Objectives of Module

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					                  Health Risk Assessment

                Controlling health risks at work

HRA-2 Slide 1                                 HRA Workshop
                         What is HRA ?

                                Identify health hazards and their
                                 harmful effects (acute/chronic)

                Review          Assess the potential risk to the
                                          Business by
                                Plotting each hazard on the RAM

                                Low Risk        Medium or High
                                                  Are Control and Recovery
                     Manage for continuous          measures adequate to
                         improvement            control health risks to ALARP?
                                                                    Don‟t know - obtain
                                                          Yes       further information


                                                         Develop and
                                                        Remedial Action

HRA-2 Slide 2                                                                             HRA Workshop
                Identifying and Assessing
                      Health Hazards
Selection of team
Identifying and assessing Health Hazards
Identifying Control Standards
Identifying nature and degree of Exposure
Evaluating Risk to Health
Deciding on Remedial Action
HRA-2 Slide 3                           HRA Workshop
                   Selection of team

• Team Leader / Asset owner–Line manager such as OIM,
   plant manager or representative of facility being assessed

• Team Member – Individuals such as operational staff, line
   supervisor familiar with plant operation and process

• Local Advisor – Individuals such as medic/OH nurse, HSE
   advisor, who can advise on the HRA process and exposure

• Specialist Staff – Occupational hygienist, OH physician,
   toxicologist, ergonomist
HRA-2 Slide 4                                             HRA Workshop
                     Selection of team

 To gather necessary information team members
  must be able to:
 •   Observe the activity being performed
 •   Predict any potential departure from observed practice
 •   Ask supervisors, staff etc. the relevant questions
 •   Undertake simple diagnostic tests
 •   Identify and review relevant technical literature
 •   Gather the information systematically
 •   Form valid, justifiable conclusions about exposures and risks
HRA-2 Slide 5                                             HRA Workshop
            How to select Assessment Units

 The assessment unit is what is within the
  boundaries of the HRA
 Assessment units should be self-contained, either
  physically or as a process
 It should cover all aspects of the working
 The nature and the severity of the hazards and
  risks involved, the familiarity of the task, available
  resources and country-specific requirements
  should be taken into account
HRA-2 Slide 6                                  HRA Workshop
            Organisation and Preparation

 Collect pre reading material and references such as:
 Plans and drawings for plant specifications
 Incident / injury reports (incl. occupational illnesses) and incident
 Plant and equipment fault reports
 Maintenance records for control measures
 Records of health surveillance and sickness absence
 Occupational hygiene surveys, health and safety surveys
 Minutes of health and safety committee meetings

HRA-2 Slide 7                                              HRA Workshop
                What are Health Hazards

 A Health Hazard has the potential to cause harm to
 Health hazards may be divided into the following
       chemical
       biological
       physical
       ergonomic
       psychological

HRA-2 Slide 8                               HRA Workshop
                Health hazards of primary concern

  Cause fatalities in the short or long term
       e.g. infectious diseases (short term), carcinogenic
       substances (long term)
  Expose the company to substantial future social
  and monetary liabilities
       e.g. noise induced hearing loss, repetitive strain injury,
       psychological stress
  Cause minor health effects which could cause
  severe business disruption
       e.g. major food poisoning outbreak

HRA-2 Slide 9                                           HRA Workshop
                 How to identify Health
 Walk through surveys
       Looking, smelling, talking, listening; use your senses!
 Refer to Health Hazard Inventories
 Use HRA Yellow Guide, appendix 2
 Look at Records
      incident/fault reports, inspections, maintenance,
       sickness absence, hygiene surveys, operating
 Use experience from elsewhere

HRA-2 Slide 10                                        HRA Workshop
                      Types of Effects

 Acute, immediate
      • Lung, skin or eye damage from corrosive liquid
 Acute, late onset
      • Sick building syndrome
 Chronic, intermittent / on-off
      • Repetitive Strain Injury
 Chronic permanent
      • Lung cancer

HRA-2 Slide 11                                       HRA Workshop
                 Identify Health Hazards and
                    their harmful Effects

          Agent                     Source                  Route               Harmful Effect

   Silica dust (crystalline)    Refractory bricks          Inhalation         Lung disease (silicosis)

     Used mineral oils              Engine oil                Skin              Dermatitis, cancer

            Noise              Process noise above          Hearing                Hearing Loss

            Heat                    Plant heat            Whole body          Heat stress, heat stroke

     Legionella bacteria       Spray cooling towers        Inhalation         Legionnaire’s Disease

   Repetitive movements         Workplace design      Whole or part of body      Musculo-skeletal

HRA-2 Slide 12                                                                      HRA Workshop
                 Factors influencing the
                  Relationship between
                    Hazard and Risk
 Cumulative exposure
 Individual susceptibility
 Threshold levels
 Knowledge gaps
 Workstyle changes
 Real world practices

HRA-2 Slide 13                             HRA Workshop
                     Assigning Hazard Ratings
 Hazard Rating           Definition Consequence Category (harm to people)

                         Slight health effects: Not affecting work performance or causing
                 1       disability, e.g. non toxic dusts (as an acute hazard)

                         Minor health effects: Agents capable of minor health effects
                 2       which are reversible, e.g. irritant and defatting agents, many food
                         poisoning bacteria
                         Major health effects: Agents capable of irreversible health
                 3       damage without loss of life, e.g. noise, poor manual handling
                         tasks, hand/arm vibration, chemicals causing systemic effects,
                         1 to 3 fatalities or Permanent Total Disability: Agents capable of
                 4       irreversible damage with serious disability or death, e.g.
                         corrosives, known human carcinogens (small exposed
                         population), heat, cold, psychological stress
                         Multiple fatalities: Agents with the potential to cause multiple
                 5       fatalities, e.g. chemicals with acute toxic effects (hydrogen
                         sulphide, carbon monoxide), known human carcinogens (large
                         exposed population)
HRA-2 Slide 14                                                               HRA Workshop
                 Hazard Ratings

 Consider Harm to:

 Select the category with the highest
  consequence rating!

HRA-2 Slide 15                          HRA Workshop
                 Risk Assessment Matrix

     The Risk Assessment Matrix (RAM) is the tool
     which allows assessment of the risk to the business
     from each identified health hazard
     It will assist you in prioritizing potential health risks
     and determine which risks need documented
     demonstration of controls
     Ensure that health risks are assessed properly by
     taking into account acute and chronic harmful health
HRA-2 Slide 16                                         HRA Workshop
     Health Risk = Consequences X Probability (Likelihood)
                                                            Increasing Probability
                                    A                   B             C            D                                E
                             Never heard of in   Heard of incident     Incident has      Happens several     Happens several
                                the world         in our industry    occurred in Shell   times per year in   times per year in
                                                                         company          Shell company        our location

       1       Slight
       2       Minor                                                                                                             Likelihood
       3   Major Injury                                                                                                          Acute - Estimated on the
       4   1-3 fatatlities                                                                                                       basis of experience and
       5     Multiple
                                                                                                                                 or evidence that a certain
                                                   Categories                                                                    outcome has previously
                                  Area 1
                                                      Area 2
                                                                         Area 3
                                                                                                                                 Chronic - Estimated
                                                                                                                                 based on the historical
                   Estimate of what could                                                                                        evidence that excess
                   happen (acute and chronic)                                                                                    exposure has occurred

HRA-2 Slide 17                                                                                                                             HRA Workshop
                      Risk Assessment Matrix
                                                                    Increasing Probability 
                 CONSEQUENCE                                         A          B           C           D           E

                                                                   Never      Heard of    Incident    Happens     Happens
             HAZARD        People        Assets      Reputa-       heard of   incident    has         several     several
             RATING                                   tion         in the     in our      occurred    times per   times per
                                                                   world      Industry    in Shell    year in     year in
                                                                                          company     Shell       our
                                                                                                      company     location.

                 1      Slight health   Slight      Slight          LOW
                        effect          damage      impact          RISK             Manage for continuous improvement
                 2      Minor health    Minor       Limited
                        effect          damage      impact                                               Incorporate risk reduction measures

                 3      Major           Localised   Considerab                             MED.
                        health effect   damage      le impact                              RISK

                 4      PTD* or 1 to    Major       Major                                              HIGH
                        3 fatalities    damage      national                                           RISK

                 5      Multiple        Extensive   Major                                         Intolerable – investigate alternatives
                        fatalities      damage      int’national

             * PTD = Permanent Total Disability

             Note: Environment consequence column omitted

HRA-2 Slide 18                                                                                                        HRA Workshop
                    Generic RAM HRA outcomes
  Health Hazard      Examples of situations or activities                Harmful health effects               Consequence        Likelihoo     RAM Risk
                      in which the health hazard may                      from over exposure                    Category           d-L         Rating (C x
                                   occur                                    (Consequences)                      (harm to                           L)
                                                                                                               people) - C

Chemical Hazards

Asbestos             Materials containing asbestos, for example,      Acute: Mildly Irritating to eyes and
                     gaskets, ceiling tiles, partitians, insulation   respiratory tract                      Cat 1 Carcinogen:      C               5C - High
                                                                      Chronic: Category 1 carcinogen         4/5

Benzene              Processing, handling and distribution of         Acute: Irritant to eyes and
                     benzene containing process streams and           respiratory tract; narcotic to CNS.    Cat 1 Carcinogen:      B          5B - Medium
                     products, e.g. naphthas, platformate,            Chronic: Category 1 carcinogen                4/5
                     condensate, gasoline.

Ethylene oxide       Shell chemicals marketed product and             Acute: cold burns to skin and eyes.
                     process material                                 Shortness of breath, dizziness and     Cat 2 Carcinogen:      B          4B - Medium
                                                                      drowsiness on inhalation. May                 4/5
                                                                      cause pulmonary oedema.
                                                                      Chronic: Category 2 carcinogen
                                                                      and mutagen

Epoxy Resins         Contained in some adhesives (maintenance)        Acute: Irritant to skin and eyes
                                                                      Chronic: skin sensitiser                  Sensitiser: 3       C          3C - Medium

Hydrogen sulphide    Waste gas stream; sour crude oil;                Acute: Chemical asphyxiant
                     condensates; bitumen and fuel oil tank head      causing respiratory paralysis.             Chemical           C               5C - High
                     spaces                                           Chronic: n/a                             asphyxiant: 5

HRA-2 Slide 19                                                                                                                       HRA Workshop
                 Low RAM Ratings

  Manage for continuous improvement
    via standard procedures and
     competences in HSE-MS (ensure these
     are adequate)
    ensure Exposure Limits and other
     control standards are met

HRA-2 Slide 20                     HRA Workshop
            Medium and High RAM Ratings
  Detailed review of controls
           Standards of control
           Who is exposed and when
           Estimate or measure exposure
           Compare existing controls against standards (are
            OELs met and risks As Low As Reasonably
            Practicable - ALARP?)
           Consider need for routine exposure monitoring
            and/or health surveillance
  For risks assessed as High
           give serious consideration to alternative ways of
            carrying out the operation

HRA-2 Slide 21                                          HRA Workshop
                 Control and Recovery

 Identify exposure
 Hierarchy of controls
 Control standards
 Use of control chart for individual risk
 Apply ALARP principle
 Exposure measurements
 Health Surveillance

HRA-2 Slide 22                           HRA Workshop
                 What is exposure?

 Exposure is defined as:
    The amount of the hazard to which a person
    has been exposed(dose). This is a
    combination of the magnitude, frequency
    and duration of exposure

HRA-2 Slide 23                          HRA Workshop

 Magnitude (extent of exposure) is affected
      Concentration/intensity of the agent
      Work practices
      Agent‟s physical characteristic impacting on the
       exposure route
      Existing controls

HRA-2 Slide 24                                 HRA Workshop
                  Exposure routes

            Ear                     Nose


  Skin                                Whole body

HRA-2 Slide 25                              HRA Workshop
            Hazards and Exposure routes
 Hazard                              Exposure route
 Noise                               ear
 Chemical Liquids                    skin (through uptake of the skin, or
                                     through injection)
                                     transferred from hand to mouth
 Chemical gases, vapours and dusts   nose, mouth, lungs – inhalation
 Chemical dusts                      trapped in the nose and throat, or
                                     transferred from hand to mouth,
                                     leading to ingestion
 Vibrations                          whole body or specific parts e.g.
                                     hands, eyes
 Heavy lifting & other ergonomic     muscoloskeletal system
HRA-2 Slide 26                                               HRA Workshop
                   Target Organs
Central nervous
    system                         Eye
      Ear                          Nose

         Lung                       Heart
      Liver                        Digestive tract

HRA-2 Slide 27                             HRA Workshop
           Hazard, exposure route and target organ

 Hazard              Exposure route Target organ
 Noise               Ear                     Ear

 Chemical liquids    Inhalation, skin, eye   Direct contact with lungs,
 and dusts                                   skin and eyes. May also be
 (hazard dependent                           absorbed in blood stream
 on the specific                             and carried to susceptible
 chemical)                                   organs: central nervous
                                             system, reproductive system,
                                             kidney, liver
 Stress              Mind                    Heart, mental impairment

HRA-2 Slide 28                                               HRA Workshop
                   Factors Affecting Intake
                 for chemical and biological
 Physical form
    Gas/vapour/liquid/solid
    Particle size
    Particle shape
  Solubility
    Carriers
  Breathing rate

HRA-2 Slide 29                           HRA Workshop
                 Identify who is exposed

 Typical Job Types
       Plant Operators - divided by operational group
       Road Tanker Drivers - divided by product group
       Maintenance Staff - mechanical, electrical, vehicle etc.
       Cleaning Staff - plant and/or office
       Laboratory Technicians - sub-divide as appropriate
       Administrators - office based with minimal plant
       Field Staff - geologists

HRA-2 Slide 30                                          HRA Workshop
                 Estimate exposure level
 Identify tasks:
      Use workplace experience
      Review historical records
      Discuss with staff involved in doing the task
      Visit work area/walk through survey
 Include tasks involved in:
      Normal operations
      Abnormal conditions and foreseeable emergencies

HRA-2 Slide 31                                         HRA Workshop
                 Estimate exposure level

         What is a „task‟ ?
          An activity which a competent person can be
         instructed to do in a single sentence
          A plant   operator could be asked to take a process stream
         A plant cleaner could be asked to deal with a spillage
          A fitter could be asked to take a pump out of service
          A laboratory technician could be asked to analyse a
         sample for benzene content

HRA-2 Slide 32                                              HRA Workshop
                    Estimate exposure level

         Review tasks
         Frequency, duration and estimates of
         concentration/intensity of exposure
          Work practices and existing controls
                 Effectiveness of existing control measures
         Compare existing controls against relevant
         control standards
         Who else is exposed?
                 Employees, contractors, third parties

HRA-2 Slide 33                                             HRA Workshop
             Estimate exposure level-without
                 exposure measurement

  Exposure may be acceptable when:
       evidently so
       operations are in accordance with suppliers‟
       documented procedures
       previous measurements under similar or worst
       case conditions indicate low exposure
       process operated in accordance with
       recognised guidance on good practice

HRA-2 Slide 34                               HRA Workshop
             Estimate exposure level-without
                 exposure measurement

  Exposure may be unacceptable when:
       there is evidence of fine dust deposits
       fume or particles are visible in light beams
       there are broken, defective or poorly maintained
       the process is not operated in accordance with
       recognised guidance on good practice
       complaints are made of discomfort or excessive odour
       ill-health related to exposure is detected

HRA-2 Slide 35                                     HRA Workshop
                 Hierarchy of controls

 The hierarchy of controls is a list in
  preferential order of the means by which
  exposure to health hazards can be
      Substitution (alternatives)
      Engineering (plant and equipment)
      Personal protective equipment

HRA-2 Slide 36                             HRA Workshop
                        Types of controls

    Elimination and substitution
    Engineering (plant and equipment):
                 Equipment/processes designed to prevent
                 or minimize release of the hazard
                   Examples: containment (enclosure), exhaust
                   ventilation, remote venting/vapor recovery

HRA-2 Slide 37                                             HRA Workshop
                   Types of controls

         Safe systems of work / Permit to work system
         Record systems
         Staff Instruction, Information & training
         Supervision, Emergency arrangements

        Personal Protective Equipment
             Respiratory & Skin Protection as a secondary line of
            defence or as the only option
HRA-2 Slide 38                                             HRA Workshop
                 Effectiveness of Controls

      The types of control vary in their
      effectiveness according to the control
                 Elimination    Most Effective
                 PPE            Least Effective
HRA-2 Slide 39                                    HRA Workshop
                       Control selection

        Control selection to achieve ALARP must
        consider the control effectiveness and cost:
        consider the most effective controls first
        limit PPE to:
             -infrequent tasks
             -temporary use until more effective controls are in
             -as a precaution should other controls fail
HRA-2 Slide 40                                                HRA Workshop
                 Maintenance of controls

 Controls are only effective if they work
      Engineering controls
            Preventive maintenance, inspections and tests
      Procedural controls
            Record systems, information and training
            Effective supervision
            Routine maintenance, inspection and training
      Emergency measures
            Inspections and realistic exercises
HRA-2 Slide 41                                               HRA Workshop
                    Control standards

   Occupational Exposure Limits (OELs)
   Specifications for control:
        Engineering Control Standards (SES, DEP)
        Procedural (manufacturer’s/supplier’s info/industry good

        Personal Protective Equipment

    National, Company, Group, Industry and
   International Standards

HRA-2 Slide 42                                            HRA Workshop
                 What are exposure limits?

 Chemical agents
      Occupational Exposure Limits are levels of airborne
       concentrations of hazardous compounds that are
       considered safe for the workplace
      OEL‟s and recommendations are set by competent
       national authorities
       OEL‟s are normally used for chemical agents, but the
       concept can also be applied for physical, biological and
       psychosocial agents and for ergonomics

HRA-2 Slide 43                                        HRA Workshop
            Occupational exposure limits

          Physical Agents, e.g.
          Shell ‘Noise Guide’ recommended criteria
             Daily Noise Dose - 85 dB(A) Leq
             Design Limit - 85 dB(A) at 1 meter
          Cold stress
          Ionising radiation
          Heat stress
HRA-2 Slide 44                                    HRA Workshop
            Occupational exposure limits

          Biological agents
                 Control to as low as reasonably practicable
                 Include ergonomic principles to all work

                 Refer to specialist for evaluation and
HRA-2 Slide 45                                             HRA Workshop
           Engineering control standards

 Face velocities of Lab Hoods should meet recognized
 design standards
 Rotating equipment mechanical seals that do not leak
 Transfer lines/hoses with disconnect fittings that do not
 Capture velocities for welding hoods meet recognized
 ventilation standards
 Engineering controls are inspected regularly
 Engineering controls are on a PM (preventive
 maintenance) schedule

HRA-2 Slide 46                                    HRA Workshop
                 Procedural standards

 written procedures for tasks involving exposure
 (permit to work system)
 procedures include work practices that minimize
 work practices are understood (e.g. training &
 validated by testing) and followed by employees
 (supervision, validated by auditing)

HRA-2 Slide 47                              HRA Workshop
            Personal Protective Equipment

        respirators
        gauntlets (gloves)
        goggles
        protective clothing
        foot protection

HRA-2 Slide 48                       HRA Workshop
            Personal protective equipment

 Adequate use of PPE includes an assessment of:
 • PPE requirement for each task
 • PPE selection to match the hazard
 • PPE is practical & functional for the task
 • PPE requirements are understood by employees (e.g. training &
   validated by testing)
 • PPE is used correctly (e.g. training & validated by audit))
 • PPE is used when required (validated by audit)
 • PPE is inspected and maintained regularly (validated by audit)
HRA-2 Slide 49                                             HRA Workshop
                 Use of Control Chart

     Are controls meeting the control
     Control chart: tool for decisions
     Use of information on exposures and
     Combining „hazard rating‟ and „exposure

HRA-2 Slide 50                          HRA Workshop
                     Hazard rating categories
          HAZARD RATING   DEFINITION (Consequence Category: Harm to People)

                 1        Slight health effects: Not affecting work performance or causing disability, e.g. non toxic dusts
                          (as an acute hazard)

                 2        Minor health effects: Agents capable of minor health effects which are reversible, e.g. irritant
                          agents, defatting agents, many food poisoning bacteria

                 3        Major health effects: Agents capable of irreversible health damage without loss of life, e.g.
                          noise, poor manual handling tasks, hand/arm vibration, chemicals causing systemic effects,

                 4        One to three fatalities or Permanent Total Disability: Agents capable of irreversible damage
                          with serious disability or death, e.g. corrosives, known human carcinogens (small exposed
                          population), sensitisers where the onset of sensitisation threatens continuing employment, heat,
                          cold, psychological stress

                 5        Multiple fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with
                          acute toxic effects (hydrogen sulphide, carbon monoxide), known human carcinogens (large
                          exposed population)

HRA-2 Slide 51                                                                                        HRA Workshop
                   Exposure Rating
    Exposure       Exposure       Definition
    Rating         Band
    a) Very Low    < 0.1 x OEL    Exposures are negligible

    b) Low         > 0.1 - <0.5   Exposure are controlled well below OEL
                   x OEL          and are likely to remain so in accordance
                                  with standards
    c) Medium      > 0.5 – 1 x    Exposures are currently controlled below
                   OEL            OEL to meet standards but control may be
                                  reliant on less robust measures such as
                                  personal protective equipment
    d) High        > OEL          Exposure are not adequately controlled to
                                  meet standards and continuously/regularly
                                  exceed OEL
    e) Very High   >> OEL         Exposures are excessive and will almost
                                  certainly result in health damage to
                                  persons exposed

HRA-2 Slide 52                                                HRA Workshop
                                       Control Chart

                      Exposure Rating 

    Hazard Rating      Very Low             Low              Medium             High                Very High
                           (a)                (b)               (c)               (d)                     (e)
           1                    No     immediate               Third                Second        Priority
           2                  action   required               priority
           3                                                                     First Priority
           4                                                                               for
           5                                                                                      Action
     Exposure Band     <0.1*OEL (2)        0.1*OEL -     0.5*OEL - 1*OEL         > OEL                >> OEL
         (1)                               0.5*OEL

        1. reference to exposure bands is a qualitative estimate only where no exposure data are available
        2. OEL: Occupational Exposure Limit

HRA-2 Slide 53                                                                                      HRA Workshop
                 Evaluate the Adequacy of
  What is the nature of the hazard to health ?
       Use Hazard Rating (RAM Consequence Category)

  What is the nature and degree of exposure for the
  task ?
       Assign Exposure Rating

  Combine in Control Chart

HRA-2 Slide 54                                   HRA Workshop
                 Remedial Action Plan

  The Remedial Action Plan must cover:

       Recommendations divided into four levels of
       action (first, second, third priority and no
       immediate action required)
       Is recommendation agreed or not?
       Responsible person
       Due date

HRA-2 Slide 55                               HRA Workshop
                 Actions Control Chart (1)
                  To aid priority setting
       Action 1st priority
            Stop the exposure; notify management immediately
            Identify all sources
            Implement immediate control improvements e.g. PPE
            Consider need for exposure measurement
            Identify and implement work practice and control
            Review HRA, including measurements

HRA-2 Slide 56                                      HRA Workshop
                 Actions Control Chart (2)
                  To aid priority setting
       Action 2nd priority
            Reduce exposure to below OEL (Hazard Ratings 1-2)
            Consider reducing to below 0.5 x OEL (Hazard Ratings 3-5)
            Identify and implement work practice and control
            improvements (*)
            Consider need for exposure measurement (*)
            Review HRA, including measurements (*)
       Action 3rd priority
            Actions with asterisk under 2nd priority
       Action – No Immediate Action Required
            Normally no need for immediate action to improve controls.
            Manage for continuous improvement

HRA-2 Slide 57                                                  HRA Workshop
                 ALARP Definition

     Definitions of ALARP
      “ balancing the reduction in risk against the
      time, difficulty and cost of achieving it”

     This level represents the point, objectively
       assessed, at which the time, difficulty and
       cost of further reduction measures become
       unreasonably disproportional to the additional
       risk reduction obtained.

HRA-2 Slide 58                                 HRA Workshop
     ALARP is influenced by the following factors:

        risk to be avoided

        sacrifice involved in taking measures to avoid
        the risk (money, time and trouble)

        comparison of the two

HRA-2 Slide 59                                  HRA Workshop
                 ALARP- rule of thumb

     List the measures that have been taken to
      reduce the risk
     Go on to identify an additional option which
      might be introduced to reduce the risk further
     Give reasons why this additional control is not

HRA-2 Slide 60                                HRA Workshop

                                  Tolerability level

           Risk to                                            Cost of
           Health                         •                   Control
                     Legal Liability          ALARP    Wasteful

HRA-2 Slide 61                                                HRA Workshop
                  What remedial action?

 Is risk to health ALARP?
      Yes, when only a small reduction in risk would require
       an unreasonable amount of time, trouble, difficulty or
      Select appropriate additional controls/barriers
           Hierarchy of controls including recovery preparedness
           Other measures like: measurements, monitoring, health
            surveillance, maintenance of controls, instruction & training
           Priorities for implementation

HRA-2 Slide 62                                                   HRA Workshop
                 Exposure measurements

 Identify who may be exposed to health risks
 Identify the relevant exposures to
  individuals in the workplace
 Assess your work environment to determine
  when you need to do exposure

HRA-2 Slide 63                        HRA Workshop
                 Purpose of exposure
     Verification of the efficiency of control
     Justification for additional control measures
     Choice of control measures (eg for noise
     To establish and document historical records
      of exposure levels for all workers
     To ensure and demonstrate compliance with
      regulatory and other exposure guidelines
     Epidemiological studies or investigating
      reported health effects
     To alleviate employee concerns
HRA-2 Slide 64                               HRA Workshop
                 Objectives of exposure
 Baseline - to define range and distribution of
  exposure for defined jobs
 Worst case – to identify potentially high
 Detailed – when baseline study provides
  insufficient data
 Routine – periodic exposure monitoring to check
  that control measures remain effective
 Compliance - to ensure that exposure is below
  regulatory and other guidelines
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                 Monitoring methods

 Personal Monitoring
      worker exposure with normal work procedure
      breathing zone for inhalation exposure
      near ear for noise exposure
      full shifts / task samples
 Area (Environmental) Monitoring
      contaminant concentration in work area
      plant conditions
      effectiveness of controls
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                 Monitoring methods
      Biological Monitoring
           Determine body absorption of potentially
            hazardous substance from all sources
           Measure changes in the composition of
            body fluid, tissue or expired air
           May be used to indicated inadequate
            control, improper work procedure
           Provides accurate information about the
            absorbed dose of a substance in the body
           Not all substances have a method or a BLV
            (biological Limit Value)
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                 Sampling Strategy

 Where to Sample
 When to Sample
 Whom to Sample
 How long to Sample
 How many samples to take

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                    Health Surveillance

         Monitoring and health surveillance aims to
         (periodically) assess exposures and health in
         order to
            Confirm the effectiveness of existing control
            Collect data for the detection and evaluation of
             hazards to health
            Confirm compliance with predetermined criteria
            Required by law

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                 Medical Surveillance

 Medical Surveillance selection criteria
 Is there a risk to health (based on HRA)
 The prevention/intervention potential ("can
  we do something about it?")
 Can we detect it?
 Are the detection methods suitable?

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                 Document & Review HRA

       Appropriate Depth of Records
       Linked with Medical Records
       Informing Staff
       Archiving of Records
       Reviewing Records

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                 Appropriate Documentation
  Records should:
       be retrievable
            Internal/external audits, authorities and review
       meet legal requirements
       be detailed enough to ensure audit trail on how
       conclusions were reached
       allow traceability from individual name via Job Type to
       include exposure monitoring and health surveillance

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                 Informing Staff of Findings

  Involves staff in HRA process
  Ensures that:
       Health risks are understood
       Control measures are used
       Staff can alert assessment teams on changes
  May be a legal requirement

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                 Archiving of Records

  As required by local law and/or practice
    30 - 40 years are typical
  Allows for re-introduction of old processes

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                        Reviewing HRAs

 Senior management will confirm the status of HRA
  through HSE annual letter
 Action Items
       Short term reviews of action items
            Against target dates and responsible persons
  Change in process, hazard, legislation etc
  Change in controls
  New information on the effect
       Incidents, illnesses, complaints, new knowledge
  On an agreed cycle
       Between 1 and 5 years dependent on risk
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