OCCUPATIONAL HEALTH

(XBHM 3103)

CASE STUDY ISSUE FOR WATER-COOLING TOWER

CASE STUDY ISSUE
 Workplace area (cooling tower) was not cleaned and disinfected regularly

 Worker absence due to high fever, chest pain, cough, difficulty to breath and
mental confused

 Additional effects of other irritants such as tobacco smoking

 Chest X-ray suspected pneumonia

 No monitoring and training provide on-site job

 No precaution measure taken

 Investigation result diagnosis of bacterial infection

 INTRODUCTION
HEALTH HAZARD
POTENTIAL SOURCE TO HARM / ADVERSE HEALTH EFFECT ON A PERSON

RISK FACTOR
EXPOSURE OF AN INDIVIDUAL THAT INCREASES THE LIKEHOOD OF
DEVELOPING A DESEASE OR INJURY (WHO 2017)
DISEASE
A OBSTACLE IN THE WELL BEING OF OUR BODY THAT AFFECTS THE
FUNCTIONING OF ORGANS AND ORGAN SYSTEMS.
 ACTION RISK
POSSIBILITY PROBABILITY
OF CAUSING (Exposure) OF HARM
HARM OCCUR
 WHAT IS HIRARC
A COMPOUND WORD WHICH IS MADE UP OF THREE CONSECUTIVE
ACTIVITIES RUNNING ONE AFTER THE OTHER THAT CONSIST OF:

i.) HAZARD IDENTIFICATION

THIS IS A PROCESS OF EXAMINING THE WORKPLACE AND TASKS TO
IDENTIFY THE HAZARDS WHICH ARE ACTUALLY INHERENT IN THE JOB

ii.) RISK ASSESSMENT

LOOK AT THE POSIBILITY OF ACCIDENT BASE ON COLLECTION DATA ON
EACH IDENTIFIED HAZARD THEN DETERMINED IT

iii.) RISK CONTROL

THE INTRODUCTION OF MEASURES WHICH WILL ELIMINATE OR REDUCE THE
RISK OF A PERSON EXPOSED TO A HAZARD
RISK ASSESSMENT
RISK ASSESSMENT PROCESS
RISK ASSESSMENT MATRIX
 TYPE OF HAZARD

SAFETY HAZARD

MECHANICAL

ELECTRICAL
HEALTH
HAZARD
PHYSICAL

CONFINED SPACE
CATEGORIES OF HAZARD
 METHOD OF IDENTIFICATION
 DO INPECTION
 HEALTH & SAFETY AUDIT
 INTERVIEW PERSON INVOLVE
 JOB SAFETY CHECK
 CREATE A HAZARD CHECKLIST
 KEEP TRACK STATISTIC OF ACCIDENT, INJURY AND
NEAR MISS
 TYPE OF DISEASE
CONTAMINATION FROM BIOLOGICAL SOURCES IN COOLING TOWERS.
BACTERIA, VIRUSES, FUNGI AND ALGAE CAN ALL ENTER A WATER SUPPLY,
SUPPORTED BY THE HOT, HUMID AND NUTRIENT-DENSE ENVIRONMENT
OF THE COOLING TOWER.

AS THE COOLING TOWER MOVES AIR THROUGH A RECIRCULATED WATER

SYSTEM, IT RELEASES A “CONSIDERABLE AMOUNT OF WATER VAPOR”
INTO THE ATMOSPHERE. IF IT CONTAINS BACTERIA, PEOPLE CAN BECOME
INFECTED BY INHALING
FINE AIRBORNE AEROSOLS
GENERATED BY COOLING
TOWERS
 TYPE OF DISEASE
DISEASE THAT ARE REGCONIZE FROM THE
DIAGNOSIS OF BACTERIAL INFECTION IN COOLING
WATER

 PNEUMONIA

 LEGIONNAIRES' DISEASE

 PONTIAC FEVER
TYPE OF DISEASE
PNEUMONIA
 Inflammation of the parenchyma of the
lung
 Caused by: Viral infection (refer images
of microbes)
 Symptoms : refer images
 Short incubation period of 3 to 10 days
 Spread thru inhalation
 Spread via air-borne droplets from a
cough or sneeze
 Mild to life-threatening.
 TYPE OF DISEASE
LEGIONNAIRES' DISEASE – SEVERE PNEUMONIA
 Caused by: bacteria
 Legionella
 Symptoms : refer images
 Short incubation period of 2 to 10 / 14
days
 Required medical treatment
 Spread thru inhalation near infected
area can’t be transmitted from person
to person
 Potentially life-threatening condition.
 TYPE OF DISEASE
PONTIAC FEVER – MILD FLU-LIKE ILLNESS
 Caused by: bacteria
 Legionella pneumophila,
 Legionella longbeachae,
 Legionella feeleii,
 Legionella micdadei,
 Legionella anisa
 Symptoms : flu-like, fever, tiredness, myalgia, headache, sore throat nausea and
cough
 Short incubation period of 1 to 3 days
 Resolves spontaneously and often goes undiagnosed and untreated
 Non fatal
Control Measure for Workplace
A WAY OF DETERMINING WHICH ACTIONS WILL BEST CONTROL
EXPOSURES. CONTROLLING EXPOSURES TO HAZARDS IN THE
WORKPLACE IS VITAL TO PROTECTING WORKER.
USING THIS HIERARCHY CAN
LOWER WORKER EXPOSURES
AND REDUCE RISK OF ILLNESS
OR INJURY
 HEALTH SURVEILLANCE
A PROCESS TO MONITOR THE WORKERS AND WORKPLACE AREA FOR
EARLY DETECTION OF RISK, HAZARDS AND WORK RELATED
DISEASES.
BELOW ARE HEALTH SURVEILLANCE ACTIVITIES :
 HEALTH SURVEILLANCE

A CLINICAL APPROACH IN IDENTIFYING AND MONITORING THE

CHANGES IN HEALTH STATUS AND NECESSARY TREATMENT FOR
RECOVERY THAT ONLY INVOLVE HISTORY OF ILLNESS, PHYSICAL
EXAMINATION, LABORATORY ANALYSIS OR MEDICAL IMAGING AND
DIAGNOSIS EXCLUDED MEDICAL TREATMENT BUT THE WORKERS
WHO ARE DIAGNOSED WITH INJURY OR DISEASES DURING MEDICAL
ASSESSMENT WILL BE REFERRED TO RELEVANT CLINIC OR HOSPITAL.
 HEALTH SURVEILLANCE

TO CONTROL AND PREVENT DISEASE FROM OCCURRENCE AND

REDUCE ITS CONSEQUENCES. THE SUMMARY PROCESS ARE AS
BELOW:
REMEDIATION/ SUGGESTION
 Infection Control

 Microbes Risk Assessment

 Microbes Risk Control

 Education of Health Care Workers

 Add these activities and carried out at predetermined intervals:

 Training on handling chemical, on-site job

 Regular inspections, servicing and cleaning at cooling tower

 Monthly HCC testing to identify bacterial levels in system

 Legionella testing.
 REMEDIATION/ SUGGESTION
 Implementation of HIRARC
 Established a comprehensive training manual
 Record keeping and monitoring

 Respiratory protection

 Personal Protection Equipment

 Hazards Communication Programme

THANK YOU