CHAPTER 4

HEALTH HAZARDS

LECTURED BY:
MOHD HADRI MOHAMED NOR

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SUBTOPIC
4.1
4.2
4.3
4.4

Introduction to Health Hazard and Hygiene

Chemical Hazards
Physical Hazards
Biological Hazards

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4.1

INTRODUCTION TO HEALTH HAZARD

& HYGIENE

HISTORY
In 5th century BC, Hippocrates, a Greek doctor
initiated scientific foundation to make a link
between the adverse effects suffered by lead
workers and their exposure to metal.

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In the 1st century AD, Pliny the Roman Elder

recorded how workers refining red mercuric
sulfide wore bladders over their faces to avoid
inhaling dust.
Only in 15th century that the dangers in
substances such as lead, mercury and dust from
mining became widely recognized and efforts
were made to reduce exposures.

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In 18th century, Rammazini an Italian doctor also

known as Father of Occupational Medicine
published books on diseases related to exposures
of metals, dusts and some chemical and also the
importance of physician to inquire patients
occupation.

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DEFINITION OF OCCUPATIONAL HEALTH

Occupational Health is the promotion and
maintenance of the highest degree of
physical, mental and social well-being of
workers in all occupations by preventing
departures from health, controlling risks and
the adaptation of work to people, and people
to their jobs. [ILO/WHO 1995]

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HAZARD TYPES
Acute
Immediate in their effects and relatively simple control.
Chronic
Difficult to assess or identify as they may take a long time to have any
effect.

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PRINCIPLE OF PREVENTION AND CONTROL

Anticipate
Identify/Recognise
Assess/Evaluate
Control
Review

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HIERARCHY OF CONTROL

Eliminate
Substitute
Isolate
Engineering control
Administrative control
PPE

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HEALTH SURVEILLANCE AND BIOLOGICAL

MONITORING
Health surveillance is the monitoring of individuals in order to
identify changes in health due to exposure to hazardous
substances.
Biological monitoring is the measurement of a hazardous
substance, its metabolite or other substances like enzymes in
body tissues, fluids or exhaled air.

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OCCUPATIONAL REHABILITATION
Rehabilitation includes the medical treatment which
assist recovery, as well as management of the process
which helps people stay at or return to work.

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4.2

CHEMICAL HAZARDS

SUB-TOPIC
4.2.1
4.2.2
4.2.3
4.3.4

Legal Provision
How Chemical Affect Health
Dangerous Situation Increasing Risk Exposure
Chemical Safety Data Sheet (CSDS)

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4.2.1 LEGAL PROVISION

Factories and Machinery Act
Factory and Machinery (Lead) Regulations 1984
Factory and Machinery (Asbestos Process) Regulations 1986
Factory and Machinery (Mineral Dust) Regulations 1989

Five main aspect related to this statutory

Permissible exposure limit

Exposure monitoring
Medical inspection
Control methods
Other matters such as records, penalty, etc

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Occupational Safety and Health Act

OSH (Control of Industrial Major Accidents Hazards) Regulation
1996
Control of major disaster caused by chemical

OSH (Classification, Packaging and Labeling of Hazardous

Chemicals) Regulation 1997
Supply of chemicals
Chemical Safety Data Sheet (CSDS)

OSH (Prohibition of Use of Substance) Order 1999

Prohibition of dangerous chemical

Management of chemicals, PEL, evaluating risk, medical

monitoring

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4.2.2 HOW CHEMICAL AFFECT HEALTH

DIRECT CONTACT
Direct contact with corrosive chemical such as alkali or
acid
Irritant chemicals cause skin to flare up
Cause skin allergy example nickel

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CHEMICAL ROUTES OF ENTRY INTO HUMAN

BODY

INHALATION
INGESTION
ABSORPTION
INJECTION

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INHALATION

Breathing and smoking causes

us to inhale substances which
enter the lungs.
Substance
inhaled into the lungs are
readily absorbed into the blood
stream.

INHALATION
INGESTION
ABSORPTION
INJECTION

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INGESTION

Swallowing a substance causes

penetration into the blood
stream via the stomach and
small intestine.

INHALATION
INGESTION
ABSORPTION
INJECTION

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ABSORPTION

Entering the body through the

skin causes substances to enter
the blood stream at a slower rate
than by inhalation or absorption.
However, the resulting entry and
distribution within the body is
the same.

INHALATION
INGESTION
ABSORPTION
INJECTION

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INJECTION

Injection occurs when substances

are forced through this skin. This
can occur as a result of such
means as compressed air, or by
having the skin abraded by a
penetrating object.

INHALATION
INGESTION
ABSORPTION
INJECTION

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4.2.3 DANGEROUS SITUATION - INCREASING RISK EXPOSURE

Lack of awareness on hazardous chemicals

Leakage or accidentally spillage of chemicals
Working in a enclosed area or room with poor ventilation
Doing routine that involve chemicals
Machine breakdown
Lack of safety management

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4.2.4 CHEMICAL SAFETY DATA SHEET (CSDS)

Introduction
CSDS is a brochure or informational paper containing
information related to hazardous chemical which are
important in the safe use and handling of chemicals at
workplace.
Objectives of CSDS

Understand the safety recommendation and their rationales

Realize the results of failure to comply to safety requirements
OSH (Prohibition of Use of Substance) Order 1999
Identify symptoms of over exposure
Obtain input for the formulation of strategies and
recommendation in the safe use of hazardous chemicals

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Legal Provision
Regulation 9(1) of the OSH (Classification, Packaging
and Labeling) Regulations 1997
Requires supplier to prepare and provide CSDS for every
hazardous chemical supplied.
Supplier is defined as the party supplying the chemical to the
user which includes formulators, manufacturers, importers or
distributors.
Supplier also required to review CSDS regularly
The information required must be with the objective to protect
the safety and health of the worker, and not for use for any
reason.

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Mandatory Information
There are 15 types information required
Chemical product itself and the company identification
Composition of the ingredients that clearly identifies the
hazardous chemical for the purpose of conducting a hazard
evaluation.
Hazard identification
First aid measures
Accidental release measures
Handling and storage
Exposure control and PPE
Physical and chemical properties
Stability and reactivity
Toxicology information
Ecological information

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Disposal information
Transportation information
Date of preparation of CSDS

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4.3

SUB-TOPIC
4.3.1
4.3.2
4.3.3

Noise
Vibration
Heat Stress

PHYSICAL HAZARDS

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4.3.1 NOISE
DEFINITION
Sound
Generated by mechanical vibrations that can be detected by
human ears.
It is a force carried out through various mediums (air, water,
solids)

Noise
Unwanted sound

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COMPONENTS
Number of vibrations per
second
Unit Hertz (Hz)

A
Frequency

B
Frequency B > Frequency A

Amplitude
Peak magnitude or maximum
movement of the sound wave.
Unit decibel (dBA)

intensity

Frequency

1 cycle

B
Amplitude of B > A

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TYPE OF NOISE
Continuous noise

amplitude

Noise that has the sound intensity between maximum and

minimum less than 3 dBA.

changing of
amplitude < 3 dB

time

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Fluctuation noise
Noise that has varying intensity levels from high to low over 3 dBA.

amplitude

> 3 dB

time

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Impulse noise
Noise that has high intensity within a short duration such as the
sound of a bullet shot.

amplitud
e

>1s

< 0.5 s
time

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Interval noise
Noise that occurs at certain durations and may repeat at certain
intervals

amplitude

< 3 dB

< 3 dB

time

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LEGAL PROVISION RELATED TO NOISE

Factories and Machinery (Noise Exposure) Regulation
1989

Permissible exposure limit.

Exposure monitoring.
Methods of compliance.
PPE for specific hearing protection.
Audiometric testing program.
Employee information and training.
Warning sign.
Record keeping
Miscellaneous

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LEGAL PROVISION PERMISSIBLE EXPOSURE LIMIT (PEL)

Action level (AL)
85 dBA

PEL
Continuous noise
For 8 hours: 90 dBA
Ceiling limit: 115 dBA

Impulse noise
Ceiling limit: 140 dBA

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OCCUPATIONS AT RISK

Mining
Quarrying
Construction
Manufacturing
Textile
Etc.

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HEALTH EFFECT

Disturbed emotion and anger

Communication problem
Tinnitus
Psychology pressure
Increase of blood pressure
Damage or loss of hearing
Conduction type
Damage to the ear drum
Displacement of ossicle bones in the middle ear

Neuro-sensory
Damage to the hair follicles in the inner ears
Loss of hearing due to over exposure to loud noise
Normal cases: both ears

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CONTROL MEASURES
Engineering controls
Substitution of less noisy equipment
Isolation of noisy equipment from main area

Administrative controls

Proper risk assessment before purchase noisy equipment

Reduction of exposure to noise
Training and lectures
Have written policy to ensure safe work practice
Exposure monitoring

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Health monitoring
Once annually
Exposure PEL
Initial hearing test shows that there is hearing problem
Hearing Threshold Standard

Once every 2 years for noise exposure between 85-90 dBA

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AUDIOMETRIC BOOTH
Audiometric
booth

audiometer

printer

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4.3.1 VIBRATION
DEFINITION
Vibration
Refer to movement of solids where the amplitude and frequency
produced may cause harmful to those exposed.

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TYPES OF VIBRATION

(IN CONTEXT OF WORKERS HEALTH)

Whole body vibration (WBV)

Where the vibration usually transferred when in contact with the feet or
buttocks
Vehicle operation
Heavy vehicles

Hand arm vibration (HAV)

Where the vibration usually transferred when in contact with the hand due to
use of vibrating equipment
Hand drill
Chainsaw
Etc.

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HEALTH EFFECT
Whole body vibration (WBV)
Blurring eye
Nausea, vomiting, headache, back pain
Can cause lung and heart malfunction

Hand arm vibration (HAV)

Damage blood vessel, nerve and musculoskeletal system
Pale finger, numbness and pain
Carpal tunnel syndrome

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PREVENTION AND MONITORING CONTROL

Evaluate risk prior to purchasing a vibrating equipment

Eliminate hazard
Substitute: with less vibrating equipment, anti-vibration
Reduce exposure
Training, information, instruction
Periodical maintenance equipment

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4.3.1 HEAT STRESS

INTRODUCTION
Heat stress occurs when the bodys
means of controlling its internal
temperature starts to fail. As well as air
temperature, factors such as work rate,
humidity and clothing worn while working
may lead to heat stress.

Workers who are exposed to

extreme heat or work in hot
environments may be at risk of heat
stress. Exposure to extreme heat
can result in occupational illnesses
and injuries.

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COMPILATION OF SEVERE HEAT STRESS IN BODY

- Heat stroke
- Heat exhaustion
- Heat syncope
- Heat cramp
- Heat rash

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Heat Stroke
- Occurs when the body becomes unable to control its temperature: the body's
temperature rises rapidly, the sweating mechanism fails, and the body is
unable to cool down.
- Can cause death.

First Aid

Symptom
Hot, dry skin or profuse sweating
Hallucinations
Chills
Throbbing headache
High body temperature
Confusion/dizziness
Slurred speech
CALL 999

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Heat Exhaustion
- Heat exhaustion is the body's response to an excessive loss of the water and
salt, usually through excessive sweating.
Symptom

First Aid

Heavy sweating
Extreme weakness or fatigue
Dizziness, confusion
Nausea
Clammy, moist skin
Pale or flushed complexion
Muscle cramps
Slightly elevated body temperature
Fast and shallow breathing

Have them rest in a cool, shaded

or air-conditioned area.
Have them drink plenty of water or
other cool, nonalcoholic beverages.
Have them take a cool shower,
bath, or sponge bath.

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Heat Syncope
- is a fainting/dizziness, usually occurs with prolonged standing or sudden rising
from a sitting or lying position. Factors that may contribute to heat syncope
include dehydration and lack of acclimatization.
Symptom

Light-headedness
Dizziness
Fainting

First Aid

Sit or lie down in a cool place when

they begin to feel symptoms.

Slowly drink water, clear juice, or a
sports beverage.

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Heat Cramp
- Usually affect workers who sweat a lot during strenuous activity.
- Low salt levels in muscles causes painful cramps.
- May also be a symptom of heat exhaustion
Symptom

Muscle pain or spasms usually in the abdomen, arms, or legs

First Aid

Stop all activity, and sit in a cool place.

Drink clear juice or a sports beverage.
Do not return to strenuous work for a few hours after the cramps subside
because further exertion may lead to heat exhaustion or heat stroke.
Seek medical attention if the worker has heart problems, the worker is on
a low-sodium diet, the cramps do not subside within one hour.

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Heat Rash
- Is a skin irritation caused by excessive sweating during hot, humid weather.
Symptom

Heat rash looks like a red cluster of pimples or small blisters.

It is more likely to occur on the neck and upper chest, in the groin, under
the breasts, and in elbow creases.

First Aid

Try to work in a cooler, less humid environment when possible.

Keep the affected area dry.
Dusting powder may be used to increase comfort.

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REDUCING THE RISK

- Control the temperature
- Provide mechanical aid
- Regulate the length of exposure to hot environments
- Prevent dehydration
- Provide personal protective equipment
- Provide training for your workers
- Allow workers to acclimatize to their environment and identify which workers
are acclimatized/assessed as fit to work in hot conditions.
- Identify employees who are more susceptible to heat stress
- Monitor the health of workers at risk

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HEAT STRESS INDEX

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Heat May Be Natures Deadliest

Killer

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4.4

BIOLOGICAL HAZARDS

INTRODUCTION
Community and employee
awareness
Identification of biological agents
that cause Legionnaire disease,
Hepatitis B and HIV
Industries such as agriculture,
health care, biotechnology, research
and clinical laboratories

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DEFINITIONS
Biological agent
Includes living micro-organisms such as viruses and bacteria
capable of exuding toxins, exposure to which may cause
disease or death in human, animals and plants.

Etiological agent
Agent that causes the actual contraction of disease.

Infection
Attacks of pathogenic organism on the body, which may or
may not cause contraction of disease.

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Bio-safety
An area of science that serve to disconnect chains of infection.

Agent
Physical, radiological, chemical or biological entity that may cause certain
effects upon exposure.

Host
Host where the agent is present (example: human)

Environment
Includes living and non-living things (biosphere, atmosphere, lithosphere
and hydrosphere)

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INTERACTION BETWEEN HOST, AGENT AND

ENVIRONMENT
Host
Agent
- Carrier
- Substitute for pathogen
- Antibiotics resistance
- Virulent factors
- Communicability factor
- Fatal factor

Agent
Host

Environmen
t

- Health status
- Management system
- Training
- Health surveillance
- Use of PPE
- Perceptions
- Reservoir

Environment
- Population density
- Medical support facilities
- Weather (wind, temperature)
- Social, politics, ethics
- Facility design

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ANOTHER FACTORS

Agent must be pathogenic

Presence of reservoir
Agent must be able to escape from reservoir
The ability of agent to move in the environment
There is an entry on the new host
Host is susceptible to the agent

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CHAIN OF INFECTION
Patogen

Takungan

Pelepasan
dari
takungan
Transmisi
melalui
persekitan
Tapak
kemasukan
Hos
rentan

Control of infection = break any connection between chain

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BIOLOGICAL SAFETY CABINET CLASSIFICATION

Potential of BioHazard
Level I

Description of
Agent

Level IV

Control

Low risk
Not known whether
can cause disease

Bacteria
Bacillus subtilis
E.Coli K12

Normal biological
practices
Suitable isolation

May cause disease

on human

Bacteria
Salmonella
Virus
Hepatitis A, B, C, D
Fungers
Cryptococcus

Bio-hazard label
Autoclave
Medical
surveillance

Agent is indigenous

Virus
HIV, TB

Special design
Specific LEV

Agent is dangerous
High exposure may
cause risk to life

Virus
Ebola

Special design

Level II

Level III

Example

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WORKING SAFELY WITH BIOLOGICAL AGENTS

Bio safety program management

Identify the scope of the programme based on the risk

Develop policy and procedure
Provide training for workers, supervision and regular refresher course
Provide suitable facilities

Administrative controls
Establish a bio-safety committee
Appoint bio-safety officer (BSO Bio Safety Level III & IV)

Physical containment
Based on bio-safety level

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Disinfection and sterilization

Use of chemical or physical agent
Sterilization kill organisms in total

Accident, spill and emergency training

Requires specific training

Transportation of biological agent

Should be viewed from the perspective of anticipating and preventive accidents
Compliance with sea and air transport standards

Biological risk communication

Biological communication strategy should be develop
Other than workers, should also include the public

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