CHAPTER 4

HEALTH HAZARDS

LECTURED BY:
MOHD HADRI MOHAMED NOR
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SUBTOPIC
4.1 Introduction to Health Hazard and Hygiene
4.2 Chemical Hazards
4.3 Physical Hazards
4.4 Biological Hazards
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4.1 INTRODUCTION TO HEALTH HAZARD

& HYGIENE

HISTORY
• In 5th century BC, Hippocrates, a Greek doctor
initiated scientific foundation to make a link
between the adverse effects suffered by lead
workers and their exposure to metal.
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• In the 1st century AD, Pliny the Roman Elder

recorded how workers refining red mercuric
sulfide wore bladders over their faces to avoid
inhaling dust.
• Only in 15th century that the dangers in
substances such as lead, mercury and dust from
mining became widely recognized and efforts
were made to reduce exposures.
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.
• In 18th century, Rammazini an Italian doctor also
known as Father of Occupational Medicine
published books on diseases related to exposures
of metals, dusts and some chemical and also the
importance of physician to inquire patient’s
occupation.
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DEFINITION OF OCCUPATIONAL HEALTH

“Occupational Health is the promotion and

maintenance of the highest degree of
physical, mental and social well-being of
workers in all occupations by preventing
departures from health, controlling risks and
the adaptation of work to people, and people
to their jobs.” [ILO/WHO 1995]
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HEALTH EFFECT IN HEALTH HAZARD

• Acute
• Immediate in their effects and relatively simple
control.

• Chronic
• Difficult to assess or identify as they may take
a long time to have any effect.
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PRINCIPLE OF PREVENTION AND CONTROL

• Anticipate
• Identify/Recognise
• Assess/Evaluate
• Control
• Review
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HIERARCHY OF CONTROL

• Eliminate
• Substitute
• Isolate
• Engineering control
• Administrative control
• PPE
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HEALTH SURVEILLANCE AND BIOLOGICAL

MONITORING

• Health surveillance is the monitoring of

individuals in order to identify changes in
health due to exposure to hazardous
substances.
• Biological monitoring is the measurement of
a hazardous substance, its metabolite or
other substances like enzymes in body
tissues, fluids or exhaled air.
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OCCUPATIONAL REHABILITATION

• Rehabilitation includes the medical treatment which

assist recovery, as well as management of the process
which helps people stay at or return to work.
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4.2 CHEMICAL HAZARDS

SUB-TOPIC
4.2.1 Legal Provision
4.2.2 How Chemical Affect Health
4.2.3 Dangerous Situation – Increasing Risk Exposure
4.3.4 Safety Data Sheet (SDS)
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4.2.1 LEGAL PROVISION

• Factories and Machinery Act
– Factory and Machinery (Lead) Regulations 1984
– Factory and Machinery (Asbestos Process) Regulations 1986
– Factory and Machinery (Mineral Dust) Regulations 1989

• Five main aspect related to this statutory

– Permissible exposure limit
– Exposure monitoring
– Medical inspection
– Control methods
– Other matters such as records, penalty, etc
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• Occupational Safety and Health Act

– OSH (Control of Industrial Major Accidents Hazards) Regulation
1996
Control of major disaster caused by chemical
– OSH (Classification, Labeling and Safety Data Sheet of
Hazardous Chemicals) Regulation 2013
Supply of chemicals
Safety Data Sheet (SDS)
– OSH (Prohibition of Use of Substance) Order 1999
Prohibition of dangerous chemical
– Management of chemicals, PEL, evaluating risk, medical
monitoring
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4.2.2 HOW CHEMICAL AFFECT HEALTH

DIRECT CONTACT

• Direct contact with corrosive chemical such as alkali or

acid
• Irritant chemicals cause skin to flare up
• Cause skin allergy example nickel
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CHEMICAL ROUTES OF ENTRY INTO HUMAN

BODY

INHALATION
INGESTION
ABSORPTION
INJECTION
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Breathing and smoking causes

INHALATION us to inhale substances which
enter the lungs. Substance
inhaled into the lungs are
readily absorbed into the blood
stream.

INHALATION
INGESTION
ABSORPTION
INJECTION
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Swallowing a substance causes

INGESTION penetration into the blood
stream via the stomach and
small intestine.

INHALATION
INGESTION
ABSORPTION
INJECTION
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Entering the body through the

ABSORPTION skin causes substances to enter
the blood stream at a slower rate
than by inhalation or absorption.
However, the resulting entry and
distribution within the body is
the same.

INHALATION
INGESTION
ABSORPTION
INJECTION
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Injection occurs when substances

INJECTION are forced through this skin. This
can occur as a result of such
means as compressed air, or by
having the skin abraded by a
penetrating object.

INHALATION
INGESTION
ABSORPTION
INJECTION
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4.2.3 DANGEROUS SITUATION - INCREASING RISK EXPOSURE

• Lack of awareness on hazardous chemicals

• Leakage or accidentally spillage of chemicals
• Working in a enclosed area or room with poor ventilation
• Doing routine that involve chemicals
• Machine breakdown
• Lack of safety management
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4.2.4 SAFETY DATA SHEET (SDS)

Introduction
• SDS is a brochure or informational paper containing
information related to hazardous chemical which are
important in the safe use and handling of chemicals at
workplace.

• Objectives of SDS
– Understand the safety recommendation and their rationales
– Realize the results of failure to comply to safety requirements
– OSH (Prohibition of Use of Substance) Order 1999
– Identify symptoms of over exposure
– Obtain input for the formulation of strategies and
recommendation in the safe use of hazardous chemicals
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Legal Provision

• Part V Safety Data Sheet – Regulation 13 OSH

(Classification, Labeling and Safety Data Sheet of
Hazardous Chemicals) Regulation 2013
– Requires supplier to prepare and provide SDS for every
hazardous chemical supplied.
– Supplier means a person who supplies a hazardous chemical,
including a principal supplier and subsidiary supplier. Subsidiary
supplier – supplier who repacks, distributes or retail hazardous
chemical. Principal supplier – who formulates, manufactures,
imports, recycles or reformulate hazardous chemical.
– Supplier also required to review SDS regularly
– The information required must be with the objective to protect the
safety and health of the worker, and not for use for any reason.
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Mandatory Information

• There are 16 types information required

– Identification of the hazardous chemical and of the supplier
– Hazard identification
– Composition and information of the ingredients of hazardous
chemical
– First aid measures
– Fire fighting measures
– Accidental release measures
– Handling and storage
– Exposure control and personal protection
– Physical and chemical properties
– Stability and reactivity
– Toxicological information
– Ecological information
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– Disposal information
– Transportation information
– Regulatory information
– Other information
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4.3 PHYSICAL HAZARDS

SUB-TOPIC
4.3.1 Noise
4.3.2 Vibration
4.3.3 Heat Stress
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4.3.1 NOISE

DEFINITION
• Sound
– Generated by mechanical vibrations that can be detected by
human ears.
– It is a force carried out through various mediums (air, water,
solids)

• Noise
– Unwanted sound
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COMPONENTS
1 cycle

• Frequency A
Frequency
– Number of vibrations per
second B
– Unit Hertz (Hz)
Frequency B > Frequency A

intensity
x

A
• Amplitude
– Peak magnitude or maximum
movement of the sound wave.
– Unit decibel (dBA) B

Amplitude of B > A
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TYPE OF NOISE

• Continuous noise
– Noise that has the sound intensity between maximum and
minimum less than 3 dBA.
amplitude

changing of
amplitude < 3 dB

time
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• Fluctuation noise
– Noise that has varying intensity levels from high to low over 3 dBA.

> 3 dB
amplitude

time
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• Impulse noise
– Noise that has high intensity within a short duration such as the
sound of a bullet shot.

>1s
amplitude

< 0.5 s

time
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• Interval noise
– Noise that occurs at certain durations and may repeat at certain
intervals

< 3 dB
amplitude

< 3 dB

time
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LEGAL PROVISION RELATED TO NOISE

• Factories and Machinery (Noise Exposure) Regulation

1989
– Permissible exposure limit.
– Exposure monitoring.
– Methods of compliance.
– PPE for specific hearing protection.
– Audiometric testing program.
– Employee information and training.
– Warning sign.
– Record keeping
– Miscellaneous
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LEGAL PROVISION – PERMISSIBLE EXPOSURE LIMIT (PEL)

• Action level (AL)

– 85 dBA

• PEL
– Continuous noise
For 8 hours: 90 dBA
Ceiling limit: 115 dBA
– Impulse noise
Ceiling limit: 140 dBA
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OCCUPATIONS AT RISK

• Mining
• Quarrying
• Construction
• Manufacturing
• Textile
• Etc.
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HEALTH EFFECT

• Disturbed emotion and anger

• Communication problem
• Tinnitus
• Psychology pressure
• Increase of blood pressure
• Damage or loss of hearing
– Conduction type
Damage to the ear drum
Displacement of ossicle bones in the middle ear
– Neuro-sensory
Damage to the hair follicles in the inner ears
Loss of hearing due to over exposure to loud noise
Normal cases: both ears
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CONTROL MEASURES

• Engineering controls
– Substitution of less noisy equipment
– Isolation of noisy equipment from main area

• Administrative controls
– Proper risk assessment before purchase noisy equipment
– Reduction of exposure to noise
– Training and lectures
– Have written policy to ensure safe work practice
– Exposure monitoring
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• Health monitoring
– Once annually
Exposure PEL
Initial hearing test shows that there is hearing problem
Hearing Threshold Standard
– Once every 2 years for noise exposure between 85-90 dBA
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AUDIOMETRIC BOOTH

Audiometric
booth

audiometer

printer
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4.3.1 VIBRATION

DEFINITION
• Vibration
– Refer to movement of solids where the amplitude and frequency
produced may cause harmful to those exposed.
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TYPES OF VIBRATION (IN CONTEXT OF WORKERS HEALTH)

• Whole body vibration (WBV)

– Where the vibration usually transferred when in contact with the
feet or buttocks
Vehicle operation
Heavy vehicles

• Hand arm vibration (HAV)

– Where the vibration usually transferred when in contact with the
hand due to use of vibrating equipment
Hand drill
Chainsaw
Etc.
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HEALTH EFFECT

• Whole body vibration (WBV)

– Blurring eye
– Nausea, vomiting, headache, back pain
– Can cause lung and heart malfunction

• Hand arm vibration (HAV)

– Damage blood vessel, nerve and musculoskeletal system
– Pale finger, numbness and pain
– Carpal tunnel syndrome
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PREVENTION AND MONITORING CONTROL

• Evaluate risk prior to purchasing a vibrating equipment

• Eliminate hazard
• Substitute: with less vibrating equipment, anti-vibration
• Reduce exposure
• Training, information, instruction
• Periodical maintenance equipment
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4.3.1 HEAT STRESS

INTRODUCTION
Heat stress occurs when the body’s
means of controlling its internal
temperature starts to fail. As well as air
temperature, factors such as work rate,
humidity and clothing worn while working
may lead to heat stress.

Workers who are exposed to

extreme heat or work in hot
environments may be at risk of heat
stress. Exposure to extreme heat
can result in occupational illnesses
and injuries.
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COMPILATION OF SEVERE HEAT STRESS IN BODY

- Heat stroke
- Heat exhaustion
- Heat syncope
- Heat cramp
- Heat rash
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Heat Stroke
- Occurs when the body becomes unable to control its temperature: the body's
temperature rises rapidly, the sweating mechanism fails, and the body is
unable to cool down.
First Aid
- Can cause death.

Symptom

• Hot, dry skin or profuse sweating

• Hallucinations
• Chills
• Throbbing headache
• High body temperature
• Confusion/dizziness
• Slurred speech
CALL 999
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Heat Exhaustion
- Heat exhaustion is the body's response to an excessive loss of the water and
salt, usually through excessive sweating.

Symptom First Aid

• Heavy sweating • Have them rest in a cool, shaded

• Extreme weakness or fatigue
• Dizziness, confusion
• Nausea
• Clammy, moist skin
• Pale or flushed complexion
• Muscle cramps
• Slightly elevated body temperature
• Fast and shallow breathing
or air-conditioned area.
• Have them drink plenty of water or
other cool, nonalcoholic beverages.
• Have them take a cool shower,
bath, or sponge bath.
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Heat Syncope
- is a fainting/dizziness, usually occurs with prolonged standing or sudden rising
from a sitting or lying position. Factors that may contribute to heat syncope
include dehydration and lack of acclimatization.

Symptom

• Light-headedness
• Dizziness
• Fainting

First Aid

• Sit or lie down in a cool place when

they begin to feel symptoms.
• Slowly drink water, clear juice, or a
sports beverage.
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Heat Cramp
- Usually affect workers who sweat a lot during strenuous activity.
- Low salt levels in muscles causes painful cramps.
- May also be a symptom of heat exhaustion

Symptom

• Muscle pain or spasms usually in the abdomen, arms, or legs

First Aid

• Stop all activity, and sit in a cool place.

• Drink clear juice or a sports beverage.
• Do not return to strenuous work for a few hours after the cramps subside
because further exertion may lead to heat exhaustion or heat stroke.
• Seek medical attention if the worker has heart problems, the worker is on
a low-sodium diet, the cramps do not subside within one hour.
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Heat Rash
- Is a skin irritation caused by excessive sweating during hot, humid weather.

Symptom

• Heat rash looks like a red cluster of pimples or small blisters.

• It is more likely to occur on the neck and upper chest, in the groin, under
the breasts, and in elbow creases.

First Aid

• Try to work in a cooler, less humid environment when possible.

• Keep the affected area dry.
• Dusting powder may be used to increase comfort.
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REDUCING THE RISK

- Control the temperature

- Provide mechanical aid
- Regulate the length of exposure to hot environments
- Prevent dehydration
- Provide personal protective equipment
- Provide training for your workers
- Allow workers to acclimatize to their environment and identify which workers
are acclimatized/assessed as fit to work in hot conditions.
- Identify employees who are more susceptible to heat stress
- Monitor the health of workers at risk
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HEAT STRESS INDEX

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Heat May Be Nature’s Deadliest

Killer
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4.4 BIOLOGICAL HAZARDS

INTRODUCTION
• Community and employee
awareness
• Identification of biological
agents that cause Legionnaire
disease, Hepatitis B and HIV
• Industries such as agriculture,
health care, biotechnology,
research and clinical
laboratories
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DEFINITIONS
• Biological agent
– Includes living micro-organisms such as viruses and
bacteria capable of exuding toxins, exposure to which
may cause disease or death in human, animals and
plants.

• Etiological agent
– Agent that causes the actual contraction of disease.

• Infection
– Attacks of pathogenic organism on the body, which
may or may not cause contraction of disease.
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• Bio-safety
– An area of science that serve to disconnect chains of
infection.

• Agent
– Physical, radiological, chemical or biological entity
that may cause certain effects upon exposure.

• Host
– Host where the agent is present (example: human)

• Environment
– Includes living and non-living things (biosphere,
atmosphere, lithosphere and hydrosphere)
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INTERACTION BETWEEN HOST, AGENT AND

ENVIRONMENT
Host
- Health status
Agent - Management system
- Carrier - Training
- Substitute for pathogen Agent
- Health surveillance
- Antibiotics resistance Host - Use of PPE
- Virulent factors - Perceptions
- Communicability factor - Reservoir
- Fatal factor

Environmen Environment
t
- Population density
- Medical support facilities
- Weather (wind, temperature)
- Social, politics, ethics
- Facility design
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ANOTHER FACTORS

• Agent must be pathogenic

• Presence of reservoir
• Agent must be able to escape from reservoir
• The ability of agent to move in the environment
• There is an entry on the new host
• Host is susceptible to the agent
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CHAIN OF INFECTION

Patogen

Takungan

Pelepasan
dari
takungan
Transmisi
melalui
persekitan
Tapak
kemasukan

Hos
rentan
Control of infection = break any connection between chain
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BIOLOGICAL SAFETY CABINET CLASSIFICATION

Potential of Bio- Description of Example Control
Hazard Agent
Low risk Bacteria Normal biological
Not known whether practices
Level I Bacillus subtilis
can cause disease Suitable isolation
E.Coli K12
May cause disease Bacteria Bio-hazard label
on human Autoclave
Salmonella
Level II Virus Medical
surveillance
Hepatitis A, B, C, D
Fungers
Cryptococcus
Agent is indigenous Virus Special design
Level III
HIV, TB Specific LEV

Agent is dangerous Virus Special design

Level IV High exposure may Ebola
cause risk to life
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WORKING SAFELY WITH BIOLOGICAL AGENTS

• Bio safety program management

– Identify the scope of the programme based on the risk
– Develop policy and procedure
– Provide training for workers, supervision and regular refresher
course
– Provide suitable facilities

• Administrative controls
– Establish a bio-safety committee
– Appoint bio-safety officer (BSO – Bio Safety Level III & IV)

• Physical containment
– Based on bio-safety level
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• Disinfection and sterilization

– Use of chemical or physical agent
– Sterilization kill organisms in total

• Accident, spill and emergency training

– Requires specific training

• Transportation of biological agent

– Should be viewed from the perspective of anticipating and
preventive accidents
– Compliance with sea and air transport standards

• Biological risk communication

– Biological communication strategy should be develop
– Other than workers, should also include the public
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