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July 2008

Examiners Report
NEBOSH International
Diploma in
Occupational Health
and Safety (Unit IB)

Examiners Report

NEBOSH INTERNATIONAL DIPLOMA
IN OCCUPATIONAL HEALTH AND SAFETY


Unit IB International control of
hazardous agents in the workplace


JULY 2008




CONTENTS



Introduction 2



General Comments 3



Comments on individual questions 4



2008 NEBOSH, Dominus Way, Meridian Business Park, Leicester LE19 1QW
tel: 0116 263 4700 fax: 0116 282 4000 email: info@nebosh.org.uk website: www.nebosh.org.uk

The National Examination Board in Occupational Safety and Health is a registered charity, number 1010444

T(s):exrpts/J /J -B0807 DW/DA/DT/REW


Introduction



NEBOSH (The National Examination Board in Occupational Safety and Health) was formed in 1979 as
an independent examining board and awarding body with charitable status. We offer a comprehensive
range of globally-recognised, vocationally-related qualifications designed to meet the health, safety,
environmental and risk management needs of all places of work in both the private and public sectors.
Courses leading to NEBOSH qualifications attract over 25,000 candidates annually and are offered by
over 400 course providers in 65 countries around the world. Our qualifications are recognised by the
relevant professional membership bodies including the Institution of Occupational Safety and Health
(IOSH) and the International Institute of Risk and Safety Management (IIRSM).

NEBOSH is an awarding body to be recognised and regulated by the UK regulatory authorities:

The Office of the Qualifications and Examinations Regulator (Ofqual) in England
The Department for Children, Education, Lifelong Learning and Skills (DCELLS) in Wales
The Council for the Curriculum, Examinations and Assessment (CCEA) in Northern Ireland

NEBOSH follows the GCSE, GCE, VCE, GNVQ and AEA Code of Practice 2007/8 published by the
regulatory authorities in relation to examination setting and marking (available at the Ofqual website
www.ofqual.gov.uk). While not obliged to adhere to this code, NEBOSH regards it as best practice to
do so.

Candidates scripts are marked by a team of Examiners appointed by NEBOSH on the basis of their
qualifications and experience. The standard of the qualification is determined by NEBOSH, which is
overseen by the NEBOSH Council comprising nominees from, amongst others, the Health and Safety
Executive (HSE), the Department for Education and Skills (Df ES), the Confederation of British
Industry (CBI), the Trades Union Congress (TUC) and the Institution of Occupational Safety and
Health (IOSH). Representatives of course providers, from both the public and private sectors, are
elected to the NEBOSH Council.

This report on the Examination provides information on the performance of candidates which it is
hoped will be useful to candidates and tutors in preparation for future examinations. It is intended to
be constructive and informative and to promote better understanding of the syllabus content and the
application of assessment criteria.

NEBOSH 2008


Any enquiries about this report publication should be addressed to:

NEBOSH
Dominus Way
Meridian Business Park
Leicester
LE10 1QW

Tel: 0116 263 4700
Fax: 0116 282 4000
Email: info@nebosh.org.uk
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General Comments



Many candidates are well prepared for this unit assessment and provide comprehensive and relevant
answers in response to the demands of the question paper. This includes the ability to demonstrate
understanding of knowledge by applying it to workplace situations.

There are always some candidates, however, who appear to be unprepared for the unit assessment
and who show both a lack of knowledge of the syllabus content and a lack of understanding of how
key concepts should be applied to workplace situations.

In order to meet the pass standard for this assessment, acquisition of knowledge and understanding
across the syllabus are prerequisites. However, candidates need to demonstrate their knowledge and
understanding in answering the questions set. Referral of candidates in this unit is invariably because
they are unable to write a full, well-informed answer to the question asked.

Some candidates find it difficult to relate their learning to the questions and as a result offer responses
reliant on recalled knowledge and conjecture and fail to demonstrate any degree of understanding.
Candidates should prepare themselves for this vocational examination by ensuring their
understanding, not rote-learning pre-prepared answers.


Recurrent Problems

It is recognised that many candidates are well prepared for their assessments. However, recurrent
issues, as outlined below, continue to prevent some candidates reaching their full potential in the
assessment.

Many candidates fail to apply the basic principles of examination technique and for some
candidates this means the difference between a pass and a referral.

In some instances, candidates are failing because they do not attempt all the required
questions or are failing to provide complete answers. Candidates are advised to always
attempt an answer to a compulsory question, even when the mind goes blank. Applying basic
health and safety management principles can generate credit worthy points.

Some candidates fail to answer the question set and instead provide information that may be
relevant to the topic but is irrelevant to the question and cannot therefore be awarded marks.

Many candidates fail to apply the command words (also known as action verbs, eg describe,
outline, etc). Command words are the instructions that guide the candidate on the depth of
answer required. If, for instance, a question asks the candidate to describe something, then
few marks will be awarded to an answer that is an outline.

Some candidates fail to separate their answers into the different sub-sections of the questions.
These candidates could gain marks for the different sections if they clearly indicated which
part of the question they were answering (by using the numbering from the question in their
answer, for example). Structuring their answers to address the different parts of the question
can also help in logically drawing out the points to be made in response.

Candidates need to plan their time effectively. Some candidates fail to make good use of their
time and give excessive detail in some answers leaving insufficient time to address all of the
questions.

Candidates should also be aware that Examiners cannot award marks if handwriting is
illegible.
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UNIT IB International control of hazardous agents in the
workplace











Section A all questions compulsory

Question 1 (a) Outline the four stages of occupational health and hygiene
practice. (4)

(b) An organisation is concerned about the level of absence arising
from work related injuries and ill-health. Suggest practical ways
in which the organisations occupational health department could
assist in the management of this problem. (6)


The first stage in occupational health and hygiene practice is recognising and
identifying hazards that can cause harm in the workplace. This would be followed by
taking measurements to determine who might be affected and to what extent. Once
the measurements have been completed, an evaluation of the level of risk posed by
the identified hazards will have to be carried out and this will point to the need to
introduce control measures to eliminate or minimise the risk.

There are a number of practical ways in which the organisations occupational health
department might assist in managing the problem described such as: using pre-
employment screening to identify potential employees who would be at a greater risk
of suffering ill-health resulting in absence; carrying out regular health surveillance of
existing employees engaged in activities with known health hazards; collecting data
on sickness absence and analysing it to identify trends in or reasons for absence;
liaising with medical practitioners and providing rapid access to treatments such as
physiotherapy and counselling which will aid return to work; assisting managers to
arrange phased return to work in certain circumstances and providing practical advice
on adaptations to work practice to minimise risk of repeat injury; and taking an active
part in carrying out risk assessments at the workplace.






















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Question 2 Bulldozer drivers at a large construction site have reported incidences of
back pain which they believe are caused by exposure to whole body
vibration.

(a) Outline a range of control measures that could be used to
minimise the risk of the drivers experiencing back pain caused by
exposure to whole body vibration. (7)

(b) Suggest THREE other possible work-related causes of the back
pain being experienced by these bulldozer drivers. (3)


Control measures that could be used to minimise the risk to bulldozer drivers from
exposure to whole body vibration include selecting a vehicle with the size, power and
capacity best suited for the terrain and task; organising traffic routes used by
bulldozers to avoid as far as possible the need to travel on rough and uneven
surfaces; maintaining site roadways and vehicle suspensions; ensuring that an
individuals exposure to whole body vibration is kept below recommended thresholds;
fitting suspension seats with vibration damping characteristics and adjusting these to
suit the weight of individual drivers to avoid bottoming out; organising work patterns
including job rotation to ensure that drivers have breaks away from the vehicle and
advising them on how to minimise exposure to whole body vibration by avoiding jolts
and shocks.

In answering part (b), candidates might have suggested other possible work related
causes for the back pain such as: poor posture; sitting for long periods of time; the
poor layout of controls requiring the driver to stretch and twist to reach a particular
control or to obtain good vision; incorrect seat adjustment or no method provided for
adjustment which could make hand and foot controls difficult to operate; the repeated
climbing into and jumping down from a high cab and carrying out other construction
related activities such as the manual handling of heavy loads.



Question 3 Identify a range of information sources an employer could use to
determine the extent of employee work-related stress within an
organisation. (10)


There are a number of information sources available in house that employers might
use to determine the extent to which their organisations have a work related stress
problem. These include data on accidents and levels of sickness absence; health
surveillance data; records of staff turnover and poor or erratic timekeeping; the
number of complaints received from employees and the grievances or discipline
problems that have arisen; information available from the completion of staff
questionnaires or from performance appraisals, return to work or exit interviews or
informal discussions and the results of an assessment of performance carried out
against published management standards.










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Question 4 (a) Outline what is meant by the term biological monitoring AND
indicate circumstances in which such monitoring may be
appropriate. (6)

(b) Outline the practical difficulties that an employer must take into
account when introducing a programme of biological monitoring. (4)


In answering the first part of the question, candidates should have stated that
biological monitoring is concerned with the measurement or assessment of hazardous
substances or their metabolites in tissues, secretions, excreta or expired air. It is a
complementary technique to air monitoring or sampling and can be used to determine
if existing controls are adequate; when there is a well established link between the
biological monitoring and the effect; when information is required on the accumulated
dose in a target organ; when there is a specified guidance value against which a
comparison might be made; when there is significant absorption by non-respiratory
routes and in circumstances when there is significant reliance on personal protective
equipment.

For part (b), candidates were expected to identify that, apart from the monitoring
required by law, biological monitoring would normally be conducted on a voluntary
basis. Consequently the informed consent of those involved would have to be
obtained, their concerns overcome and the confidentiality of the results maintained.
Other difficulties include the availability of suitable facilities or a location to carry out
the monitoring especially if this has to be done at the end of a shift; the availability of
specialists to carry out the monitoring for example if blood samples are to be taken;
maintaining the integrity of samples to avoid cross contamination and ensuring there
was no possibility of cross infection; the fact that there are few guidance values
available for comparison; that exposure may be non-occupational and finally the cost
involved in carrying out the exercise.



Question 5 Personal dust monitoring has been carried out on five employees, all of
whom work in the same factory area where dust is released. The five
employees were sampled at the same time and for equal duration. Four
of the results are roughly equivalent but the fifth is significantly higher.

Outline the possible reasons for this apparent discrepancy. (10)


In outlining the reasons for the apparent discrepancy, candidates could have
considered those associated with the working environment and the tasks being
performed; those resulting from possible failures with the monitoring equipment and
those connected with the individual employee. In considering the working
environment, there could have been areas in the workplace which were not as well
ventilated as others with possible problems with the local exhaust ventilation provided.
As for the monitoring equipment for the individual concerned, there could have been
errors in the calibration of the pump flow, in the timing of the air measurement, in the
selection of the filter and in weighing the filter at the end of the exercise either
because of a mis-reading or because different and possibly uncalibrated scales were
used for the rogue sample. The individual, too, could have had a part to play if he had
been particularly involved in the more dusty operations, had taken fewer or shorter
breaks than the other operators and had not taken sufficient care with his personal
hygiene and had continued to wear dusty overalls for long periods. Finally the
possibility of deliberate sabotage could not be discounted.


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Question 6 (a) Outline the following toxicological terms:

(i) LD
50
; (2)

(ii) LC
50
. (2)

(b) Outline the advantages and disadvantages of using animal
studies to investigate whether a substance used at work may be
carcinogenic to humans. (6)


For part (a), to gain the two marks available in each case, candidates were expected
to outline that LD50 relates to a single oral or dermal dose which when administered to
a test population, is sufficient to kill 50 per cent of that population. LD50 is measured in
terms of milligrams (or grams) per kilogram of body weight. LC50, on the other hand, is
an inhaled concentration sufficient to kill 50 per cent of a test population in a fixed
period of time (usually 4 hours) and is measured in milligrams (or grams) per litre of
air.

For the second part of the question, candidates should have outlined that the
advantages of using animal studies include the fact that these methods avoid human
exposure and hence possible human deaths and that the data can be collected more
quickly and arguably more ethically than using epidemiological methods. Animals
provide the best available models as they relate more closely to humans and the
studies are more likely to detect carcinogenic potential than in vitro testing such as
Ames tests. When considering the disadvantages, candidates could have outlined that
the dose/response effect may vary in different animal species and so extrapolating
data to humans may not always be reliable. Additionally, conducting animal studies
can be time-consuming and expensive and there are often ethical considerations and
public opinion that can make this approach more difficult to undertake. There is also
the consideration that animals being treated for exposure to a particular substance
may not help to identify synergistic effects that could arise in humans exposed to other
substances at the same time and that the tests are carried out in laboratory conditions
rather than in a workplace. There could also be difficulties with the no observed
adverse effect level for carcinogens.
























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Section B three from five questions to be attempted

Question 7 A parcel sorting depot is experiencing a high number of manual handling
related injuries. The employees handle a large number of different
parcels and packages each day.

(a) Identify the different types of hazard that may be inherent in the
loads being handled. (6)

(b) In order to reduce the level of manual handling required, the
employer has decided to invest in a range of non-powered
handling devices, (trolleys, trucks etc). Describe the steps that
should be taken when selecting such devices and introducing
their use. (10)

(c) Outline a range of additional control measures that could be
introduced to minimise the risks associated with manual
handling. (4)


For part (a), the different types of hazard that candidates could have identified
included: weight of load and the fact that the weights would be unknown; parcels may
be difficult to grasp, as they are likely to be smooth with no handholds with unstable
contents which are likely to move or with the centre of gravity not in the centre of the
parcel; awkward shapes would be common or parcels that are too large for the
handler to see over; sharp edges or corners and the possibility that the contents might
spill out, some of which could be hazardous.

Candidates who provided better answers for part (b) split them into two sections
dealing first with the selection of the devices and then with their introduction. The
selection of the handling devices requires consultation with the employees both in the
selection and the trials; seeking advice from suppliers on suitability; requesting
equipment on a trial basis to check whether it solves the problem without creating new
ones; observing the equipment in use at other organisations; considering the
requirements for maintenance; ensuring the proposed use will be within the safe
working load of the device; ensuring there is sufficient room to manoeuvre; ensuring
the suitability of the device in the light of the stability and surface of the terrain on
which it was to be used; checking that braking controls were adequate and that the
handle height was adjustable between waist and shoulder; and that the design of the
equipment was such as to prevent parcels from falling off. As far as introducing the
use of the devices, this would require consideration of operator training, storage when
not in use, maintenance arrangements and a procedure for reporting defects; and
ensuring there are a sufficient number of devices available which are readily
accessible.

For part (c), additional control measures that candidates might have considered were;
changing the workplace layout to reduce carrying distances, twisting and stooping and
avoiding lifting from floor level or above shoulder height; varying the work and its
duration and pace; marking up loads with information such as the weight and the
heavy end; introducing mechanical assistance such as conveyors or fork lift trucks;
using team lifting where appropriate and providing training in manual handling.






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Question 8 (a) Describe the possible health effects from exposure to ionising
radiation. (5)

(b) Outline the control measures that should be in place where
persons may be exposed to ionising radiation at work. (15)


For part (a) of this question, candidates should have described that the possible
health effects from exposure to ionising radiation will depend on the type of radiation
and the frequency and duration of exposure and will include nausea, vomiting,
dermatitis, burns either superficially to the skin or more penetrating burns causing cell
damage, cataracts, temporary or permanent infertility, decreased immunity and cancer
induction.

Control measures that should be in place where persons may be exposed to ionising
radiation at work include limiting the time of exposure with the exclusion of particularly
vulnerable groups such as young persons and pregnant women; the use of sealed
sources whenever possible; increasing the distance between the radiation source and
those at risk to reduce the level of exposure; using shielding between the radiation
source and those likely to be exposed with the amount of shielding required
dependent on the energy of the source; prohibiting eating and drinking in unsealed
radioactive areas together with the need for a high standard of personal hygiene to
prevent spread and the covering of all breaks in the skin with protective material; the
provision, use and laundering of personal protective equipment such as gloves, lab
coats and over shoes; the availability of competent advice and the provision of training
and information to employees on the health risks involved and the control measures to
be applied; personal monitoring by means of film badges; regular monitoring of the
work area for example by means of a Geiger counter and ensuring the safe disposal
of all contaminated materials.



Question 9 A company that operates hotels and health spas recognises the risks
associated with the legionella bacteria.

(a) In this scenario identify specific sources of potential exposure to
legionella for BOTH employees and guests. (5)

(b) Describe the control measures that this company should
implement to minimise people being exposed to legionella
bacteria. (15)


In answering part (a), candidates could have chosen from a list which includes; water
storage and transfer systems (including showers and taps) where the temperature is
between 20 and 45 degrees; spa baths, saunas, steam rooms and pools; water
features such as fountains and cascades; fire and garden sprinkler systems; laundry
rooms; and pipe work where dead legs exist and stagnation may occur.

In answers to part (b), measures which should have been described include
identification of a competent person for overseeing Legionella control; regular
disinfection of hot water systems with biocides; annual cleaning and disinfection of
calorifiers; inspection and cleaning of water storage tanks; avoiding dead legs in
transfer pipe work; maintaining hot water storage temperatures at temperatures
greater than 60 degrees C and cold water below 20 degrees C; keeping shower heads
and taps clean and free from scale and running showers and taps for several minutes
each week in unoccupied rooms; running showers and taps immediately prior to
occupation of a room; treating spa pools continuously with chlorine or biocides and
cleaning them on a regular basis; avoiding the use in systems of susceptible materials
such as wood or rubber; training all relevant employees in risk factors and controls;
minimising biofilm formation, for example by covering water tanks and the use of
chemicals, and introducing regular monitoring procedures and record keeping.
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Question 10 (a) Explain what is meant by the terms carcinogen and mutagen. (4)

(b) Describe the control measures that should be adopted when,
because of the nature of the work, it is not possible to eliminate a
carcinogen or substitute it with an alternative substance. (16)


In answering part (a) of the question, candidates should have explained that a
carcinogen is a substance that may cause cancer or bring about changes in the
make up of cells while a mutagen causes or increases the rate of mutation in DNA
and may affect subsequent generations.

For part (b), specific control measures that should be adopted when it is not possible
to eliminate a carcinogen or substitute it with an alternative substance include
reducing exposure to a level as low as reasonably practicable by minimising quantities
used and/or changing the physical form; the use of a totally enclosed system or
automation of the process to physically separate workers from the process and, where
this is not possible, the use of a partial enclosure in the workplace or appropriate local
exhaust ventilation. It would also be necessary to provide appropriate storage
including the use of closed/sealed containers and recognition that it may be better to
store one large quantity in a controlled manner than to deal with frequent supplies of
smaller amounts. Materials would have to be correctly labelled and the areas of use
restricted with identifying signs to indicate their boundaries. Any waste carcinogenic
products should be labelled and stored in a secure area pending removal by a
specialist contractor. The numbers working in the restricted areas should be
minimised and non-essential personnel excluded. Precautions should also be taken
against contamination including prohibiting eating, drinking and applying cosmetics in
contaminated areas; providing appropriate warning signs to demark these areas; and
providing adequate washing facilities.

Monitoring of levels of exposure should be carried out on a regular basis to ensure the
adequacy of the control measures in place with the recognition that the use of
personal protective equipment can only be used as a secondary control in
combination with other controls.



Question 11 (a) Describe the structure of the skin and how hazardous
substances may enter the body by this route. (6)

(b) Explain how contact (primary) dermatitis can occur. (4)

(c) A number of employees working in a hair salon have reported
problems of skin irritation on their hands, which for at least one
employee has been diagnosed as contact dermatitis.

Advise the salon manager on the likely causes and the steps
that could be taken to try to overcome these instances of contact
dermatitis. (10)


For part (a) of the question, candidates should have described how the skin has an
outer layer, the epidermis, consisting of dead cells that are continually shed and
provide protection for the inner layer, the dermis. The dermis comprises living cells
and contains blood capillaries, nerve endings and sweat glands. It is partially
permeable and substances that are soluble in water or fat may migrate or be
absorbed through the skin and enter the blood stream. Hazardous substances may
also enter via cuts or abrasions or by injection.

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A good answer to the second part of the question would have explained how contact
dermatitis occurs following prolonged or repeated exposure to certain substances
which de-fat or degrease the skin, destroying the natural oils and leaving it dry,
cracked and inflamed. The dermatitis occurs at the point of contact and skin normally
recovers following cessation of exposure though repeated instances of contact
dermatitis may lead to chronic conditions.

In answering part (c), candidates were asked to provide advice on the likely causes of
contact dermatitis in employees in a hair salon and the precautionary measures that
should be taken. The causes of dermatitis amongst hairdressers include exposure to
irritant substances such as bleaches and dyes, prolonged contact with water and
detergents, the removal of natural oils from the skin and the possibility of sensitisation
to one or more of the materials used. There may also be contributory factors such as
individual susceptibility, the concentration and potency of the substances in use, the
frequency and duration of exposure to the substances, damaged skin, poor personal
standards of hygiene and a failure to protect hands by using barrier creams and
gloves.

Steps that could be taken to reduce the incidence of dermatitis would include a clear
skin care policy; the identification of susceptible persons during recruitment
procedures; ensuring safety data sheets are available for all products used; the
elimination or substitution of allergic products; job rotation to reduce individual
involvement in wet work, perms and the application of dyes; the provision and use of
disposable gloves when using shampoos, bleaches or colouring agents; the provision
of training and information with particular reference to standards of personal hygiene
such as washing and drying hands thoroughly to remove residual products after use,
the application of skin care creams to restore moisture to the skin and the correct
method of removing gloves to avoid contaminating hands; and encouraging the staff
to report problems with their skin as soon as they are noticed.

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The National Examination
Board in Occupational
Safety and Health
Dominus Way
Meridian Business Park
Leicester LE19 1QW
telephone +44 (0)116 2634700
fax +44 (0)116 2824000
email info@nebosh.org.uk
www.nebosh.org.uk