Occupational Medicine 2009;59:304–309

doi:10.1093/occmed/kqp076

IN-DEPTH REVIEW
...............................................................................................................................................................................................

Offshore industry: management of health hazards

in the upstream petroleum industry
Karen Niven and Ron McLeod
...................................................................................................................................................................................

Background Upstream oil and gas operations involve a range of activities, including exploration and drilling, con-
ventional oil and gas production, extraction and processing of ‘tar sands’, heavy oil processing and

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pipeline operations.
...................................................................................................................................................................................
Aims Firstly, to outline the nature of health risks in the offshore oil and gas industry to date. Secondly, to
outline the commercial, technical and social challenges that could influence the future context of
health management in the industry. Thirdly, to speculate how the health function within the industry
needs to respond to these challenges.
...................................................................................................................................................................................

Methods A review of the published literature was supplemented with industry subject matter and expert opin-
ion.
...................................................................................................................................................................................

Results There was a relatively light peer-reviewed published literature base in an industry which is perceived as
having changed little over three decades, so far as offshore health hazards for physical, chemical, bi-
ological hazards are concerned. Recent focus has been on musculoskeletal disorders and stress.
...................................................................................................................................................................................

Conclusions The relative stability of the knowledge base regarding health hazards offshore may change as more
innovative methods are employed to develop hydrocarbon resources in more ‘difficult’ environments.
Society’s willingness to accept risk is changing. Addressing potential health risks should be done much
earlier in the planning process of major projects. This may reveal a skills gap in health professionals as
a consequence of needing to employ more anticipatory tools, such as modelling exposure estimations
and the skills and willingness to engage effectively with engineers and other HSSE professionals.
...................................................................................................................................................................................

Key words Health hazards; human factors engineering; occupational health; offshore industry; safety manage-
ment.
...................................................................................................................................................................................

Introduction This involves trying to move from reliance on reactive

Upstream operations are conducted globally, though with
historically the highest level of activity in areas including
the North Sea, the Gulf of Mexico, the South China Sea
and the Caspian Sea. More recently, there has been in-
creasing investment in operations in waters offshore West
Africa, India, the deep waters off the coast of Brazil and
Western Canada.
This paper has three aims. Firstly, to briefly outline the
nature of health risks in the offshore oil and gas industry
to date. Secondly, to outline the commercial, technical
and social challenges that could influence the future con-
text of health management in the industry. The final goal
is to speculate how the health function within the industry
needs to respond to these challenges.
Shell Health, Shell International B.V., Carel van Bylandtlaan 30, PO Box 162,
2501 AN The Hague, The Netherlands.
Correspondence to: Karen Niven, Shell Health, Shell International B.V., Carel van
Bylandtlaan 30, PO Box 162, 2501 AN The Hague, The Netherlands. Tel: 131 70
3774072; fax: 131 70 3772840; e-mail: karen.niven@shell.com
health management to a more proactive approach. This
would mean a switch from the current approach of iden-
tifying, controlling and responding to health risks built into
operations, to one in which the health function influences
business and project decision making so as to remove or
control health issues at source.
Current situation
Most of the available research base on health issues is de-
rived from studies offshore in the North Sea (both UK
and Norwegian sectors) and the Gulf of Mexico.
Gardener [1] has reviewed health risks on offshore oil
and gas installations. He concludes that although details
(such as some chemicals used) have changed and some
new hazards (such as Legionella and health risks associ-
ated with the widespread move towards computer-based
working) have emerged, offshore hazards have changed
little over three decades, with the main concerns relating
to musculoskeletal disorders and stress.

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 K. NIVEN AND R. MCLEOD: OFFSHORE INDUSTRY: MANAGEMENT OF HEALTH HAZARDS 305
The process of health risk assessment (HRA) as it is
usually applied in the industry covers five groups of po-
tential health hazards: physical, chemical, biological, er-
gonomic and psychological hazards [2]. These are each
briefly reviewed below.
Physical hazards
Noise and vibration can both independently pose signifi-
cant health risks (e.g. from drill floors, shakers, sack rooms,
generators, compressors and mixers). The typical ap-
proach, where noise cannot be mitigated at source or
via engineering controls, has been to establish noise control
zones requiring the use of hearing protection, based on
area noise measurements [1]. Some regulators require
area measurements to be used for comparison between
installations [3]. Design guides on noise levels have been
area based, as part of asset integrity maintenance
(machines get noisier as they age, proactive maintenance
can contribute significantly to lowering area noise).
The use of hand-held vibrating tools is widespread on
offshore installations (e.g. grinders, needle guns, impact
wrenches, air drills and chipping hammers). This creates
the possibility for hand–arm vibration syndrome in work-
ers who use these tools routinely.
Various forms of radiation and thermal extremes are
also relatively common on offshore platforms. Exposure
to extreme heat and direct sunlight in tropical areas and to
extreme cold in high latitudes can become significant
sources of health risk dependent on the geographical re-
gion of the world.
Chemical hazards
Published exposure data from systematic sampling of haz-
ardous agents on upstream operations are limited or pub-
lished some years ago. Since benzene is a natural
component of crude oil and natural gas, a few studies have
reported data on benzene exposure. Substances, such as hy-
drogen sulphide (H2S), are usually well controlled through
sealed systems, permit to work systems, gas purging, area
and personal monitoring, training, emergency plans, etc.
In the past, the composition of drilling ‘mud’ had con-
siderable toxicity for both the humans and the environ-
ment. However, the composition has changed over the
years, with a general trend to materials of lower toxicity
[1]. Other potential toxic and suspected carcinogenic
agents or mixtures exist, such as mineral oil mist and va-
pour, asbestos fibres, formaldehyde, tetrachloroethylene,
welding/cutting fumes, acids, coatings, etc.
Many epidemiological studies of workers in the petro-
leum industry have been conducted to help address
whether there is an excess of mortality from cancers.
The vast majority of these have been limited to oil refinery
workers (i.e. ‘downstream’). Only four cohort studies
[4–7] and one case–control study [8] have studied the
oil and gas exploration and production segment of the
industry (i.e. ‘upstream’).
The weight of the evidence, based on the results of
these studies, is suggestive of an increased risk of mortal-
ity from leukaemia among upstream petroleum workers,
who started working before 1940 and who had a long du-
ration of employment (over 30 years). Gardner [1] came
to a similar conclusion.
An increased incidence of haematopoietic cancers, espe-
cially acute myeloid leukaemia (AML) and multiple mye-
loma, has been found among Norwegian offshore
operators. However, the possible causes are not clear at this
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time and require further study. It is possible that some non-
occupational factors, such as smoking or exposure to radia-
tion arising from industrial or natural sources not associated
with employment, could play a role. The conclusion drawn
by the Norwegian investigators that the increased incidence
of AML was most probably associated with benzene expo-
sure was speculative and not substantiated by the evidence.
Upstream petroleum workers exposure levels to ben-
zene, toluene, xylene and ethylbenzene, based on per-
sonal air monitoring data, are generally regarded as low
during regular activities [9]. Higher exposures, usually
less than a full shift duration, may be encountered during
maintenance tasks (e.g. when containment is broken or
vessels need to be entered for cleaning). There has also
been speculation that dermal exposures during early years
of operations could be high, but such exposure has not
been routinely assessed.
Biological hazards
Food-poisoning outbreaks are typical manifestations of
biological hazards in the offshore workplace. They tend
to occur more commonly in less developed areas, often
related to poor hygiene associated with water dispensers,
ice makers and ice cream machines. Also galley space can
be limited, so cold storage can be deficient. Airborne dis-
eases can spread rapidly through ventilation systems on
offshore installations because accommodation is pressur-
ized and living space is usually at a premium.
Robust health risk management is required to control
health risk from potential Legionella contamination of
water pipes, particularly in showers of accommodation
blocks and air-conditioning plants.
Ergonomic hazards
‘Ergonomic hazards’ generally refers to health problems
due to the interaction between the following: (i) the pos-
tures people are forced to adopt to reach, act on or operate
the objects and equipment they work with and (ii) the na-
ture and time history of the application of force on those
objects.
306 OCCUPATIONAL MEDICINE
Ergonomic health issues are usually associated with the
musculoskeletal system and principally the upper limbs,
neck and lower back. They can also be associated with
impaired visual function arising from working on visually
demanding tasks over extended durations with inappro-
priate task lighting.
The critical factor that identifies a health issue as being
‘ergonomic’ is that the injury arises because the way the
environment and equipment are arranged requires people
to adopt postures, movements, apply force and read ma-
terial in conditions that are potentially damaging to health
in order to complete what is expected of them in the nor-
mal course of their work.
There is a widespread view among health practitioners
involved in offshore operations that upper limb disorders
(ULDs) arising from poor workplace ergonomics are rel-
atively common. Accurate and reliable data are, however,
difficult to find.
A recent study by the UK Health & Safety Executive
[10] investigated the root causes behind 126 manual han-
dling injuries in the UK sector of the North Sea. The
study concluded that in 23% of the cases, the root cause
was due to either poor workplace design or poor equip-
ment design. A further 9% were due to workers using
the wrong equipment for the job (usually because the cor-
rect equipment was not readily available). Most of these
can probably be considered to be due to genuinely ergo-
nomic hazards in the workplace. They provide support to
the view that ergonomic issues are a significant source of
health hazard in the offshore work environment.
Psychological hazards
Psychological hazards are different from other occupa-
tional hazards (e.g. noise and chemicals) because
• The level of stress within an organization varies both
rapidly and significantly over time;
• Stress occurs in hot spots in an organization and is
rarely uniform;
• The effort required to conduct a full objective assess-
ment of stress and controls is high and should not be
undertaken lightly;
• Comprehensive stress and control assessments actually
impact on stress;
• There is some evidence that stress in an organization or
population is normal and often transient and
• Currently available data does not directly measure
stress while interpretation is difficult and often counter-
intuitive.
Nevertheless, it is possible to identify stressors that are
common to the offshore environment that require special
attention. Examples include work overload, lack of job
clarity and frequent change. Also relevant are prolonged
periods of limited interaction with people (phone, Inter-
net, etc.), poor leisure activities, limited sleep quality and
quantity (as a result of shift patterns and noise). The in-
creased use of higher risk methods of transport (e.g. heli-
copters) can also increase perceived levels of stress.
The future context
The second part of this paper briefly outlines two impor-
tant characteristics of the expected macroeconomic con-
text of future petroleum operations as they affect the
management of health hazards offshore.
Two factors dominate this forward look
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• The move to ‘difficult oil’ and
• Societies reducing acceptance of risk, in both the devel-
oped and the developing worlds.
Difficult oil
The industry is generally agreed that the days of ‘easy oil’
are over, i.e. where significant fields of high-quality crude
oil and natural gas can be accessed relatively close to ma-
jor markets, using technologies and engineering techni-
ques that are mature and well understood.
Globally, significant as yet undeveloped hydrocarbon
resources still exist. However, they will no longer be ‘easy’
to recover or transport for refining and sales [11]. Future
exploration and production will be significantly more dif-
ficult than in the past in a number of important ways:
• Oil and gas fields will be more geographically remote
from major markets (further offshore, Arctic regions,
etc.);
• They will be more technologically challenging to discover
and produce (deeper water, deeper in the earth’s crust,
higher H2S levels requiring significantly improved safety
engineering and operational controls) and
• They are likely to be of lower quality, taking significantly
more effort and resources to turn raw material into mar-
ketable products. This is most obvious in the case of the
Canadian oil sands, where extraction is based on open-
cast mining operations. Conversion of the oil sands to
refinable crude oil feedstock involves relatively simple
technology, though on a giant scale and involving signif-
icant amounts of energy and other resources.
Societies’ acceptance of risk
At the same time as the challenge of finding and extracting
oil and gas is becoming more difficult, many aspects of the
socio-political context of oil and gas operations are also
changing and redefining the future market conditions.
Very obviously, concern over the environment is ex-
tremely high on this agenda.
 K. NIVEN AND R. MCLEOD: OFFSHORE INDUSTRY: MANAGEMENT OF HEALTH HAZARDS 307
Perhaps more subtle is the anticipated continuation of
the long-term trend for society to be less willing to accept
risk associated with commercial activities. The reducing
acceptance of risk to health at work is as true in the
developing world—where many of the major investments
in oil and gas exploration and production are taking
place—as in the developed world.
The future oil and gas industry is therefore seen as one
in which there is reducing acceptance, both culturally and
commercially, of exposing people to risks to their health
and/or safety in the course of their work.
Implications for health management
A key question arising from these two anticipated aspects
of the future macroeconomic climate is whether the risk
profile of exposure to health hazards in offshore oil and
gas operations is likely to change in the future. In the ab-
sence of hard evidence to the contrary, in our opinion,
probably the most credible assumption is that the move
into an era of difficult oil will tend to increase the chal-
lenges facing health management for workers in the in-
dustry. The need to explore and produce oil and gas in
increasingly remote and challenging geographical areas,
to deal with ‘unconventionals’ such as the oil sands, to
process raw products with high H2S content, the need
to be able to operate in increasingly deep waters and to
drill to even greater depths, all potentially bring increases
in the associated health risks.
On the other side of the equation, there seems little rea-
son to be confident that new technologies alone, or exist-
ing engineering design and production techniques, will be
any more successful at reducing health risk per unit of
time and money spent in the future than they have been
in the recent past. That is not to understate the enormous
improvements that have been made over recent decades
through improved technology and health and safety man-
agement.
The two factors discussed above—difficult oil and re-
ducing acceptance of risk—stress the principle of ‘As
Low as Reasonably practicable’ (ALARP) [12] in oppos-
ing directions; we have assumed that difficult oil poten-
tially increases the inherent health risks associated with
oil and gas operations, while the level of risk society is pre-
pared to consider to be ‘Acceptable’ or ‘Tolerable’ is re-
ducing.
The clear implication is that, even without seeking to
reduce the risk exposure below current levels, oil and
gas companies are going to have to improve their ability
to effectively reduce and control risk to health. Put another
way, unless the industry further improves its ability to re-
duce risk to health (as well as safety and environment) pro-
actively, more projects will become commercially or
economically unviable due to the cost and effort needed
to control risk than is currently the case.
How, then, is the industry dealing with this dilemma:
the need to continue to reduce exposure to health risks,
while maintaining existing, and developing new oil and
gas facilities in an economic climate of difficult oil and
reducing acceptance of risk in society?
The answer, perhaps with reflection, is obvious and is
the same as has become common across other technical
disciplines, from Process Engineering to Safety and Value
Engineering. It is by ensuring that health issues are ade-
quately taken into account when making early investment
decisions, as well as by engaging with the other project
engineering disciplines to (i) identify health risks associ-
ated with engineering options and (ii) influence facility
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and organizational design in ways that effectively mitigate
the health risks.
Modifying the health paradigm
The health function can be thought of as comprising two
groups of subject matter experts: (i) physicians, nurses,
counsellors, physiotherapists, etc., who focus on attend-
ing to the specific health needs of individuals and (ii) hu-
man factors engineers, industrial hygienists, toxicologists,
etc., whose attention is concerned with health impacts on
groups of individuals with similar exposure potential for
health risks (e.g. welders, office workers, operators, etc.).
If, as suggested above, the era of difficult oil will tend to
increase health risks in the future, there will need to be
a deliberate move towards more proactive assessment
of health implications on groups (e.g. on both construc-
tion workers and operational staff) earlier in the process of
developing and constructing facilities.
This is illustrated conceptually in Figure 1, which
shows an increase in health effort early in the lifecycle
of new facilities, balanced with an anticipated reduction
in the need for health professionals during the operational
phase.
However, the current profile of deployment of indus-
trial hygiene resources in many oil majors is that almost all
(probably in the order of 90%) are deployed at locations
providing a relatively reactive service (e.g. within a down-
stream business unit such as a refinery). Even those with
a global role tend to work with business units to respond
to reactive requests and issues. This means that the real-
ization of the ALARP potential is currently restricted to
controlling risks that are ‘given’ or inherent in the design
of the asset.
Human factors engineering (HFE) concentrates on
supporting capital projects from the early stages of the de-
velopment process (i.e. beginning in front-end engineer-
ing, if not earlier). It is clear from experience to date that
more proactive integration of industrial hygiene and HFE
principles could add significant health value to the design
phase of capital projects by ensuring that health risks are
reduced to ALARP through improved engineering
308 OCCUPATIONAL MEDICINE
Figure 1. Illustration of the projected change in health effort over the
lifecycle of a typical offshore facility (Conceptual).
measures, with less reliance on management, training,
procedures and personal protective equipment as
controls.
Evaluating the skill gap
Since the ‘health engineer’ does not currently exist in the
job marketplace, industrial hygiene support in the future
indicates a partial shift in attention from ‘traditional’,
transactional support towards one that works closely with
HFE and concentrates more on value-adding proactive
input on chemical and physical hazard evaluation during
the design phase of major projects.
This means that industrial hygienists will need to be able
to leverage their skills in anticipating, predicting and mod-
elling exposure to health hazards rather than relying on
measuring them and developing procedural and other
operational controls.
In addition to these changing skill requirements, hygien-
ists capable of fulfilling this front-end project role will need
to have significantly better understanding of project
procedures and project culture. They will need the per-
sonal motivation to want to work in what can often be
a high pressure and always time-constrained engineering
environment.
Quantifying the potential benefits
One of the well-accepted challenges in health is the quan-
tification of the added value and/or cost-effectiveness of
health interventions compared to, for example, safety en-
gineering. Key performance indicators are usually subjec-
tive and realized over the long run, if at all [13]. The health
input is frequently seen more as a necessary evil, required
for legal compliance rather than adding value in itself. This
remains a fertile area for future research and development.
Conclusions
The current and recent historical situation with regard to
health hazards in the offshore oil and gas industries can be
summarized in three key points.
• Exposures to health hazards inherent to the raw prod-
uct have been relatively stable over recent decades.
• After nearly a century of experience, and with relatively
stable and mature processes, chemicals, and engineering
facilities,the health risksoffshore are relatively well under-
stood and can be considered in the five categories forming
the basis of the health risk assessment (HRA) process;
• There are few published studies presenting accurate
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and reliable data on health issues compared with the
‘downstream’ (refining, etc.) petroleum industry. This
is probably partly due to commercial sensitivities, as
well as to the rapid and often relatively short-time scale
of many upstream operations. The data that are avail-
able also tend to be western-centric, with very little in-
formation on health issues in the developing world.
The upstream petroleum industry is facing major
changes in the future macroeconomic climate in many
ways. Two of these are particularly important for health:
• The move to difficult oil;
• The continuation of the long-term trend for societies
globally to be less willing to accept risk arising from
commercial activities.
Across the industry, the health function in major com-
panies is responding to these changes in a number of
ways, including the following:
• By improving the ability to predict and model potential
health risks (in ways similar to how explosion and noise
modelling are currently conducted).
• By seeking to develop health functions that are capable
of integrating with project development processes to
ensure barriers against health risks are effectively
strengthened as each layer of defence is developed (en-
gineering, procedures, training and personal protective
equipment).
Conflicts of interest
None declared.
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