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STEP NOTES

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Occupational Health and Hygiene

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2 019 E D I T I O N

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 Occupational Health and Hygiene Step Notes

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Introduction
‹‹ What is “chronic toxicity”?
‹‹ What constitutes a chemical hazard?

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‹‹ When are workers most at risk from asbestos products?
‹‹ What are the duties of employers regarding first aid?
Questions like these will often come up in health and safety matters and, as a
Safety Practitioner, you need to have a good understanding of the fundamentals of
occupational health and hygiene.
The following notes aim to give comprehensive cover of key issues and terms arising
in occupational health and hygiene. They have been compiled under five main topic
areas:

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‹‹ General aspects of occupational health and hygiene.
‹‹ Categories of occupational health hazards.
‹‹ Measurement and evaluation techniques.
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‹‹ Prevention and control measures.
‹‹ Personal protective equipment.
If you are already working in health and safety, you will be familiar with many of the
issues linked to industrial hygiene. However, we hope that these notes will provide a
useful reference. To help you we have also listed the main regulations and a glossary
of key terms.

General Aspects of Occupational Health and Hygiene

Stages in Occupational Health Practice
The aim of occupational hygiene is to identify and control occupational environments
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that may be potentially harmful to the health of people at work. Good occupational
hygiene practice involves four stages:
‹‹ Recognising and identifying.
‹‹ Measuring.
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‹‹ Evaluating.
‹‹ Preventing or controlling.

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Recognition and Identification
The main types of occupational hygiene hazards may be classified as:

Chemical Physical Biological Ergonomic

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Includes Includes ionising Includes Includes the body
liquids, fumes, and non-ionising bacteria, position in relation to
mists, vapours, radiation, viruses and work tasks, repetitive
gases and noise, vibration, fungi. actions, work pressure,
dusts. extremes of fatigue, boredom and
temperature or the effect on the body of
pressure and responses to metabolic
humidity. cycles.

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All of the above environmental conditions or stresses may cause illness, impaired
health or significant discomfort to people at work.
Measurement
This establishes the level of hazard and is generally carried out:
‹‹ continuously - where the potential hazard is very high, which can be considered
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as a control strategy; or
‹‹ intermittently - this could be an initial determination of potential hazards, spot
measurements in established processes, or routine check measurements.
The equipment used for measurement will depend on the particular type of hazard
under consideration.
Evaluation
This is the term used to determine the degree of health impairment likely to result
from the identified hazard. When evaluating the degree of damage that might result
from exposure to a harmful condition, you should consider the:
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‹‹ Harmful characteristics of the substance, energy or condition involved.

‹‹ State that the substance is in (solid, liquid or gas).
‹‹ Concentration, intensity, or level of the exposure to the harmful agent.
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‹‹ Time of the exposure.

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Prevention and Control
The type and design of control strategies dealing with hygiene problems will depend
very much on the evaluation of the particular situation.

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Controlling hygiene might include:
‹‹ Changing the process - altering the plant design or working procedures to reduce
the exposure from the harmful agent.
‹‹ Substituting or replacing a hazardous substance with a less harmful one.
‹‹ Segregating or isolating the process or work operation from workers by:
–– totally enclosing the process or the operators; or
–– carrying out the process away from the main work area ("isolation in space");
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–– limiting a particular process to periods when there will be a small number of
people in the vicinity of the work ("isolation in time").
‹‹ Suppressing or reducing the concentration of dusts or fumes by operating under
wet conditions for example.
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‹‹ Ventilating the whole workplace environment by a series of air changes in a
given period. Local Exhaust Ventilation (LEV) controls the formation of a harmful
atmosphere by removing the harmful agent at the place of generation and
ducting it safely in airflow to a place where it is less harmful.
‹‹ Reducing time exposure to reduce the effect of a harmful agent, by allowing a
person to work in a potentially harmful environment for limited periods only.
‹‹ Specifying and incorporating hazard reduction, process control and other safety
features at the design stage.
‹‹ Ensuring personal and general environmental hygiene - the personal cleanliness
of workers and their general environment is a very important factor in
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occupational hygiene control.

‹‹ Implementing personal protection - this is a "second-line" method of hygiene
control, to be used only when the hazard cannot be controlled at source.
‹‹ Training and educating promotes occupational hygiene and safety by educating
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about hazards and the ways in which they can be controlled and training in the
methods which will provide the physical control.

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Routes of Entry into the Body
The process of entry for a toxic agent is by absorption across the skin of the body
(the outer skin) or across the lining (epithelium) of the lungs or gastrointestinal tract.

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The route of entry is the way along which the toxic agent is transported to, or arrives
at, the site where absorption and entry occur.
There are two main ways in which entry may occur:
‹‹ By absorption across the body's "cover", either the outer skin (epidermis) or the
lining (epithelium) of the inner tract.
‹‹ By direct entry into the body's structure where the "cover" is broken, i.e. via a
break in the skin (e.g. when the skin is chapped and breaks up on movement,
or when a pimple has been picked). Entry by this method is sometimes called

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injection.
The areas where toxic substances may be absorbed are through the:
‹‹ Outer skin surface.
‹‹ Tissue covering the surfaces of the respiratory tract.
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‹‹ Tissue covering the surfaces of the gastrointestinal tract, which extends from the
mouth to the furthest extremities of the intestines.
Aspiration is a route of entry for solids or liquids directly into the lungs. Substances
that have been ingested, if expelled in vomit, may run down into the respiratory tract
or substances may be sucked directly into the lungs.
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Routes of entry

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The three main ways in which toxic substances can enter the body are through skin
contact, inhalation and ingestion.
Skin Contact

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The skin is the most vulnerable area, as it can be in contact with toxic substances
which may be solid, liquid or gaseous, and in very high concentrations in terms of
quantity of substance to skin area.
The skin forms the outer covering of the body and is continuous with the membrane
lining which covers the cavities within the body structure and which have their
openings at the body's outer surface. The skin provides the body's main defence
against external irritants, in particular the outermost layer of the epidermis and
glandular secretions that provide a greasy protective coating, which give the skin
toughness and a high level of waterproofing.

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The surface of the skin also has groups of capillary blood vessels set out at various
intervals and the flow of blood through these areas helps control heat. There are also
many sensory nerve endings in the skin layers.
The skin is a partially permeable membrane covering the external surface of the
body. If it becomes contaminated by water or fat-soluble materials, they may pass
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through the intact skin and into the underlying subcutaneous tissues, where they are
absorbed into the blood capillary vessels and thence into the circulatory system.
Inhalation
The respiratory system is an airway with two main parts: the air passages (the upper
respiratory tract) and the lungs. The lungs are the most vulnerable part of the body,
as they can readily absorb gases, soluble dust and fumes.
Air enters the nose or mouth and passes down the trachea which divides into two
bronchi, which are repeatedly branched into smaller air sacs or alveoli, that form the
delicate lining of the lungs across which gas exchange between the blood and the air
takes place.
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The alveoli are potentially at risk from a naturally dusty environment. In order to
protect the lungs, the body has developed defence mechanisms of biochemical
clearance and physical filtration.
‹‹ Biochemical Clearance
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This operates when particulate matter becomes deposited in the alveoli. It

triggers a defensive mechanism which involves the movement of phagocytes
from the blood into the alveoli. They engulf foreign bodies in an effort to
neutralise their harmful action.

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This process may cause inflammation and scar-tissue formation. If it occurs on
the alveoli surface, then scar tissue produces an "inelastic" structure and loss of
lung function. The process can proceed to cause a progressive disease condition,
with scarring occurring and the lung structure becoming stiffened. This causes

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breathing to become more arduous and exerts stress upon the heart.
‹‹ Physical Filtration
The efficiency of the physical filtration system depends on the size of particulate
matter which is able to penetrate the system. Dust particles which can enter into
the nose and nasal sinuses are about 100 µm and particles below 10 µm are able
to pass through. The size-range 7 µm to 0.5 µm is termed the respirable range,
but sizes below 0.5 µm are still potentially hazardous, as deposition may occur.
Ingestion

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‹‹ For ingested materials to become hazardous they must be able to be absorbed
across the walls of the gastrointestinal tract. The gastrointestinal tract is the least
vulnerable area of the body since the possibility of solid or liquid toxicants being
ingested is very limited.
‹‹ The gut extends through the body from the mouth to the anus. Its function is the
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control of ingested foodstuffs, in four stages:
–– Ingestion, via mastication and swallowing.
–– Digestion; treatment of foodstuffs for absorption into the body.
–– Absorption of treated foodstuffs.
–– Excretion of food residues and desorbed waste products.
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Schematic outline of the digestive system

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The stomach is an enlarged section of the gastrointestinal tract which forms a
receptacle for foodstuffs. It is constructed of several muscle systems which enable
foodstuffs to be continually mixed while the main digestive process takes place. The
stomach provides an acid medium for digestion.

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The small intestine extends from the stomach to the large intestine and its walls are
richly supplied with blood capillaries. Absorption of the end-products of digestion
into the underlying blood vessels occurs here. As well as nutrients, non-nutrients
such as toxic chemicals may pass into the body by this route.
The large intestine forms the final section of the gastrointestinal tract from the small
intestine to the anus. The large intestine takes no part in digestion or absorption of
nutrients. Its main function is to reabsorb water from the final mixture passed from
the small intestine.

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The gastrointestinal tract is involved with aqueous systems in its operation and the
pH of the system is therefore very important.
For the absorption to take place of ingested materials encountered in an
occupational setting, their chemistry must be complementary to aqueous media and
to the pH changes that occur.
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Target Organs
The body systems that are most affected by the absorption of toxic substances are:
‹‹ Blood, which circulates throughout most of the body structure in a network of
flexible tubes known as blood vessels. The red blood cells contain haemoglobin
which provides the chemical system that enables oxygen to be transported
throughout the body. White blood cells form the main defensive system in
combating disease and the effects of toxic actions and this involves moving in
and out of the blood vessels and wandering freely through the tissues, where
they ingest harmful micro-organisms or debris, or concentrate at the site of
infection or injury to attack foreign matter. They also protect the body by forming
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antibodies.
‹‹ The heart, which lies centrally between the lungs. Blood vessels leaving the heart
are called arteries. These branch into smaller capillaries supplying nutrients and
oxygen from the lungs to the organs and collecting other material and carbon
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dioxide from the cells. Blood from capillaries flows into veins and then back to
the heart.
‹‹ The liver, which acts as a vast chemical factory. It plays an essential role in the
metabolism of protein, carbohydrate and fat; is concerned with the absorption
and storage of vitamins; and with the synthesis of blood-clotting factors. The liver

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