • • • •

Contact with raw meat or poultry. Exposure to cleaning products and other chemicals. Musculoskeletal injuries from working in from awkward positions, or performing repetitive manual tasks. (Appendix 1) Lifting or carrying heavy trays or other objects. (Appendix 2) Noise exposure. (Appendix 11) Slips, trips and falls. (Appendix 5) Stress. (Appendix 6) Dealing with difficult or potentially violent customers. Long hours of work or extended work days. Working alone. (Appendix 7) What are some preventive measures for a server?

• • • •

Learn safe lifting techniques. (Appendix 2) Wash your hands before eating, drinking or smoking, or after going to the toilet, and at the beginning and end of the day. If you come in contact with raw food such as meat or poultry, wash your hands before touching anything else. (Appendix 8) Wear appropriate personal protective equipment and apparel for the task. Wear shoes with non-skid soles. What are some good general safe work practices?

• • • • • •

Practice safe lifting techniques. Follow company safety rules. Know how to report a hazard. (Appendix 9) Follow good housekeeping procedures. (Appendix 10) Work safely with chemicals according to recommended practices. Select the personal protective equipment. Use, maintain and store it according to manufacturer's recommendations.

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Housekeeping What kind of work do people do in housekeeping in a hotel? Housekeeping in a hotel is a very physically demanding job that includes many, varied tasks. Typically, in this case study, housekeepers were responsible for cleaning 16 rooms per shift. The actual amount of work depends on the size of the room and the number of beds. A housekeeper needs between fifteen and thirty minutes to do one room. A housekeeper carries out the following tasks: • • • • • •

making beds (Figures 1a, 1b, 1c), tidying rooms (Figure 2), cleaning and polishing toilets, taps, sinks, bathtubs and mirrors (Figures 3a, 3b), washing floors, removing stains, and vacuuming .

Figure 1a

Figure 1b Making Beds

Figure 1c

Figure 3a

Figure 2

What are the risk factors of housekeeping? The main risk factors for repetitive motion injuries (RMIs) in housekeeping are: • •

heavy physical workload and excessive bodily motions which are a high risk for back injuries and forceful upper limb motions in awkward positions which are a high risk for neck or shoulder and arm injuries. Page 5

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Space limitations require workers to use many uncomfortable postures. These are: • • • • • • • • •

standing or walking, stooping, squatting, kneeling, stretching, reaching, bending, twisting, and crouching.

A housekeeper changes body position every three seconds while cleaning a room. If we assume that the average cleaning time for each room is twenty-five minutes, we can estimate that a housekeeper assumes 8,000 different body postures every shift. In addition, forceful movements while using awkward body positions include lifting mattresses, cleaning tiles, and vacuuming every shift. Housekeeping is a physically demanding and very tiring job. It can be classified as "moderately heavy" to "heavy" work because the energy required is approximately 4 kilocalories per minute (4 kcal/min.) How can we reduce the risk factors for RMI? Hotel housekeepers work in a unique place. Hotels are usually designed for the comfort of their guests rather than their housekeeping staff. This fact makes it very difficult to improve working conditions for housekeepers by means of better engineering. However, some improvements can be made by selecting more appropriate equipment. Lighter vacuum cleaners (preferably the self-propelling type), and lighter service carts with wheels designed for carpeted floors would ease the workload for their operators providing this equipment is always kept in good repair. When new vacuum cleaners are purchased, low noise emissions should be one of the criteria. Improving the body postures that pose a major risk for musculoskeletal disorders seems an unachievable task. Again, this fact results from the peculiarity of hotels as a workplace. To attract guests and remain competitive, hotel management pursues a policy that everything should be "so clean it sparkles". Floors, walls, windows, mirrors, and bathroom fixtures might be adequately cleaned with some form of an extension tool to reduce bending and overstretching. However, the demand for spotless cleanliness and hygiene, management often requires their cleaning staff to spend extra time and effort cleaning by kneeling, leaning, squatting, crouching, slouching and stretching. These postures will in time contribute to new musculoskeletal injuries and aggravate old ones. New approaches, other than strictly ergonomic ones, need to be investigated. For example, action can be taken from the administrative level. Options for improvement include: • • • •

job rotation, job enrichment and job enlargement, team work, and education and training on work practices.

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How can job rotation reduce the risk for RMI? Job rotation is one possible approach. It requires workers to move between different tasks, at fixed or irregular periods. However, it must be a rotation where workers do something completely different. Different tasks must use different muscle groups to allow muscles already stressed to recover. How can job enlargement and enrichment reduce the risk for RMI? Another approach is job enlargement. This increases the variety of tasks built into the job. It breaks the monotony of the job and avoids overloading one part of the body. Job enrichment involves more autonomy and control for the worker. How can team work reduce the risk for RMI? Team work can provide greater variety and more evenly distributed muscular work. The whole team is involved in the planning of the work. Each team member carries out a set of operations to complete the whole product, allowing the worker to alternate between tasks. This reduces the risk of RMI. How can improved work practices reduce the risk for RMI? A well-designed job, supported by a well-designed workplace and proper tools, allows the worker to avoid unnecessary motion of the neck, shoulders and upper limbs. However, the actual performance of the tasks depends on individuals. Training should be provided for workers who are involved with housekeeping activities. It is important that housekeeping staff be informed about hazards in the workplace, including the risk of injuries to the musculoskeletal system. Therefore, identification of the hazards for such injury at any given hotel is fundamental. Individual work practices, including lifting habits, are shaped by proper training. Training should encourage employers and workers to adopt methods that reduce fatigue. For example, it is advisable to plan one's workload and do the heavier tasks at the beginning of the workshift, rather than at the end, when fatigue is at its maximum. When a person is tired, the risk of injuring a muscle is higher. Training should also explain the health hazards of improper lifting and give recommendations on what a worker can do to improve lifting positions. Training should also emphasize the importance of rest periods for the workers' health and explain how active rest can do more for keeping workers healthy than passive rest. The effect of such training can reach far beyond occupational situations because the workers can apply this knowledge also in their off-job lives.

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Hotel laundry What kind of work do people do in the hotel laundry? Work in this case study of a hotel laundry is divided into two operations done by two separate groups of workers. Sorting, washing and drying towels is completed by one group of two workers. Drying (except for towels) and folding is completed by another group of six workers.

What are the tasks involved in "Sorting and Washing"? In this hotel, housekeepers use a laundry chute to get the dirty linen from the upstairs down to the laundry area. The sorting and washing operation involves the following: • • • • • • • •

sorting laundry loading bins which weigh 60 pounds of dry laundry, and 120 pounds when wet transporting (pushing/pulling) bins to washer loading washer unloading washer transporting (pushing/pulling) bins to dryer (towels only) loading dryer with towels unloading towels from the dryer

In one eight-hour shift, 20 bins of laundry are processed by two workers (Figure 1.). The dry laundry is handled four times (60 lbs x 4 handlings x 20 bins = 4,800 lbs); the wet laundry is handled twice (120 lbs x 2 handlings x 20 bins = 4,800 lbs). The workload is distributed evenly, so each worker handles approximately 4,800 lbs or 2,200 kg of laundry every day.

Figure 1 - Sorting laundry

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The handling of the laundry requires the use of considerable force: • • •

pulling laundry from the pile under the chute (Figure 2, 3) loading laundry into the washer (Figure 4) pulling wet laundry from the washer (Figure 5)

Figure 3 - Sorting laundry

Figure 4 - Loading the washer

Figure 2 - Sorting laundry

These movements are particularly stressful on the hands, wrists and shoulders. Handling the laundry requires whole body motions beyond acceptable ranges. Reaching above the shoulder, bending to the floor (Figure 5) and twisting are examples. In addition, the job is carried out while standing on a concrete floor which adds stress to the feet and legs as well as to the rest of the body.

Figure 5 - Pulling wet laundry from the washer

What are the risk factors of "Sorting and Washing"? The RMI section of OSH Answers has more information on general ergonomic RMI risk factors. Carrying out the sorting and washing tasks can be hazardous to the workers. There are three major risk factors: • • •

The heavy work load (handling over 2 tonnes of laundry per shift) combined with bodily motions beyond safe ranges create risk for back injuries. Frequent and forceful movements (while pulling/pushing the laundry) and forceful grips create a high risk for wrist and other upper limb injuries. Working while standing/walking on a hard floor creates the risk for lower leg discomfort, and accelerates the development of fatigue.

These factors have a compounding effect. In other words, each of them increases the effect of the others

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What are the tasks involved in "Drying and Folding"? In this operation there are three workstations at which five different tasks are performed: • • • • •

feeding the rolling dryer with small pieces of laundry (Figure 6) feeding the rolling dryer with large pieces of laundry (Figure 7) retrieving small pieces of laundry from the rolling dryer (Figure 8) retrieving large pieces of laundry from the rolling dryer (Figure 9) folding towels (Figure 10)

Figures 6 and 7 - Feeding the rolling dryer

Figures 8 and 9 - Retrieving laundry from the rolling dryer

As an example, to feed the roller dryer with small laundry such as pillow cases (Figure 6), a worker performs the following tasks: • • •

reaching for the laundry in the bin (Figure 11) unfolding and stretching the laundry spreading the laundry on rollers (Figure 6)

Figure 10 - Folding towels

Figure 11 - Reaching for the laundry

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To feed the dryer with laundry such as bed sheets, two workers form a team (Figure 7). This task involves the following:

• • • •

reaching for bedsheets in the bin (Figure 11) unfolding the bedsheets spreading the bedsheets (Figure 12) spreading the bedsheets on rollers

Figure 12 - Spreading the laundry

What are the risk factors of "Drying and Folding"? Several aspects of feeding the dryer with both small and large pieces of laundry pose the risks for repetitive motion injuries. Workers are at a high risk for upper arm, neck and shoulder injuries because of limited control over the pace of work, highly repetitious movements (one task lasts approximately 3 to 8 seconds), working with arms at or above shoulder level, and hand manipulation while handling the laundry. Bending and twisting, reaching forward and upward, and standing in a leaning-forward position contribute to low back pain. Prolonged standing on a hard floor contributes to lower leg discomfort and speeds up the development of muscular fatigue. All of these factors have a compounding effect. In other words, each of them increases the effect of the others. What are the tasks involved in retrieving pieces of laundry? To retrieve small laundry such as pillow cases from the regular dryer (Figure 8) a worker performs the following tasks:

• •

reaching forward to pick up the laundry folding laundry

To retrieve big pieces of laundry such as bedsheets, which come out of the dryer partially folded (Figure 13), a worker performs the following movements:

• • •

bending and reaching for the bedsheet folding the bedsheet piling the bedsheet Figure 13 - Retrieving bedsheets

What are the risk factors of retrieving pieces of laundry? Workers involved in retrieving small pieces of laundry are at risk for repetitive motion injuries. The hazardous conditions are: • • • • • • •

no control over pace of work repetitive movements constrained work posture leaning forward standing position reaching forward beyond recommended range working with extended arms standing on a hard floor Page 11

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The lack of control over the pace of work, highly repetitious movements, constrained work posture, and extended arms while working create a high risk for RMIs. Neck, shoulders and upper arms are at the highest risk for injuries. Leaning forward, over-reaching and prolonged standing in a restricted position put workers at high risk for low back injury. Prolonged standing on a hard floor contributes to lower leg discomfort and speeds up the development of muscular fatigue. All of these factors have a compounding effect. In other words, each of them increases the effect of the others. Workers involved in retrieving big pieces of laundry are at risk for repetitive motion injuries, including low back pain. The hazardous conditions are: • • • •

prolonged stooped standing position due to a low work surface repetitive movements standing on a hard floor no control over the pace of work

Contributing factors are prolonged, restricted, and stooped working positions and bending. There is also a risk for injuries of the neck and shoulders. Prolonged standing on a hard floor contributes to lower leg discomfort and speeds up the development of muscular fatigue. All of these factors have a compounding effect. In other words, each of them increases the effect of the others. How can we reduce the risk factors for RMI? General Continual twisting and reaching while working with extended arms can contribute to the development of repetitive motion injuries. However, the risk for such injuries while folding towels is somewhat lower when drying and folding of bedsheets and pillow cases. Some control over the pace of work and some flexibility in the working postures are responsible for the reduced risk. Let's see how we can improve the operations in this hotel laundry facility: Sorting and Washing In the laundry processing plant, the sorting and washing operations are typically manual material handling tasks. These tasks pose the risk for low back pain. Manual material handling cannot be fully eliminated but it is possible to reduce it by reorganizing the flow of work. For example, instead of sorting towels and linen before loading them into the bins, it would be preferable to load the laundry in the bins directly from the pile under the chute. This would eliminate handling the same laundry twice. Further improvements of working conditions can be achieved by reducing stressful body movements while handling the laundry. Shortening the laundry chute (pipe) through which laundry is dropped would create more space so that the laundry would not compress against the pipe itself. As a consequence, the sorting of the laundry would require less pulling force.

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To reduce bending while reaching for the laundry at the bottom of the bins, it would be advisable to use different types of bins. For example, a bin with one side that opens mounted on a moveable tilt/lift table (Figure 14). To reduce pulling and pushing while manoeuvering the bins full of laundry, it would be advisable to use lighter bins with wheels designed for hard floors. In addition, the bins should be maintained regularly with particular attention to the wheels.

Figure 14 - Tilt-lift table

Working in the sorting and washing areas requires standing on a concrete floor. Since the application of anti-fatigue matting is not practical, workers should wear shoes that provide good cushioning or they should use proper inserts to lessen the stress on the feet and on the lower back. Drying and Folding The overall workload, poor layout of the work station, improper design of the laundry bins and the repetitiveness of the work are the major risk factors for repetitive motion injuries in the drying and folding job. Providing bins with one side that opens on elevating devices would reduce bending and other awkward body positions while reaching for towels at the bottom of the bins. To reduce awkward body positions such as reaching above shoulder level while feeding the dryer, it would be advisable to use a platform. Narrowing the counter that separates the worker from the dryer would reduce reaching forward. Retrieving pieces of laundry and folding towels To reduce awkward body positions such as reaching above shoulder level while retrieving pillow cases from the dryer, it would be advisable to use a platform (Figure15). Narrowing the counter that separates the worker from the dryer would reduce reaching forward. Workers should have a sit/stand stool available to rest between tasks. Also, a foot bar to allow the worker to switch the weight of the body from one foot to the other should be made available.

Figure 15 - Standing on a platform while retrieving laundry

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Partially folded bedsheets coming out of the dryer should be collected in a basket (Figure 16) so that when completing the folding operation, a worker can use a counter of appropriate height and reduce excessive bending. To reduce discomfort due to prolonged standing while folding towels, anti-fatigue matting should be used. Also, a saddle chair and a foot bar should be provided.

Figure 16 - Collecting bedsheet in a basket To further reduce the stress on the body due to prolonged standing, it would be advisable to use sit/stand devices (Figure 17). If it is not practical to sit while performing the task, workers should use these devices between tasks.

Figure 17 - A sit-stand saddle chair

General Recommendations One of the main risk factors for repetitive motion injuries in the laundry is the repetitiveness of the work. To change the repetitive patterns of work, we need to do different tasks. Job rotation and team work are two options that allow workers to vary tasks. Job rotation requires workers to move between different tasks at fixed or irregular periods of time. Workers in the laundry cannot fully benefit from job rotation because all the tasks are similar in nature. Still, the feeling of change reduces monotony and slows down the development of fatigue. In team work, workers form a team and each member of the team shares several different tasks. The whole team is involved in the planning of the work. The team controls all aspects of work. This improves attitude and job satisfaction, which are important factors in the prevention of occupational diseases.

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Office general Office staff may type or file documents, correspondence, reports, statements and other material. Their workstation usually has a computer/VDT and telephone, among other equipment. The main duties of an office worker include: • • • • •

Answer telephone or personal enquiries Photocopy and collate documents Maintain and update filing, inventory, mailing and database systems Open, sort and route incoming mail and courier packages Process reports, applications, receipts, expenditures and other documents, using a computer

What are some health and safety issues for office workers? Although office environments don't usually present the same physical hazards as some of the more safety-critical industries, there are other hazards to be aware of: • • • • • • • • • • • • •

Perfumes and other scents (potential allergens) In some cases, exposure to cleaning products Indoor air quality Sitting for long periods of time Working in from awkward positions, or performing repetitive manual tasks Lifting awkward or heavy objects Eye strain Working in uncomfortable temperatures Annoying or distracting noise and vibration from electronic equipment Slips, trips and falls Risk of violence Working alone Stress

What are some preventive measures for office workers? • • •

Learn about how to avoid musculoskeletal pain or injury from repetitive or physically awkward tasks. Take breaks as needed. (Appendix 1) Learn safe lifting techniques. (Appendix 2) Keep all work areas clear of clutter.

What are some good general safe work practices? • • • • •

Follow company safety rules. Learn about chemical safety, WHMIS and MSDSs Know how to report a hazard (Appendix 9) Practice safe lifting (Appendix 2) Follow good housekeeping procedures. (Appendix 10)

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Landscaper What does a landscaper do? Under the label "landscaper" we are referring to gardeners, greenkeepers, lawn care specialists and horticultural workers. These people work in businesses or homes, indoors or outdoors. Some of the main duties of a landscaper are to: • • •

Plan, create and maintain landscaped environments, which may include flowers, plants, trees, lawns, fences, decks, patios or water features. Prepare and spray chemical mixtures using various types of equipment. Operate powered equipment and hand tools.

What are some health and safety issues for landscapers? Depending on exact occupation or geographic location, the following are possible risks: • • • • • • • • • • •

Exposure to infectious human and animal waste. Irritation or allergic reaction from plants, or from insect bites or stings. Histoplasmosis from bird droppings. Hantavirus from mouse droppings. Exposure to pesticides and other toxic chemicals. Pain or injury from working in awkward positions, lifting and carrying heavy objects. Noise. (Appendix (11) Exposure to extreme temperatures. (Appendix 4) Work with heavy machinery, manual and power tools, and ladders. Working near electrical lines. (Appendix 12) Working alone. (Appendix 7)

What are some preventive measures for landscapers? • • • • • • • •

Wash your hands frequently. (Appendix 8) Remove contaminated clothing and footwear to avoid transferring chemicals to your home or other "clean" spaces. Wash contaminated items before re-wearing or discarding. Keep your limbs covered to avoid insect bites. Protect yourself from the sun and from extreme heat or cold. Learn safe lifting techniques. (Appendix 2) Wear appropriate personal protective equipment. Know how to safely use equipment and tools.

What are some good general safe work practices? • • • • • • • •

Practice safe lifting techniques. Work safely with equipment, tools, and ladders. Follow recommendations when working with chemicals. Use, maintain and store personal protective equipment according to manufacturers' recommendations. Stay hydrated to avoid heat stress. Follow company safety rules. Know how to report a hazard. (Appendix 9) Follow good housekeeping procedures. (Appendix 10) Page 16

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Electrician What does an electrician do? Electricians work in commercial, industrial or residential settings. Some of their main duties are to: • • • • • •

Install, repair and maintain electrical systems Conform to building codes and other regulations Read, prepare or interpret blueprints and drawings Prepare cost estimates and documentation for clients Use, clean and maintain various equipment Supervise apprentices or other workers

What are some health and safety issues for electricians? Electricians work in a variety of settings and may be exposed to several hazards, including: • • • • • • • • • • • • • • •

Lead, solvents, solder, and other materials Risk of fatal electrical shock (Appendix 12) Risk of electrical burns Working in confined spaces (Appendix 13) Welding hazards, including UV radiation Extreme temperatures (Appendix 4) Risk of pain or injury from awkward positions, repetitive manual tasks, or lifting heavy objects (Appendix 1,2) Moulds, fungi and bacteria Risk of infection from bird or rodent droppings Working at heights Risk of eye injury from flying particles Slips, trips and falls (Appendix 5) Working with various hand tools, power tools and equipment Shift work or extended work days Possible exposure to asbestos

What are some preventive measures for electricians? • • • • • •

Keep tools and equipment in good working order. Use appropriate personal protective equipment for the task, including footwear. Keep work areas clear of clutter and equipment. Avoid awkward positions, and repetitive tasks, Learn safe lifting techniques. Follow a recommended shift work pattern, and know the associated hazards.

What are some good general safe work practices? • Follow correct procedures for: o Electrical safety o Confined spaces entry o Working at heights o Working with hand tools, and power tools

• • • • •

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Use, maintain and store personal protective equipment according to manufacturer's recommendations. Learn about chemical hazards, WHMIS and MSDSs. Know how to report a hazard Follow good housekeeping procedures. Follow company safety rules.

Carpenter What does a carpenter do? A carpenter builds or repairs various structures, working primarily with wood. Some of a carpenter's main duties are to: • • • • • •

Measure, cut, shape, assemble and join materials. Read, prepare and interpret blueprints and drawings. Prepare cost estimates and documentation for clients. Conform to building codes and other regulations. Use, clean and maintain various equipment and tools. Supervise apprentices or other workers.

What are some health and safety issues for carpenters? Carpenters face their own unique set of occupational hazards. These include the following: • • • • • • • • • •

Use of various machinery and tools. Moulds, fungi and bacteria. Chemicals, solvents and other materials - dermatitis, allergic reactions or respiratory problems. Cancer risk from wood dust. Flammable or combustible materials, including wood dust. Risk of pain or injury from working in awkward positions, performing repetitive tasks, or lifting. (Appendix 1,2) Extreme temperatures when working outdoors. (Appendix 4) Risk of eye injury from flying particles. Working at heights. Shift work or extended work days.

What are some preventive measures for carpenters? • • • • • • • •

Install and maintain good ventilation. Keep tools and equipment in good working order. Clean up wood dust regularly. Wear appropriate eye protection, footwear, and other protective equipment for the task. Keep work areas clear of clutter and equipment. Learn safe lifting techniques. Avoid awkward postures or repetitive tasks, or take frequent breaks. Follow a recommended shift work pattern, and know the associated hazards.

What are some good general safe work practices? • Work safely with all equipment: o Woodworking machines o Hand tools o Powered hand tools • Use, maintain and store personal protective equipment as recommended by the manufacturer.

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• • • • •

Follow safe lifting techniques. Follow company safety rules. Learn about chemical hazards, WHMIS and MSDSs. Know how to report a hazard. Follow good housekeeping procedures.

Appendix 1 What are work-related musculoskeletal disorders (WMSDs)? Work-related musculoskeletal disorders (WMSDs) are a group of painful disorders of muscles, tendons, and nerves. Carpal tunnel syndrome, tendonitis, thoracic outlet syndrome, and tension neck syndrome are examples. Work activities which are frequent and repetitive, or activities with awkward postures cause these disorders which may be painful during work or at rest. Almost all work requires the use of the arms and hands. Therefore, most WMSD affect the hands, wrists, elbows, neck, and shoulders. Work using the legs can lead to WMSD of the legs, hips, ankles, and feet. Some back problems also result from repetitive activities. How common are WMSDs? WMSDs are recognized as leading causes of significant human suffering, loss of productivity, and economic burdens on society. However, we do not have reliable estimates of the number of WMSDs in Canada. The data available are limited and does not represent the magnitude of the problem because there is a great deal of under-reporting of these types of injuries. For example, over 20,000 Ontario workers received compensation in 1987 for new cases of WMSDs, accounting for about 600,000 days of lost work. In British Columbia, over half the industrial disease claims are due to WMSDs. A survey of cashiers throughout B.C., performed by Simon Fraser University and the United Food and Commercial Workers in 1982, indicated that over 30% of the work force surveyed suffered a form of WMSD. What are the risk factors for WMSDs? WMSDs arise from ordinary arm and hand movements such as bending, straightening, gripping, holding, twisting, clenching and reaching. These common movements are not particularly harmful in the ordinary activities of daily life. What makes them hazardous in work situations is the continual repetition, often in a forceful manner, and most of all, the speed of the movements and the lack of time for recovery between them. WMSDs are associated with work patterns that include: • • • •

Fixed or constrained body positions Continual repetition of movements Force concentrated on small parts of the body, such as the hand or wrist A pace of work that does not allow sufficient recovery between movements

Generally, none of these factors acts separately to cause WMSD. WMSDs commonly occur as a result of a combination and interaction among them. Heat, cold and vibration also contribute to the development of WMSD. Body Position There are two aspects of body position (posture) that contribute to injuries in jobs involving repetitive tasks. The first relates to the position of the part of the body that performs the actual task, usually the upper limb. For example, tasks that require repetitive movements to the extreme ranges of the joint in the wrist, elbow or shoulder contribute to the occurrence of a painful condition in those areas. Table 1 gives examples of such movements. Poor layout of the workstation and improper selection of equipment and tools can lead to these hazardous body movements. Page 19

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Table 1 Body Movement repetitive, horizontal or vertical movements of the wrist to the extreme ranges (Fig. 1A)

Areas of Pain wrist and palm

moving fingers while the wrist is in an extreme position (Fig. 1B,1C) repetitive bending or straightening of the elbow from its neutral position (at a right angle)

elbow

twisting the wrist and forearm (Fig. 2) reaching above shoulder level (Fig. 3B) reaching behind the trunk (Fig. 3C)

neck and shoulder

reaching far out in front of the body (Fig. 3A) twisting the arm (Fig. 3C)

The other postural aspect that contributes to WMSD is a fixed position of the neck and the shoulders. To perform any controlled movement of an upper limb, the worker must stabilize the shoulder-neck region. Muscles in the shoulder and the neck contract and stay contracted to hold the position stable for as long as the task requires. The contracted muscles squeeze the blood vessels. This restricts the flow of blood all the way down to the working muscles of the hand where the blood, because of the intense muscular effort, is needed the most. The result is twofold. The neck-shoulder muscles become fatigued, even though there is no movement. This contributes to pain in the neck area. At the same time, the reduced blood supply to the remaining parts of the upper limb accelerates fatigue in the moving muscles, making them more susceptible to injury.

Figure 2 - Exerting force while extending forearm Figures 1A, 1B & 1C Hazardous movements of the hand

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Repetition Workers performing highly repetitive tasks are at the highest risk for WMSD. This shows that repetition of movements, although it never acts separately, is most likely the strongest risk factor. Tasks requiring repetitive movements always involve other risk factors for WMSD such as fixed body position and force: the worker, in order to perform the task, has to maintain the shoulder and neck in a fixed position and to exert some force.

Figure 3A - Hazardous reaching movements - reaching forward

Figure 3B - Hazardous reaching movements - reaching above shoulder level

Figure 3C - Hazardous reaching movements - reaching behind the trunk

Work involving movement repeated over and over again is very tiring. This is because the worker cannot fully recover in the short periods of time that are given between tasks. With time, the effort to maintain the repetitive movements, even if they involve minimal forces, steadily increases. When the work activity is continued in spite of the developing fatigue, injuries occur. Force The force required to do the task also plays an important role in the onset of WMSD. More force equals more muscular effort, and consequently, a longer time is needed to recover between tasks. Since in repetitive work, as a rule, there is not sufficient time for recovery, the more forceful movements develop fatigue much faster. Exerting force in certain hand positions is particularly Page 21

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hazardous (Fig. 1A-4F). The amount of force needed depends on the weight of the tools and objects that the worker is required to operate or move, and their placement in relation to the worker's body. More strength has to be used, the farther away from the body the force has to be applied. The shape of the tool plays an important role, also. Tools that do not allow the best position of the wrist, elbow and shoulder substantially increase the force required. Worn and poorly maintained tools are very important as well, yet often overlooked. For example, a worn screwdriver, pliers with worn jaws, or dull scissors can increase the operating force as much as tenfold. Figure 4A - Pulp pinch

Figure 4B - Lateral pinch

Figure 4A and 4B - Exerting force in various hand positions

Figure 4C - Palm

Figure 4D - Finger

Press

Pinch Figures 4C and 4D - Exerting force in various hand positions

Figure 4F - Finger press

Figure 4E - Pulp

grasp Figures 4E and 4F - Exerting force in various hand positions

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Pace of Work Pace of work determines the amount of time available for rest and recovery of the body between cycles of a particular task. The faster the pace, the less time is available and the higher the risk for WMSD. When the worker has no control over timing and speed of work because of external factors like assembly line speed or quota systems then stress level increases. With higher stress level comes muscle tension causing fatigue and again increased risk for WMSD. Controlling the pace of work externally denies the worker the flexibility to determine their own work speed. It is a human characteristic to work at varying rates at different times of the day. Temperature and Vibration Temperature and humidity affect the worker performing repetitive work. When it is too hot and too humid, the workers tire more quickly and thereby become more susceptible to injury. On the other hand, cold temperatures decrease the flexibility of muscles and joints, increasing the likelihood of injury of any kind. Vibration affects tendons, muscles, joints, and nerves. Workers using vibrating tools may experience numbness of the fingers, loss of touch and grip, and pain. For more information on this subject, refer to OSH Answers document Raynaud's Phenomenon. How do WMSDs occur? WMSDs do not happen as a result of a single accident or injury. Rather, they develop gradually as a result of repeated trauma. Excessive stretching of muscles and tendons can cause injuries that only last a short time. But repeated episodes of stretching causing tissue inflammation can lead to long-lasting injury or WMSDs. WMSDs include three types of injuries: • • •

muscle injury tendon injury nerve injury

Muscle Injury When muscles contract, they use chemical energy from sugars and produce by-products such as lactic acid which are removed by the blood. A muscle contraction that lasts a long time reduces the blood flow. Consequently, the substances produced by the muscles are not removed fast enough, and they accumulate. The accumulation of these substances irritates muscles and causes pain. The severity of the pain depends on the duration of the muscle contractions and the amount of time between activities for the muscles to get rid of those irritating substances.

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Tendon Injury Tendons consist of numerous bundles of fibres that attach muscles to bones. Tendon disorders related to repetitive or frequent work activities and awkward postures occur in two major categories --tendons with sheaths (Fig. 5), found mainly in the hand and wrist; and tendons without sheaths (Fig. 6), generally found around the shoulder, elbow, and forearm. The tendons of the hand are encased in sheaths through which the tendon slides.

Figure 5 - Finger tendons and their sheaths

The inner walls of the sheaths contain cells that produce a slippery fluid to lubricate the tendon. With repetitive or excessive movement of the hand, the lubrication system may malfunction. It may not produce enough fluid, or it may produce a fluid with poor lubricating qualities. Failure of the lubricating system creates friction between the tendon and its sheath, causing inflammation and swelling of the tendon area. Repeated episodes of inflammation cause fibrous tissue to form. The fibrous tissue thickens the tendon sheath, and hinders tendon movement. Inflammation of the tendon sheath is known as tenosynovitis.

Figure 6 - Tendon, muscle, bone unit

When inflamed, a tendon sheath may swell up with lubricating fluid and cause a bump under the skin. This is referred to as a ganglion cyst. Tendons without sheaths are vulnerable to repetitive motions and awkward postures. In fact, when a tendon is repeatedly tensed, some of its fibres can tear apart. The tendon becomes thickened and bumpy, causing inflammation. Tendonitis is the general term indicating inflammation of the tendon. In some cases, such as in the shoulder, tendons pass through a narrow space between bones. A sac called the bursa filled with lubricating fluid is inserted between the tendons and the bones as an anti-friction device. As the tendons become increasingly thickened and bumpy, the bursa is subject to a lot of friction and becomes inflamed. Inflammation of the bursa is known as bursitis. Nerve Injury Nerves carry signals from the brain to control activities of muscles. They also carry information about temperature, pain and touch from the body to the brain, and control bodily functions such as sweating and salivation. Nerves are surrounded by muscles, tendons, and ligaments. With repetitive motions and awkward postures, the tissues surrounding nerves become swollen, and squeeze or compress nerves (Fig. 7A,7B).

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Figure 7A - Wrist in natural condition

Figure 7B - Wrist showing symptoms of Carpal Tunnel Syndrome

Compression of a nerve causes muscle weakness, sensations of "pins and needles" and numbness. Dryness of skin, and poor circulation to the extremities, may also occur. What are the symptoms of WMSDs? Pain is the most common symptom associated with WMSDs. In some cases there may be joint stiffness, muscle tightness, redness and swelling of the affected area. Some workers may also experience sensations of "pins and needles," numbness, skin colour changes, and decreased sweating of the hands. WMSDs may progress in stages from mild to severe. Early stage: Aching and tiredness of the affected limb occur during the work shift but disappear at night and during days off work. No reduction of work performance. Intermediate stage: Aching and tiredness occur early in the work shift and persist at night. Reduced capacity for repetitive work. Late stage: Aching, fatigue, and weakness persist at rest. Inability to sleep and to perform light duties. Not everyone goes through these stages in the same way. In fact, it may be difficult to say exactly when one stage ends and the next begins. The first pain is a signal that the muscles and tendons should rest and recover. Otherwise, an injury can become longstanding, and sometimes, irreversible. The earlier people recognize symptoms, the quicker they should respond to them. Table 2 outlines occupational risk factors and symptoms of the most common disorders of the upper body associated with WMSDs.

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Table 2 Identified disorders, occupational risk factors and symptoms Disorders

Occupational risk factors

Symptoms

Tendonitis/tenosynovitis

Repetitive wrist motions Repetitive shoulder motions Sustained hyper extension of arms Prolonged load on shoulders

Pain, weakness, swelling, burning sensation or dull ache over affected area

Epicondylitis (elbow tendonitis)

Repeated or forceful rotation of the forearm and bending of the wrist at the same time

Same symptoms as tendonitis

Carpal tunnel syndrome

Repetitive wrist motions

Pain, numbness, tingling, burning sensations, wasting of muscles at base of thumb, dry palm

DeQuervain's disease

Repetitive hand twisting and forceful gripping

Pain at the base of thumb

Thoracic outlet syndrome

Prolonged shoulder flexion Extending arms above shoulder height Carrying loads on the shoulder

Pain, numbness, swelling of the hands

Tension neck syndrome

Prolonged restricted posture

Pain

How are WMSDs recognized? The evaluation of WMSDs includes identifying workplace risks. Evaluation begins with a discussion of the person's employment and requires a detailed description of all the processes involved in a typical workday. Consideration is given to the frequency, intensity, duration, and regularity of each task performed at work. Diagnosis of WMSDs is confirmed by performing laboratory and electronic tests that determine nerve or muscle damage. One such test, electroneuromyography (ENMG), encompasses two areas: electromyography (EMG) and nerve conduction velocity (NCV). Magnetic resonance imaging (MRI), an alternative to x-rays, provides images of tendons, ligaments, and muscles and improves the quality of the diagnostic information. How are WMSDs treated? The treatment of WMSDs involves several approaches including the following: • • • •

Restriction of movement Application of heat or cold Exercise Medication and surgery

Restriction of Movement The first approach to treatment of WMSDs is to avoid the activities causing the injury. This often requires work restrictions. In some cases, transfer to a different job should be considered. A splint can also be used to restrict movements or to immobilize the injured joint. However, the use of splints in occupational situations requires extreme caution. If used inappropriately, splints can cause more damage than good. Splints are usually used for two reasons: to mechanically support a joint where an excessive load on the joint is anticipated, or to restrict the movement of the injured joint. Page 26

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In the occupational context, splints should not be used as a mechanical support for the joint. Instead, the job should be redesigned to avoid the extreme load on the worker's joint in the first place. To be effective, the use of splints to immobilize an affected joint also requires that the work activity that caused the injury be stopped or changed. If injurious work continues, then the worker is exposed to risk of injury to other joints that have to compensate for the one that is splinted. Application of Heat or Cold Applying heat or cold seems to relieve pain and may accelerate the repair process. Heat is recommended for pain relief of minor injuries. It is not recommended for injuries with significant inflammation and swelling. Heat increases the flow of blood and increases swelling. Ice reduces pain and swelling. Exercise Stretching is beneficial because it promotes circulation and reduces muscle tension. However, people suffering from WMSDs should consult a physical therapist before exercising. Stretching or exercise programs can aggravate the existing condition if not properly designed. Medication and Surgery Anti-inflammatory drugs can reduce pain and inflammation. The doctor may try more elaborate treatments or even surgery if all other approaches fail. How can we prevent WMSDs? Hazards are best eliminated at the source; this is a fundamental principle of occupational health and safety. In the case of WMSDs, the prime source of hazard is the repetitiveness of work. Other components of work such as the applied force, fixed body positions, and the pace of work requiring repetition of the same movements over and over again, are also contributing factors to WMSDs. Therefore the main effort to protect workers from WMSDs should focus on avoiding repetitive patterns of work through job design which may include mechanization, job rotation, job enlargement and enrichment or teamwork. Where elimination of the repetitive patterns of work is not practical, prevention strategies involving workplace layout, tool and equipment design, and work practices should be considered. Job Design Mechanization One way to eliminate repetitive tasks is to mechanize the job. Where mechanization is not feasible or appropriate, other alternatives are available. Job Rotation Job rotation is one possible approach. It requires workers to move between different tasks, at fixed or irregular periods of time. But it must be a rotation where workers do something completely different. Different tasks must engage different muscle groups in order to allow recovery for those already strained.

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However, job rotation alone will not be effective in reducing WNSDs if not combined with the proper design of workstations. And it will not be effective while the high pace of work persists. Job Enlargement and Enrichment Another approach is job enlargement. This increases the variety of tasks built into the job. It breaks the monotony of the job and avoids overloading one part of the body. Job enrichment involves more autonomy and control for the worker. Team Work Team work can provide greater variety and more evenly distributed muscular work. The whole team is involved in the planning and allocation of the work. Each team member carries out a set of operations to complete the whole product, allowing the worker to alternate between tasks, hence, reducing the risk of WMSDs. Workplace Design The guiding principle in workplace design is to fit the workplace to the worker. Evaluation of the workplace can identify the source or sources of WMSD. Proper design of the workstation decreases the effort required of the worker to maintain a working position. Ideally, the workstation should be fully adjustable, providing a worker with the options to work in standing, sitting or sitting-standing positions, as well as fitting the worker's body size and shape. Detailed information about proper workplace design can be found in the OSH Answers documents "Working in a Standing Position" and "Working in a Sitting Position". Tools and Equipment Design Proper design of tools and equipment significantly decreases the force needed to complete the task. Providing the worker with the proper jigs or fixtures for tasks that require holding elements saves a lot of muscular effort in awkward positions. Good tools, maintained carefully and where necessary frequently changed, can also save a lot of muscle strain. More information about hand tools and preventing WMSD resulting from their use can be found in the OSH Answers document "Hand Tool Ergonomics". Work Practices A well-designed job, supported by a well-designed workplace and proper tools, allows the worker to avoid unnecessary motion of the neck, shoulders and upper limbs. However, the actual performance of the tasks depends on individuals. Training should be provided for workers who are involved in jobs that include repetitive tasks. Workers need to know how to adjust workstations to fit the tasks and their individual needs. Training should also emphasize the importance of rest periods and teach how to take advantage of short periods of time between tasks to relax the muscles, and how to consciously control muscle tension throughout the whole work shift.

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Conclusion WMSDs of muscles, tendons and nerves are a major cause of lost work in many labour-intensive industries. Occupational risk factors include continual repetition of movements, fixed body positions, forces concentrated on small parts of the body, and lack of sufficient rest between tasks. Prevention must aim at eliminating the repetitiveness of the work by proper job design. Where this is not possible, preventive strategies such as good workplace layout, tool and equipment design, and proper work practices should be considered. Early recognition of these disorders is very important because medical treatments are unlikely to be effective once these injuries become longstanding. Preventive and control measures, in order to be truly effective, require significant involvement on the part of the workers, their representatives, and management to improve occupational health and safety. How does repetitiveness and pace of work influence WMSDs? Repetitive movements are especially hazardous when they involve the same joints and muscle groups over and over and when we do the same motion too often, too quickly and for too long. To analyze how repetitive a task is, we need to describe it in terms of steps or cycles. For example, the bottle packing operation (Figure 6) requires workers to pack boxes with twenty-four bottles.

Figure 6 - Packing bottles

One cycle can be described as follows: • • • •

reach for bottles grasp bottles move bottles to box place bottles in box

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If a worker grasps four bottles each time, the same cycle would have to be repeated six times to fill a box. Assuming that one cycle lasts two seconds, it would take twelve seconds to pack a box with twenty-four bottles. There are no rules to judge movements as either high or low in repetition. Some researchers classify a job as "high repetitive" if the time to complete such a job was less than 30 seconds or "low repetitive" if the time to complete the job was more than 30 seconds. Although no one really knows at what point WMSDs may develop, workers performing repetitive tasks are at risk for WMSDs Work involving movement repeated over and over is very tiring because the worker can not fully recover in the short periods of time between movements. Eventually, it takes more effort to perform the same repetitive movements. When the work activity continues in spite of the fatigue, injuries can occur. What should I know about force of movements? Force is the amount of effort our bodies must do to lift objects, to use tools, or to move. The amount of force we use to do a job depends on many factors such as the weight of the objects and their placement in relation to the body. It requires more force to lift and carry a box with arms outstretched and held away from the body (Figure 7) or to lift the same objects in a "pinch" position (Figure 7a) than in a "hook" position (Figure 8, 8a).

Figure 7a - Pinch position Figure 7 - Lifting in a "pinch"

A force of more than four kilograms, or nine pounds, is considered significant. This is the force used to hammer a nail, for example. Although no one really knows when WMSDs will develop, workers performing forceful movements are at risk. Work involving forceful movements is very tiring again because there is not time for a full recovery between movements. Eventually it takes effort to perform the same task. When the work activity continues in spite of the developing fatigue, injuries occur.

Figure 8a -Hook position

Figure 8 - Lifting in a "hook"

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Appendix 2 Lifting general practice What types of protective clothing should be worn? DO WEAR • • •

lightweight, flexible, tear and puncture-resistant clothing, safety boots with toe caps and slip-resistant soles, and protective gloves, appropriate for the materials being handled.

DO NOT WEAR • • •

aprons, coats, clothing with exposed buttons, zippers or loose flaps, or heavy duty mitts.

What should you do before lifting? • • • • • • • • • •

Always check before lifting to see if mechanical aids such as hoists, lift trucks dollies or wheelbarrows are available. Get help with heavy or awkward loads. Assess the weight of the load. Identify the weight of the load. Be sure that you can lift the load without over-exertion. Be sure that the load is "free" to move. Check that the planned location of the load is free of obstacles and debris. Be sure that the path to the planned location of the load is clear. Grease, oil, water, litter and debris can cause slips and falls. Particular handling and lifting techniques are needed for different kinds of loads or materials being handled (for example, compact loads, small bags, large sacks, drums, barrels, cylinders, sheet materials like metal or glass). Do not lift if you are not sure that you can handle the load safely.

What are some general tips for lifting? • • • • • • • • • • •

Prepare for the lift by warming up the muscles. Stand close to the load and face the way you intend to move. Use a wide stance to gain balance. Be sure you have a good grip on the load. Keep arms straight. Tighten abdominal muscles. Tuck chin into the chest. Initiate the lift with body weight. Lift the load as close to the body as possible. Lift smoothly without jerking. Avoid twisting and side bending while lifting.

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Appendix 3 Microwave ovens and their risks Why do people worry about microwave radiation? Microwave ovens are used daily in restaurants, cafeterias, lounges, kitchens, snack bars, and homes. Microwave oven users are often concerned about potential health hazards from the exposure to microwave radiation leakage. With the latest technological advances in door seal design and with proper maintenance, microwave oven leakage has been greatly minimized or eliminated. How do microwave ovens work? In a microwave oven, food is cooked by exposing it to microwave radiation. Most household microwave ovens operate on a frequency of 2450 megahertz (MHz or million cycles per second) in a continuous wave (cw) mode. Larger ovens used for industrial applications sometimes operate at 915 MHz. The microwave energy from the magnetron is transferred to the oven cavity through a waveguide section. A mode stirrer spreads the microwave energy more or less evenly throughout the oven.

The microwave radiation produces heat inside the food in the oven. Heat is produced when the water molecules in the food vibrate (at a rate of 2,450,000,000 times per second) when the food absorbs the microwave radiation. The movement of the molecules produce friction which causes heat. This heat cooks or warms up the food. Can microwaves leak radiation? Old or faulty door seals are the most common causes of microwave radiation leakage. Mechanical abuse, a build-up of dirt, or simple wear and tear of continued use can cause door seals to be less effective. Theoretically, there will be small amounts of leakage through the viewing glass but measurements have shown this to be insignificant.

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What are the health effects of microwave radiation? A large amount of literature has been published on the biological effects of microwave radiation. Generally speaking, exposure to very high levels of microwave radiation can result in significant amounts of energy being absorbed by the body. Just as with food, this energy is transformed into heat in the body. Sensitive body parts, such as the eyes, testes and brain, are not able to get rid of the extra heat that may build up. However, the situations where effects of thermal (heat) damage has actually occurred to the eye or brain required long term exposure to very high power densities well in excess of those measured around microwave ovens. Some biological effects cannot be explained by a temperature rise in the body or in any one part. Persons working in microwave fields have reported headaches, eyestrain, over-all fatigue and disturbance of sleep. These effects have been associated with the interaction of the microwave fields with the central nervous system of the body. Such effects have been labeled as "non-thermal" interactions. These may be responsible for some of the long-term effects from prolonged exposure to low levels of electromagnetic fields. There is no confirmed scientific evidence to prove a link between such effects and microwave radiatus exposure. However, it must be emphasized that these effects usually occur with pulsed or pulse-modulated fields and not with the continuous wave fields associated with microwave ovens. What are some general safety precautions for microwave ovens? Safety tips for operation of microwave ovens: • •

• • •

Do not operate oven when empty. Exercise extreme caution if you have a pacemaker implant. Microwave radiation may cause pacemaker interference. Persons with pacemaker implants should not be near a microwave oven unless they are sure that it is in good operating condition and there is no leakage of microwave radiation. Check to see that door seal and inside surfaces of door and oven cavity are clean after each use. Keep out of the reach of children. Do not permit young children to operate the oven. Do not put face close to door window when oven is operating.

Safety tips for installation and maintenance of microwave ovens include: • • •

• •

Take special care to ensure that no damage occurs to the part of the oven making contact with the door or door seals. Ensure that the microwave is unplugged or disconnected from electrical power before reaching into any accessible openings or attempting any repairs. Ensure that the adjustment of applied voltages, replacement of the microwave power generating component, dismantling of the oven components, and refitting of waveguides are undertaken only by persons who have been specially trained for such tasks. The services of a qualified repairman should be sought when any malfunction is suspected. Do not by pass the door interlocks. Do not test a microwave power generating component without an appropriate load connected to its output. The power generated must never be allowed to radiate freely into occupied areas.

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Appendix 4 Extreme Hot or Cold Temperature Conditions Is there a temperature at which work becomes dangerous and should be stopped? The short answer is yes. Both very cold and very hot temperatures could be dangerous to your health. Excessive exposure to heat is referred to as heat stress and excessive exposure to cold is referred to as cold stress. In a very hot environment, the most serious concern is heat stroke. In absence of immediate medical attention, heat stroke could be fatal. Heat stroke fatalities do occur every summer. Heat exhaustion, and fainting (syncope) are less serious types illnesses which are not fatal but interfere with a person's ability to work. At very cold temperatures, the most serious concern is the risk of hypothermia or dangerous overcooling of the body. Another serious effect of cold exposure is frostbite or freezing of the exposed extremities such as fingers, toes, nose and ear lobes. Hypothermia could be fatal in absence of immediate medical attention. What are the warning signs of heat stroke and hypothermia? The victims of heat stroke and hypothermia are unable to notice the symptoms, and therefore, their survival depends on co-workers' ability to identify symptoms and to seek medical help. While symptoms can vary from person to person, the warning signs of heat stroke can include complaints of sudden and severe fatigue, nausea, dizziness, lightheadedness, and profuse and prolonged sweating. If a co-worker appears to be disorientated or confused (including euphoria), or has unaccountable irritability, malaise or flu-like symptoms, the worker should be moved to a cool location and seek medical advice. Warning signs of hypothermia can include complaints of nausea, fatigue, dizziness, irritability or euphoria. Workers can also experience pain in their extremities (hands, feet, ears, etc), and severe shivering. Workers should be moved to a heated shelter and seek medical advice when appropriate. Dehydration (hypo hydration) is the removal of water from an object. Medically, dehydration is a serious and potentially lifethreatening condition in which the body contains an insufficient volume of water for normal functioning. In humans, dehydration can be caused by a wide range of diseases and states that impair water homeostasis in the body. These include: •

External or stress-related causes o Prolonged physical activity without consuming adequate water, especially in a hot environment o Prolonged exposure to dry air, e.g., in high-flying airplanes (5-15% r.h.) Page 34

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o o o

Diarrhea Shock Vomiting

•

Infectious diseases o Cholera o Gastroenteritis o Shigellosis o Yellow fever

•

Malnutrition o Excessive consumption of alcohol o Fasting o Recent rapid weight loss may reflect progressive depletion of fluid volume. o Patient refusal of nutrition and hydration

Symptoms may include headaches similar to what is experienced during a hangover, a sudden episode of visual snow, decreased blood pressure (hypotension), and dizziness or fainting when standing up due to orthostatic hypotension. Untreated dehydration generally results in delirium, unconsciousness, and in extreme cases death. Dehydration symptoms generally become noticeable after 2% of one's normal water volume has been lost. Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin. Athletes may suffer a loss of performance of up to 50%, and experience flushing, low endurance, rapid heart rates, elevated body temperatures, and rapid onset of fatigue. Symptoms of mild dehydration include thirst, decreased urine volume, urine that is darker than usual, unexplained tiredness, lack of tears when crying, headache, dry mouth, and dizziness when standing due to orthostatic hypotension. In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include lethargy or extreme sleepiness, seizures, sunken fontanel (soft spot) in infants, fainting, and sunken eyes. The symptoms become increasingly severe with greater water loss. One's heart and respiration rates begin to increase to compensate for decreased plasma volume and blood pressure, while body temperature may rise because of decreased sweating. Around 5% to 6% water loss, one may become groggy or sleepy, experience headaches or nausea, and may feel tingling in one's limbs (paresthesia). With 10% to 15% fluid loss, muscles may become spastic, skin may shrivel and wrinkle, vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal. The best treatment for minor dehydration is drinking water and stopping fluid loss. Water is preferable to sport drinks and other commercially-sold rehydration fluids, as the balance of electrolytes they provide may not match the replacement requirements of the individual. To stop fluid loss from vomiting and diarrhea, avoid solid foods and drink only clear liquids. Dehydration is best avoided by drinking plenty of water. The greater the amount of water lost through perspiration, the more water must be consumed to replace it and avoid dehydration. Since the body cannot tolerate large deficits or excesses in total body water, consumption of water must be roughly concurrent with the loss (in other words, if one is perspiring, one should also be drinking water frequently). Drinking water slightly beyond the needs of the body entails no risk, since the kidneys will efficiently remove any excess water through the urine with a large Page 35

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margin of safety. A person's body, during an average day in a temperate climate such as the United Kingdom, loses approximately 2.5 liters of water. This can be through the lungs as water vapor, through the skin as sweat, or through the kidneys as urine. Some water (a less significant amount, in the absence of diarrhea) is also lost through the bowels. In warm or humid weather or during heavy exertion, however, the water loss can increase by an order of magnitude or more through perspiration—all of which must be promptly replaced. In extreme cases, the losses may be great enough to exceed the body's ability to absorb water from the gastrointestinal tract; in these cases, it is not possible to drink enough water to stay hydrated, and the only way to avoid dehydration is to reduce perspiration (through rest, a move to a cooler environment, etc.). A useful rule of thumb for avoiding dehydration in hot or humid environments or during strenuous activity involves monitoring the frequency and character of urination. If one develops a full bladder at least every 3-5 hours and the urine is only lightly colored or colorless, chances are that dehydration is not occurring; if urine is deeply colored, or urination occurs only after many hours or not at all, water intake may not be adequate to maintain proper hydration. When large amounts of water are being lost through perspiration and concurrently replaced by drinking, maintaining proper electrolyte balance becomes an issue. Drinking fluids that are hypertonic or hypotonic with respect to perspiration may have grave consequences (hyponatremia or hypernatremia, principally) as the total volume of water turnover increases. If water is being lost through an abnormal mechanisms such as vomiting or diarrhea, that carry away electrolytes in large quantities, an imbalance can develop very quickly into a medical emergency. In fact, the main mechanisms through which diseases such as infantile diarrhea and cholera kill their victims are dehydration and loss of electrolytes.

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Appendix 5 Slips, trips and falls Why is prevention of slips, trips and falls important? In Canada some sixty thousand workers get injured annually due to fall accidents. This number represents about fifteen percent of the "time-loss injuries" that were accepted by workers' compensation boards or commissions across Canada. Not mentioning a great economical loss, it amounts for a lot of pain and suffering and sometimes (much too often) even death. All these, in most of cases, do not have to happen. What is needed is: • • •

understanding how fall accidents happen, identifying the trouble areas, and eliminating or minimizing hazards of falling.

How do falls happen? Statistics show that the majority (60 percent) of falls happen on the same level resulting from slips and trips. The remaining 40 percent are falls from a height. This document will summarize information on "falls on the same level" (slips and trips). Falls from an elevation, such as falls from ladders, roofs, down stairs or from jumping to a lower level, etc., will discussed in another document since each type of fall requires different features in a fall prevention program. Slips Slips happen where there is too little friction or traction between the footwear and the walking surface. Common causes of slips are: • • • • •

wet or oily surfaces, occasional spills, weather hazards, loose, unanchored rugs or mats, and flooring or other walking surfaces that do not have same degree of traction in all areas.

Trips Trips happen when your foot collides (strikes, hits) an object causing you to lose the balance and, eventually fall. Common causes of tripping are: • • • • • • •

obstructed view, poor lighting, clutter in your way, wrinkled carpeting, uncovered cables, bottom drawers not being closed, and uneven (steps, thresholds) walking surfaces.

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How to prevent falls due to slips and trips? Both slips and trips result from some a kind of unintended or unexpected change in the contact between the feet and the ground or walking surface. This shows that good housekeeping, quality of walking surfaces (flooring), selection of proper footwear, and appropriate pace of walking are critical for preventing fall accidents. Housekeeping Good housekeeping is the first and the most important (fundamental) level of preventing falls due to slips and trips. It includes: • • • • • • • • •

cleaning all spills immediately, marking spills and wet areas, mopping or sweeping debris from floors, removing obstacles from walkways and always keeping them free of clutter, securing (tacking, taping, etc.) mats, rugs and carpets that do not lay flat, always closing file cabinet or storage drawers, covering cables that cross walkways, keeping working areas and walkways well lit, replacing used light bulbs and faulty switches.

Without good housekeeping practices, any other preventive measures such as installation of sophisticated flooring, specialty footwear or training on techniques of walking and safe falling will never be fully effective. Flooring Changing or modifying walking surfaces is the next level of preventing slip and trips. Recoating or replacing floors, installing mats, pressure-sensitive abrasive strips or abrasive-filled paint-on coating and metal or synthetic decking can further improve safety and reduce risk of falling. However, it is critical to remember that high-tech flooring requires good housekeeping as much as any other flooring. In addition, resilient, non-slippery flooring prevents or reduces foot fatigue and contributes to slip prevention measures. Footwear In workplaces where floors may be oily or wet or where workers spend considerable time outdoors, prevention of fall accidents should focus on selecting proper footwear. Since there is no footwear with anti-slip properties for every condition, consultation with manufacturers' is highly recommended. Properly fitting footwear increases comfort and prevents fatigue which, in turn, improves safety for the employee. For more information on footwear visit our web-page Foot safety. What can you do to avoid falling at work? It is important remembering that safety is everybody business. However, it is employers' responsibility to provide safe work environment for all employees. Employees can improve their own safety too.

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You can reduce the risk of slipping on wet flooring by: • • • •

taking your time and paying attention to where you are going, adjusting your stride to a pace that is suitable for the walking surface and the tasks you are doing, walking with the feet pointed slightly outward, and making wide turns at corners.

You can reduce the risk of tripping by: • • •

always using installed light sources that provide sufficient light for your tasks or, using a flashlight if you enter a dark room where there is no light, and ensuring that things you are carrying or pushing do not prevent you from seeing any obstructions, spills, etc.

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Appendix 6 Stress Can "workplace stress" be defined? We hear a lot about stress, but what is it? Taber's Cyclopedic Medical Dictionary defines stress as "the result produced when a structure, system or organism is acted upon by forces that disrupt equilibrium or produce strain". In simpler terms, stress is the result of any emotional, physical, social, economic, or other factors that require a response or change. It is generally believed that some stress is okay (sometimes referred to as "challenge"or "positive stress") but when stress occurs in amounts that you cannot handle, both mental and physical changes may occur. "Workplace stress" then is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands. In general, the combination of high demands in a job and a low amount of control over the situation can lead to stress. Stress in the workplace can have many origins or come from one single event. It can impact on both employees and employers alike. As stated by the Canadian Mental Health Association: Fear of job redundancy, layoffs due to an uncertain economy, increased demands for overtime due to staff cutbacks act as negative stressors. Employees who start to feel the "pressure to perform" can get caught in a downward spiral of increasing effort to meet rising expectations with no increase in job satisfaction. The relentless requirement to work at optimum performance takes its toll in job dissatisfaction, employee turnover, reduced efficiency, illness and even death. Absenteeism, illness, alcoholism, "petty internal politics", bad or snap decisions, indifference and apathy, lack of motivation or creativity are all by-products of an over stressed workplace. I have heard stress can be both good and bad. Is this true? Some stress is normal. In fact, it is often what provides us with the energy and motivation to meet our daily challenges both at home and at the workplace. Stress in these situations is the kind that helps you "rise" to a challenge and meet your goals such as deadlines, sales or production targets, or finding new clients. Some people would not consider this challenge a type of stress because, having met the challenge, we are satisfied and happy. However, as with most things, too much stress can have negative impacts. When the feeling of satisfaction turns into exhaustion, frustration or dissatisfaction, or when the challenges at work become too demanding, we begin to see negative signs of stress. What are examples of things that cause stress at the workplace?

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In the workplace, stress can be the result of any number of situations. Some examples include: Categories of Job Stressors Factors unique to the job

Role in the organization

Career development

Relationships at work (Interpersonal)

Organizational structure/climate

Examples

• • •

workload (overload and underload)

• • •

shiftwork / hours of work

• • •

role conflict (conflicting job demands, multiple supervisors/managers)

• • • •

under/over-promotion

• • • •

supervisors

• • •

participation (or non-participation) in decision-making

pace / variety / meaningfulness of work autonomy (e.g., the ability to make your own decisions about our own job or about specific tasks) physical environment (noise, air quality, etc) isolation at the workplace (emotional or working alone)

role ambiguity (lack of clarity about responsibilities, expectations, etc) level of responsibility

job security (fear of redundancy either from economy, or a lack of tasks or work to do) career development opportunities overall job satisfaction

coworkers subordinates threat of violence, harassment, etc (threats to personal safety)

management style communication patterns

(Adapted from: Murphy, L. R., Occupational Stress Management: Current Status and Future Direction. in Trends in Organizational Behavior, 1995, Vol. 2., p. 1-14) Can stress really cause health effects? Yes, stress can have an impact on your overall health. Our bodies are designed, preprogrammed if you wish, with a set of automatic responses to deal with stress. This system is very effective for the short term "fight or flight" responses we need when faced with an immediate danger. The problem is that our bodies deal with all types of stress in the same way. Experiencing stress for long periods of time (such as lower level but constant stressors at work) will activate this system, but it doesn't get the chance to "turn off". The body's "pre-programmed" response to stress has been called the "Generalized Stress Response" and includes: • • • • • •

increased blood pressure increased metabolism (e.g., faster heartbeat, faster respiration) decrease in protein synthesis, intestinal movement (digestion), immune and allergic response systems increased cholesterol and fatty acids in blood for energy production systems localized inflammation (redness, swelling, heat and pain) faster blood clotting Page 41

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• •

increased production of blood sugar for energy increased stomach acids

(From the Basic Certification Training Program: Participant's Manual, Copyright© 1999 by the Workplace Safety and Insurance Board of Ontario). Luckily, there are usually a number of warning signs that help indicate when you are having trouble coping with stress before any severe signs become apparent. These signs are listed below. How do I know if someone is (or if I am) having trouble coping with stress? There are many different signs and symptoms that can indicate when someone is having difficulty coping with the amount of stress they are experiencing: Physical: headaches, grinding teeth, clenched jaws, chest pain, shortness of breath, pounding heart, high blood pressure, muscle aches, indigestion, constipation or diarrhea, increased perspiration, fatigue, insomnia, frequent illness Psychosocial: anxiety, irritability, sadness, defensiveness, anger, mood swings, hypersensitivity, apathy, depression, slowed thinking or racing thoughts; feelings of helplessness, hopelessness, or of being trapped Behavioral: overeating or loss of appetite, impatience, quickness to argue, procrastination, increased use of alcohol or drugs, increased smoking, withdrawal or isolation from others, neglect of responsibility, poor job performance, poor personal hygiene, change in religious practices, change in close family relationships Do all of these signs or symptoms happen all at once and what level of help should be sought? No, not normally. The signs and symptoms from stress tend to progress through several phases or stages. The phases can be described as below: Phase Phase 1 - Warning Early warning signs are often more emotional than physical and may take a year or more before they are noticeable.

Phase 2 - Mild Symptoms Warning signs have progressed and intensified. Over a period of 6 to 18 months, physical signs may also be evident.

Phase 3 - Entrenched Cumulative Stress

Signs/Symptoms

• • • • •

feelings of vague anxiety

• • •

talking about feelings

emotional fatigue

•

taking time for yourself

• • • •

sleep disturbances

•

more aggressive lifestyle changes may be needed.

•

short-term counseling

• • •

withdrawal from contact with others

•

increased use of alcohol, smoking,

depression boredom apathy

more frequent headaches/colds muscle aches intensified physical and emotional fatigue

taking a vacation making a change from regular activities

irritability intensified depression

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Action

The help of medical and psychological professionals is

non-prescription drugs This phase occurs when the above phases continue to be ignored. Stress starts to create a deeper impact on career, family life and personal well-being.

Phase 4 - Severe/ Debilitating Cumulative Stress Reaction This phase is often considered "selfdestructive" and tends to occur after 5 to10 years of continued stress.

• • • • • • • • • • •

depression

• • • • • • • • • • • • • • • • •

careers end prematurely

highly recommended.

physical and emotional fatigue loss of sex drive ulcers marital discord crying spells intense anxiety rigid thinking withdrawal restlessness sleeplessness

asthma

Significant intervention from professionals.

heart conditions severe depression lowered self-esteem/self-confidence inability to perform one's job inability to manage personal life withdrawal uncontrolled anger, grief, rage suicidal or homicidal thinking muscle tremors extreme chronic fatigue over-reaction to minor events agitation frequent accidents carelessness, forgetfulness paranoia

(From: Anschuetz, B.L. "The High Cost of Caring: Coping with Workplace Stress" in Sharing: Epilepsy Ontario. Posted 29 November 1999) What are some general tips for dealing with stress at the workplace? Since the causes of workplace stress vary greatly, so do the strategies to reduce or prevent it. Where stress in the workplace is caused, for example, by a physical agent, it is best to control it at its source. If the workplace is too loud, control measures to deal with the noise should be implemented where ever possible. If you are experiencing pain from repetitive strain, workstations can be re-designed to reduce repetitive and strenuous movements. More detailed information and suggestions are located in the many other documents in OSH Answers (such as noise, ergonomics, or violence in the workplace, etc.) or by asking the Inquiries Service. Job design is also an important factor. Good job design accommodates an employee's mental and physical abilities. In general, the following job design guidelines will help minimize or control workplace stress: •

the job should be reasonably demanding (but not based on "sheer endurance") and provide the employee with at least a minimum of variety in job tasks

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• • • •

the employee should be able to learn on the job and be allowed to continue to learn as their career progresses the job should comprise some area of decision-making that the individual can call his or her own. there should be some degree of social support and recognition in the workplace the employee should feel that the job leads to some sort of desirable future

Is there anything I can do to help myself deal with the stress I am experiencing? In many cases, the origin of the stress is something that cannot be changed immediately. Therefore, finding ways to help maintain good mental health is essential. There are many ways to be proactive in dealing with stress. In the workplace, you might try some of the following as suggested by the Canadian Mental Health Association: Laughing is one of the easiest and best ways to reduce stress. Share a joke with a co-worker, watch a funny movie at home with some friends, read the comics, and try to see the humour in the situation. Learn to relax, take several deep breaths throughout the day, or have regular stretch breaks. Stretching is simple enough to do anywhere and only takes a few seconds. Take charge of your situation by taking 10 minutes at the beginning of each day to priorize and organize your day. Be honest with your colleagues, but be constructive and make practical suggestions. Be realistic about what you can change. (From: Canadian Mental Health Association, "Sources of Workplace Stress" Richmond, British Columbia) What else can I do to improve my overall mental health? Ten general tips for mental health include: 1.

build confidence

identify your abilities and weaknesses together, accept them build on them and do the best with what you have

2.

eat right, keep fit

a balanced diet, exercise and rest can help you to reduce stress and enjoy life.

3.

make time for family and friends

these relationships need to be nurtured; if taken for granted they will not be there to share life's joys and sorrows.

4.

give and accept support

friends and family relationships thrive when they are "put to the test"

5.

create a meaningful budget

financial problems cause stress. Over-spending on our "wants" instead of our "needs" is often the culprit.

6.

volunteer

being involved in community gives a sense of purpose and satisfaction that paid work cannot.

7.

manage stress

we all have stressors in our lives but learning how to deal with them when they threaten to overwhelm us will maintain our mental health.

8.

find strength in numbers

sharing a problem with others have had similar experiences may help you find a solution and will make you feel less isolated.

9.

identify and deal with moods

we all need to find safe and constructive ways to express our feelings of anger, sadness, joy and fear.

10.

learn to be at peace with yourself

get to know who you are, what makes you really happy, and learn to balance what you can and cannot change about yourself.

(From: Canadian Mental Health Association - National Office. Home Page located at: http://www.cmha.ca/ ) Page 44

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Appendix 7 Working Alone What is meant by 'working alone'? A person is alone at work when they are on their own; when they cannot be seen or heard by another person; and when they cannot expect a visit from another worker. It is important to consider all situations carefully. Working alone includes all employees who may go for a period of time where they do not have direct contact with a co-worker. For example, the receptionist in a large office building may be considered a "lone" worker. Alternatively, a construction worker who is doing work in a bathroom or other location that cannot be seen by co-workers may also be considered a lone worker. Other examples are gas station attendants, convenience store clerks, food outlet employees, taxi drivers, home care employees, social service workers, security guards or custodians. Is working alone a problem? While it is not always hazardous to work alone, it can be when other circumstances are present. Whether a situation is a high or low risk will depend on the location, type of work, interaction with the public, or the consequences of an emergency, accident, injury, etc. This wide variety of circumstances makes it important to assess each situation individually. What are examples of high risk activities? High risk activities can involve risks from a variety of sources such as those below: • • • • • • •

at heights, in confined spaces (such as tanks, grain bins or elevators, culverts, etc.), with electricity, with hazardous substances or materials, with hazardous equipment such as chainsaws or firearms, with materials at great pressure, or, with the public, where there is a potential for violence.

What can be done to help a lone worker stay safe? Check the regulations in your area. Some jurisdictions have specific laws concerning working alone. There are many steps that can be taken to help ensure the safety of the lone worker: • • • • • •

Assess the hazards of your workplace. Talk to employees about their work. Get their input about the work they do and possible solutions. Investigate incidents at your workplace, and those from similar workplaces. Avoid having a lone work whenever possible, especially for jobs with a recognized risk. Take corrective action to prevent or minimize the potential risks of working alone. Provide appropriate training and education.

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• • •

Report all situations, incidents or 'near misses' where being alone increased the severity of the situation. Analyze this information and make changes to company policy where necessary. Establish a check-in procedure. Make sure that regular contact is kept with all employees. Establish ways to account for people (visually or verbally) while they are working. Schedule higher risk tasks to be done during normal business hours, or when another worker capable of helping in an emergency is present.

What is an example of a check-in procedure? It is important that a check-in procedure be in place. Decide if a verbal check-in is adequate, or if the employee must be accounted for by a visual check. Make sure your plan is appropriate for both regular business hours as well as after main office hours. For most lone workers, the telephone will be the main source of contact. If you work at a desk or station, have a telephone close by. If you are away from a main office or work station, the use of a cell phone is very helpful. If a cell phone is unreliable in your area, be sure to have alternative methods of communication available (such as use of public telephones, site visits or satellite technology). When travelling out of the office, the main contact person should know the following details: • • • • • •

destination, estimated time of arrival, return time or date, contact information, mode of travel (public transit, car, plane, etc.) and, alternate plans in the event of bad weather, traffic problems, etc.

An example of a check-in procedure is: • • • • • • •

Prepare a daily work plan so it is known where the lone employee will be and when. Identify one main person to be the contact at the office, plus a back up. Define under what circumstances the lone employee will check in and how often. Stick to the visual check or call-in schedule. You may wish to have a written log of contact. Have the contact person call or visit the lone employee periodically to make sure he or she is okay. Pick out a code word to be used to identify or confirm that help is needed. Develop an emergency action plan to be followed if the lone employee does not check-in when he or she is supposed to.

What are some factors to consider when assessing the workplace or situations? The following are some points to consider. Each circumstance will be different, so be sure to adapt the questions to suit your situation. Length of time the person will be working alone: • • •

What is a reasonable length of time for the person to be alone? Is it reasonable for the person to be alone at all? How long will the person be alone to finish the job? Page 46

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• •

Is it legal for the person to be alone while doing certain activities? (For example: some jurisdictions may restrict working alone in a confined space, or during lock-out / tag-out operations). What time of the day will the person be alone?

Communication: • • • •

What forms of communication are available? Is it necessary to "see" the person, or is voice communication adequate? Will emergency communication systems work properly in all situations? If the communication systems are located in a vehicle, do you need alternative arrangements to cover the person when they are away from the vehicle?

Location of the work: • • • • • • •

Is the work in a remote or isolated location? (Remember that a remote location does not have to be far away. Storage rooms that are rarely used can be considered remote or isolated.) Is transportation necessary to get there? What kind of transportation is needed? Is the vehicle equipped with emergency supplies such as food and drinking water, as well as a first aid kit? Will the person need to carry some or all of the emergency supplies with them when they leave the vehicle? Does the person need training to be able to use the first aid equipment? What are the consequences if the vehicle breaks down? Will the person have to leave the vehicle for long periods of time?

Type or nature of work: • • • • • • • • • •

Is there adequate training and education provided for the person to be able to work alone safely? Is there adequate personal protective equipment available? Is it in good working order? What machinery, tools or equipment will be used? Is there a high risk activity involved? Is fatigue likely to be a factor? Are there extremes of temperature? Is there risk of an animal attack, insect bite (poisonous, or allergic reaction), etc.? If the person is working inside a locked building, how will emergency services be able to get in? (For example: a night cleaner in a secure office building) Does the work involve working with money or other valuables? Does the work involve seizing property or goods (such as repossession, recovering stolen property, etc)?

Characteristics required by the individual who is working alone • •

Are there any pre-existing medical conditions that may increase the risk? Does the person have adequate levels of experience and training? (For example: first aid, communication systems repair, vehicle breakdowns, relevant administrative procedures, and/or outdoor survival?)

(questions adapted from: WorkSafe Western Australia Commission, 1999. "Working Alone: Guidance Note")

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Appendix 8 Washing hands Is it important to wash your hands? Simply put, yes. Hand washing is the single most effective way to prevent the spread of infections. You can spread certain "germs" (a general term for microbes like viruses and bacteria) casually by touching another person. You can also catch germs when you touch contaminated objects or surfaces and then you touch your face (mouth, eyes, and nose). "Good" hand washing techniques include using an adequate amount of soap, rubbing the hands together to create friction, and rinsing under running water. The use of gloves is not a substitute for hand washing. Please note: In some workplaces, universal precautions should be followed when workers are exposed to blood and certain other body fluids. Please see the OSH Answers document Universal Precautions for more complete information. When should I wash my hands? Different situations where people can pick up "germs" include: • • • • • • • •

when hands are visibly soiled, after using the washroom (includes changing diapers), after blowing your nose or after sneezing in your hands, before and after eating, handling food, drinking or smoking, after touching raw meat, poultry, or fish, after handling garbage, visiting or caring for sick people, handling pets, animals or animal waste.

Ensuring that employees wash their hands properly after using the washroom is very important in reducing disease transmission of stomach "flus" (which really is not a "flu" or influenza) and other gastrointestinal infections. Using soap and lathering up is very important (rinsing hands in water only is not as effective). Use comfortably warm, running water. Hands should be washed for a minimum of 10 seconds - longer if the hands are visibly soiled. To help people (especially children) wash long enough, one option may be to sing a short song such as "Happy Birthday". The idea of surgeons scrubbing for an operation (as on TV) is very similar. How do I properly wash my hands? For effective hand washing, follow these steps: • • • • • • •

remove any rings or other jewelry, use warm water and wet your hands thoroughly, use soap (1-3 mL) and lather very well, scrub your hands, between your fingers, wrists, and forearms with soap for 10 seconds, scrub under your nails, rinse thoroughly, turn off the taps/faucets with a paper towel, Page 48

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• •

dry your hands with a single use towel or air dryer, protect your hands from touching dirty surfaces as you leave the bathroom.

Other tips include: • • • • •

Cover cuts with bandages and wear gloves for added protection (cuts are very vulnerable to infections). Artificial nails and chipped nail polish have been associated with an increase in the number of bacteria on the fingernails. Be sure to clean the nails properly. Keep your hands away from your eyes, nose or mouth. Assume that contact with any human body fluids is infectious. Liquid soap in disposable containers is best. If using reusable containers, they should be washed and dried before refilling. If using a bar of soap, be sure to set it on a rack that allows water to drain or use small bars that can be changed frequently.

When there is no soap or water available, one alternative is to use waterless hand scrubs. Some of these products are made of ethyl alcohol mixed with emollients (skin softeners) and other agents. They are often available as a rinse, or on wipes or towelettes. They can be used by paramedics, home care attendants, or other mobile workers where hand washing facilities are not available. However, these agents are not effective when the hands are heavily contaminated with dirt, blood, or other organic materials. In addition, waterless hand scrubs may have a drying effect on the skin and may have odours which may be irritating to some users.

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Appendix 9 Reporting hazards What should I do if I notice a hazard? You should report it immediately to your supervisor. You do not need to wait for an inspection team to come by. In fact, health and safety legislation requires employees to report hazards to their supervisor. The immediate hazard reporting process allows employees to report hazardous conditions or practices as they notice them. This procedure allows for prompt reporting and subsequent corrective action without waiting for the next round of regular inspections. Hazards can be reported verbally or by filling a simple form available at bulletin boards or other conspicuous places. The following is an example of such a form. Hazard Report Form - Example Name:

Date:

Location: Equipment: Description of the hazard:

Suggested corrective action:

Signature: Supervisor's remarks:

Corrective action taken:

Signature of Supervisor:

Date:

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Appendix 10 Workplace housekeeping Why should we pay attention to housekeeping at work? Effective housekeeping can eliminate some workplace hazards and help get a job done safely and properly. Poor housekeeping can frequently contribute to accidents by hiding hazards that cause injuries. If the sight of paper, debris, clutter and spills is accepted as normal, then other more serious health and safety hazards may be taken for granted. Housekeeping is not just cleanliness. It includes keeping work areas neat and orderly; maintaining halls and floors free of slip and trip hazards; and removing of waste materials (e.g., paper, cardboard) and other fire hazards from work areas. It also requires paying attention to important details such as the layout of the whole workplace, aisle marking, the adequacy of storage facilities, and maintenance. Good housekeeping is also a basic part of accident and fire prevention. Effective housekeeping is an ongoing operation: it is not a hit-and-miss cleanup done occasionally. Periodic "panic" cleanups are costly and ineffective in reducing accidents. What is the purpose of workplace housekeeping? Poor housekeeping can be a cause of accidents, such as: • • • • •

tripping over loose objects on floors, stairs and platforms being hit by falling objects slipping on greasy, wet or dirty surfaces striking against projecting, poorly stacked items or misplaced material cutting, puncturing, or tearing the skin of hands or other parts of the body on projecting nails, wire or steel strapping

To avoid these hazards, a workplace must "maintain" order throughout a workday. Although this effort requires a great deal of management and planning, the benefits are many. What are some benefits of good housekeeping practices? Effective housekeeping results in: • • • • • • • • • • •

reduced handling to ease the flow of materials fewer tripping and slipping accidents in clutter-free and spill-free work areas decreased fire hazards lower worker exposures to hazardous substances better control of tools and materials more efficient equipment cleanup and maintenance better hygienic conditions leading to improved health more effective use of space reduced property damage by improving preventive maintenance less janitorial work improved morale

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How do I plan a good housekeeping program? A good housekeeping program plans and manages the orderly storage and movement of materials from point of entry to exit. It includes a material flow plan to ensure minimal handling. The plan also ensures that work areas are not used as storage areas by having workers move materials to and from work areas as needed. Part of the plan could include investing in extra bins and more frequent disposal. Worker training is an essential part of any good housekeeping program. Workers need to know how to work safely with the products they use. They also need to know how to protect other workers such as by posting signs (e.g., "Wet - Slippery Floor") and reporting any unusual conditions. Housekeeping order is "maintained" not "achieved." This means removing the inevitable messes that occur from time to time and not waiting until the end of the shift to reorganize and clean up. Integrating housekeeping into jobs can help ensure this is done. A good housekeeping program identifies and assigns responsibilities for the following: • • • • •

clean up during the shift day-to-day cleanup waste disposal removal of unused materials inspection to ensure cleanup is complete

Do not forget out-of-the-way places such as shelves, basements, sheds, and boiler rooms that would otherwise be overlooked. The orderly arrangement of operations, tools, equipment and supplies is an important part of a good housekeeping program. The final addition to any housekeeping program is inspection. It is the only way to check for deficiencies in the program so that changes can be made. The documents on workplace inspection checklists provide a general guide and examples of checklists for inspecting offices and manufacturing facilities. What are the elements of an effective housekeeping program? Dust and Dirt Removal In some jobs, enclosures and exhaust ventilation systems may fail to collect dust, dirt and chips adequately. Vacuum cleaners are suitable for removing light dust and dirt. Industrial models have special fittings for cleaning walls, ceilings, ledges, machinery, and other hard-to-reach places where dust and dirt may accumulate. Dampening floors or using sweeping compounds before sweeping reduces the amount of airborne dust. The dust and grime that collect in places like shelves, piping, conduits, light fixtures, reflectors, windows, cupboards and lockers may require manual cleaning. Special-purpose vacuums are useful for removing hazardous substances. For example, vacuum cleaners fitted with HEPA (high efficiency particulate air) filters may be used to capture fine particles of asbestos or fibreglass. Compressed air should not be used for removing dust, dirt or chips from equipment or work surfaces.

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Employee Facilities Employee facilities need to be adequate, clean and well maintained. Lockers are necessary for storing employees' personal belongings. Washroom facilities require cleaning once or more each shift. They also need to have a good supply of soap, towels plus disinfectants, if needed. If workers are using hazardous materials, employee facilities should provide special precautions such as showers, washing facilities and change rooms. Some facilities may require two locker rooms with showers between. Using such double locker rooms allows workers to shower off workplace contaminants and prevents them from contaminating their "street clothes" by keeping their work clothes separated from the clothing that they wear home. Smoking, eating or drinking in the work area should be prohibited where toxic materials are handled. The eating area should be separate from the work area and should be cleaned properly each shift. Surfaces Floors: Poor floor conditions are a leading cause of accidents so cleaning up spilled oil and other liquids at once is important. Allowing chips, shavings and dust to accumulate can also cause accidents. Trapping chips, shavings and dust before they reach the floor or cleaning them up regularly can prevent their accumulation. Areas that cannot be cleaned continuously, such as entrance ways, should have anti-slip flooring. Keeping floors in good order also means replacing any worn, ripped, or damaged flooring that poses a tripping hazard. Walls: Light-coloured walls reflect light while dirty or dark-coloured walls absorb light. Contrasting colours warn of physical hazards and mark obstructions such as pillars. Paint can highlight railings, guards and other safety equipment, but should never be used as a substitute for guarding. The program should outline the regulations and standards for colours. Maintain Light Fixtures Dirty light fixtures reduce essential light levels. Clean light fixtures can improve lighting efficiency significantly. Aisles and Stairways Aisles should be wide enough to accommodate people and vehicles comfortably and safely. Aisle space allows for the movement of people, products and materials. Warning signs and mirrors can improve sight-lines in blind corners. Arranging aisles properly encourages people to use them so that they do not take shortcuts through hazardous areas. Keeping aisles and stairways clear is important. They should not be used for temporary "overflow" or "bottleneck" storage. Stairways and aisles also require adequate lighting. Spill Control The best way to control spills is to stop them before they happen. Regularly cleaning and maintaining machines and equipment is one way. Another is to use drip pans and guards where possible spills might occur. When spills do occur, it is important to clean them up immediately. Absorbent materials are useful for wiping up greasy, oily or other liquid spills. Used absorbents must be disposed of properly and safely. Page 53

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Tools and Equipment Tool housekeeping is very important, whether in the tool room, on the rack, in the yard, or on the bench. Tools require suitable fixtures with marked locations to provide orderly arrangement, both in the tool room and near the work bench. Returning them promptly after use reduces the chance of being misplaced or lost. Workers should regularly inspect, clean and repair all tools and take any damaged or worn tools out of service. Maintenance The maintenance of buildings and equipment may be the most important element of good housekeeping. Maintenance involves keeping buildings, equipment and machinery in safe, efficient working order and in good repair. This includes maintaining sanitary facilities and regularly painting and cleaning walls. Broken windows, damaged doors, defective plumbing and broken floor surfaces can make a workplace look neglected; these conditions can cause accidents and affect work practices. So it is important to replace or fix broken or damaged items as quickly as possible. A good maintenance program provides for the inspection, maintenance, upkeep and repair of tools, equipment, machines and processes. Waste Disposal The regular collection, grading and sorting of scrap contribute to good housekeeping practices. It also makes it possible to separate materials that can be recycled from those going to waste disposal facilities. Allowing material to build up on the floor wastes time and energy since additional time is required for cleaning it up. Placing scrap containers near where the waste is produced encourages orderly waste disposal and makes collection easier. All waste receptacles should be clearly labelled (e.g., recyclable glass, plastic, scrap metal, etc.). Storage Good organization of stored materials is essential for overcoming material storage problems whether on a temporary or permanent basis. There will also be fewer strain injuries if the amount of handling is reduced, especially if less manual materials handling is required. The location of the stockpiles should not interfere with work but they should still be readily available when required. Stored materials should allow at least one metre (or about three feet) of clear space under sprinkler heads. Stacking cartons and drums on a firm foundation and cross tying them, where necessary, reduces the chance of their movement. Stored materials should not obstruct aisles, stairs, exits, fire equipment, emergency eyewash fountains, emergency showers, or first aid stations. All storage areas should be clearly marked. Flammable, combustible, toxic and other hazardous materials should be stored in approved containers in designated areas that are appropriate for the different hazards that they pose. Storage of materials should meet all requirements specified in the fire codes and the regulations of environmental and occupational health and safety agencies in your jurisdiction.

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Appendix 11 Noise hazards What are sound and noise? Sound is what we hear. Noise is unwanted sound. The difference between sound and noise depends upon the listener and the circumstances. Rock music can be pleasurable sound to one person and an annoying noise to another. In either case, it can be hazardous to a person's hearing if the sound is loud and if he or she is exposed long and often enough. Sound is produced by vibrating objects and reaches the listener's ears as waves in the air or other media. When an object vibrates, it causes slight changes in air pressure. These air pressure changes travel as waves through the air and produce sound. To illustrate, imagine striking a drum surface with a stick. The drum surface vibrates back and forth. As it moves forward, it pushes the air in contact with the surface. This creates a positive (higher) pressure by compressing the air. When the surface moves in the opposite direction, it creates a negative (lower) pressure by decompressing the air. Thus, as the drum surface vibrates, it creates alternating regions of higher and lower air pressure. These pressure variations travel through the air as sound waves (Figure 1).

Figure 1

The hearing mechanism of the ear senses the sound waves and converts them into information which it relays to the brain. The brain interprets the information as sound. Even very loud sounds produce pressure fluctuations which are extremely small (1 in 10,000) compared to ambient air pressure (i.e., atmospheric pressure). The hearing mechanism in the ear is sensitive enough to detect even small pressure waves. It is also very delicate: this is why loud sound may damage hearing.

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Why is noise an important workplace hazard? Noise is one of the most common occupational health hazards. In heavy industrial and manufacturing environments, as well as in farms, cafeterias, permanent hearing loss is the main health concern. Annoyance, stress and interference with speech communication is the main concern in noisy offices, schools and computer rooms. To prevent adverse outcomes of noise exposure, noise levels should be reduced to acceptable levels. The best method of noise reduction is to use engineering modifications to the noise source itself, or to the workplace environment. Where technology cannot adequately control the problem, personal hearing protection (such as ear muffs or plugs) can be used. Personal protection, however, should be considered as an interim measure while other means of reducing workplace noise are being explored and implemented. As a first step in dealing with noise, workplaces need to identify areas or operations where excessive exposure to noise occurs. How can I tell if my workplace is too loud? If you answer yes to any of the following questions, the workplace may have a noise problem. • • • •

Do people have to raise their voices? Do people who work in noisy environments have ringing in their ears at the end of a shift? Do they find when they return home from work that they have to increase the volume on their car radio higher than they did when they went to work? Does a person who has worked in a noisy workplace for years have problems understanding conversations at parties or restaurants, or in crowds where there are many voices and "competing" noises?

If there is a noise problem in a workplace, then a noise assessment or survey should be undertaken to determine the sources of noise, the amount of noise, who is exposed and for how long. What is a sound pressure level? Sound pressure converted to the decibel scale is called sound pressure level gives a detailed explanation of decibels and sound pressure levels. Figure 2 compares sound pressures in pascals and sound pressure levels in decibels (dB). The zero of the decibel scale (0 dB) is the sound pressure of 0.00002 Pa. This means that 0.00002 Pa is the reference sound pressure to which all other sound pressures are compared on the dB scale. This is the reason the decibels of sound are often indicated as dB re 0.00002 Pa.

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What kinds of noise are there? Noise can be continuous, variable, intermittent or impulsive depending on how it changes over time. Continuous noise is noise which remains constant and stable over a given time period. The noise of boilers in a power house is relatively constant and can therefore be classified as continuous. Most manufacturing noise is variable or intermittent. Different operations or different noise sources cause the sound changes over time. Noise is intermittent if there is a mix of relatively quiet periods and noisy. Impulse or impact noise is a very short burst of loud noise which lasts for less than one second. Gun fire or the noise produced by punch presses are examples of such noise.

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Appendix 12 Electrical Safety Why is it so important to work safely with or near electricity? The electrical current in regular businesses and homes has enough power to cause death by electrocution. Even changing a light bulb without unplugging the lamp can be hazardous because coming in contact with the "hot" or live part of the socket could kill a person. What kinds of injuries result from electrical currents? There are four main types of injuries: electrocution (fatal), electric shock, burns, and falls. These injuries can happen in various ways: • • •

•

direct contact with the electrical energy. when the electricity arcs (jumps) through a gas (such as air) to a person who is grounded (that would provide an alternative route to the ground for the electricity). thermal burns including flash burns from heat generated by an electric arc, and flame burns from materials that catch on fire from heating or ignition by electrical currents. High voltage contact burns can burn internal tissues while leaving only very small injuries on the outside of the skin. muscle contractions, or a startle reaction, can cause a person to fall from a ladder, scaffold or aerial bucket. The fall can cause serious injuries

What are some general safety tips for working with or near electricity? • • • • • • • • • • • • • •

Inspect tools, power cords, and electrical fittings for damage or wear prior to each use. Repair or replace damaged equipment immediately. Always tape cords to walls or floors when necessary. Nails and staples can damage cords causing fire and shock hazards. Use cords or equipment that is rated for the level of amperage or wattage that you are using. Always use the correct size fuse. Replacing a fuse with one of a larger size can cause excessive currents in the wiring and possibly start a fire. Be aware that unusually warm or hot outlets may be a sign that unsafe wiring conditions exists. Unplug any cords to these outlets and do not use until a qualified electrician has checked the wiring. Always use ladders made of wood or other non-conductive materials when working with or near electricity or power lines. Place halogen lights away from combustible materials such as cloths or curtains. Halogen lamps can become very hot and may be a fire hazard. Risk of electric shock is greater in areas that are wet or damp. Install Ground Fault Circuit Interrupters (GFCIs) as they will interrupt the electrical circuit before a current sufficient to cause death or serious injury occurs. Make sure that exposed receptacle boxes are made of non-conductive materials. Know where the breakers and boxes are located in case of an emergency. Label all circuit breakers and fuse boxes clearly. Each switch should be positively identified as to which outlet or appliance it is for. Do not use outlets or cords that have exposed wiring. Do not use power tools with the guards removed. Do not block access to circuit breakers or fuse boxes.

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•

Do not touch a person or electrical apparatus in the event of an electrical accident. Always disconnect the current first.

What are some tips for working with power tools? • • • • • • • •

Switch tools OFF before connecting them to a power supply. Disconnect power supply before making adjustments. Ensure tools are properly grounded or double-insulated. The grounded tool must have an approved 3-wire cord with a 3-prong plug. This plug should be plugged in a properly grounded 3-pole outlet. Test all tools for effective grounding with a continuity tester or a ground fault circuit interrupter (GFCI) before use. Do not bypass the switch and operate the tools by connecting and disconnecting the power cord. Do not use electrical tools in wet conditions or damp locations unless tool is connected to a GFCI. Do not clean tools with flammable or toxic solvents. Do not operate tools in an area containing explosive vapours or gases.

What are some tips for working with power cords? • • • • • •

Keep power cords clear of tools during use. Suspend power cords over aisles or work areas to eliminate stumbling or tripping hazards. Replace open front plugs with dead front plugs. Dead front plugs are sealed and present less danger of shock or short circuit. Do not use light duty power cords. Do not carry electrical tools by the power cord. Do not tie power cords in tight knots. Knots can cause short circuits and shocks. Loop the cords or use a twist lock plug.

What is a Ground Fault Circuit Interrupter (GFCI)? A Ground Fault Circuit Interrupter (GFCI) works by detecting any loss of electrical current in a circuit. When a loss is detected, the GFCI turns the electricity off before severe injuries or electrocution can occur. A painful shock may occur during the time that it takes for the GFCI to cut off the electricity so it is important to use the GFCI as an extra protective measure rather than a replacement for safe work practices. GFCI wall outlets can be installed in place of standard outlets to protect against electrocution for just that outlet, or a series of outlets in the same branch. A GFCI Circuit Breaker can be installed on some circuit breaker electrical panels to protect an entire branch circuit. Plug-in GFCIs can be plugged into wall outlets where appliances will be used.

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What is a sample checklist for basic electrical safety? Inspect Cords and Plugs •

Check power cords and plugs daily. Discard if worn or damaged. Have any cord that feels more than comfortably warm checked by an electrician.

Eliminate Octopus Connections • • •

Do not plug several power cords into one outlet. Pull the plug, not the cord. Do not disconnect power supply by pulling or jerking the cord from the outlet. Pulling the cord causes wear and may cause a shock.

Never Break OFF the Third Prong on a Plug •

Replace broken 3-prong plugs and make sure the third prong is properly grounded.

Never Use Extension Cords as Permanent Wiring • • •

Use extension cords only to temporarily supply power to an area that does not have a power outlet. Keep power cords away from heat, water and oil. They can damage the insulation and cause a shock. Do not allow vehicles to pass over unprotected power cords. Cords should be put in conduit or protected by placing planks alongside them.

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Appendix 13 Confined Spaces Is working in a confined space hazardous? Many workers are injured and killed each year while working in confined spaces. An estimated 60% of the fatalities have been among the would-be rescuers. A confined space can be more hazardous than regular workspaces for many reasons. To effectively control the risks associated with working in a confined space, a Confined Space Hazard Assessment and Control Program should be implemented for your workplace. Before putting together this program, make sure to review the specific regulations that apply to your workplace. If the confined space cannot be made safe for the worker by taking precautions then workers should NOT enter the confined space until it is made safe to enter by additional means. What is a confined space? Generally speaking, a confined space is an enclosed or partially enclosed space that: • • •

is not primarily designed or intended for human occupancy has a restricted entrance or exit by way of location, size or means Can represent a risk for the for the health and safety of anyone who enters, due to one or more of the following factors: o its design, construction, location or atmosphere o the materials or substances in it o work activities being carried out in it, or the o mechanical, process and safety hazards present

Confined spaces can be below or above ground. Confined spaces can be found in almost any workplace. A confined space, despite its name, is not necessarily small. Examples of confined spaces include silos, vats, hoppers, utility vaults, tanks, sewers, pipes, access shafts, truck or rail tank cars, aircraft wings. Ditches and trenches may also be a confined space when access or egress is limited.

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What are the hazards in a confined space? All hazards found in a regular workspace can also be found in a confined space. However, they can be even more hazardous in a confined space than in a regular worksite. Hazards in confined spaces can include: •

• • • • • • • • • • • •

Poor air quality: There may be an insufficient amount of oxygen for the worker to breathe. The atmosphere might contain a poisonous substance that could make the worker ill or even cause the worker to lose consciousness. Natural ventilation alone will often not be sufficient to maintain breathable quality air. Chemical exposures due to skin contact or ingestion as well as inhalation of 'bad' air. Fire Hazard: There may be an explosive/flammable atmosphere due to flammable liquids and gases and combustible dusts which if ignited would lead to fire or explosion. Process-related hazards such as residual chemicals, release of contents of a supply line. Noise. Safety hazards such as moving parts of equipment, structural hazards, entanglement, slips, falls. Radiation. Temperature extremes including atmospheric and surface. Shifting or collapse of bulk material. Barrier failure resulting in a flood or release of free-flowing solid. Uncontrolled energy including electrical shock. Visibility. Biological hazards.

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Why is working in a confined space more hazardous than working in other workspaces? Many factors need to be evaluated when looking for hazards in a confined space. There is smaller margin for error. An error in identifying or evaluating potential hazards can have more serious consequences. In some cases, the conditions in a confined space are always extremely hazardous. In other cases, conditions are life threatening under an unusual combination of circumstances. This variability and unpredictability is why the hazard assessment is extremely important and must be taken very seriously each and every time one is done. Some examples include: • • • • • • •

The entrance/exit of the confined space might not allow the worker to get out in time should there be a flood or collapse of free-flowing solid. Self-rescue by the worker is more difficult. Rescue of the victim is more difficult. The interior configuration of the confined space often does not allow easy movement of people or equipment within it. Natural ventilation alone will often not be sufficient to maintain breathable quality air. The interior configuration of the confined space does not allow easy movement of air within it. Conditions can change very quickly. The space outside the confined space can impact on the conditions inside the confined space and vice versa. Work activities may introduce hazards not present initially.

What should be done when preparing to enter the confined space? The important thing to remember is that each time a worker plans to enter any work space, the worker should determine if that work space is considered a confined space. Be sure the confined space hazard assessment and control program has been followed. The next question to ask is - Is it absolutely necessary that the work be carried out inside the confined space? In many cases where there have been deaths in confined spaces, the work could have been done outside the confined space! Page 63

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Before to entering any confined space, a trained and experienced person should identify and evaluate all the potential hazards within the confined space. An important step in determining the hazards in a confined space is air testing. Air quality testing: The air within the confined space should be tested from outside of the confined space before entry into the confined space. Care should be taken to ensure that air is tested throughout the confined space - side-to-side and top to bottom. A trained worker using detection equipment which has remote probes and sampling lines should do the air quality testing. The sampling should show that: • • •

The oxygen content is within safe limits - not too little and not too much. A hazardous atmosphere (toxic gases, flammable atmosphere) is not present. Ventilation equipment is operating properly.

The results of the tests for these hazards are to be recorded on the Entry Permit along with the equipment or method(s) that were used in performing the tests. Air testing may need to be ongoing depending on the nature of the potential hazards and the nature of the work. Conditions can change while workers are inside the confined space and sometimes a hazardous atmosphere is created by the work activities in the confined space What are other safety precautions? Many other situations or hazards may be present in a confined space. Be sure that all hazards are controlled including: • • • •

Any liquids or free-flowing solids are removed from the confined space to eliminate the risk of drowning or suffocation. All pipes should be physically disconnected or isolation blanks bolted in place. Closing valves is not sufficient. A barrier is present to prevent and liquids or free-flowing solids from entering the confined space. The opening for entry into and exit from the confined space must be large enough to allow the passage of a person using protective equipment.

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