Unit B Rev Notes

NEBOSH NATIONAL DIPLOMA
HAZARDOUS AGENTS
IN THE WORKPLACE
UNIT B REVISION NOTES

Module 945B.1.6
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NEBOSH National Diploma | Hazardous Agents in the Workplace – Revision Notes
NEBOSH NATIONAL DIPLOMA
HAZARDOUS AGENTS IN THE WORKPLACE
UNIT B REVISION NOTES
CONTENTS
LIST OF TOPICS PAGE
INTRODUCTION 1
SYLLABUS........................................................................................................ 1
EXAMINATION STRATEGY ................................................................................ 3
LAST MINUTE PRACTICE .................................................................................. 3
B1: GENERAL ASPECTS OF OCCUPATIONAL HEALTH AND HYGIENE 5
NATURE AND HISTORY OF OCCUPATIONAL HEALTH AND HYGIENE ................... 5
THE ROLE AND FUNCTION OF OCCUPATIONAL HEALTH AND HYGIENE
SPECIALISTS ................................................................................................... 6
PHYSIOLOGY ................................................................................................... 9
B2: PRINCIPLES OF TOXICOLOGY AND EPIDEMIOLOGY 12
CLASSIFYING HAZARDOUS SUBSTANCES ........................................................ 12
MAIN ROUTES OF ATTACK ON THE HUMAN BODY........................................... 17
TOXICOLOGY................................................................................................. 20
EPIDEMIOLOGY ............................................................................................. 22
B3: HAZARDOUS SUBSTANCES – EVALUATING RISK 25
ASSESSING RISKS.......................................................................................... 25
EXPOSURE LIMITS FOR AIRBORNE CONTAMINANTS........................................ 27
B4: HAZARDOUS SUBSTANCES – PREVENTIVE AND PROTECTIVE
MEASURES 29
PREVENTIVE AND PROTECTIVE MEASURES ..................................................... 29
CARCINOGENS............................................................................................... 32
PERSONAL PROTECTIVE EQUIPMENT.............................................................. 32
B5: HAZARDOUS SUBSTANCES – MONITORING AND MAINTENANCE OF
CONTROL MEASURES 36
MEASUREMENT OF AIRBORNE CONTAMINANTS .............................................. 36
BIOLOGICAL MONITORING............................................................................. 42
MONITORING AND MAINTENANCE OF CONTROL MEASURES ........................... 43
B6: BIOLOGICAL AGENTS 45
BIOLOGICAL AGENTS AND EFFECTS ON THE HUMAN BODY............................. 45
ASSESSMENT AND CONTROL OF RISK ............................................................ 49
B7: PHYSICAL AGENTS 1 – NOISE AND VIBRATION 55
NOISE - PHYSICS ........................................................................................... 55
EFFECTS........................................................................................................ 56
AUDIOMETRY ................................................................................................ 58
MEASUREMENT AND ASSESSMENT OF EXPOSURE ........................................... 59
CONTROLS .................................................................................................... 63
VIBRATION - PHYSICS ................................................................................... 65
EFFECTS........................................................................................................ 66
MEASUREMENT AND ASSESSMENT OF EXPOSURE ........................................... 68
CONTROLS .................................................................................................... 68
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B8: PHYSICAL AGENTS 2 – RADIATION AND THERMAL ENVIRONMENT 71
RADIATION PHYSICS ..................................................................................... 71
NON-IONISING RADIATION............................................................................ 72
IONISING RADIATION.................................................................................... 76
THERMAL ENVIRONMENT – EXTREMES OF TEMPERATURE .............................. 81
B9: PSYCHO-SOCIAL AGENTS 85
STRESS ......................................................................................................... 85
SUBSTANCE MISUSE ...................................................................................... 89
VIOLENCE...................................................................................................... 90
B10: ERGONOMIC FACTORS 94
ERGONOMICS ................................................................................................ 94
DISPLAY SCREEN EQUIPMENT ........................................................................ 95
MANUAL HANDLING ....................................................................................... 96
INTRODUCTION
The RRC study material provides a comprehensive set of reference notes,
which amply covers the requirements of the NEBOSH National Diploma.
However, its strength is also its weakness in that there is too much material
to retain in detail. Consequently, your examination success strategy must
be based on a revision programme that makes best use of this material, but
is focused on the requirements of the NEBOSH examinations. Many
students simply rely on either trying to learn all the notes, which is almost
impossible, or concentrating on likely topics, which seriously reduces your
examination question choice, and therefore your chances of passing.
This revision guide has been prepared with the examinations in mind. It
covers key points within the syllabus.
Important: this revision book is NOT intended to replace a proper

course of learning.
The notes below give you guidance on using the syllabus as your best
revision tool and also suggest tactics for maximising mark attainment from
examination questions. There is no substitute for hard work, and the more
study time you can spare the better, but the secret is to use this time
effectively.
SYLLABUS
Your secret to success is the Guide to the NEBOSH National Diploma in
Occupational Health and Safety. The guide sets out the structure of
the Diploma (examinations and the assignment) and contains the syllabus.
Keep it by your bedside and read it every day. All the examination
questions are taken from the syllabus and therefore, as you become more
familiar with the syllabus, you will be less likely to be 'thrown' by a surprise
question.
NEBOSH examination questions are set from the syllabus, not from the RRC
notes; therefore an important revision technique is to map your notes
against the syllabus. You will find that in general, your RRC notes follow
the syllabus quite closely, but this exercise is important to help you see 'the
big picture' or 'the helicopter view', which you need in order to familiarise
yourself with the whole of the course material. It is all too easy, when
studying a specific section of the RRC text, to lose sight of where the
material fits into the grand scheme of things, what practical use it is, or how
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the Health and Safety Practitioner might use it in real life. Constant
reference back to the syllabus will put that topic in perspective and help you
to see how it relates to the field of health and safety generally. It will also
help you to cross-refer to other related topics, which you may have to do in
more complex examination questions.
To gain this overview, you must at least know the elements that make up
each of the three main units and how they relate to the RRC material. Note
that each element in the NEBOSH syllabus (e.g. Element B1: General
Aspects of Occupational Health and Hygiene) contains the following two
important sections:
Learning outcomes, which specify what you should be able to

demonstrate an understanding of, through the application of your
knowledge to familiar and unfamiliar surroundings.
Content, which gives you the topics that you should be fully familiar
with.
By using these sections of the syllabus you can test whether you possess
the necessary skills, knowledge and understanding relevant to that element
or whether you need to do more.
An effective revision technique is to take a pin (blunt, of course, for health
and safety reasons!) and randomly stick it in some part of the syllabus.
Now write down what you know about that topic. Initially this might be
very little, in which case, go back to your RRC notes and summarise the key
issues that you need to know. Make a note of this topic and return to it a
few weeks later and see how much more you can now remember. If you
practise this regularly you will eventually cover all of the syllabus and in the
process find that you understand and retain the material much more
effectively. This is 'active revision' where you are testing your memory to
see what you have learnt. It is far more effective than 'passive revision'
where you simply read the RRC notes and usually switch off after 30
seconds with little recall of the material.
The Learning Outcomes section of the syllabus refers to knowledge and
understanding. You will find it easier if you ensure that you understand the
topic first, then fill in the knowledge requirements (the detail) later. Ask
yourself searching questions on each topic such as: "What use is this?",
"How would the Health and Safety Practitioner apply this in real life?",
"What is the point of this topic?", until you feel that you thoroughly
understand why the Health and Safety Practitioner needs to know this area.
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Once you have this level of understanding, the knowledge (detail) will be
much easier to retain, and in some cases you may simply be able to derive
it from your own workplace experiences.
Your revision aim is to achieve this comprehensive overview of the syllabus.

Once you have this, you are in a position to at least say something about
each of the topic areas and thus tackle any question set on the syllabus
content.
EXAMINATION STRATEGY
The examination process may seem complex, but success simply depends
on averaging around half marks or more for each question. Marks are
awarded for setting down ideas that are relevant to the requirements of the
question, and convincing the examiner that you understand what you are
talking about. If you have the knowledge and understanding derived from
study of the syllabus as set out above, then this should not be a problem.
An important examination skill is carefully reading and analysing the
question so that you are clear about what is required to answer it. The
more you can study past examination questions, the more familiar you will
become with the way they tend to be phrased and 'the shape' of the answer
required.
A common failing in answering questions is to go into too much detail on
specific topics and fail to address the wider issues. If you only deal with
half of the relevant issues, you can only achieve half of the marks. Try to
give as broad an answer as you can, without stepping outside the subject
matter of the question altogether. Ensure that you explain each issue in
order to convince the examiner that you have this all-important
understanding. Giving relevant workplace examples is a good way of doing
this.
LAST MINUTE PRACTICE

Finally, a useful way to combine syllabus study with examination practice is
to attempt your own examination questions. By adding a question word,
such as "explain" or "describe" in front of the syllabus topic areas you can
produce a whole range of questions similar to many of those used in past
papers. This is excellent examination practice because it serves as a
valuable topic revision aid, whilst requiring you to set out your notes in the
way that you would under examination conditions.
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B1: GENERAL ASPECTS OF

OCCUPATIONAL HEALTH AND HYGIENE
NATURE AND HISTORY OF OCCUPATIONAL
HEALTH AND HYGIENE
Purpose and Nature of the Occupational Health and
Hygiene Discipline
The discipline of occupational health is concerned with the two-way
relationship of work and health:
The effects of the working environment on the health of the worker.
The influence of the worker's state of health on their ability to perform

workplace tasks.
A combined approach to occupational health and hygiene:
Recognition of a particular health effect by a worker, safety

representative, nurse or doctor.
Diagnosis of the illness and treatment by a nurse or doctor.
Discovery of the environmental cause by a hygienist.
Implementation of controls by a safety engineer, hygienist or

ergonomist.
Occupational hygiene practice follows a logical and systematic approach:
Recognition of the health hazard.
Quantification of the extent of the hazard by measuring level and/or

duration, and relating the measurements to the appropriate
occupational exposure standards.
Assessment of the risk to health in the workplace.
Selection and implementation of appropriate control measures.

Stages in Occupational Health and Hygiene Practice
Recognition/Identification - identifying those factors that may cause
harm.
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Measurement - determining who is affected and by how much.
Evaluation - making a judgment on the risk posed.
Control - putting measures in place to reduce or eliminate the risk.

Categories of Occupational Health Hazards
Chemical
Dusts, fibres, gases, vapours, etc. and the associated hazards.
Physical
Noise, vibration, radiation, heat, etc.
Biological
Bacteria, fungus, virus, mites, insects, etc.
Psychosocial
Stress, substance misuse, violence at work, etc.
Ergonomic
Posture, workplace layout, etc.
THE ROLE AND FUNCTION OF

OCCUPATIONAL HEALTH AND HYGIENE
SPECIALISTS
Occupational Health Specialists
Occupational Hygienist
Is concerned with the measurement of risk and interpretation of results,

making use of special equipment and instruments:
Measurement of airborne contaminants, and comparing the results

with those published in EH40.
Measurement of heat, noise and other pollutants.

Measurements on ventilation systems and other environmental control
devices to ensure they operate at optimum performance.
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Occupational Health Physician
Is concerned with the diagnosis and assessment of health hazards and

stress at work:
Statutory medicals.
Health surveillance under COSHH.
Pre-employment health assessment.
Post-sickness/rehabilitation/ill-health retirement health assessment.

Occupational Health Nurse
Is concerned with:
Assisting the employer in complying with health and safety legal

responsibilities.
Monitoring the health of employees.
Promoting good health activities in the workplace.
Working with line managers to minimise hazards, ensure compliance

with health and safety legislation and implement the organisation's
occupational health policies.
Dealing with cases of substance misuse.
Advising on placement at work through pre-employment health

assessments.
Health assessment after return to work from accident or ill-health.
Managing health centre facilities, offering basic health checks and co-
ordinating first-aid services.
Advising on ergonomic issues.
Promoting good health education and activities in the workplace,

geared to encouraging employees to take personal responsibility for
their health.
Providing advice and counselling.
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Employment Medical Advisory Service (EMAS)
Functions
Section 55 of the Health and Safety at Work, etc. Act (HSWA)

1974 identifies the functions of EMAS as:
− Ensuring certain parties, including the Secretary of State, HSC
and trade unions, are kept informed and advised on issues
concerning health matters for people at, or starting work.
− Giving information and advice to employers and others on health
matters, including training.
− Other issues as identified by the Secretary of State.
Responsibilities
− Advising the inspectorate on occupational health aspects of
regulations and associated ACoPs.
− Examinations of workers in known hazardous
environments/occupations.
− Other medical examinations and investigations.
− Giving advice on occupational health hazards, such as: poisons,
substances, noise, vibration, dust, stress, etc.
− Carrying out research into occupational health.
− Giving advice on the provision of occupational medical, nursing
and first-aid services.
− Giving advice on training for employment.
Occupational Health Services

Medical examination:
− Investigation of and reporting on workers suffering from a
notifiable industrial disease or exposure to a noxious substance
in the workplace - a statutory requirement.
− Periodic examination of persons employed in certain specific
trades.
Pre-employment examinations:
− Medical review after a period of sickness or injury absence.
Health promotion.
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Counselling.
PHYSIOLOGY
Respiratory System
Air passages – nasal cavity, pharynx and bronchi.
Lungs – bronchioles and alveoli.

Digestive System
Ingestion, via mastication and swallowing.
Digestion: treatment of foodstuff for absorption into the body.
Absorption of treated foodstuffs.
Excretion of food residues and desorbed waste products.

Circulatory System
Blood
Red blood cells for oxygen transport.
White blood cells for combating disease.
Platelets to aid clotting.
Plasma.
Transport of Oxygen
Oxygen molecules (O2) from the air are inhaled into the lungs and pass
through the very thin alveoli epithelium (lining) and capillary blood vessels
into the blood.
Components of the Circulatory System
A pump - the heart.
Pipes for carrying the fluid - the blood vessels.
Valves for regulating the fluid flow within the heart and blood vessels.
Heart
Oxygenated blood from lungs to organs.
Deoxygenated blood from organs to lungs.
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Blood Vessels
Blood vessels leaving the heart are called arteries.
Blood from capillaries flows into the veins.

Lymphatic System
Some of the tissue fluid and excess water for cellular secretion is not
returned to the normal circulatory system and drains under slight pressure
into a second circulatory system, which is called the lymphatic
system. It comprises a system of vessels, ducts and glands.
Nervous System
The central nervous system comprises the brain and the spinal cord. The
peripheral nervous system consists of the motor (controlling movement)
and sensory (controlling sensation) nerves.
Skin
Epidermis forms the outermost layer of skin and is composed of:
Horny zone, outermost layers of the epidermis. OPTIC

NERVE
Germinal (or living) zone, deeper level in the epidermis.
Dermis (or living skin) forms the inner part of the skin structure and consists
of mainly fibrous and elastic connective tissue.
The Eye
Spherical in shape.
Contains a transparent medium (vitreous humour) through which light

is focused by a lens on to a sensitive layer (the retina).
The front of the eyeball (the cornea) is also transparent.

The Ear
Sound waves are collected by the outer ear.
They pass through the auditory canal to the ear drum.

Changes in sound pressure cause the ear drum to vibrate in proportion
to the sound intensity and frequency.
Vibrations are transmitted through the middle ear to the cochlea.
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The cochlea contains hairs that vibrate in response to the stimulus

received from the middle ear.
Electrical impulses are produced which travel along the auditory nerve
to the brain, where they are perceived as sound.
The Nose
The nasal cavities ensure that inhaled air reaches the lungs at a
suitable temperature and humidity.
The lining of the inside of the nose contains special cells that are
capable of detecting chemicals in the air.
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B2: PRINCIPLES OF TOXICOLOGY AND

EPIDEMIOLOGY
CLASSIFYING HAZARDOUS SUBSTANCES
The Physical Form or State of Hazardous Substances
Solids.
Liquids.
Dusts.
Gases.
Fibres.
Mists.
Fumes.
Vapours.
Risk and Safety Phrases Contained in the Approved
Supply List
The general nature of the risk.
The precautions to take in relation to the identified properties of the

substance.
Contents of Safety Data Sheets
1. Identification of the substance or preparation and the company/
undertaking.
2. Hazards identification.
3. Composition/information on ingredients
4. First-aid measures.
5. Fire-fighting measures.
6. Accidental release measures.
7. Handling and storage.
8. Exposure controls and personal protection.
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9. Physical and chemical properties.
10. Stability and reactivity.
11. Toxicological information.
12. Ecological information.
13. Disposal considerations.
14. Transport information.
15. Regulatory information.
16. Other information.

Toxicity
The ability to produce serious, acute or chronic health risks and even death.
The following are some examples of common workplace chemicals and the
associated toxic effects.
Trichlorethylene
Colourless, non-flammable organic liquid, widely used as an industrial

solvent.
Attacks:
− The central nervous system.
− The skin.
− The respiratory tract.
Symptoms include:
− Headaches.
− Dizziness.
− Irritability.
− Mental confusion.
− Visual disturbance.
− Nausea.
− Vomiting.
− Gradual loss of consciousness.
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Asbestos
Causes asbestosis, lung cancer and mesothelioma.
Symptoms include:
− Breathlessness.
− Coughing.
− Pain between the shoulder blades or behind the sternum (breast
bone).
Carbon Monoxide
Found in combustion gases.
Prevents oxygen transport by the blood.
Symptoms of exposure include:

− Giddiness.
− A sense of oppression in the chest.
− Loss of power in the lower limbs, with the victim falling to the
ground unconscious.
Isocyanates
Used in the manufacture of flexible foams and paints.
Act as irritants and allergens.

Siliceous Dust
Causes numerous chest and respiratory tract diseases.
Breathlessness on exertion.
Coughing with associated sputum.
Chest pains.
Impaired lung function.
Lung and heart failure.

Lead
Inorganic lead compounds, inhalation of dusts.
Organic lead compounds, inhalation and skin contact.
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Symptoms include:
− Nausea, vomiting and headaches.
− Constipation and severe intermittent colic.
− Dullness, restlessness, tremor, convulsion or coma.
− Headaches, anaemia and palsy.
Corrosive Substances
Rapidly destroy the living tissue of the body when they make contact.
Acids: sulphuric acid; hydrochloric acid; nitric acid; phosphoric acid.
Alkalis: sodium hydroxide, potassium hydroxide, ammonia.
Concentrated acids and alkalis will cause severe burns to the skin on
contact.
Contact with the eyes is likely to cause serious damage.
Inhalation of acid or alkali mist or fume will cause severe damage to

the respiratory tract.
Ingestion will cause corresponding damage to the gastrointestinal

tract.
Irritant Substances
Non-corrosive substances which through immediate, prolonged or
repeated contact with the skin or mucus membrane may cause
inflammation.
Ammonia, chlorine, silicates.

Harmful Substances
These cause an adverse effect on health when inhaled, swallowed or
absorbed through the skin.
Dermatitic Hazards
Occupational dermatitis is a non-infectious, inflammatory condition of the
skin which results from external contact with chemical, biological or physical
agents.
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Primary/Contact Dermatitis
Brought about by contact with primary cutaneous irritants and occurs at the
site of contact, provided the irritants act for a sufficient time and in
sufficient concentration.
Secondary/Allergic Dermatitis
Caused by substances called cutaneous sensitisers.
These substances do not always cause an inflammatory response on

first contact but may take a week or more to develop.
A more serious condition, immune (allergic) response, occurs in the

metabolic reactions of the skin structure and develops within hours of
contact with the sensitising material.
Sensitisation
Chemical agents produce an allergic reaction in certain individuals each time
the person is exposed to very small quantities of the causative agent.
Skin
− The sensitising chemical passes through the epidermal barrier
causing antibodies to be formed and symptoms associated with
sensitisation.
− The skin reaction will occur whenever there is further contact
with the sensitising agent.
Respiratory System
Allergic sensitisation occurring in the respiratory system results in

asthma.
Carcinogenic
Agents (either physical or chemical) which have the ability to produce
malignant tumours.
Attacks the mechanism which controls the reproduction of normal

cells.
Effects will not appear for many years after exposure.
No threshold of harm, and any level of exposure has the potential to

cause cancer.
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Examples include:
− Tars and polycyclic aromatics.
− Asbestos.
− Vinyl chloride monomer.
− MbOCA.
− Wood dust.
− Chromium.
Mutagenic
Substances and preparations that alter cell development and cause
changes in future generations.
Most mutations have an adverse effect on the living organism and

might lead to cancer or even the immediate death of the cell.
Examples of mutagens include acrylamide and potassium dichromate.
MAIN ROUTES OF ATTACK ON THE HUMAN

BODY
Main Routes of Entry of Harmful Substances
Process of Entry
There are two main ways in which entry may occur:
Absorption
− Outer skin surface.
− Tissue covering the surfaces of the respiratory tract.
− Tissue covering the surfaces of the gastrointestinal tract.
Direct Entry
− Break in the skin.
Routes of Entry
Skin contact.
Inhalation.
Ingestion.
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Mucus membranes of the eye.

Local and Systemic Effects
Local effects are confined to the specific area of the body where
contact with the toxic material occurs.
Systemic effects occur at organs or parts of the body distant from the
site where initial contact with the toxic substance was made.
Target Organs and Systems
Systemic toxins do not often present the same degree of toxicity to all
organs; their toxicity may be concentrated in a few organs or systems,
referred to as “Target Organs/Systems” for a given toxin. Some examples
are given below:
The bloodstream and circulatory system.
The lymphatic system.
The liver.
The urinary system.

− Kidneys.
The reproductive system.
The Body's Defence Mechanisms
The body’s defences are collectively called the immune system. It is usually
divided into
Innate (or ‘non-specific’) Immune Response.
Adaptive (or ‘Specific’ or ‘Acquired’) Immune Response.

Inhalation and Respiratory Defences
Inhalable dust is the total amount inhaled into the respiratory system
through the nose.
Respirable dust is the fraction that penetrates through to the gas

exchange region of the lung.
Initial filtration of particles larger than 10 µm takes place in the hairs
in the nasal cavity.
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Smaller particles and aerosols between 7 and 10 µm are trapped in the

mucus secreted by goblet cells lining the conducting airways and then
transported upwards by the ciliary escalator to the pharynx where they
can be either swallowed or expectorated.
Smaller particles and aerosols between 0.5 and 7 µm pass into the
respiratory units where deposition takes place in the respiratory
bronchioles and alveoli. Here they may be ingested as foreign bodies
by macrophages, large cells normally found in tissues which produce
blood cells. Macrophages may migrate back along the respiratory
pathways to the ciliary escalators, ultimately to be swallowed or
expectorated.
Blood-Borne Attacking Cells - Leucocytes
Three basic types of leucocytes are:
Granulocytes
Move in and out of the blood vessels and into tissues, where they
ingest (or eat) harmful micro-organisms or debris, by phagocytosis
(phago means to eat).
Lymphocytes
They constitute the adaptive (or specific or acquired) immune system.

Mainly protect the body by forming antibodies.
Monocytes
They protect the body by leaving the bloodstream and maturing into
Macrophages - they ingest things like granulocytes but also mediate
in the adaptive immune response
Inflammatory Response
Acute inflammation - immediate defensive reaction of tissue to injury.
Chronic inflammation - scarring and fibrosis (pneumoconiosis).
Respiratory Inflammation
Rhinitis.
Laryngitis.
Tracheitis.
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Bronchitis.
Inflammation of the Skin
Can result in dermatitis.
TOXICOLOGY
Legal Requirements
The Notification of New Substances Regulations 1993 relate to the
use of new substances in the UK and require a range of physico-chemical,
toxicological and ecotoxicological studies. Types of toxicological studies that
are required are:
Acute toxicity.
Skin and eye irritancy.
Skin sensitisation.
Subacute toxicity (28 days).

Mutagenicity (bacterial and non-bacterial).
Carcinogenicity.
Reproductive Toxicity
Dose/Response Relationships
Dose is the amount per unit body mass of toxic substance to which
the organism is exposed.
Response is the resultant effect.
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100
PER CENT EFFECT (DEATHS)

LD90
50
LD50
0
LOG DOSE
Dose/Response Curve
LD50 is the estimated dose that will kill 50% of a sample of animals.
LD90 is the estimated dose that will kill 90% of a sample of animals.
LC50 is the concentration of airborne toxin that will kill 50% of exposed
animals in a specified time.
LC90 is the concentration of airborne toxin that will kill 90% of exposed
animals in a specified time.
Types of Toxicity Test
Acute toxicity tests:
− The effects which occur within a short period after dosing.
Fixed dose testing:
− Test substance is administered to the test animals at one dose
level.
− Dose at which toxic signs are detected is used to classify the test
materials.
Subacute toxicity tests:
− Expose animals to a substance for a prolonged period of one or
three months.
− Enable toxic effects which have a slow onset to be detected.
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Chronic toxicity tests:

− Lifetime exposure of animals to the substance under study.
Mutagenicity testing - aims to identify the potential to cause
damage to genetic material. This, in turn, indicates the possibility that
the substance in question could possess mutagenic or carcinogenic
properties.
Long-term toxicity tests - involve lifetime studies on animals

exposed to potentially toxic substances and are able to provide a
wealth of information on mode of action, dose effect relationships and
target organs.
Chemical analogy studies - enable predictions to be made on the

possible mode of toxic activity based on the chemical structure and
properties of substances.
EPIDEMIOLOGY
The distribution of a particular occupational disease and the search to
identify the occupational factors that may be involved.
Uses
Primary monitoring to identify hazards.
Secondary monitoring to keep known hazards under control.
Determining causes helps to establish health standards.
Community studies reveal how many people are affected and how
seriously.
Evaluating health services to find out how they are used, their
success in reaching certain standards and the value attached to them
by the population they serve.
Limitations
The "healthy worker" effect.
A poor response rate.

A high turnover of study populations.
The latency period between exposure and effect is longer than the
study period.
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Poor quality of health affects data and/or exposure data.
No effect of exposure noted which may be a consequence of a poor or

small study population.
Types of Epidemiological Study
Cross-Sectional Studies
A "snapshot in time" of the relevant workforce.
Advantage - is a quick and cheap opportunity to study the problem in

hand.
Disadvantage – is that the population at risk is assessed over a narrow

time frame.
Outcome-selective: study examines the prevalence of a particular

occupational condition within the population.
Exposure-selective: study examines a particular population that

has been exposed to a specified occupational condition.
Longitudinal Studies
The Case-Control Study

− Retrospective, beginning with a definition of a group of cases and
relating these (along with non-cases or controls) to the past
exposure history.
− Compares a group of individuals who have the disease or
condition with another group who do not.
The Follow-Up Study
− Prospective study of a group of exposed, and possibly non-
exposed control, persons where the exposure is defined and
accurately known.
− Group followed up over an appropriate period of time to assess
the eventual outcome of the exposure.
National and Local Records
Death certificates.
Birth certificates.
Morbidity.
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Practical Application of Epidemiological Methods
Broad steps:
Establish objectives and hypotheses.
Define study population.
Prepare protocol and questionnaires.
Undertake pilot study.
Collect and analyse data.
Test hypotheses, and record and report conclusions.
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B3: HAZARDOUS SUBSTANCES –

EVALUATING RISK
ASSESSING RISKS
Examples of Occupations Presenting Specific Exposure Risks and
Typical Chemicals Involved
Occupation(s) Chemical Disease or Effect
Lead workers (paint, pipes and Lead Lead poisoning (anaemia)

manufacture of petrol additives)
Pesticide users DDT Nerve damage
Gardeners Paraquat (Weedol) Lung and kidney damage
Brewery workers Carbon dioxide Asphyxia
Garage workers Carbon monoxide Asphyxia
Sewer workers Hydrogen sulphide Asphyxia
Swimming pool workers Chlorine Irritant gas
Woodworkers Hardwoods Nasal cancer
Shipbuilding and car brake shoe Asbestos Lung cancer

manufacture
Factors To Be Considered in the Assessment of Risks to

Health from Chemical Agents
Numbers exposed.
Aerosol/particle size.
Concentration.
Type and duration of exposure.
Frequency of exposure.
Effect of mixtures – synergy.
Continuing and contingent exposures.
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Thresholds of exposure.
Factors Affecting the Risks to the Individual
Individual Susceptibility
Pregnant women or those who have recently given birth.
Atopic persons.
Lifestyle.
Solubility in Body Fluids
Physical form of the substance (gas, liquid, solid) and its chemical properties
(water soluble, organic liquid soluble in lipids/fats, soluble in acid or alkaline
solutions) gives us an indication of the way in which the material may
interact with the body and hence its potential for harm.
Synergy
May enhance the harmful effect of one or more of the substances.

Age
Young persons.
Older workers.
Sensitisation
Sensitised people can suffer from a range of symptoms if exposed to

allergens.
Morphology
This is the form (size and shape) and structure of the contaminant. Various
parameters of particles such as size, size distribution, particle shape,
density, chemical properties and velocity affect their motion in air (including
settling rate) and their clearance from, and absorption in, the lungs when
inhaled.
Some particle shapes include:
Spherical.
Isometric.
Platelets.
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Fibres.
EXPOSURE LIMITS FOR AIRBORNE

CONTAMINANTS
Meaning and Use of Occupational Exposure Limits
Workplace Exposure Limit (WEL)
A type of OEL designed to control the absorption into the body of

harmful substances following inhalation.
Maximum concentration of an airborne substance, averaged over a

reference period, to which employees may be exposed by inhalation.
The workplace exposure limit should not be exceeded.

Units Used for Exposure Limits
The two main units used for measuring airborne concentrations are:
• Parts per million (ppm).
• Milligrams per cubic metre of air (mg/m3 or mg m-3).

Guidance Note EH40
Gives advice on the exposure limits, expressed as concentrations, to which

airborne substances hazardous to health should be controlled in the
workplace.
Criteria for Establishment of Workplace Exposure
Limits
A WEL value is set at a level at which no adverse effects on human health
would be expected to occur based on the known and/or predicted effects of
the substance. Where such a level cannot be identified with reasonable
confidence or is not reasonably achievable, then the WEL value is based at
a level corresponding to what is considered to represent good control,
taking into account the severity of the likely health hazards and the costs
and efficacy of control solutions. Wherever possible, a WEL is not set at a
level at which there is evidence of adverse effects on human health.
WELs are set on the recommendation of the Advisory Committee on Toxic
Substances (ACTS). The first step in deriving a WEL involves an assessment
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of the toxicology of the substance in order to identify the potential for

adverse health effects and to understand the dose-response relationship.
If a NOAEL is identified, then this value is used as the starting point for
determining the highest level of exposure at which no adverse health effects
are predicted to occur in an occupational context.
The final step in the process is to determine the actual levels of exposure
that are being achieved in the workplace. If these actual exposure levels
are below the level identified by ACTS, or if ACTS believes that achieving a
lower level is reasonably practicable, then ACTS will set the WEL at this
level.
However, for certain substances it is not possible to set a NOAEL. In these

cases ACTS will set a WEL at a level commensurate with good occupational
hygiene practice. In setting this level ACTS will consider the severity of
likely health effects and the costs and efficacy of the possible control
solutions. Wherever possible, the WEL is not set at a level where there is
positive evidence of adverse effects on human health.
Role of Biological Limit Values
The concentration of the hazardous substance or its metabolite found

in blood or urine.
Significance of Short- and Long-Term Exposure Limits
Expressed as time-weighted average (TWA) concentrations.
Designed to reduce the risk of chronic long-term and acute short-term

effects resulting from the absorption of harmful substances.
Long-Term Exposure Limits (LTELs)
Designed to control the accumulation of harmful substances in the

body, or conditions which would enhance a disease risk with
continuing contact.
Short-Term Exposure Limits (STELs)
Designed to control adverse effects which might result from exposure

to a high concentration of a contaminant over short periods of time.
28 © Copyright RRC

PREVENTIVE AND PROTECTIVE
MEASURES
PREVENTIVE AND PROTECTIVE MEASURES
General Principles
These include:
Eliminate the hazard.
Use physical or engineering controls which reduce the risk at source

and provide protection generally rather than individually.
Control the person by job design, management, or (as a last resort)

personal protective equipment.
The Eight Principles of Good Practice (COSHH Regs)
Principle 1
Design and operate processes and activities to minimise emission, release

and spread of substances hazardous to health.
Principle 2
Take into account all relevant routes of exposure – inhalation, skin and
ingestion – when developing control measures.
Principle 3
Control exposure by measures that are proportional to the health risk.

Principle 4
Choose the most effective and reliable control options that minimise the
escape and spread of substances hazardous to health.
Principle 5
Where adequate control of exposure cannot be achieved by other means,

provide, in combination with other control measures, suitable personal
protective equipment.
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Principle 6
Check and review regularly all elements of control measures for their
continuing effectiveness.
Principle 7
Inform and train all employees on the hazards and risks from substances
with which they work, and the use of control measures developed to
minimise the risks.
Principle 8
Ensure that the introduction of measures to control exposure does not

increase the overall risk to health and safety.
Strategies
Elimination
Avoid exposing employees to the risk.

Substitution
Replace the substance with a different one that has less potential for harm.
Change of Work Method
Minimise or suppress the generation of the agents of concern.

Change of Work Patterns
Reduce the length of time of exposure and consequently minimise the risks
to health.
Isolation and Segregation
Isolate the hazard physically to ensure that no person is exposed to risk.

Engineering Controls
Local Exhaust Ventilation
Operates by removing a contaminant at the point of generation and

ducting it away in an airflow to a safe place.
Main parts:
− Hood
− Receptor
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Contaminant directed naturally into the hood by thermal

draughts, directional movement (for solids), or by local
generation.
− Captor
Contaminants captured by airflow into the hood.
− Ducting
As straight as possible with gentle bends.
− Filter or Purifying System
Cyclones, washers, bag filters and electrostatic systems.
− Ventilation Fans and Motors
o Axial flow.
o Centrifugal fans.
− Exhaust Outlet
Away from any air inlets.
Fume Cupboards
Type of local extract ventilation system widely used in laboratories.
Enclosed chamber accessed through a vertical sliding sash.
Continuous airflow through the sash into the enclosure prevents the
back-release of any contaminant into the laboratory.
Multi-Hood Extraction Systems
A number of separate exhaust hoods serving different processes but

connected by a system of branched pipes and main ducts to a central fan,
common air-cleaning plant and discharge point.
Dilution Ventilation
Dilutes the contaminant concentration to an acceptable level by

changing the whole workplace air over a given period of time, i.e. air
changes per hour.
Workplace air is extracted by the use of fans set in the walls or roof.
Two important criteria:
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− Rate of contaminant generation.

− Position of the extraction fans.
Emergency and Spillage Procedures

Issues to Consider
Training to deal with spillages.
Selection and maintenance of PPE.
Training and supervision of the users.
Liaison with emergency services.
First-aid provision.
Environmental damage.
CARCINOGENS
Measures to be adopted where it is not reasonably practicable to prevent
exposure to carcinogens:
Totally enclose the process and handling systems, unless this is not
reasonably practicable.
Prohibit eating, drinking and smoking in areas that may be

contaminated by carcinogens or mutagens.
Clean floors, walls and other surfaces at regular intervals and

whenever necessary.
Designate those areas and installations which may be contaminated by

carcinogens or mutagens, using suitable and sufficient warning signs.
Store, handle and dispose of carcinogens and mutagens safely,

including using closed and clearly labelled containers.
PERSONAL PROTECTIVE EQUIPMENT

Factors Affecting the Choice of PPE
Type of protection.
Level of protection.
Compatibility.
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Consultation.
Personal and workplace factors.
Supervision of use.
Wearer acceptability.
Respiratory Protection
Respirators, which are designed to purify respirable air by inhaling it
through a medium that removes the contaminants.
Breathing apparatus, which supplies pure respirable air from an

uncontaminated source.
Types of Respirator
Filtering Face-Piece Respirator
Filtering material worn over the nose and mouth and secured by twin
elastic headbands.
Cheap and disposable.

Ori-Nasal or Half-Mask Respirator
Flexible rubber or plastic face-piece that covers the nose and mouth,
to which is fixed a replaceable cartridge capable of removing the
airborne contaminant during inhalation of respirable air.
Protection against dusts, fumes, gases and vapours.

Full-Face or Canister Respirator
Designed to cover the mouth, nose and eyes.
Have replaceable gas-absorbent canisters which are either fitted

directly to the face-piece, like a single cartridge half-mask, or
connected via a flexible corrugated rubber breathing tube.
Powered Clean-Air Respirator
Pump provides a positive air pressure during breathing, which reduces

user fatigue.
Mainly designed for protection against dusts.
Cannot be used in oxygen-deficient atmospheres.
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Powered Visor Respirator
Purified air is blown down over the user's face behind a protective visor.
Types of Breathing Apparatus
Fresh Air Hose Apparatus
User is connected to a fresh air supply by an air hose and draws air through
by inspiratory effort.
Compressed Airline Apparatus
Provides air from a compressed air source to full or half face-piece

respirators, hoods, coverall suits or protective visors.
Constant flow respirator – receives a continuous flow of air from the

supply.
Demand flow respirator – respirable air only flows into the mask when
the user inhales.
Self-Contained Apparatus
Provides air or oxygen to the user from cylinders or some other form
of container, which is carried in a harness on the user's chest or back.
Provides respiratory protection in toxic, corrosive, dusty and oxygen-

deficient atmospheres.
Significance of Assigned Protection Factors
The measure of the ability of APR to protect the respiratory system.
The ratio of the concentration of contaminant in the working

atmosphere to the measured concentration within the face-piece when
the equipment is in use.
A higher ratio gives better protection.

Factors Affecting Choice of Respiratory Equipment
Type of hazard.
Contaminant concentration safely tolerated by the user, i.e. the

hygiene limit.
Contaminant concentration.
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Eye Protection
Nature of Hazards for which Eye Protection Available
Protection against impact from: flying particles; dust; chemical splashes;

molten metal; mists, sprays and gases; welding; non-ionising radiation; and
laser light.
Types of Eye Protection
Spectacles fitted with side pieces.
Goggles, which provide full eye enclosure and are secured by a

flexible headband.
Face visors, which provide both eye and face protection. They are
secured by an adjustable head frame or may be fixed to a safety
helmet.
Skin Protection
Types of Hand and Lower Arm Protection
Gloves or gauntlets provide protection against high and low

temperatures, chemicals and rough handling work.
Barrier creams protect against dermatitis.
Limitations:
− Loss of dexterity and tactile sensation.
− Local heating of the hands.
− Removal during a hazardous operation.
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MONITORING AND MAINTENANCE OF
CONTROL MEASURES
MEASUREMENT OF AIRBORNE
CONTAMINANTS
Strategies for Sampling
Peak measurements involve monitoring over successive short periods
of time to establish the peak concentration reached.
Static sampling equipment is placed at fixed positions, which are

selected to provide the most useful information regarding the principal
contaminants emitted into the workroom air.
Personal sampling assesses individual exposure to airborne

contaminants in relation to the occupational exposure limits set.
HSG173: Monitoring Strategies for Toxic Substances describes a

strategy which can be adopted (see following flow diagram):
36 © Copyright RRC
Initial Appraisal
Stage 1: Gather information.
Stage 2: Conduct some simple qualitative tests.

Basic Survey
Identify groups most likely to be significantly exposed to a hazardous

substance and conditions or factors giving rise to exposure. Use crude
methods to estimate personal exposure.
Detailed Survey
Used for example when:
Dealing with carcinogens, mutagens and respiratory sensitisers.
Exposure is highly variable between employees doing similar tasks.
The initial appraisal and basic survey indicate:
− TWA concentrations very close to the WEL.
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− The cost of additional controls, which needs to be justified with

more detailed evidence of the exposure profile.
Involves techniques similar to those already used for the initial appraisal
and basic survey but more detailed monitoring and analysis would be used
to identify exposure patterns and the degree of control.
Reappraisal
Once remedial action has been taken, you need to see if the changes have
had the desired effect.
Routine Monitoring
Once you have implemented effective controls, you may decide to use
routine monitoring to ensure that controls stay effective.
Description of Sampling Heads
Types of Sampling Heads
Protected.
Cyclone.
Cowl.
Choice in Relation to Nature of Atmospheric Particulate
Personal sampling - inhalable dust.
Background sampling - inhalable dust.
Personal sampling – respirable dust.
Background sampling – respirable dust (cyclone or parallel plate

separator pre-selector).
Method of Use
Stabilise the airflow at the required rate.
Fit the sampling head with a clean, pre-weighed filter.
Attach the sampling head to the operator, near the nose-mouth

region.
Record the time at the start of the sampling period and check the flow
rate as necessary.
38 © Copyright RRC
At the end of the sampling period, note the time and remove the filter
for reweighing.
Volume of air passing through the filter is calculated by multiplying the

flow rate (cubic metres per minute) by the sampling time (minutes).
Metal
Weight gain (mg) of the filter, divided by the volume sampled, gives Tube
the average dust concentration in milligrams per cubic metre of air
(mg/m3).
Types of Device for Sampling Vapours
Passive Devices
Employ absorbent material to sample concentrations of airborne

pollutants without using a pump to draw air through the collector by
allowing the gases to diffuse and/or permeate to the absorbent
surface.
At the end of the sampling period, the holder is returned to the

laboratory, where the absorbent material is removed and the amount
of gas or vapour collected can be analysed.
The badge-type sampler has a flat, permeable membrane supported

over a shallow layer of sorbent.
The tube-type sampler has a smaller permeable membrane supported

over a deep metal tube filled with sorbent.
Activated Charcoal Tubes and Pumps
A continuous stream of air is pumped through a tube containing

activated charcoal and any gases or vapours will be absorbed.
The amount of pollutant collected can then be determined back in the

laboratory.
Direct Reading Instruments
Chemical reactions designed to produce a colour change, which
enables a qualitative analysis to be made.
Electrical detection, in conjunction with chemical or electrochemical

processes.
Physical methods based on the absorption of ultraviolet or infrared

radiation in proportion to the concentration of the contaminant.
© Copyright RRC 39
Advantages
Some can be used to continuously monitor the air for the given
substance.
Specific to a given substance.
Give an immediate (or nearly so) reading of a contaminant

concentration.
Very useful for identifying periods of peak concentrations during a

working shift.
Many instruments can be connected to a chart recorder, data logger or

a warning device so do not need constant attention.
Disadvantages
Some are expensive.
Need a competent technician.
Need to be calibrated to ensure accurate measurement.
Can be influenced by mixtures.

Stain Tube (Colourmetric) Detectors
Use
A known volume of air is drawn over a chemical reagent supported in

a glass tube.
The contaminant reacts with the reagent and the length of the stain is
proportional to the concentration of the gaseous contaminant.
Limitations
Rate of flow of air.
Accuracy of the sampled volume.
Possibility of cross-sensitivity of tube reagents.
Problems caused by variations in temperature and pressure.

Shelf life - turn over stock and use only currently operative tubes.
Reagent complexity causes a variation between each tube.
40 © Copyright RRC
Hand-operated stain tube systems are capable of only a point-in-time

or grab sample.
Dust Monitoring (Tyndall Beam)
Use
A powerful parallel-beamed light illuminates the suspected dust cloud.
To prevent the glare from the beam, the dust cloud is viewed from a
direction slightly oblique to the main light beam and the image of the
lamp itself is shielded with a screen.
Limitations
Method is qualitative not quantitative and just gives a visual indication

of the nature of the problem.
Need a special lamp for use in flammable atmospheres.
Should be protected from water to avoid shattering at the high

temperatures at which they operate.
Risk of burns due to the high operating temperature.
Can cause eye damage if the beam is looked at directly.

Measurement Principles
Dusts - Gravimetric and Chemical Analysis
Dust collected using a simple particulate filter is determined

gravimetrically.
For some dust samples, chemical analysis may be carried out.

Fibres - Microscopy
Used to count fibres collected on the filter of a sampling device.
By calculating the number of fibres in a known proportion of the

sample collected, the number in the whole sample and the airborne
concentration.
Vapours - Chemical Analysis
Vapours collected on absorbents within samplers can be desorbed in a

laboratory and chemically analysed.
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Importance of Use of Standard Methods - MDHS Series

Analysis and measurement of chemical agents must be carried out in a
consistent and reproducible manner.
MDHS (Methods for the Determination of Hazardous Substances)

Guidance on Analysis is a series of detailed descriptions of analytical
methods which have been approved by the Health and Safety
Executive for most chemical agents that are likely to be encountered in
the workplace.
BIOLOGICAL MONITORING
Definition
The measurement and assessment of workplace agents or their
metabolites (substances formed when the body converts the chemical)
in exposed workers. Measurements are made either on samples of
breath, urine or blood, or any combination of these.
Basic Principles
Involves measuring the chemical exposed to at work (or what it breaks
down into) in a sample of breath, urine or blood.
Valuable assessment technique in the following circumstances:

− Absorption likely to be through skin and ingestion rather than
inhalation, therefore air monitoring is not a useful indicator of
uptake.
− Valid laboratory methods available for the detection of the
chemical or its metabolites.
− Reference values available for the interpretation of the results
obtained.
Advantages and Disadvantages of Biological

Monitoring
Advantages include:
It can help to demonstrate whether personal protective equipment

(e.g. gloves and masks) and engineering controls (e.g. extraction
systems) are effective in controlling exposure.
It measures individual exposure to a chemical by all routes of entry.
42 © Copyright RRC
It identifies what has been absorbed by the body (unlike airborne

monitoring).
It shows how effective improvements in control measures have been

in reducing exposure.
It gives reassurance to workers that their individual exposure is being

monitored.
Disadvantages include:
Sampling may require blood to be taken which would require a

physician or nurse.
Measurements relate to individuals, so confidentiality and data

protection issues need to be addressed.
Standards aim to protect the majority of the exposed population.

Therefore, an individual may suffer adverse changes at concentrations
below the standard.
MONITORING AND MAINTENANCE OF

CONTROL MEASURES
Visual Inspection of Engineering Controls
Glove boxes - total enclosures accessed through flexible gloves and
kept under negative pressure to prevent any release of contaminant.
Fume hoods - partial enclosures accessed through a vertical sliding

sash. Again the enclosure is kept under negative pressure, so the
airflow is through the sash into the hood, to prevent any release of
contaminant.
Captor hoods - placed as near as possible to the hazard and capture

contaminants by an airflow into the hood before they reach the
operator.
Receptor hoods - large structures designed to capture contaminants

which have been directed naturally into the hood by thermal draughts,
directional movement, or local generation.
Visual inspections of filters, outlets, trunking, hoods, gloves and

dampers.
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Measurements for Assessing Performance of Exhaust

Ventilation
Capture Velocities
The air velocity and airflow pattern must be adequate to capture all the
contaminant released to prevent escape into the workplace.
Face Velocities
Airflow patterns around the hood are determined by using a smoke

tube or similar smoke generator at various locations near to the hood
inlet.
Face velocity is measured by:

− The rotating vane anemometer.
− The heated head anemometer.
Transport Velocities
Air velocity to keep most particles airborne.
Heated head anemometer is small enough to insert into an access hole

in the duct wall.
Pitot-static tube measures velocity pressure inside the ventilation

system.
Static Pressures
Manometer measures pressure by displacing a column of liquid in a

U-tube.
Diaphragm gauge gives a reading on a dial as a result of direct

pressure on a diaphragm.
Statutory Requirements
A requirement of the COSHH Regulations is that engineering controls

such as local exhaust ventilation systems, provided to control exposure to
substances hazardous to health, must be thoroughly examined and tested
at least once in every 14 months.
44 © Copyright RRC
B6: BIOLOGICAL AGENTS

BIOLOGICAL AGENTS AND EFFECTS ON
THE HUMAN BODY
Types of Biological Agent
Fungi
− Moulds and yeasts.
− Inhalation of organic dust contaminate with fungi spores (mouldy
cellulose-based material such as straw) that causes the biological
pneumoconiosis, such as farmer's lung.
Bacteria
− Single-celled organisms that reproduce by division. They vary
widely in shape (with the shape being used to classify and name
types of bacteria) and include spheres (cocci), rods (bacilli) and
spirals (spirochetes).
− Anthrax forms spores which enables it to survive adverse
conditions such as heat, cold and lack of water.
Viruses
− Self-replicating, genetic material contained in a protein shell that
invades host cells, takes control of the cell material to produce
more viruses, and releases these viruses to enter other host cells.
− Hepatitis and AIDS are two diseases caused by viruses present in
human bodily fluids.
Modes of Transmission of Disease
Inhalation
Bioaerosols consisting of suspensions of bacteria, spores and organic

dusts can be inhaled into the respiratory tract.
Ingestion
Biological agents may enter the body through contaminated food and
drink, or by hand contact with contaminated surfaces and then hand-
to-mouth transfer.
© Copyright RRC 45
Skin Contact
− Micro-organisms are able to enter the body through cuts,
scratches and abrasions.
− Needle-stick injuries involving contaminated sharp implements
can allow entry of biological agents through the skin.
Entry Through the Conjunctivae
The membranes surrounding the eye are very thin and allow a route of
entry to biological agents.
Mechanisms of Attack on the Body
Fungi: little is known about the actual mechanisms. Some clearly attack
body cells directly. Some produce toxins (mycotoxins) harmful to humans.
Bacteria: most attack body cells directly. Other bacteria produce toxins.
Viruses: these need other cells (those of the host) in order to survive; they
cannot reproduce on their own. The virus attaches to a host cell and injects
its own strand of DNA or RNA into the host cell. It then takes control of the
cell functions. The host cell is forced to make copies of the virus and the
cell usually explodes in the process.
Different Types of Toxins Produced by Micro-Organisms
Bacterial Toxins:
− Endotoxins, these are part of the cell wall and are only released
when the cell dies. Examples include toxins released from dead
bacteria in refuse, sewage sludge and contaminated water.
− Exotoxins, these are secreted by the organism (often as a
waste product) as the cell grows.
Fungal Toxins – these cannot usually be classified as either
endotoxins or exotoxins and are called:
− Mycotoxins, which are produced by fungi growing on foodstuffs
and are rare compared to bacterial toxins.
Signs and Symptoms of Disease and the Body's Defence

Mechanisms
The effects of attack by micro-organisms vary with the organism. Effects

may include damage to organs, allergic responses (skin reactions, coughs,
46 © Copyright RRC
wheezes, rhinitis, asthma and allergic alveolitis) and death in some cases.
Effects may be:
Acute - occurring over a short timescale.
Chronic - symptoms may remain over weeks or months.
Diseases may also have an incubation period preceding the symptoms.
The body’s defence mechanisms to these attacks were discussed in Element

B2, and include:
The skin, which acts as a barrier when intact.
The mechanism of the respiratory tract, which deals with dust and
solid particles (ciliary escalator).
Acidic pH levels in the stomach, which can destroy bacteria.
Protective enzymes in saliva and tears.

Zoonoses
Animal infections that may be transmitted to people in the course of their

work (anthrax, brucellosis).
Sources and Symptoms of Biological Diseases
Anthrax
An acute, infectious disease of farm animals caused by a bacterium.
Initial lesion rapidly takes on an ulcerated appearance.

Swelling of the lymph glands, and temperature rises to between 100°
and 102°F.
Cryptosporidosis
Parasitic infection caused by the protozoa Cryptosporidium parvum in

water supplies and contaminated food.
Symptoms are watery diarrhoea and abdominal pain with flu-like

symptoms.
Farmer's Lung
Hypersensitivity due to an antigen present in the dust of mouldy hay

and other vegetable matter.
© Copyright RRC 47
Symptoms are development of a dry cough, general malaise,

weakness, slight fever, and extreme shortness of breath on exertion.
(Viral) Hepatitis
Common occupational disease amongst medical staff.
Flu symptoms and jaundice.
Chronic infectious hepatitis may follow, leading to cirrhosis and

possibly death.
HIV/AIDS
AIDS is caused by the Human Immunodeficiency Virus (HIV), which attacks

the immune system by which the human body can resist infections.
Legionellosis
Legionella growth in water systems is due to:

− Water temperatures in the range of 25-45°C.
− The presence of sediment, sludge, scale and organic material.
− Slime on surfaces in contact with water can protect the
organisms from biocides.
Infection caused by inhaling airborne droplets or particles containing
Legionella.
Initial symptoms include high fever, chills, headaches and muscle pain.
A dry cough soon develops and most patients suffer difficulty with
breathing.
Leptospirosis
Contact with water or mud and slime contaminated by rats.
Leptospira icterohaemorrhagiae is found in the kidneys of rats and

reaches the outside in excretions of urine; it is from this source that
humans are infected.
Fever with flu-like symptoms lasting for about a week.

Jaundice may be present for three or four weeks.
E-Coli
Bacteria found in the gut of humans and animals.
48 © Copyright RRC
Infection through poor hygiene or contaminated food.
Can have serious consequences for the very young, the elderly and
those whose immune system is compromised.
Biological Sensitisation
Biological agents may cause an allergic reaction in an individual so that
subsequent exposure causes an extreme reaction, which may cause
respiratory difficulties such as asthma and/or a skin reaction such as
dermatitis.
ASSESSMENT AND CONTROL OF RISK

Occupational Groups at Risk
Exposure to Biological Hazards
Agricultural workers.
Health service workers/laboratory workers.

Mortuary workers.
Emergency services.
First-aiders.
Laundry workers.
Sewage and construction workers.
Food handlers.
Vulnerable Groups
The elderly, debilitated or chronically sick - reduced resistance to

infection.
Pregnant and breast-feeding women and their children - transmitted to

the unborn child in the placenta or via milk after birth.
People with a suppressed immune system - less able to resist
infection.
Intentional Work and Opportunistic Infection
There are three ways in which you might be exposed to biological agents at
work:
© Copyright RRC 49
1. As a result of intentionally working with biological agents, e.g. in a

microbiology Laboratory.
Since the identity of the hazard is known, control measures to

minimise the risk of infection can be identified, implemented and
monitored – as we discuss later.
2. Incidental to work, e.g. farming, refuse collection and sewage
treatment.
Most biological infections occur this way. The presence of the agent is
less likely to have been identified or adequate control measures to
have been implemented.
3. Not a result of, or connected with, work that you do.
For example, catching flu from a work colleague - this isn’t under the
control of the employer (to any great extent).
COSHH only deals with the first two cases. It is not concerned with the
final case.
Role of Diagnostic Laboratories
Identify the biological agent concerned.
A sample of infected material is sent to a diagnostic laboratory, which

can grow the organism and identify it.
Risk Assessment of Biological Hazards
Risk Assessment Procedure
Hazard Categorisation of Micro-Organisms
Ability to Hazard to Spread in the Prophylaxis

Category Cause Workers Community and
Human Treatment
Disease
Group 1 Unlikely - - -
Group 2 Possible Possible Unlikely Available
Group 3 Serious Serious Possible Available
Group 4 Severe Serious Likely Not Available
Risk assessment for biological agents needs to take account of:
50 © Copyright RRC
The ability to replicate and infect (unlike chemical agents).
The existence of no simple dose-response relationship (unlike most

chemical agents) so the risk may be high at small doses.
Uncertainty about the presence of the agent, e.g. in patients, animals,

etc.
Practically, this means the main points that need to be considered in making
an assessment of the risks to health of workers exposed to biological agents
are:
The hazard group of the agent.
The form of the agent – hardy spores or infectious stages.
How and where they are present.
How they are transmitted.
The nature of the disease it may cause (seriousness and availability of

vaccination or treatment).
The likelihood of exposure (including frequency of exposure) and

consequent disease.
Identification of activities (don’t forget emergencies or other non-

routine things) where exposure could occur.
The following activities will specifically involve exposure to biological

agents:
− Microbiological laboratory work.
− Genetic manipulation.
− Work with animals and animal products.
− Healthcare, where there is exposure to human disease or human
materials.
− Work with, or proximity to, water systems contaminated with
legionella.
Identification of workers and non-workers at risk (including the
numbers at risk and any vulnerable groups mentioned earlier).
Persons directly exposed (those working with biological agents).
© Copyright RRC 51
Persons indirectly exposed (those who need to enter areas where

biological agents are handled).
Persons who may be affected by an accident or incident releasing

biological agents (other workers or members of the public).
As always with risk assessment, the degree of rigour/detail must reflect the
level and nature of the risk.
Control Strategies for Biological Agents
Eradication (or elimination).
Reduced virulence.
Change of work method to minimise generation of aerosols.
Isolation and segregation.
Containment:
Level 1 is suitable for handling agents that are unlikely to cause

human disease.
Level 2, as Level 1, but a number of additional precautions needed,

e.g. procedures likely to give rise to infectious aerosols must be carried
out in microbiology safety cabinets.
Level 3, as level 2, but some additional precautions including the
requirement for laboratories to be sealable for disinfection and
maintained at a negative pressure.
Level 4, as level 3, but further precautions including entry through an

airlock, input and extract air filtered and all work carried out in closed
safety cabinets.
Ventilation:
− Class I
o Open-fronted cabinets where air is drawn in, filtered through
a High Efficiency Particulate Air (HEPA) filter and discharged
to atmosphere.
o Cabinet protects the operator only from agents that might
infect the operator by airborne routes.
− Class II
52 © Copyright RRC
o Open-fronted cabinets where air is drawn in, exhausted

through slits in the front base of the cabinet then filtered
through a HEPA filter. The air drawn down over the open
front forms a curtain to prevent the escape of aerosols back
into the laboratory.
o Cabinets protect the operator and also the work from
external contamination.
− Class III
o Totally enclosed, leak-proof cabinets where the operator
works through glove ports, air is drawn in and extracted
through a HEPA filter and discharged to atmosphere.
o Cabinets protect both the operator and the work from
external contamination.
Sharps control.
Immunisation/vaccination.
Decontamination and disinfection:

− Biological agents capable of causing disease are killed or
rendered harmless by exposure to disinfectants or biocides.
Further Control Measures
Effluent and Waste Disposal
Microbiological materials will remain hazardous.
Should be rendered safe before disposal by heat treatment, involving

autoclaving or incineration, or chemical disinfection.
Clinical waste is a controlled waste.

Personal Hygiene Measures
Washing facilities and not eating, drinking or smoking.

Personal Protective Equipment
Absorption through the skin – gloves.
Absorption through the conjunctivae – eye protection.
Inhalation into the lungs - respiratory protection.
© Copyright RRC 53
Biohazard Signs
Baseline Testing and Health Surveillance
Pre-Employment Screening
Identify persons who may be particularly vulnerable to the effects of

exposure to biological agents.
Health Surveillance
Early detection of signs of ill-health and periodic testing to monitor for

disease development.
Control Measures in Hospitals, Laboratories and Animal Houses
Hospitals and Laboratory Work

− Potential exposure to body fluids such as blood and plasma,
excretions such as urine and faeces, or human tissues.
− Controls:
o Protection of wounds and cuts.
o Avoiding exposure to sharps.
o Use of face and eye protection.
o Use of protective clothing.
o Possibly a containment level approach (depending on hazard
group of micro-organisms).
Animal Houses
− Exposure to zoonoses.
− Controls:
o Covering cuts.
o Wearing gloves, protective clothing and eye protection.
o General hygiene and cleanliness.
o Security to prevent animals escaping.
o Proper disposal of animal waste.
o Possibly a containment level approach (depending on hazard

group of micro-organisms).
54 © Copyright RRC
B7: PHYSICAL AGENTS 1 – NOISE AND

VIBRATION
NOISE - PHYSICS
Definition
Unwanted sound.
Basic Concepts of Sound
Sound – the sensation which the brain perceives when pressure

variations in the air are detected by the ear.
Amplitude is the maximum displacement of sound wave pressure

(measured in Pa). A larger amplitude means louder – though loudness
is the ear’s subjective response to sound intensity.
The intensity of sound is the power transmitted per unit area

(measured in W/m2); it is proportional to the square of the amplitude.
Frequency - cycles per second (Hz) – determines the pitch.
The pitch is the way the brain interprets the frequency of sound. The
greater the frequency, the higher the pitch.
Wavelength - the distance between wave crests or wave troughs.

Tone
Character of the sound we hear, (combination of frequencies which make

up the sound).
Decibel (dB)
Used to measure sound intensity.
The threshold of hearing is assigned a value of 0 dB.
Decibel scale is logarithmic, rather than linear.
A-weighted scale mimics the human ear's response across the range
of frequencies.
Evaluation of Occupational Noise
Sound can be considered as travelling in all directions from a source.
© Copyright RRC 55
Intensity of the sound provides a good measure of the energy (or

sound pressure) received by the ear and therefore a measure of the
physical harm that can be produced.
Intensity of the surface energy derived from the sound can therefore
be expressed as watts per metre squared, W/m2.
Measurement of Sound Intensity
Sound intensity (I) is directly proportional to the square of the sound
pressure (p), written as:
I α p2
An increase of 3 dB represents a doubling of the sound intensity (and

therefore double the harm).
An increase of 10 dB represents a tenfold increase in the sound

intensity.
Addition of Combined Sounds
Equal Values
The introduction of another source of equal value will double the sound
intensity and hence increase the dB reading by three.
Unequal Values
Levels separated by 10 dB (or more) produce no significant increase

on the higher level when combined.
Identical levels give a 3 dB increase.
It is possible to make a rough estimate of combined levels of sound

separated by <10 dB by using a combined sound level table.
Noise Rating Curves
NR curves are based on equal loudness contours, but are used for
determining the level of annoyance of broad-spectrum noises.
EFFECTS
The Ear
Outer ear with auditory canal – collects sound onto eardrum.
56 © Copyright RRC
Middle ear – transmits and amplifies sound to cochlea.
Inner ear – stimulates nerve ends at base of hair cells and transmits
sound energy patterns to auditory centre of brain.
Effects of Exposure to High Noise Levels
Noise Dose
Damaging effects of noise are related to the total amount of energy or

"dose" which the ear receives.
Dose/energy depends on two factors:

− Level of noise.
− Duration of exposure.
Hearing Loss
Conductive Hearing Loss
Physical breakdown of the conducting mechanism of the ear resulting

from an acute acoustic trauma.
Sensorineural Hearing Loss
Exposure to excessive noise, resulting in varying levels of acoustic

trauma.
Types of Hearing Loss
Tinnitus
− Exposure to excessive noise levels.
− An acute condition which may recede with time.
Temporary Threshold Shift (TTS)
− Exposure to a high noise level; hearing acuity returns with time.
(Fatigue of the hair cells in the cochlea.)
− A dip in hearing acuity occurs at 4000 Hz.
© Copyright RRC 57
Permanent Threshold Shift (PTS)
A non-reversible condition which usually follows from continual TTS

exposure.
Presbycusis
Reduction in hearing acuity with frequencies at the higher end of the

audio range which occurs naturally with age.
Noise-Induced Hearing Loss (NIHL)
Failure of the hair cells in the cochlea to respond fully to sound

intensities which have frequencies within the speech range.
Other Effects of Noise on Health
Neuropsychological disturbances:
− Headaches.
− Fatigue.
− Insomnia (sleeplessness).
− Irritability.
Psychological responses:
− Cardiovascular system disturbances:
o Hypertension.
o Cardiac disease.
− Digestive disorders:
o Ulcers.
o Colitis.
AUDIOMETRY
Assessment of Hearing Loss
Measurement of hearing performance in order to detect actual noise-
induced hearing loss.
Audiometry Technique
Preparation and instructions given about the test procedure.
58 © Copyright RRC
Earphones fitted over the ears and the test is then carried out on each
ear.
A threshold test is undertaken (ear subjected to sound at a frequency

of 1 kHz at varying levels of intensity).
Ears tested through a range of frequencies and hearing loss recorded

for each frequency.
Accuracy of audiometry can be affected by:
Technical limitations.
Learning effect.
Headphone fit.
Evaluation of Audiograms
Pictorial representation of hearing loss at various frequencies is
produced.
Common use of audiometric testing is at the pre-employment stage.
MEASUREMENT AND ASSESSMENT OF

EXPOSURE
Types of Instrumentation
Simple Sound Level Meter
For making routine spot checks. Not considered adequate for

establishing compliance with CNAWR 2005.
Integrating Sound Level Meters
For measuring noise levels and average value for the measurement
period. For use in compliance with CNAWR 2005, it must at least
be:
− a Class 2 instrument (BS EN ISO 61672-1:2003); or
− a Type 2 instrument (BS EN 60804:2001 – the previous

standard);
and
− capable of measuring:
© Copyright RRC 59
o equivalent continuous A-weighted sound pressure level (LAeq

or Leq dB(A)) which is used to calculate the daily personal
noise exposure (LEP,d)); and
o maximum C-weighted peak sound pressure level.

Personal Sound Exposure Meters (Dosimeters)
To measure the total noise dose over the whole working period.
Methodology for Use of a Sound Level Meter
Check batteries for adequate output.
Calibrate the meter using the appropriate calibration attachment.
Set the meter on "slow response".
Set the meter to read A-weighted sound level.
Set the meter to read the highest attenuation reading possible (this is
done to protect the meter from unknown high sound levels).
Before readings are taken, re-check batteries.

Leq and LEP,d
Leq represents the average noise dose over the measurement period.
LAeq (alternatively written Leq dB(A)) represents the A-weighted version
of the above.
LEP,d represents the average noise dose over eight hours.
LEP,d may be calculated from exposure data using a formula. A

simplified ready-reckoner method also exists.
Use of Frequency Analysis
Selection of hearing protection.
Identifying noise control measures (structural materials).
Frequency analysis is typically done for so-called octave band centre

frequencies - 63.5, 125, 250, 500, 1000, 2000, 4000, 8000 Hz. It is
then called Octave band analysis.
60 © Copyright RRC
Background Noise
Any noise measurements carried out with plant operating will include
any background noise.
Need to estimate noise generated by the plant and equipment only.

Noise Surveys
Identify people at risk of hearing damage.
Determine the daily noise exposure (LEP,d) of those who are likely to be
exposed at or above the lower exposure action value.
Identify additional information to comply with CNAWR 2005, such as

where noise control and hearing protection may be required.
So, practically it includes:
Surveying the workplace to gather data.
Analysing the results and comparing with action values.
Deciding if you need to do any more to control noise.
Planning what more you need to do and doing it.
Recording findings.
Reviewing assessment, as necessary.

Planning and Approach to Measuring Noise Exposure
Values
Who Should be Assessed?
All workers likely to be exposed at or above the lower or upper

exposure action values.
What Equipment is Needed?
An integrating sound level meter, calibrator, and dosimeter.
What Should be Measured?
Initially:
− LAeq - equivalent continuous A-weighted sound pressure level.
© Copyright RRC 61
− Maximum C-weighted peak sound pressure level(s) to which the

person is exposed.
− Duration of exposure.
− These will enable calculation of the daily noise exposure (LEP,d).
Where?
At every location that the person works in or walks through during the
day. Note the time spent in each location. Take measurements at the
position occupied by the operator’s head and preferably with the
person not present. If using a dosimeter, place the microphone on the
person’s shoulder (to prevent it touching the neck).
For How Long?
Measurements need to be sufficient to account for variations in the

day.
Group Sampling
If several workers work in the same area, you may be able to assess
the exposure for all by doing measurements in selected locations.
Mobile Workers and Highly-Variable Daily Exposures (e.g.

maintenance)
There is no typical daily exposure here. Measure a range of different
activities likely to be encountered – estimate the worst likely exposure
from these.
Very Short Duration Noise (e.g. gunfire, explosions and

cartridge-operated tools)
This may already be included in the overall noise measurements of

LAeq for the exposure period. There are methods to assess these
separately if it has been excluded from other measurements (or if the
meter does not have sufficient dynamic range).
Second, More Detailed, Noise Survey May be Needed
For example, where exposure is at or exceeds the upper exposure

action value or the exposure limit value, you may need to use
frequency (octave band) analysis to enable proper selection of noise-
attenuating materials and hearing protection.
62 © Copyright RRC
Interpretation and Evaluation of Results

Equivalent continuous daily personal noise exposure levels (LEP,d)
should be interpreted by reference to the Control of Noise at Work
Regulations 2005.
Analysis of the data will enable the identification of circumstances

where a risk of hearing damage exists.
Short-term strategy designation of hearing protection areas.
Longer-term aim to reduce noise generation at source.
CONTROLS
Noise Pathways
A receiver may experience noise from the source either directly, through
transmission or through reflection.
A sound wave front interacts with a slab of material so that some is

reflected, some is absorbed and some transmitted.
Damping
Effective at reducing the noise radiated from steel panels and any structure
that can 'ring' due to vibration.
Diffusion
This involves reflecting sound waves off convex or uneven surfaces. It

helps evenly distribute sound and so blends it. It can eliminate sharp
echoes.
Acoustic Properties of Materials
Absorption and Absorption Coefficients
Sound is converted into other forms of energy.
Reflection and reflection coefficients.
Sound is reflected by material.

Transmission and Transmission Coefficients
Degree of transmission depends on density and thickness, and the

frequency of the sound.
© Copyright RRC 63
Sound Reduction Index (SRI)
This is the difference, in decibels (dB), between the sound level incident on
a material and the sound level transmitted through the material, i.e. the
level of attenuation (sound reduction) of noise. SRI is also known as
sound transmission loss. SRI varies with frequency and so it is
measured at various frequencies to obtain the transmission loss spectrum.
These spectra can be fitted to standard contours (in a similar manner to the
case of the noise rating curves discussed earlier), to give single value
known as the weighted SRI.
Evaluation of Noise Control Techniques
Noise reduction at source, e.g. relocation, redesign and maintenance.
Attenuation in transmission (reduce the transmission of noise before it

reaches the worker), e.g. isolation, barriers and enclosure.
Control at the receiver, e.g. acoustic havens and hearing protection

(passive and active).
Acoustic Enclosures (Design Features)
Protection of the internal absorbent lining.
Robust construction.
Sealing between panel and floor, and around penetrating ducts and
pipes.
Access for operation and maintenance.
Robust locks to doors and hatches.
Observation windows.
Adequate internal space.
Adequate lighting and ventilation.

Acoustic Havens (Design Features)
Noise reduction properties of the haven.

Observation windows.
Adequate internal space.
Adequate lighting and ventilation.
64 © Copyright RRC
Adequate seating.
Inclusion of as many controls as possible to reduce the time needed to

be spent wearing ear protection in the noisy environment outside the
haven.
Hearing Protection
Disposable Earplugs
− Glass down.
− Expanding Polyurethane Foam. These are useful for:

o Temporary use.
o Where employee turnover may be high.
Reusable Earplugs
Earmuffs (Ear Defenders)

Significance of Attenuation Data
Hearing protection should be chosen to reduce noise exposure at the
user's ear to below the relevant action value.
To provide protection, the composition of the noise must be

understood, which is done by means of octave band analysis.
Factors Affecting the Degree of Protection Afforded by
Hearing Protectors
Spectacles and other PPE may reduce the effectiveness of earmuff fit.
Hearing protectors may not be correctly fitted.
Re-usable equipment needs to be properly stored, maintained and

inspected.
Hearing protectors may not be worn at all times in the noisy area.
VIBRATION - PHYSICS
Vibration - oscillatory motion involving an object
moving back and forth.
Amplitude
Extent of vibration from the point of rest.
© Copyright RRC 65
Magnitude
Usually expressed in terms of acceleration and measured using an

accelerometer (m/s2).
Frequency
Cycles per second.
EFFECTS
Discomfort Effects
The Lower frequency vibrations tend to cause physical discomfort.
Ill-Health Effects - Hand-Arm Vibration
Circulatory disorders (blanching of fingers).
Neurological disorders (numbness and tingling).
Muscular effects (difficulty with grip and reduced dexterity).

Articular effects (bone and joint problems).
Vibration-Induced White Finger
Produced at work by exposure to vibrations from hand-held tools.
Frequency range over which injury can occur is between 5 Hz and

2000 Hz, (lower frequencies, i.e. 5 Hz to 150 Hz, risk is considered to
be at its greatest).
Increase in amplitude increases the potential risk.

Symptoms
Tingling and numbness in the fingers.
Fingers suffer blanching.
Reduced manipulative ability.
Possibility of gangrene.
Pathology
Lack of blood flow to the fingers.
Caused by abnormal conditions in the small arteries.
66 © Copyright RRC
Standardised Diagnostic Tests for HAVS (including Vibration-

Induced White Finger)
Vascular (blood flow) tests:
Time taken for the finger to return to full circulation after cold
provocation test (CPT).
Finger systolic blood pressure test (FSBP).
Sensorineural tests (for assessing nerve damage):
Vibrotactile perception threshold (VPT).
Thermal (temperature) perception threshold (TPT).

Classification of Severity of VWF
On the Stockholm Workshop scale and the Griffin method.

Tools and Processes Associated with VWF
Pneumatic-riveting, caulking, fettling, hammering and drilling.
Chipping hammers.
Pedestal, and flexible grinders and polishers.
Chainsaws.
Concrete vibro-thickeners and levelling vibratables.

Whole-Body Vibration
Principal Health Problems
Back disorders.
Abdominal pain.
Digestive disorders.
Urinary problems.
Balance, headaches and visual problems.

Workers at Risk
Drivers of heavy vehicles (tractors and earth-moving vehicles).
Drivers of forklift trucks.
© Copyright RRC 67
Operators of heavy machines (power presses).
Aircraft personnel.
MEASUREMENT AND ASSESSMENT OF

EXPOSURE
Using an accelerometer that has three electronic sensors that measure
the acceleration caused by the vibration in each of the three planes X,
Y and Z.
Monitoring device is attached to the hand and the signals measured by

each sensor are combined to an overall frequency-weighted
acceleration.
Equivalent daily exposure represents the eight-hour frequency

weighted root mean square acceleration entering the hand-arm
system.
Exposure Standards
Hand-arm vibration: the daily exposure limit value is 5 m/s A(8); the
daily exposure action value is 2.5 m/s2 A(8).
Whole-body vibration: the daily exposure limit value is 1.15 m/s2 A(8);
the daily exposure action value is 0.5 m/s2 A(8).
CONTROLS
Risks
Depend on:
− The magnitude of the measured average acceleration (m/s2).
− The exposure time.
− Individual susceptibility.
Strategy for a Risk Assessment

Practically, you need to cover the following steps to assess the vibration
risk:
Identify where there is likely to be a significant vibration risk (hand-

arm and whole-body).
68 © Copyright RRC
Consider which tools and processes expose employees (typical ones

discussed earlier); look at manufacturer handbooks, etc. which may
warn of vibration risks; look at ill-health symptoms and records;
discuss with employees and safety representatives.
Identify who is at risk.
Decide on the level of risk.
Look at vibration information available for the tools and processes
identified (remember that you may not need to actually measure it in
many cases); consider the duration of exposure (remember this means
the actual “contact” or “trigger” time); compare your findings with the
Exposure Action Value (EAV) and Exposure Limit Value (ELV).
Decide what more needs to be done to eliminate or control the risk
(including the need for health surveillance).
To help prioritise your risk assessment workload, the HSE suggest:
For Hand-Arm Vibration:
High risk (above the ELV) would generally be:

− Employees regularly operating:
o Hammer action tools > one hour per day.
o Some rotary (and other) action tools for > two hours per
day.
Medium risk (above the EAV) would generally be:

− Employees regularly operating:
o Hammer action tools > 15 mins per day.
o Some rotary (and other) action tools for > one hour per day.
For Whole-Body Vibration:

Most machine and vehicle activities produce WBV below the ELV in
normal use.
Some off-road machinery used for long periods may exceed the ELV.
Risk Control Measures
Elimination.
© Copyright RRC 69
Substitution.
Reduction of vibration transmission to hands.
Maintenance.
Reduced time exposure.
Health surveillance.
Information, instruction and training.
70 © Copyright RRC
B8: PHYSICAL AGENTS 2 – RADIATION

AND THERMAL ENVIRONMENT
RADIATION PHYSICS
Types of Non-Ionising Electromagnetic Radiation –
Origins and Sources
Energy of electromagnetic radiation is proportional to its frequency.
Radiation of a high enough frequency (X-ray, gamma ray) is energetic

enough to ionise matter.
Non-ionising radiation is radiant energy which does not have sufficient

energy to cause ionisation in matter:
− Ultraviolet - naturally occurring in sunlight, emitted from
sunlamps, arc welding.
− Visible - naturally occurring in sunlight, emitted from arc welding,
etc.
− Infrared - naturally occurring in sunlight, emitted from arc
welding and as a result of heating effects.
− Microwave - microwave communications, anti-intruder alarms,
cooking, diathermy.
− Radiowaves - naturally occurring, emitted from satellite
communications, TV and radio broadcasts, radar, magnetic
resonance imaging (MRI) in medical diagnosis.
Particulate and Non-Particulate Types of Ionising

Radiation – Origins and Sources
Ionisation occurs by the removal of electrons from the structure of the atom
and leaves behind an ion pair.
Types include:
Alpha radiation.
Beta radiation.
Gamma radiation.
X-ray radiation.
© Copyright RRC 71
Neutrons.
Radiation Protection Agencies
International Commission for Radiological Protection (ICRP).
Radiation Protection Division of the Health Protection Agency (formerly

the National Radiological Protection Board (NRPB)).
NON-IONISING RADIATION
Acute and Chronic Physiological Effects of Exposure
Ultraviolet Radiation
Acute effects – reddening of the skin.
Chronic effects of exposure to ultraviolet radiation are:

− Premature ageing of the skin.
− Cancer of the skin.
Photosensitisation.
Effect upon the eyes:

− ‘Kerato conjunctivitis’.
Formation of toxic contaminants.
Sterilisation effects.
Infrared Radiation
Produced by hot bodies.
Causes skin burns and cataracts.

Microwaves
Microwave radiation covers the wavelength region between about 1

mm and 1 m.
Biological harm is caused by the process of heating.

Radiowaves
Used for heating purposes.
72 © Copyright RRC
Severe radio frequency burns can occur by contact with the heating
units.
Lasers
Optical systems which are able to generate a highly concentrated

beam of radiation.
Ability to physically destroy tissue.

Measurement
Optical
Spectrophotometer or a spectroradiometer.
Radio Frequency (RF) and Microwaves
Equipment to display power density.

Lasers
Calorimeter absorbs the energy and measures the heat created.

Controls
Assessment of Risks
Assessment of exposure used as a means of assessing risk and also

compliance with Exposure Limit Values (ELVs).
Electromagnetic fields and artificial optical radiation may require

measurement (though you may rely on equipment manufacturer data where
available) for proper assessment. Natural optical radiation (i.e. solar) may
be assessed subjectively. The risk assessment should consider:
Level, wavelength (or frequency) range and duration of exposure to

EMF and artificial optical sources.
Exposure to natural optical sources.
Exposure limit values.
Workers particularly at risk.

Interactions between optical radiation and photosensitising chemicals.
Indirect effects such as (for optical) temporary blinding, explosion or

fire and (for EMF) interference with medical equipment (including
© Copyright RRC 73
pacemakers), initiation of detonators, fires/explosions (from sparks

caused by induced fields), etc.
Existence of replacement equipment designed to reduce the levels of

exposure.
Information obtained from health surveillance.
Multiple sources of exposure.
Simultaneous exposure to multiple frequency EMF fields.
Laser classifications.
Information provided by manufacturers of optical radiation sources.

General Control Principles
Action to reduce exposure (elimination or reduction) is based on the

general principles of prevention (MHSWR 1999).
Eliminate as far as possible – explore alternative technologies.
Other working methods that reduce the risk – administrative controls

for routine operation, maintenance, etc. (also permits).
Choose equipment emitting less radiation (depends on work).
Technical measures to reduce the emission of radiation:

− Interlocks, shielding, enclosures, screens, etc.
Maintenance.
Design, siting and layout of workplaces and workstations – control

over direction, stray fields/reflections (by painting surfaces matt
black), etc.
Limit duration and level/intensity of exposure, e.g. time, distance

(except lasers where distance doesn’t work!).
PPE, e.g. eye protection.
Follow manufacturer instructions.

Signs.
Supplement with specific information and instruction for employees and

health surveillance (as necessary).
74 © Copyright RRC
Protection from Ultraviolet Radiation

Shielding of the skin.
Eye protection.
Screened areas.
Interlock systems.
Protection from Infrared Radiation
Distance.
Eye protection.
Skin protection.
Protection from Microwave Radiation
Enclosure in a metal structure.
Access doors.
Hazards Classification of Lasers and Associated
Controls
Class 1 considered safe under reasonably foreseeable use.
Class 1M similar to Class 1 but the beam is not safe if viewed with the
aid of magnifying optical instruments.
Class 2 (for lasers emitting in the visible range). Low power devices.
Eye protection is normally afforded by the aversion response and the
blink reflex of the eye.
Class 2M similar to Class 2 but beam is not safe if viewed with the aid
of magnifying optical instruments.
Class 3R laser products limited to maximum output power of 5 mW.

These can potentially cause eye injury.
Class 3B laser products limited to a maximum output power of 500

mW. These are considered hazardous to the eye – both directly and
reflections.
Class 4 high-powered devices (> 500 mW). They are hazardous to

eyes and skin and can cause fires.
© Copyright RRC 75
Main Methods of Control
Engineered controls:
− Interlocks on equipment and rooms.
− Screening/enclosures.
− Non-reflective surfaces.
Administrative controls:
− Warning lights (to indicate “in operation”).
− Signs.
− Training for users of Class 3R, 3B and 4 (and possibly even for
lower classes).
− Work methods.
− Appointment of people with specific responsibility (laser safety
officers).
PPE:
− Laser safety eyewear.
− Skin protection (if appropriate).
IONISING RADIATION
Effects
Biological Effects of Exposure
Critical changes to chemical structures of cellular matter.
Damage to the structure of chromosomal material.
Rapid death of cells.
Delayed cell reproduction, or its prevention.
Permanent modification of cell structure which will be passed on to

daughter cells.
Units of Radioactivity, Radiation Dose and Dose Equivalent
Half-life – is the time required for one half of a quantity of radionuclide

to disintegrate.
76 © Copyright RRC
Activity - an estimate of the likely ‘amount’ of radiation being emitted

(Bq).
Absorbed dose – measure of energy deposited by the radiation.
Equivalent dose – measure of the likely biological damage resulting

from radiation exposure (Sv).
Effective dose - this is a weighted sum of all the equivalent doses

and relates to the whole body. The equivalent dose for each tissue is
multiplied by its respective tissue-weighting factor. These products
are then added together to arrive at the effective dose for the whole
body.
Acute and Chronic Effects of Irradiation
Somatic Effects
− Symptoms produced in the irradiated person which result from
direct damage to body cells.
− Early effects:
ο Nausea and vomiting.
ο Infection death.
ο Gastrointestinal death.
ο Central nervous system death.

− Late effects:
ο Carcinogenic effects.
ο Cataract formation.
Genetic Effects
− Damage to male or female reproductive cells.
− Characteristics will occur in the offspring.
Dose/Response and Dose Effect

Non-Stochastic Effects
− The severity of the effect increases with increasing dose.
− Dose limits can be set below the threshold.
− Radiation sickness, skin burns or cataracts.
© Copyright RRC 77
Stochastic Effects
− The likelihood of the effect increases with increasing dose.
− There is no threshold for a dose limit.
− Radiation-induced cancer and radiation-induced genetic effects.
Workplace Occurrences and Applications of Ionising

Radiation
Alpha Radiation
Nuclear industry, static eliminators, some types of smoke detectors.
Beta Particles
− Medical research, thickness gauges.
− X-rays – medicine, evaluate crystal structures.
− Gamma rays – radiography, radiotherapy treatment.
Neutrons
Nuclear industry.
Measurement
Ionisation chambers.
Scintillation detectors.
Film badges.
Thermoluminescent dosimeters.
Controls
Radiological Limits
Annual limits are:
78 © Copyright RRC
Equivalent Dose (in mSv)
Category Effective Lens of eye Skin1 Extremities2 Abdomen3

dose
(in mSv)
Employees 20 150 500 500 13
18 and over
Trainees < 6 50 150 150 13
18 years
Others 1 15 50 50 -
1
Averaged over any 1 cm2.
2
Hands, forearms, feet, ankles.
3
Applies to female workers of reproductive capacity only.
Classified person: an employee who is at least 18 years old and fit for
work and likely to receive an equivalent dose of more than three tenths of
the dose limit OR an effective dose of more than 6 mSv per year. Such
people are subject to medical surveillance and assessment/recording of
doses.
Practical Control of External Radiation
Shielding.
Distance.
Reduced time exposure.

Practical Control of Internal Radiation
Containment of unsealed radioactive material.
Respiratory protective equipment.

Role of the Radiation Protection Adviser and the Radiation
Protection Supervisor
Controlled area: an area where it is necessary to follow special

procedures designed to restrict significant exposure; or an area where it is
likely that any person may exceed an effective dose of 6 mSv per year, or
employees of 18 years of age or older are likely to receive an equivalent
dose exceeding three tenths of a relevant dose limit.
Supervised area: an area where it is necessary to keep conditions under
review to determine whether it should be designated as a controlled area;
or an area where any person is likely to receive an effective dose > 1
mSv/year or an equivalent dose > 1/10th of any relevant dose limit (for
employees 18 years old or more).
© Copyright RRC 79
Radiation employers are required to consult with and appoint suitable

Radiation Protection Advisers (RPAs). Their main role is to advise the
employer on IR Regulations 1999. RPAs must have particular experience
of the type of work the employer undertakes.
Radiation employers must consult with RPAs on:
Implementing requirements for controlled and supervised areas.
Plans for new/modified sources of ionising radiation.
Calibration/servicing/use of equipment used for monitoring radiation

levels.
Critical examinations by installers.
Periodic examination and testing of engineering controls, systems of

work, etc. for restricting exposure.
Special systems of dose limitation for employees.
Any other situations where RPA advice needed for observing the Regs.
The Approved Code of Practice to the Regulations also advises consultation

on:
Risk assessment.
Designation of controlled and supervised areas.
Investigations (incidents, spillages, etc.).
Contingency plans.
Dose assessment and recording.
QA programme for equipment used in connection with medical

exposures.
Employers must also appoint one or more Radiation Protection Supervisors

(RPSs) who are responsible for ensuring that the local rules are complied
with.
Duties of the RPS include record-keeping, registration of workers, radiation

monitoring and the implementation of local rules.
80 © Copyright RRC
THERMAL ENVIRONMENT – EXTREMES OF

TEMPERATURE
Effects
Working in High and Low Temperatures and Humidity
Exposure to hot, humid conditions may lead to:
Inability to concentrate.
Muscle cramps (due to insufficient salt intake).
Heat rash.
Severe thirst (due to dehydration).
Fainting.
Heat exhaustion - fatigue, giddiness, nausea, headache, moist skin.
Heat stroke - hot dry skin, confusion, convulsions, loss of

consciousness.
Exposure to extreme cold conditions may lead to:
Cold injuries:
− Non-freezing, e.g. chilblains, trenchfoot (in damp cold
environments).
− Freezing, e.g. frostbite.
Hypothermia (from excessive lowering of body core temperature):
− Sensation of cold followed by pain, then numbness.
− Muscular weakness.
− Drowsiness.
− Coma.
Typical Work Situations Likely to Lead to Thermal Discomfort
Heat stress:
− Furnace work, handling molten metal.
− Glass-making.
− Welding, brazing.
© Copyright RRC 81
− Boiler and furnace maintenance, boiler-room work.

− Deep-mining work.
− Laundries.
− Kitchens.
− Fire-fighting.
Cold stress:
− Outdoor work (agriculture, maintenance, etc.).
− Sea fishing, shipping.
− Oil rigs.
− Deep freeze stores, cold rooms.
− Diving.
Measurement
Human Body/Thermal Environment Parameters
Surrounding temperature.
Humidity.
Air velocity.
Metabolic rate.
Clothing.
Duration of exposure.
Instrumentation
Thermometers
− Liquid thermometers.
− Thermocouples.
− Resistance thermometers.
Thermometers are used to measure three important temperature

parameters – dry bulb air temperature, wet bulb air temperature and
radiant temperature.
82 © Copyright RRC
− Dry bulb air temperature can be measured using mercury/alcohol

in glass thermometers, thermocouples or resistance
thermometers.
− Wet bulb temperature is obtained with the sensing head covered
with a muslin sock wetted with distilled water and protected from
radiant heat.
− Measurements of radiant temperature are usually made with a
black globe thermometer.
Hygrometer
− Paper or hair hygrometer.
− Whirling hygrometer.
Used to measure humidity.
Kata Thermometer/Anemometer
Used to determine wind velocity.

Heat Indices and Assessment of Exposure to Thermal Environment
Extremes
Wet Bulb Globe Temperature (WBGT)
WBGT = 0.7 WB + 0.3 GT indoors
WBGT = 0.7 WB + 0.2 GT + 0.1 DB outdoors
where WB is the wet bulb temperature
GT is the globe thermometer temperature
DB is the dry bulb temperature.
Effective Temperature (ET)
Takes into account wet bulb temperature, dry bulb temperature and
air velocity.
Corrected Effective Temperature (CET)
Effective temperature but corrects the index to take account of radiant

heat (globe temperature used instead of dry bulb temperature).
© Copyright RRC 83
Heat Stress Index (HSI)
Balances heat inputs (from the environment and from the metabolic
rate) against heat loss by the evaporation of sweat. HSI is essentially a
measure of strain in terms of body sweating.
Predicted 4-Hour Sweat Rate (P4SR)
Uses the six thermal parameters to calculate a nominal sweat rate that
would be necessary to maintain thermal equilibrium.
Wind Chill Index (WCI)
Index of heat loss from the body developed to quantify the risk
resulting from the combined cooling effect of wind and cold conditions.
Controls
Circulation of air and ventilation.
Workplace design.
Work organisation – restricted work periods, supervision.
Health surveillance.
Personal protective equipment.
84 © Copyright RRC
B9: PSYCHO-SOCIAL AGENTS

STRESS
Identification
Ill-Health Effects Associated with Stress
Physical effects:
− Raised heart rate.
− Increased sweating.
− Headaches.
− Dizziness.
− Blurred vision.
− Aching neck and shoulders.
− Skin rashes.
− Lowered resistance to infection.
Behavioural changes:
− Increased anxiety and irritability.
− Increased alcohol consumption.
− Increased smoking.
− Difficulty sleeping.
− Poor concentration.
− Inability to cope with everyday tasks and situations.
Serious ill-health conditions:
− High blood pressure.
− Heart disease.
− Anxiety and depression.
− Ulcers.
− Thyroid disorders.
© Copyright RRC 85
Causes of Stress
Organisational Factors
− Unreasonable pace of work.
− Lack of control over work.
− Inadequate managerial support.
− Demanding work schedules.
Personal Relationships
− Feelings of isolation.
− Bullying and harassment.
Physical Factors in the Workplace
− Lighting.
− Temperature.
− Noise.
− Space.
− Ergonomic design.
Working Hours
Legal Obligations
Health and Safety at Work, etc. Act 1974.
Working Time Regulations 1998.
Management of Health and Safety at Work Regulations 1999.

Case Law
Walker v. Northumberland County Council (1994)

An employer can be held liable for mental injury to an employee caused by
work-related stress.
Sutherland v. Hatton (2002)

More detailed explanation of the extent of an employer's duties.
86 © Copyright RRC
Signs of Stress at Work
Work Performance
− Reduction in output or productivity.
− Increase in wastage and errors.
− Deterioration in planning and control of work.
− Poor decision-making.
Relationships
− Tension and conflict between colleagues.
− Poor relationships with clients.
− Increased incidence of industrial relations or disciplinary
problems.
Staff Attitudes and Behaviour
− Loss of motivation and commitment.
− Erratic or poor timekeeping.
− An increase in working hours but with possibly less output.
Sickness Absence
− Increase in general absence.
− Frequent short periods of absence.
Controls
Control Actions to Reduce Stress
Change the Source of the Problem
Improve:
− The physical environment.
− Management style.
Change the Individual's Response to the Problem
Help the individual to cope.

Organisational Culture and Management
Clear company objectives.
© Copyright RRC 87
Good communication.
Employee involvement during organisational change.
Good management support, training and development.

Management of Change
Flexibility to try to accommodate the wishes of individuals.
Scope for varying working conditions to increase ownership.
An open attitude by managers to encourage trust.
Ensuring fair treatment for staff involved in significant change.
Ensuring training and resources to cope with new environments.

Clarity of Roles
Clear personal objectives and responsibilities (documented in a written

job description).
An understanding of the organisational objectives and how the

employee’s role fits into this.
Job Design and Staff Selection
Involving the person in some aspects of job design.
Identifying carefully the requirements of the job and the skills and
experience of the person to be recruited.
Offering early training and instruction.
Clear definition of tasks and responsibilities.
Introduction of variety and avoidance of short work cycles.
Proper use of skills.
Proper training for those constantly dealing with the public or client
groups.
Proper hazard control.

Work Schedules
Flexible work schedules.
Planned and agreed work hours.
88 © Copyright RRC
Setting targets that stretch the individual but are reasonable.

Relationships at Work
Training in interpersonal skills.
Effective systems to deal with interpersonal conflict, bullying and racial

or sexual harassment including:
− Grievance procedure.
− Proper investigation of complaints.
Management Standards Approach (HSE)
Demands.
Control.
Support.
Relationships
Role.
Change.
SUBSTANCE MISUSE
Alcohol- and Drug-Related Problems in the Workplace
Effects of Alcohol and Prescribed and Controlled Drugs
Mood changes.
Irritability/aggression/confusion.
Theft/dishonesty (to pay for an expensive habit).
Poor concentration/production.
Poor time-keeping.
Increased absenteeism.
Increased staff turnover (persistent abusers may be dismissed from

their employment).
Reduced productivity (even when not absent).
© Copyright RRC 89
Increased risk of accidents - alcohol and drugs affect judgment and

physical co-ordination and so can increase the risk of accidents
(particularly in safety-critical tasks).
Testing for Drugs and Alcohol
Alcohol - measured in breath, blood and urine ("breathalyser" kits).
Drugs - blood, urine and saliva (test kits).

Coping with the Effects of Alcohol and Drugs
Establish whether there is a problem.
Develop and implement an alcohol/drugs policy.

− Measures to reduce alcohol/drug-related problems.
Prohibition/restriction of the availability of alcohol/drugs on the
premises.
Education programmes.
Identification, assessment and referral of individuals with alcohol/drug

issues.
Treatment and rehabilitation programmes.
Rules governing conduct and disciplinary measures for their

infringement (including dismissal).
Equal opportunities.
Confidentiality.
VIOLENCE
Identification
Definition
"Any incident in which a person is abused, threatened or assaulted in

circumstances relating to their work.”
Occupations at Risk from Violence
Handling money/valuables.
Working with the public in caring/teaching professions.
90 © Copyright RRC
Carrying out inspection or enforcement duties.
Working with potentially violent people.
Working alone/home visiting.
Sectors of employment:
− Health service.
− Public transport.
− Licensed premises.
− Retail trades.
− Government/local authority counter and enforcement staff.
Risk Factors
The Employee
− Appearance.
− Age and experience.
− Sex.
− Personal attributes.
The Assailant
− Personality.
− Unpredictable behaviour.
− Complainants.
Legal Duties to Protect Employees from Violence
Health and Safety at Work, etc. Act 1974.
Management of Health and Safety at Work Regulations 1999.

Methodology of Risk Identification
Staff Surveys
Collect information on aggressive and violent incidents in which

employees felt threatened or stressed.
Incident Reporting
Introduce a formal reporting system.
© Copyright RRC 91
Risk Assessment
− Work activity - incidence of persons at risk.
− Hazardous situations - identified from a general analysis of
risk factors in the workplace.
Controls
Planning to Cope with Violence
Find out if there is a problem.
Decide what action to take.
Take action.
Check what you have done.

Guidance to Staff on Dealing with an Incident
Techniques designed to give protection or minimise the risk of injury.
Recognise situations where violence could result.

Communication Systems
Information on staff whereabouts and expected time of arrival is

recorded and monitored.
Information communicated to the appropriate staff so that any

concerns about personal safety can be quickly followed up.
Pagers, mobile phones and personal alarms.

Staff Training
Causes of violence, identifying early signs of violence, and how to

avoid or handle it.
Safe systems of work that minimise the risk of violence.
Interpersonal skills.
Physical and Procedural Control Measures to Reduce Risks of
Violence
Change the job to give less face-to-face contact with the public.
Use cash-free systems.
92 © Copyright RRC
Change the layout of public waiting areas.
Redesign counters to give staff protection from physical contact.
Vet closely the credentials of clients and customers.
Use panic buttons, personal alarms, mobile phones, to enable rapid

contact for assistance.
Use security measures such as cameras, protective screens and

security-coded doors to monitor staff and prevent unauthorised
access.
Arrange that staff working in the community follow a known schedule,

periodically report in to base, have information on high-risk patients
and are equipped with extra protection if the risk warrants it.
© Copyright RRC 93
B10: ERGONOMIC FACTORS

ERGONOMICS
Conditions Likely to Result from Lack of Attention to
Ergonomic Principles
Work-Related Upper Limb Disorders (WRULDs)
Affect the soft connecting tissues, muscles and nerves of the hand,
wrist, arm and shoulder.
Severity may vary from occasional aches, pains and discomfort of the
affected part through to well defined and specific disease or injury.
Arise from ordinary movements, such as forceful repetitive gripping,

twisting, reaching or moving.
Hazard created by prolonged repetition, often in a forceful and

awkward manner, without sufficient rest or recovery time.
Range of occupations affected including production-line workers,

packers, painters and machine operators.
Musculoskeletal Problems
Prolapsed disc.
Typical Workplace Examples
Cramp of the arm or forearm due to repetitive movements (RSI).
Carpal tunnel syndrome.
Tendonitis.
Bursitis (swelling at the elbow or knee).
Inflammation of the tendon sheath in the thumb.
All caused by:
Undesirable force.
Unsuitable rate of working or single repetitive tasks.
Awkward posture of the hand, wrist, forearm or shoulder.
94 © Copyright RRC
Risk Reduction Measures

The ergonomic design of tools, equipment and workplaces.
Job rotation.
Adjusting the work routine, including adequate rest breaks.
Training.
DISPLAY SCREEN EQUIPMENT

Conditions Associated with VDU Operation
Musculoskeletal Injury and Discomfort
− Upper limb discomfort and pain.
Eye and Eyesight Effects
Fatigue and Stress

Assessment of Risk from Display Screen Equipment
Use
Physical requirements of the task – the way in which the worker
interacts with the physical objects in the work setting in undertaking
the particular activities required by the task.
Environmental context – the way in which the worker is affected by

the environment when undertaking the task activities.
Equipment – the way in which the worker is affected by the physical

characteristics of the work equipment itself.
Analysis of DSE Workstations
Environment and Equipment
Key areas for consideration:
General lighting and heating.
Local lighting.
Distracting noise.
Sufficient legroom and clearance.
Windows allow plenty of natural light.
© Copyright RRC 95
Software or information displayed on the screen must be appropriate

for the task.
The screen should provide a stable image, be of sufficient size and be

free of glare or reflections.
The keyboard should be of appropriate design, usable with comfort,

and fully adjustable.
Work surface – large enough.
Work chair – fully adjustable.
Footrest – provided to assist posture if required.

Interaction Between the User and the Equipment
Workstations suitable for any special needs of the individual worker.
Worker should be at a suitable height in relation to the work surface.
Work materials and frequently used equipment or controls should be

within easy reach.
Sufficient clear and unobstructed space.

Control Measures
Ergonomic considerations.
Daily work routine of users.
Eye and eyesight testing.
Training and information.
MANUAL HANDLING
Main Injuries from Manual Handling
Sprains/strains.
Fractures.
Lacerations.
Assessment of Risk from Manual Handling
The task – analysis of the nature of the handling operation and
identification of high-risk activities.
96 © Copyright RRC
The load – analysis, including measurements, of the object(s) being

handled.
Individual capability – consideration of the (mainly) physical

characteristics of the persons doing the handling operation and their
ability in terms of knowledge and skills.
The working environment – analysis of the immediate physical

surroundings within which the handling operation takes place.
Control Measures
Automation and Mechanical Assistance
Ergonomics
Task Layout and Work Routine

− Sequencing.
− Work routine.
− Using teams.
Modifying the Load
− Weight and size.
− Making the load easier to grasp.
− Making the load more stable and rigid.
− Making the load less damaging to hold.
− Markings.
Reorganising the Work Environment
− Workstation design.
− Floor conditions.
− Changes of level.
− Atmospheric conditions.
− Personal protective equipment.
© Copyright RRC 97
Personal Considerations
Key Points of Kinetic Handling Techniques
Before Lifting
A number of key checks to be made.
The Lift or Movement
Good technique is essential here.
Completing the Task
Principles to be applied for setting loads down.
98 © Copyright RRC

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NEBOSH NATIONAL DIPLOMA

HAZARDOUS AGENTS IN THE WORKPLACE

UNIT B REVISION NOTES

© Copyright RRC Training

Important: this revision book is NOT intended to replace a proper

Learning outcomes, which specify what you should be able to

Your revision aim is to achieve this comprehensive overview of the syllabus.

LAST MINUTE PRACTICE

B1: GENERAL ASPECTS OF

The effects of the working environment on the health of the worker.

The influence of the worker's state of health on their ability to perform

A combined approach to occupational health and hygiene:

Recognition of a particular health effect by a worker, safety

Diagnosis of the illness and treatment by a nurse or doctor.

Discovery of the environmental cause by a hygienist.

Implementation of controls by a safety engineer, hygienist or

Occupational hygiene practice follows a logical and systematic approach:

Recognition of the health hazard.

Quantification of the extent of the hazard by measuring level and/or

Assessment of the risk to health in the workplace.

Selection and implementation of appropriate control measures.

Measurement - determining who is affected and by how much.

Evaluation - making a judgment on the risk posed.

Control - putting measures in place to reduce or eliminate the risk.

Dusts, fibres, gases, vapours, etc. and the associated hazards.

Noise, vibration, radiation, heat, etc.

Bacteria, fungus, virus, mites, insects, etc.

Stress, substance misuse, violence at work, etc.

Posture, workplace layout, etc.

THE ROLE AND FUNCTION OF

Is concerned with the measurement of risk and interpretation of results,

Measurement of airborne contaminants, and comparing the results

Measurement of heat, noise and other pollutants.

Occupational Health Physician

Is concerned with the diagnosis and assessment of health hazards and

Health surveillance under COSHH.

Pre-employment health assessment.

Post-sickness/rehabilitation/ill-health retirement health assessment.

Assisting the employer in complying with health and safety legal

Monitoring the health of employees.

Promoting good health activities in the workplace.

Working with line managers to minimise hazards, ensure compliance

Dealing with cases of substance misuse.

Advising on placement at work through pre-employment health

Health assessment after return to work from accident or ill-health.

Advising on ergonomic issues.

Promoting good health education and activities in the workplace,

Providing advice and counselling.

Employment Medical Advisory Service (EMAS)

Section 55 of the Health and Safety at Work, etc. Act (HSWA)

Occupational Health Services

Lungs – bronchioles and alveoli.

Digestion: treatment of foodstuff for absorption into the body.

Absorption of treated foodstuffs.

Excretion of food residues and desorbed waste products.

Red blood cells for oxygen transport.

White blood cells for combating disease.

Platelets to aid clotting.

A pump - the heart.

Pipes for carrying the fluid - the blood vessels.

Oxygenated blood from lungs to organs.

Deoxygenated blood from organs to lungs.