Health Risk Assessment

Controlling health risks at work

HRA-2 Slide 1

HRA Workshop

What is HRA ?
Identify health hazards and their harmful effects (acute/chronic)

Review

Assess the potential risk to the Business by Plotting each hazard on the RAM
Low Risk Medium or High Risk

Manage for continuous improvement

Are Control and Recovery measures adequate to control health risks to ALARP? Yes
Don t know - obtain further information

No Develop and Implement Remedial Action Plan

Document

HRA-2 Slide 2

HRA Workshop

Identifying and Assessing Health Hazards

Selection of team Identifying and assessing Health Hazards Identifying Control Standards Identifying nature and degree of Exposure Evaluating Risk to Health Deciding on Remedial Action
HRA Workshop

HRA-2 Slide 3

Selection of team
Team Leader / Asset ownerLine manager
such as OIM, plant manager or representative of facility being assessed

Team Member Individuals such as operational

staff, line supervisor familiar with plant operation and process

Local Advisor Individuals such as medic/OH

nurse, HSE advisor, who can advise on the HRA process and exposure controls

HRA-2 Slide 4

Specialist Staff Occupational hygienist, OH

HRA Workshop

Selection of team
To gather necessary information team members must be able to:
Observe the activity being performed Predict any potential departure from observed
practice

Ask supervisors, staff etc. the relevant questions Undertake simple diagnostic tests Identify and review relevant technical
literature

HRA-2 Slide 5

Gather the information systematically

HRA Workshop

How to select Assessment Units

The assessment unit is what is within the boundaries of the HRA Assessment units should be self-contained, either physically or as a process It should cover all aspects of the working environment The nature and the severity of the hazards and risks involved, the familiarity of the task, available resources and country-specific requirements should be taken into account
HRA Workshop

HRA-2 Slide 6

Organisation and Preparation

Collect pre reading material and references such as:
Plans and drawings for plant specifications Incident / injury reports (incl. occupational illnesses) and incident investigations Plant and equipment fault reports Maintenance records for control measures Records of health surveillance and sickness absence Occupational hygiene surveys, health and safety surveys Minutes of health and safety committee meetings
HRA Workshop

HRA-2 Slide 7

What are Health Hazards

A Health Hazard has the potential to cause harm to health Health hazards may be divided into the following groups:
chemical biological physical ergonomic psychological

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HRA Workshop

Health hazards of primary concern

Cause fatalities in the short or long term
e.g. infectious diseases (short term), carcinogenic substances (long term)

Expose the company to substantial future social and monetary liabilities

e.g. noise induced hearing loss, repetitive strain injury, psychological stress

Cause minor health effects which could cause severe business disruption
e.g. major food poisoning outbreak

HRA-2 Slide 9

HRA Workshop

How to identify Health Hazards

Walk through surveys Looking, smelling, talking, listening; use your senses! Refer to Health Hazard Inventories Use HRA Yellow Guide, appendix 2 Look at Records
incident/fault reports, inspections, maintenance, sickness absence, hygiene surveys, operating procedures

Use experience from elsewhere

HRA Workshop

HRA-2 Slide 10

Types of Effects
Acute, immediate
Lung, skin or eye damage from corrosive liquid

Acute, late onset

Sick building syndrome

Chronic, intermittent / on-off

Repetitive Strain Injury

Chronic permanent
Lung cancer

HRA-2 Slide 11

HRA Workshop

Identify Health Hazards and their harmful Effects

Agent
Silica dust (crystalline) Used mineral oils Noise

Source
Refractory bricks Engine oil Process noise above 85dB(A) Plant heat Spray cooling towers Workplace design

Route
Inhalation Skin Hearing

Harmful Effect
Lung disease (silicosis) Dermatitis, cancer Hearing Loss

Heat Legionella bacteria Repetitive movements

Whole body Inhalation Whole or part of body

Heat stress, heat stroke Legionnaires Disease Musculo-skeletal disorders

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HRA Workshop

Factors influencing the Relationship between Hazard and Risk

Cumulative exposure Individual susceptibility Threshold levels Knowledge gaps Workstyle changes Real world practices
HRA Workshop

HRA-2 Slide 13

Assigning Hazard Ratings

Hazard Rating 1 2 3 4 5
Definition Consequence Category (harm to people)
Slight health effects: Not affecting work performance or causing disability, e.g. non toxic dusts (as an acute hazard) Minor health effects: Agents capable of minor health effects which are reversible, e.g. irritant and defatting agents, many food poisoning bacteria Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling tasks, hand/arm vibration, chemicals causing systemic effects, sensitisers 1 to 3 fatalities or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), heat, cold, psychological stress Multiple fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (hydrogen sulphide, carbon monoxide), known human carcinogens (large exposed population)
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HRA-2 Slide 14

Hazard Ratings
Consider Harm to:
People Assets Reputation Select the category with the highest consequence rating!
HRA Workshop

HRA-2 Slide 15

Risk Assessment Matrix

The Risk Assessment Matrix (RAM) is the tool which allows assessment of the risk to the business from each identified health hazard It will assist you in prioritizing potential health risks and determine which risks need documented demonstration of controls Ensure that health risks are assessed properly by taking into account acute and chronic harmful health effects
HRA Workshop

HRA-2 Slide 16

Health Risk = Consequences X Probability (Likelihood)

A
Never heard of in the world

Increasing Probability C D
Incident has occurred in Shell company Happens several times per year in Shell company

E
Happens several times per year in our location

Heard of incident in our industry

1 2 3 4 5

Slight Injury/Illness Minor Injury/Illness Major Injury 1-3 fatatlities Multiple Fatalities
Categories LOW Area 1 MEDIUM Area 2 HIGH Area 3

Likelihood
Acute - Estimated on the basis of experience and or evidence that a certain outcome has previously occurred Chronic - Estimated based on the historical evidence that excess exposure has occurred

Consequence
Estimate of what could happen (acute and chronic)

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Risk Assessment Matrix

Increasing Probability CONSEQUENCE
HAZARD RATING People Assets Reputation

A
Never heard of in the world

B
Heard of incident in our Industry

C
Incident has occurred in Shell company

D
Happens several times per year in Shell company

E
Happens several times per year in our location.

1 2 3 4 5

Slight health effect Minor health effect Major health effect PTD* or 1 to 3 fatalities Multiple fatalities

Slight damage Minor damage Localised damage Major damage Extensive damage

Slight impact Limited impact Considerab le impact Major national Major intnational

LOW RISK

Manage for continuous improvement Manage for continuous improvement Incorporate risk reduction measures Incorporate risk reduction measures
MED. RISK HIGH RISK

Intolerable investigate alternatives Intolerable investigate alternatives

* PTD = Permanent Total Disability

Note: Environment consequence column omitted

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HRA Workshop

Generic RAM HRA outcomes

Health Hazard Examples of situations or activities in which the health hazard may occur Harmful health effects from over exposure (Consequences) Consequence Category (harm to people) - C Likelihood -L RAM Risk Rating (C x L) Chemical Hazards
Asbestos Materials containing asbestos, for example, gaskets, ceiling tiles, partitians, insulation Acute: Mildly Irritating to eyes and respiratory tract Chronic: Category 1 carcinogen Acute: Irritant to eyes and respiratory tract; narcotic to CNS. Chronic: Category 1 carcinogen

Cat 1 Carcinogen: 4/5

5C - High

Benzene

Processing, handling and distribution of benzene containing process streams and products, e.g. naphthas, platformate, condensate, gasoline. Shell chemicals marketed product and process material

Cat 1 Carcinogen: 4/5

5B - Medium

Ethylene oxide

Acute: cold burns to skin and eyes. Shortness of breath, dizziness and drowsiness on inhalation. May cause pulmonary oedema. Chronic: Category 2 carcinogen and mutagen Acute: Irritant to skin and eyes Chronic: skin sensitiser Acute: Chemical asphyxiant causing respiratory paralysis. Chronic: n/a

Cat 2 Carcinogen: 4/5

4B - Medium

Epoxy Resins

Contained in some adhesives (maintenance)

Sensitiser: 3

3C - Medium

Hydrogen sulphide

Waste gas stream; sour crude oil; condensates; bitumen and fuel oil tank head spaces

Chemical asphyxiant: 5

5C - High

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Low RAM Ratings

Manage for continuous improvement via standard procedures and competences in HSE-MS (ensure these are adequate) ensure Exposure Limits and other control standards are met

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Medium and High RAM Ratings

Detailed review of controls
Standards of control Who is exposed and when Estimate or measure exposure Compare existing controls against standards (are OELs met and risks As Low As Reasonably Practicable - ALARP?) Consider need for routine exposure monitoring and/or health surveillance

For risks assessed as High

give serious consideration to alternative ways of carrying out the operation
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HRA-2 Slide 21

Control and Recovery

Identify exposure Hierarchy of controls Control standards Use of control chart for individual risk Apply ALARP principle Exposure measurements Health Surveillance
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HRA-2 Slide 22

What is exposure?
Exposure is defined as:
The amount of the hazard to which a person has been exposed(dose). This is a combination of the magnitude, frequency and duration of exposure

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Exposure
Duration Frequency Magnitude (extent of exposure) is affected by:
Concentration/intensity of the agent Work practices Agents physical characteristic impacting on the exposure route Existing controls
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HRA-2 Slide 24

Exposure routes
Ear Eye Nose Mouth

Lung Musculoskeletal Skin Whole body

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Hazards and Exposure routes

Hazard
Noise Chemical Liquids

Exposure route
ear skin (through uptake of the skin, or through injection) Eye transferred from hand to mouth ingestion nose, mouth, lungs inhalation trapped in the nose and throat, or transferred from hand to mouth, leading to ingestion whole body or specific parts e.g. hands, eyes

Chemical gases, vapours and dusts Chemical dusts Vibrations

Heavy lifting & other ergonomic hazards muscoloskeletal system

HRA Workshop

HRA-2 Slide 26

Target Organs
Central nervous system Ear Lung Liver Skin Reproductive system Eye Nose Mouth Heart Musculo-skeletal system Digestive tract Kidneys

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Hazard, exposure route and target organ

Hazard
Noise

Exposure route
Ear

Target organ
Ear Direct contact with lungs, skin and eyes. May also be absorbed in blood stream and carried to susceptible organs: central nervous system, reproductive system, kidney, liver Heart, mental impairment

Chemical liquids and Inhalation, skin, eye dusts (hazard dependent on the specific chemical)

Stress

Mind

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Factors Affecting Intake for chemical and biological agents

Physical form Gas/vapour/liquid/solid Particle size Particle shape Solubility Carriers Breathing rate
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HRA-2 Slide 29

Identify who is exposed

Typical Job Types
Plant Operators - divided by operational group Road Tanker Drivers - divided by product group Maintenance Staff - mechanical, electrical, vehicle etc. Cleaning Staff - plant and/or office Laboratory Technicians - sub-divide as appropriate Administrators - office based with minimal plant exposure Field Staff - geologists
HRA Workshop

HRA-2 Slide 30

Estimate exposure level

Identify tasks:
Use workplace experience Review historical records Discuss with staff involved in doing the task Visit work area/walk through survey

Include tasks involved in:

Normal operations Maintenance Abnormal conditions and foreseeable emergencies
HRA Workshop

HRA-2 Slide 31

Estimate exposure level

What is a task ?
An
A

activity which a competent person can be instructed to do in a single sentence plant operator could be asked to take a process stream sample A plant cleaner could be asked to deal with a spillage A fitter could be asked to take a pump out of service A laboratory technician could be asked to analyse a sample for benzene content

HRA-2 Slide 32

HRA Workshop

Estimate exposure level

Review tasks
Frequency, duration and estimates of concentration/intensity of exposure Work practices and existing controls
Effectiveness of existing control measures

Compare existing controls against relevant control standards Who else is exposed?
Employees, contractors, third parties
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HRA-2 Slide 33

Estimate exposure level-without exposure measurement

Exposure may be acceptable when:
evidently so operations are in accordance with suppliers documented procedures previous measurements under similar or worst case conditions indicate low exposure process operated in accordance with recognised guidance on good practice
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HRA-2 Slide 34

Estimate exposure level-without exposure measurement

Exposure may be unacceptable when:
there is evidence of fine dust deposits fume or particles are visible in light beams there are broken, defective or poorly maintained controls the process is not operated in accordance with recognised guidance on good practice complaints are made of discomfort or excessive odour ill-health related to exposure is detected

HRA-2 Slide 35

HRA Workshop

Hierarchy of controls
The hierarchy of controls is a list in preferential order of the means by which exposure to health hazards can be controlled
Elimination Substitution (alternatives) Engineering (plant and equipment) Procedural Personal protective equipment
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HRA-2 Slide 36

Types of controls
Elimination and substitution Engineering (plant and equipment):
Equipment/processes designed to prevent or minimize release of the hazard
Examples: containment (enclosure), exhaust ventilation, remote venting/vapor recovery systems
HRA Workshop

HRA-2 Slide 37

Types of controls
Procedural:
Safe systems of work / Permit to work system Record systems Staff Instruction, Information & training Supervision, Emergency arrangements

Personal Protective Equipment (PPE):

Respiratory & Skin Protection as a
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HRA-2 Slide 38

Effectiveness of Controls
The types of control vary in their effectiveness according to the control hierarchy:
Elimination Substitution Engineering Procedural PPE Least Effective
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Most Effective

HRA-2 Slide 39

Control selection
Control selection to achieve ALARP must consider the control effectiveness and cost:
consider the most effective controls first limit PPE to:
-infrequent tasks -temporary use until more effective controls are in place
HRA Workshop

HRA-2 Slide 40

Maintenance of controls
Controls are only effective if they work
Engineering controls
Preventive maintenance, inspections and tests

Procedural controls
Record systems, information and training Effective supervision

PPE
Routine maintenance, inspection and training

Emergency measures
Inspections and realistic exercises
HRA Workshop

HRA-2 Slide 41

Control standards
Occupational Exposure Limits (OELs) Specifications for control:
Engineering Control Standards (SES, DEP) Procedural (manufacturers/suppliers info/industry good practice) Personal Protective Equipment

National, Company, Group, Industry and International Standards

HRA Workshop

HRA-2 Slide 42

What are exposure limits?

Chemical agents
Occupational Exposure Limits are levels of airborne concentrations of hazardous compounds that are considered safe for the workplace OELs and recommendations are set by competent national authorities OELs are normally used for chemical agents, but the concept can also be applied for physical, biological and psychosocial agents and for ergonomics

HRA-2 Slide 43

HRA Workshop

Occupational exposure limits

Physical Agents, e.g.
Shell Noise Guide recommended criteria Daily Noise Dose - 85 dB(A) Leq Design Limit - 85 dB(A) at 1 meter Cold stress Ionising radiation Heat stress Lasers Vibrations
HRA Workshop

HRA-2 Slide 44

Occupational exposure limits

Biological agents
Control to as low as reasonably practicable

Ergonomics
Include ergonomic principles to all work activities

Psychological
Refer to specialist for evaluation and treatment
HRA Workshop

HRA-2 Slide 45

Engineering control standards

Face velocities of Lab Hoods should meet recognized design standards Rotating equipment mechanical seals that do not leak Transfer lines/hoses with disconnect fittings that do not leak Capture velocities for welding hoods meet recognized ventilation standards Engineering controls are inspected regularly Engineering controls are on a PM (preventive maintenance) schedule HRA-2 Slide 46
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Procedural standards
written procedures for tasks involving exposure (permit to work system) procedures include work practices that minimize exposure work practices are understood (e.g. training & validated by testing) and followed by employees (supervision, validated by auditing)

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Personal Protective Equipment

respirators gauntlets (gloves) goggles protective clothing foot protection

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Personal protective equipment

Adequate use of PPE includes an assessment of:
PPE requirement for each task PPE selection to match the hazard PPE is practical & functional for the task PPE requirements are understood by employees (e.g. training & validated by testing) PPE is used correctly (e.g. training & validated by audit)) PPE is used when required (validated by audit)
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HRA-2 Slide 49

Use of Control Chart

Are controls meeting the control standards? Control chart: tool for decisions Use of information on exposures and controls Combining hazard rating and exposure rating

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Hazard rating categories

HAZARD RATING DEFINITION (Consequence Category: Harm to People) 1 Slight health effects: Not affecting work performance or causing disability, e.g. non toxic dusts (as an acute hazard) Minor health effects: Agents capable of minor health effects which are reversible, e.g. irritant agents, defatting agents, many food poisoning bacteria Major health effects: Agents capable of irreversible health damage without loss of life, e.g. noise, poor manual handling tasks, hand/arm vibration, chemicals causing systemic effects, sensitisers

One to three fatalities or Permanent Total Disability: Agents capable of irreversible damage with serious disability or death, e.g. corrosives, known human carcinogens (small exposed population), sensitisers where the onset of sensitisation threatens continuing employment, heat, cold, psychological stress Multiple fatalities: Agents with the potential to cause multiple fatalities, e.g. chemicals with acute toxic effects (hydrogen sulphide, carbon monoxide), known human carcinogens (large exposed population)

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Exposure Rating
Exposure Rating
a) Very Low b) Low c) Medium

Exposure Band
< 0.1 x OEL

Definition
Exposures are negligible

> 0.1 - <0.5 x Exposure are controlled well below OEL and are likely to remain so in accordance with standards OEL > 0.5 1 x OEL
Exposures are currently controlled below OEL to meet standards but control may be reliant on less robust measures such as personal protective equipment Exposure are not adequately controlled to meet standards and continuously/regularly exceed OEL Exposures are excessive and will almost certainly result in health damage to persons exposed
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d) High e) Very High

> OEL >> OEL

HRA-2 Slide 52

Control Chart
Exposure Rating Hazard Rating 1 2 3 4 5 Exposure Band (1) <0.1*OEL (2) 0.1*OEL 0.5*OEL 0.5*OEL - 1*OEL > OEL Very Low (a) No action Low (b) immediate required Medium (c) Third priority First Priority for Action >> OEL High (d) Second Very High (e) Priority

1. reference to exposure bands is a qualitative estimate only where no exposure data are available 2. OEL: Occupational Exposure Limit

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HRA Workshop

Evaluate the Adequacy of Controls

What is the nature of the hazard to health ?
Use Hazard Rating (RAM Consequence Category)

What is the nature and degree of exposure for the task ?

Assign Exposure Rating

Combine in Control Chart

HRA-2 Slide 54

HRA Workshop

Remedial Action Plan

The Remedial Action Plan must cover:
Recommendations divided into four levels of action (first, second, third priority and no immediate action required) Is recommendation agreed or not? Responsible person Due date
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HRA-2 Slide 55

Actions Control Chart (1) To aid priority setting

Action 1st priority
Stop the exposure; notify management immediately Identify all sources Implement immediate control improvements e.g. PPE Consider need for exposure measurement Identify and implement work practice and control improvements Review HRA, including measurements

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Actions Control Chart (2) To aid priority setting

Action 2nd priority
Reduce exposure to below OEL (Hazard Ratings 1-2) Consider reducing to below 0.5 x OEL (Hazard Ratings 3-5) Identify and implement work practice and control improvements (*) Consider need for exposure measurement (*) Review HRA, including measurements (*)

Action 3rd priority

Actions with asterisk under 2nd priority

Action No Immediate Action Required

Normally no need for immediate action to improve controls. Manage for continuous improvement

HRA-2 Slide 57

HRA Workshop

ALARP Definition
Definitions of ALARP balancing the reduction in risk against the time, difficulty and cost of achieving it This level represents the point, objectively assessed, at which the time, difficulty and cost of further reduction measures become unreasonably disproportional to the additional risk reduction obtained.
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HRA-2 Slide 58

ALARP
ALARP is influenced by the following factors: risk to be avoided sacrifice involved in taking measures to avoid the risk (money, time and trouble) comparison of the two

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ALARP- rule of thumb

List the measures that have been taken to reduce the risk Go on to identify an additional option which might be introduced to reduce the risk further Give reasons why this additional control is not adopted

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ALARP

Tolerability level

Risk to Health

Cost of Control
Wasteful

Legal Liability

ALARP

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What remedial action?

Is risk to health ALARP?
Yes, when only a small reduction in risk would require an unreasonable amount of time, trouble, difficulty or cost.

Otherwise
Select appropriate additional controls/barriers considering
Hierarchy of controls including recovery preparedness measures Other measures like: measurements, monitoring, health surveillance, maintenance of controls, instruction & training Priorities for implementation

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Exposure measurements
Identify who may be exposed to health risks Identify the relevant exposures to individuals in the workplace Assess your work environment to determine when you need to do exposure monitoring/measurements

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Purpose of exposure measurements

Verification of the efficiency of control measures Justification for additional control measures Choice of control measures (eg for noise control) To establish and document historical records of exposure levels for all workers To ensure and demonstrate compliance with regulatory and other exposure guidelines Epidemiological studies or investigating reported health effects To alleviate employee concerns
HRA Workshop

HRA-2 Slide 64

Objectives of exposure measurement

Baseline - to define range and distribution of
exposure for defined jobs Worst case to identify potentially high exposure Detailed when baseline study provides insufficient data Routine periodic exposure monitoring to check that control measures remain effective Compliance - to ensure that exposure is below regulatory and other guidelines
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HRA-2 Slide 65

Monitoring methods
Personal Monitoring
worker exposure with normal work procedure breathing zone for inhalation exposure near ear for noise exposure full shifts / task samples

Area (Environmental) Monitoring

contaminant concentration in work area plant conditions effectiveness of controls
HRA Workshop

HRA-2 Slide 66

Monitoring methods
Biological Monitoring
Determine body absorption of potentially hazardous substance from all sources Measure changes in the composition of body fluid, tissue or expired air May be used to indicated inadequate control, improper work procedure Provides accurate information about the absorbed dose of a substance in the body Not all substances have a method or a BLV (biological Limit Value)
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Sampling Strategy
Where to Sample When to Sample Whom to Sample How long to Sample How many samples to take

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Health Surveillance
Monitoring and health surveillance aims to (periodically) assess exposures and health in order to
Confirm the effectiveness of existing control measures Collect data for the detection and evaluation of hazards to health Confirm compliance with predetermined criteria Required by law
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Medical Surveillance
Medical Surveillance selection criteria Is there a risk to health (based on HRA) The prevention/intervention potential ("can we do something about it?") Can we detect it? Are the detection methods suitable?
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Document & Review HRA

Appropriate Depth of Records Linked with Medical Records Informing Staff Archiving of Records Reviewing Records
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HRA-2 Slide 71

Appropriate Documentation
Records should:
be retrievable
Internal/external audits, authorities and review

meet legal requirements be detailed enough to ensure audit trail on how conclusions were reached allow traceability from individual name via Job Type to tasks include exposure monitoring and health surveillance

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Informing Staff of Findings

Involves staff in HRA process Ensures that:
Health risks are understood Control measures are used Staff can alert assessment teams on changes

May be a legal requirement

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Archiving of Records
As required by local law and/or practice 30 - 40 years are typical

Allows for re-introduction of old processes

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Reviewing HRAs
Senior management will confirm the status of HRA through HSE annual letter Action Items
Short term reviews of action items
Against target dates and responsible persons

Change in process, hazard, legislation etc Change in controls New information on the effect
Incidents, illnesses, complaints, new knowledge

On an agreed cycle
Between 1 and 5 years dependent on risk
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