Friday, 20 May 2011 13:09

Emergency and Security Services

Emergency and security services exist to deal with extraordinary and threatening situations. The people who work in such services are therefore confronted with events and circumstances that lie outside the usual experience of human beings in their daily lives. Although each of the occupations has its own set of hazards, risks and traditions, they share several features in common. These include the following:

  • long periods of relative quiet or routine interrupted abruptly by periods of intense psychological stress
  • long periods of relative inactivity interrupted abruptly by periods of intense physical activity
  • rigid codes of behaviour and high expectations for performance, often accompanied by detailed orders for how to do the job and high penalties for failure
  • personal danger; the worker allows himself or herself to be exposed to hazards that are unusual for anyone else in the community
  • a primary objective of rescuing or protecting others who are not able to save themselves
  • a secondary objective of protecting property from destruction or damage
  • teamwork under demanding conditions
  • a rigid hierarchy or “chain of command” to reduce uncertainty and to make sure that procedures are followed correctly.

 

The form of organization and the means by which the mission of these services is carried out varies. The circumstances of the mission of a service affect the attitude and approach to the job; these differences are perhaps best understood by considering the object of control for each emergency service.

Firefighting is perhaps the most representative emergency and security service. This occupation arose historically as a way to limit property damage from fires, and started as a private service in which fire-fighters might save the businesses and houses of persons who paid insurance premiums but would let the property of others burn, even if they were right next door. Soon, society determined that private fire services were inefficient and that it would be much more practical and useful to make them public. Thus, firefighting became a municipal or local government function in most parts of the world. Private firefighting services still exist in industry, at airports and in other settings where they are coordinated with municipal services. In general, fire-fighters enjoy a great deal of trust and respect in their communities. In firefighting, the object of control, or the “enemy”, is the fire; it is an external threat. When a fire-fighter is injured on the job, it is perceived as the result of an external agent, although it might be an indirect assault if the fire were set by an arsonist.

Police services and the military are given the responsibility by society to maintain order, generally in response to an internal threat (such as crime) or to an external threat (such as war). Armed force is the essential means of accomplishing the mission, and the use of appropriate tactics and investigative techniques (whether criminal investigation or military intelligence) is standard procedure. Because of the high potential for abuse and misuse of force, society in general has imposed strict limitations on how force is used, especially toward civilians. Police especially are watched more closely than other emergency and security personnel to ensure that they use their monopoly on force correctly. This sometimes leads to the perception by police officers that they are not trusted. For the police and for soldiers, the object of control, or the “enemy”, is another human being. This creates many situations of uncertainty, feelings of guilt and questions about rights and proper behaviour that fire-fighters do not have to face. When police or soldiers are injured in the line of duty, it is usually the direct result of intentional human action taken against them.

Paramedical and rescue personnel are responsible for recovering, stabilizing and rendering initial treatment to people who are injured, ill or trapped in circumstances from which they cannot escape by themselves. Often they work side by side with fire-fighters and police. For them, the object of control is the patient or victim whom they are trying to help; the victim is not an “enemy”. Moral and ethical issues in these occupations are most prominent when the victim is partially responsible for his or her condition, as when a driver is intoxicated by alcohol or a patient refuses to take medication. Sometimes, victims who are not rational or who are angry or under stress may act in an abusive or threatening way. This is confusing and frustrating for paramedical and rescue personnel, who feel that they are doing their best under difficult circumstances. When one of these workers is injured on the job, it is perceived as almost a betrayal, because they were trying to help the victim.

Hazardous materials response teams are often part of fire services and have a similar organization on a small scale. They evaluate and take initial steps to control chemical or physical hazards that may present a threat to the public. Hazardous waste remediation workers are less tightly organized that these other occupations and exist to clean up a problem that has been around for a while. In both cases, the workers are dealing with a potential hazard in which the fundamental problem is uncertainty. Unlike the other occupations, in which it was clear who or what was the object of control, these workers are controlling a risk that may be difficult to identify. Even when the chemical or hazard is known, the future risk of cancer or disease is usually uncertain. Workers often cannot know whether they have been injured on the job because the effects of exposure to chemicals may not be known for many years.

Potential Occupational Hazards

The common hazard to all of these workers is psychogenic stress. In particular, they are all subject to so-called critical events, which are situations perceived to be of grave or uncertain but probably serious danger that a person cannot escape. Unlike a member of the general public, a worker in one of these occupations cannot simply walk away or leave the scene. Much of their own sense of self-esteem comes from how they handle just such situations. For workers who survive critical events, there is often a period of denial followed by a period of depression and distracted behaviour. Thoughts of what the worker has seen and a sense of guilt or inadequacy intrude on his or her thinking. It is difficult to concentrate, and the worker may have nightmares. The worst critical events are generally considered to be those in which victims have died because of a mistake or because it was not possible for the rescuer to save them, in spite of his or her best efforts.

Many of these occupations also involve the rescue and stabilization of people who may be ill with communicable diseases. The infections that most commonly present a problem are AIDS and HIV infection generally, hepatitis B and C and tuberculosis. HIV and hepatitis B and C viruses are both transmitted by human body fluids and may therefore pose a hazard to emergency response personnel when there is bleeding or if the worker is deliberately bitten. Emergency response personnel are now usually trained to consider all subjects (victims or criminals) as potentially infected and infective. HIV precautions are described elsewhere. Tuberculosis is transmitted by sputum and by coughing. The risk is particularly great during the resuscitation of persons with active cavitary tuberculosis, an increasingly frequent problem in economically disadvantaged inner city areas.

Injury is a risk common to all of these occupations. Fires are always unsafe, and the hazards of the fire itself may be combined with the risk of structures breaking apart, unstable floors, falling objects and falls from a height. Violence is a more common hazard of police and military combat services, obviously, because that is what they were created to control. However, aside from intentional violence there is a potential for hazards from traumatic incidents involving automotive traffic, mishandling of weapons and, especially in the military, occupational injuries in support areas. Hazardous materials workers may deal with a variety of unknown chemicals which may have a hazard of explosion or fire in addition to their toxic properties.

These occupations vary greatly in their potential for health problems. Aside from stress-related outcomes and the potential for communicable diseases mentioned, each occupation is different in its health concerns.

Preventive Guidelines

Each occupation differs in its approach to prevention. However, there are a few measures that are common to all or most of them.

Many services now require their workers to go through a process called critical event debriefing following such incidents. During these debriefings, the workers discuss the event in the presence of a trained mental health worker-how they feel about it, and their feelings about their own actions. Critical event debriefing has been shown to be very effective in preventing later problems, such as post-traumatic stress syndrome, following critical events.

Rigorous fitness screening at the time of hire is usually part of the selection process for police and fire personnel, and many services require these members to stay fit through regular exercise and training. This is intended to ensure satisfactory and consistent performance, but it has the additional effect of reducing the likelihood of injuries.

Infectious hazards are difficult to anticipate because victims may not show outward signs of infection. Emergency response personnel are now taught to use “universal precautions” in handling body fluids and to use protective equipment such as gloves and safety eyeglasses if there is a risk of coming into contact with body fluids. Often, however, such events are unpredictable or difficult to control if the victim is violent or irrational. Routine immunization with hepatitis B vaccine is advised where the risk is high. Disposable resuscitation equipment is recommended to reduce the risk of transmitting communicable diseases. Special care should be taken with needles and other sharp objects. Human bites should be cleaned thoroughly and treatment given with penicillin or a penicillin-like drug. When HIV infection has been confirmed in the person who was the source, or contamination and transmission may have taken place by needlestick or invasive contact with blood or body fluids, a physician’s advice should be sought about the advisability of prescribing antiviral drugs that reduce the chance of infection in the worker. Tuberculosis infection in an exposed worker can be confirmed by skin test and then treated prophylactically before it becomes a serious disease.

Other preventive measures are specific to the particular occupations.

 

Back

The decision to publish the second edition of the Encyclopaedia of Occupational Health and Safety was taken some 15 years ago, and its preparation lasted throughout the years 1966 to 1971. Since then a great deal of progress has been made in the knowledge and activities covered by this publication. Side by side with technological progress there have been great advances in methods of identifying, evaluating and controlling occupational hazards and providing health protection in the workplace. Toxic substances, dust in industry, mineral fibres, non-ionising radiation, allergy and occupationally induced cancer have been the subject of intensive experimental research and important epidemiological studies. Nevertheless, the changes that took place in working environments in the 1970s were not due merely to wider technical knowledge and awareness. A new trend began to take shape: the workers’ claim for a better quality of life at work and the increasing involvement of trade unions in health and safety protection in the workplace, the fuller support by employers of comprehensive occupational health and safety programmes and increasing efforts by governments to apply far-reaching measures in this field. This trend has been reflected in national and international legislation concerning the working environment and working conditions, which has advanced to an unprecedented extent. Thus the panorama of occupational health and safely, industrial hygiene and ergonomics has undergone profound changes in many member countries of the ILO, not only as regards the state of the art, but also as regards the practical application of these disciplines in the workplace…

It is 63 years since the ILO first established as one of its basic objectives “the protection of the worker against sickness, disease and injury arising out of his employment”. The objective is still the same, but the form and methods of this protection have evolved along with technical progress and economic development… International dissemination of the most recent scientific and practical knowledge in this field is an integral part of ILO activity—together with the traditional modes of action: standard-setting and technical co-operation—to promote the increased effectiveness of health and safety protection at work throughout the world. The new edition of the Encyclopaedia will make an important contribution to that great endeavour.

Francis Blanchard
Director-General
International Labour Office
Geneva, 1983

Occupational accidents and diseases remain the most appalling human tragedy of modern industry and one of its most serious forms of economic waste. The best estimates currently available on a world basis reckon the number of fatal injuries at the workplace at close to 100,000 annually. In some highly industrialised countries industrial accidents are responsible for the loss of four or five times as many working days as industrial disputes. In certain cases their cost is comparable to that of national defence. Industrialisation and the mechanisation of agriculture have made the problem acute in a much wider range of countries and occupations.

The economic burden on the community cannot be expressed in compensation costs alone. It also includes loss of production, disruption of production schedules, damage to productive equipment and—in the case of large-scale accidents—major social dislocations. But the economic burden is by no means the full measure of the human cost…
Originally, the main thrust of preventive action was to improve the unhealthiest working conditions and remedy the appalling lack of physical protection against the most dangerous occupational hazards. The first international standards were designed either to do away with the more flagrant abuses impairing health, such as the employment of very young children, over-long hours of work, the absence of any form of maternity protection, and night work by women and children, or to combat the risks most commonly encountered by industrial workers—anthrax, and lead or chronic phosphorus poisoning.

When the ILO passed beyond formulating these basic standards to grapple with the problem of social security, the first question it considered was compensation for occupational accidents and diseases. Workmen’s compensation legislation already existed in many countries; it was developed on the basis of ILO standards and its financial implications gave a powerful impetus to preventive measures. The ILO did much to bring about the standardisation of industrial injury and occupational disease statistics and the systematic collection of data on accident frequency…
Gradually this concentration of attention upon the most flagrant abuses and the highest accident and disease rates broadened into a more comprehensive approach designed to promote the highest standards of safety and health in all industries and occupations. The monumental Model Code of Safety Regulations for Industrial Establishments for the Guidance of Governments and Industry, first issued in 1949 on the basis of work initiated during the Second World War and periodically revised since, was an important step in this direction. It furnished an impetus which has now found expression in a wide range of codes of practice and guides to practice which are complementary to it. In the 1950s this broader approach was reflected in new comprehensive international standards for the protection of workers’ health, welfare facilities and occupational health services.

In the 1960s these were supplemented by a new series of specific provisions dealing with particular risks which had assumed increased importance. In factories, one accident in six is caused by machinery; hence the importance of international standards on the guarding of moving parts which regulate not only the use, sale and hire of machinery having dangerous parts but also its manufacture…

Modern industrial medicine has outgrown the stage where it merely involved first aid in the event of an accident and the diagnosis of occupational diseases; nowadays it is concerned with all the effects of work upon physical and mental health, and even with the impact of man’s physical or psychological disabilities upon his work…

Technological progress now moves far more swiftly than it did 40 years ago. There is every reason to believe that the pace will quicken still further. This second edition of the Encyclopaedia will therefore be merely the next stage in our work. But each stage is the indispensable foundation for its successor. During the coming years the Encyclopaedia of Occupational Health and Safety will be an essential tool for humanising the working environment and improving the lot of workers the world over. In human and economic terms alike higher health and safety standards are a primary responsibility of enlightened social policy and efficient management. Neither can be effective without the comprehensive body of knowledge necessary to appraise the relevance of current information to policy and action. The present Encyclopaedia, which was prepared under the technical responsibility of Dr. Luigi Parmeggiani, Chief of the Occupational Safety and Health Branch, is designed to make readily accessible to all the comprehensive knowledge of these matters which is now available. In editing the Encyclopaedia, Dr. Parmeggiani has worthily maintained the traditions established by Dr. Luigi Carozzi, who laid the foundations of the industrial health work of the ILO.

Wilfred Jenks
Director-General
International Labour Office
Geneva, 1971

In 1919 the International Labour Conference at Washington requested the International Labour Office “to draw up a list of the principal processes to be considered as unhealthy”. But it was impossible in practice to draw up such a list, at least in a complete or final form, on account of the number and complexity of the operations which in some aspects could be considered unhealthy, the continuous evolution of industrial technique which does away with causes of disease in one direction, while giving rise to fresh possibilities of disease in another, and the indefinite character of the conception of “unhealthiness” which varies at different times and in different countries.

These considerations led to the idea of substituting for the list of unhealthy processes requested by the Conference, a sort of encyclopaedia which would analyse from the triple point of view of the work to be done, the worker employed, and the environment in which he worked, the various tasks involved in human labour, the properties of the substances dealt with, the operations involved in handling and working up these substances, the possible sources and carriers of intoxication and disease, the statistical data on the effects as far as known, the symptoms, the diagnosis, the therapeutic and prophylactic treatment, and the protective legislation already in existence.
It was a difficult task, and one which was bound to be open to the reproach of being neither complete nor final. But how could it be otherwise? No one can hope to fix once for all something which is living, evolving, progressive. Although, as was mentioned above, the evolution of technical practice in industry may create new dangers for the worker every day, yet the progress of this same technique and of industrial hygiene may, on the following day, do away with certain existing dangers, which must, notwithstanding, be recorded and analysed in this work. One of the virtues of this work is just the fact that it is not final. It seizes one moment in social life and in the progress of industrial hygiene, but it requires to be kept constantly up to date precisely because it is a scientific as well as a practical work.

This is its dual nature, as it is that of every piece of research undertaken by the International Labour Office, the strict purpose of which is to make science the servant of practical action. This Encyclopaedia is not a work of pure propaganda; it never sacrifices scientific objectivity to the ideas which the authors naturally have at heart. On the other hand, it is not purely a treatise on medicine or hygiene; it claims no originality in the treatment of the various questions; it does not claim to be an exhaustive study; on each subject it merely gives a summary of the existing position of science, with figures taken from statistics for the sake of example and not in support of any argument. It has tried to keep a middle path between a purely scientific work intended for the expert, and a popular manual. It is meant to supply workers, employers, their organisations, and practising doctors with the information necessary to enable them to discover, combat, and prevent occupational diseases, the economic consequences of which are as harmful to production as their social consequences are to the world of labour…

…The International Labour Office, in collaborating with these scientists for some years, has obtained a clearer consciousness of the scope of its mission. The Preamble to Part Xlll of the Peace Treaty [of Versailles] included among the urgent tasks of the Office the protection of workers “against sickness, disease and injury arising out of their employment”. The signatory States, in agreeing to this statement of principle, seem to have accepted the dictum of Beaconsfield that the health of the people is the most important of all problems. The Office has put at the disposal of those concerned a statement up to the actual position of science and has conveyed to the legislator the elements of physiology and physio-pathology necessary to him for setting up a code of industrial health; by collecting and concentrating this information in one work, and thereby increasing its range and appeal, the Office is continuing the work of those who, since the inception of “large-scale” industry, have endeavoured to protect human life, openly or insidiously menaced by new technical processes…

In ancient societies, dangerous and disagreeable tasks were reserved for criminals. Fourier, for all his fertile imagination, dared not foresee that the progress of industrial technique would one day lead to the suppression of unhealthy or dangerous occupations: he reserved filthy or dangerous work for his “small gangs”. Nowadays the problem is entirely different: the conscience of modern society realises that occupational diseases should not be reserved for certain persons, but that they should be made to disappear. The origins and the causes are now known, and all that is wanted is will and organisation. There are plenty of other sufferings and plenty of other infirmities to which mortals are exposed. As Puccinotti has said: “Life must be preserved for labour, and labour must be made harmless to life”. …

Albert Thomas
Director-General
International Labour Office
Geneva, 1930

Tuesday, 03 May 2011 10:26

Preface to the Fourth Edition (1998)

It is a sobering thought that the prefaces to the preceding editions of this Encyclopaedia are still timely: occupational illnesses and injuries remain an unnecessary blight on the human landscape. Much progress has been made since the publication of the first edition of this work. Exposure to some extremely dangerous poisons, such as the deadly radium painted on watch faces to make them glow in the dark, or the crippling and disfiguring phosphorus that had been used as the combustible material in matches, have been completely eradicated. Governments have established regulations and have undertaken many noteworthy actions to guard against the entirely preventable tragedies of occupational death, disease and disability. The level of knowledge among all our constituents is vastly improved. The ILO itself has contributed to this progress with Conventions, Recommendations and Codes of Practice governing many workplace conditions, as well as with its many technical cooperation programmes and specialized publications. Equally important, the capability of medicine, science and engineering to solve problems, and to provide better means of recognition and of hazard prevention has dramatically increased. Social systems are in place for worker protection and for worker participation in decisions relating to their work environments.

Yet, despite tireless efforts to promote better working conditions, the ILO and others must still combat many forms of exploitation of working people, such as child labour, indentured servitude and clandestine work, with their inevitably hazardous and oppressive conditions. Tens of millions of others labour while exposed to chemical, physical and social hazards which drain their health and their spirits. Solutions to such problems of occupational injury and illness will not arise simply from issuing publications or obtaining advice from experts. The health and well-being of workers is an issue of social justice and the ILO stands above all for the ideal of promoting social justice in the world. Ultimately solutions are social as much as technical. It is not merely the lack of know-how that perpetuates the toll of death, disability and disease in the working population, it is the lack of the social means and the social will to do something about it. The societal basis for occupational safety and health is perhaps the most important reason for the ILO to publish the Encyclopaedia of Occupational Health and Safety. With its publication we present a panorama of the problems, and their technical and social solutions: we define the fields for action.

The Encyclopaedia’s popularity and influence have been enormous. Tens of thousands of copies have been in use throughout the greater part of this century. Earlier editions have been published in Spanish, French, Russian, Chinese, Hungarian and Serbo-Croatian. The Encyclopaedia is the most widely distributed publication of the ILO. The process of compiling the fourth edition has continued the tradition of reaching out to world experts, which the Office sees as essential to its continued growth and relevance. We have assembled a network of more than 2,000 specialists from over 65 countries who have extensively contributed their time, energy and expertise to the writing and reviewing of articles and the editing of chapters. Most major health and safety institutions, governmental, academic or private, from around the world, are contributing in one form or another to this immense undertaking, an act of generosity and support for which we are grateful. The hope and the intent is that this Encyclopaedia provide technical, theoretical and ethical underpinnings to the ongoing work of achieving the goal of social justice in a global economy.

Michel Hansenne
Director-General
International Labour Office
Geneva, 1998

No one profession holds the key to understanding and solving the problems of work-related hazards. The field of occupational safety and health is truly multidisciplinary.

The intent of the fourth edition of the International Labour Organization’s Encyclopaedia of Occupational Health and Safety is to present a panoramic view of the basic available information in the field. But what comprises the “field”? Let us consider an example.

How might a group of various experts approach health and safety issues that relate to long-term use of visual display units (VDUs), the now familiar computer screens? A physician, charged with the occupational health service for a group of VDU workers, might tend to schedule medical exams to look for signs and symptoms of physical illness. Eye examinations would be one logical component. VDU-specific eyeglasses might be one solution. The epidemiologist, on the other hand, would confront the problem statistically. She would want to gather data on the results of the examinations of a group of VDU workers and compare them to workers who did not engage in VDU work, in order to determine the relative risks of the job for various health outcomes. The occupational hygienist would focus on the environment and might measure the lighting levels or test for particular contaminants. The ergonomist could orient towards the design of the equipment itself and study the physical interactions between the machine and the worker. The psychologist would look towards organizational factors—the social structure in the workplace—concentrating on issues such as job demands, job control and electronic performance monitoring, while the basic researcher might be more interested in experiments on the biological mechanisms that could ultimately explain any effects observed. The educator might develop training materials for helping workers function optimally on the job. The trade unionist and the employer may be interested in the application of principles of occupational health to conditions of employment and contractual agreements. Finally, the lawyer and the government regulator might be considering still other pragmatic issues, such as compensation for injuries, or “proving” possible health effects for establishing workplace regulation.

Each of these approaches is a valid and important aspect of occupational health and safety and each complements the other. No one profession holds the key to understanding and solving the problems of work-related hazards. The “field” of occupational safety and health is truly multidisciplinary.

Multidisciplinarity is challenging to the encyclopaedia editor. Facts may be neutral, but the way in which they are comprehended, interpreted and applied is culture bound, where by culture we mean the integrated pattern of human belief, behaviour and knowledge. In technical fields, culture will be a reflection of the basic discipline of training, as well as of personal philosophy. Not only will what you are—a lawyer, hygienist, trade unionist or physician—guide your thinking, but who you are—whether you are a representative of government, labour or management, for example—will inevitably influence your perceptions of the universe, its demands, its effects. Where you developed your expertise will also matter, since the philosophical and practical underpinnings of science and medicine, too, are culture bound and hence not the same throughout the world. At the very least you will be bound by the realities of available resources and this will inevitably alter your perspective. A seasoned professional attempts to minimize such biases, but one look at the real world shows how pervasive they are.

The problems of multidisciplinarity have not been solved in this Encyclopaedia, and probably will never completely be solved anywhere, but a pragmatic approach has been developed here. The Encyclopaedia has been developed in parts, sections and chapters which correspond to the various disciplines that comprise occupational health and safety. It has been designed to provide the general user with background information on the major disciplines of occupational health and safety in an understandable manner that will, at the same time, be considered rigorous by professionals in those fields. We have attempted to provide sufficient depth and breadth of coverage to permit workers in one area to appreciate and be stimulated by the ideas and approaches of other disciplines in occupational health and safety. We have endeavoured to make the descriptions of hazard recognition and control as straightforward as possible, with a minimum of jargon. The overall structures is:

Volume I

  • The Body and Health Care take a medical approach and provides information on disease, its detection and prevention, and occupational health services and health promotional activities.
  • Prevention, Management and Policy covers legal, ethical and social policy aspects of the field, as well as educational and informational and institutional resources.
  • Tools and Approaches provides insight into the disciplines which comprise the study and application of occupational health and safety: engineering, ergonomics, occupational hygiene, epidemiology and statistics and laboratory research.

Volume II

  • Hazards spans the range of chemical, physical and social hazards, accidents and safety management methods that may be encountered around the world. The nature of the hazard is detailed, together with technical information on its recognition, evaluation and control.

Volume III

  • Chemicals presents basic data on use in industry and chemical, physical and toxicological properties information on more than 2,000 chemicals categorized by chemical family
  • Industries and Occupations takes a “how things work” and “how to control hazards” approach to all the major industries. The hazards associated with a variety of occupations which span several industrial sectors are presented in a hazard card format.

Volume IV

  • Indexes and Guides provides a how-to-use the Encyclopaedia guide; lists of tables and figures and collaborating institutions; and indexes of chemical substances, cross-references, subjects and authors cited.

 

Several thousand internationally recognized experts have been called upon to be writers and reviewers of this Encyclopaedia. They have been drawn from virtually all the major institutions around the world and we have attempted to assure that international perspectives are represented because such perspectives are not the same everywhere and it is the responsibility of the International Labour Organization to promote the free interchange of different conceptualizations. Further, problems and solutions vary around the globe and it makes good sense to seek out the expertise of those who personally know and understand the issues.

In this Encyclopaedia we have planted an occupational health and safety garden with facts, figures and interpretations to assist in the blossoming of safe and healthful working conditions around the world. The seeds have been sown in more or less orderly disciplinary groupings, so that the reader, once becoming familiar with the garden paths, can create any bouquet of facts that she or he wants. The indexes in the fourth volume provide a more detailed map, including a valuable index guide to the essential cross-referencing of information. The experienced reader will soon learn what is planted where and will be able to make his way along a favoured route.

The electronic version of this work has additional navigational aids, with its built-in hyperlinks and specialized search facilities. By judicious creation of searches, the astute CD-ROM user could even plant an entirely new and rearranged garden of his or her own.

The Encyclopaedia is not, of course, one hundred per cent complete. Isolated facts are missing. Some notions may be outdated even before we go to press. This is the sign of an active and creative field of human endeavour. This Encyclopaedia could not have been written without the countless hours of work of individuals from around the world. The reader will find the names of our collaborators in the lists of authors and editors, and in the Directory of Experts which is published in the electronic version of this work. Most of these individuals came to the effort with the full support and assistance of the institutions with which they were affiliated. Volume IV contains a non-exhaustive list of these collaborating institutions, as well.

We are grateful for the extensive support in this worldwide effort. Of course, the individual viewpoints presented are ultimately those of the authors and not of their institutions or the International Labour Office. We hope that the compendium of ideas presented here will hasten the day in which occupational death and disease is a rarity in the world.

Jeanne Mager Stellman
Editor-in-Chief
Geneva, 1998

The most common form of occupational dermatosis to be found among construction workers is caused by exposure to cement. Depending on the country, 5 to 15% of construction workers—most of them masons—acquire dermatosis during their work lives. Two types of dermatosis are caused by exposure to cement: (1) toxic contact dermatitis, which is local irritation of skin exposed to wet cement and is caused mainly by the alkalinity of the cement; and (2) allergic contact dermatitis, which is a generalized allergic skin reaction to exposure to the water-soluble chromium compound found in most cement. One kilogramme of normal cement dust contains 5 to 10 mg of water-soluble chromium. The chromium originates both in the raw material and the production process (mainly from steel structures used in production).

Allergic contact dermatitis is chronic and debilitating. If not properly treated, it can lead to decreased worker productivity and, in some cases, early retirement. In the 1960s and 1970s, cement dermatitis was the most common reported cause of early retirement among construction workers in Scandinavia. Therefore, technical and hygienic procedures were undertaken to prevent cement dermatitis. In 1979, Danish scientists suggested that reducing hexavalent water-soluble chromium to trivalent insoluble chromium by adding ferrous sulphate during production would prevent chromium-induced dermatitis (Fregert, Gruvberger and Sandahl 1979).

Denmark passed legislation requiring the use of cement with lower levels of hexavalent chromium in 1983. Finland followed with a legislative decision at the beginning of 1987, and Sweden and Germany adopted administrative decisions in 1989 and 1993, respectively. For the four countries, the accepted level of water-soluble chromium in cement was determined to be less than 2 mg/kg.

Before Finland’s action in 1987, the Board of Labour Protection wanted to evaluate the occurrence of chromium dermatitis in Finland. The Board asked the Finnish Institute of Occupational Health to monitor the incidence of occupational dermatosis among construction workers to assess the effectiveness of adding ferrous sulphate to cement in order to prevent chromium-induced dermatitis. The Institute monitored the incidence of occupational dermatitis through the Finnish Register of Occupational Diseases from 1978 through 1992. The results indicated that chromium-induced hand dermatitis practically disappeared among construction workers, whereas the incidence of toxic contact dermatitis remained unchanged during the study period (Roto et al. 1996).

In Denmark, chromate sensitization from cement was detected in only one case among 4,511 patch tests conducted between 1989 and 1994 among patients of a large dermatological clinic, 34 of whom were construction workers. The expected number of chromate-positive construction workers was 10 of 34 subjects (Zachariae, Agner and Menn J1996).

There seems to be increasing evidence that the addition of ferrous sulphate to cement prevents chromate sensitization among construction workers. In addition, there has been no indication that, when added to cement, ferrous sulphate has negative effects on the health of exposed workers. The process is economically feasible, and the properties of the cement do not change. It has been calculated that adding ferrous sulphate to cement increases the production costs by US$1.00 per tonne. The reductive effect of ferrous sulphate lasts 6 months; the product must be kept dry before mixing because humidity neutralizes the effect of the ferrous sulphate.

The addition of ferrous sulphate to cement does not change its alkalinity. Therefore workers should use proper skin protection. In all circumstances, construction workers should avoid touching wet cement with unprotected skin. This precaution is especially important in initial cement production, where minor adjustments to moulded elements are made manually.

 

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Wednesday, 06 April 2011 20:16

Welder

Synonym: Fusion welder

Job profile

Definition and/or description

DEF18

Joins metal parts by various processes in which the surface layers of the metals are in most cases heated to fusion, with or without pressure; the main groups of welding processes are electric-arc (including metal-arc, inert-gas shielded arc, flux cored arc, plasma arc and submerged arc), gas-flame (including oxyacetylene, oxyhydrogen), resistance, electron-beam, induction, laser-beam, thermit, electroslag and solid-state (friction, explosion, diffusion, ultrasonic and cold) welding. Selects and sets up manual or automatic welding equipment and materials according to work specifi- cations or supervisor’s instructions. Examines and prepares surfaces to be joined by cleaning, degreasing, brushing, filing, grinding and other means. Positions workpieces. Adjusts valves or electric switches to control flow of gases, electric current, etc. Ignites or turns off gas-flame, electric arc, thermit mixture or other source of heat. Guides and applies flame, electrode, filler rod, laser-beam, etc. to the workpieces. Examines welded joint for quality or adherence to specifications.

Related and specific occupations

RELOCC10

Thermal cutter (flame cutting, arc cutting, electron-beam cutting); weld surfacer; spark-erosion machine operator.

Tasks

TASK2

Adjusting (flow, pressure, etc.); aligning; annealing; applying (fluxes); arc cutting; arc welding; assembling and disassembling; bending; bolting; bonding; brazing; brushing; calculating (current); chipping (excess metal); clamping; cleaning (surfaces); connecting (hoses and cables); controlling; cutting; degreasing; dipping; dressing (electrodes); examining (quality of joint); filing; filling; fixing; flame cutting; fusing; grinding; guiding (rod along the flame); hammering; handling; heat treating; heating and preheating; holding; igniting; installing; inserting; joining; knocking (welds); laying-out; lifting and lowering; loading and unloading; maintaining; marking; melting; mending; mounting; moving; placing; polishing; positioning; preparing; rebrasing; removing (residues); repairing; scarfing (welds); screwing and unscrewing; securing; selecting (tools, materials); separating; servicing; setting up; soldering; sprinkling; straightening; switching (on and off); timing (controls); tinning; torching; touching up; weld-surfacing; welding.

Hazards

Accident hazards

ACCHA1

– Falls from height, particularly in construction work;

– Blows from falls of heavy metal parts, gas cylinders, etc.;

– Cuts and stabs from sharp metal edges, etc.;

– Burns from hot metal surfaces, flames, flying sparks, molten metal droplets, thermal radiation, etc.;

– Foreign particles into the eyes. This is a very common risk, and flying particles may enter the eyes even after the welding flame or arc is extinguished;

– Penetration of molten metal droplets or sparks into ears (particularly in overhead welding);

– Fires ignited by flying sparks, flames, red-hot metal etc. A special fire hazard exists when the surrounding atmosphere becomes enriched in oxygen; ignition becomes much easier (e.g., clothes may catch fire and lubricants and solvents are readily ignited);

– Dust explosions during welding in premises in which flour, grain dust, etc., are present;

– Injection of flying metal particles into the skin (face, neck and hands);

– Tyre explosions during welding of vehicle wheels;

– Ignition and explosion of hydrogen (produced by corrosion processes) and various residual combustible gases in mixtures with air in closed vessels;

– Acute poisoning by phosgene formed from chlorinated hydrocarbons which are used to clean the metal, or as paint, glue and other solvents, or by hazardous gases generated during welding, in particular ozone, carbon monoxide and nitrogen oxides;

– Electrocution or electric shocks in all processes using electric current; a particular hazard exists from transient overvoltages, or when using more than one power supply at the same time;

– Ignition of clothes in processes using gas-oxygen mixtures, if the surrounding air is enriched (“sweetened”) accidentally or intentionally with oxygen, in particular if clothes are soiled with oils or grease;

– Fires or explosions within the welding system (pipes, acetylene generator) in gas-oxygen flame-welding processes, in particular because of flame flashbacks or backfire due to faulty equipment or human error;

– Fires and explosions from improper handling of calcium carbide or acetylene in oxyacetylene welding;

– Trapping of clothing, fingers, hair, arms, etc., in automatic (“robotic”) welders.

Physical hazards

PHYSIC1

– Exposure to excessive noise levels;

– Exposure to excessive heat or cold, in particular in construction work;

– Exposure to x or gamma rays during weld inspection by radiography;

– Exposure to x rays from electron-beam welding machines;

– Chronic damage to eyes, skin drying and other skin problems (“heat rash”) as a result of exposure to strong actinic light (in particular UV) and heat. Such effects may be aggravated if good exhaust ventilation exists, since the screening effect of dust is eliminated by the ventilation.

Chemical hazards

CHEMHA18

– Exposure to welding fumes (see note 3);

– Chronic poisoning as a result of exposure to zinc or cadmium in fumes when welding zinc- or cadmium-plated parts, or to polychlorinated biphenyls from the decomposition of anticorrosion oils, or to constituents of thermal decomposition products from paints during the welding of painted pieces, or to asbestos when flame-cutting asbestos-insulated pieces;

– Siderosis (a type of pneumoconiosis) as a result of inhalation of iron oxide;

– Damage to central nervous system, lungs and liver as a result of inhalation of phosphine (phosphine may be fumed during generation of acetylene from low-purity calcium carbide);

– Respiratory disease due to high concentration of carbon dioxide in the air and the related oxygen deficiency, particularly in closed, poorly ventilated places (this may be aggravated in the case of workers with cardiovascular or pulmonary diseases);

– Irritation of the eyes and the pulmonary system by nitrogen oxides and/or ozone;

– Carbon monoxide poisoning.

Ergonomic and social factors

ERGO2

– Repetitive strain injury by static-load work;

– Musculoskeletal disturbances because of work in awkward postures;

– Eye strain and fatigue;

– Strenuous physical workload during lifting of heavy parts;

– Muscular stress and strain of hands, from the handling of heavy welding guns, in particular in overhead welding.

Addendum

Notes

NOTES17

  1. According to published reports, welders are at increased risk of pneumoconiosis (in particular siderosis), of cancer of several types (e.g., liver, nasal, sinonasal and stomach) and of possible hearing loss because of the combined effect of noise and exposure to carbon monoxide.
  2. The shoulders and the neck of a welder may be heavily exposed to sparks and heat.
  3. Exposure to welding fumes constitutes the major chemical hazard during welding by processes of most types. Such fumes are formed in the air upon cooling and condensation of substances volatilized by the heat of the welding process, from the base metals being welded, from electrodes, filler rods, fluxes, electrode coatings, etc. used in the process, as well as from “extraneous” materials such as metal or paint coatings on the base metal, residues of cleaning materials, etc. As a rule, the particle size of fumes is in the micron or submicron range, but such particles may coalesce and form larger aggregates. Most fume particles are in the “respirable” category, and may thus penetrate deep into the respiratory system and be deposited there. Welding fumes normally contain oxides of the metals being welded (in particular, in the case of steel, iron, chromium, nickel, manganese, vanadium and other oxides) and of the electrodes, silica, alumina, magnesia, alkali- and alkali-earth oxides (in particular baria) and may contain substantial amounts of fluorides, paint, oil and solvent residues or decomposition products. Fumes produced when using thoriated electrodes contain thorium oxide. In the welding of non-ferrous metals, the fumes may contain oxides of the metals being welded and small amounts of highly poisonous impurities such as arsenic and antimony compounds. The amount of fumes formed depends on the type of welding process, but may be as high as 2-3 g/min or even more (e.g., in manual arc welding or in welding with flux-cored electrodes).

 

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Wednesday, 06 April 2011 20:12

Solderer and Brazer

Synonyms: Soldering equipment operator; hard-solderer; silver-solderer; brazer-assembler; brazier

Job profile

Definition and/or description

DEF14

Joins metal parts by means of a fusible alloy (“solder” or “braze”; see Note 1). A solderer/brazer selects and sets up manual or automatic soldering equipment and materials according to work specifications. Examines and prepares parts to be joined by cleaning, degreasing (may use ultrasonic degreaser), brushing, filing and other means. Clamps workpieces into position for soldering. Switches on and controls electric current or gas-flame. Cleans soldering iron tip. Applies fluxes, soldering iron tip, torch or flame, solder wire, etc. to the workpieces. Examines soldered pieces for quality and adherence to specifications. Cleans surface of the soldered workpiece to remove flux and solder residues. May melt and separate soldered joints to repair or reuse parts.

Tasks

TASK

Adjusting (flow, pressure, etc.); aligning; annealing; applying (fluxes); arc cutting; arc welding; assembling and disassembling; bending; bolting; bonding; brazing; brushing; calculating (current); clamping; cleaning (surfaces); connecting (hoses; cables); controlling; cutting; degreasing; dipping; examining (quality of joint); filing; filling; fixing; flame cutting; fusing; grinding; guiding (rod along the flame); hammering; handling; heat treating; heating and preheating; holding; igniting; installing; inserting; joining; knocking (welds); laying-out; lifting and lowering; loading and unloading; maintaining; marking; melting; mending; mounting; moving; placing; polishing; positioning; preparing; rebrazing; removing (residues); repairing; screwing and unscrewing; securing; selecting (tools, materials); separating; servicing; setting up; soldering; sprinkling; straightening; switching (on and off); timing (controls); tinning; torching; touching up.

Industries in which this occupation is common

INDS10

Soldering and brazing, as full- or part-time occupations, are encountered in a very large number of manufacturing industries, workshops, technical services, research institutions, etc., such as, for example, all electrical and electronic manufacturing, assembly, maintenance and repair; air conditioning and refrigeration; manufacture of metal boxes, housings, storage tanks and containers; gas and chemicals supply lines; radiator manufacturing and repair (car and home-heating); jewellery manufacturing; artwork; tinker shops in research institutions; musical instruments manufacturing and repair; dental labouratories; many “cottage” industries, etc.

Hazards

Accident hazards

ACCHA1

– Blows, in particular on feet, from the fall of heavy workpieces, pipe sections, etc.;

– Cuts and stabs, in particular on the fingers, from sharp edges, protrusions, files (or other instruments) during the preparation of workpieces for soldering, and during the cleaning of the soldered product;

– Damage to eyes as a result of penetration of solid particles (particularly when using rotary wire brushes or abrasive wheels for cleaning), or molten metal, flux droplets, or droplets of cleaning solutions into the eyes;

– Electrocution or electric shock when using electrical soldering equipment;

– Skin burns from contact with hot surfaces, flames and splashes of hot solder or fluxes;

– Fires, as a result of ignition of flammable solvents and other substances, by the soldering flame or by sparks;

– Fire and explosions, particularly when using oxyacetylene, air-propane and other blow-torch processes;

– Chemical burns as a result of splashes of corrosive chemicals used in metal cleaning, in particular strong acids or mixtures of acids and oxidizing solutions (e.g., sulphuric/nitric or sulphuric/chromic acid mixtures), or metal-cleaning creams, etc.

– Acute (and sometimes fatal) poisoning by phosgene and other poisonous gases formed from chlorinated solvents in contact with a high-temperature source, in particular during brazing.

Physical hazards

PHYSIC4

– Exposure of eyes to strong light emitted during certain high-temperature brazing processes;

– Heat rashes as a result of continuous exposure of skin to heat from the soldering and brazing processes.

Chemical hazards

CHEMHA

– Skin allergies as a result of exposure to solvents, to rosin (colophony), hydrazine, aminoethanolamines, and activators in fluxes;

– Ulceration (and other dermatological problems) of fingertips due to the handling of metal pieces and exposure to fluxes;

– Rashes and dermatitis, especially when using liquid fluxes;

– Irritation of eyes, mucous membranes and respiratory tract as a result of exposure to aerosols and gases evolved in acid-cleaning processes (e.g., nitrogen oxides);

– Irritation of eyes, mucous membranes and respiratory tract as a result of exposure to flux components or to their decomposition products released during the soldering (e.g., hydrochloric acid, zinc and ammonium chlorides), fluorides, formaldehyde (formed in the pyrolysis of core solder), fluoroborates, rosin, hydrazine salts, etc., or to ozone and nitrogen oxides formed in air during certain high-temperature brazing processes;

– Neurotoxic disturbances as a result of exposure to aliphatic, aromatic and chlorinated solvents used in metal cleaning;

– Chronic poisoning as a result of exposure to a variety of poisonous metals present in the solder, most commonly lead, cadmium, zinc, antimony and indium (and in particular to their fumes released during the soldering) or exposure to poisonous metals in the dross and drippings from soldering operations;

– Adverse coronary effects as a result of chronic inhalation of small amounts of carbon monoxide in certain flame-soldering operations;

– Poisoning by substances released during the cleaning or soldering/brazing of painted workpieces (e.g., isocyanates).

Ergonomic and social factors

ERGO3

– Heat stress due to exposure to a hot environment;

– Fatigue and muscular pains due to repetitive work, especially when working overtime;

– Eye strain when working under inadequate illumination;

– Leg fatigue when working long hours in a standing posture.

Addendum

Notes

NOTES5

  1. The process is called “soldering” when the solder has a melting point below 426 °C, and “brazing” or “hard soldering” (different terms may be used in different countries) when the solder has a higher melting point. Manual soldering processes include electric-iron, gas-flame, torch, chemical-cartridge and gas-heated iron soldering, as well as dip tinning; automatic processes include dip-, flow-, wave- and spray-gun soldering.
  2. According to published reports, solderers and brazers may be at increased risk of spontaneous abortions in the case of pregnant woman solderers; increased risk of bronchial asthma and hyperreactivity due to exposure to soldering fumes and gases, particularly to rosin (colophony) fumes and decomposition products, and to tetrafluorides.

 

References

National Safety Council (NSC). 1994. Soldering and Brazing. Datasheet 445-Rev-94. Washington, DC: NSC.

 

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Wednesday, 06 April 2011 20:01

Sanitarian

Synonyms: Sanitary inspector; sanitation inspector; sanitation supervisor; environmental technician; pollution-control technician (DOT). Also: public-health inspector; environmental-health inspector; environmental-quality inspector; environmental technician/engineering aid; registered/certified sanitarian

Job profile

Definition and/or description

DEF15

Plans, develops and executes environmental health programme; organizes and conducts training programme in environmental health practices for schools and other groups; determines and sets health and sanitation standards and enforces regulations concerned with food processing and serving, collection and disposal of solid wastes, sewage treatment and disposal, plumbing, vector control, recreational areas, hospitals and other institutions, noise, ventilation, air pollution, radiation and other areas; confers with government, community, industrial, civil defence and private organizations to interpret and promote environmental health programmes; collaborates with other health personnel in epidemiological investigations and control. Advises civic and other officials in development of environmental health laws and regulations (DOT).

Related and specific occupations

RELOCC6

Sanitary engineer; public-health engineer; environmental engineer; food and drug inspector; exterminator; mosquito sprayer (DOT).

Tasks

TASK12

Analysing; assembling and installing; burning (of garbage, etc.); calculating; catching (insects, rodents, etc.); checking; constructing; controlling; designing; determining (quantities, treatment techniques, etc.); developing; digging; disinfecting; disposing; disseminating (information); distributing (information or training material); driving; educating; enforcing; estimating (quantities); eradicating (pests); evaluating; examining; executing; exterminating; guiding; handling; improving (control techniques, etc.); inspecting; investigating; measuring; operating; planning; preventing; questioning; reporting; sampl- ing; sanitizing; spraying; supervising; surveying; testing; transferring; warning; witnessing.

Auxiliary tasks

Administering; advising; answering; applying; assisting; collaborating; collecting; compiling; computing; coordinating; discussing; filing; fixing; initiating; instructing; interpreting; lecturing; negotiating; organizing; participating (in committees, programmes, etc.); promoting; reviewing; scheduling; standardizing; teaching; training; writing.

Hazards

Accident hazards

ACCHA1

– Slips, trips and falls from ladders, stairs, elevated platforms, etc., during field visits of plants and throughout inspection operations;

– Falls into open pits and manholes while inspecting water and sewage systems;

– Acute poisoning by gases (e.g., sulphur dioxide and hydrogen sulphide) during inspection and cleaning of sewage systems;

– Acute poisoning resulting from operation and handling of drinking water and swimming-pool chlorination and bromination equipment and containers;

– Acute poisoning caused by use of various pesticides (see Appendix) throughout pest control/extermination operations;

– Burns resulting from garbage-burning operations and from operating incinerators;

– Relatively high risk of being involved in road accidents as a result of extensive and frequent driving on badly kept roads and off-roads;

– Electrical shock resulting from work with mechanized and electrical field equipment;

– Fires and explosions caused by flammable and explosive substances (e.g., solvents, gasoline, etc.).

Physical hazards

PHYSIC1

– Exposure to excessive noise (relevant for sanitarians engaged in industrial hygiene, heating and ventilation systems and in inspection of “noisy” industries such as the heavy industries, the textile industry and printing);

– Exposure to ionizing radiation (relevant for sanitarians engaged in control and supervision of radioisotope usage, x-ray equipment and radioactive wastes);

– Exposure to non-ionizing radiation (e.g., in water sterilization by UV);

– Exposure to extreme climatic conditions while working in the field.

Chemical hazards

CHEMHA4

– Chronic poisoning as a result of exposure to various toxic materials, such as pesticides (including insecticides, herbicides, rodenticides, fungicides, algicides, nematocides, etc.), their vapours and aerosols throughout extermination operations or disposal of containers with toxic pesticide residues;

– Contact with strong oxidants, especially chlorine compounds used for disinfection of drinking water and swimming pools;

– Toxic gases present in sewage systems or in industrial plants with inadequate ventilation systems;

– Dermatites and eczemas resulting from contact with various oils and solvents used for pest control, garbage- burning operations or other chemicals commonly used in sanitary laboratories.

Biological hazards

BIOHAZ4

– Exposure to various micro-organisms while working with liquid or solid wastes;

– Bites and stings by various insects (e.g., bees, flies, fleas, ticks, mites, mosquitoes and wasps), snakes, scorpions, rodents, etc., during field and laboratory work;

– Risk of contracting infectious diseases while working in hospitals.

Ergonomic and social factors

ERGO3

– Physical and/or verbal assault while carrying out sanitary inspections of buildings, businesses, shops, etc.

– Attempts of those subjected to inspection to file unwarranted complaints which result in psychological stress, nervousness, etc.

Addendum

References

Freedman, B. 1977. Sanitarian’s Handbook, 4th edition. New Orleans, LA: Peerless Publishing Co.

Last, JM and RB Wallace (eds.). 1992. Maxcy-Rosenau-Last Public Health and Preventive Medicine, 13th edition. Englewood Cliffs, NJ: Prentice Hall.

Tchobanoglous, G and FL Burton. 1991. Metcalf & Eddy Wastewater Engineering—Treatment, Disposal, and Reuse, 3rd edition. New York: McGraw-Hill.

Appendix

Principal chemicals to which sanitarians may be exposed:

– Acids

– Activated carbon

– Alcohols

– Aldrin

– Allethrin

– ANTU

– Asbestos

– Benzene hexachloride

– Bichloride of mercury

– Borax

– Boric acid

– Bromine

– Cadaverine

– Calcium cyanide

– Calcium hypochlorite

– Carbamates

– Carbolic acid

– Carbon monoxide

– Carbon disulphide

– Chloramines

– Chlordane

– Chlorinated hydrocarbons

– Chlorine

– Chlorine dioxide

– Copper sulfate

– Cresol

– Crude oil

– Cyanides

– DDD (TDE)

– DDT

– Detergents

– Diatomaceous earth

– Diazinon

– Dieldrin

– Diesel oil

– Dioxin

– Dipterex

– Disinfectants

– Fluorides

– Fluorine

– Formaldehyde

– Fuel oils

– Fumigants

– Fungicides

– Heptachlor

– Herbicides

– Hexametaphosphate

– Hydrocyanic acid

– Hydrofluoric acid

– Hydrogen sulphide

– Indol

– Iodine

– Kerosene

– Larvicides

– Lime

– Lindane

– Malathion

– Methoxychlor

– Mineral acids

– Nitrates

– Nitric acid

– Organic acids

– Organic phosphates (polyphosphates)

– Orthotolidine

– Ozone

– Parathion

– Pesticides

– Phenol

– Pine oil

– Pival

– Potassium permanganate

– Pyrethrum

– Quaternary ammonium compounds

– Rodenticides

– Skatole

– Soaps

– Sulphur dioxide

– Sulphuric acid

– Warfarin

– Xylene

– Zeolites

 

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