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Occupational Health for Good BusinessOccupational Health for Good Business

Foreword 1

Occupational Health 2

Occupational Health Hazards 3

Sources of Occupational Health Hazards 7

Occupational Health Programme 11

Legislation Relating to Occupational 15Health

Occupational Diseases 17

Occupational Health Service 26

Contents

*A Chinese version is available


1

Foreword

Hong Kong has a working population of over 3 million people, encompassing every industry. No

matter what industry you are involved in, occupational health is an important issue affecting you and

it should be given serious attention. During work, if materials, equipment and operational procedures

are incorrectly handled, potential adverse effects to employees and the company could arise, such

as the development of occupational illnesses, an increase in absenteeism, a reduction in productivity

and an increase in insurance cost. As long as employers and employees work together to stress the

importance of occupational health and make improvements, these problems can be readily solved.

The purpose of this manual is to introduce the key concepts of occupational health to employers

and employees and allow them to become aware of occupational health hazards and remedial

measures, thus helping everyone avoid occupational diseases.


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Occupational Health

Even if occupational health hazards do not lead to occupational diseases, they will often result in employee discomfort. Problems such as “Sick Building Syndrome”, reactions to psychological stress and susceptibility to fatigue can affect health and reduce work efficiency. Therefore, we must emphasise the importance of occupational health so as to reduce hazards and prevent occupational diseases.

What is “occupational health”? A wide range of factors in our work such as incorrect working methods, environmental hazards, toxic substances or hazardous equipment can all have adverse effects on the human body. An unhealthy body can affect your work and productivity.

“Occupational health” examines the correlation between work and health.

The Joint Committee on Occupational Health of the International Labour Organization and World Health Organization made a definition of occupational health as early as 1950:

“Occupational health should aim at the promotion and maintenance of the highest

degree of physcial, mental and social well-being of workers in all occupations; the

prevention among workers of departures from health caused by their working

conditions; the protection of workers in their employment from risks resulting from

factors adverse to health; and the placing and maintenance of the worker in an

occupational environment adapted to his physiological and psychological ability.”


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There are many occupational hazards that might affect our health. Categorised according to their nature, they can be divided into physical, chemical, biological, ergonomic and psychological aspects:

I. Physical Hazards 1. Noise and vibration

Long-term exposure to noise w i thout e ffec t i ve hear ing protection can result in hearing loss. Long-term use of vibrating tools (such as jackhammers) can result in pain and tingling sensations in the arms and even disability.

2. LightingIntense light, dim light, glare and strong contrasts can lead to eyestrain, sore eyes, headaches and dizziness.

3. TemperatureWorking under high temperatures can result in heatstroke; working in frozen conditions increases suscept ib i l i ty to chilblains.

4. Air pressureD i v e r s a n d t h o s e w o r k i n g i n pressurized tunnels are likely to suffer from decompression sickness if they return to a normal pressure without appropriate decompression. Sufferers experience pain in the joints, dizziness and vomiting.

5. Non-ionising radiationThe ultraviolet radiation generated during electric arc welding can injure the eyes and result in conjunctivitis (Arc Eye) . The infrared rays emit ted by molten metals can result in heat-induced cataracts.

6. Ionising radiationWhen proper protective measures are not taken and the body is subjected to excessive ionising radiation such as from x-rays or radioactive matter, the person exposed may suffer from illnesses such as leukaemia or skin cancer.

Occupational Health Hazards

Radiation zone

DANGER


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LiquidsFor example:◆ Acidic cleaning agents used by cleaners◆ White spirit used by printing workers◆ Toxic reagents used in laboratories

Hydrogen sulphide

Dusts, fumes, mistsFor example:◆ S i l i ca dust generated by

mining and construction work◆ Metal fumes generated by

welding◆ Acid mists emitted during

electroplating processes

II. Chemical HazardsGasesFor example: ◆ Hydrogen sulphide inside manholes◆ Exhaust from LPG-fueled forklift

trucks◆ Ozone emitted by photocopiers


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III. Biological Hazards

Contact with micro-organisms (viruses, fungi, etc.) may result in various illnesses.

For example:

◆ Health care personnel and laboratory personnel may become infected with tuberculosis, hepatitis and other illnesses due to contact with blood, secretions and excretions.

◆ Persons in regular contact with animals, such as butchers, farmers, tanners and veterinarians are relatively more susceptible to contracting infectious diseases such as anthrax, glanders and avian flu, etc.

◆ Workers in rodent-infested areas such as sewers are at risk of being infected with leptospirosis.

◆ Improperly serviced ventilation systems and cool ing towers may al low the breeding and spreading of bacteria that lead to Legionnaires’ disease.


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IV. Ergonomic Factors

Ergonomics examines the interaction between people, tools and their work environment to make working more comfortable and at the same time increase efficiency. A few examples of poor ergonomics are as follows:

V. Psychological Factors

An appropriate amount of stress can boost work efficiency. However, when stress is excessive it can damage your physical and mental health and lead to problems such as anxiety, headaches, depression, gastric ulcers and heart disease.

◆ Using a workbench that is either too high or too low

◆ The design of tools makes users adopt a bad posture

◆ Doing repetitive work with an improper posture


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All industries have their own characteristics and the hazards they generate are also different. Nevertheless, the source of hazards can be categorised into several specific areas - materials, machinery and equipment, work methods and environment. Can you spot the source of hazards from the situations below?

Construction site

Sources of Occupational Health Hazards

Cement may irritate the skin

A lot of sawdust and noise is created when using the circular saw

The worker is not wearing protective clothing to protect himself under the burning sun

The worker is bending his waist to transport the planks

Machinery and equipment

Material

Environment

Work method


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Kitchen

Heavy materials such as 50 kg bags of rice

Noise created by the stove and exhaust ventilation system

High temperatures and steam generated while cooking

Chopping forcefully with knives


Material

Environment

Work method


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Office

Decorating materials release irritants and volatile compounds

Strong light emitted by the photocopier Poorly positioned workstation and strong light from outside will adversely affect the computer user

An office worker is stretching out too far to reach for a file placed overhead


Material

Environment

Work method


To berepaired

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Laboratory

Toxic and irritating chemicals

The fume cupboard has not been properly ser-viced and is leaking gas

The nearby clerical worker is being affected by the emitted gases

Without carrying out experiments that emit toxic gases inside the fume cupboard


Material

Environment

Work method


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To ensure occupational health, a comprehensive occupational health programme is indispensable.

I. Anticipating and identifying health hazards

Consideration should be given to work processes, tools and equipment at the design stage so as to make every effort to avoid hazards and ensure the health of employees. For work already underway, we must identify and evaluate hazards. Methods used can include conducting workplace inspections, referring to occupational safety and health publications, interviewing with employees and consulting the MSDS.

Occupational Health Programme


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II. Evaluating health risk

After identifying the health hazards, the next step is to evaluate the level of risk. Different evaluation methods should be used to analyse the degree of risk of different health hazards, for example, measuring air contaminant levels, measuring work frequencies and physical demands, analysing survey results and evaluating existing control measures, etc. Results should be compared with the relevant standards.

Risk assessment


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III. Developing control measures

When the assessment reveals unacceptable occupational health risk levels, control measures should be adopted.

Local exhaust ventilation

Extract hazardous materials directly from their source t o p r e v e n t t h e m f r o m contaminating the indoor air.

Ventilation system

Draw in large amounts of fresh air to dilute indoor air contaminants.

1. Engineering controlSubstitution of hazardous materials

Using non-toxic or low-toxicity materials to replace highly toxic materials.

Isolation

Enclose the machinery or process emitting hazardous e lements or enc lose the employee to avoid or decrease the chances of exposing employees to the hazards.

Change of work processes

Automate work processes or adopt work methods with lower risks.


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2. Administrative controlPhysical examination

Physical examinations should be carried out before an employee starts work and periodically thereafter so as to arrange suitable work for the employee and diagnose occupational illnesses.

Training

Provide adequate training to allow workers to understand proper working methods.

Work allocation

Decrease the time workers are exposed to hazards and provide adequate rest times.

3. Personal protectionWhen engineering or administrative control measures are not feasible or cannot reduce risks to an acceptable level, or when installing and carrying out maintenance of machinery, personal protective equipment should be used.

Personal protective equipment must be properly selected, up to standard and suitable for the intended work environment and hazards present. Employers must also provide adequate training and supervision to ensure that employees are able to properly use and maintain the equipment. Other crucial elements are to have sufficient stocks for replacement and maintain relevant records.

Sanitary facilities

Provide adequate and convenient cleaning facilities and lavatories.

Monitoring of risks

Draw up and execute a risk-monitoring plan.

Health education

Educate employees about a healthy work style and lifestyle.

Immunization

To prevent employees contracting and spreading serious diseases.


15

Legislation relating to occupational health

In Hong Kong the main legislation ensuring employee health is the “Occupational Safety and Health Ordinance” and the “Factory and Industrial Undertaking Ordinance”. The laws stipulate that employers must assume “general duties” to ensure the health and safety of their employees at work, including the provision of instruction and training, non-hazardous work environment and machinery, etc. The legislation also requires employees to cooperate with employers to take care of their own and fellow employees’ health and safety. Under these two laws there are a number of subsidiary regulat ions detai l ing the requirements for specif ied processes , equipment and environmental conditions. Other laws related to occupational health include the “Radiation Ordinance”, “Pesticides Ordinance”, etc.

Reporting of occupational

diseases

According to the provisions of the "Occupational Safety and Health Ordinance", when a doctor discovers or suspects that an employee is or was suffering from one of the 51 kinds of occupational diseases listed in the ordinance, the doctor must make a written report to the Commissioner for Labour in the approved format. The 51 kinds of occupational diseases are listed on the following page.

According to the provisions of the “Employee Compensation Ordinance”, when an employee loses the ability to work or dies as a result of any of the occupational diseases stipulated in the or-dinance, the employer must make a report to the Labour Department.


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Compensation for occupational diseases

According to the "Employee Compensation Ordinance", "Pneumoconiosis (Compensation) Ordinance" and "Occupational Deafness (Compensation) Ordinance", sufferers of the 51 kinds of occupational diseases, after meeting certain conditions, are eligible to receive the legally stipulated compensation.


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Maintaining a healthy body and mind depends on the normal functioning and interaction of each of the body’s systems (such as the respiratory system, nervous system, urinary system, cardiovascular system and reproductive system). If we are subjected to the excessive effects of occupational health hazards, discomfort and even occupational diseases may arise.

Occupational diseases tend to occur after a long period of contact with hazards and so most people have a relatively low awareness of occupational diseases. Added to this are various other factors (including those we might encounter in our daily lives) that can also bring about the same disorders and symptoms. Therefore, to ascertain what factors have led to the disease and to determine whether a disease is caused by a person’s occupation can be very difficult.

Despite this, we certainly must not treat occupational diseases lightly as some cannot be fully cured, and the consequences of contracting an occupational disease can be adversely affected family life, disability and even death. Below are some examples of occupational diseases.

Occupational Diseases

Occupational Deafness Trades or processes Construction industry and manufacturing industries such as hardware, textiles, plastics and sandblasting, etc.

CausesDeafness is caused by damage to the auditory nerve cells in the cochlea through excessive exposure to noise. The degree of hearing impairment depends on the noise intensity and duration of exposure. Generally speaking, long-term exposure to noise levels in excess of 85 decibels can potentially damage your hearing.

Symptoms Ringing in the ears, deterioration of hearing and even permanent hearing loss.

Preventive measuresIn order to protect employees' hearing, employers must establish an effective hearing conservation programme. The programme should include -

1. Assessment of workplace noise levels and keeping of assessment records.

2. Utilization of engineering control measures such as isolation and improvements in machine maintenance to reduce noise levels.

3. Testing employees’ hearing.4. Provision of suitable approved hearing protectors.5. Provision of employee training related to noise.


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Preventive measures At present, there are no effective cures and so prevention is especially important. Methods for prevention include -

1. Isolating or enclosing work processes, using local exhaust ventilation to control the amount of silica dust and maintaining the cleanliness of the work environment.

2. Reducing the chances of employee contact with silica dust and reducing the number of employees exposed to silica dust.

3. Providing employees with information about the health effects of silica dust.

4. Arranging periodic health examinations for employees exposed to silica dust.

5. If the above measures cannot be immediately carried out, the temporary use of respiratory protective equipment should be considered.

What do you know about the hazards of

silica dust?

SilicosisTrades or processesQuarries, tunnel excavation, construction, ceramics production, use of refractory materials and silica containing abrasives, etc.

CausesThe lungs become damaged due to the inhalation of silica dust over a number of years.

SymptomsTightness of breath, coughing and the gradual deterioration of the functioning of lungs. In serious cases, sufferers can experience breathing difficulties even when doing light activities or resting.


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Causes Tenosynovitis is due to the prolonged and repetitive movement of muscles in hands and forearms along with quick and strenuous use, resulting in damage and inflammation to the muscle tendons.

SymptomsPain in the hands, swelling and tenderness. The symptoms may spread to the forearms.

Preventive measures1. To prevent tenosynovitis you must do your best to avoid bending or twisting your wrists.2. When grasping things, you should use the whole hand and avoid just using the fingers to

grasp objects.3. Reduce as much as possible repetitive movements such as typing for a long period and

reduce the speed and force used in performing tasks. Wherever possible, use electrical tools and well-designed tools to assist you.

4. Let your hands and forearms rest and do some related exercises to allow the tendons to relax.

Tenosynovitis of the hands or forearmsTrades or processesData inputters, clerical workers, cashiers, mechanics, stocktakers, warehouse workers, musicians, etc. If you encounter the following situations in your daily or working life you are also at risk of developing tenosynovitis of the hands or forearms.

3. Frequently grasping or squeezing tools or other instruments.

4. Frequently raising your arms.

1. The hands frequently perform a repetitive movement.

2. You often bend your wrists during your work.


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Occupational dermatitisTrades or processes Cleaning, cement, construction, metals, paints, chemical industry, plastics, hairdressing, meat and food handling, agriculture, health care, printing, electroplating, leather, etc.

CausesOccupational dermatitis is a skin disease caused by contact with chemical, physical or biological hazards.

SymptomsDermatitis is often localized in the part of the body that has come into contact with the offending material. Red spots, rashes, blisters, peeling skin or cracking due to keratinisation may appear in any of the contact areas, such as the hands or forearms. Contact dermatitis can usually be fully cured with medical attention and the cessation of contact with the irritant concerned, but it will recur if contact is renewed.

Preventive measures1. Read and understand safety information about the chemicals

and other irritants you might come into contact with.2. Reduce direct contact with irritants. For example, replace

highly irritating materials with less irritating ones. 3. Avoid contact with chemicals that have previously

created an allergic reaction.4. Keep the workplace tidy and clean up

spilled chemicals and other materials as soon as possible.

5. Put on suitable protective equipment such as gloves, aprons, goggles and face masks before handling chemicals or other irritating substances.

6. Use a neutral cleaning agent to wash your hands immediately after completing work and apply skin cream.


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Occupational asthmaTrades or processesHandling chemicals such as isocyanates, platinum salts, hardening agents, formaldehyde, etc. as well as coming into contact with dust particles generated from animals, insects, plants and cereal grains, etc.

CausesUsually caused by coming into contact with some kind of chemicals during work duties. When workers develop an allergic reaction after contact with a certain chemical, symptoms may appear very quickly or after several hours.

SymptomsThe most obvious symptom is not necessarily wheezing. The patient may only have a cough or just slight difficulty breathing. If the patient continues to be in contact with the chemicals then the symptoms may be aggravated. After a patient temporarily ceases contact with the chemicals, for example over the weekend or during rest periods, the symptoms become alleviated. If a worker has had an allergic reaction before, the worker will have a recurrence of symptoms immediately if he or she comes into contact with the chemical.

Preventive measuresTo prevent occupational asthma, you must avoid using asthma-inducing substances. If contact is unavoidable, the work environment should be kept well ventilated and workers should wear personal protective equip-ment such as respirators and gloves, etc.


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Peripheral polyneuropathyTrades or processesJobs using adhesives and degreasing agents containing n-hexane, such as shoemaking, raincoat and handbag manufacture, patching tires and printing.

CausesInhaling excessive quantities of hexane vapour in the work environment or the skin coming into contact with solvents containing hexane.

Preventive measuresDo all possible to use hexane-free or low-hexane solvents. In additi control the a i r contaminants in the work environment. Employees who come into contact with chemicals and solvents shou ld use appropr ia te per sona l protective equipment such as respirators and gloves.

SymptomsA weakness or numb sensation may develop in the limbs and result in difficulty of movement or muscular atrophy, loss of sensation, tendon reflex or hyporeflexia. Hexane may also affect the central nervous system and cause damage to vision and memory. The recovery period for peripheral polyneuropathy is very long and sufferers may not be able to recover completely.

Thinner


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Preventive measuresTo prevent hepatitis B all relevant staff must observe the procedures of infection control and universal precautions. If you have a needlestick injury or suspect you may have become infected you should immediately consult a doctor for diagnosis and treatment.

Hepatitis BTrades or processesNursing personnel, research staff, laboratory personnel, pathology or dissection staff and persons who frequently come into close contact with human blood, blood products or sources containing the hepatitis virus may become infected with this illness.

CausesThe disease is caused by the hepatitis B virus. The virus enters the blood system of the infected person through needles, cuts and abrasions, etc.

SymptomsSymptoms include discomfort, muscle pains, headaches, nausea, vomiting, anorexia, abdominal pain and itching sores. Patients become jaundiced and the urine turns a deep colour with stools becoming lighter in colour. The liver becomes sore and distended. Some patients may become carriers and some may develop chronic hepatitis. Carriers have a higher chance of developing liver cancer.


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Preventive measures1. Use heat-insulating materials to insulate the

source of heat. 2. Install an air-extraction system above the

source of heat or in another suitable location. 3. Enhance ventilation facilities.4. Provide a comfortable rest area and supply

sufficient drinking water.5. For special hot jobs, employees must wear

personal protective equipment such as heat insulating gloves, infrared-reflecting face shields, aluminium reflective clothing, etc.

HeatstrokeTrades or processesRestaurant kitchens, laundries, boiler rooms, outdoor physical work, etc.

CausesPathological changes created by the body's inability to adapt to high temperatures.

SymptomsExcessive exposure to heat causes an increase in body's heat load and / or failure of the body's heat dissipating functions, causing: ◆Temporary heat fatigue ◆Heat exhaustion◆Heat rashes ◆Fainting◆Heat cramps ◆Heatstroke

Heat exhaustion: dizziness, headaches and temporary disorientation caused by sweating due to high temperatures, resulting in the body becoming deficient in water and salt and cardiovascular function being affected.

Heatstroke: rises in temperature, dry skin without perspiration, quick breathing, weak pulses and coma. Can be fatal if treatment is not given immediately. It is caused by damage to the body's temperature control functions.

Heat cramps: sufferers experience brief and intermittent cramps. It is caused by salt deficiency after profuse sweating if the sufferer only replenishes water and neglects to replenish the body's salts.


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Occupational cancerTrades or processesWork locations where there is contact with carcinogenic substances or ionising radiation.

CausesIonising radiation can lead to leukaemia, skin cancer, lung cancer, cancer of the bones, etc. Carcinogenic chemical substances such as certain kinds of dusts, metals, solvents and pigments can cause lung cancer, skin cancer, cancer of the nose, liver cancer, bladder cancer, etc. In addition, people may develop liver cancer or other cancers after contact with biological hazards such as hepatitis B and AIDS.

Preventive measuresThe most effective means for the prevention of occupational cancer is to substitute carcinogenic substances with non-carcinogenic substances. The next step is to prevent employees from coming into contact with carcinogenic substances. For example, enclosing the systems that generate or spread carcinogenic substances, monitoring the levels of exposure, installing ventilation systems and providing appropriate personal protective equipment for employees to use.

Carcinogenic substance

Non-carcinogenic substance


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The main objectives of occupational health are to promote the health of employees, prevent

potential occupational risks from destroying our health and prevent occupational diseases. In order

to raise the health levels of employees we must firstly understand occupational hazards, monitor

employee health, evaluate work health risks and adopt measures to prevent or reduce health risks.

To achieve this, in addition to requiring the cooperation of employers and employees, we must

also rely on doctors, nurses, occupational hygienists, epidemiologists, ergonomists, psychologists,

occupational therapists, physiotherapists, engineers and toxicologists.

In Hong Kong, apart from the specialised divisions for safeguarding employee health in some

large organisations, the Occupational Safety & Health Council and the Labour Department both

provide occupational health services to the public.

To increase citizens’ awareness of the importance of occupational health, the Occupational

Safety & Health Council has organised a range of major promotional activities. The OSHC has also

published and distributed free of charge a large number of occupational health publications,

and has established a specialised team to provide an occupational health consultancy service to

businesses and organisations. We welcome interested businesses, organisations and individuals to

contact us.

Occupational Health Service

Occupational Safety & Health Council

Tel: 2739 9377 Fax: 2739 9779

Hotline: 2739 9000

SafeFax: 2316 2576

E-mail: [email protected]

Contact details:

occupational health for - oshc.org.hkoccupational health for occupational health for good...

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