Health Risk Assessment

1. Health Risk Assessment Controlling health risks at work

2. What is HRA ?

3. 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

4. Selection of team • Team Leader / Asset owner–Line 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 • Specialist Staff –Occupational hygienist, OH physician, toxicologist, ergonomist

5. 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 • Gather the information systematically • Form valid, justifiable conclusions about exposures and risks

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. Identify Health Hazards and their harmful Effects Agent Source Route Harmful Effect Silica dust (crystalline) Used mineral oils Noise Heat Legionella bacteria Repetitive movements Refractory bricks Engine oil Process noise above 85dB(A) Plant heat Spray cooling towers Workplace design Inhalation Skin Hearing Whole body Inhalation Whole or part of body Lung disease (silicosis) Dermatitis, cancer Hearing Loss Heat stress, heat stroke Legionnaire’s Disease Musculo-skeletal disorders

13. Factors influencing the Relationship between Hazard and Risk • Cumulative exposure • Individual susceptibility • Threshold levels • Knowledge gaps • Workstyle changes • Real world practices

14. Assigning Hazard Ratings

15. Hazard Ratings Consider Harm to: • People • Assets • Reputation Select the category with the highest consequence rating!

16. 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

17. Health Risk = Consequences X Probability (Likelihood) 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)

18. Risk Assessment Matrix Manage for continuous improvement Incorporate risk reduction measures Intolerable – investigate alternatives

19. 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 Cat 1 Carcinogen: 4/5 C 5C - High Benzene Processing, handling and distribution of benzene containing process streams and products, e.g. naphthas, platformate, condensate, gasoline. Acute: Irritant to eyes and respiratory tract; narcotic to CNS. Chronic: Category 1 carcinogen Cat 1 Carcinogen: 4/5 B 5B - Medium Ethylene oxide Shell chemicals marketed product and process material 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 Cat 2 Carcinogen: 4/5 B 4B - Medium Epoxy Resins Contained in some adhesives (maintenance) Acute: Irritant to skin and eyes Chronic: skin sensitiser Sensitiser: 3 C 3C - Medium Hydrogen sulphide Waste gas stream; sour crude oil; condensates; bitumen and fuel oil tank head spaces Acute: Chemical asphyxiant causing respiratory paralysis. Chronic: n/a Chemical asphyxiant: 5 C 5C - High Generic RAM HRA outcomes

20. 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

21. 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

22. Control and Recovery • Identify exposure • Hierarchy of controls • Control standards • Use of control chart for individual risk • Apply ALARP principle • Exposure measurements • Health Surveillance

23. 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

24. Exposure • Duration • Frequency • Magnitude (extent of exposure) is affected by: • Concentration/intensity of the agent • Work practices • Agent’s physical characteristic impacting on the exposure route • Existing controls

25. Exposure routes Eye Ear Nose Mouth Lung Musculo-skeletal Skin Whole body

26. Hazards and Exposure routes

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

28. Hazard, exposure route and target organ

29. Factors Affecting Intake for chemical and biological agents • Physical form • Gas/vapour/liquid/solid • Particle size • Particle shape • Solubility • Carriers • Breathing rate

30. 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

31. 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

32. Estimate exposure level • What is a ‘task’ ? • An activity which a competent person can be instructed to do in a single sentence • A 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

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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 secondary line of defence or as the only option

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

40. 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 • as a precaution should other controls fail

41. 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

42. Control standards • Occupational Exposure Limits (OELs) • Specifications for control: • Engineering Control Standards (SES, DEP) • Procedural (manufacturer’s/supplier’s info/industry good practice) • Personal Protective Equipment • National, Company, Group, Industry and International Standards

43. What are exposure limits? • Chemical agents • Occupational Exposure Limits are levels of airborne concentrations of hazardous compounds that are considered safe for the workplace • OEL’s and recommendations are set by competent national authorities • OEL’s are normally used for chemical agents, but the concept can also be applied for physical, biological and psychosocial agents and for ergonomics

44. 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

45. 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

46. 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

47. 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)

48. Personal Protective Equipment respirators gauntlets (gloves) goggles protective clothing foot protection

49. 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) • PPE is inspected and maintained regularly (validated by audit)

50. 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’