CHEMICAL HAZARD AND

PREVENTION

Fire & Safety Department

SMBB Institute of Trauma Karachi
Objectives of this session
Understand the key definitions and fundamental
concepts of chemical hazards

Identification of chemical hazard and route of

exposure

Describe the worksite assessment process

Identify the hierarchy of control measures

Spot the hazard
Key Definitions
Hazard
A situation that poses a level of threat
to life, health, property or environment

Risk
The chance of something happening that will have
an impact on life, health, property
or environment

(AS/NZS 4360:2004)
Exposure
Defined as the contact over time and space
between a person and one or more
biological, chemical or physical agents
based on frequency, magnitude and
duration

(US Nuclear Regulatory Commission,

1991).
Toxicology
Defined as the study of
adverse, and potentially
adverse, effects of
chemicals which have,
or may have, the
capacity to cause injury
to living organisms.
"Dosis facit venenum" -
The Dose Makes the
Poison

All substances are

poisons; there is none
which is not a poison.
The right dose
differentiates a
poison…." Paracelsus
(1493-1541)
Dose
The dose of a hazardous substance is
generally expressed with the following
equation:

Dose = concentration (level) x duration of exposure.

This is a fundamental principle on which

occupational exposure limits (OELs) are
based
Toxicity
Refers to its capacity to injure if
it reaches a susceptible site on
the body. Whether ill-effects
will occur depends on:

The properties of the chemical

The dose (amount of chemical
acting on the body)
The susceptibility or resistance
of the exposed individual
The route by which the
substance enters the body
Identification of Chemical Hazard
Substances which can be inhaled, or are respirable, include
gases, vapours and aerosols, may be defined as follows:

 GASES: substances which normally exist in gaseous

form at standard pressure and temperature

 VAPOURS: the gaseous form of substances normally

liquid at standard pressure and temperature

 AEROSOLS: suspensions of variable size particles

capable of remaining airborne
Dusts – caused by mechanical abrasion or
fragmentation of solids
Fumes – produced by combustion,
sublimation or condensation of volatile solids.
Smokes – suspension of solid particles
produced by incomplete combustion of
organic materials
Mists – airborne droplets usually formed by
condensation of vapours but may be produced
by atomisation of a liquid
Chemicals That Present Hazard or Risk
◦ Flammability: catch fire readily; gasoline
◦ Reactivity: unstable and may explode or create
toxic fumes when mixed with water;
explosives, concentrated sulfuric acid
◦ Toxicity: injurious to health; pesticides,
chlorine
Material Safety Datasheets
A document containing important information about
a hazardous chemical (which may be hazardous
substance and/or dangerous goods) and must state:

a hazardous substance's product name

the chemical and generic name of certain
ingredients
the chemical and physical properties of the
hazardous substance
health hazard information
precautions for safe use and handling
Chemical Groups

International Version published by the WHO

and European Union

Available at:
http://www.ilo.org
Safety Label

Available at:
http://www.cdc.gov/niosh
Route of Exposure
The Respiratory System
A large range of vapours and gases, dusts, fumes can
enter the respiratory tract through inhalation

Odours - danger lies in using chemicals which

have no odour, or where toxicity occurs before
odour is detected. People who have had a long
term exposure to a chemical tend to ignore the
smell
Dusts - Many dust particles are small enough to
enter the alveoli air pockets where they can cause
damage
The Skin
The protective properties of the skin can be
reduced by exposure to chemicals such as
degreasers, detergents, and solvents

Chemical exposure can result in dryness,

splitting and cracking and damage to the skin
surface

Sensitivity to chemicals can cause allergic

reactions - in rare circumstances can cause death
The Eyes
Some chemicals have very strong vapours
that can cause acute discomfort to the
eyes.
Exposure to these types of fumes can
cause permanent damage to the eyes.
Care must be taken to protect from
splashes as well as fumes
The Gastro - Intestinal Tract
Usually due to poor housekeeping, dusty
environments and the close proximity of
toxic airborne substances to eating
facilities.
Poor hygiene practices (not washing
hands before eating & not wearing gloves
when dealing with chemical) can also
prove hazardous
Potential Chronic Health Problems
Occupational Asthma (Glutaraldehyde)
Carcinogen (Ethylene oxide and
Cyctotoxic Drugs)
Kidney Failure (Lead fumes)
Lung Fibrosis (Diesel) ?
WORKSITE ASSESSMENT PROCESS
Direct health indicators (worker
complaints, illness statistics, biological or
radiological signs before symptoms occur)

Previous experience and information

(MSDS, material inputs, the process, the
pattern of exposure, work procedures)

Walk-through survey (5 P’s; People, Premises, Process, Product,

Personal Protective Equipment)

Specific Site

Specific Task
Risk Assessment
Systematic process for describing and
quantifying the risks associated with
hazards including substances, processes,
action or events.
The overall process of risk identification,
risk analysis and risk evaluation
(AS/NZS 4360:2004).
Hazard Risk & Health
Consequence

Poor lifting techniques of Musculoskeletal Injuries

patients and equipment -Lumber Disc Protrusion
(over 20 kgs) -Back Injury

Improper recapping of Needlestick Injuries

needles -Bloodborne diseases
(HIV, Hepatitis B)

Chemical handling on Respiratory problems

Glutaraldehyde (Cidex) for -Occupational Asthma
disinfecting endoscopy and -Contact Dermatitis
operating theatre
instruments
Chemical handling on Glutaraldehyde (Cidex) for
disinfecting endoscopy and operating theatre
instruments
Exposure Occupational Risk
Exposure
Limits (OELs)
8 hours <0.2ppm Low

PPE in place
(hand gloves,
face guard, face
mask)

Fume window
closed
8 hours >0.2ppm High

PPE not in
place

Fume window
open
Control measures
5 steps of hierarchy of control measures
Elimination (Remove)
Substitution (Replace)
Engineering Control (Remodel/Renovate)
Administrative/Procedural Control
(Reinforce)
Personal Protective Equipment (last
Resort)
Elimination
Depends!
-Detrimental effect on human body
-Demand of the product

Substitution
-Replace with a less hazardous substance
Engineering Control
-Fume Cupboard (Grading for different types of chemical
handling/performance)
-Ventilated room with back vent

Administrative/Procedural Control
-Education and Training
-Legislation
-Standard Safety Procedure (Chemical Handling)
-MSDS
-Incident Report
-Regular medical checkup
Personal Protective Equipment
Different types of chemical have different
use on each equipment
-Hand Gloves
-Face Guard/Mask
-Safety Apron/Safety Suit
-Rubber Boots
-Helmet ?
SCENARIO
You as an Occupational Health Nurse have been advised to
investigate an incident in the endoscopy unit. It was reported
that 10 healthcare workers have been suffering from acute
exacerbation of asthma for 3 days. It was later identified that
all affected HCWs were handling Glutaraldehyde (Cidex)
while disinfecting endoscopic instruments.

(a) Describe how would you perform a worksite assessment.

(b) Using the hierarchy of control measures, provide

recommendation in order to minimise the health impact of
Glutaraldehyde (Cidex)
WORKSITE ASSESSMENT

Walk through Survey

5 P’s (People, Premise, Process and Product,
Personal Protective Equipment)

Specific Site

Specific Task
(the pattern of exposure, work procedures)
Substitution

Replace Glutaraldehyde with a less toxic substance.

Engineering Controls
Provide local exhaust ventilation such as laboratory hood, large
enough to contain the Glutaraldehyde immersion system and an
equipment washing and rising sink at the source. The design should
include a face velocity at the hood with the airflow directed toward
the back of the hood away from the operator’s breathing zone. This
system will require an appropriate amount of filtered and tempered
replacement air in order to work properly

Increase general room ventilation. This solution is generally

ineffective in controlling exposure due to short-term tasks such as
equipment cleaning or solution changes that may generate a high
concentration contaminant quickly
Provide buckets and other containers that
are shaped to minimise the surface area of
the liquid.

Modify facility design to limit traffic or

potential exposure to individuals who are
not involved with the disinfection process.
Exposure to Glutaraldehyde solutions in
confined spaces should be avoided
Administrative controls
Reviewing work practices periodically in all areas where
Glutaraldehyde is used in order to prevent overexposure.
Communicate with other areas of the hospital setting that use
Glutaraldehyde such as surgical department, emergency
rooms, intensive care unit or central sterile supply department

Training and educating new and current healthcare workers

regarding safe work practices is essential in reducing chemical
exposure. All new and current healthcare workers should be
instructed about the potential hazards associated with
Glutaraldehyde, proper use of protective clothing, safe work
practices, avoidance of exposure in a confined space and
personal hygiene concerns. This would include education
regarding signs and symptoms associated with overexposure
to Glutaraldehyde
Personal protective equipment
A written procedure detailing the type of clothing and
the proper use of protective clothing should be
provided to healthcare workers involved in
maintenance and disinfecting medical instruments.
Proper gloves wear such as butyl rubber, polyurethane
or Viton could be use
Respirators or face mask are necessary when the
exposure to a chemical exceeds 0.1ppm.
Nevertheless, this should be known not as a primary
control since the availability of engineering control
and substitution of chemical. Yet, this can still be use
in non routine maintenance or emergencies (NIOSH,
2005).
Further Information
http://www.worksafe.vic.gov.au

http://www.westcoastdhb.org.nz

http://www.ilo.org

http://www.cdc.gov/niosh

http://toxnet.nlm.nih.gov/