hra workshop hra-2 slide 1 health risk assessment controlling health risks at work

HRA WorkshopHRA-2 Slide 1

Health Risk Assessment

Controlling health risks at work


What is HRA ?

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

Assess the potential risk to the Business by

Plotting each hazard on the RAM

Are Control and Recoverymeasures adequate to

control health risks to ALARP?

Medium or High Risk

Low Risk

Yes

No

Develop and Implement

Remedial Action Plan

Manage for continuous improvement

Don’t know - obtain further information

Review

Document


Identifying and Assessing Health Hazards

Selection of team

Identifying and assessing Health Hazards

Identifying Control Standards

Identifying nature and degree of Exposure

Evaluating Risk to Health

Deciding on Remedial Action


Selection of team

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

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

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

• Specialist Staff – Occupational hygienist, OH physician, toxicologist, ergonomist


Selection of team

To gather necessary information team members must be able to:

•Observe the activity being performed

•Predict any potential departure from observed practice

•Ask supervisors, staff etc. the relevant questions

•Undertake simple diagnostic tests

• Identify and review relevant technical literature

•Gather the information systematically

• Form valid, justifiable conclusions about exposures and risks


How to select Assessment Units

The assessment unit is what is within the boundaries of the HRA

Assessment units should be self-contained, either physically or as a process

It should cover all aspects of the working environment

The nature and the severity of the hazards and risks involved, the familiarity of the task, available resources and country-specific requirements should be taken into account


Organisation and Preparation

Collect pre reading material and references such as: Plans and drawings for plant specificationsIncident / injury reports (incl. occupational

illnesses) and incident investigationsPlant and equipment fault reports Maintenance records for control measuresRecords of health surveillance and sickness

absenceOccupational hygiene surveys, health and safety

surveys Minutes of health and safety committee meetings


What are Health Hazards

A Health Hazard has the potential to cause harm to health

Health hazards may be divided into the following groups: chemical biological physical ergonomic psychological


Health hazards of primary concern

Cause fatalities in the short or long term e.g. infectious diseases (short term), carcinogenic

substances (long term) Expose the company to substantial future social

and monetary liabilities e.g. noise induced hearing loss, repetitive strain injury,

psychological stress Cause minor health effects which could cause

severe business disruption e.g. major food poisoning outbreak


How to identify Health Hazards

Walk through surveys Looking, smelling, talking, listening; use your senses!

Refer to Health Hazard Inventories

Use HRA Yellow Guide, appendix 2

Look at Recordsincident/fault reports, inspections, maintenance,

sickness absence, hygiene surveys, operating procedures

Use experience from elsewhere


Types of Effects

Acute, immediate• Lung, skin or eye damage from corrosive liquid

Acute, late onset• Sick building syndrome

Chronic, intermittent / on-off• Repetitive Strain Injury

Chronic permanent• Lung cancer


Identify Health Hazards and their harmful Effects

Agent

Silica dust (crystalline)

Used mineral oils

Noise

Heat

Legionella bacteria

Repetitive movements

Source

Refractory bricks

Engine oil

Process noise above 85dB(A)

Plant heat

Spray cooling towers

Workplace design

Route

Inhalation

Skin

Hearing

Whole body

Inhalation

Whole or part of body

Harmful Effect

Lung disease (silicosis)

Dermatitis, cancer

Hearing Loss

Heat stress, heat stroke

Legionnaire’s Disease

Musculo-skeletal disorders


Cumulative exposureIndividual susceptibilityThreshold levelsKnowledge gapsWorkstyle changesReal world practices

Factors influencing the Relationship between

Hazard and Risk


Assigning Hazard Ratings

Hazard Rating Definition Consequence Category (harm to people)

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

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

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

41 to 3 fatalities or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), heat, cold, psychological stress

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


Hazard Ratings

Consider Harm to:

PeopleAssetsReputation

Select the category with the highest

consequence rating!


Risk Assessment Matrix

The Risk Assessment Matrix (RAM) is the tool which allows assessment of the risk to the business from each identified health hazard

It will assist you in prioritizing potential health risks and determine which risks need documented demonstration of controls

Ensure that health risks are assessed properly by taking into account acute and chronic harmful health effects


Increasing Probability A B C D E Never heard of in

the world

Heard of incident in our industry

Incident has occurred in Shell

company

Happens several times per year in Shell company

Happens several times per year in

our location

1 Slight Injury/Illness

2 Minor Injury/Illness

3 Major Injury

4 1-3 fatatlities

5 Multiple Fatalities

Categories LOW MEDIUM HIGH Area 1 Area 2 Area 3

ConsequenceConsequence

Estimate of what could Estimate of what could happen (happen (acute and chronicacute and chronic))

LikelihoodLikelihood

AcuteAcute - Estimated on the - Estimated on the basis of experience and basis of experience and or evidence that a certain or evidence that a certain outcome has previously outcome has previously occurredoccurred

Chronic Chronic - Estimated - Estimated based on the historical based on the historical evidence that excess evidence that excess exposure has occurredexposure has occurred

Health Risk = Consequences X Probability (Likelihood)Health Risk = Consequences X Probability (Likelihood)


Increasing Probability

CONSEQUENCE A B C D E

HAZARD RATING

People

Assets

Reputa-

tion

Never heard of in the world

Heard of incident in our Industry

Incident has occurred in Shell company

Happens several times per year in Shell company

Happens several times per year in our location.

1 Slight health effect

Slight damage

Slight impact

LOW RISK

2 Minor health effect

Minor damage

Limited impact

3 Major health effect

Localised damage

Considerable impact

MED. RISK

4 PTD* or 1 to 3 fatalities

Major damage

Major national

HIGH RISK

5 Multiple fatalities

Extensive damage

Major int’national

* PTD = Permanent Total Disability

Note: Environment consequence column omitted

Manage for continuous improvementManage for continuous improvement

Incorporate risk reduction measuresIncorporate risk reduction measures

Intolerable – investigate alternativesIntolerable – investigate alternatives

Risk Assessment Matrix


Health Hazard Examples of situations or activities in which the health hazard may

occur

Harmful health effects from over exposure

(Consequences)

Consequence Category (harm to

people) - C

Likelihood - L

RAM Risk Rating (C x

L)

Chemical Hazards

Asbestos Materials containing asbestos, for example, gaskets, ceiling tiles, partitians, insulation

Acute: Mildly Irritating to eyes and respiratory tractChronic: Category 1 carcinogen

Cat 1 Carcinogen: 4/5

C

5C - High

Benzene Processing, handling and distribution of benzene containing process streams and products, e.g. naphthas, platformate, condensate, gasoline.

Acute: Irritant to eyes and respiratory tract; narcotic to CNS.Chronic: Category 1 carcinogen

Cat 1 Carcinogen:

4/5

B

5B - Medium

Ethylene oxide Shell chemicals marketed product and process material

Acute: cold burns to skin and eyes. Shortness of breath, dizziness and drowsiness on inhalation. May cause pulmonary oedema. Chronic: Category 2 carcinogen and mutagen

Cat 2 Carcinogen:

4/5

B

4B - Medium

Epoxy Resins Contained in some adhesives (maintenance) Acute: Irritant to skin and eyesChronic: skin sensitiser

Sensitiser: 3

C

3C - Medium

Hydrogen sulphide Waste gas stream; sour crude oil; condensates; bitumen and fuel oil tank head spaces

Acute: Chemical asphyxiant causing respiratory paralysis.Chronic: n/a

Chemical

asphyxiant: 5

C

5C - High

Generic RAM HRA outcomes


Low RAM Ratings

Manage for continuous improvementvia standard procedures and

competences in HSE-MS (ensure these are adequate)

ensure Exposure Limits and other control standards are met


Medium and High RAM Ratings

Detailed review of controlsStandards of controlWho is exposed and whenEstimate or measure exposureCompare existing controls against standards (are

OELs met and risks As Low As Reasonably Practicable - ALARP?)

Consider need for routine exposure monitoring and/or health surveillance

For risks assessed as Highgive serious consideration to alternative ways of

carrying out the operation


Control and Recovery

Identify exposureHierarchy of controlsControl standardsUse of control chart for individual riskApply ALARP principleExposure measurementsHealth Surveillance


What is exposure?

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


Exposure

DurationFrequencyMagnitude (extent of exposure) is affected

by:Concentration/intensity of the agentWork practicesAgent’s physical characteristic impacting on the

exposure routeExisting controls


Lung

Ear Eye

Skin

NoseMouth

Musculo-skeletal

Whole body

Exposure routes


Hazards and Exposure routes

Hazard Exposure routeNoise ear

Chemical Liquids skin (through uptake of the skin, or through injection)Eye transferred from hand to mouth ingestion

Chemical gases, vapours and dusts nose, mouth, lungs – inhalation

Chemical dusts trapped in the nose and throat, or transferred from hand to mouth, leading to ingestion

Vibrations whole body or specific parts e.g. hands, eyes

Heavy lifting & other ergonomic hazards

muscoloskeletal system


Lung Heart

Digestive tractLiver

Kidneys

EarEye

Skin

NoseMouth

Central nervous system

Musculo-skeletal system

Reproductive system

Target Organs


Hazard, exposure route and target organ

Hazard Exposure route Target organ

Noise Ear Ear

Chemical liquids and dusts

(hazard dependent on the specific chemical)

Inhalation, skin, eye Direct contact with lungs, skin and eyes. May also be absorbed in blood stream and carried to susceptible organs: central nervous system, reproductive system, kidney, liver

Stress Mind Heart, mental impairment


Factors Affecting Intake for chemical and biological

agentsPhysical form

Gas/vapour/liquid/solid Particle size Particle shape

Solubility Carriers

Breathing rate


Identify who is exposed

Typical Job Types Plant Operators - divided by operational group

Road Tanker Drivers - divided by product group

Maintenance Staff - mechanical, electrical, vehicle etc.

Cleaning Staff - plant and/or office

Laboratory Technicians - sub-divide as appropriate

Administrators - office based with minimal plant exposure

Field Staff - geologists


Identify tasks:Use workplace experienceReview historical recordsDiscuss with staff involved in doing the taskVisit work area/walk through survey

Include tasks involved in:Normal operationsMaintenanceAbnormal conditions and foreseeable emergencies

Estimate exposure level



What is a ‘task’ ? An activity which a competent person can be instructed to do in a single sentence

A plant operator could be asked to take a process stream sample

A plant cleaner could be asked to deal with a spillage

A fitter could be asked to take a pump out of service

A laboratory technician could be asked to analyse a sample for benzene content



Review tasksFrequency, duration and estimates of concentration/intensity of exposure Work practices and existing controls

Effectiveness of existing control measures

Compare existing controls against relevant control standardsWho else is exposed?

Employees, contractors, third parties


Exposure may be acceptable when: evidently so operations are in accordance with suppliers’

documented procedures previous measurements under similar or worst

case conditions indicate low exposure process operated in accordance with

recognised guidance on good practice

Estimate exposure level-without exposure measurement


Exposure may be unacceptable when: there is evidence of fine dust deposits fume or particles are visible in light beams there are broken, defective or poorly maintained

controls the process is not operated in accordance with

recognised guidance on good practice complaints are made of discomfort or excessive odour ill-health related to exposure is detected

Estimate exposure level-without exposure measurement


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

Hierarchy of controls


Types of controls

Elimination and substitutionEngineering (plant and equipment):

Equipment/processes designed to prevent or minimize release of the hazard

Examples: containment (enclosure), exhaust ventilation, remote venting/vapor recovery systems


Types of controls

Procedural: Safe systems of work / Permit to work system

Record systems

Staff Instruction, Information & training

Supervision, Emergency arrangements

Personal Protective Equipment (PPE): Respiratory & Skin Protection as a secondary line of defence or as the only option


Effectiveness of Controls

The types of control vary in their effectiveness according to the control hierarchy:

Elimination Most Effective

Substitution

Engineering

Procedural

PPE Least Effective


Control selection

Control selection to achieve ALARP must consider the control effectiveness and cost:

consider the most effective controls first

limit PPE to:

-infrequent tasks

-temporary use until more effective controls are in place

-as a precaution should other controls fail


Maintenance of controls

Controls are only effective if they workEngineering controls

Preventive maintenance, inspections and tests

Procedural controlsRecord systems, information and training

Effective supervision

PPERoutine maintenance, inspection and training

Emergency measuresInspections and realistic exercises


Control standards

Occupational Exposure Limits (OELs)

Specifications for control:Engineering Control Standards (SES, DEP)

Procedural (manufacturer’s/supplier’s info/industry good practice)

Personal Protective Equipment

National, Company, Group, Industry and International Standards


Chemical agentsOccupational Exposure Limits are levels of airborne

concentrations of hazardous compounds that are considered safe for the workplace

OEL’s and recommendations are set by competent national authorities

OEL’s are normally used for chemical agents, but the concept can also be applied for physical, biological and psychosocial agents and for ergonomics

What are exposure limits?


Physical Agents, e.g.Shell ‘Noise Guide’ recommended criteria

Daily Noise Dose - 85 dB(A) Leq

Design Limit - 85 dB(A) at 1 meterCold stressIonising radiationHeat stressLasersVibrations

Occupational exposure limits


Biological agentsControl to as low as reasonably practicable

Ergonomics

Include ergonomic principles to all work activities

PsychologicalRefer to specialist for evaluation and treatment

Occupational exposure limits


Engineering control standards

Face velocities of Lab Hoods should meet recognized design standardsRotating equipment mechanical seals that do not leak Transfer lines/hoses with disconnect fittings that do not leakCapture velocities for welding hoods meet recognized ventilation standardsEngineering controls are inspected regularlyEngineering controls are on a PM (preventive maintenance) schedule


Procedural standards

written procedures for tasks involving exposure (permit to work system)

procedures include work practices that minimize exposure

work practices are understood (e.g. training & validated by testing) and followed by employees (supervision, validated by auditing)


Personal Protective Equipment

respirators

gauntlets (gloves)

goggles

protective clothing

foot protection


Personal protective equipment

Adequate use of PPE includes an assessment of:

• PPE requirement for each task

• PPE selection to match the hazard

• PPE is practical & functional for the task

• PPE requirements are understood by employees (e.g. training & validated by testing)

• PPE is used correctly (e.g. training & validated by audit))

• PPE is used when required (validated by audit)

• PPE is inspected and maintained regularly (validated by audit)


Are controls meeting the control standards?

Control chart: tool for decisionsUse of information on exposures and

controlsCombining ‘hazard rating’ and

‘exposure rating’

Use of Control Chart


HAZARD RATING DEFINITION (Consequence Category: Harm to People)

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

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

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

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

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

Hazard rating categories


Exposure Rating Exposure Band

Definition

a) Very Low < 0.1 x OEL Exposures are negligible

b) Low > 0.1 - <0.5 x OEL

Exposure are controlled well below OEL and are likely to remain so in accordance with standards

c) Medium > 0.5 – 1 x OEL

Exposures are currently controlled below OEL to meet standards but control may be reliant on less robust measures such as personal protective equipment

d) High > OEL Exposure are not adequately controlled to meet standards and continuously/regularly exceed OEL

e) Very High >> OEL Exposures are excessive and will almost certainly result in health damage to persons exposed

Exposure Rating


Exposure Rating

Hazard Rating Very Low (a)

Low (b)

Medium (c)

High (d)

Very High (e)

1 No immediate Third Second Priority

2 action required priority

3 First Priority

4 for

5 Action

Exposure Band (1)

<0.1*OEL (2) 0.1*OEL - 0.5*OEL

0.5*OEL - 1*OEL > OEL >> OEL

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

Control Chart


Evaluate the Adequacy of Controls

What is the nature of the hazard to health ?

Use Hazard Rating (RAM Consequence Category)

What is the nature and degree of exposure for the task ?

Assign Exposure Rating

Combine in Control Chart


Remedial Action Plan

The Remedial Action Plan must cover:

Recommendations divided into four levels of action (first, second, third priority and no immediate action required)

Is recommendation agreed or not? Responsible person Due date


Actions Control Chart (1)To aid priority setting

Action 1st priority Stop the exposure; notify management immediately Identify all sources Implement immediate control improvements e.g. PPE Consider need for exposure measurement Identify and implement work practice and control

improvements Review HRA, including measurements


Actions Control Chart (2)To aid priority setting

Action 2nd priority Reduce exposure to below OEL (Hazard Ratings 1-2) Consider reducing to below 0.5 x OEL (Hazard Ratings 3-5) Identify and implement work practice and control

improvements (*) Consider need for exposure measurement (*) Review HRA, including measurements (*)

Action 3rd priority Actions with asterisk under 2nd priority

Action – No Immediate Action Required Normally no need for immediate action to improve controls.

Manage for continuous improvement


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

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

ALARP Definition


ALARP is influenced by the following factors:

risk to be avoided

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

comparison of the two

ALARP


List the measures that have been taken to

reduce the risk

Go on to identify an additional option which

might be introduced to reduce the risk further

Give reasons why this additional control is not

adopted

ALARP- rule of thumb


••

••

•

•

Risk toHealth

Tolerability level

Cost ofControl

ALARPLegal Liability Wasteful

ALARP


Is risk to health ALARP?Yes, when only a small reduction in risk would require

an unreasonable amount of time, trouble, difficulty or cost.

OtherwiseSelect appropriate additional controls/barriers

consideringHierarchy of controls including recovery preparedness

measuresOther measures like: measurements, monitoring, health

surveillance, maintenance of controls, instruction & trainingPriorities for implementation

What remedial action?


Identify who may be exposed to health risksIdentify the relevant exposures to

individuals in the workplaceAssess your work environment to determine

when you need to do exposure monitoring/measurements

Exposure measurements


Verification of the efficiency of control measuresJustification for additional control measuresChoice of control measures (eg for noise

control)To establish and document historical records of

exposure levels for all workersTo ensure and demonstrate compliance with

regulatory and other exposure guidelinesEpidemiological studies or investigating

reported health effectsTo alleviate employee concerns

Purpose of exposure measurements


Baseline - to define range and distribution of exposure for defined jobs

Worst case – to identify potentially high exposure

Detailed – when baseline study provides insufficient data

Routine – periodic exposure monitoring to check that control measures remain effective

Compliance - to ensure that exposure is below regulatory and other guidelines

Objectives of exposure measurement


Personal Monitoringworker exposure with normal work procedurebreathing zone for inhalation exposurenear ear for noise exposurefull shifts / task samples

Area (Environmental) Monitoringcontaminant concentration in work areaplant conditionseffectiveness of controls

Monitoring methods


Biological MonitoringDetermine body absorption of potentially

hazardous substance from all sourcesMeasure changes in the composition of

body fluid, tissue or expired airMay be used to indicated inadequate

control, improper work procedureProvides accurate information about the

absorbed dose of a substance in the bodyNot all substances have a method or a BLV

(biological Limit Value)

Monitoring methods


Where to SampleWhen to SampleWhom to SampleHow long to SampleHow many samples to take

Sampling Strategy


Monitoring and health surveillance aims to (periodically) assess exposures and health in order to

Confirm the effectiveness of existing control measures

Collect data for the detection and evaluation of hazards to health

Confirm compliance with predetermined criteria

Required by law

Health Surveillance


Medical Surveillance selection criteria

Is there a risk to health (based on HRA)

The prevention/intervention potential ("can we do something about it?")

Can we detect it?

Are the detection methods suitable?

Medical Surveillance


Document & Review HRA

Appropriate Depth of Records

Linked with Medical Records

Informing Staff

Archiving of Records

Reviewing Records


Appropriate Documentation

Records should: be retrievable

Internal/external audits, authorities and review

meet legal requirements be detailed enough to ensure audit trail on how

conclusions were reached allow traceability from individual name via Job Type to

tasks include exposure monitoring and health surveillance


Informing Staff of Findings

Involves staff in HRA process Ensures that:

Health risks are understood Control measures are used Staff can alert assessment teams on

changes

May be a legal requirement


Archiving of Records

As required by local law and/or practice 30 - 40 years are typical

Allows for re-introduction of old processes


Reviewing HRAs

Senior management will confirm the status of HRA through HSE annual letter

Action Items Short term reviews of action items

Against target dates and responsible persons

Change in process, hazard, legislation etc Change in controls New information on the effect

Incidents, illnesses, complaints, new knowledge On an agreed cycle

Between 1 and 5 years dependent on risk

hra workshop hra-2 slide 1 health risk assessment controlling health risks at work

Documents

hra workshop hra

hra process

health health hazards

work slide

ergonomist slide

account slide

hra assessment units

hra yellow guide