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Acknowledgement
We hereby wish to express our sincere gratitude to our lecturers Mr. V.M. Karunarathne and
Dr. Aseni Wikramathilake for enlightening us by giving a wise knowledge regarding the
Health Safety and Welfare. Also our lecturer Ms. Chathuri Manjula who made this course
work a success by giving their helping hand at all time we raise our problems.

Also we would like to extend our gratitude to officers and staff members of Access
Engineering PLC on behalf of their dedication for our field visit to the Gall Face Hotel
Renovation project.

More over our acknowledgement goes to our fellow colleagues who helped us, as well as
the library staff of the University of Moratuwa for providing us with these necessary
resources.

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Table of Contents
Introduction ........................................................................................................................... 1

1.0 Introduction to the selected industry .......................................................................... 2

2.0 Identify specific hazardous related to the construction industry ................................ 3

3.0 Chronic health effects on workers exposed to them ................................................... 6

3.1 Asthma .................................................................................................................... 6

3.2 Silicosis ................................................................................................................... 6

3.3 Occupational Hearing Loss ..................................................................................... 7

3.4 Pulmonary Siderosis ............................................................................................... 7

3.5 Fibrosis.................................................................................................................... 7

3.6 Asbestosis ............................................................................................................... 8

3.7 Pneumoconiosis ...................................................................................................... 9

3.8 Bronchitis .............................................................................................................. 10

4.0 Precautionary measures taken by the organization................................................... 11

4.1 Conducting training regarding the safety culture ................................................. 11

4.2 First aid boxes and other medical facilities available in the site .......................... 11

4.3 Personal Protective Equipment (PPE) .................................................................. 12

4.4 Providing Washing Facilities ................................................................................ 13

4.5 Limited the manual lifting and carrying aids ........................................................ 14

4.6 Display Safety boards and signs in construction site ............................................ 14

5.0 Improvements needed to avoid the risk of chronic health effects as per the WHO
guidelines ............................................................................................................................. 15

5.1 Examinations and encounter for administrative purpose (Code–Z02) ................. 15

5.2 Medical observation and evaluation for suspected diseases and conditions (Code–
Z03) .............................................................................................................................. 15

5.3 Routine general health checkups (Code–Z10) ...................................................... 16

5.4 Personal encountering health services for counselling and medical advice (Code–
Z71) .............................................................................................................................. 16

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5.5 Examinations on exposure to the risk factors (Code-Z57) ................................... 16

6.0 Conclusion ................................................................................................................ 17

References ........................................................................................................................... 19

List of Tables
Table 1: Hazardous in construction industry ......................................................................... 3
Table 2 : Causes for disease and symptoms of disease ......................................................... 4

List of Figures
Figure 1: Silicosis .................................................................................................................. 6
Figure 2: Pulmonary Siderosis .............................................................................................. 7
Figure 3: Fibrosis in lungs ..................................................................................................... 8
Figure 4: Asbestosis .............................................................................................................. 9
Figure 5 : Pneumoconiosis .................................................................................................... 9
Figure 6 : Bronchitis ............................................................................................................ 10
Figure 7: Construction site .................................................................................................. 11
Figure 8: Safety sign - 1 ...................................................................................................... 12
Figure 9: Safety sign - 2 ...................................................................................................... 13
Figure 10: Safety Sign -3 ..................................................................................................... 13
Figure 11: Safety sign - 4 .................................................................................................... 14

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Introduction
Occupational health and safety is concerned with protecting the safety, health and welfare
of people engaged in work or employment .It’s important to identify potential hazards and
the probable chronic impacts of those in order to safe guard the employee and the
organization. Chronic Disease is a long-lasting condition that can be controlled but not cured
and chronic disease is the leading cause of death and disability.

Selected site for the case study is Renovation Project of Gall Face Hotel by Access
Engineering PLC. Access Engineering PLC is one of the leading construction contractor in
Sri Lanka who gave priority to the occupational health and safety in their work sites

In this report is mainly focused on chronic diseases caused by construction sector. Report
consists five parts sections. First section provides an introduction the selected work sites, it
is essential to identify nature of the work carried out in there. Then second section explains
the specific hazardous related to our selected site and third section is about chronic health
effect on workers exposed to them. It consists with the brief description about chronic
diseases with the causes and its impact to the human body. Figures have been added to this
section in order to understand them easily.

Fourth section of the report discusses precautionary measures which are currently practiced
in the selected site. Final section of the report includes improvement needed to avoid the risk
of chronic health effects as per the WHO guidelines. Under the each sections, relevant tasks
are clearly descried with the examples in a simple way.

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1.0 Introduction to the selected industry

Selected construction project for the case study part of the report is Renovation of Galle Face
Hotel, the project is carried out by the Access Engineering PLC. Access Engineering PLC is
one of the leading construction contractor in Sri Lanka who highly concern about the
occupational health and safety in their work sites.

Project Details

 Project Name : Renovation of Galle Face Hotel, Colombo

 Duration : 18 months
 Main Contractor : Access Engineering PLC
 Number of sub-contractors : 12
 Number of workers : 240
 Operations : 24/7

Almost 240 labor has been working under and heavy machine such as crane, external hoister
are working these construction site. Because the Access is the main contractor of the
renovation they always ensure the safety and health of the construction site. The safety
manager of the access is the responsible person for the all safety and health aspect of the
construction site.

They always consider and follow the hazards identifications and remedial action, Safety
culture, Details about accidents, incidents and near misses, Safety violations recorded within
the site, Details about accident free man hours etc.. Because these finding safety manager
always bother about the safety factors which identified through the existing site.

Access engineers follows OSHA standard for the safety. In additionally they follows Green
Cross concept. They count the minor accident or major accident about the workers in
construction site. It shows their picture of green cross. The main reason for that is our
company follows the highly specified safety methods to protect our workers from the
dangerous circumstances

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2.0 Identify specific hazardous related to the construction

industry
Construction site is a place where different type of processes going simultaneously. So there
is high possibility to expose in to various types of hazardous without any awareness because
most of hazardous caused for the long term impact on human body.

Following listed down substances can be identified as the specific hazardous substances in
the construction industry which directly caused for the chronic health effects.

 Construction dust (Asbestos and Silica dust)

 Cement
 Lead
 Solvents (VOCs)
 Isocyanides
 Flammable gasses used for welding

In addition to above mentioned substances which are coming under the chemical hazardous,
all other types of hazards are available in the site as follows.

Table 1: Hazardous in construction industry

Category of hazard Type of hazard Exposure due to

Physical hazards Noise Due to machine operations
Heat Welding
Vibration Earth compaction
Electricity Unsafe connections
Mechanical hazards Moving equipment Earth moving equipment
Rotating equipment Rotating tools (Drill, Grinder etc.)
Biological hazards Harmful micro organism Unsafe sanitary condition
Improper waste management
Uncleanliness in the site
Ergonomic hazards Repetitive works Bar bending
Offsetting
Mental hazards Mental stress Unsatisfied working environment

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Construction sites are occupied with the people who are involved in different activities such
as management works, administrative works, technical works and direct labour. Therefore
the exposure to the hazardous is directly depend on the tasks which have to be carried out.
Some of them are common for the every employees in the site, but impact of some specific
hazards is only for some particular worker in the site.

Following tables indicates the hazards which are caused for the chronic diseases and
symptoms of disease and also this categorizations has done by considering the type of the
employee who directly exposed to them.

Table 2 : Causes for disease and symptoms of disease

Exposed Employee Causes for long term disease Symptoms of disease

types
Every workers who  Exposure to wide range of  Respiratory system
dust (Wood dust, earth related issues
works in
dust, concrete or other dust,  Hard to breath short
construction site dust caused due to drilling) and long breath
pattern
 Unstoppable cough
 Throat irritation
 Eye strains

Workers who  Exposure to cement for  Ditto

long time
expose to cement in
forms of cutting,
blasting, drilling
and grinding
Welders,  Exposure to fumes and  Sputum production
technicians, roofing
gasses  Short breath
 Years of air flow  Allergies
and paving tile obstruction  Can’t be able to
attachers, Painters, recognize smells
 Asthma can be more
Varnishers severe
The people who are  Exposure to high noise for  Hearing deficiencies
a long time period
in the site

The persons who  Heavy material handling  Low back pain

handles material  Awkward posture  Shoulder aches

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 Crook back
 Bulging stomach

Heavy machine  Vibration of powered tools  Damages in nerves

and machine and blood vessels
operators, heavy
 Whole body
vehicle drivers vibration and
shivering
Material handlers,  Touching dangerous  Skin dryness
porters
substances during working  Skin itchiness and
hours redness
 Swollen and crack
skin
 Blisters
All workers  Stress related to work  Anger
 Fatigue because tight  High turnover
schedule  Improper behavior
 burnout pattern

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3.0 Chronic health effects on workers exposed to them

Most health effects experienced in construction are typically chronic. This makes it difficult
to associate where the exposure occurred. For example, a worker in their later years presents
with a chronic health effect. The exposures that may have caused the damage could have
occurred very early in his working life.

3.1 Asthma
Asthma is a chronic (continuing over time) disease of the lungs. Occupational asthma is an
allergic reaction some people experience when they are exposed to substances in the
workplace e.g.:-dust. These substances are called ‘respiratory sensitizers’ or asthmagens.
They can cause a ‘hypersensitive state’ in the airways of those affected. In our construction
site, most of the area could be see the dust climate. When the employee’s exposures the dusts
long time it affect this type of effect.

3.2 Silicosis
Silica is a major constituent of construction materials such as bricks, tiles, concrete and
mortar. It is the biggest risk to construction workers. Silica as a dust generates above
mentioned materials during the construction tasks. In our selected site, these dusts could be
identified when cutting, drilling, grinding and polishing. Some of this dust is fine enough to
get deep into employee’s lungs. The fine dust is known as repairable crystalline silica (RCS)
and is too fine to see with normal lighting. It is commonly called silica or silica dust.

Silicosis can cause severe breathing problems and increases the risk of lung infections.
Silicosis usually follows exposure to RCS over many years,

Figure 1: Silicosis

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3.3 Occupational Hearing Loss

Exposure to high levels of noise can cause permanent hearing loss. In our selected
construction sites have many noisy operations and can be a significant source of noise
exposure. When the employee’s hear high level of noise long time it affect this type of effect.

3.4 Pulmonary Siderosis

Pulmonary Siderosis is due to deposition of iron in the in the lungs, usually in the form of
iron oxide’. With the heat emitted from the arc or torch, arc welding melts and boils the iron
that is being cut or welded lungs, usually in the form of iron oxide’. In our construction site
could be see the welding of grills. But this welding person was only wearing a googles.
Therefore this type of disease can be happen due to unsafe condition.

Figure 2: Pulmonary Siderosis

3.5 Fibrosis
Fibrosis means the development of fibrous connective tissue as a reparative response to
injury or damage. Fibrosis may refer to the connective tissue deposition that occurs as part
of normal healing or to the excess tissue deposition that occurs as a pathological process.

Pulmonary fibrosis

Pulmonary fibrosis refers to a number of conditions that cause interstitial lung damage,
followed by fibrosis and eventually loss of lung elasticity. These conditions lead to
symptoms such as persistent cough, chest pain, difficulty breathing and fatigue.

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Liver cirrhosis

Cirrhosis refers to the scar tissue and nodules that replace liver tissue and disrupt liver
function. If liver cirrhosis is detected and diagnosed during the early stages of disease, any
further damage to the liver may be prevented.

Cystic fibrosis

Cystic fibrosis is a genetic disease that primarily affects the lungs and digestive system.

Figure 3: Fibrosis in lungs

3.6 Asbestosis
Asbestosis is a chronic (long-term) lung condition caused by prolonged exposure to asbestos.
The four main diseases caused by asbestos are mesothelioma, lung cancer, asbestosis and
plural plaque. Breathing in asbestos fibers may eventually scar the lungs of some people,
which can lead to a number of symptoms, including:

 Shortness of Breath
 Cough
 wheezing
 fatigue (extreme tiredness)
 Chest Pain

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Figure 4: Asbestosis

3.7 Pneumoconiosis
Pneumoconiosis is a group of lung diseases caused by inhaled dust particles. It is a disease
characterized by fibrosis and caused by the chronic inhalation of mineral dusts, silica and
asbestos.

Pneumoconiosis cases can be classified in four groups:

 Coal worker’s pneumoconiosis

 Asbestosis
 Silicosis
 Other unspecified pneumoconiosis

Pneumoconiosis usually takes 20 or 30 years to develop, and then the workers often do not
notice symptoms until they are over 50. The main symptoms are coughing and difficulty in
breathing, which gradually increases. Asbestosis patients are more likely to develop lung
cancer, especially if they smoke cigarettes. Damaged lungs make the heart work harder, and
heart problems can accompany severe cases of pneumoconiosis.

Figure 5 : Pneumoconiosis

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3.8 Bronchitis
Bronchitis is an inflammation of the lining of the bronchial tubes, which carry air to and
from the lungs. People who have bronchitis often cough up thickened mucus, which can be
discolored. Bronchitis may be either acute or chronic. The symptoms can be identified as

follows;

 Cough
 Fatigue
 Shortness of breath
 Slight fever and chills
 Chest discomfort

Figure 6 : Bronchitis

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4.0 Precautionary measures taken by the organization

As in all other construction site, Access Construction site is also considered safety as the
first and most important element during their construction carrying out. Following shows the
precautionary measures they use in order to overcome the chronic health effects.

4.1 Conducting training regarding the safety culture

In Access construction site they consider the main aspect is the safety of the workers.
Therefore, the main policy in site is wearing the safety helmet at all-times. Once a week they
conduct the meeting and discuss about the safety problems which are arise to the workers in
previously.

Figure 7: Construction site

4.2 First aid boxes and other medical facilities available in the site
These are provided in emergency cases. Especially, the workers can be got in the eye
damages, breathing problems due to the dust and chemicals in construction site. That is
formed by handling, crushing, grinding, drilling or blasting of materials. There is special
attention to the injuries happen in construction site and perfect training has given first aid at
an emergent case. In addition to that, all the medicines and instructions for in case of any
incident displayed adhere to the first aid box.

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Figure 8: Safety sign - 1

4.3 Personal Protective Equipment (PPE)

In order to ensure of the employee safety wearing PPE is essential to any worker and also
there are notices that the employee should wear the PPE.

 Dust Mask and Respirators

The worker may directly expose to the silica dust or any other chemical when doing the
concrete cutting, crushing and drilling concrete, masonry and concrete work, welding,
demolishing in the construction site. Respirators and dusk mask are provided to each and
every worker who involves those things. It prevents the dust entering into the lungs and
prevents chronic health effects.

 Safety Gloves

Safety gloves are provided to workers who expose to cement in forms of cutting, blasting,
drilling and grinding and other pesticides handling process as well as the material handlers
and porters. When they are touching dangerous substances during long period skin dryness
and skin itchiness may happen. It can be minimized by using the safety gloves.

Vibrating hand-held power tools or machinery used as a regular part of the job can cause
permanent harm. A range vibration white finger can result from frequent poorly controlled
exposure. Aware those workers to regular break from work involving vibration and
encourage operators to exercise fingers. Workers are advised to use gloves to keep hands
warm but that do not provide any protection from vibration.

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 Safety Goggles

Safety goggles are provided to the welders, roofing and paving tile attaches in order to
prevent from gasses and fumes entering into the eyes.

 Ear plugs and Ear muffs

These are provided to the workers who are exposure to the high noise for a long period. That
is preventing the hearing deficiencies from the workers.

 Safety Boots

Safety boots are provided for the workers who are exposed to the cement dust. But the
practical situation is workers are refused to use those safety equipment’s even though they
aware about this chronic diseases.

Figure 9: Safety sign - 2

4.4 Providing Washing Facilities

The worker who is engaged in the application of paints, coatings and any pesticides provided
the washing facilities to enable worker to remove such substance.

Figure 10: Safety Sign -3

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4.5 Limited the manual lifting and carrying aids

Manual lifting and carrying of labors are limited by using modern vehicles and devices
within the site. Carrying and handling can create excessive stresses on areas of the body like
the back. This can cause immediate damage to muscles and tendons such as strains and
sprains. It can also lead to longer term or recurrent problems known as musculoskeletal
disorders.

Many devices are available including pallet trucks, sack barrows, trolleys, lifting devices
and grips to help better grasp loads. These reduce the risk of injury by applying the body
forces more efficiently of the workers.

4.6 Display Safety boards and signs in construction site

Safety boards are hanged throughout the side to remind the workers the safety and health
should be the first.

Figure 11: Safety sign - 4

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5.0 Improvements needed to avoid the risk of chronic health

effects as per the WHO guidelines
Chronic diseases has been become a dangerous impact on occupant in the construction
industry as well as other industries. As a responsible international body on safety, health and
welfare of people in worldwide, WHO (World Health Organization) provides effective
guidelines for the prevention of the chronic diseases which are commonly available in the
construction industry.

As per the International Statistical Classification of Diseases and Related Health Problems
(ICD-10) in Occupational Health publication (1990), following can be identified as
guidelines which can be applicable to construction industry.

5.1 Examinations and encounter for administrative purpose (Code–Z02)

Health and safety related administrative processes such as pre-employment medical
examination has positive impact on the prevention of chronic diseases. Health condition of
the occupants different form one person to another and it is depend on their previous work
conditions, personal immunization, age, economic and social back grounds.

Some people have higher risk on developing chronic diseases than others when the tendency
of developing occupational related diseases. Prevention of such kind of employments and
also prevention of allocation of such labor for risky works is a practical solution to avoid
developing chronic health effects.

5.2 Medical observation and evaluation for suspected diseases and

conditions (Code–Z03)
Medical observations and evaluations supports to discover the risk in the work sites which
may directly or indirectly caused for the chronic diseases. Involvement of expert external
party may provide better evaluation regarding the suspected diseases and risk conditions.
Based on the recommendations of evaluations, necessary actions can be taken to avoid
unhealthy conditions or proactive measure can be taken to mitigate the risk available.

Working environment in the construction industry changes with different stages of the
project. So it is better to conduct medical observations at several times in the work site
considering the all the risk factors available in the different stages of the construction sites.

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5.3 Routine general health checkups (Code–Z10)

Application of routine general health checkups will be effective guideline because it paves
path to identify health condition of the employees. This can be done in a predetermined
scheduled manner with the support of consultants to get maximum output from it. When the
health checkups are conducted as a process by keeping the historical medical records and
the deviations or any other abnormal health conditions of the occupants can be identify
before it becomes critical, therefore the proactive medical aids can be taken at the pre
developing stage to protect from the chronic health effects.

5.4 Personal encountering health services for counselling and medical

advice (Code–Z71)
Personal health services for counselling and medical advices supports employees to get an
idea about health condition of them as well as to get exact solutions for the health problems.
Employee has opportunity to get solutions for the health problem by considering their
personal problems and also the risk factors employees exposed during the works.

5.5 Examinations on exposure to the risk factors (Code-Z57)

Separate examinations can be conducted foe the evaluation of risk factors associated in the
construction industry as follows.

 Occupational exposure to noise

 Occupational Exposure to temperature
 Occupational Exposure to vibration
 Occupational exposure to dust / air contaminates
 Occupational exposure to toxic agents

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6.0 Conclusion
Construction workers can be exposed to many risk factors during their working life and they
therefore face an increased risk of developing chronic health problems. The variety of
exposure differs enormously between and within construction workers as this depends, for
instance, on the worksite, work tasks and weather conditions. Occupational health and safety
in a construction setting is not a single duty. Without improvements such as the bridging of
accidents control and occupational health and safety, the involvement of occupational health
and safety experts, employers and unions, we can expect further disaster when the next
disease outbreak occurs.

Selected site for the case study is renovation of Galle Face Hotel by Access Engineering
PVT ltd. This report help to identify chronic health effects on workers exposed to them in
construction side

Construction workers can be exposed to many risk factors during their working life and they
therefore face an increased risk of developing health problems. When considering chronic
diseases are not passed from person to person in the construction site. They are of long
duration and generally slow progression.

In the construction site there are variety of exposure differs enormously between and within
construction workers as this depends, for instance, on the worksite, work tasks and weather
conditions. Occupational health and safety in a construction setting is not single duty. It
protects workers and, by doing so, also protects the public and environment. Without
improvements such as the bridging of accidents control and occupational health and safety,
the involvement of occupational health and safety experts, employers and unions, we can
expect further disaster when the next disease outbreak occurs.

Finally the concerns will pursuit to the ultimate results of the well OHS management system.
That is the workforce of the country will be healthier and the work environment will be much
better to work well. That will be caused to increase the productivity of the construction
industry, happiness of the workforce; satisfaction of the clients, contractors and ultimately it
will be helped to achieve the goals and objectives of the industry smoothly.

This is a rare chance to identify the requirement of hazardous related to chronic health effect
on workers exposed for the construction industry and this report will be helped to
improvement needed to avoid the risk of chronic health effects as per the WHO guidelines.

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Ultimately the preparation of this report leads to improve our skills and knowledge regarding
the Occupational Health and Safety as well as chronic impacts of safety and health condition.
Also this course work was better approach to apply theoretical knowledge to practical
application experience its importance.

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References

WHO. (2014, 11 28). Retrieved from http://www.who.int/:

http://www.who.int/occupational_health/publications/en/oehicd10.pdf

European Commission. Information notices on diagnosis of occupational diseases. Report

Eur 14768 EN. European Communities, Luxembourg, 1997.

European schedule of occupational diseases. European Commission (90/326/EEC).

Karjalainen A, Virtanen S. European Statistics on Occupational Diseases - Evaluation of the
1995 pilot data. Eurostat Working Papers 3/1999/E/no2, Eurostat, Luxembourg, 1999.

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Individual contribution

Student’s Name Contribution

Hettige A.U.P Precautionary measures taken by the organization

Ifka M.I.F Identify specific hazardous related to the selected

industry
Kumara K.D.L.P Introduction to the selected industry

Ranathunga R.J.K.D.M.T Chronic health effect on workers exposed to them.

Report introduction
Somarathna K.K.G.P Chronic health effect on workers exposed to them.
Report introduction
Thayalini V. Conclusion of the report

Weerasinghe K.A.G.R.K Improvements need to avoid the risk of chronic health

effects as per the WHO guidelines

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