Occupational Safety and Health Management

for the Recycling Industry

l Z 3
Michael K.H. Leung ,Annie W.Y. Ng , and Alan H.S. Chan
I
Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
(mkhleung@hku.hk)
2
School of Design, The Hong Kong Polytechnic University, Hong Kong, China
3
0epartment of Manufacturing Engineering and Engineering Management, City University of Hong Kong, HK, China

Abstract -The workers in the recycling indnstry have to man-days loss available in Hong Kong. There is a need
deal with various kinds of toxic and harmful substances in to conduct an in-depth study to identify OSH problems,
wastes on a regular basis. Due to the unique high-risk to analyze the high risk activities and to develop practical
operations and processes in the recycling industry, the
solutions to tackle the problems. The main purpose of
occupational safety and health (OSH) management system
this project was to study the issues of occupational safety
for general working environments requires serious
and health (OSH) in the recycling industry and to
modifications to better safeguard the health of workers. In
this project, the existing OSH working environment and establish effective OSH management program for
operational practices have been reviewed. Accordingly, reduction and prevention of OSH hazards and problems
effective OSH management program has been established in the trade.The project will be completed with the
for the recycling industry. The subsequent implementation following subsequent key tasks:
will enable systematic OSH management to collect injury 1. To conduct a cross-sectional territory wide survey
statistical data, identify mitigation measures and thus to review and identify the OSH problems in recycling
improve the OSH performance.
industries in Hong Kong.
2. To collect general OSH information of the recycling
Keywords Safety And Health, Human Factors,
industry in Hong Kong.
Recycling Industry, Environment
3. To identify the high risk activities based on the
findings from the aforesaid survey.
4. To collect the views and suggestions on the
I.INTRODUCTION
improvement of current OSH situation from the
employees in the recycling industry.
In Hong Kong, municipal wasteloads have been
5. To formulate a practical solution including
increasing at an annual rate of 3% rn The remaining
engineering controls, administrative controls and
landfill space will last only for 6 to 10 years if the waste
ergonomic controls to reduce the problems associated
levels continue to increase at the present rate. The waste
with the high risk activities in recycling industries in
disposal problem becomes more and more serious in
Hong Kong. The engineering control measures are listed
Hong Kong. That speeds up the growth of the recycling
in Section 3: Control Measures at Workplace.
industry. The Hong Kong Government has committed to
6. To develop a comprehensive Training and
increase the overall recovery rate of municipal solid
Promotional Kit for both employers and employees for
waste by 50% by 2014 r21-
the recycling industries to implement sounded control
Recycling involves the separation and collection of
measures in prevention of occupational accidents.
materials for processing and remanufacturing into new
products, and the use of the products to complete the
cycle. The aims of recycling are to prevent the waste of
II.METHOOOLOGY
potentially useful materials, reduce the consumption of
fresh raw materials and reduce energy usage, and thereby
The project was conducted in two main phases. The
lower greenhouse gas emissions. Recycling is a key
first phase was to identify the OSH issues and understand
concept of modern waste management. It becomes a very
the potential risks of the recycling workers. Both local
important element of the local waste management
and overseas literatures had been reviewed, and the Hong
framework. According to the online Hong Kong
Kong General Association of Re-Cycling Business and
Collector/Recycler Directory r31, there are 413 recycling
other recycling associations were consulted. The work
companies in Hong Kong. Papers, plastics, ferrous
natures, activities of different types of employees,
metals and non-ferrous metals are the major types of
machines or tools used and working environments in the
recyclable wastes recovered l4J. The municipal solid
recycling industry were reviewed. Specific hazards
waste recovery rates and its export values rise
arising from different types of wastes being handled or
continuously towards 45% and HK$6 billion in 2007'
processed (e.g. electrical, chemical, biological and
respectively r51-
mechanical hazards) and signs of OSH problems or
A proper OSH management system is urgently
symptoms amongst the workforce had been identified.
needed to ensure safe operation of the business. There is
The second phase focused on the development of
a lack of related injury statistics and information of

978-1-4244-3672-9/09/$25.00 ©2009 IEEE

1255
OSH management program. The OSH management measurements will be assessed with OSH standards and
program was established to cope with the identified OSH guidelines to determine the OSH level.
hazards and problems associated with the high risk
activities in the recycling industry. B. Management controls

Through the OSH review, practical solutions

IILOSH ISSUES IN RECYCLING INDUSTRY including engineering controls, administrative controls
and ergonomic controls have been recommended on a
Waste for recycling come from various sources priority basis. The recycling industry related (i)
including households and industries. There are some engineering controls, (ii) administrative controls and (iii)
OSH studies on the recycling industry in U.K., Europe, ergonomic controls include the followings:
Canada, and U.S. For example, it was found that workers
sorting recyclable paper are exposed to high levels of (i) Engineering controls
bio-aerosols and dustiness of recyclable paper is high in a) Recycling machines should be properly maintained.
terms of dust and endotoxin r61, Electronics recycling b) Employees have been advised not to repair
workers are usually exposed to polybrominated diphenyl recycling machines themselves. Only trained technicians
ethers (PBDEs) rn Workers in plastic bottle-recycling should carry out the repair and maintenance works.
factories have a potential risk of organophosphate c) Recycling machines should be equipped with
pesticide intoxication L8J, Workers in the recycling of proper emergency stops.
radioactive scrap metals would expose to radiation and d) Operator of a recycling machine should have a
toxic chemicals r91, The carbon monoxide concentration padlock for locking out the control panel before leaving.
is higher than the threshold limit values by 50% in e) Alarms should be installed to indicate the start-up
household-waste sorting areas LIOJ, Excessive noise from of recycling machines.
glass being tipped into empty chambers was found Lll J, f) Conveyor-driving mechanisms (belts, pulleys,
Workers in recyclable material sorting centers reported couplings, etc) should be covered by solidly attached
suffering from limb and back pain LI2J. The above safety guards.
evidences clearly show the urgent need for a g) The sources of noise originating from recycling
comprehensive OSH study for the recycling industry in machines should be isolated, confined or covered.
Hong Kong.
(ii) Administrative controls
a) Occupational safety and health rules and guidelines
IV. OSH MANAGEMENT PROGRAM should be implemented.
b) Appropriate occupational safety and health training
A.Data collection should be provided for employees.
c) Safety inspection should be conducted regularly to
Suitable questionnaires have been developed for the ensure working environment is in compliance with
OSH survey and assessment. They are prepared based on regulated and internal safety standards.
the literatures on the OSH matters in local and overseas d) Risk assessment should be conducted before the
recycling industries. The questionnaires are given in introduction of procedures and new machines and
Appendices I and II. OSH data and information will be facilities.
collected for the work natures, activities of different e) Appropriate warning signs should be posted to
types of employees, machines or tools used and working identify specific hazards in the work environment.
environments in the recycling industry. Specific hazards
arising from different types of wastes being handled or (iii) Ergonomic measures
processed (e.g. electrical, chemical, biological and a) Employees performing manual handling work
mechanical hazards) and signs of OSH problems or should be provided with mechanical assistance.
symptoms amongst the workforce will be identified. The b) Task variability should be incorporated so that
views and suggestions on the improvement of current workers do not have to perform similar repetitive tasks
OSH situations from the employees in the recycling (e.g. push or pull bundles of recycled items) throughout
industry will be collected and analyzed. the full shift.
Additionally, the prevalence and degree of the c) Appropriate rest breaks should be provided for
subjective work-related health complaints will be employees.
determined. The total working days lost for the whole d) Workers' sensations of discomfort and pain should
workforce and the corresponding economic loss will then be recorded. The workstations, rotation and pace should
be estimated. The objective measurements, such as reduce workers' constraints.
noise, lighting, thermal condition (temperature and e) The heights of the pick-up point and deposit point
humidity), air quality (respirable suspended particulates, should be adjusted to reduce awkward neck movements
bioaerosols, volatile organic compounds (VOC) etc.) and and back postures.
posture at work, will be further assessed. The

1256
 V. FUTURE WORKS V. SUMMARY

The OSH management system will facilitate a Recycling is a growing industry. It directly reduces
detailed study of the recycling industry for improvement waste generated and indirectly reduces the greenhouse
of its safety and health performance in Hong Kong. This gas emission. Effective OSH management program
project will continue with the following development: guidelines are urgently needed to catch up with the
I. We shall conduct a cross-sectional territory wide growth in its business demand. In this project, an OSH
survey to review and identify the OSH problems in the management program has been set up specially for the
recycling industries in Hong Kong. The number of unique operational features of the recycling industry. Its
company participants is estimated based on the implementation will increase the OSH awareness and
confidence level of 95% and margin of error at +/-10% performance significantly for the whole recycling
[Sample size = ((Z score for confidence level x 0.5) / industry.
2
margin of error) J.
2. We shall collect general OSH information of the
recycling industry in Hong Kong and identify the number VI.ACKNOWLEDGMENT
of recycling companies and the employees in Hong
Kong. The authors would like to thank the Hong Kong
3. We shall develop a suitable questionnaire and General Association of Re-Cycling Business and Lo's
assessment checklists for the survey. Enviro-Pro Holdings Ltd. for their support in this project.
4. We shall be responsible for identifying and sourcing
a representative sample of companies in the recycling
industry with appropriate size and business nature for the REFERENCES
Study in order to scrutinize the actual situation of the
industry. We shall then arrange visits to these companies [IJ Environmental Protection Department, Hong Kong's Environment
- Waste (2008).
to conduct the survey. The types of recycling may cover
[2] Environmental Protection Department, A policy framework for the
households, industrials, commercials and construction management of municipal solid waste (2005).
(including renovation and maintenance), etc. The major [3] Hong Kong Waste Reduction, Hong Kong Collector/Recycler
recyclable materials include ferrous metal, non-ferrous Directory (2007).
[4J Hong Kong Waste Reduction, Waste Recycling Statistics (2008).
metal, plastic, paper, glass etc.
[5] Environmental Protection Department, Monitoring of Solid Waste
5. During the visit, we shall identify and observe the in Hong Kong - Waste Statistics for 2007 (2008).
work natures, activities of different types of employees, [6] Breum, N.O., WUrtz, H., Midtgaard, U. and Ebbeh0j, N., Waste

machines or tools used and the working environment in Management & Research, 17, p.100 (1999).
[7J Thuresson, K., BergmanA-, Rothenbacher, K., Herrmann, T.,
the recycling industries.
SjOlin, S., Hagmar, L., Papke, O. and Jakobsson, K., Chemosphere,
6. We should identify specific hazards arising from 64, p.1855(2006).
different types of wastes being handled or processed, for [8J Wang, c.L., Chuang, H.Y., Chang, c.Y., Liu, S.T., Wu, M.T. and

example, liquid or solid wastes, food remains, etc. Ho, c.K., Environmental Health Perspectives, 108, p.ll03 (2000).
[9J Nieves, L.A., Chen, S.Y., Murphie, w.E. and Lilly, M.J., Energy
7. During the visit, we shall identify signs of OSH
Citations Database (1994).
problems or symptoms amongst the workforce and [10] Jacques, L. and Serge, G., Journal of the Air & Waste Management
collect the views and suggestions on the improvement of Association, 51, p.352 (200 I).
current OSH situation from the employees in the [IIJ Health and Safety Executive, Mapping health and safety standards
in the UK waste industry (2004).
recycling industry.
[12J IRSST (2005). Prevention of occupational health and safety risks
8. We should analyze the data collected from the in recyclable material sorting centres.
survey with suitable statistical tools and come up with
the practical solutions for employers in the recycling
industries to tackle the identified OSH problems based
on the findings of the study.
9. We should develop a guideline introducing the
control measures with reference to the results of the
survey.
10. We shall develop an online OSH management self
assessment tool to be used by the public on the Council
website.
11. Based on the findings of the contract out research
study services; we shall develop and produce a DIY Kit
to tackle OSH problems in the Hong Kong recycling
industry. The DIY Kit shall include a training program
with both teaching and training materials on how to cope
with the identified OSH problems in the Hong Kong
recycling industry.

1257
 Appendix I. Survey on Occupational Safety and Sedi.on 3: C:::ontnd Measures at Wor kplare
Yo. No Roma,k<
Health Problems for Companies in Hong Kong 3.1 Ad.m.iDi:strative I:untnds
0) H.avf!o OCCUp<d:iIlln.al ....rl:Ety .and health ['ulf!.S .and gnidi!olini!-S b_n 0 0
Recycling Industry implementE!d?

b) Is ap p ropriate Qccupational sai-ety lind h-eal.th training provided 0 0

for IE-mplayee.s.?
Tbi. questionnaire is used to identify the existing occupational safety and health proble"",
foe oomp=i'" in Hong Kong recycling industry. All infonnation provided will be kept Has safety inspection 'bee-n ccooucted regular1y tD lE-ru.ure 0 0
'J
oonfidential. WOl'l::ing enviranm-ent is in c omplian.c-e with regulated and
int-E!l'n.al :!iarety :5tiW.dard:!i?'
�::�any Name: ______

d) Are riw assf!.Ssed l:Jefu['j!. the :introduction af pl'OCM1D'e5 and 0 0

new macb.m-es and fac:ilitiil!-S?

Sedi.on 1: Work Practice

.) H.ave appI'opriamwarningsigns bell!-n posteod to identify specific 0 0
1.1 Types Qf l'E!cycled it-em5 b�i.ng handled .md PJ'OCE'.s.sed in theccmpany
haza:rd.s. within anarlBil?
D Glas..s. D Paper D M-eta.l D Plastic
D eJDth-es D Otb:E!�J pleasespecify: __

3.2 ED!;ineering [untroh

a) Are l'E!cycling machine:!i approprian-ly m aintained? 0 0
1.2 Whel'E! the �Ied items. �ome &em"]
D HQu.s�hD1d!i D Indllltrials D Commercial..s D ConstroctiOJl b) H.avf!o employee... l::u!'11!11 .mmll!'d not tD l'Epair l'E!cycling marnine... 0 0
D Otb:E!�J pleasespecify: ____
th-emseJve!i?

'J Are r� ling m.a.cbine... egu.ipped Wlth prop�r em.eJ""ge-ncy 0 0

Part-time employees .s.taps?

1.3 NumbeJ' of-em pJ oyeesin theccmpany

d) Do� th-e Dp� rata
r Qf a l'E!cycling chi ma ne
have a padlock. for 0 0

1.4 Average! number of working day.s. pel" we�k lDd;:ing D1I1: the �ontrD1 pan�l beful'E! 1e!avin.g?
--- days ---- days

1.,5 Average! number of working hoUl'S PH'day 00= .) Havf!o :in.s.talllI!d oilarm... indi �.ttiDg � moidtin-e5 .s.taJ"t-up? 0 0
_____ _____ 00=

f) Are C'4JR'VeyQr-driving m -echani5ms (b�ltsr pulleys, �o�, 0 0

-etc) oovenod by .solid1y atta.ched guard.3."]
1.6 How many e-m pl oye� arE! working in � foIfuwing natol'E!S of work"]
g) Are the sow'c€s of noise Qriginating" from r�ling ma�bine... 0 0
nDl.at!ed. ronfin.ed Q[' cov-e-red?

Ii} Recycled i tem collectDJ' 3.] ErgonOIDic mP<l...'5:UTI!'.!5:

a) Are empooY'H'.s. perfurm.ing manua1 b.andling work provided 0 0
b) Sorting l'E!cycled itml5
with mechanical asmtan.ce"]

c) EquipmentjMach:in.eryoperator
b) Is tasl:varia'bi1ity in�orpDl"ated.so that WQrkers do not bave ta 0 0
perfonn.s.imila:r:rep�tit:iQns taili (e,g. pw.h Qr puDbuncll� of
d) MaintE!na:JI.C'e .md repair :rec:yd.ed items) througlroutth-e full.s.hift?

,J Are apPl'Dpriatll!- ren breah pl"DVid-ed fur empooyee!i? 0 0

f} Ot:hel':5. please specify:____

d) Are WD:I'brs' 5�n5a1:i0R'5 of disCllurrfort and paiR :re['on3ed? And 0 0
th-e WQrhtation..... mtatiQD and pafi:! ar � adaptll!d m redUfi:!
1.7 Machine-s and colllis usecl atwDl"k WOl'ker ...' [,Dn!i1r.ainb"]
D Forklift D loader D Mech.an.ica1:KHter D Compa.c:ror
o Conveyor 0 Cart 0 Spmner DHammer .) Are the heights ofthe pid-up point and depQsit point adjust-ed 0 0
o Screwdriver 0 others. pi.... speoi!y. ____ to reduce awkw"ard nd m -eme ov n.t5
and back poo-'tUrII!s"]

Sedi.on Z: Work Related Health Prob1em and IIlnes:ii Sedi.on 4: CoUective and Individual Means of Protection
Z.l [)id YDU[' IE-m pl �
es .s.uff-e['&em the- falfuwing 1WrK r-ellJted health prablems and iUru!',5.5i1!'.s ilt..mlli" Y., N. Remal"ks
3._ 4.1 Per.!5:DDal protective equipmPnt:
Heahh problems iIInd iUDeS:5E!s*
I-;N"O=-, .. ..li"ttle
::-rA · ·i :'''
'i'''<'Sritv'' = ''''=.:-,
' ....=ri=o'''
::::---j �fu::;mn a) Is thel'E! :5uffi.centpE!�Dnal prDtective eguipm-ent (II!-.g. g].ove.5,
foot prct-eHoU) available for im.m-ediat-e U'5E!?
0 0

all �..Jtb
probJems D 0
b) Is the pE!�nal pmtecti.ve elJDipm-eDt fuee &.am ...c:ratch-es and in
fmPa3.t30 g�]Qd [,DnditiQD".:'
dar»
Cut,.pWJ.Cture., scrape
Disloea.tion 4.2 Sanitary fari1ities:
fall DJ'!ilipmjwy
a) Are sufficientmilets and washing facilities p rovidlHl for D 0
Pro...... -empJoyei!5?'
Irritati"n of the eye/Skill/mw:ou..s
membrane5 b) Are the toil�ts and washing facilitie.s. bpt clE!an and hygienic D 0
Leg H'a.mp/foDt pain and de·an.ed at III!aSI: OD.C'e a .day"]
Mu.sculod:-E!l.etal problems
OrE!"anic- du'il: toxic �'I1Il.draffi@ Are the toilets and washing facilit:ie!i. elJDipped with .s.anitatiDn
,J 0 0
products (e.g. soap, pa(K!'rtDW@l...)?'

4.3 first <nd fadlities:

a) Havf!o eyewash fountain... and -emel'gil!'ncy shDWer:s been instaUIHl 0 0
for em� rg-ency rinsing of thefa�� or bQdy?
2: ::'. md yt:mr IE-mp l�i1!'5 � .any injl1l"ie� tD dJ.e. following hody 111,,::�,m.lU1S at wo['l: i• .oort 3rJ dar?- b) Are sufficientfirst aid bDX11!:5 prDVid-ed? o 0
IDju["II!d Body Pre ueo..:y WbarkiDd ofiDjmies
i.o.::iltiDD NDtatall Often SomKimes Always haveYOUl'emp1oyees c) Do the fir:staid bm.:e.s. �on.ta:in i tem
... required bylawr.s.u ch a.s. D 0
had, .s.teJ'ile gaU2E!, ��i'l,l"ll! gauze bandage.s. and ai.mgula:r
bandages?'

4.... Means; of e...cape:

a) Are there sufficient exits in the wDl"kplafi:! to .illow lJDi�k o 0
-e'lr.l.CUat:ion from the pl'�mi'5E!S fur all-emp1oye�?

b) Is em.eJ"gil!'ncy lighting pr DVid-ed in ensts?' D 0

2.3 In dJ.E. la5t 12 months, how many days ofsick leave have year employees taken dU2- tD WOJ'k­ c) Are aD me.m.s. of escape! l:-ept clean and unob!i'l::rUeted?' o 0
_Iatf!od hJ!.oilth pl'Obll!-Iru.".!

d) AreaDme.m.s.of -e5�apE!m�bY'aniDomina:l:II!d·EXIT""!i:ign? D 0

1258
 Appendix I (cant.)
-e) .An!' aD melilil- Df-E!sca.pe €quipped with an automatic dD:!IDl'E! o 0
.s.yst-em
whi�h II functioning properly?'

f) Can aD fire doers be e.a.silyapellecl CDl' e-sca.pe? o 0

4.5 Fire 6ghting @quipm.lmt:

a) An!opropertypeandnumbe[lIJff:irefightingequipment(e.;.fire D 0
-el:.1:ingu.i.:shel'.5., firE. bJ.a:nb.t, and sand bucbt) av:a.i.Lable"]

b) Is the £ire fi;htin!; equipment storedpl'Opedy a.nd eli.:SYto o 0

]D�Ie-:'

o 0

d) Have :su:fficient number cd" emptoye.es bee-n tI'amed to USie- the o 0

fil'E! fighting �uiplrnmt?

Section 5: Risks of Act:id.enb atWorkp1ace

5.1 Are t:bel'E! .i311:::ddenn DfCDl'J'ecl in the workplaCIe-?
DYes, pt.asll!-speci:£ythll!-numbel' af accidents: _______
ON"

5.2 HaVE! any � been mli.de in the workplaCIE- :since the a.ccident 0CCIUT1Hi?
� �:s.plNslI!-!ipeci:£ythll!-clia..ng4!'.s.: __________________

1259
 Appendix II. Survey on Occupational Safety and Section 3: Oa::�01 Sofrly ODd H'etilRh Silll!rtioo III Work
1L Hillfl!' fDu",,� .ilnyo::::mpatmill saft!ty .ilm:ltl@i1hn tr.ilini� il"l ttl!" OXIIp.ilI"l"'�
Health Problems for Workers in Hong Kong Recycling D YI!!5 D ND

Industry
12_ HilS tII@OXIIpiil"l'fprovlded iill"I'f per.iOnillgeall-s?
This questiOimail."e is used to ideDlify the exlsting 00I:� � and health problems D YI!'!ii.P�!ip@C::lfythl!"lO'\Iided�i1f:li _______________

ful." workers in HOI:I8 Kong recydingind:ostry.AD inmrmation provided win be kept ONo
ronfulentiaI.
1.]_ 'IMIid tind:i of pmle£lilJl! �r.ii tliJ'Io'e fDU worn ill wort�
D Ma:it
Set:tion 1: Work Prarnce D H@lmet
D Anti-slip full1'wleill"
D GocI;Ies
D Sarety belt
OOIove
D Others: _____
L Worklnll: mode
DPd.rrtimil!'
DFuiltme
14_ DoYIlLlthr.ktne �lerieI n thE:
i wortpl;ue is acceplilble�
DYI!!5 DNII

.2.. Numbet"ofWDl'kingmyspl!I'"weet
15_ Do YIlLl thr.t tne IighWJg In tII@'\IIOI'Io:pI;;[E:is.'5ufficil!m'1'
---_ .... D YI!!5 D ND

3. Numbet" of V«Ifking hours; per dii\l 16_ DoYIlLIthr.ktne � r. tII@WClI'IIpIiiI(E:is.goIldIl!I'lCIUBn'1'

D YI!!5 D ND
____ hou�

11_ DoJIlLI hilV@ .ilny vill"W5 .i1 s� ons

m:l l 011 thl! imfllOVll'!mR'ltmOlITl"'rll::5.iIfI!ty.ilud tI@illtn5itLJillionill:
4. How long tI;we YCJu worti!d in1:1Ji::!. recyr:lng indlHlry? work'1'
o �tl'lanl ye;ilr Dl-5yeir.ii D6-10year5 o l1-1.S)'eill'S
o 1Il-2OVS;III''5 0 :i':l-25yl!lilfS- 0 :l6-:JO'jElilI'S- o MDl'1!!thain.J(J veOlf5

�Nilrul'1!'5olWOl"k Section 4: iPersnlllillnfunnation

D ReqJ:led item colletlor'" 0 5orli� n!!qrJ:led itetru: D Eql.liiprnerrtlMildJineryoperawr- UtGe!ndl!l'"
D Maintenill"l[1!: iII"IC repair 0 Driver o OtIIel3': _ _ _ __

6.. TVIle5 of f1!t}'!:led ilems being himdlll!d OII"IC proce!Sed 031-40 D 41-50 D51or;;txwf!
D GI� D Paper 0 Meti" DPiil5tic
DCDlnes D Othel3: _____ 2Q_Ed�D11
DPrimillYOI"bellJW o SeOOl"ldary 0 DiI;iIIlllIIiI 0 Uniuel3ity or ilbll'oll!
D Otnel3: ____

DForlIift o looder o MedliInil:ill sorter

D Conveyor o Can D Spanner
D Srrewaiver 00.....,." _____

Set:tion 2: Work Helsteel Health Problem Bod Illness

HnlfL prDbJl!IIIlI:;IInd! .eB_� SeveriSr C:nH- D.nd::io.

Notat A1iitle Sam!! Senom WiI!I tbf- Dfth
ill ..... """'"
problem probl.e.:2i
=br (io�st}O
)'IHIIjOO? -days)

I....",

'"Suo..in:e. Poul§ll!!n et ill. (19B51. An et ill. (1'3'991 ilml IDever et ill. (20021

9. Hai� you got iII"IV ir"-uril!§ to t h l! followingbody kx::atil:ms;lt wort hi .to

InjOHdBadyl.ol'Uion. F � WlutlDll.J:injoriM
Nat;rlaD. Often Scaorime:s � han-yotbd?

Brl

10_ In ....I!' 'iI!it 12 mmntl5. h� milnv diil'll'S of 5 ic t IBalIJI! hiW@Yf)Llulc:l!'ndul!'ul WOI't.-rebtl!!d hewJlth
problElT1:li�

1260