asian pacific newsletter3 2005

Asian-Pacific NewsletterON OCCUPATIONAL HEALTH AND SAFETY

Volume 12, number 3, November 2005

Occupational health and safety in Asia:Practical solutions

54

Volume 12, number 3, November 2005Occupational health and safety in Asia:Practical solutions

Published by theFinnish Institute of Occupational HealthTopeliuksenkatu 41 a AFI-00250 Helsinki, Finland

Guest Editor-in-ChiefSuvi Lehtinen

Guest EditorInkeri Haataja

Linguistic EditorSheryl Hinkkanen

Layout of the cover pagesTuula Solasaari-Pekki

The Editorial Board is listed (as of28 February 2005) on the back page.

This publication enjoys copyright underProtocol 2 of the Universal CopyrightConvention. Nevertheless, short excerpts ofthe articles may be reproduced withoutauthorization, on condition that the sourceis indicated. For rights of reproduction ortranslation, application should be made tothe Finnish Institute of OccupationalHealth, Office of Information and Interna-tional Affairs, Topeliuksenkatu 41 a A, FI-00250 Helsinki, Finland.

The electronic version of the Asian-Pacific Newsletter on Occupational Healthand Safety on the Internet can be accessedat the following address:http://www.occuphealth.fi/Asian-PacificNewsletter

The issue 1/2006 of the Asian-Pacific News-letter deals with health and safety culture.

Photograph on the cover page: International Labour Organisation/

Cassidy K.

Printed publication:ISSN 1237-0843On-line publication:ISSN 1458-5944

Finnish Institute of OccupationalHealth, 2005

Asian-PacificNewsletter onOccupationalHealth and Safety

Contents

The responsibility for opinions expressed in signed articles, studies and other contribu-tions rests solely with their authors, and publication does not constitute an endorsementby the International Labour Office, the World Health Organization or the FinnishInstitute of Occupational Health of the opinios expressed in them.

Editorial 55Kazutaka Kogi

Challenges in the application of Control Banding 56Tools case studies from South IndiaR Steinberg, J Hannak, K Balakrishnan

The practical application in developing countries 60Gerry Eijkemans, Berenice Goelzer

Capacity Building of Occupational Safety and 63Health in Agriculture in VietnamInitial results of the projectVu Nhu Van

Ergonomic problems among foundry workers 65in China A field survey and simulation studyin the laboratoryLing Lei, Youxin Liang

Participatory work improvement in Thailand 68Sudthida Krungkraiwong

Prevention and control of silicosis 71 Experience in agate industryLakho J Bhagia, Harasiddh G Sadhu, Habibullah N Saiyed

Results of five years implementation of the 75National Programme for Elimination of Silicosisin VietnamNguyen Thi Hong Tu, Tran Thi Ngoc Lan, Tran Anh Thanh

Meeting in response to the World Day for Safety 79and Health at Work and the 10th InternationalNoise Awareness Day in VietnamPham Ngoc Hai

55 Asian-Pacific Newslett on Occup Health and Safety 2005;12:55

ractical workplace improve-ments are the focus of atten-tion in occupational health

throughout Asia. We are increasinglyaware that solving work-related healthproblems requires the prompt imple-mentation of locally adjusted im-provements. This is especially true insolving health problems related to theincreasingly complex work environ-ment, work methods and daily stress.We now know that we can learnmuch from many practical types ofimprovements achieved by action-oriented programmes that are spread-ing in many Asian countries.

Examples of practical solutions arenumerous. The use of hand-trucksand lifters combined with heat barri-ers, screening of hazardous sourcesand machine guards are essential inreducing health risks of various formsof materials handling work. Elbow-height workstations withconveniently located containers and controls allowing natu-ral work postures and smooth teamwork are helpful for pre-venting musculoskeletal disorders. Similarly, flexible team-work systems and supportive communication aids are con-tributing to the reduction of stress-related risks.

Case study results reported from our Asian network part-ners confirm the usefulness of these practical solutions invarious work settings. For example, experiences in our workimprovement network (www.win-asia.org) cover small en-terprises, farms, construction sites, working homes andprocessing plants. These experiences show that multiple im-provements of practical nature are usually implemented at aworkplace. When these improvements are done by using lo-cal materials and skills, they tend to be sustainable. As prac-tical improvements are in most cases readily applicable andlead to visible benefits, they can encourage local people tofurther improve their workplaces in multiple, practical ways.This is demonstrated in South and Southeast Asia, China,Korea and Japan.

Three types of support measures that can facilitate thevoluntary use of practical solutions may be mentioned. Suchmeasures are commonly used by our network partners. Theyhelp people examine practical options and benefits as well ashow to proceed. The three types are (a) presenting manypositive and simple examples of improvements achieved lo-cally; (b) utilizing solution-oriented group work tools, suchas action checklists and low-cost improvement manuals; and(c) training local trainers who act as facilitators of practical

Occupational health in Asia:practical solutions

solutions. It is encouraging that var-ious short-term training courses andworkshops, held in a number ofcountries in Asia, apply these meas-ures fully. These efforts were initiallysupported by the effective applicationof the WISE (Work Improvement inSmall Enterprises) methodology de-veloped by the ILO, and are nowdeveloped into similar action train-ing programmes for manufacturing,agriculture, construction, and theinformal sector.

It is striking that the group worksteps used in implementing practicalsolutions to work-related health riskscorrespond with the Plan-Do-Check-Act cycle of occupational safety andhealth management systems. Learn-ing positive local examples helps toplan practical solutions. The use ofaction checklists and manuals sup-

ports the implementation of risk-reducing practical improve-ments. Trainers trained in facilitating group work for theseimprovements assist local people in continual improvementwhile acting on their own positive achievements.

Evidence of the effectiveness of the practical improve-ments achieved by participatory workplace steps is accumu-lating. It is clear that accident rates fall, musculoskeletal loadsdecrease, environmental risks decline and mental strains di-minish as a result of implementing voluntarily chosen prac-tical solutions. Training in practical, low-cost improvementshas real effects.

The exchange of experiences involving the above-men-tioned types of support measures will be important for ourfuture international cooperation. This can surely be linked withthe activities of the ILO and WHO and other internationalorganizations as well as NGO networks such as the win-asianet. Communication through websites will be a great help.

Kazutaka KogiAdvisory ResearcherInstitute for Science of LabourKawasaki,JapanE-mail: [email protected]

P

56Asian-Pacific Newslett on Occup Health and Safety 2005;12:5660

IntroductionControl banding is widely regarded asa useful tool for the management ofchemical hazards in workplaces, espe-cially in small and medium-sized enter-prises (SMEs). During the internation-al planning meeting on control band-ing in developing countries, held inUtrecht, the Netherlands, June 1416,2004 under the aegis of the WorldHealth Organization (WHO), it wasagreed to further explore the possibili-ties and limitations of practically apply-ing the control banding approach incountries such as India. In line with this,the National Institute of OccupationalHealth (NIOH), Ahmedabad, and theDepartment for Environmental HealthEngineering at the Sri RamachandraMedical College, Chennai, initiatedsteps to look specifically into the fol-lowing three issues:1. the reliability of control banding in

predicting likely exposure to chem-icals, with reference to established(national) occupational exposurelimits

2. the usability of control banding inthe context of Indian small and me-dium-sized enterprises, particularlyin terms of identifying and assess-ing chemical hazards, deciding onappropriate control measures andevaluating the impact of measuresand reduction of exposure

3. identification of measures and stepsto facilitate the use of control band-ing tools by wide strata of industryin India.WHOs Task Force 10 seeks to eval-

uate the usability of some of these tools,such as the ILO Safework ChemicalControl Toolkit (1), the UK Health andSafety Executive (HSE) Control of Sub-stances Hazardous to Health Regula-tions (COSHH) Essentials and the Ger-man Gesellschaft fr TechnischeZusammenarbeit (GTZ) ChemicalManagement Guide. In emerging econ-

Challenges in the application of

Control Banding Tools case studies from South India

R Steinberg, J Hannak, K Balakrishnan, India

omies like India, although chemical useis high, the infrastructure for occupa-tional hygiene is grossly underdevel-oped. Demonstration of the validity ofalternative risk management tools istherefore considered to be of tremen-dous importance for the improvementof workplace environments.

With regard to the first issue, it wasdecided to compare, with the help ofan exploratory study, the results ob-tained with traditional occupationalhygiene methods against those obtainedwith the application of control band-ing tools in a cross-section of large in-dustries in South India. While the con-trol-banding concept may be equallyapplicable to large, medium and smallenterprises, given the paucity of base-line information in SMEs, it was decid-ed to pilot the validation on the situa-tion in large enterprises where a largedataset dealing with workplace evalua-tions was readily available to the inves-tigating team.

For the assessment of the usabilityof control banding in the context ofIndian small and medium-sized enter-prises, selected SMEs were invited toapply the ILO tool and share their ex-perience and insights. To date, only lim-ited information is available on the ap-plicability and acceptability of such riskassessment tools in SMEs in India.

In continuation of these efforts, atechnical working group meeting, thefirst of its kind to be held in India, wasorganized in April 2005 to present anddiscuss the results. This meeting in-volved different stakeholders, such aschemical manufacturers, formulators,end-user of chemicals (tanneries, textileunits, etc.) participating in the consul-tation mechanisms at the national lev-el. The purpose was to arrive at a suita-ble common course of action to addressthe above-mentioned aspects, as well asto establish a mechanism for continua-tion of efforts in India.

MethodsValidation of tools againstestablished exposure evaluationmethodsFor a period of three years the investi-gators have been conducting numerousoccupational hygiene studies in the lo-cal industry. For the purpose of the val-idation study, the results from a cross-section of 35 different enterprises rep-resenting various industrial sectors (i.e.the petrochemical, automotive, manu-facturing and engineering sectors, tan-neries, textile units, pesticide formula-tors, chemicals, glass and polymer man-ufacturers) were used as the referencedatabase.

The underlying exposure evalua-tions were based on occupational hy-giene measurements according to pro-tocols outlined by NIOSH, USA. Thespecific contaminants addressed includecommon solvents, organic compounds,asbestos, silica, acids and bases, metalfumes, and dusts.

The findings and recommendationsof the corresponding evaluation reportswere transferred to a standardized da-tasheet format. The datasheets listedsuch information as a description of thespecific operations (job tasks), thechemical name (CAS No.), the availa-ble risk information (e.g. MSDS, R-phrases), the scale of use and controls(if any) for the individual tasks.

The data thus compiled were sub-sequently run through the ILO Toolkitand the COSHH Essentials. On a se-lective basis, data were also cross-checked with the GTZ Chemical Man-agement Guide. The respective out-comes from the control band and eval-uation studies were compared in termsof (i) recommended control measuresand (ii) concentration ranges.


Assessment of the usability ofcontrol banding tools in SMEs andidentification of specific challengesBased on the investigators previous col-laboration on occupational safety &health related issues with different tan-neries in the Indian state of Tamil Nadu,India, eight voluntary tanneries wereselected for field-testing of the controlbanding tools (i.e. ILO Toolkit/COSHH Essentials and the GTZChemical Management Guide). Intro-ductory training on the application ofthe tools was given to employers andtechnical personnel in these tanneries.Then the tanneries were requested touse control banding on their own, toidentify potential hazards in handlingchemicals and to determine adequatecontrols.

The conversion of rawhides to fin-ished leather requires a great amountand a large variety of chemicals. Onaverage around 500 kg of chemicals areused for the processing of one ton ofraw material, which in the end will yieldaround 250 kg of finished leather. InIndia, leather tanning is predominant-ly carried out in small and medium-sizedcompanies. The size categorization isusually done in accordance with the in-stalled production capacities. Accord-ingly, a small-scale tannery has a dailyproduction capacity of up to 1 ton ofraw material and employs around 35workers, with the owners usually tak-ing active part in the day-to-day opera-tions.

During regular meetings betweenthe investigators and tannery represent-atives, issues and difficulties arisen dur-ing the exercise were listed and discussedwith users of the toolkits. These find-ings were compared against the findingsobtained in other countries and dis-cussed further in the technical workinggroup meeting.

ResultsValidation of the tools againstestablished exposure evaluationmethodsWith regard to the categorisation of chem-ical substances in the hazard bands, someinconsistencies were noted. For example,a comparison of the hazard band tablesused by the ILO Chemical Toolkit andthe GTZ Chemical Management Guiderevealed that some R-phrases were allo-cated to different hazard bands.

The ILO Chemical Toolkit wasfound to contain an instance of ambig-uous allocation of chemicals hazardproperties from the users point of view.For example, a layperson, for whom thetools are meant, may have difficultiesin identifying the correct hazard bandfor R40, as the ILO Chemical Toolkitdifferentiates between R40 Carc. Cat.3 and R40 Muta. Cat. 3. (Hazard bandD or E).

The R-phrases of certain chemicalsgiven in the ILO website chemicals in-formation sheets (www.ilo.org) and theMSDSs of chemical manufacturers donot match with the R-phrases listed inthe ILO Toolkit (1). This may causeconfusion when determining the haz-ard group. This was particularly the casefor the following chemical substances: As per the ILO website/IPCS, theR-phrases listed for n-butanol specifi-cally include R10 and R20. The ILOToolkit does not consider these R-phras-es in the table Hazard group allocationfrom classification definitions. R10 isnot relevant, as it describes the physicalhazard flammable which is under thepurview of the tool. This issue is notexplained in the preamble of the ILOToolkit. With regard to R20, the ILOToolkit only lists combined R-phrasesfor the respective hazard group alloca-tion. R20 appears as R20/21/22, R40/20/21/22 and R48/20/21/22. An inex-perienced user is not sure how to iden-tify the correct hazard band. In contrast,the hazard allocation matrix in the GTZChemical Management Guide explicit-ly differentiates single and combined R-phrases. In the ILO Safework Chemical Con-trol Toolkit, the preset grouping of com-mon solvents in hazard groups is notconsistent with the given R-phraseswhen reference is made to the ILOchemical information sheets and otherMSDSs. For example, as per Table 1:Hazard Group, the preset hazard groupfor identification of toluene amongcommon solvents is B. When the giv-en hazard allocation is used, however,the R-phrase 48/20 leads to hazardgroup C.

With regard to the comparability ofrecommended controls, comparisonbetween the target concentrations ofspecified hazard bands (2), recommend-ed control approaches, actual exposureconcentrations, occupational exposurelimits (OELs) and controls in place in-

dicated that some OELs are higher thanthe underlying target concentrationranges for the different hazard bands(see Table 1) (3). In some cases, the rec-ommended controls as per the outcomefrom the control bands exceed the levelof controls in place. However, the con-trols in place, which belong to lower-level control strategies as per controlband tools, are sufficient to reduce ex-posure levels below the respective OELs(see Table 2). When translated to theSME level, this implies an unnecessaryfinancial burden for the respective en-terprises.

As has been pointed out by studiesdone in other countries, the currentscope of chemical and exposure situa-tions actually covered is limited. Thishas also been confirmed by the feedbackreceived from trial applications inSMEs. Process generated components,which represent a considerable part ofthe exposure situations in the industryconcerned, fall out of the scope of thecontrol banding tools; harmful fumesor gases which evolve as a result of mix-ing of certain chemicals are not covered.

An example is ammoniacal silvernitrate, which reacts with a reducingcompound used for preparing silver-coated glass. During the process, harm-ful ammonia vapours are released. Thecontrol banding approach cannot beapplied. The same has been experiencedwith copper and zinc fumes, with tolu-ene and xylene vapours generated dur-ing different operations, or with H2S,which is occasionally generated as a by-product during leather manufacture.

With regard to the example of am-moniacal silver nitrate, the current lim-itation of practical use for risk assess-ment has become obvious. Ammonia-cal silver nitrate develops explosive prop-erties, which would need to be consid-ered for the purpose of risk assessment.As the tools focus mainly on inhalationexposure (as yet not all tools take skinexposure into consideration), exclusionof such hazard properties by the con-trol banding tool creates doubts aboutpracticability among users.

Table 1. Airborne concentration ranges (2)Hazard band Range in ppm

A > 50 to 500B > 5 to 50C > 0.5 to 5D < 0.5


Table 2. Some of the results obtained through application of Control Banding in various industries

Measurement results [ppm] Chemical

substance Process/Operation /

Task Hazard band Control

approach STEL TWA TLV

[ppm] Controls in place

Automotive supplier, brakes manufacturer Ammonia Manual dosing of

ammonia and printing of drawing sheets

C

3 14 - STEL: 35 Engineering control (LEV) and PPE

TCE Degreasing in open tank

C & S

3 270

42

190

45

STEL: 100 TWA: 50

Engineering controls: general ventilation, cooling coil in the degreasing tank and PPE

Nitric acid Dipping of material into bath in plating shop

C

3 - < 0.052 TWA: 0.05

General ventilation

Chromic acid

Auto zinc plating (Dipping of material into bath)

E

4 - 0.00075 TWA: 0.010

PPE and general ventilation

Hydro-chloric acid

Zinc barrel plating (dipping of material into bath)

C & S

3 - < 0.088 Ceiling: 2


Sodium hydroxide

Dipping material into baths (phosphating line)

C (CMG => B)

2 - 0.039 TWA: 0.61


Car manufacturer Formal-dehyde

Manual spray painting with air gun

C (D or E; R40,

carcinogenic or mutagenic?)

2 0.1 - STEL: 0.3


Toluene Manual spray painting with air gun

C & S

2 - 0.18 TWA: 50


Xylene Manual spray painting with air gun

B & S

2 - 1.5 TWA: 100


n-Butanol Manual spray painting with air gun

B

2 - 7.9 TWA: 20


Cosmetics, household cleaner Sodium hydroxide

Manual dosing during blending operation

C (CMG => B)

2 < 2.017 < 0.07 Ceiling: 1.22

PPE

Hydro-chloric acid

Manual dosing during blending operation C & S

3 2 - Ceiling: 2

PPE

Ammonia Manual dosing during blending operation

C

3 22 - STEL: 35

PPE

Glass/mirror manufacturer Ammonia* Mirror plant C

n.a - 11 TWA: 25

Fully automated, local exhaust ventilation

Xylene Manual transferring and dosing xylene in the paint mixer

B & S (CMG =>

C & S)

2 34 160 STEL: 150 TWA: 100

Engineering control (LEV) and PPE

* Ammoniacal silver nitrate reacts with reducing compound and gives off ammonia vapour

TLV: Threshold Limit Value issued by the ACGIHSTEL: Short Term Exposure LimitTWA: Time Weighted AverageCMG: GTZs Chemical Management GuidePPE: Personal Protective Equipment


Usability and specific challenges ofcontrol banding tools in SMEsThe applicability of control bandingtools fundamentally rests on the availa-bility of reliable hazard information. Asfar as generic chemical substances areconcerned, the participating companiesdid not face any problems in accessingMSDSs. However, a majority of chem-ical substances used in this sector are inthe form of preparations for which inmany cases the companies could notobtain the corresponding MSDS or R-phrases.

As pointed out above, problems wereencountered with regard to correct de-termination of hazard bands. For exam-ple, R-phrases listed for toluene includeR 11-38-48/20-63-65-67 as per theILO information sheet. This R-phrasematches partly with the R-phrase givenin the Toolkit. Furthermore, R48/20did not exist in the enumeration of theILO Toolkit. The definition All dustsand vapours not allocated to anotherband was found to be unspecific andneeded a clearer definition.

The chosen bridging examples fordetermination of respective quantitieswere found to be helpful and appropri-ate. However, with regard to the quan-tity ranges given in kg or litres, the us-ers felt that the quantity ranges were toowide. For example, the use in kg mightrefer to anything between 1 and 999kg, and 1 kg seemed to be closer to 999mg than 999 kg. The user had difficul-ties in deciding on the correct use atdifferent stages. For example: How aredilution factors taken into considera-tion? Or: How should one handle situ-ations when chemicals are mixed priorto actual use? The amount of use wasusually determined by the quantity usedat the point of processing. The users didnot apply a differentiated determinationof quantities at previous steps or taskswhere the same chemical was handled(e.g. in chemical store, in preparationor dilution, transport to the dosingpoint).

In certain compositions (e.g. paints),the boiling point was found to be aninadequate measure for characterizingvolatility. Even slight changes in con-centration, i.e. in the range of a few percent, can increase or decrease the vola-tility. In most cases, information withregard to the concentration of individ-ual components was not available.

The users were not clear about theterm operating temperature. It wasuncertain whether temperature referredto the substance or the surroundings.Besides, most users did not have anyprovisions in place to determine the ac-tual ambient temperature and relied onestimates only.

With regard to the general determi-nation of the exposure prediction band,it is felt that several additional aspectsneed to be taken into consideration toarrive at a high level of reliability andprecision. Such amendments could pos-sibly encompass aspects that are consid-ered in existing risk assessment andchemical management tools, such as theAustrian Risk assessment of chemicalagents tool (4) and the German Col-umn Model (embedded in a statutoryguideline [5]). These additional aspectsmight include: Technical setting: Likelihood of ex-

posure due to the workplace andplant design, processes and equip-ment)

Organizational issues: Frequencyand duration of exposure, numberof exposed persons, level of person-al protective equipment

Personal issues: Training, education,workload.In course of further development of

the chemical control toolkit, other haz-ardous properties such as flammabili-ty, explosives, and reactivity shouldbe also considered.

Representatives of participatingcompanies were able to use the toolsfollowing a short on-site introductionto arrive at the general control strate-gies, but they did not proceed to theactual implementation of control meas-ures based on the risk assessment. Theusers were unclear about the best wayof translating these into situation-spe-cific control measures suitable for thelocal conditions. They expressed theneed for external guidance in findingand implementing controls for any ofthe four standard control strategies.

The current control fact sheets un-der the COSHH Essentials and ILOpertain to a very few industrial sectors.The control sheets of the COSHH Es-sentials take into account Europeanframework conditions for SMEs. Acces-sibility to these was limited. It was feltthat sector-specific guidance sheets,preferably based on good practices,were required.

It was felt that basic understandingand awareness of chemical exposurehazard are prerequisites. Implementa-tion would require initial coaching instarting the process (in line as propa-gated in the GTZ Chemical Manage-ment Guide) by a facilitating structure.

As per the users, the main immedi-ate advantage of applying the tool wasthe increased awareness of the need ofinventorying and categorizing thechemicals in use. When beginning withthe application, the user recognized thatchemical management was helpful forunderstanding the companys use ofchemicals. The entrepreneurs started toassess their handling of chemicals in thevarious areas at the same time. Therebythey identified critical operations usingchemicals and started by developinginventories with all relevant informationon hazards and operational parameters.These steps are well in line with GTZsChemical Management Guide, whichuses the control band as an element ofan otherwise more comprehensive ap-proach to chemical management.

ConclusionHazard communication, in terms ofaccess to and basic understanding ofhazard information to determine haz-ard band, is the critical and, at present,the most limiting factor in the applica-tion of the tools. Existing limitationspertain to (1) availability and access torelevant hazard information (MSDS,container labels and markings) and (2)interpretation of R-phrases. The quali-ty of MSDS (e.g. in terms of correctand sufficient information content) andthe labelling of containers are inconsist-ent. The available information as re-quired by law and provided by mostlylarge-scale chemical manufacturers doesnot reach the end-users given the cur-rent structures and practices in the dis-tribution of chemicals.

Furthermore, European suppliersand their Indian subsidiaries and coun-terparts mostly use R-phrases. It is rec-ommended the R-phrases or the Glo-bal Harmonised System (GHS) stand-ards be incorporated into the IndianStandards, for easy access to relevanthazard information. Initial effortsshould focus on ensuring proper label-ling of all chemical containers alongwith the safety instructions.

To increase the understandability ofMSDS (e.g. retrieval of relevant infor-


mation), the comprehensive MSDScould be translated into simpler anduser-friendlier safety information forready use at the SME level.

Uncertainties regarding quantitiesand physicochemical parameters (due toinadequate hazard identification infor-mation) contributed the most to diffi-culties in establishing exposure bands.

Furthermore, exposures throughconscious skin contact and secondaryexposures to chemical by-products can-not be addressed using the availabletools, although this would be desired bylocal users. The approach towards ar-riving at and selecting the appropriatecontrol bands is widely understood.However, it was suggested that the ex-isting control bands be translated as sec-tor specific good practices in order tomake these more widely acceptable.Most of the control measures and equip-ment recommended in the ILO/COSHH fact sheets are not appropri-ate under prevailing local conditions.

In view of the inconsistencies be-tween tools in defining hazard catego-ries, further investigation needs to ex-amine whether these differences resultin corresponding inconsistencies in therecommended control strategies/ap-proaches. Considerable external guid-ance and support is still needed to ini-tiate the application of control bandingin SMEs. The GTZ Chemical Guidetool offers an interesting perspective inthis direction, by emphasizing the eco-nomic benefits during the initial phaseof implementation (6).

There is a need for adaptation andmodifications to make it suitable formicro-enterprises, small enterprises andthe informal sector. For example, thelimited literacy levels of owners and staffin these units pose a challenge. Thesource of information and communi-cation of these tools needs to be madesimpler for a layman (e.g. use of colourcodes to identify hazard). For this pur-pose a Training-of-Trainer approachis preferable.

As per the feedback received fromusers, there is a preference for an inte-grated chemical management approach,which integrates a simple and practicalcontrol banding instrument, rather thanhaving a tool exclusively meant forchemical risk assessment only.

References

1. International Labour Office (Programme onsafety and health at work and the environment Safework): ILO Chemical Control Toolkit,Draft Guidelines (http://www.ilo.org/public/english/protection/safework/ctrl_banding/toolkit/main_guide.pdf, date of access: 17/04/05), 15 p.

2. Evans P, Garrod A. COSHH essentials easysteps to control chemicals. In: The Global Oc-cupational Health Network, GOHNET News-letter, 2004;(7):56.

3. Tischer M, Brekendiek-Kamper S, Poppek U.Evaluation of the HSE COSHH Essentials Ex-posure Predictive Model on the Basis of BAuAField Studies and Existing Substance ExposureData; Ann Occup Hyg 2003;47(7):55769.

4. AUVA Allgemeinen Unfallversicherungs-an-stalt (Austrian Employers Liability Insurance):Sicherheitsinformation Evaluierung Che-mische Arbeitsstoffe (Safety information Riskassessment of chemical agents); Issued by AUVA(http://www.auva.at/mediaDB/48851.PDF,date of access: 17/04/05) 26 p.

5. Technische Regeln fr Gefahrstoffe 440 Er-mitteln und Beurteilen der Gefhrdungen du-rch Gefahrstoffe am Arbeitplatz: Ermitteln vonGefahrstoffen und Methoden der Ersatzstoff-prfung (Technical guidelines for hazardouschemicals 440 Determining and assessing ofhazards of chemicals in the workplace: Deter-mining of hazardous agents and methods forevaluation of substitutes); Issued by the Ger-man advisory board for hazardous chemicals(AGS), 28 p., 2002.

6. Chemical Management Guide GTZ, Novem-ber 2003, Eschborn/Germany.

7. Tischer M, Scholaen S. Chemical Managementand Control Strategies: Experiences from theGTZ Pilot Project on Chemical Safety in In-donesian Small and Medium-sized Enterpris-es; Ann Occup Hyg 2003;47(7):5715.

R SteinbergJ HannakKalpana BalakrishnanDepartment of EnvironmentalHealth EngineeringSri Ramachandra Medical Collegeand Research Institute(Deemed University)PorurChennai-600116India

E-mail: [email protected]

here is scientific and technicalknowledge available today that,if applied could prevent and con-

trol most occupational risk factors. How-ever, on a worldwide basis, healthywork environments are still the privilegeof a few, as too many workers continueto be exposed to often very serious occupational hazards. The general envi-ronment continues to be polluted includ-ing through large scale disasters.

Even in industrially developed coun-tries, there is a knowledge-applicationgap. Prevention fails more often dueto an inability to apply existing knowl-edge, adapted to specific conditions,than to an absence of knowledge. Theapplication of the available knowledgeon hazard prevention and control intoappropriate and effective solutions at theworkplace level must be further promot-ed. The wide dissemination of such so-lutions is also essential.

Observations in many countries,particularly developing countries, revealthat common constraints to the effec-tive implementation of adequate con-trol strategies include insufficient aware-ness, education and political will, short-age of adequate human and financialresources, deficiencies in information/access to information, and in commu-nication among professionals and insti-tutions, inadequate preventive ap-proaches (including too much relianceon quantitative evaluations, not enoughsource control and too complicated con-trol solutions), as well as failure to in-volve workers and their representativesdirectly in problem-solving processes.

For many years the World HealthOrganization has promoted the preven-tion and control of occupational riskfactors. The Global Strategy on Occu-pational Health for All recommends anumber of key principles for interna-tional and national occupational healthpolicies, which include the following: avoidance of hazards (primary preven-

tion) safe technology optimization of working conditions integration of production with health

and safety activities.

Gerry EijkemansBerenice Goelzer, WHO

T


When the Health and Safety Exec-utive (HSE, United Kingdom) devel-oped COSHH Essentials, both the ILOand WHO decided to promote this toolinternationally. The underlying conceptfor the COSHH Essentials has beencalled control banding (now renamedoccupational risk managementtoolkit). In the past, WHO has devel-oped PACE (prevention and controlexchange), and ILO has developedWISE (Work Improvement for SmallEnterprises). The experiences learnedfrom those initiatives were important forthe implementation of the controlbanding.

The key objective of the promotionof the International Chemical Toolkitis to support countries to focus theirefforts on the control of hazards, insteadof only focusing on the assessment ofthe hazards. An International Techni-cal Group (ITG) was established withrepresentatives from WHO, IPCS, ILO,IOHA, HSE, NIOSH and GTZ in2004, and prepared a structure for theproject, aiming at individual work plansand including twinning of organizationsfor mutual support, exchange of infor-mation and experiences thus strength-ening the activities and avoiding dupli-cation. One important aspect is capac-ity building and training.

Under the Strategy, a meeting wasorganized in Utrecht in June 2004, bythe Occupational Health Team ofWHO, together with the InternationalProgramme for Chemical Safety (IPCS).The objective of the meeting was tolaunch effective action in selected coun-tries, including the elaboration of mod-els and strategies for implementation atthe country level. Representatives of(upcoming) WHO Collaborating Cen-tres in four countries participated; fromtheir experience, it was expected that theproject will be expanded to includemany more countries. International col-laboration can appreciably strengthennational capabilities for the preventionand control of health hazards in thework environment, thus contributing tothe protection of workers health andof the environment, worldwide. Shar-

ing of knowledge and experiences willalso contribute to avoid duplication ofefforts and waste of valuable resources.

The specific objectives of this meet-ing were: To plan pilot projects for the imple-

mentation of the chemical safetytoolkit and occupational hygiene infour countries (Benin, Brazil, India,South Africa)

To develop effective twinning strate-gies with the implementing agenciesin the four pilot countries

To plan the training activities on thechemical safety toolkit in the four se-lected countries

To develop a network of experts thatwill support the implementation ofthe project in the selected countries.

Participants were from Benin (Uni-versit dAbomey Calavi, UnitdEnseignement et de Recherche enSant au Travail et Environnement),Brazil (Fundacentro), India (NationalInstitute of Occupational Health,Ahmedabad and Department of Envi-ronmental Health Engineering, SriRamachandra Medical College and Re-search institute, Chennai), South Afri-ca (National Centre for OccupationalHealth, Industrial Health ResearchGroup and Occupational & Environ-mental Health, Faculty of Health Sci-ences, University of Cape Town), Bel-gium (Universit Catholique de Lou-vain), the Netherlands (TNO), Switzer-land (Institut Universitaire Romand deSant au Travail (IST, Lausanne), Serv-ice Cantonal de Toxicologie Industrielleet de Protection contre les PollutionsInterieures, Geneva), the United King-dom (HSE), and the United States ofAmerica (NIOSH). Participants workedtogether for three days to work towardsthe development of strategies for effec-tive intervention. Representatives ofWHO, IOHA and UNITAR were alsopresent.

During the first day of the meetingthe concepts of Control Banding, theInternational Chemical Toolkit, theGTZ Chemical Management Toolkitand other similar tools were presentedand discussed. The next days were spent

on the development of pilot projects inthe four countries, taking into accounttheir specific needs, capacities, legisla-tion, culture and other relevant aspects.

The pilot projects that were devel-oped included the following phases:plan, implement, evaluate and improve.The pilot project also included aware-ness raising, training, and developmentor adaptation of practical and effectivepreventive solutions for specific jobs. Itwas discussed that this could be en-hanced by a Database of Control Solu-tions and Mechanisms for continued ex-change of experiences and information.In each country, an intermediary wasidentified. This would be the organiza-tion or institution that receives thetraining (train-the-trainers) and willsupport the selected workplaces in theimplementation of the project. Thesecould be national institutes, local/na-tional governments, universities, non-governmental organizations (NGOs) orother relevant stakeholders.

Main outcomes andconclusions of the meetingThere was a general consensus (comingfrom earlier discussions international-ly) that the title of the methodology hadto be changed for a number of reasons.The title Control Banding is adequatefor the method initially designed by theHSE and transformed into the Inter-national Chemical Toolkit, for chemi-cals that are used, either in the liquid orpowder form. However, the principle ofacting (whenever appropriate) without,or before, carrying out quantitative eval-uations opens wider possibilities thatshould not be overlooked and which donot exactly fit into the banding ter-minology. This is the case when specif-ic guidance is given for specific risk fac-tors, e.g.., silica. For example, the HSEhas developed much control guidanceto avoid exposure to airborne dust con-taining silica; this is called Silica Es-sentials. It is possible and desirable toexpand the concept to other hazards andalso to specific operations. Moreover,the translation of the term ControlBanding into other languages has

The practical application in developing countries


posed some problems. For these reasons,a broader title to indicate the use of thisconcept has been sought and the deci-sion was to name it Occupational RiskManagement Toolbox. To avoid initialmisunderstandings, the term Occupa-tional Risk Management Toolbox willbe accompanied by Control Banding,in brackets. The Toolbox will contain aset of Toolkits (for example: ergonom-ics, noise, working conditions) that willbe developed over time.

Country projectsThe participants divided into four sub-groups, one for each represented coun-try. The objective was to develop an ac-tion plan for each country, after brain-storming on the following basic ques-tions: What is needed for control banding

to be useful in developing countries?Which tool to use?

What is needed to implement it? How to reach the established targets? How to achieve sustainability?

Four pilot projects were developed.Each country made effective use of theavailable resources, twinning institu-tions and experts. For the detailed pilotprojects please refer to the WHO Web-site, where the full report of the meet-ing will be posted (www.who.int/oeh).

Benin focused the pilot effort on theagricultural sector (cotton). The GTZChemical toolkit was selected as the firstchoice instrument for this intervention,since there is guidance available on pes-ticides.

Brazil decided to focus the effort onsmall and medium enterprises (SMEs)that use chemicals, for example, furni-ture and shoe manufacturing and paintrecycling.

India proposed the development ofthree pilot projects for medium to largeenterprises in Western India, mediumto large enterprises in Southern India,and a small enterprise test project (ex-ploring the relations with ILOs Inter-national Programme on the Eliminationof Child Labour).

South Africa decided to link the pi-lot project with the newly adopted (June04) National Programme for the elimi-nation of silicosis, focusing on quarriesand foundries.

Some of the initial draft proposals,which were prepared during the meet-ing, would form the basis for more de-tailed projects.

Supporting activitiesIt was considered by all participants thateducation and training are of funda-mental importance, as well as other as-pects of capacity building such as facil-ities, equipment and access to informa-tion. It was also concluded that the im-possibility of carrying out quantitativeexposure assessment should never be ablockage to the implementation of ob-viously required control measures. Al-though exposure assessment is necessaryin many cases, there are situations whenmuch can be achieved without it. Thisdoes not mean that exposure assessmentis not important.

A database containing control solu-tions for specific operations would bedesirable. HSE, NIOSH and other in-stitutions already have a sizeable collec-tion of tested controls. An inventory ofexisting solutions should be elaborated,as well as guidance for its application,which may require adaptation (as somemeasures may not be feasible in all situ-ations). It is necessary to develop solu-tions which are adequate for SMEs.Solutions designed or adapted for usein developing countries should also bepart of this database. It should be keptin mind how important it is to searchfor source control solutions, includingsubstitution, modification, and workpractices. It should also be pointed outthat, particularly concerning inhalationhazards, personal protective equipmentshould be regarded as a last resort.

It was considered important to cre-ate an interactive, annually updatedCD-ROM of the International Chemi-cal Toolkit. This has now been producedby HSE and ILO.

Progress made so farIn Brazil, Fundacentro has translated animportant part of the toolkit, and isimplementing it in small enterpriseswith several partners. In South Africa,the National Programme on the Elimi-nation of Silicosis has been establishedunder the leadership of the Ministry ofLabour, and the feasibility of the use ofthe silica essentials is being evaluated.A first report has been presented by theNIOH for this purpose. In Benin, thefeasibility of applying in agriculture isbeing studied. In this issue the resultsof the pilot testing in India are present-ed. Additionally, the internationaltoolkit is being evaluated in Singaporeby the Ministry of Manpower.

Conclusions and the wayforwardThe usefulness of the toolkit for indus-trially developed countries has been ef-fectively demonstrated in Europe, par-ticularly in the UK. The use in devel-oping countries will, however, be verydifferent, with particular issues that haveto be addressed, such as political will,scarce resources, language, just to men-tion a few.

The development of the pilotprojects is a first step on the long waytowards effective implementation ofcontrol strategies at a large scale in theSouth. They will permit to identify is-sues related to sustainability, bottle-necks, critical factors for success and theneed for additional research and re-sources (materials, databases, transla-tion, etc.). The (political) commitmentof all participants, and the quality of thepilot projects developed, indicate thatthere is a good possibility for success.Support for those, and similar initiativesin other countries will be needed.

For further information please contactDr. Gerry Eijkemans at the WorldHealth Organization.

Websites for further information:

www.coshh-essentials.org.uk

www.ilo.org/public/english/protection/safework/ctrl_banding/ index.htm

www.unece.org/trans/danger/publi/ghs/ghs.htm

http://www.who.int/occupational_health/publications/newsletter/gohnet7e.pdf

Gerry EijkemansBerenice GoelzerOccupational HealthWorld Health Organization20, Avenue AppiaCH-1211 Geneva 27Switzerland

E-mail: [email protected]


Risks of occupationalaccidents and diseases inagricultural productionAgriculture plays an important role insocio-economic development in Viet-nam. 57.9% of the labour force wasengaged in agricultural production in2004. Farmers are exposed every day tomany safety and health hazards relatedto agricultural work, such as sunstroke,awkward posture, exposure to pesti-cides, unsafe use of electricity and ma-chines, that increase the risk of occupa-tional accidents. Statistics show that onaverage, the proportion of accidentscaused by electricity to one thousandworkers in agriculture is 7.9, and therespective figure for accidents caused bymachines and equipment in agricultureis 8.6 (MOLISA, internal report onoccupational safety and health in 2004);on average, more than 30% of poison-ing cases are caused by pesticides andchemicals; 76% of direct sprayers ofpesticides suffer from vertigo, 69.7% ofthem have symptoms of headache, and36.6% have symptoms of rash. Thesethreaten labourers safety and health,and probably push them into povertyand debt. Modernization of agricultureand increases in productivity and out-put are necessary to reduce poverty andraise living standards among farmers. Itis therefore urgent to take feasible meas-ures to safeguard labourers from acci-dents and diseases.

The projectThe project Capacity Building of Oc-cupational Safety and Health in Agri-culture in Vietnam (RAS/04/M01/JPN) funded by the Government ofJapan was launched in May 2004. It isimplemented on the basis of tripartitecooperation in which the Ministry ofLabour, Invalids and Social Affairs

(MOLISA) functions as the Govern-ments representative agency while theMinistry of Health, Ministry of Agri-culture and Rural Development, Viet-nam Cooperative Alliance (representa-tive of employers), the Vietnam Farm-ers Association (representative of farm-ers as employees), the Vietnam WomenAssociation and relevant agencies andorganizations involved in this project actas collaborative agencies. The Interna-tional Labour Organisation is theprojects executing agency and providesgeneral technical support. The project,which has been implemented in fourselected provinces Ha Nam, Nghe An,Can Tho and Hau Giang aims to ac-celerate practical activities that will im-prove working conditions and ensureoccupational safety and health in agri-culture in Vietnam, by means of policyassistance at the national level and ini-tiative promotion at the grassroots lev-el. It also supports preparations towardsratifying the ILOs Convention No. 184on occupational safety and health(OSH) in agriculture.

The project is driven by three im-mediate objectives: (1) at the end of theproject, national policy and legislativeframeworks will have been strengthenedto support farmers initiative in improv-ing safety, health and working condi-tions; (2) sustainable support mecha-nisms to the self-help initiative of localfarmers in improving safety, health andworking conditions will have been es-tablished; and (3) at the end of theproject, local farmers in the projectprovinces will have the capacities forcontinuous improvement of safety,health and working conditions in agri-culture.

After one year of operation, the ini-tial results gained show that the projectsmajor objectives have been addressedseriously and realized effectively.

Activities of the projectDevelopment of national policy and leg-islative frameworks to support farmersinitiative in improving safety, health andworking conditions is one of the threemajor objectives of the project. In real-izing this objective, the MOLISA hasdeveloped the National Program onLabour Protection and has made thedraft version available for discussion atnational and international workshops,such as the workshop Development ofthe national OSH programme held inHa Long, Quang Ninh in March 2005and attended by representatives ofASEAN countries.

A taskforce for developing the na-tional profile of OSH has been set up.It includes 21 members from 18 func-tional and relevant agencies and organ-izations. Fundamental informationfrom the national profile has been usedto develop the national programme onlabour protection. Members of the Na-tional Council for Labour Protectionwill be consulted about the draft ver-sion before its submission to the Gov-ernment for approval by the end of2005.

A set of training materials on OSHin agriculture has been completed dur-ing the implementation of the project.Among the training material producedare: (1) training material on OSH inagriculture (WIND program); (2) a setof photo books on OSH in agricultureand manuals for implementing activi-ties as well as for supervising and report-ing the improvements made. The set ofmaterials focuses on action-orientedtraining methods, the aim being toguide farmers as they make improve-ments in OSH and working conditions.

The training material on OSH inagriculture (the WIND programme)consists of an action checklist and fivetechnical topics on: (1) materials stor-

Capacity Building of Occupational Safetyand Health in Agriculture in Vietnam

Initial results of the project

Vu Nhu Van, Vietnam


age and handling; (2) safety in the useof electricity and agro-mechanical ma-chines; (3) appropriate arrangement ofworkplaces; (4) the work environmentand safe use of chemicals; and (5) wel-fare facilities. This manual provides notonly fundamental knowledge of OSHin agriculture but also introduces pic-tures of typical improvements and prac-tical measures for improving workingand living conditions with the materi-als and capacity available to farmers andat low cost.

The set of photo books on OSH inagriculture was compiled from hundredsof pictures of local typical improvementsmade after training courses. Thousandsof flyers, leaflets and posters about theprogramme on OSH in agriculture andon improving farmers working condi-tions have also been disseminated tofarmers. These materials are effectivesupport tools for agricultural labourerstraining.

Beside activities at national level,activities at grassroots level have alsobeen actively implemented by theproject support committees in the se-lected provinces. The provincial projectsupport committees have organizedeight pilot training courses on theWIND programme, attended by 244farmer trainees. After these courses,farmers have made 275 improvements,58 of which dealt with agro-productstorage and handling, 16 with safety inthe use of electricity and agro machines,76 with appropriate arrangement ofworkplaces, 50 with the work environ-ment and safe use of chemicals and 75dealt with welfare facilities.

The improvements were initiated bysimple actions that are easy to do. Theinitial actions involve the making ofmulti-level shelves for storing agro-products, materials and tools. Actions

gradually shift to improvements inworking conditions, and subsequentlyto the prevention of occupational acci-dents and diseases by means of guard-ing moving parts of machines andequipment and to storage and safe useof chemicals.

Following the training courses onOSH in agriculture, workshops review-ing the results of the improvement thatwere introduced were held in April 2005in the selected provinces. Each work-shop was attended by 50 representativesof agencies in the provinces, districtsand communes. Some farmers who hadcarried out typical improvements wereinvited to the workshops to present theirimprovements.

The initial results have been, andwill keep on being, disseminated to oth-er farmers in order to improve workingconditions and ensure occupationalsafety and health in agriculture. Thepilot training courses for farmers haveproved the practical impacts of theproject. However, because the need toprovide training for farmers is so great,it is necessary to organize training cours-es given by farmer volunteers. For thisreason, a training of trainer course for

farmer volunteers was held in Nghe Anon 815 June 2005, after which pro-vincial project support committees wereset up to organize other courses forfarmer volunteers in their localities.

Activities to beimplementedIn 2005, each of the selected provinceswill hold four training courses, eachwith 20 farmer volunteers. Farmer vol-unteers will be trained in how to pro-vide training in the mini-WIND meth-od for other farmers living in their area.They will also be given the necessarymaterials (the WIND training materi-al, book of photos on OSH in agricul-ture, a notebook of improvements, a bagand hat, etc.).

One important point is to selectappropriate volunteers, who are able tohelp the local authorities and the pro-vincial project support committees todisseminate knowledge of OSH in ag-riculture directly to other farmers andwho are able to support these farmerscarry out improvements. Around 240mini-WIND courses are planned to beheld by volunteers in the selected prov-inces in 2005. In the coming years, thenetwork of farmer volunteers will beexpanded.

The initial results of the project arealso good examples. They provide valu-able experience and useful informationfor OSH performance in agriculture inVietnam.

Vu Nhu VanDeputy Director-GeneralBureau for Safe WorkMinistry of Labour, Invalids andSocial Affairs, No. 12 Ngo QuyenHanoi, VietnamE-mail: [email protected] by Vu Nhu Van

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IntroductionChina is undergoing a unique transi-tional period of economic reform whichis bringing about tremendous changesin both production technology and theorganization of labour, for which rea-sons we may face a variety of emergingchallenges with respect to occupationalhealth and safety. With stringent con-trol of chemical and physical hazardssince the Occupational Diseases Preven-tion and Control Act, (the ODPC Act),PR China, was passed, work-relatedmusculoskeletal disorders have gradu-ally become one of the most predomi-nant problems in occupational health.There is an urgent need for more ef-forts devoted: i) to ergonomic issues,particularly in modern industries witha better work environment but a lackof proper work station design and ade-quate organization of labour; and ii) tosmall-scale industries where the physi-cal workload is heavy and work postureis awkward.

As is the case with efforts to controlother occupational health hazards, therecognition of ergonomic problems isthe precursory step towards an optimalapproach to control that includes assess-ment of risk factors and health moni-toring, the aim being to provide an ev-idence base for further ergonomic in-tervention. This article presents a casestudy conducted among foundry work-ers, field surveys, and a simulation ex-periment carried out in a laboratory; allefforts that were made in order to gaina better understanding of the possiblemechanisms of the problem.

Foundry work process has long beenregarded as a highly hazardous occupa-

tion. It is characterized by heavy expo-sure to both chemical and physical haz-ards as well as ergonomic loading. Al-though profound change has occurredin foundry technology and in the ma-terials used, the basic process and po-tential hazards remain much the samein many foundries. In fact, metal cast-ing is still a labour-intensive and com-plex process requiring significantamounts of repetitive manipulation andstressful physical and postural loads, andthus is associated with work safety prob-lems, including musculoskeletal disor-ders caused by manual materials han-dling and acute injuries caused, amongothers, by falling or moving objects.However, in the past, many more effortswere focused on the adverse health ef-fects resulting from exposure to chemi-cal risk factors; few studies have been

done to assess and seek solutions to er-gonomic problems in China.

A general description of thefoundry work processesAs shown in Figure 1, three major tasksmake up the foundry process: mould-ing; cleaning; and turning. The produc-tion of the cast starts from mouldingand includes sand preparation, core-making, moulding, pouring and shak-ing out; then cleaners removed the ex-cess metal from the cast and polish; af-terwards, the cast is further processedby turners, yielding the final article. Thestudy population was recruited fromworkers who were working directly forthe foundry. The miscellaneous group,including electricians, mechanicians,administrative personnel and cooks,served as controls for the study.

Ergonomic problems amongfoundry workers in China

A field survey and simulation study in the laboratory

Ling Lei, Youxin Liang, P.R. China

Fini shedCasting

Sandpreparation

M olding

Core making

MeltingAlloying

Chargepreparation

CleaningPolishing

Shakeout

Mold pouring & cooling

Latheoperating

ProductsFigure 1. The foundry work process


Field survey

Prevalence of musculoskeletaldisordersWell-trained interviewers used ques-tionnaires to interview 617 foundryworkers, who also received a physicalexamination by an orthopedist. Itshowed that the highest prevalence ofpain occurred in the lower back(29.2%), followed by shoulder pain(10.5%), but there was no significantdifference among four groups. Thepositive rate of backache (16.9%)among moulders was significantly high-er than among others; and was followedby cleaners (9.5%).

However, when work-related musc-uloskeletal disorders were defined as painthat had started in the current work andhad lasted for more than one week with-out a history of injury in that body part(1), the prevalence of musculoskeletaldisorders differed significantly amongvarious groups. The prevalence of work-related low back pain among mouldersand cleaners was 29.9% and 26.2%, re-spectively; this was significantly higherthan that among turners (15.4%) andthe miscellaneous group (14.4%).

Work system analysisThe ergonomic workplace analysis (2)and the Ovako Working-posture Ana-lyzing System (OWAS) (3) were used to

assess the risk factors inducing muscu-loskeletal disorders. Awkward work pos-tures and movements, and heavy noiseexposure were found to be common infoundry work (see Figures 25). Forexamples, 1) Lathe operators worked ina standing posture, bending forwardslightly (61.7%) and with repetitivemotions of the arms for the entire workshift. 2) Cleaners almost always workedwith the back bent (87.2%) and hadhand exposure to vibration. 3) Mould-ers also frequently carried out manualmaterials handling activities, includingshovelling (17.4%), pressing (15.9%),lifting (8.8%) and carrying (10.2%) inaddition to the posture with the backbent.

Figure 2. Cleaning and polishing Figure 3. Lathe operation

Figure 4. Moulding Figure 5. Pouring

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Surface ElectromyographyMeasurementsThe activities of trunk muscles theerector spinae, rectus abdominis andexternal oblique muscles on both sides were recorded and analysed during fivemoulding work cycles. A Noraxon Tele-myo 8-Channel System of Surface Elec-tromyography (sEMG) was used for thispurpose (see Figure 6). It was found thatthe erector spinae muscles had the high-est averaged sEMG values for all thetrunk muscles, with over 20% of themaximum voluntary contraction(MVC), and up to 50% of the MVCfor some motions, which reached about420 times that of the static postures.By contrast, the averaged sEMG valuefor the rectus abdominis muscles wasless than 10% of the MVC. Unsymmet-rical sEMG accounted for 60% of theworking time, the average difference insEMG values between the two sides ofthe body reached 5 times, while thegreatest difference between the two sideswas 100 times. Further analysis alsoshowed that lifting, carrying and tamp-ing produced high sEMG signals andshovelling caused asymmetric signals. Itwas concluded that imbalanced trunkmuscle activities and overstrain due toasymmetric motions of the body sidesmight be the main reasons for back in-juries among moulders.

Simulation study at thelaboratoryIn simulation of moulding work, tenhealthy volunteers were asked to per-form 100 repeated lifts, at a pace of 8times/min, within a span of 12.5 min-utes. The interval between two lifts was7500 ms; the object weighed 100N andwas 493922cm3 in size. The sEMGsof the erect spinae muscles were record-ed during repeated lifts and two maxi-mum voluntary contractions (MVC)before and after lifting in order to ana-lyse amplitude and frequency. Com-pared against the values measured be-fore repeated lifts, the median frequen-cy intercept was significantly decreasedamong 80% of the subjects; it averaged11.60 Hz (14.58%) on the left side and9.52 Hz (12.65%) on the right side ofthe erector spinae muscle. Spectrumpower analysis showed that the centralfrequency shifted to the left. The repet-itive lifting imitating the moulding taskwas able to induce fatigue of the erec-

tor spinae muscle, which might be themechanical basis for chronic back in-jury among moulders.

Recommended ergonomicinterventionsThe moulding process was one of themost harmful jobs with regard to lowback injury; the main risk factor waslifting. Both repetitiveness and ergo-nomically poor performance of liftingcould pose the risk of inducing low backinjury. Ergonomic intervention wastherefore recommended:Health surveillance. Employers are re-quired to examine workers for symp-toms of musculoskeletal disorders peri-odically. Those workers suffering fromsevere low back pain are then transferredfrom their original jobs or referred toseek medical treatment.Development of production technology.Employers are required to improve au-tomation and to minimize the compo-nent of manual materials handling, es-pecially lifting.Improvement of work loading andposture. A work platform of appropri-ate height is needed for cleaners to pre-vent their working in bent postures. Formoulding workers, the tasks involvinglifting should be improved; good han-dles are needed in order to decrease theload of lifting and to shorten the dis-tance of carrying.Organization and schedule optimiza-tion of work. Technology trainingshould be conducted among employ-ees in order to minimize the risks causedby inadequate work performance. In

addition, the work breaks should belonger, with proper relaxing physical ex-ercises.Personal protective equipment. Thepersonal protective equipment is need-ed to prevent workers exposure to noiseand vibration as well as to prevent inju-ries at work.Dissemination of ergonomic knowledge.Workers should be empowered by pro-viding them with basic knowledge andskills in ergonomics. This would im-prove their work style and work pos-tures, thus contributing to self-preven-tion of musculoskeletal disorders, localfatigue, and work injury.

References

1. Bernard B, Sauter S, Fine L, Petersen M, HalesT. Job task and psychosocial risk factors forwork-related musculoskeletal disorders amongnewspaper employees. Scand J Work EnvironHealth 1994;20:41726.

2. Ahonen M, Launis M, Kuorinka T. ErgonomicWorkplace Analysis. Helsinki: The Finnish In-stitute of Occupational Health, 1989:130.

3. Louhevaara V, Suurnkki T. OWAS: a methodfor the evaluation of postural load during work.Training Publication II. Helsinki: Finnish In-stitute of Occupational Health, 1992.

Dr. Ling Lei, Associate ProfessorProf. Youxin LiangDepartment of OccupationalHealth, Fudan University School ofPublic Health138 Yi Xue Yuan RoadShanghai 200032, P.R. China

E-mail: [email protected]: [email protected]

Figure 6. Surface electromyography testing for moulding work

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IntroductionDuring the past decade, occupationalsafety and health (OSH) conditions inThailand were seen as unsatisfactoryeven though the rate of occupationalinjuries (occupational accidents and dis-eases) showed a somewhat decreasingtrend. According to the WorkmensCompensation Fund, in 1992, therewere 131,800 cases of occupational in-juries; the rate of occupational injuriesper 1,000 workers was 43.7 for all cas-es, 17.6 when excluding cases that ledto sick leave lasting 3 days or less. In2003, a total of 210,673 cases of occu-pational injuries occurred, and the rateof occupational injuries per 1,000 work-ers was 29.9 for all cases, 8.1 when ex-cluding cases that led to sick leave last-ing 3 days or less.

Participatory workimprovement: occupationalinjuriesThe Department of Labour Protectionand Welfare has conducted various ac-tivities to improve working conditionsand the environment at workplaces inorder to reduce the rate of occupation-al injuries. One famous and very pow-erful activity is the participatory ap-proach by using the Work Improvementin Small Enterprises, or WISE Tech-nique. The WISE approach was devel-oped by the ILO and is implementedin many industrializing countries, withsupport from the ILO. The WISEmethodology has proved to be effectivein improving working conditions andproductivity at many workplaces. Inmany countries it has also been provedthat participatory training courses andadvisory labour systems can play vitalroles in mobilizing managers and work-ers to take self-help actions in order toimprove working conditions, the workenvironment and productivity.

National Institute for the Improve-ment of Working Conditions and En-

Participatory workimprovement in Thailand

Sudthida Krungkraiwong, Thailand

Year Workers under Occupational Occ. injuries rate/1,000 Workersthe Workmens injuries All Cases involvingCompensation Cases 3 days of sick

Fund (N) leave excluded1992 3,020,415 131,800 43.7 17.61993 3,355,805 156,548 46.7 17.71994 4,248,414 186,053 43.8 15.71995 4,903,736 216,335 44.1 15.11996 5,425,422 245,616 45.3 15.61997 5,825,821 230,376 39.5 12.81998 5,145,830 186,498 36.2 11.71999 5,321,872 171,997 32.3 10.22000 5,417,041 179,566 33.2 9.72001 5,544,436 189,621 34.2 9.42002 6,541,105 190,979 29.2 8.12003 7,033,907 210,673 29.9 8.1

vironment (NICE) first started to ap-ply the WISE approach in Thailand in1986, where it was used for the owners,managers and supervisors in small andmedium-sized enterprises located inBangkok and the provinces. In 1996,NICE launched a WISE methodologyproject for enterprises with a highnumber of occupational injuries. Wefound that enterprises participating inthe project were able to improve theirworking conditions and the work envi-ronment, and especially were able toreduce the number of occupational ac-cidents. (See Table 2)

Participatory workimprovement: hot workenvironmentsWe also applied the WISE approach atenterprises where the work environmentwas problematic; for example, at a lampmanufacturer where environmental heatposed the possible problem of heat stressto workers. On the basis of the WISEchecklist and brain-storming, it wassuggested that the working group placea shield between the furnace and theworkers. Using a wet bulb globe ther-mometer we measured the environmen-

Table 1. Occupational injuries in Thailand 19922003

Table 2. Number of occupational accidents occurring in 19951997 at six metalpressing factories

Enterprises Workers Occupational accidents (N)(N) 1995 1996 1997

Factory A 115 32 13 10Factory B 24 22 3 1Factory C 54 15 3 2Factory D 15 11 3 0Factory E 20 4 3 2Factory F 28 3 0 0


tal temperature and the temperate atthree distances from the furnace: near= less than 101 cm, intermediate = 101250 cm and far = more than 250 cm.We found that if a shield was in place,the temperature for the distance in ques-tion was lower than that measured forthe same distance without a shield. Inparticular, the globe temperatures for

Table 3. Result of applying a work/rest regimen (each hour) before the improvement(without a shield) and after the improvement (with a shield)

Distance from the furnace Work / rest regiment (each hour)Without a shield With a shield

Near = less than 101 cm 0 50 / 50Intermediate = 101250 cm 25 / 75 75 / 25Far = more than 250 cm 25 / 75 75 / 25

the same distances, were the highesttemperatures among each group.

From the ISO 7243 - 1982: HotEnvironments - Estimation of the HeatStress on Working Man, Based on theWBGT Index, we found that the sim-ple improvement of setting up a shieldcan increase the duration of workingtime (Table 3).

Participatory workimprovement:musculoskeletal disordersNICE is also conducting the DREAM(Durable Risk-reduction EmphasisedActivity to prevent Musculoskeletalproblems at work) Project, which is aparticipatory approach aiming to im-prove working conditions and workenvironment at enterprises whose work-ers have problems with musculoskele-tal disorders. We use ISO/TS 20646Ergonomics procedures for the im-provement of local muscular workloadsas our guideline. We found that manyworkplaces can improve their workingconditions and work environment inorder to reduce workers muscular work-loads. In the polishing process, for ex-ample, workers have to sit and bend

Figure 3. Environmental measurement indicating the effect of the shield

Figure 1. A worker in front of the furnace Figure 2. Environmental measurement with a shield in place

Effect of the shield

0 5 1 0 1 5 2 0 2 5 3 0 3 5 4 0 4 5

Far without S

Far with S

Mid without S

Mid with S

N without S

N with S

WBGTGTD BW B


their bodies forward to polish materi-als. Their seats were without backrestand footrest could not be adjusted.

After a group discussion, it was de-cided to improve the seats by havingchairs with backrests and by having ad-justable footrests. A survey conductedamong the workers before and after theimprovement revealed that the workerswere satisfied with the new chairs, whichhad a backrest, and with the adjustablefootrests, especially as these can reducemuscle workload. (Table 4.)

Another factory made improve-ments to work organization. There wefound that efficiency was improved af-ter the improvement. As an example,before the improvement the workershad to lift the same piece up and downnine times, whereas after the improve-ment they had to lift the same piece onlysix times. (Table 5.)

ConclusionThe participatory approach has provedto be effective in improving workingconditions and the environment atworkplaces, and is thus also effective inimproving productivity. If we focusimprovement efforts on the cause sourceof occupational injuries, we can reducethe numbers of occupational accidentsand occupational diseases.

Literature

National Institute for the Improvement of Work-ing Conditions and Environment. OccupationalSafety and Health Situation Report year 2004.Department of Labour Protection and Welfare,2005.

Ms. Sudthida KrungkraiwongChief, OSH Development SectionNational Institute for theImprovement of WorkingConditions and Environment(NICE)Department of Labour Protectionand Welfare, Ministry of Labour22/22 BaromrajchachonnaneeRoadTaling ChanBangkok 10170Thailand

E-mail:[email protected]

Table 4. Workers comments concerning the situation before and after the improve-ment

Workers comments Before After

Appropriate chair size and comfort Poor / Fair Goodwhile sitting

Suitable height of chairs Fair Good

Suitable backrest Poor Good

Appropriate distance between chairs Poor Goodand footrest

Reducing fatigue while resting Poor Goodon the backrest

Table 5. Efficiency before and after the improvement

Improvement Before After Improvementin efficiency

Safety and ergonomics increase 9 times/piece 6 times/piece 33 %(lifting up and down)

Reduction in work in process 180 sets 30 sets 83 %

Reduction of delay time 0.553 hour 0.1196 hour 73 %

Reduced moving part distances 21 meters 4 meters 81 %

Fewer operators needed 4 persons 3 persons 25 %

Smaller area needed 16.5 meter3 10 meter3 40 %

Figure 4. Before the improvement, polishing process workers sat without a backrestand footrest could not be adjusted.

Figure 5. After the improvement chair with a backrest and adjustable footrest


IntroductionAgate, a variety of chalcedony knownto the world for more than 6,000 years,is a mineral containing a high percent-age of crystalline silica. The Indian ag-ate industry is principally a cottage in-dustry situated in Khambhat (the seaport of Cambay) and surrounding vil-lages in the state of Gujarat, and inJaipur city of Rajasthan, India. Kham-bhat has been well known for produc-ing agate jewellery and decorative arti-cles for many centuries. This industryemploys a large number of workers(about 15,000) and earns valuable for-eign currency. Being a home-based in-dustry, it is outside the purview of ex-isting regulations such as the FactoriesAct, Workmens Compensation Act, etc.

The making of agate jewellery anddecorative pieces consists of the follow-ing sequence (Figure 1). The agatestones are baked in small earthen potsand then broken down (chipped) to therequired size and rough shape with asmall hammer. The stones are thenabraded against the rotating emerywheel of a grinding machine, to give thefinal shape. After grinding, the articlesare polished in a closed rotating drumcontaining water and grinding powderconsisting of silica flour or other abrad-ing material, e.g. dust produced duringthe grinding of agate stone. Very littleor no dust is generated during the proc-ess of baking, chipping and polishing.

Exposure to airborne dustAirborne dust generated during theprocess of grinding pervades the workenvironment and the adjacent areas.The grinders who are nearest to thesource of dust generation are at maxi-mum risk of exposure. The workers en-gaged in other processes, such as bak-ing, chipping and polishing, are at a

variable distance and are thus exposedto varying concentrations of dust. Fac-tories are located in the midst of resi-dential areas, some of them withinhouse premises. Thus not only theworkers but also the people living in thesurroundings are exposed to siliceousdust. Long-term exposure to silica dustcan lead to silicosis, increased suscepti-bility to tuberculosis (1) and to a high-er risk of developing lung cancer (2).Silicosis is a progressive disease involv-ing fibrosis (scarring) of the lung. Thereis no treatment for the disease. It istherefore important to study the mag-nitude of the problem and to take ap-propriate control measures to preventthe exposure of workers and the sur-rounding community.

Magnitude of the problemA study among agate grinders conduct-ed by the National Institute of Occupa-tional Health, Ahmedabad, revealed a38% prevalence of silicosis. About 60%

of the workers showing radiological evi-dence of silicosis had worked for less than10 years (3). Another study done amonga group of agate workers (chippers andgrinders) by Rastogi et al. (4, 5) showedan 18% prevalence of silicosis as well asa low Vital Capacity (VC) and ForcedExpiratory Volume in one second(FEV

1). A follow-up study carried out

by NIOH six years later, in 1993, showedthat 10.5% of silicosis cases had remainedstatic and 17.4% had progressed furtherwhen compared against the 1987 study.In addition, there were 11.6% new casesof silicosis during the intervening sixyears (6). A more recent study amongthe people living in the surroundinghouseholds showed an 11% prevalenceof silicosis and a 6% prevalence of tu-berculosis (7). Thus there is a high prev-alence of silicosis and of tuberculosisamong workers and the surroundingpopulation; this silicosis is due to inha-lation of silica dust emanating mainlyduring the process of grinding.

Prevention and control of silicosis Experience in agate industry

Lakho J Bhagia, Harasiddh G Sadhu, Habibullah N Saiyed, India

Figure 1. Process of making agate jewellery and decorative pieces.


Dust levels in factories andsurrounding areasAn occupational hygienic surveyshowed that the total dust concentra-tions on grinding machines were in therange of 14.7525.40 mg/m3, whereasthe respirable dust concentrations werein the range of 2.352.74 mg/m3, withfree silica contents of 60% (8). As perthe Indian Factories Act 1948 (9), thepermissible levels for free silica (quartz)in respirable air are calculated by fol-lowing the formula:

Permissible respirable dust =

mg/m3 of air .

As per the above formula, the per-missible respirable dust levels would be0.16 mg/m3 of air.

The ambient quartz concentrationsin the vicinity of the agate grindingmachines and control localities were alsomeasured. The dust concentrations inthe vicinity were in the range of 7.06mg/m3 to 28.15 mg/m3 with an aver-age of 15.28 mg/m3, whereas the samein control localities were in the range of1.83 mg/m3 to 4.30 mg/m3 with an av-erage of 3.03 mg/m3. The average quartzconcentration in the vicinity was foundto be approximately five times higherthan that in the control localities. Al-though there are no air quality stand-ards for crystalline silica in India or else-where, the Environmental ProtectionAgency has suggested an Interim An-nual Air Quality Standard of 5 mg/m3

(10).

Steps for prevention andcontrol of silicosisDevelopment of appropriate dust con-trol technology; use of a dust controlsystem. It is evident that high levels ofairborne dust in the work and commu-nity environments is responsible for thehigh prevalences of various respiratorymorbidities among workers and the sur-rounding community. The source ofdust is localized at the point of stonegrinding; hence the use of a local ex-haust system with a suitable air clean-ing device is the method of choice forpreventing dust-related morbidity. Ourefforts in this direction were initiatedin 1987.

Figure 2A shows the first local ex-haust ventilation system we developedin 198788. In this local exhaust sys-tem, a pump was used to sprinkle water

over the dust-laden air sucked from thesource to remove the dust particles. Thewater was recirculated. An industrialhygiene study carried out during theinitial trial reported satisfactory effica-cy of this system; however, the industrydid not accept the system due to theneed to change the water frequently andthe rusting caused by the presence ofwater.

A local exhaust system consisting ofa three-phase motor (2 horsepower) andbag filters for dust collection (replacing

water sprinkling and bag filters) wasthen developed with the help of GujaratRural Technology Institute (GRTI)(Figure 2B). Two workers could carryout grinding on one machine. The effi-cacy of this unit was tested and wasfound to exceed 90% in terms of dustreduction. This system showed satisfac-tory results during laboratory studies;however, during the actual field trials,it was not accepted because of the highinstallation cost, increased power con-sumption and unavailability of three-

Figure 2C. Modified NIOH local exhaust system (20023).

Figure 2A. First local exhaust sys-tem developed by the NIOH in1987.

Figure 2B. The Local exhaust sys-tem developed by the GRTI (1999).

10% respirable quartz + 2


phase electric connections in most units.In consequence of the above feed-

back, the NIOH together with localengineers developed a grinding machinewith an inbuilt local exhaust system(Figure 2C). Three persons could sit atthis machine at one time. The machinehad 0.75 horsepower single-phase mo-tor and an inbuilt blower which suckedair through a hood placed near thegrinding wheel. The blower and grind-ing wheel were connected to the sameshaft and rotated by the same motor.After successful laboratory trials, fivesuch units were installed at differentplaces.

After this new device had been inuse for several months, both the work-ers and the owners were happy becausethe dust control device meant that theenvironment of the workplace and itssurrounding area was clean, it increasedworker efficiency because the workercould now sit continuously for a longerperiod, and some money could beearned by selling the dust collected inthe filter bags. The dust sold is used topolish agate. The workers and ownersalso reported the following limitations: Speed variation: The traditional ma-chine motor operates at 1440 rpm.When designing the unit, a high speed(2800 rpm) was selected to get propersuction. During grinding, the speed hasto be changed slightly, depending on thesize of the article. This is accomplishedin the traditional grinding machines byadjusting the distance between thegrinding wheel and the motor. With thetraditional machine, the speed can alsobe varied by changing the diameter ofthe pulley at the bottom. The new unitposed some difficulties in grinding dif-ferent sized articles, because of its fixed,high speed. Working habits: The new unit re-quired that the workers sit on a chairwhile operating it. The workers were re-luctant to change their traditional work-ing habits of sitting on the ground whileworking. Fear of electric shock: The tradition-al machines are normally operated withloose electric connections, which if un-plugged accidentally can lead to elec-tric shock. However, the traditionalmachines have an electrically safe wood-en frame which minimizes such acci-dents. Since the new unit has an ironframe, the workers operating it wereafraid of electric shock.

Reduced efficacy: With the reduceddiameter of the emery wheel caused byattrition from grinding, the gap betweenthe hood and emery wheel increased,reducing the efficiency of the system.

The views of workers and ownerswere considered and the local exhaustsystem was modified, incorporating fol-lowing changes:

A hood was designed and installedover the traditional cutting machine; itincluded a wooden work bench to re-move the fear of electric shock. Thehood was made flexible so that it couldbe moved nearer to the emery wheelwhen the diameter of the latter shrinks.This would prevent a reduction in effi-cacy owing to the reduced diameter ofthe emery wheel. The grinding wheeland blower were driven with the samemotor. A wooden pulley with two di-ameters was attached to the shaft of themotor. The pulley diameters were ad-justed so that the grinding wheel rotat-ed at nearly 1440 rpm and the blowerfan at the speed of the motor, i.e. 2800rpm. The lower portion of the bag fil-ter is metallic and tapering at the end.Dust laden air was given tangential en-try into the bag filter.

The modified dust control devicewas installed in ten units (five each withvertical and horizontal shaft) grindingmachines. Figure 3 shows the efficacyof each of the five machines evaluated.Although the new device brought a sig-nificant reduction in the dust levels, the

respirable dust levels at machines B andC were higher than the permissible lev-els. To increase efficacy, the capacity ofthe motor should be increased, but theowner did not agree to this because itwould increase the electricity bill. Thesemachines have been in operation for thepast two years.

To secure the commitment of work-ers and owners, the following addition-al steps were taken.

1. Legal measures to bring smallerfactories under the purview of lawA Special Notification was issued by theChief Inspector of Factories, Gujaratstate which brings agate factories withfour or more workers under the pur-view of the Factories Act by the StateGovernment. However, most of the fac-tories are still beyond the reach of theFactories Act as the workers are self-employed.

2. Awareness programmes forstakeholdersTo increase awareness among workersand owners, an exhibition cum work-shop (sponsored by WHO) was organ-ized. To ensure commitment at thehighest level, the Minister in Charge ofthe Labour and Health Department,Government of Gujarat, was invited toinaugurate the awareness workshop(Figure 4). Scientists from the Institutegave information on silicosis and howto prevent it. As a measure of mass

Figure 3. Results of efficacy for the modified NIOH local exhaust system.


awareness for workers and the commu-nity, the clippings regarding silicosis andits preventive measures were shown onlocal TV channels by cable operatorsand in cinema theaters in Khambhat.Various posters showing the hazards ofsilicosis and silicotuberculosis, and howto prevent these diseases, were preparedand displayed at public places, includ-ing bus stops, the local theater, schools,panchayat (community) buildings, etc.A booklet, Agate Workers occupation-al disease silicosis Prevention and con-trol was compiled in the vernacular lan-guage and about 1,000 copies were dis-tributed among various stakeholders(Figure 5).

3. Capacity building Manpower development: A one-

week training programme separate-ly for the factory inspectors andmedical officers working in the high-risk areas of Gujarat and Rajasthanwas organized at NIOH.

Building infrastructure at the localhospital for diagnosis of silicosisand dust surveillance: With fundsavailable from the Ministry ofHealth and Family Welfare (Govern-ment of India) under a specialscheme called Prevention and con-trol of silicosis in small scale indus-

try, the local hospital was suppliedwith an X-ray machine and spirom-eter dedicated for the silicosis pa-tients. From the same scheme, theindustrial hygiene laboratory ofGujarat State was supplied withequipment for dust collection andmeasurement levels to be used forsurveillance of the agate industry.

Concluding remarksThe above measures have created aware-ness among workers and owners, yet weare still far from eliminating silicosisfrom the agate industry. Although thereis a solution that would prevent the dis-ease, it is not accepted by large numberof owners although the workers them-selves are keen to work in conditionswi

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