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oCCupational health and safety management systems |n100824 v e r s i o n o f 10 J u ly 2012

Compliance with legislation and regulations for users of environmental and/or occupational health and safety management systems



We at SCCM are convinced – and our experience has proven – that

any organization, large or small, will achieve better environmental

performance by using the ‘plan-do-check-act’ approach outlined in

the ISO 14001 standard.

Copyright SCCMAll rights reserved. Nothing included in this publication may be made public, and/or reproduced by means of printing, photocopying, microfilm or any other method, without prior written permission from SCCM.

DisclaimerAlthough the utmost care has been taken with this publication, errors and omissions cannot be entirely excluded. SCCM therefore accepts no liability, not even for direct or indirect damage occurring due to or in relation with the use of the content of this publication.



Compliance with legislation and regulations for users of environmental and/or occupational health and safety management systems

N100824, 10 july 2012



Contents

chapter 1

1 Background 5

chapter 2

2 Compliance management within the ISO 14001 and OHSAS 18001 standards 7

chapter 3

3 The compliance management system in detail, by element 10 3.1 Commitment to compliance 10 3.2 Identifying legislation and regulations 11 3.3 Translating legal requirements into their impact on the organization 14 3.4 Ensuring that organizational and technical measures for meeting the requirements are taken 16 3.5 Self-evaluation of compliance with legislation and regulations 18 3.6 Internal audit 20 3.7 Management review of compliance 21

chapter 4 4 Relationship to the other parts of the managementsystem 22

annexes

1 Sample of a simple register of legislation and regulations for an offset printing company 242 Sample applicable legal environmental and compliance requirements 263 Sample translation of legal environmental requirements into concrete tasks 294 Sample translation of general environmental requirements into specific rules 315 Sample of simple register of OHS legislation and regulations for an offset printing company 34 6 Sample applicable legal OHS requirements and how to ensure compliance 36 7 Sample translation of legal OHS requirements into concrete tasks 38 8 Sample translation of general OHS requirements into specific rules 41 9 Sample management review procedure 43



c h a p t e r 1

Background

It is important for an organization to ensure it is complying with legislation and regulations. Organizations are held accountable for their ‘compliance behaviour’ and non-compliance carries heavy risks. Management wants to know if their organization is ‘in compliance’. Proper compliance with legislation and regulations is a precondition for operating a sustainable and socially responsible business. An organization’s management can only state with conviction that it has control of its compliance when it is working on it systematically.

Compliance with legislation and regulations is one of the basic requirements of both the ISO 14001 and OHSAS 18001 standards. Both standards in fact contain all the elements of a ‘compliance management system’ with which compliance can be demonstrated:> Identifying legislation and regulations.> Translating legal requirements into their impact on the organization.> Ensuring implementation.> Self-evaluating compliance.> Internal audits.> Management review of the results.

In 2008, the Dutch government launched a programme promoting innovation in supervision (‘Vernieuwing toezicht’). One element of this programme is ‘systemic supervision’, the basic principle of which is that an organization must have a system for adequately controlling its occupational health and safety (hereafter OHS) and environmental risks. As a minimum, an organization must achieve the level of control laid down in legislation and regulations. Systemic supervision emphasizes evaluating the management system, instead of checking each individual requirement of legislation and regulations. An element of this – compliance management – is the systematic identification and compliance with legislation and regulations.

Aim of this publicationOur objective is to help show organizations in practical terms how to interpret the requirements in the ISO 14001 and OHSAS 18001 standards related to compliance with legislation and regulations. This booklet provides some concrete examples, but there certainly are other ways the requirements can be worked out. The idea is to inspire you to find an interpretation that is right for your own organization.

This document is intended as an aid, and organizations are free to use the suggestions in it or not.

EA 7/04This document is also based on the EA 7/04 guideline ‘Legal compliance as a part of Accredited ISO 14001: 2004 certification’. This guideline was published in 2007 by the European Co-operation for Accreditation, and must be followed by every certification body accredited in an EU member state. The document can be found on www.sccm.nl.



Computer programsEvery organization must document its management system and support its implementation, whether or not using dedicated software. This booklet frequently shows the relationship with procedures and instructions. In practice, these can be ‘automated’ by using software with the various steps built into it. The user automatically is taken through these steps.



c h a p t e r 2

2 Compliance management within the ISO 14001 and OHSAS 18001 standards

Various elements of both the ISO 14001 and OHSAS 18001 standards contain direct or indirect references to ‘compliance with legislation and regulations’. Together these elements constitute the compliance management system. Table 1 shows the elements of the standard that make explicit reference to legislation and regulations. Although the ‘internal audit’ element does not explicitly refer to legislation and regulations, it is included here since the internal audit is an essential link.



Table 1: Compliance management related to requirements in the ISO 14001 and OHSAS 18001 standards

The elements of the standard listed in table 1 constitute the ‘core’ of the compliance management system. Of course other elements are also relevant for achieving proper compliance (such as communication, monitoring and measuring, and nonconformities and corrective action). They will be discussed in chapter 4.

Chapter 3 will discuss how each part of the compliance management system can be interpreted, and also has references to other parts of the standard.

CoM p l i A N C E M A N Ag E M E N t E l E M E N t

t Ext o f i S o 14001 (for most clauses identical or very similar to OHSAS 18001)

C l Au S E N o.i S o 14001

C l Au S E N o.o H SA S 18001

1 Commitment to compliance Top management shall define the organization’s environmental policy and ensure that, within the defined scope of its environmental management system, it includes a commitment to comply with applicable legal requirements and with other requirements to which the organization subscribes which relate to its environmental aspects.

4.2 c 4.2 c

2 Identifying legislation and regulations

The organization shall establish, implement and maintain (a) procedure(s) to identify and have access to the applicable legal and other requirements to which the organization subscribes related to the organization’s environmental aspects.

4.3.2 a 4.3.2

3 Translating legal requirements into impact on the organization

The organization must establish, implement and maintain (a) procedure(s) to determine how these legal and other requirements apply to its environmental aspects.

4.3.2 b

4 Ensuring that organizational and technical measures are taken in order to comply with the requirements

The organization shall ensure that these applicable legal and other requirements to which the organization subscribes are taken into account in establishing, implementing and maintaining its environmental management system.

4.3.2 4.3.2

The objectives and targets shall be measurable, where practicable, and consistent with the environmental policy, including the commitments to prevention of pollution, to compliance with applicable legal requirements […].

4.3.3 4.3.3

The organization shall identify and plan those operations that are associated with the identified significant environmental aspects in line with its environmental policy, objectives and targets, in order to ensure that they are carried out under specified conditions […].

4.4.6 4.4.6

5 Self-assessing compliance Consistent with its commitment to compliance, the organization shall establish, implement and maintain a procedure(s) for periodically evaluating compliance with applicable legal requirements. The organization shall keep records of the results of the periodic evaluations.

4.5.2.1 4.5.2.1

6 Internal audit The organization shall ensure that internal audits of the environmental management system are conducted at planned intervals to a) determine whether the environmental or OHS management system conforms to planned arrangements, and has been properly implemented and is maintained, and b) provide information on the results of audits to management.

4.5.5 4.5.5

7 Management review of compliance

Reviews shall include assessing opportunities for improvement and the need for change to the environmental management system, including the environmental policy and environmental objectives and targets. Input to management reviews shall include:> results of internal audits and evaluations of compliance with legal requirements and other requirements to which the organization subscribes, and> changing circumstances, including developments in legal and other requirements related to the organization’s environmental aspects.

4.6 4.6



Compliance with legislation and regulations is also an important element of the EMAS (Eco Management and Audit Scheme) regulation. Under this regulation, companies can obtain the right to use a European ‘environmental logo’. To qualify, an organization must have an environmental management system and draw up an annual environmental report. The EMAS environmental management system is based on the ISO 14001 standard, but has some additional requirements. An organization following the plan outlined in this document will meet these requirements.



c h a p t e r 3

3 The compliance management system in detail, by element

This chapter elaborates the elements of the compliance management system. The diagrams show in a nutshell the relationship between the step described and the steps before and after it.

3.1 Commitment to compliance

The organization’s top management must lay down its commitment to comply with legislation and regulations in its environmental and/or OHS policy. In practice, this is done by including a text in a ‘policy declaration’ signed by top management, in which other policy principles (such as the commitment to improving performance) are laid down.

More important than the written statement is the way that this commitment is communicated within the organization by its top management. It is essential that compliance with legislation and regulations is part of the organization’s internal culture. Simply putting a statement down on paper is not enough to bring this about, however; regular communication about the importance of compliance is part of this commitment. It is important that the culture allows for open communication about compliance, and that employees are encouraged to come forth promptly to discuss any problems with compliance.

Clause 4.4.2 of both standards is also relevant in this regard, since it sets requirements for creating awareness about compliance with the environmental or OSH policy, by the organization’s employees as well as third parties such as temporary workers.

Employee awareness and involvement can be encouraged by:> Oral and written communication from top management reiterating the importance of compliance, and the progress made in this area.> Making this a regular agenda item in meetings.

Commitment to compliance

§ 3.1

Impact of legalrequirements

§ 3.3

Keeping track of changes in legislation

and regulations§ 3.2

Identifying relevantlegislation and

regulations§ 3.2

Laid down in policy: the commitment tocomply with legislation and regulations

> > > >

>



3.2 Identifying legislation and regulations

Which legislation and regulations are relevantThe organization must identify legislation and regulations that apply to it, meaning that they relate to the organization’s environmental and/or OHS aspects. On the basis of the organization’s process steps/ operations/present facilities, an evaluation is made of which legislation and regulations may apply. The requirements identified may be in both Dutch and European law or regulations. If an organization has operations outside the Netherlands, it must also identify the applicable legal requirements for the other country or countries. Identifying the relevant legislation and regulations is sometimes done in two steps. Sometimes legislation and regulations only apply if a particular limit or threshold is exceeded, for example, the presence of certain quantities of certain substances. It is then important:> to document why the legislation and regulations in question are applicable (or not);> in the case of ‘critical limits’, to ensure that limits are not exceeded, or if they are exceeded, that timely action is taken. A sample of this process is in annex 4.

For environmental legislation and regulations in the Netherlands, the organization can first ask:> Does the 2008 Activities Decree (Activiteitenbesluit) apply?> Does the organization need permits/licences to operate?

Connections to other legislation, semi-legislation (see below) and regulations arise from the Activities Decree and Water Act.

If an organization needs permits or licences to operate, then using the requirements in the permit/licence alone is not sufficient. The permit is a practical ‘translation’ of the law, in most cases of one particular law. For example, the scope of a permit required under the Environmental Management Act will not go much further than the Environmental Management Act itself, and may include a few requirements from the Activities Decree. Other requirements that apply to the company are not covered by these permits.

Commitment to compliance

§ 3.1


§ 3.3

Keeping track of changes in

legislation andregulations

§ 3.2

identifying relevantlegislation and

regulations§ 3.2

Sources:– branch information– competent authority– www.antwoordvoorbedrijven.nl– Agentschap NL– www.arboportaal.nl– consulting firm

Regular checking bycompetent official

> > > >

> >



Regarding OHS legislation and regulations in the Netherlands, it is important to know if an approved OHS ‘catalogue’ (regulations agreed by government and industry) is available for the sector in which the organization operates.

At European level, there is a distinction between regulations, directives and decrees. Regulations apply directly and do not have to be included in national legislation. Where European legislation is integrated in Dutch legislation and regulations, it is sufficient to use only the Dutch legislation. Where this is not the case, the European legislation applies in addition to the Dutch law.

Thus there are different levels of legislation, for example:> Permits/licences issued to the organization (if applicable).> National legislation.> European regulations, directives or decrees. > ‘Semi-legislation’.

For the sake of convenience, in this publication ‘semi-legislation’ is understood to refer to all agreements used as state of the art. Examples include:> Publications from the Hazardous Substances Publication Series (Publicatiereeks Gevaarlijke Stoffen, for example PGS 15).> State-of-the-art descriptions such as laid down in the workbooks for the environment and industry policy target groups or from the IPPC (Integrated Pollution Prevention and Control directive) in ‘best available technology’ (BAT) and BREF (BAT reference) documents.> Covenants.> OHS ‘catalogues’ referred to above.

Besides the legal requirements, there are other requirements that must be identified. Examples of these are requirements in insurance conditions, requirements of the parent company or requirements of customers. These will not be discussed further in this publication, but they must be included in the management system.

It must be realized that some legislation and regulations will be more clearly applicable and some less. An organization must also have an intention to be familiar with, and to comply with, less obvious legislation and regulations. The question is whether an organization can fairly be expected to be familiar with all the applicable legislation and regulations. This will also be taken into consideration during the certification process. The obvious legislation and regulations in any case will be those that SCCM has made summaries of (see www.sccm.nl) and legislation and regulations related to activities considered to entail risk from an environmental and/or OHS perspective.

Keeping up to date with legal and other requirementsThe overview of legal requirements must be kept up to date, even when there are changes to legislation. Organizations must therefore keep track of these changes and evaluate how they may affect areas such as operational control, as well as measuring and monitoring and any objectives.



Enshrined in a procedure (or another method in the system) are:> who keeps track of changes in legislation and regulations and other requirements;> what sources of information are used;> how often this is done;> who translates this information into requirements for the organization, and how;> how this is recorded;> how changes are communicated internally;> who determines how, and how often, compliance with the requirements is checked.

It is important that the person responsible for keeping track of and evaluating legislation and regulations is also competent to do so (clause 4.4.2). Competence includes knowledge of:> the processes in the organization related to legislation and regulations;> the main thrust of the various kinds of legislation and regulations that can apply.

Often there are several officials/departments in an organization who play a part in this process, such as HRM for health-related legislation, Technical Services for inspection requirements and relevant technical standards, a QES (Dutch ‘KAM’; from quality, working conditions and environmental concerns) department for general legal changes, and possibly a legal/accounting department for insurance conditions, etc.

Good working relationships and laying down who does what can make these things clearer.

With regard to keeping track of changes in legal requirements, there must also be a regular check to see if the applicable requirements still fit the environmental and/or OHS aspects and the company’s operations. New or different requirements may apply due to changes in, or of, operations. There may also be requirements that no longer apply. If desired, evaluating the implications of legislation and regulations on new operations or changes can be a part of an MoC (Management of Change) procedure.

the result> A procedure concisely laying down who identifies and keeps up to date with legislation and regulations and how they do so (what the sources of information are; what format is used to record information; frequency of updating; the person responsible; where information is laid down).> An overview of legislation and regulations in effect and any other particular requirements. Annexes 1 and 5 show examples of a format for identifying legislation and regulations, giving an indication of the desired level of detail.



Ex A M p l EAnnexes 1 and 5 give example of ways to set down information about the legislation and regulations.It is not always immediately clear whether a specific law or regulation applies, for example when its applicability is linked to concentrations of a substance. This can be laid down in an additional document. The Dutch guideline PGS 15, for example, contains many different requirements for storing hazardous substances. A company must first use safety-data sheets to determine whether the substances and the amounts it stores are governed by the PGS 15 guideline. These requirements are further dependent on whether the substance is stored indoors our outdoors, in a closet, vault or rack, on the ground floor or a higher floor. This information will determine if parts of the PGS 15 will (or will not) apply. The organization must determine which specific prescriptions apply to be able to monitor compliance. This is worked out with an example in annex 4.

3.3 Translating legal requirements into their impact on the organization

Once an organization knows which legislation and regulations affect it, it will be necessary to ‘unravel’ them to find the specific requirements that affect it. An organization can only make a pronouncement about its own compliance if these requirements are made explicit. This is a time-consuming (albeit one-time) operation, especially for organizations subject to many laws and regulations. Ultimately, however, it has great added value.

It must be clear how the legislation and regulations impact the organization, for example:> Technical provisions that must be made; > Organizational measures required;> Emissions that must be kept below certain levels;> Studies that must be done;> Notifications that must be made;> Obligatory monitoring, and monitoring reports.

Identifying relevantlegislation and

regulations§ 3.2

Implementing measures ensuring

compliance§ 3.4

impact of legalrequirements

§ 3.3

Keeping track of changes in

legislation andregulations

§ 3.2

Tasks and resposibilities in:– job descriptions– procedures and/or operational instructions – technical provisions

>> > > >

>



The applicable articles/requirements/rules for each legal or other requirement can be added to the overview of legislation and regulations from step 1. Of course, this more detailed explanation may be set down in another document within the management system.

Linking the legal aspects with the register of environmental and/or OHS aspects and the risk inventory will make the right level of detail easier to see.

linking legislation/regulations to activities and officers Besides identifying legislation and regulations, an organization must identify and evaluate its environmental and/or OHS aspects. The organization’s operations/processes will dictate the line of approach. Making this identification usually shows a connection between the applicable legislation and regulations and the officers responsible. The organization can opt to combine the translating all the legal requirements into their impacts on the organization with the identifying of its environmental and/or OHS aspects. If it does so, it is important to ensure that all legislation and regulations have been adequately incorporated.

Ultimately, the responsibilities and tasks with regard to such things as legal requirements come together in the job descriptions, procedures and/or operational instructions. When identifying both environmental and/or OHS aspects and legislation and regulations, items in specific job or task descriptions or procedures/operational instructions can be numbered and referred to (see 3.4).

the result > A procedure (whether or not combined with the procedure from 3.3) which lays down who is responsible for determining the impact on the organization of the requirements in the applicable legislation and regulations. Additional conditions for implementation (frequency, method of documentation, etc.) can also be laid down.> An overview of the requirements per element of legislation and regulations, and their impacts on the organization.

SA M p l EAnnexes 2 and 6 contain tables with examples of how to systematically display the requirements in the applicable legislation and regulations. Since a given requirement can apply to more than one area in the organization, there is sometimes more than one ‘rule’ for the same requirement. Each table shows the person or department responsible for compliance and for ensuring compliance, with reference to a relevant document.Another approach is to link the requirements directly to the tasks necessary for adequate compliance. Examples are included in annexes 3 and 7.



3.4 Ensuring that organizational and technical measures for meeting the requirements are taken

Once the organization knows which requirements apply, it determines how each requirement will impact it. What measures and action are necessary to comply with the requirements?

If a requirement has not yet been met, an action must be defined in the organization’s environmental or OHS programme (clause 4.3.3) to achieve compliance with it (this programme may be annually updated). It may be necessary to notify and confer with the competent authority to define this action.

The next step is to ensure that these measures and actions are actually taken. Doing so properly guarantees that the requirement is met even in between compliance checks (see step 4).

The method of ensuring compliance depends on the type of requirement for the organization. There are roughly four types of requirements:> ‘Static’ requirements: requirements for parts of the organization that do not change often, such as requirements for a building (fire-proof doors, presence of a sprinkler system, etc.).> Technical requirements: requirements for technical measures and maintenance.> Performance and monitoring requirements: requirements that entail taking measurements (of concentrations, annual obligations or amounts), keeping records or drawing up reports (including reports, measurements and studies by third parties).> Organizational requirements: for matters such as training and instructing personnel.

The static requirements are checked once and ensured using such tools as a ‘management of change (MoC) procedure’. This procedure determines, for example, what action and measures to take in the event of certain changes.


§ 3.3

Self-evaluation of compliance with

legislation/regulations§ 3.5

Ensuring compliancemeasures work

§ 3.4

implementing measures ensuring

compliance§ 3.4

Methods for ensuring compliance include:– checklist– frequent measuring, recording and reporting– procedures and/or operational instructions– management of change procedure– translating measures into action and responsibilities

Define action in improvement programme to achieve compliance

>> > > >

>>



Other methods for guaranteeing compliance include:> a checklist which is gone through at defined intervals;> frequent measuring, recording and reporting (these can be kept up to date in a register or overview of measurements, records and reports);> laying down the method in procedures or instructions which are ensured by means of internal audits;> translating requirements into action linked to officers and recording these actions once carried out (see examples in annexes 3 and 7).

The severity of these measures is proportional to the risk of nonconformities. The degree of guarantee must be heavier as the risks increase. The risk has often already been determined in the identification and evaluation phase. Its place in a risk matrix (chance x effect) is useful here.

The management system can include an overview by element of how compliance was ensured, if desired linked to the overview in step 2. If there are changes to legislation and regulations it will be easy to find what parts of the management system must be adapted. This kind of overview is a convenient aid, but the standard does not require it.

Result> Overview of how compliance with the requirements is ensured in the organization.

Ex A M p l EAnnexes 2 and 6 (right-hand columns) and 3 and 7 provide examples of how to ensure compliance with the applicable rules. Annexes 3 and 7 provide partial examples of how the requirements are translated into concrete tasks. Various instruments can be used including checklists, procedures, operational instructions, and record-keeping).



3.5 Self-evaluation of compliance with legislation and regulations

The essence of this element is that an organization must be able to say with conviction that it has its compliance with legislation and regulations under control. It is difficult to guarantee that all legislation and regulations are being complied with at every moment. Round-the-clock monitoring of all the requirements is impossible. A focused approach should enable the organization’s management to have confidence that there is a high level of compliance and that any nonconformities are resolved (where necessary, in consultation with the competent authorities).

Assuming that the organization knows which legislation and regulations apply, and has translated requirements they contain into their impacts on it, it can get a structural idea of its own compliance by taking the following steps. This means that there is an established procedure for this self-evaluation.

Approach depends on the number of requirementsIf the number of requirements in legislation and regulations is limited, a checklist can be used for a periodic check that the requirements are being met. The management system can designate who fills out the checklist and at what intervals, how the results are reported to management, and how the rectification of nonconformities is ensured.

If the number of requirements is greater, it is a good idea to establish principles for the frequency with which compliance with the individual requirements is evaluated. This frequency will depend on factors like the chance of a nonconformity with the requirements and any consequences of a nonconformity. Using these general principles as a basis, an organization can determine the appropriate frequency and method of evaluation for each requirement.

Basis of the approach To determine how and how often compliance with particular requirements should be evaluated, there must be an idea of:> The chances of a nonconformity with these requirements arising.> The potential consequences of such a nonconformity for the environment, safety or working conditions.


compliance§ 3.4

Internal audit§ 3.6

Self-evaluation of compliance with

legislation/regulations§ 3.5


§ 3.4

Frequency of evaluation depending on, for example:– number of legal requirements– chance of nonconformities– consequences of nonconformities for environment, safety or working conditions– frequency of change in requirements– consequences of change in requirements

> > >>

>



There is a relationship here with the requirement from the standard to identify and evaluate environmental and/or OHS aspects. The OHSAS 18001 standard requires the application of a risk assessment in evaluating the OHS aspects. The ISO 14001 standard does not require this, although organizations with an integrated management system often do apply the risk assessment when identifying their environmental aspects. The SCCM publication ‘Information for product organizations: identifying and evaluating environmental aspects’ provides examples. The outcome of the risk assessment can be used to determine how strictly to specify the evaluation of compliance with legislation and regulation for a particular environmental aspect.

An organization can establish a few basic principles for specifying how it evaluates its own compliance. This can be done using the matrix also used for the risk assessment, as shown in table 2. Each organization can use its own categories for chances and effect.

Table 2: Example of principles for specifying self-evaluation of compliance

N Atu R E o f REquiREMENt

S Co p E o f R i S K 1

StAt i C t E C H N i CA l p E R f o R M A N C E/M o N i to R i N g

o RgA N i zAt i o N A l

Acceptable Test only if a change or incident occurs, as part of MoC2 procedure

> maintenance check 2x per year

> 2x per year data evaluated by environment/OHS coordinator

> 1x per month on rounds with checklist

High-risk 1x per month on rounds with checklist

> monthly maintenance check


> 4x per year records evaluated by environment/OHS coordinator

Extremely high (unacceptable risk)

1x per week on rounds with checklist

> weekly maintenance check



1 Based on categories in table 6 of SCCM publication ‘Information for product organizations: identifying and evaluating environmental aspects ’

2 MoC = Management of Change procedure: among other things this procedure indicates what must be done, checked, recorded, etc. in the event of changes in the organization, processes or products.

The higher the risk becomes, the more often the self-evaluation must be performed. It must be clear how compliance is evaluated for each requirement. This means that it is known:> Who is responsible for carrying out the evaluation;> What is evaluated (for example which rules or checklist, etc.);> How to record that the evaluation has been done, and how any nonconformities are dealt with.



Evaluating compliance can take various forms, including:> as part(s) of a checklist used for routine checks;> periodic agenda point(s) during meetings;> continuous or periodic measuring programme(s) and reporting results;> incidental measurement;> specific evaluation by management/production manager etc.;> internal audits with an additional audit focused specifically on the process of identifying and complying with legal requirements;> work-place inspections.

Checking compliance with legal and other requirementsAccording to the standard, the organization must periodically evaluate whether it is meeting these requirements and must keep records of this evaluation. The frequency of this evaluation can differ for each requirement. The organization must determine how often to evaluate the various requirements and how to perform the evaluation.

The method and the frequency of checking, including tasks and responsibilities, are set down in the procedure.

Result> A procedure that sets out how the organization evaluates its own compliance.> An overview (periodically if desired) serving as a basis for determining during the management review if compliance satisfies the principles established in the organization’s own policy.

3.6 Internal audit

During internal audits, the organization itself determines how the parts of its management system are working. The question is also whether the management system is good enough to achieve its objectives. One important objective is to comply with legislation and regulations. The internal audit yields essential information for the management review (see 3.7). The SCCM publication ‘Internal audits’ contains suggestions for carrying out internal audits.Sometimes people think that the internal audits can be used to perform the ‘self-evaluation’ in section 3.5. This is only possible to a limited degree. Since the internal audits are intended to evaluate the organization’s own system, they also test the effectiveness of the procedures for self-evaluating compliance. Compliance can only be evaluated using the internal audits if requirements from legislation and regulations are embedded in procedures or instructions.


compliance§ 3.4

Management review of compliance

§ 3.7

internal audit§ 3.6


§ 3.5

Testing the effectiviness of procedures forevaluation organization’s own compliance

> >> >>

>



3.7 Management review of compliance

The results of the evaluation of compliance must be available during the management review (clause 4.6). If management is to make a judgement of compliance, they must be given an overview of performance. For top management, it is in any case important to know for which legislation and regulations compliance is critical and/or insufficient and what measures need to be taken (if necessary) to improve compliance. The cause of any nonconformity is also investigated so as to formulate corrective as well as preventive action.

An example of part of a management review procedure is in annex 9.

Result> A procedure for performing the management review (when, by whom, what information as input and what decisions are made).> For each management review, a report of the evaluation by top management of (among other things) compliance with legislation and regulations, and decisions about any necessary action (modifying policy; making means available, etc.).


compliance§ 3.4

Management review of compliance

§ 3.7

Internal audit§ 3.6


§ 3.5

Evaluation by management on overview of complianceperformance

> > >>

>



c h a p t e r 4

Relationship to the other parts of the management system

This publication discusses the parts of the ISO 14001 and OHSAS 18001 standards having a direct reference to compliance with legislation and regulations. Other parts of the management system are also important for proper compliance. A brief indication of their relationship to compliance follows, in order of the elements of the standard.

The numbers of the sections of the standard are indicated, and are the same for both standards.

identifying environmental and oHS aspects (4.3.1)The legislation and regulations must be identified for the applicable environmental and/or OHS aspects. For most companies, the relationship between the environmental and/or OHS aspects and the legislation that applies to them is found in the register of environmental and/or OHS aspects. Often a column is added with references to the applicable legislation and regulations.

This reference is useful in the event of changes in legislation, since it makes it easy to find the applicable environmental or OHS aspect and the part of the organization to which it applies, and to assign the impact of the new legislation to the right part of the organization.

This relationship goes both ways: if there are changes to an environmental or OHS aspect due to factors such as changes in the process, the relevant legislation or regulation can be used to determine if the requirements are still being met.

Competence, training and awareness (4.4.2)The employee responsible for keeping track of legislation and regulations and translating the prevailing requirements to their impacts on the organization must have sufficient knowledge to perform this task.

Communication (4.4.3)Requirements in legislation and regulations that determine how work is performed must be communicated to employees to achieve compliance.

Control of documents (4.4.5)If procedures or instructions are drawn up for complying with and checking legislation and regulations, they fall under the requirements for control of documents.



Emergency preparedness and response (4.4.7)One of the things that must be evaluated in the event of an emergency or disaster is its effect on compliance with legislation and regulations and other requirements. If the requirements are not being met, even temporarily, a decision must be taken whether to inform the competent authority. Action must also be taken to control environmental and/or OHS aspects and reduce risks, and to come into compliance with the legal and other requirements as quickly as possible again.

Monitoring and measuring (4.5.1) control of records (4.5.4)Monitoring, measuring, or keeping records can be a requirement in prevailing legislation and regulations or other requirements. It also records the demonstrability of compliance with legislation and regulations.

Nonconformity, corrective and preventive action (4.5.3)If nonconformities are found during the evaluation of compliance, corrective and preventive action will be taken as quickly as possible.



a n n e x 1

Sample simple register of legislation and regulations for an offset printing firm

l AW, R E g u l At i o N o R ot H E R R E q u i R E M E N t

R E M A R KS WAy i N W H i C H l E g i S l At i o N, R E g u l At i o N o R ot H E R R E q u i R E M E N tS A p p ly

Activities Decree Prevailing regulations determined using the Netherlands environment (VROM) ministry’s AIM tool; see Activities Decree checklist. Not all of these rules actually apply. The rules that do not apply are in an overview indicating why each does not apply.

Applicable requirements are established / translated into a checklist. ‘Static’ (such as building-related) requirements are checked once. For recording, see file on checking legislation

Handbook of environmental measures for the graphics industry and packaging printers

Last update 2009/2010. The environmental measures checklist is gone through (once, see file on checking legislation). All prescribed measures have been implemented.

Netherlands emission guidelines for air (NeR)

VOC emission regulations for the graphic industry (general) from chapter 3.4.4. (April 2003). The measures regarding VOCs are in the workbook of environmental measures and not in the NeR.

The VOC requirements from the handbook are met (for recording, see file on checking legislation).

Decree on ozone-depleting substances (October 2003) and Regulation on leak-tight cooling installations (1997)

Applies to cooling installations maintained by a company accredited by STEK (foundation for preventing emissions in cooling technologies).

The company does not maintain cooling equipment itself. The STEK accreditation of the maintenance company is monitored by the suppliers’ evaluation.

Regulation on European waste catalogue (EURAL, 1 May 2002) and ‘ESV’ list (May 2004).

A company can use these lists to determine whether waste substances should be disposed of as hazardous waste or industrial waste, and if there are specific requirements for the use of substances. The EURAL list is available through the environment (VROM) ministry site, the ESV through the site communications-industry organ KVGO. All wastes disposed of as hazardous waste are identified in the procedure for waste separation and disposal.

All hazardous substances have EURAL codes and waste substance numbers before they are disposed of. The codes are in the procedure for waste disposal, and only change if the composition of a substance changes or if the company changes waste-collection agency. Control of codes is ensured in the procedure for waste disposal.

PGS 15 (2005, incl. errata pages) The PGS applies to storage of hazardous substances if substances have an ADR code from the guidelines, since the lower limit (from one of the ADR codes) is being exceeded.

The overview of hazardous substances lists substances which fall under the PGS 15 rules, based on their ADR codes. The substances, quantities and storage location are used to determine which PGS 15 rules apply. These rules are translated into a PGS 15 checklist; see annex 4

(Dutch) Working Conditions Regulations (article 4.3.2b) regarding maximum amounts of isopropyl alcohol (IPA) in damping water (2000).

Requirements in Working Conditions Regulations article 4.3.2. For automatic dosing systems, the legal limit is 8 percent by volume.

This requirement applies to all offset presses. IPA concentrations are checked and recorded weekly. The department head checks records and takes any necessary action. Internally a limit of 5% is observed.



the following (and other measures) do not apply:1 Het Solvents Decree (VOC emissions guideline) does not apply to offset printers.2 BREF: surface treatment with solvents (available through Infomil site but not applicable because the company uses under 100 tons of solvents).3 Packaging tax, applicable if over 50,000 kg of packaging is used per year. The company uses less than this amount.4 Insurance requirements; these have no relationship to environmental aspects.5 The permit has been replaced by the Activities Decree as of 1 January 2010. There are no rules in the permit which should be seen as custom guidelines during the transition period.


R E M A R KS WAy i N W H i C H l E g i S l At i o N, R E g u l At i o N o R ot H E R R E q u i R E M E N tS A p p ly

Regulation on packaging and packaging waste – paper and cardboard covenant II, of which the paper covenant is a part.

The paper-fibre covenant III applied until 31 December 2010 and the paper-fibre covenant IV applies from 1 January 2011 - 31 December 2014. The principle is to ensure collection of old paper and cardboard even if paper prices are low. Separating different paper grades will increase paper ‘yield’.

Paper and cardboard are disposed of separately. The waste separating procedure regulates which grades are disposed of separately.

National Waste Management Plan (LAP2 2009)

Establishes which wastes must be separated. The LAP2 indicates the minimum threshold quantities above which wastes must be separated. There is not a separate sector plan for printers giving additional requirements. The separation rules are described in the waste separation procedure.

REACH The role identification tool on the Reach helpdesk site finds that the printer is a downstream user.

The question tree from the identification tool and the requirements for downstream users are laid down in the ‘checking legislation’ file. The obligations for downstream users are in the purchasing procedure.

Requirements regarding sustainable purchasing of printed matter

This is not a legal requirement, but a customer demand

The requirements are in a table indicating how the requirements are being met.



a n n e x 2

Sample applicable legal environmental and compliance requirements

This example shows some of the requirements for a chemical company, along with the methods for ensuring the requirement is being met.



SuB

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ety

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para

grap

h 3.

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uant

ity o

f haz

ardo

us su

bsta

nce

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ore

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250

0 kg

/litr

e (o

ther

wis

e a

jour

nal m

ust b

e ke

pt).

Stor

ehou

seCh

eckl

ist

CL 5

6+57

S-

2PG

S 15

para

grap

h 3.

1M

axim

um o

f 50

kg sp

ray

cans

.St

oreh

ouse

1Ch

eckl

ist*

Cl 5

6

S-

3PG

S 15

para

grap

h 3.

1M

axim

um o

f 50

kg sp

ray

cans

.St

oreh

ouse

2Ch

eckl

ist

CL 5

7

S-

4PG

S 15

para

grap

h 3.

3Th

e qu

ality

of t

he fl

oor m

ust b

e vi

sual

ly a

sses

sed

annu

ally

. Liq

uid-

proo

f floo

rs m

ust b

e in

spec

ted

once

eve

ry 5

yea

rs b

y an

aut

horiz

ed

pers

on.

Stor

ehou

seCe

rtifi

cate

+

Reco

rdin

g sy

stem

S-

5PG

S 15

para

grap

h 6.

2G

as b

ottle

s mus

t alw

ays b

e se

cure

d.St

oreh

ouse

Chec

klis

t

S-

6PG

S 15

para

grap

h 3.

9Pr

oduc

t sto

rage

cap

acity

: lea

k-pr

oof b

asin

s for

all

stor

ed p

rodu

cts

(min

imum

110%

of t

he la

rges

t pac

kage

and

at l

east

10%

of t

he to

tal

stor

age

abov

e th

e dr

ip tr

ay).

Stor

ehou

seO

verv

iew

of

stor

ehou

se se

t-up

w

ith m

ax. s

tora

ge

capa

citie

s

S

-7W

m

Wm

art

icle

T-11

Ope

n fir

es a

nd sm

okin

g ar

e pr

ohib

ited

whi

le fi

lling

a ta

nk. T

he

mot

or o

f a ta

nk tr

uck

mus

t be

turn

ed o

ff w

hile

coup

ling

and

unco

uplin

g th

e fil

ling

hose

and

whi

le fi

lling

a ta

nk.

Prod

uctio

nPr

oced

ure

S

-8W

m

Wm

a

rtic

le T-

12M

easu

res m

ust b

e ta

ken

agai

nst s

tatic

ele

ctric

ity w

hile

filli

ng a

ta

nk fr

om a

tank

truc

k, th

e co

nnec

tion

betw

een

tank

and

tank

tr

uck

mus

t be

pres

ent d

urin

g th

e en

tire

fillin

g pr

oces

s, in

clud

ing

coup

ling

and

unco

uplin

g of

the

hose

.

Prod

uctio

nPr

oced

ure

Build

ing

B-1

Build

ings

dec

ree

Fi

re e

xtin

guis

hers

, ann

ual i

nspe

ctio

n by

exp

ert.

Tech

. ser

vice

sM

aint

enan

ce li

st

Was

teW

-1Co

vena

ntAr

t. 16

Sepa

rate

dis

posa

l of p

aper

/ /p

last

ic/p

alle

ts/c

hem

ical

s.Pr

oduc

tion

Ope

ratio

nal

inst

ruct

ions

WI 1

01

W

-2N

atio

nal w

aste

m

gmt p

lan

2 (L

AP2)

chap

ter 1

5Se

para

te d

ispo

sal o

f was

tes:

pla

stic

cup

s (50

0 or

mor

e p/

wk)

, w

ood

(40

kg o

r mor

e p/

wk)

, met

al (4

0 kg

or m

ore

p/w

k), a

nd a

ny

rubb

le c

reat

ed.

All d

epar

tmen

tsO

pera

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l in

stru

ctio

nsW

I 101

W

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ctor

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teW

aste

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ust b

e se

para

tely

rem

oved

and

take

n to

an

accr

edite

d co

llect

or/p

roce

ssor

.Te

ch. s

ervi

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Chec

klis

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101

Dis

char

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ater

act

Pollu

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of S

urfa

ce W

ater

s Act

pe

rmit

art.

4.1

Max

imum

dis

char

ge o

f Cr,

Cu, Z

n is

2 m

g/l,

flow

rate

max

4.5

m3

per 2

4 hr

s, sa

mpl

ing

1x p

er q

uart

er.

Prod

uctio

nAn

alys

is



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Annu

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plan

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(‘A

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Artic

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mus

t dra

w u

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Iden

tifica

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and

Eval

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an

d Ac

tion

Plan

.Pe

rson

nel

depa

rtm

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Proc

edur

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I&E

A-2

Arbo

wet

Artic

le 9

Wor

kpla

ce a

ccid

ents

and

occ

upat

iona

l illn

esse

s mus

t be

reco

rded

an

d re

port

ed.

Pers

onne

l de

part

men

tPr

oced

ure

and

Emer

genc

y re

spon

se

plan

A-3

Wor

king

Co

nditi

ons D

ecre

e (‘A

rbob

eslu

it’)

Artic

le 4

.2An

add

ition

al R

I&E

mus

t be

done

for e

xpos

ure

to h

azar

dous

su

bsta

nces

.Pe

rson

nel

depa

rtm

ent

Proc

edur

e, R

I&E

A-4

Arbo

besl

uit

Artic

le 4

.3Ex

posu

re to

haz

ardo

us su

bsta

nces

mus

t rem

ain

belo

w th

resh

old

valu

es.

Pers

onne

l de

part

men

tO

verv

iew

of

mea

sure

men

ts ,

reco

rds,

proc

edur

e

A-5

Arbo

besl

uit

Artic

le 8

.1Pe

rson

al p

rote

ctiv

e eq

uipm

ent m

ust m

eet s

tand

ards

and

be

used

co

rrec

tly.

Purc

hasi

ng a

nd

KAM

/QES

.Pr

oced

ure,

in

form

atio

n, sa

fety

gu

ide

A-6

Arbo

besl

uit

Artic

le 8

.2Th

e us

e of

per

sona

l pro

tect

ive

equi

pmen

t mus

t be

eval

uate

d in

th

e RI

&E.

Pers

onne

l and

KA

M/Q

ES.

RI&

E an

d re

port

A-7

Arbo

besl

uit

Artic

le 8

.3Pe

rson

al p

rote

ctiv

e eq

uipm

ent m

ust b

e av

aila

ble,

use

d,

mai

ntai

ned

and

repa

ired.

KAM

/QES

and

Tech

. se

rvic

esPr

oced

ures

, sup

ply

man

agem

ent

* Se

e ex

ampl

e in

ann

ex 4

** W

m: E

nviro

nmen

tal M

anag

emen

t Act



a n n e x 3

Sample translation of legal environmental requirements into concrete tasks

Below is an example of a company that has translated its legal requirements into employee tasks (only those involving storage of hazardous substances are shown here). Where possible, the company has integrated the requirements into the procedures and operational instructions in its management system. For monitoring purposes (and sometimes for performing the tasks) the tasks have been put in a computerized system. After a task is completed, it must be ‘cancelled’ in the system. The environmental-OHS coordinator does random checks to see if the tasks have been performed well and carefully, and if compliance is being ensured and/or checked by means of the formulated tasks.



SuB

jEC

tlA

W o

R R

Egu

lAti

oN

SuM

MA

Ry

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KD

EtA

ilED

D

ESC

Rip

tio

N o

f R

Equ

iREM

ENtS

REf

EREN

CE

tASK

DES

CR

ipti

oN

fR

Equ

ENC

ytA

SK

Ho

lDER

PGS

PGS

15Th

e gu

idel

ine

cont

ains

rule

s for

st

orin

g pa

ckag

ed h

azar

dous

su

bsta

nces

in su

ch a

way

as

to a

chie

ve a

n ac

cept

able

le

vel o

f pro

tect

ion

for p

eopl

e an

d th

e en

viro

nmen

t. Th

e re

quire

d le

vel o

f pro

tect

ion

is d

eter

min

ed b

y th

e cu

rren

t st

ate

of th

e ar

t for

cons

truc

ting

stor

age

faci

litie

s, fir

e-fig

htin

g sy

stem

s and

wor

k eq

uipm

ent.

The

cate

gorie

s and

defi

nitio

n of

haz

ardo

us su

bsta

nces

in

PGS

15 a

re a

lso

used

in th

e Ca

rria

ge o

f Dan

gero

us G

oods

Ac

t. Cl

assi

ficat

ion

of h

azar

dous

su

bsta

nces

take

s pla

ce in

co

nfor

man

ce w

ith th

e Eu

rope

an

ADR

agre

emen

t.

Stor

age

of

pack

aged

ha

zard

ous

subs

tanc

es

The

clas

sific

atio

n of

ha

zard

ous s

ubst

ance

s in

tabl

e 3

is b

ased

on

the

tran

spor

tatio

n le

gisl

atio

n AD

R. T

he ta

ble

show

s the

lo

wer

lim

its o

f haz

ardo

us

subs

tanc

es. T

he P

GS

15 d

oes

not a

pply

und

er th

is li

mit.

Ch

apte

r 3 (G

ener

al) a

pplie

s to

[com

pany

nam

e] fo

r bo

th in

tern

al a

nd e

xter

nal

stor

age

faci

litie

s, an

d ch

apte

r 6 (S

tora

ge o

f gas

bo

ttle

s) se

ts re

quire

men

ts

for s

tora

ge o

f gas

bot

tles

over

the

limit

of 11

5 lit

res.

>

over

view

of h

azar

dous

subs

tanc

es co

ntai

ning

max

imum

qua

ntiti

es,

st

orag

e si

tes,

part

ition

ing,

etc.

>

info

rmat

ive

mat

eria

ls

an

d re

cord

s of

part

icip

ants

’

info

rmat

ion

sess

ions

>

repo

rts o

f con

sulta

tions

invo

lvin

g su

bjec

ts a

bout

whi

ch e

mpl

oyee

s mus

t be

info

rmed

>

chec

klis

t of r

equi

rem

ents

in th

e en

viro

nmen

tal

pe

rmit

for s

tora

ge si

te a

nd

ad

ditio

nal r

equi

rem

ents

from

PG

S 15

Chec

k w

heth

er p

erso

nnel

pe

rfor

min

g ta

sks a

re

info

rmed

of r

equi

rem

ents

an

d ag

reem

ents

abo

ut

stor

ing

haza

rdou

s sub

stan

ces

(prim

arily

par

titio

ning

).Ch

eck

whe

ther

per

sonn

el a

re

adeq

uate

ly tr

aine

d.

annu

ally

….

Chec

k w

heth

er p

acka

ged

haza

rdou

s sub

stan

ces a

re

stor

ed a

ccor

ding

to th

e ru

les,

usin

g th

e ‘P

GS

15 ch

eckl

ist’

and

‘ove

rvie

w o

f par

titio

ns’.

quar

terly

….

Chec

k th

at th

e st

orag

e si

tes

satis

fy th

e en

viro

nmen

tal

perm

it re

quire

men

ts, u

sing

th

e ch

eckl

ist ‘

requ

irem

ents

for

stor

age

site

s’

annu

ally

….

Info

rm n

ew e

mpl

oyee

s abo

ut

the

requ

irem

ents

agr

eem

ents

ab

out s

torin

g ha

zard

ous

subs

tanc

es

mon

thly

….

Chec

k th

at th

e ac

tiviti

es o

f th

e AD

R sa

fety

adv

isor

are

sp

ecifi

ed



a n n e x 4

Sample translation of general environmental requirements into specific rules

PGS 15 is a guideline with many different requirements for storing hazardous substances. Using safety-data sheets, a company must first determine whether the substances and amounts of them stored fall under PGS 15. The requirements are then dependent on whether the substance is stored inside or outside, in a closet, vault or rack, on the ground floor or an upper floor. These findings will determine which parts of the PGS 15 will (or will not) apply. To monitor compliance, it must be determined which specific rules apply.

The substance of this annex will be linked to the overview of the applicable legislation and regulations in annex 1 and/or the elaboration of the requirements in annex 2. One of the rules the company must obey is the PGS 15 for storing hazardous substances. The PGS 15 analysis is based on the overview of hazardous substances and ADR codes that a company must have available.

Analysis of the applicable requirements from PGS 15 (28 June 2005) including published addenda sheets up to 1 September 2010(Note: this overview is not complete!)

§ 3.1 Indicates that chapter 7 of PGS 15 (§ 3.11) should be referred to for storage of spray cans. It also indicates that the threshold is 50 kg. This means than the PGS 15 only applies if more than 50 kg of spray cans are stored (§ 3.1.2). Conclusion: the company stores less than 50 kg of spray cans, thus PGS does not apply here.

Working stock (the amount used in one day or batch) is not covered by PGS 15. Drawing off or racking is not permitted in the storage space. Empty packaging not yet cleaned is covered by PGS, however, and is stored as full packaging.

§ 3.2 Construction requirements Conclusion: the requirements for the hazardous substances storage space are covered by the prevailing requirements since the storage space existed before the publication of PGS 15 in July 2005. The requirements for storage space are listed in the permit. These requirements are checked once only, and compliance is further guaranteed by means of a management of change (MoC) procedure.



§ 3.3 Concerns floor qualityConclusion: the floor has a liquid-proof finish and must undergo periodic visual inspection.

§ 3.4 Concerns the quality of racks Conclusion: construction requirements are checked and ensured in the management of change procedure. They have periodic visual inspection.

§ 3.5 protection from lightningConclusion: lightning-proofing the facility is not necessary. This is determined using the Dutch standard NEN 1014. See the company notice: Implementing the calculation model for lightning-proofing.

§ 3.6 Explosive safety Conclusion: given the nature of the substances, there is no danger of explosion and therefore no measures of this type need to be taken.

§ 3.7 VentilationConclusion: the requirements for ventilation in the storage space were introduced during construction of the space. At least once a year, the ventilation equipment is checked to see that it functions properly and that nothing is blocking it. When the check has been performed it is recorded in the checklist ‘Meeting the PGS 15 requirements’.

§ 3.8 prevention of contaminated rainwater Conclusion: this rule does not apply, since the external storage is in an appropriate (closed) container. Rainwater cannot get onto the floor of the container.

§ 3.9 product containmentConclusion: All stored containers have leak-proof basins underneath. These basins must be able to contain at least 110% of the contents of the largest package and with at least 10% of the total amount stored. We will check this periodically.

§ 3.10 fire-proof storage closetsConclusion: Since the company uses storage vaults and not closets, this rule does not apply.

§ 3.11 packaging and labelling The packaging of hazardous substances meets the ADR requirements. The substances are stored in the approved packages in which they were delivered. The same holds for the labelling of the hazardous substances, which were labelled by the supplier.Conclusion: Only undamaged, labelled packages are being stored. If labels are (or have become) illegible, a replacement label is attached. The legibility of labels and damage to packages is checked.

NB: if a company has several storage spaces which all are covered by pgS 15, the applicable rules for each space must be determined. the rules can differ on the basis of, for instance, location (inside vs. outside, ground floor vs. upper floor), kind of substance stored or the amount(s) of substances stored.



Sample pgS 15 checklist (not complete)

A Rt. N o. R u l E / q u E St i o N f RoM p g S 15 C H E C K yE S/N o R E M A R KS / f i N D i N g S

Alg. Are all substances (including wastes), excepting the working stocks stored in the closets or basins intended for them?

Alg. Does everything look tidy and orderly (good housekeeping)?

3.1.3 Is the working stock no more than one day’s consumption?

3.1.4 Are there indications that draining or racking is taking place in the storage area?

3.1.5 Are empty, not-cleaned packages stored like full ones?

3.3.3 Is the floor clean and without cracks? (Visual inspection)

3.4 Is the quality of closets, basins, and racks good? (No damage, collapsed shelves, and collision protection still intact)

3.9 Are the leak-proof basins large enough? (each basin must be able to accommodate 110% of the volume of the largest container and at least 10% of the total volume of packages stored), calculated for each basin separately. If the agreements for substances and number of containers per basin/rack are met, the volume requirement has been met.

3.11 Is the packaging of the hazardous substances sufficient? (whole, sealed, original, ..)

3.11 Does the packaging have proper labelling and hazard symbols?

Check that substances which should not be stored together are stored separately).See the partitioning overview ……



a n n e x 5

Sample of simple register of OHS legislation and regulations for an offset printing company


R E M A R KS WAy i N W H i C H l E g i S l At i o N, R E g u l At i o N o f ot H E R R E q u i R E M E N tS A p p ly

Working Conditions Act (Arbowet)

The Working Conditions Act contains general rules for employers and employees, to ensure a safe and healthy workplace. Not every article in the Act applies to this company. The articles which do not apply are in an overview indicating why each does not apply.

Using the risk inventory and evaluation for the ‘Grafimedia’ sector, the company checks to see that it is complying with all the rules from the Working Conditions Act, Working Conditions Decree and the Working Conditions Regulations. This RI&E is performed every four years, and must be done sooner if there are changes to legislation and regulations or in the company. There is an annual check to see if the RI&E must be repeated earlier.

Working Conditions Decree (Arbobesluit)

The general rules in the Working Conditions Act are elaborated on in the Working Conditions Decree. Here as well, not all articles will apply. The articles that do not apply are in an overview indicating why each does not apply.

See text for Working Conditions Act.

Working Conditions Regulations (Arboregeling)

The Working Conditions Regulations contains more specific rules of the Working Conditions Act. Not all regulations apply to this company. The articles that do not apply are in an overview indicating why each does not apply.

See text for Working Conditions Act.

Graphic media sector requirements (‘Arbocatalogus Grafimedia’)

The Grafimedia requirements ‘catalogue’ was drawn up by representatives of both employers and employees in the graphic media branch. It contains minimum standards that companies working in the branch must meet, as well as suggestions for solutions.

The company has read all the subject pages of the ‘catalogue’ on www.arbografimedia.nl. Using the checklists and the RI&E, they have checked if all requirements are being met. There is a check each year of whether there have been any changes that make it necessary to read the pages again.

Working Times Act (Arbeidstijdenwet)

The Working Times Act prohibits employees working too many hours in a day or week.

The Ministry of Social Affairs’ (SZW) brochure on the Working Times Act has been read. The working hours and break times meet the requirements in the Act. If working hours or break times change, or if an employee is pregnant, the brochure will be checked again. There is an annual check to see if there have been changes to the Working Times Act.

Work and Care Act (Wet Arbeid en Zorg)

The Work and Care Act regulates different forms of leave, so that employees can better coordinate work with receiving and giving needed care.

If an employee’s leave may fall under the Work and Care Act (pregnancy, maternity, adoption, foster care, emergency and other short-term leave, care leave, maternity/paternity leave, or long-term care under the Dutch life-course savings scheme), the checklist based on this law is used.




R E M A R KS WAy i N W H i C H l E g i S l At i o N, R E g u l At i o N o f ot H E R R E q u i R E M E N tS A p p ly

Gatekeeper Improvement Act (Wet verbetering Poortwachter)

Officially called the ‘Eligibility for Permanent Invalidity Benefit (Restrictions) Act,’ this Act provides rules for the first two years of illness, with the goal of keeping the period of illness as short as possible.

In the event of illness, the company goes through the checklist, drawn up in consultation with the company doctor.

Tobacco Act (Tabakswet) The Tobacco Act provides measures to minimize tobacco use, and to protect non-smokers from second-hand smoke.

There is no smoking allowed inside the company premises. Smokers may smoke in the smoking area outside the building. This complies with the Tobacco Act. Each year there is a check for changes in the Tobacco Act.

Works Councils Act (Wet op de Ondernemingsraden)

This Act contains rules for the works councils and employee representative bodies.

Since the company has fewer than 50 employees, it is not required to have a works council. An annual poll is taken among employees asking if they find a need for an employee representative body.

Grafimedia Collective Labour Agreement (CAO)

The Collective Labour Agreement for the Grafimedia sector contains agreements about illness, leave, risk inventory and evaluation, and training.

The agreements in the CAO are incorporated in the checklist for leave and the checklist for illness. A summary is made of agreements about training that is used in performance appraisal interviews. In performing the RI&E, the testing agreements described in the CAO are used. With any new CAO, the checklists are modified and there is a check to see if other modifications to policy of procedures are necessary.



a n n e x 6

Sample applicable legal OHS requirements and how to ensure compliance

S u Bj E Ct N o. l AW A Rt. N o. R E q u i R E M E N t p Ro C E S S/D E pt. E N S u R E D By D o C. N o.

Policy P-1 Working Conditions Act

Article 5 The employer must draw up a risk identification and evaluation (RI&E) and an action plan.

Personnel and QES depts.

Procedure, RI&E

P-2 Working Conditions Act

Article 9 Occupational accidents and illnesses must be recorded and in certain cases reported.


Procedure, Emergency plan

P-3 Working Conditions Decree

Article 4.2 An additional RI&E must be made for exposure to hazardous substances.


Procedure, RI&E

P-4 Working Conditions Decree

Article 4.3 Exposure to hazardous substances must stay below threshold limit values.


Overview of measurements, records, procedure

Personal Protective Equipment (PPE)

PPE -1 Working Conditions Decree

Article 8.1 Personal protective equipment must meet standards, fit the hazard, circumstances and the person, and be used correctly.

Purchasing and QES depts.

Procedure, informing employees, safety guide, PPE register


Article 8.2 The use of personal protective equipment is evaluated in the RI&E.


RI&E report


Article 8.3 Personal protective equipment must be available, used, maintained and repaired.

Purchasing, QES dept. and technical services

Procedures, supply management, PPE register

Noise N-1 Working Conditions Decree

Article 6.7 The RI&E must evaluate the noise levels to which employees are exposed.


Procedure, RI&E report, Noise reports

N-2 Working Conditions Decree

Articles 6.8 and 6.9

If threshold limit values are exceeded, measures are taken, keeping in mind occupational hygiene requirements.

Technical services, Personnel and QES depts.

RI&E report, noise report, action plan


Article 6.10 An audiometric examination must be offered if threshold limit values are exceeded.

Personnel and QES depts., company physician

Procedure, register, individual medical dossiers


Article 6.11 Information and instructions should be given to employees if certain threshold limit values are being exceeded.


Procedure, RI&E-report, noise reports, information campaign



S u Bj E Ct N o. l AW A Rt. N o. R E q u i R E M E N t p Ro C E S S/D E pt. E N S u R E D By D o C. N o.

N-5 (Rubber/plastics industry)Requirements(Arbocatalogus NRK)

Solutions for noise

Compressed-air hose openings must be fitted with “quiet” nozzles. Employees are given instructions (they usually believe that these nozzles work less well).

Technical services and QES dept.

Checklist, information campaign

CL 201

N-6 NRK Requirements Solutions for noise

Use mufflers when releasing product (releasing compressed air after pressure buildup).

Technical services Checklist CL 201


Cool with water instead of quick air-cooling.

R&D, Technical services

Redesign


Cleaning with a vacuum cleaner instead of compressed air.

Production Procedure, information campaign


Limiting how far a product may fall. R&D, Technical services

Redesign


Breaking the fall of dropped products. R&D, Technical services

Redesign

Working hours and breaks

WRT -1

Working Times Act Article 5:7 An employee may work no more than 12 hours per shift.

Personnel dept. and production

Registration system

Article 5:7 An employee may work no more than 60 hours per week.


Registration system

Article 5:7 The average weekly hours worked over a period of 4 weeks must not exceed 55 hours.


Registration system

Article 5:7 The average weekly hours worked over a period of 16 weeks must not exceed 48 hours.


Registration system

Article 5:4 If an employee works more than 5.5 hours, he or she must have at least 30 minutes’ break. This may be split into two 15-minute breaks.


Registration system

Article 5:4 If an employee works more than 10 hours, the break must be at least 45 minutes. It may be divided into several breaks of at least 15 minutes each.


Registration system



a n n e x 7

Sample translation of legal OHS requirements into concrete tasks

Below is an example of a company that has translated its legal requirements into employee tasks (only a few tasks related to noise). Wherever possible, the company has integrated the requirements into the procedures and operational instructions in its management system. For monitoring purposes (and sometimes for performing the tasks) the tasks have been put in a computerized system. After a task has been completed it must be ‘cancelled’ in the system. The environmental-OHS coordinator performs random checks to see if the tasks have been performed well and carefully and if compliance is being ensured and/or checked by means of the formulated tasks.



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w

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from

the

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if eq

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e re

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equi

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w

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year

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ck th

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up

to

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and

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plet

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…..

Equi

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in

spec

ted/

test

ed.

ww

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ted

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if ne

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n th

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for

the

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insp

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cess

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t acq

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nspe

cted

if sp

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re a

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ook

and

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n th

e ba

sis o

f ins

truc

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for

the

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e if

insp

ectio

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ne

cess

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t acq

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of n

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s. …

..

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entiv

e m

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ce

of m

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nes,

equi

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t and

to

ols

A m

aint

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ce p

lan

mus

t be

draw

n up

in w

hich

revi

ew d

ays a

re

plan

ned

in a

dvan

ce.

Mai

nten

ance

pla

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raw

up

a m

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e. A

t acq

uisi

tion

of n

ew

mac

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s/eq

uipm

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tool

s. O

nce

a ye

ar, c

heck

that

all

equi

pmen

t is

incl

uded

in th

e pl

an.

…..

If de

sire

d, m

ake

a m

aint

enan

ce

‘pas

spor

t’ fo

r eac

h m

achi

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mai

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spor

t’M

ake

a m

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assp

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for e

ach

mac

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..

Hav

ing

empl

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mor

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even

tive

mai

nten

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th

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lves

can

pro

vide

var

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in

thei

r job

des

crip

tion.

mai

nten

ance

‘pas

spor

t’La

y do

wn

wha

t par

t of

mai

nten

ance

is p

erfo

rmed

by

empl

oyee

s on

the

wor

k flo

or,

tech

nica

l ser

vice

s em

ploy

ees,

and

outs

ide

com

pani

es.

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e. A

t acq

uisi

tion

of n

ew

mac

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s/eq

uipm

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nce

a ye

ar, c

heck

that

all

equi

pmen

t is

incl

uded

in th

e pl

an.

…..



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atal

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lTh

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mee

ts th

e fo

llow

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safe

ty re

quire

men

ts:

1. Th

e cu

tter

has

a h

ood

that

en

sure

s tha

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mac

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is o

ff if

th

e ho

od is

rais

ed. T

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ood

has a

sa

fety

cat

ch.

Logb

ook

and

mai

nten

ance

sc

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le.

Chec

k th

ese

aspe

cts w

hen

purc

hasi

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e cu

tter

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ing

perio

dic

mai

nten

ance

, che

ck if

this

re

quire

men

t is s

till b

eing

met

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urch

ase

and

annu

ally

.…

..

2. T

he c

utte

r‘s o

pera

ting

syst

em is

su

ch th

at it

can

not b

e tu

rned

on

acci

dent

ally

.

Logb

ook

and

mai

nten

ance

sc

hedu

le.

Chec

k th

ese

aspe

cts w

hen

purc

hasi

ng th

e cu

tter

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ing

perio

dic

mai

nten

ance

, che

ck if

this

re

quire

men

t is s

till b

eing

met

.

At p

urch

ase

and

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ally

.…

..

3. T

here

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feat

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whe

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doe

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k if

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e is

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in th

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ook

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sc

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Chec

k th

ese

aspe

cts w

hen

purc

hasi

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e cu

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ing

perio

dic

mai

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, che

ck if

this

re

quire

men

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..

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ition

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ually

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nual

ly.

…..

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mpl

oyee

s wea

r cut

-res

ista

nt

glov

es w

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repl

acin

g th

e cu

tter

bl

ades

.

Pers

onal

pro

tect

ive

equi

pmen

t re

gist

er.

Prov

ide

cut-

resi

stan

t glo

ves t

o em

ploy

ees w

ho re

plac

e cu

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bl

ades

, and

supe

rvis

e th

eir u

se.

Cont

inuo

us…

..

6. E

mpl

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s wor

king

with

cut

ters

re

ceiv

e re

peat

ed in

stru

ctio

n in

sa

fe u

se o

f the

cut

ter (

prop

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se

of sa

fety

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d/ca

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nec

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ry

caut

ion

whe

n re

mov

ing

mea

t).

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utes

of e

mpl

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mee

ting.

Tr

aini

ng p

erio

d fo

rm.

Dev

ote

time

in th

e em

ploy

ee

mee

tings

to w

orki

ng sa

fely

with

cu

tter

s. G

ive

new

em

ploy

ees

info

rmat

ion

abou

t saf

ety

whe

n w

orki

ng w

ith c

utte

rs.

Annu

ally

and

at h

ire.

…..



a n n e x 8

Sample translation of general OHS requirements to specific rules

This is an example of a way to determine whether legislation and regulations apply using specific rules. Sometimes legislation and regulations only apply if certain limits are exceeded. Here, a company canteen has computer display units (VDUs) in several places. They must find out which work stations the OHS legislation and regulations about working with computer displays apply to.

Article 5.8 of the Working Conditions Decree indicates that the articles about working with computer displays do not apply to:

1a Operating stations on machines;1b Computer systems intended primarily for use by the public;1c So-called portable systems not continuously in use on a workstation;1d Calculating machines, cash tills and other equipment provided with a small display for information or quantities and required for the direct use of this equipment;1e Conventional typewriters with displays;2 Neither does this Section apply to work whereby an employee usually uses a VDU less than two hours in every 24 hours.



Below is a list of the displays in the company canteen and in its offices, work spaces and storage spaces.

ConclusionFor the time being, the rules from OHS legislation and regulations relevant to computer display work only apply to the restaurant team leader’s work station.

S pAC E N uM B E R

D E S C R i pt i o N o f D i S p l Ay D o E S o H S l E g i S l At i o N A p p ly?

Ex p l A N At i o N C H E C K i N g

1.01 Restaurant team leader’s display Yes More than two hours per day, traditional computer work station.

1.01 Cook’s display No Average of 1.5 hours per day. Check annually if amount of computer work has increased.

1.02 Assistant team leader’s display No Average of less than one hour per day. Check annually if amount of computer work has increased.

1.02 Kitchen workers’ shared work station No Average of less than one hour per day. Check annually if amount of computer work has increased.

1.03 Cold room, display on refrigerator No Display for direct use of equipment (1d).

1.04 Walk-in freezer room, display on freezer No Display for direct use of equipment (1d).

1.10 Restaurant, staffed cash desk No Cash till (1d)

1.10 Restaurant, automatic cash desk No Used by the public (1b)

1.10 Restaurant, computer for ordering No Average of less than one hour per day. Check annually if amount of computer work has increased.

1.12 Dishwashing area, display on dishwasher No Display for direct use of equipment (1d).

1.13 Kitchen, deep-fat fryer display No Display for direct use of equipment (1d).

1.13 Kitchen, oven display No Display for direct use of equipment (1d).

1.15 Supply room, PDA for supply management No Portable system not continually in use (1c).



a n n e x 9

Sample management review procedure

Below is a part of the management review procedure, around the input and analysis regarding legislation and regulations.

Documents to be supplied for the management review:> procedure for keeping track of legislation and regulations;> overview of changes in the organization (including other changes in process or product) and the follow-up with regard to legislation and regulations (including updating applicable legislation and regulations fitting the environmental and OHS aspects, determining impact on the organization, taking measures to achieve compliance, information campaigns within the organization, etc.);> report of evaluation(s) of compliance with legislation and regulations (performance): conclusions, nonconformities, analysis of cause, corrective or preventive action;> reports of external monitoring (by government authorities etc.): nonconformities, cause analysis, corrective or preventive action;> reports/results of internal and external audits regarding legislation and regulations: nonconformities, cause analysis, corrective or preventive action;> results of competency analysis of employee(s) responsible.

Analysis by top management:> evaluate whether the method of keeping track of legislation and regulations ensures an up-to-date register of legislation;> evaluate whether changes in the organization have been adequately followed up;> evaluate if the way compliance is achieved, and the compliance itself, is sufficient;> evaluate whether sufficient corrective or preventive action has been taken;> evaluate whether the procedure for corrective action is sufficient;> evaluate whether the employee(s) involved have sufficient competence and if they need additional training.

Conclusion by management:With the management review, top management determines if the management system is still suitable, appropriate and effective. Part of this is determining if the compliance management system or method is still suitable, appropriate and effective, and that it ensures continual compliance with legal and other requirements.



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