6 pma salehuddin - advanced occuptaional health
TRANSCRIPT
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POST MODULE ASSIGNMENT (PMA)
ADVANCED OCCUPATIONAL HEALTH IN MY WORKPLACE
1.0 Introduction
1.1 Organisation Profile
The Malaysian Armed Forces is divided into 3 services; Army, Navy and Air Force. The
Malaysian Army organisation is generally divided into 4 big departments which consist of
Operational, Training, Administration and Logistics. Each of these department functions
interdependently with other departments. One of the important elements in the Training
Department for the Malaysian Army is the training unit Kolej Tentera Darat (KTD) situated
at Port Dickson.
KTD is responsible to produce Army officers from graduates from the various plethora of
tertiary education institutions. Several courses are run within a year to accommodate the
various categories of Army Officers for the Malaysian Army. The organisation structure is
shown in Figure 1.1. Basically, KTD itself is divided into 4 departments which is
Administration, Training, Logistic Support and Examination & Validation.
Figure 1.1 – KTD Organisation Structure
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1.2 OSH in KTD?
The OSH act states in section 1. (3), that it does not apply to the Armed Forces (OSH act
1994). Although the Armed Forces are not legally binded by the law in terms of OSH, KTD
acknowledges the benefit of OSH and promotes a safe and healthy working culture. The
effort is demonstrated by frequent activities of coincidentally integrating safety and health
with the overall security of the camp. There is no precise policy or committee for OSH as per
required by OSHA or OSHMS but the camp security plan and security committee has
elements of OSH embedded into it. I’m not permitted to disclose the full content of the
security plan and roles of the security committee but it is worth mentioning that elements of
OSH contained are:
a) Monitoring building condition and or structure damage.
b) Hygiene maintenance of drainage, kitchen, ration stores and dining hall.
c) Safety in military vehicle garage (tools and chemical storage, procedures and use of
PPE).
d) Military assets (ammunition, pyrotechnics and electronic warfare equipments) storing
procedures and handling in the armory and specialized stores.
e) Military Doctor report on occupational injuries and post mortem by investigating
accidents and deciding if the injuries can be prevented or genuinely unavoidable (due to the
nature of Army training).
2.0 Question
The questions provided by Dr. Rozhan Shariff Bin Radzi are:
a. List according to job title, the 4 most important or hazardous occupation that may be
found in your organisation/company. For each of these occupations, classify and discuss the
most common occupational healh hazards that can be encountered in these jobs.
b. Are you aware of any stress complaints at your workplace? How would you assess
whether stress is an issue among your workplace staff?
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3.0 Objective
The objective of this PMA is to perform the following:
a) Identify 4 hazardous occupations in the organisation.
b) Discuss occupational health hazards in these jobs.
c) Identify stress complaints in organisation.
d) Assessment of stress in workplace.
4.0 Methodology
Methodology is the manner, method, procedure, way or approach that will be used to attain,
achieve, and accomplish the objective of this PMA. The method used is application of
knowledge gained from the all the classes attended so far during EMOSHM in answering the
questions from the perspective of the organisation. No specific records or graph are recorded
or maintained by KTD, therefore assumptions and mental simulation are used to fill
informational gaps that are required to answer the questions.
5.0 Question 1
5.1 Hazardous Jobs
There are many jobs according to appointments positioned in different departments in the
previous Figure 1.1. Logically, those from the Training Department are more exposed to
occupational hazards when compared to the other 3 departments. This is due to the nature of
work for the Training Department which is usually training in the battlefield environment
when compared to the other 3 departments of mostly ‘office’ work. From the training
department, specific instructors focus on a specific skill to teach and train to the trainees
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called SME. Of course the trainees are only subject to possible acute exposure, but the SME
are subject to chronic exposure due to repetition of training for trainees from several different
courses that are run throughout the year. Of the many SME, the 4 most hazardous occupation
chosen for this PMA are:
a) Gunnery Instructor.
b) NBC Instructor.
c) Abseil and Rappel Instructor.
d) Jungle Warfare Instructor.
5.2 Gunnery Instructor
The Gunnery Instructor’s role and responsibility involves in training the theory and practical
application of using weapons, MBT gun (Figure 5.2A), artillery (Figure 5.2B), air defence
Figure (5.2C) and rocket launchers (5.2D) in combat. A simplified JHA is shown in Figure
5.2E.
Figure 5.2A – Pendekar PT-91M Pendekar MBT
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Figure 5.2C – Oerlikon 35mm Twin Cannon Air Defence
Figure 5.2D – ASTROS II Multiple Launch Rocket System (MLRS)
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JOB HAZARD ANALYSIS JOB TITLE: Gunnery Instructor DATE: 23/5/13
TITLE OF PERSON WHO DOES
JOB:
Instructor
SUPERVISOR:
Chief Instructor
ANALYSIS
PERFOMED BY:
Kapt Salehuddin
ORGANIZATION: KTD LOCATION:
Firing Range
DEPARTMENT:
Training
REVIEWED BY:
Safety and Health
Committee
SEQUENCE OF BASIC
JOB STEPS
POTENTIAL HAZARDS RECOMMENDED ACTION OR
PROCEDURE
Battle Procedure
• Explosive Ammunition – improper handling.
• Engineering Control - Ammunition containers can be made easier to hold and lift.
Loading of Ammunition
• Explosive Ammunition – improper handling.
• Mechanical – being caught between, struck by or against artillery mechanism during loading of ammunition.
• Noise – chronic exposure to hazardous noise levels.
• Environment – Mineral Dusts (firing range ground)
• Chemical – airborne chemical hazard generated from firing process producing lead dust.
• Engineering Control - Barriers to guard explosions from spectators. - Suppression of noise by inventing gun barrel silencer. - Dilution mechanism for lead dust.
• Administrative Control - Training and conditioning. - Safe Work Procedures. - Job Rotation. - Adequate breaks/rest.
• PPE - Ear plugs / ear muff. - Eye protector. - Breathing mask.
Register Target
Firing on Target
Confirmatory of Target
Hit
Reloading of
Ammunition and
Repeat Firing on Target
Process
• Ergonomic – MSD from repetitive action and awkward posture from loading heavy ammunition to gun.
• Administrative Control - Training and conditioning. - Safe Work Procedures. - Job Rotation. - Adequate breaks/rest.
Figure 5.2E – Simplified JSA for Gunnery Instructor
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Of the many practical hazards exposed to the Gunnery Intructor, chronic noise is the most
common work related occupational health hazard experienced. This is due to prolonged
repetitive exposure to high levels of the explosions of the guns firing. Noise is defined as all
adverse, unpleasant, irritating, annoying or harmful sound that reaches the hearing organ and
influences other senses and parts of the human body (Koradecka, 2010). The common
impulsive noise for gun fire is at an average 130 dB. When compared to dB values for
common noise sources (Figure 5.2 F), it is near the pain threshold of the hearing organ.
Prolonged exposure to noise above 85 dB itself may cause hearing impairment (Reese, 2009).
dB NOISE SOURCE 135 Pain Threshold 120 Jet Plane 100 Peneumatic Drill 80 Car 60 Office 40 Home 15 Birds Singing
Figure 5.3F – Common Noise Sources (Koradecka, 2010)
Considering the fact of the dangerous noise level experienced by the Gunnery Instructor, a
Hearing Conservation Program and application of hierarchy of control can be utilised for the
occupant. These interventions consist of:
a) Auditable written policy.
b) Comprehensive noise exposure assessment.
c) Noise hazard Education Training Program.
d) Audiometric Testing Program.
e) Medical evaluation and treatment.
f) Provision, training and utilization of suitable HPD.
g) Good record keeping of exposure monitoring, audiometric and clinical examination
results.
h) Applying work breaks and limiting working time (Koradecka, 2010).
i) Arranging soundproof resting rooms (Koradecka, 2010).
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5.3 NBC Instructor
The NBC Instructor’s role and responsibility involves in training the theory and practical
application of nuclear, biological and chemical warfare in the battlefield environment. This
involves of wearing the NBC suit as shown in Figure 5.3A, based on the MOPP level. The
training usually focuses on the several degrees of MOPP level as shown in Figure 5.3B.
Figure 5.3A – MOPP 4 & 5 NBC Suit
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Figure 5.3B – MOPP (Mission Oriented Protective Posture)
The training consists of provision, training, utilisation of the NBC suit and conditioning to
perform normal fieldcraft and battlecraft in a nuclear/biological/chemical hazard
environment. The NBC suit is designed to withstand hazardous chemical, biological and a
certain level or nuclear radiation exposure. The training involves wearing the NBC suit for
certain amounts of time while performing military exercises and the use of the gas mask
canisters. Therefore, the NBC instructor is chronically exposed to chemical hazard
throughout the year.
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Training for the exposure of airborne chemical and biological weapons are substituted with
tear gas within a timeframe focusing on the handling of the gas mask and replacing gas
canisters from the gas mask in an enclosed room/environment. A chemical hazard through
air contamination is defined as an occurrence of substances in the form of aerosol, gases or
vapours (Posniak and Skowron, 2010). The tear gas used in training is a form of airborne
chemical hazard. Although, the use of NBC suit protects the user from the substance, the
nature of work for the instructor which conducts training on a daily basis will increase the
likelihood risk of coming to contact and or inhaling the chemical hazard. Chronic exposure
to tear gas may cause eye scarring/glaucoma/cataract, skin irritant, suffocation, interference
with respiration, immediate lung irritation, airway constriction, and existing lung disease
aggravation.
Inhalation is the major route of entry for many hazardous chemicals in the work environment
involving those airborne contaminants that can be inhaled direct into the lungs and can be
physically classified as gases, vapors and particulate matter that includes dusts, fumes,
smokes and mist`s (Reese, 2010). Paying careful attention to prolonged exposure to tear gas
as a hazardous irritant which have a corrosive or irritating effect on the breathing organs is
particularly important because of the rapidity with which it can be absorbed in the lungs.
Several suggested measures that can be taken are:
a) Substitution of tear gas with a non hazardous gas to be used in training.
b) Develop a gas mask examination procedure of employees by a licensed party.
c) Qualitative or quantitative fit testing of gas mask.
d) Monitor replacement of gas mask canister with new canisters (sometimes old
canisters are still used).
e) Medical surveillance, lung function testing and eye examination.
5.4 Abseil and Rappel Instructor
The Abseil and Rappel Instructor’s role and responsibility involves in training the theory and
practical application of abseiling and rappelling from high locations and helicopters as shown
in Figure 5.4A and 5.4B. A simplified JHA is shown in Figure 5.4C.
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Figure 5.4B – Abseiling / Rappelling from Nuri Sikorsky S-61A-4
JOB HAZARD ANALYSIS JOB TITLE: Abseil / Rappel Instructor DATE: 23/5/13
TITLE OF PERSON WHO DOES
JOB:
Instructor
SUPERVISOR:
Chief
Instructor
ANALYSIS
PERFOMED BY:
Kapt Salehuddin
ORGANIZATION: KTD LOCATION:
Abseil / Rappel Tower
DEPARTMENT:
Training
REVIEWED BY:
Safety and Health
Committee
SEQUENCE OF BASIC
JOB STEPS
POTENTIAL HAZARDS RECOMMENDED ACTION OR
PROCEDURE
Preliminary Procedure
– Set up and testing of
abseil/rappel black
marlow rope and
equipment on tower.
• Physical – falling from
height due to faulty equipment
during testing and
demonstration.
• Ergonomics – Awkward
posture during testing,
demonstration and secondary
instructor anchoring trainee as
load.
• Engineering Control
- Install foam or net at ground
level to avoid injury or death if
falling from height.
• Administrative Control
- Frequent technical testing of
equipment (special x-ray for snap
link and figure of eight)
- Monitor equipment expiration
date.
- Training.
- Safe Work Procedures.
- Job Rotation.
- Adequate breaks/rest.
• PPE
- Helmet
Demonstration of
abseil/rappel from
tower.
Checking of each
trainee’s harness,
snap link and
figure of eight.
Primary instructor
releases trainees
individually from
tower.
Secondary instructor
anchors and receives
trainees from below
tower.
Figure 5.4C – Simplified JHA for Abseil/Rappel Instructor
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Of the hazards exposed to the Abseil and Rappel Intructor, ergonomics is the most common
work related occupational health hazard experienced. This is due to prolonged specific
ergonomic risk factors including:
a) Repetitive actions.
b) Lack of recovery.
c) Forceful exertions.
d) Awkward posture.
e) Contact stress.
f) Excessive loading for anchor.
These ergonomic risk factors may cause one or more of the common categories of
muscoskeleteal disorder:
a) Back, lower and spine disorder.
b) Shoulder and upper limb disorder.
c) Cervico-brachial disorder.
d) Neurovascular disorder.
e) Tendon disorder.
f) Muscle disorder.
Besides the recommended action for procedures, other interventions that can be taken are
having medical surveillance and establishing an ergonomics team. The ergonomics team may
be required to conduct ergonomic assessments such as:
a) Symptom survey.
b) Detailed in depth JHA.
c) Work conditions measurement.
d) Review of existing equipments and controls.
e) NORDIC questionnaire.
f) Observational methods.
g) RULA.
h) QEC.
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5.5 Jungle Warfare Instructor
The Jungle Warfare Instructor’s role and responsibility involves in training the theory and
practical application of fieldcraft and battlecraft in the jungle environment (Figure 5.5A).
Due to the frequent exposure in the jungle environment, the most common occupational
health hazard that can be encountered for Jungle Warfare Instructors are natural biological
hazards sourcing from the jungle. Some examples of biological hazards in the jungle include:
a) Hazardous bacteria.
b) Hazardous viruses.
c) Hazardous parasites.
d) Hazardous molds, spores and fungi.
e) Animals and insects.
f) Poisonous plants.
g) Disease carried by vectors (mosquitoes and rodents).
Figure 5.5 – Fieldcraft in Jungle Environment
The many possible routes of infection are:
a) Accidental injury (skin contact, cuts, wounds, etc.).
b) Contamination of food and water.
c) Animal and insect bites.
d) Poor personal hygiene.
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The types of harm that can be caused are:
a) Infection.
b) Hypersensitivity / allergy.
c) Inflammatory / irritant effect.
d) Poisonous / toxic effect.
e) Bleeding.
f) Shock.
g) Respiratory arrest.
h) GIT disturbance (vomit, diarrhea, etc.).
i) Physical injury (bites, cuts, wounds, etc.).
The Jungle Warfare Instructors are trained for first aid and to enforce standard precautions
and Safe Work Procedures including frequent routine and culture of taking care of personal
hygiene. They are also trained to identify and avoid biological hazards in the jungle
environment. Nevertheless, incidents still happen such as a case where an instructor is
infected with Leptospirosis from drinking from water contaminated by jungle rodent urine.
Additional medical, technological and organizational solutions can also be applied to limit
the effects of exposure to harmful biological agents at work (Duckiewicz, 2010) such as:
a) Protective vaccinations.
b) Constant medical care and medical checkups.
c) Advanced health education regarding nature of job.
6.0 Question 2
6.1 Definition
Stress is the arousal of an organism as a result of a stimulus from the material or social
environment that is assessed as threatening to its physical or psychological balance to an
extent that exceeds its ability to cope with the problem (Konarska, 2010). Many occupational
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stress theories have been introduced; amongst the most popular ones are Stress performance
Curve (Figure 6.1A), Karasek Job Strain Model (Figure 6.1B), Siegrist Effort Reward
Imbalance Model (Figure 6.1C) and P-E Fit (Figure 6.1D).
Figure 6.1A – Stress Performance Curve
Figure 6.1B – Karasek Job Strain Model
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6.2 Stress Complaints and Findings
There are no official data in KTD that records stress complaints amongst the employees. But
as in any organisation, elements of stress are always present in any working environment.
What should be of concerned are stress elements that cause distress, anxiety and unhappiness.
Based from military doctor’s unofficial survey, personal experience and pass incidents in
KTD, it seems that the drivers from the Logistic Support department are the most distressed.
Among the military vehicles used is the focus-demanding Condor APC as shown in Figure
6.2A.
Figure 6.2A – Rheinmetall Condor 4x4 Armored Personnel Carrier
Among the many causes of driver’s stress, the unofficial main source of stress identified is
due to shift work. The shift work involves unfair rotating shifts, inadequate work-rest ratios,
unpredictable schedules and sleep deprivation due to the demanding nature of work to
provide transportation to the field exercises involved for all the running courses in KTD.
This may cause burnout to the drivers which are hazardous to the driver and others in the
organisation.
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Organisational contributory factors may also cause distress such as work overload, excessive
bureaucracy, poor communication/feedback, role conflict and dead-end jobs. Unrelieved
work stress of the drivers will cause emotional exhaustion, depersonalization and feelings of
reduced accomplishment. Further implications to the driver:
a) Disturb the circadian body rhythm.
b) Desynchronosis.
c) Gastrointestinal problems.
d) Cardiovascular problems.
e) The distressed driver himself as a work related hazard that may contribute accidents
in the workplace such as Figure 6.2B.
Figure 6.2B – Condor Road Accident
Some of the administrative controls that can be applied are:
a) Good management of rotating or variable shifts.
b) Increase the number of drivers.
c) Provide additional health education.
d) Provide counseling.
e) Limit shift work to essential tasks.
f) Encourage good eating habits.
g) Allow adequate meals and rest breaks.
h) Protecting the driver’s sleep periods.
i) Maintain physical fitness.
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j) Driver’s family and friends should be made aware of the potential harmful
consequences of shift work.
k) Driver’s adjust family and social life to maximize interaction.
l) Job enrichment for a better career development.
m) Fair rewards.
n) Empowerment.
o) Feedback and grievance channels.
p) Employee assistance program.
q) Health promotion programs.
r) Autogenic training (relaxation technique).
s) Nootropics (cognitive enhancement supplement).
t) Somatics (awareness practices to promote psycho-physical well being).
u) Religion and spiritual activities.
6.3 Assessment of Stress Issues
Stress issues in KTD are not only experienced by drivers but everyone. There may be other
appointments in KTD with similar or more stressful condition. In order to manage the stress
of the employees, an assessment may be done throughout the workers. There are two
possible approaches for assessing stress:
a) Hire a practitioner psychologist to assess the workers.
b) Use a Risk Assessment for Occupational Stress form to get to assess worker stress
such as in Appendix A (Macbeth, 2010).
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REFERENCE
1. Dr. Rozhan Shariff Bin Radzi. Lecture Notes. 2013
2. Occupational Safety And Health Act 1994 and Regulations. Laws of Malaysia.
3. MS 1722:2011 Occupational Safety and Health Management Systems – Requirements
(First Revision). Department of Standards Malaysia.
4. Guidelines on Occupational Safety and Health Management Systems. Department of
Occupational Safety and Health. Ministry of Human Resource.
5. Koradecka N. Handbook of Occupational Safety and Health. First edition. CRC Press.
2010.
6. Ausbury S. and Ashwell P. Health and Safety, Environment and Quality Audits. First
edition. Routledge. 2011.
7. Reese C. D. Occupational Health and Safety Management : A Practical Approach.
First edition. CRC Press. 2009.
8. Mohd Sadin Misnan, Abdul Hakim Mohammed dan Abdul Rahman Dalib.
Pembangunan Budaya Keselamatan di Tempat Kerja. Edisi pertama. UTM Press.
2011.
9. Yates W.D. Safety Professional’s Reference and Study Guide. First edition. CRC
Press. 2011.
10. Friend M. and Kohn J. Fundamentals of Occupational Safety and Health. Fifth
edition. GI. 2010.
11. Posniak M. and Skowron J. Handbook of Occupational Safety and Health: Chapter 6.
First edition. CRC Press. 2010.
12. Duckiewicz J. Handbook of Occupational Safety and Health: Chapter 19. First
edition. CRC Press. 2010.
13. Konarska M. Handbook of Occupational Safety and Health: Chapter 5. First
edition. CRC Press. 2010.
14. Macbeth E. Risk Assessment for Occupational Stress. University of Essex. 2010.