3S LIFE SAFE AKADEMIE

Element 5
Physical and Psychological Health
This Chapter shall cover following NEBOSH learning objectives.

5.1 Noise
 Introduction
 The Physical and Psychological Effects of Exposure to Noise
 The Meaning of Commonly Used Terms: Sound Pressure,
Intensity, Frequency, The Decibel Scale, Db(A) And Db(C)
 When Exposure Should be Assessed; Comparison of
Measurements to Exposure Limits Established by Recognized
Standards
 Basic Noise Control Measures, Including: Isolation, Absorption,
Insulation, Damping and Silencing; The Purpose, Use and
Limitations Of Personal Hearing Protection (Types, Selection,
Use, Maintenance and Attenuation Factors)
 The Role Of Health Surveillance

5.2 Vibration
 Introduction
 When Exposure Should be Assessed; Comparison of
Measurements to Exposure Limits Established By Recognized
Standards
 Basic Vibration Control Measures, Including: Alternative
Methods of Working (Mechanization Where Possible); Low-
Vibration Emission Tools; Selection of Suitable Equipment;
Maintenance Programs; Limiting The Time Workers Are Exposed
To Vibration (Use Of Rotas, Planning Work to Avoid Long Periods
of Exposure); Suitable PPE
 The Role Of Health Surveillance

5.3 Radiation
 The Types Of, And Differences Between, Non-Ionizing and
Ionizing Radiation (Including Radon) and their Health Effects
 Typical Occupational Sources of Non-Ionizing and Ionizing
Radiation
 The Basic Ways of Controlling Exposures to Non-Ionizing and
Ionizing Radiation
 The Radon Gas and their Health Effects and its Control Measures

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 Basic Radiation Protection Strategies, Including The Role of The

Competent Person In the Workplace
 Role of Monitoring and Health Surveillance

5.4 Mental Ill-Health

 The Frequency and Extent of Mental Ill-Health at Work
 Common Symptoms of Workers With Mental Ill-Health:
Depression, Anxiety/Panic Attacks, Post-Traumatic Stress
Disorder (PTSD)
 The Causes of, And Controls for, Work-Related Mental Ill-Health
 Home–Work Interface
 Control Measures

5.5 Violence at Work

 Types of Violence at Work Including: Physical, Psychological,
Verbal, Bullying
 Jobs and Activities Which Increase The Risk of Violence
 Control Measures To Reduce Risks From Violence at Work

5.6 Substance Abuse at Work

 Introduction
 Risks To Health and Safety from Substance Abuse at Work
 Control Measures to Reduce Risks from Substance Abused at
Work

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 Protecting workers by providing PPE (Ear

defenders or ear plugs)
5.1 Noise Human Ear
There are three sections of the ear – the
Introduction: Physical & outer (or external) ear, the middle ear and the inner
Psychological Hazards at (or internal) ear.

Workplace: The sound pressure wave passes into and

Due to different ―ambient factors‖ through the outer ear and strikes the eardrum causing
(surroundings) occupational hazards at workplace it to vibrate and damage if exposed to excessive
may affect the physical & psychological well-being noise.
and abilities of workers because of - Noise, ionizing
and non- ionizing radiation, Vibration, mental ill-
health, workplace violence, substance to abuse etc.

Noise
Exposure to excessive noise may cause
Noise-Induced Hearing Loss (NIHL) and other
health and safety risks.

Noise may be transmitted directly through

the air, by reflection from surrounding walls or
buildings or through the structure of a floor or
building. In construction work, the noise and
vibrations from a pneumatic drill will be transmitted
from the drill itself, the ground being drilled and
from the walls of surrounding buildings.

Noise exposure standards are based on

worker‘s daily exposure. Normally, an exposure of
85dB (A), over more than 8 hours is the upper limit
of exposure standard.
The Physical and Psychological
Effects of Exposure to Noise
The Effects of Exposure to
Noise
Worker or employees are exposed to noise
during working in construction sites, entertainment
sectors, manufacturing sectors, mines, call centers,
etc., shall be affected / damage their ear by:

 Temporary Damage (Acute Effects) :

Physical Effects
To take the reading of noise at workplace, ―Sound  Permanent Damage (Chronic
level Meter‖ should be used. Control of Noise can be Effects): Psychological Effects
achieved by:

 Reducing noise by elimination, substitution,

maintenance, damping and silencing.
 Interrupting the sound pathway

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Temporary Damage (Acute
Effects): Physical Effects
There are three principal acute effects and cause
physical effect.
 Temporary threshold shift: Temporary
reduction in hearing sensitivity as a result a
slight deafness or sensitivity particular to
speech, which is reversible when the noise is
removed;
This is caused by short excessive
noise exposures and affects the sensory cells
in the cochlea by reducing the flow of nerve
impulses to the brain.
 Tinnitus: It is a ringing in the ears caused
by an intense and sustained high noise level.
It is caused by the over-stimulation
of the hair cells. The ringing sensation
continues for up to 24 hours after the noise
has ceased or results of repeated exposure to
excessively loud sound.
 Acute acoustic trauma: This is a Noise-
Induced Hearing Loss (NIHL), permanent,
progressive loss of hearing sense due loud
sound or explosion.
This caused by a very loud peak
noise such as an explosion. It affects either
the eardrum or the bones in the middle ear
and is usually reversible. Severe explosive
sounds can permanently damage the
eardrum.
Permanent Damage (Chronic
Effects): Psychological effect
Psychological effects to exposure to noise can
cause, Stress Effects due to irritation / background
noise continuously and difficulty in concentrating.
 Noise-Induced Hearing Loss (NIHL): This
results from permanent damage to the
cochlear hair cells. It affects the ability to
hear speech clearly but the ability to hear is
not lost completely;
 Permanent Threshold Shift (PTS): This
results from prolonged exposure to loud
noise and is irreversible due to the
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permanent reduction in nerve impulses to
the brain.
This shift is most marked at the
4000 Hz frequency, which can lead to
difficulty in hearing certain consonants and
some female voices
 Tinnitus: This is the same as the acute form
but becomes permanent. It is a very
unpleasant condition, which can develop
without warning
 Temporary deafness: This can occur after
leaving a noisy place. Hearing usually
recovers within a couple of hours. This is a
sign that continued exposure to loud noise
could permanently damage your hearing;
 Sudden extremely loud noise: This can
cause instant damage; and - repeated
exposure causes gradual hearing loss due to
repeated exposure. This is more common
and it can take years for a worker to realize
just how deaf they have become.
 Presbycusis: This is the term used for
hearing loss in older people which may have
been exacerbated by occupational noise
earlier in their lives.
The Meaning of Commonly
Used terms: Sound Pressure,
Intensity, Frequency, the
Decibel Scale, dB(A) and dB(C)
Terminology:
For, Noise measurement, the following basic
terminology is used in the measurement and
assessment of noise exposures in the workplace:
 Sound intensity (Unit Pascal): a measure
of sound energy carried by sound pressure
waves moving through the air.
It is measured by a unit known as a
Pascal (Pa – N/m2), which is a unit of
pressure similar to air pressure.
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 The Sound pressure Level (Unit Decibel - give a sound pressure level expressed as
dB scale): The Air pressure of sound waves dB(A). It is decibel value corrected for
moving through air. sensitivity of the human ear.

 Decibel (dB): The unit is called a decibel  C-Weighting dB(C): During the noise
(dB) and is defined as SPL 20 log10(p/p0) assessment, A-weighting is applied to the
dB. decibel values at different frequencies to
give a sound pressure level expressed as
It is important to note that the decibel scale dB(C).
is a logarithmic scale to the base 10 is used; each
increase of 3 dB is a doubling in sound intensity. This C-Weighting gives a more accurate reading
for impulse noise.
Example: if a sound reading changes from
75 dB to 81 dB, the sound intensity or loudness has Typical decibel value during different noises
increased by four times. Noise in dB(A) Sound Source
0 The fainted audible sound
Some Typical Sound Pressure Levels (SPL)- dB 20-30 A Quiet Library
(A) Values 50-60 A conversation
65-75 A loud radio
90-100 A Power Drill
140 A jet Aircraft taking off

When Exposure Should be

Assessed; Comparison of
Measurements to Exposure
Limits Established by
Recognised Standards
Typical Noise Level at Wood Working
The Assessment of Noise
Exposure
Several countries specify action levels at which
the hearing of employees must be protected. The
conclusion as to whether any of those levels has been
breached is reached after an assessment of noise
levels has been made.

However, before noise assessment can be

discussed, noise measurement and some sample
statutory action levels must be described.
 Frequency (Unit Hz): A measures of the
number of sound pressure waves that pass a
fixed point in one second (The Pitch), the
unit of frequency is Hertz (Hz).

 A-weighting dB (A): During the noise

assessment, A-weighting is applied to the
decibel values at different frequencies to

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The Control of Noise at Work Regulations
2005 recommends that the level of noise and/or
duration of exposure should not exceed the limits
established by the competent authority or other
internationally recognized standards. The assessment
should consider the following:
 the risk of hearing impairment;
 the degree of interference to speech
communications essential for safety
purposes;
 the risk of nervous fatigue, with due
consideration to the mental and physical
workload and other non- auditory hazards or
effects.
To prevent the adverse effects of noise on workers,
employers should:
 identify the sources of noise and the tasks
which give rise to exposure;
 seek the advice of the competent authority
and/ or the occupational health service about
exposure limits and other standards to be
applied
 seek the advice of the supplier of processes
and equipment about expected noise
emission;
 if this advice is incomplete or otherwise of
doubtful value, arrange for measurements by
persons competent to undertake these in
accordance with current national and/or
internationally recognized standards.
Noise Exposure Standards: Noise
action Levels
Those countries that have legislation to
control noise levels have introduced exposure action
level values and exposure limit values.
An exposure action value is a level of noise
at which certain action must be taken.
An exposure limit value is a level of noise
at the ear above which an employee must not be
exposed.
Therefore, if the workplace noise levels are
above this value, any ear protection provided to the
employee must reduce the noise level to the limit
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value at the ear. These exposure action and limit
values in the European Union are as follows.
The lower exposure action levels are:
 a daily or weekly personal noise exposure of
80 dB(A);
 a peak sound pressure of 135 dB(C)
The upper exposure action levels are:
 a daily or weekly personal noise exposure of
85 dB(A);
 a peak sound pressure of 137 dB(C) for
impulse noise.
The exposure limit values (as absolute limits) are:
 a daily or weekly personal noise
exposure of 87 dB(A);
 a peak sound pressure of 140 dB(C) for
impulse noise
The peak exposure action and limit values are
defined because high level peak noise can lead to
short-term and long-term hearing loss. Explosives,
guns (including nail guns), cartridge tools, hammers
and stone chisels can all produce high peak sound
pressures.
If the daily noise exposure exceeds the lower
exposure action level, then a noise assessment should
be carried out and recorded by a competent person.
There is a very simple test which can be done in any
workplace to determine the need for an assessment.
Below Table gives information on the simple test to
determine the need for a noise risk assessment.
Simple observation to determine the for a noise
Risk Assessment
The weekly exposure rate is not a simple
arithmetic average of the daily rates. If an
organization is considering the use of a weekly
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Element 5: Physical and Psychological Health
exposure level, then the following provisions should
be made:
 hearing protection must be provided if there
are very high noise levels on any one day;
 the employees and their representatives must
be consulted on whether weekly averaging is
appropriate;
 an explanation must be given to the
employees on the purpose and possible
effects of weekly averaging.
Finally, if the working day is 1 2 hours, then the
action levels must be reduced by 3 dB(A) because the
action levels assume an 8-hour working day. If there
is a variation in noise levels during the working day.
Other points to be included in a noise assessment are:
 details of the noise meter used and the date
of its last calibration;
 the number of employees using the machine,
time period of usage and other work
activities;
 an indication of the condition of the machine
and its maintenance schedule;
 the work being done on the machine at the
time of the assessment;
 a schematic plan of the workplace showing
the position of the machine being assessed;
 other noise sources, such as ventilation
systems, that should be considered in the
assessment. The control of these sources
may help to reduce overall noise levels;
 recommendations for future actions, if any.
a) inform, instruct and train employees on
the hearing risks,
b) supply hearing protection to those
employees requesting it;
c) ensure that any equipment or
arrangements provided under the
Regulations are correctly used or
implemented.
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The additional measures which the employer should
take if the upper exposure action level is reached are:
 reduce and control exposure to noise by
means other than hearing protection;
 establish hearing protection zones, marked
by notices and ensure that anybody entering
the zone is wearing hearing protection,
 supply hearing protection and ensure that it
is worn.
Basic Noise Control Measures,
Including: Isolation,
Absorption, Insulation,
Damping and Silencing; The
Purpose, Use and Limitations
of Personal Hearing Protection
Basic Noise Control Measures
To reduced time exposure of employees to the
noise source, there is a simple hierarchy of control
techniques:
 reduction of noise at source;
 reduction of noise levels received by the
employee (known as attenuation);
Interrupting the pathway
 personal protective equipment, for personal
protection
Reducing Sound at Source
There are several means by which noise could be
reduced at source:
 Eliminating the Source: Completely
remove the noise source, however, not
practical in many instances.
 Substituting the Source: change the
process or equipment (e.g. replace solid
tyres with rubber tyres or replace diesel
engines with electric motors);
 Modifying the process: By changing the
glass made bottle to plastic bottles, noise
from packing line can be reduced
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 Maintenance: improve the maintenance  Acoustic Haven: If workplace is very noisy

regime by regular lubrication of bearings, and no control being applied, than acoustic
tightening of belt drives. haven can be built that workers can retreat in
 Damping: Machine parts (Metal parts and to the escape of noisy environment.
its surfaces) can be resonate in harmony  Hearing Protection: If nothing can be used
with noise being produced by the machine. than hearing protection should be used to
 Silencing: Machines that produced sound reduce the amount of noise that penetrates to
and exhaust gases, can be fitted with the worker‘s ear.
silencer.
 Lagging: the insulation of pipes and other Hearing Protection: Types of Ear
fluid containers to reduce sound
transmission (and, incidentally, heat loss).
Protection
There are two main types of ear protection/hearing
 Isolation of the workers: the provision of
protection –
sound- proofed workrooms or enclosures
isolated away from noisy equipment (a  Earplugs and
power station control room is an example of  Ear defenders (ear muffs).
worker isolation).
Benefits and limitation of Ear Plugs
Interrupting the Pathway Benefits Limitation
Exposure of Noise can be controlled by Cheap and less expensive Difficult to see when
interrupting the pathways in following ways: fitted, so supervision
Disposable Risk of infection if dirty
Insulation: ―Acoustic enclosure‖ can be built at Comfortable to wear Lower level of protection
& do not interfere with when too high intensity
noise source. The noise will be inside the acoustic
other PPE noise
enclosure but will not be penetrated to the Benefits and limitation of Ear Defenders (Ear
environment. Muffs)
Benefits Limitation
Isolation: Noise is often transmitted in the form of Easy to supervise and Not comfortable when
mechanical vibration from the machinery into enforce use as they are used for long time
supporting structures. Isolating separates the machine visible
from supporting structures by using anti-vibration / Less chance of ear Routinely inspected,
vibration absorbent matts / springs. interaction cleaned and maintained
Higher level of Efficiency may reduce
Absorption: Once Noise created, it may travel protection possible by long hair , spectacles
directly to the receiver through air or may be or earrings
Can be integrated with Can be incompatible
reflected off hard surfaces
PPEs with other
(Walls/ceiling/building/structures). Absorption
Re-usable Need dedicated storage
involves putting sound absorbing materials in the facility
workplace.

Protecting the Receiver

The provision of personal hearing protection
should only be considered as a last resort. There is
usually resistance from the workforce to use them
and they are costly to maintain and replace. They
interfere with communications, particularly alarm
systems, and they can present hygiene problems.

The protection of receiver can be achieved The following factors should be considered when
by: selecting personal ear protection:

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 suitability for the range of sound spectrum  regular hearing checks in controlled
of frequencies to be encountered conditions;
 noise reduction (attenuation) offered by the  telling employees about the results of their
hearing checks;
ear protection
 keeping health records;
 pattern of the noise exposure  ensuring employees are examined by a
 acceptability and comfort of the wearer, doctor where hearing damage is identified.
particularly if there are medical problems
 Durability
 hygiene considerations
 compatibility with other personal protective
equipment
 ease of communication and able to hear
warning alarms
 maintenance and storage arrangements
 cost

Attenuation
There are many methods of attenuating or
reducing noise levels and these are covered in detail
in the guide. Hearing protection will have their
―Attenuation Characteristics‖, means ability to filter
the noise level.

Attenuation is important because the hearing

protection selected by the employer must be good
enough to reduce the noise levels at the worker‘s ear
to the acceptable level.

The level of noise able to penetrate the ear must

be calculated to ensure relevant exposure limit and
this can be done by.

 Noise Characteristics of workplace

 Attenuation characteristics of the hearing
protection.

The Role of Health Surveillance

The purpose of health surveillance is to, warn
you when employees might be suffering from early
signs of hearing damage, give you an opportunity to
do something to prevent the damage getting worse,
check that control measures are working.
Audiometry test (medical test) is must.

 a pre-employment or pre-assignment
medical examination,
 periodical medical examinations at intervals
prescribed as a function of the magnitude of
the exposure hazards;
 medical examinations prior to resumption of
work after a period of extended sickness.

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Health Effects of Exposure to Vibration depends

5. 2 Vibration
Introduction
Hand-held vibrating machinery such as
pneumatic drills, sanders and grinders, powered lawn
particularly in the hands, is adversely affected by the
vibration and caused Hand-Arm-Vibration-
Syndrome (HAVS) and Whole-body -Vibration
(WBV).
ILO advice for eliminating or controlling
exposure to vibration at workplace. The effects on the
body of exposure to hand–arm vibration and whole-
body vibration can be controlled by
 Reducing vibration by elimination,
substitution, changing work and technology
and maintenance
 Interrupting the vibration pathway
 Limiting the duration of exposure
 Health surveillance
on type of exposure and it will as under
Hand - Arm - Vibration Syndrome (HAVS):
Hand—arm vibration syndrome (HAVS)
describes a group of diseases caused by the exposure
of the hand and arm to external vibration. Some of
these have been described under WRULDs, such as
carpal tunnel syndrome.
HAVS normally results from long term
exposure 5-10 years or more. Once damage done its
unlikely get reverse in original and further vibration
will damage more and more only.
Symptoms of HAVS are :
 Vibration White Finger (VWF): in which
the circulation of the blood, particularly in
the hands, is adversely affected by the
vibration. During this finger turn as white
called blanching. The supply of blood starts
after some time and finger become red and
painful.

Vibration Exposure values Measured by HSE on

work equipment

The early symptoms are tingling and numbness

felt in the fingers, usually sometime after the end of
the working shift. As exposure continues, the tips of
the fingers go white and then the whole hand may
become affected. This results in a loss of grip
strength and manual dexterity. Attacks can be
The Effects on the Body of triggered by damp and/or cold conditions and, on
Exposure to Hand–Arm warming, ―pins and needles‖ are experienced.

Vibration and Whole-Body If the condition is allowed to persist, more

serious symptoms become apparent including
Vibration discoloration and enlargement of the fingers. In very
advanced cases, gangrene can develop leading to the
Health Effects of Exposure to amputation of the affected hand or finger.
Vibration
Nerve Damage: The nerves carrying sensory
completely stop working properly, resulting in pins

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and needles and loss of pressure, heat and pain
sensitivity.
Muscle Weakening: This results in a loss of grip
strength and manual dexterity
Joint Damage: abnormal bone growth, enlargement
of the fingers. In very advanced cases, gangrene can
develop leading to the amputation of the affected
hand or finger.
Carpal Tunnel syndrome: is a condition that
causes pain, numbness, and tingling in the hand and
arm. The condition occurs when one of the major
nerves to the hand — the median nerve is squeezed
or compressed as it travels through the wrist.
Whole – Body Vibration (WBV)
Effects
Whole-body vibration (WBV) is caused by
vibration from machinery passing into the body either
through the feet of standing workers or the buttocks
of sitting workers.
It is the shaking or jolting of the human body
through a supporting surface (usually a seat or the
floor), for example when driving or riding on a
vehicle along an unmade road, operating earth-
moving machines or standing on a structure attached
to a large, powerful, fixed machine, which is
impacting or vibrating.
The most common ill-health effect is back
pain which, in severe cases, may result in
permanent injury.
Reasons for back pain in drivers can include:
 poor design of controls, making it difficult
for the driver to operate the machine or
vehicle easily or to see properly without
twisting or stretching;
 incorrect adjustment by the driver of the seat
position and hand and foot controls, so that
it is necessary to continually twist, bend,
lean and stretch to operate the machine;
 sitting for long periods without being able to
change position;
 poor driver posture;
 repeated manual handling and lifting of
loads by the driver;
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 excessive exposure to whole-body vibration,
particularly to shocks and jolts;
 repeatedly climbing into or jumping down
from a high cab or one which is difficult to
get in and out of.
The risk increases where the driver or
operator is exposed to two or more of these factors
together.
a) Acute effects include reduce visual and
manual control, and increased heart rate and
blood pressure.
b) Chronic or long-term effects include
permanent spinal damage, damage to the
central nervous system, hearing loss and
circulatory and digestive problems.
The most common occupations which
generate WBV are driving fork-lift trucks,
construction vehicles and agricultural or
horticultural machinery and vehicles.
There is growing concern throughout to
ensure control measures include the proper use of the
equipment including correct adjustments of air or
hydraulic pressures, seating and, in the case of
vehicles, correct suspension, tyre pressures and
appropriate speeds to suit the terrain.
When Exposure Should be
Assessed; Comparison of
Measurements to Exposure
Limits Established by
Recognised Standards
The Assessment of Vibration
Exposure
The damage to the body in the form of
HAVS and back pain is dependent on the dose of
vibration received.
The dose of vibration is determined by the
“Vibration Magnitude” (the level of vibration) and
the ―Duration of Exposure” time that the worker
was exposed to the vibration.
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Employer must take the vibration assessment of If any workers exposed to equal or more than the
the workers who are working to exposed vibration. above vales, the employer must take actions for
control.
The Control of Vibration at Work Regulations
2005 recommends that the level of vibration and/or
duration of exposure should not exceed the limits
Basic Vibration Control
established by the competent authority or other Measures, Including:
internationally recognized standards. The assessment
should consider the following: Alternative Methods of
 The Vibration Magnitude
Working (Mechanisation
 Duration of Exposure Where Possible); Low
The vibration exposure standard is set on the Vibration Emission Tools;
basis that the amount of damage done is dependent
on amount of energy absorbed by the body.
Selection of Suitable
Equipment; Maintenance
The dose of vibration is called “eight Hour
Energy Equivalent Vibration Magnitude or A(8)” Programmes; Limiting The
Vibration measurement and assessment must Time Workers are Exposed to
be done by competent and experienced person.
Vibration measurement can be done by
Vibration (Use of Rotas,
accelerometer. Planning Work to Avoid Long
Vibration Exposure Standards Periods of Exposure); Suitable
The vibration exposure standards recognizes two PPE
different types of vibration exposure

 Hand Arm Vibration Syndrome (HAVS)

Basic Vibration Control Measures
To reduced time exposure of employees to the
 Whole Body Vibration (WBV)
vibration source, there is a simple hierarchy of
And control techniques:

Two daily personal vibration exposure levels set
which put different legal requirements on the
employer as under for 8-hours reference period:
 Daily exposure Action
 Daily Exposure Limits
Reducing Vibration at Source
A daily exposure action and limit values for both
HAV and WBV has been given below:
could be reduced at source:
Hand Arm Vibration Syndrome (HAVS)
 Daily exposure Action: 2.5 m/s2
 Daily Exposure Limits: 5 m/s2
Whole Body Vibration (WBV)
 Daily exposure Action: 0.5 m/s2
 Daily Exposure Limits: 1.15 m/s2
 reduction of vibration at source;
 Interrupting the pathway reduction of
vibration levels received by the employee
(known as attenuation);
 Limit the duration of exposure
There are several means by which vibration
 Eliminating the Source: Completely
remove the vibration source, however, not
practical in many instances.
 Substituting the Source: change the
process or equipment
 Changing Work Techniques: By changing
the tungsten hammer drill to diamond tipped
drill during cutting holes or drilling

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 Maintenance: improve the maintenance
regime by regular lubrication of bearings,
tightening of belt drives.
Interrupting the Pathway
Exposure of vibration can be controlled by
interrupting the pathways in following ways:
Isolation: Noise is often transmitted through solid
materials by direct contact. Isolating separates the
vibrating parts from the user‘s hand by using anti-
vibration mountings.
Limit the Duration of Exposure
To limit the vibration exposure to the operator, divide
the vibration dose and duration of exposure by
following ways.
 Limit the duration of exposure: calculate
the duration of exposure and ensure the
control
 Job Rotation: By sharing the jobs within
many operators can control the vibration
exposure
Role of Health Surveillance
The ILO Code of Practice ‗Ambient factors in the
workplace‗ recommends that workers should be
given a pre-employment medical examination /
medical history for jobs involving HAVS is present
from earlier employment. Where these symptoms are
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diagnosed, such employment should not be offered
unless vibration has been satisfactorily controlled.
If a worker is exposed to hand-transmitted
vibration, the occupational health professional
responsible for health surveillance should:
 examine the worker periodically, as
prescribed by national laws and regulations,
for HAVS and ask the worker about any
symptoms;
 examine the worker for symptoms of
possible neurological effects of vibration,
such as numbness and elevated sensory
thresholds for temperature, pain and other
factors.
The ILO Code also recommends that
employers should ensure that workers who are
exposed to significant vibration are:
a) informed about the hazards of prolonged use
of vibrating tools;
b) informed of the measures that the worker
can take to minimize risk, particularly the
proper adjustment of seating and working
positions;
c) instructed in the correct handling and use of
hand tools;
d) encouraged to report finger blanching,
numbness or tingling, without facing
unwarranted discrimination, for which there
should be recourse in national law.
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5.3 Radiation
The Types of, and
Differences Between, Non-
Ionising and Ionising
Radiation (Including Radon)
and their Health Effects
Types of radiation and their
health effects
 Ionizing radiation: is emitted from
radioactive materials, either in the form of
directly ionizing alpha and beta particles
or indirectly ionizing X-rays and gamma
rays or neutrons.
It has a high energy potential and
an ability to penetrate ionizes and damage
body tissue and organs.
Radiation that cause ionization in
the material that absorbs it
 Non-ionizing radiation: includes
ultraviolet (UV), visible light, infrared
(IR), microwaves and radio waves
As the wavelength is relatively
long, the energy present is too low to ionize
atoms which make up matter.
The action of non-ionizing
radiation is to heat cells rather than change
their chemical composition.
Radiation that does not cause
ionization in the material that absorbs it.
Typical Occupational Sources
of Non-Ionising and Ionising
Radiation
Ionizing Radiation:
There are mainly 5 types of Ionizing radiation
i. Alpha particles: consist of two protons and
two neutrons and have a positive charge.
They have little power to penetrate the skin
and can be stopped using very flimsy
material, such as paper. Their main route
into the body is by ingestion
ii. Beta particles are high-speed electrons
whose power of penetration depends on their
speed, but penetration is usually restricted to
2 cm of skin and tissue. They can be stopped
using aluminum foil. There are normally
two routes of entry into the body: inhalation
and ingestion
iii. X-Rays a form of high-energy
electromagnetic radiation, they are very
penetrating and will pass through body
iv. Gamma rays, which are similar to X-rays,
are electromagnetic radiation and have far
greater penetrating power. They are
produced from nuclear reactions and can
pass through the body.
v. Neutrons, Neutron radiation is often called
indirectly ionizing radiation. They are more
penetrating than alpha radiation or beta
radiation.
In some cases they are more
penetrating than gamma radiation, which is
impeded in materials of high atomic
number.

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Health Effects of Ionizing
Radiation
Ionizing radiation attacks the cells of the body by
producing chemical changes in the cell DNA by
ionizing it (thus producing free radicals), which leads
to abnormal cell growth. The effects of these ionizing
attacks depend on the following factors:
 the size of the dose the higher the dose then
the more serious will be the effect;
 the area or extent of the exposure of the
body the effects may be far less severe if
only a part of the body (e.g. an arm) receives
the dose;
 the duration of the exposure a long exposure
to a low dose is likely to be more harmful
than a short exposure to the same quantity of
radiation.
Ionizing radiation doze exposures are:
Acute exposure effects: can cause, dependent on the
size of the dose,
 Sickness and diarrhea
 Hair loss
 Anaemia due to red blood cell damage,
 Reduce immune system due to white blood
cell damage
 nausea and vomiting,
 skin burns and blistering,
 Collapse and death.
Chronic exposure can lead to
 leukemia
 cancer.
 Genetic mutations
 Birth defects
Typical Occupational Sources of
Ionizing Radiation
The principal workplaces which could have
ionizing radiation present are the nuclear industry,
medical centers (hospitals and research centers),
educational centers and the construction industry.
 Alpha Particles: Smoke detectors and
science labs
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 Beta particles: Science labs and thickness
gauges
 X-rays: Medical radiography and baggage
scanners
 Gamma Rays: Industrial Radiography for
nondestructive metals and welds
 Neutrons: Nuclear Power stations
The Basic Ways of Controlling
Exposures to Non-Ionising and
Ionising Radiation
Basic Means of controlling
Exposure to Ionizing Radiation
Protection is obtained by :
a) Shielding is the best method because it is an
‘engineered‘ solution. It involves the placing
of a physical shield, such as a layer of lead,
steel or concrete, between the worker and
the radioactive source. The thicker the shield
the more effective it is.
b) Time involves the use of the reduced time
exposure principle and thus reduces the
accumulated dose.
c) Distance works on the principle that the
effect of radiation reduces as the distance
between the worker and the source
increases.
 General public exposure: 1mSv
(millisievert) per year
 Occupational Exposure: 20mSv
(millisievert) per year
Non Ionizing Radiation
There are following types of non-ionizing radiations
 Ultraviolet (UV): It is electromagnetic
radiation with wavelength from 10 nm
(with a corresponding frequency of
approximately 30 PHz) to 400 nm (750
THz), shorter than that of visible light but
longer than X-rays, not visible to human
eye, emitted by white hot materials like arc
produced during arc welding, cracking fires,
etc.
 Visible light: The visible spectrum is the
portion of the electromagnetic spectrum that
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is visible to the human eye, the sun,  infrared (IR): Laser travelling devise, laser
Incandescent light bulbs, fluorescent, and pointer
neon lights are other examples of visible  Microwaves: Food industry,
light. telecommunication equipment, radar,
 infrared (IR): Infrared, sometimes called aircraft etc.
infrared light, is electromagnetic radiation  Radio waves: Radio, TV, antenna, mobiles
with wavelengths longer than those of etc.
visible light. It is invisible to the human eye,
it is used in industrial, scientific, military, Basic Means of controlling
law enforcement, and medical application.
 Microwaves: are a form of electromagnetic
Exposure to Non-Ionizing
radiation with wavelengths ranging from Radiation
about one meter to one millimeter, it is low The basic methods of controlling Non-ionizing
frequency electromagnetic waves and radiation are as under
generally used to cook many types of food,
fixed traffic speed cameras, radar, aircraft, Employers need to be aware of the risks
ships and weather forecasters, etc. their employees are taking when they work outside
 Radio waves: Is a type of electromagnetic without adequate protection from the sun. With
radiation with wavelengths in the growing concern following the rise in skin cancers,
electromagnetic spectrum longer than the HSE has suggested the following hierarchy of
infrared light. It is used in standard controls for outdoor working:
broadcast radio and television, shortwave
 relocate some jobs inside a building or to a
radio, navigation and air-traffic control,
shady location;
cellular telephony, and even remote-
 undertake some outdoor work earlier or later
controlled toys.
in the day;
 provide personal protection such as wearing
Health effects of Non Ionizing long sleeve shirts or loose clothing with a
Radiation close weave;
 Ultraviolet (UV): can cause redness and  wearing hats with a wide brim;
sunburn to skin, pain, inflammation to the  using a high factor sunscreen of at least
surface of eye, can lead to blindness, skin SPF15on any exposed skin;
cancer, cancer to eye  provide suitable education and training for
 Visible light: this can cause blindness outdoor workers;
temporary if intense or permanent blindness,  provide suitable information and supervision
skin burns to instigate safe systems of work that protect
 infrared (IR): Development of contracts workers from the sun.
over some times, redness, skin burns
 Microwaves: high dose can damage internal
organ or can be fatal
 Radio waves: cause heating and severe
burns, internal organ damage etc.

Typical Occupational Sources of

Non-Ionizing Radiation
 Ultraviolet (UV): Sunlight, arc welding
 Visible light: Red hot steel in rolling mill,  Ultraviolet (UV): enclosed the source,
glass manufacturing industry cover the skin, protect eyes.

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 infrared (IR): enclosed the source, cover Radon is a naturally-occurring radioactive

the skin, protect eyes. gas that can cause lung cancer. Radon gas is inert,
 Microwaves: caused internally and can be colorless and odorless.
controlled by
 Enclosing Radon is naturally in the atmosphere in
 Safe Distance trace amounts. Outdoors, radon disperses rapidly
and, generally, is not a health issue. Most radon
 Isolation
exposure occurs inside homes, schools and
 Radio waves: Radio, TV, antenna, mobiles
workplaces.
etc.

Lasers use visible light and light from the

invisible wavelength spectrum (infrared and
ultraviolet). Fully enclosing the light, dark goggles
for eye protection, shielding to prevent escape of the
laser beam and use of non-reflective surface.

As the word laser implies, they produce

‘light amplification by stimulated emission of
radiation‘. This light is highly concentrated and does
not diverge or weaken with distance and the output is
directly related to the chemical composition of the
medium used within the particular laser. The output
beam may be pulsating or continuous the choice
Typical Occupational Source of
being dependent on the task of the laser Radon Gas
Workers spending significant amount of time in sub-
The Radon Gas and their ground could be high at risk of radon exposure

Health Effects and its Control  Workers in Basement area / office

 Miners
Measures  Construction workers involved in tunnel

Radon Gas Control measure of Radon Gases

The ground is the most important source as
radon can seep out and build up in houses and indoor
workplaces. The highest levels are usually found in
underground spaces such as basements, caves and
mines
Variety of methods can be used to reduce radon
gas levels, including sealing cracks in floors and
walls and increasing ventilation though sub-slab
depressurization using pipes and fans.
Exposure level can be measure in following ways
of Radon Gases

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The Becquerel per cubic meters (Bq/m3): which by the person being monitored when used as a
measures the activity of a radioactive substance per personal dosimeter, and is a record of the radiation
second, dose received sent to laboratory for analysis.

The Sievert (Sv): which measures the biological Health surveillance is important for:
effects of the radiation normally measured in milli
sieverts (mSv).  detecting ill-health effects at an early stage,
so employers can introduce better controls to
the Becquerel (Bq) measures the amount of prevent them getting worse
 During periodic health checkup and review
radiation in a given environment and the millisievert  Special surveillance if dose limit exceeded
(mSv) measures the ionizing radiation dose received  providing data to help employers evaluate
by a person. health risks
 enabling employees to raise concerns about
Basic Radiation Protection how work affects their health
 highlighting lapses in workplace control
Strategies, Including the Role measures, therefore providing invaluable
feedback to the risk assessment
of the Competent Person in the  providing an opportunity to reinforce
training and education of employees (eg on
Workplace the impact of health effects and the use of
protective equipment)
Basic Radiation Protection
Strategies
The workers can be protected from Ionizing/Non-
ionizing/Radon radiation strategically following
ways.

 Elimination: Radiation exposure should be

eliminated as far as practicable
 Reduction of Exposure: If elimination not
practicable, reduced to the lowest level
reasonably practicable.
 Expose limit should not be exceeded more
than the dose limit
 Risk-assessment must be done for exposure
by competent person
 Training and information must be given to
employees and workers who are exposed
 Health surveillance must be done for
exposed employees and workers

The Role of Monitoring and

Health Surveillance
Health surveillance ongoing health checks. These
health checks may be required by law for employees
who are exposed radiation substances hazardous to
health.
Worker‘s exposure to radiation generally done by
using “Dosimeter”.
A radiation dosimeter is a device that measures
dose uptake of external ionizing radiation. It is worn

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5.4 The Mental Ill Health
Introduction-The frequency
and Extent of Mental Ill-Health
at Work
Mental Ill-Health refers to a wide range of
mental health conditions/disorders that affect mood,
thinking and behavior of a person.
Examples of mental illness include Stress,
depression, anxiety disorders, schizophrenia, eating
disorders and addictive behaviors.
Mental ill-health is a Psychological factors
that may contribute to mental illness include, severe
psychological trauma suffered as a child, such as
emotional, physical, or sexual abuse, an important
early loss, such as the loss of a parent.
HSE defines, Work-related stress as the
reaction people have to excessive pressure or other
types of demand placed on them.
An important distinction between pressure
and stress:
Pressure: which can be a positive state if managed
appropriately and a normal reaction to reasonable
demands,
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Stress: Which can arise in response to intense,
continuous or prolonged exposure to excessive
pressures and can be detrimental to health.
However, a recent report commissioned by the HSE
has concluded that there is no simple and universal
definition of work- related stress, largely because of
the complex nature of work-related stress.
The mental ill-health can be grouped as under:
 Demand
 Control
 Support
 Relationship
 Role
 Change
The Prevalence of Mental Ill-
health within the Workplace
Globally, an estimated 264 million people suffer
from depression, one of the leading causes of
disability, with many of these people also suffering
from symptoms of anxiety.
A recent WHO-led study estimates that
depression and anxiety disorders cost the global
economy US$ 1 trillion each year in lost productivity.
Unemployment is a well-recognized risk factor
for mental health problems, while returning to, or
getting work is protective. A negative working
environment may lead to physical and mental health
problems, harmful use of substances or alcohol,
absenteeism and lost productivity.
Workplaces that promote mental health and
support people with mental disorders are more likely
to reduce absenteeism, increase productivity and
benefit from associated economic gains.
A healthy workplace can be described as one where
workers and managers actively contribute to the
working environment by promoting and protecting
the health, safety and well-being of all employees by:
 Protect mental health by reducing work–
related risk factors.

 Promote mental health by developing the
positive aspects of work and the strengths of
employees.

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 Address mental health problems regardless  Low energy level,

of cause.  Low concentration,
 Daily behavior or self-esteem.
Common Symptoms of  With thoughts of suicide.
 Thought of self-harm
Workers with Mental Ill-
Panic Attacks
Health: Depression,
Anxiety/Panic Attacks, Post- A panic attack is a sudden episode of
intense fear that triggers severe physical reactions
Traumatic Stress disorder when there is no real danger or apparent cause. Panic
attacks can be very frightening. When panic attacks
(PTSD) occur, you might think you're losing control, having a
heart attack or even dying.
Common Types of Mental Ill-
Many people have just one or two panic
Health attacks in their lifetimes, and the problem goes away,
perhaps when a stressful situation ends. But if you've
Anxiety had recurrent, unexpected panic attacks and spent
long periods in constant fear of another attack, you
Anxiety is body's natural response to stress. may have a condition called panic disorder.
It's a feeling of fear / unease / worry.
Although panic attacks themselves aren't
Most people with an anxiety disorder have a life-threatening, they can be frightening and
combination of physical and psychological symptoms significantly affect your quality of life. But treatment
Physical Symptom Psychological Symptom can be very effective.
Rapid or pounding Feelings of apprehension
heartbeat. or dread Panic attacks typically include some of these
Feeling restless or signs or symptoms:
Shortness of breath
irritable
Excessive sweating Feeling tense or jumpy  Sense of impending doom or danger
Tremors or twitches. Anticipating the worst  Fear of loss of control or death
Headache  Rapid, pounding heart rate
Fatigue or weakness Constantly watching for  Sweating
Insomnia signs of danger  Trembling or shaking
Nausea or upset stomach.  Shortness of breath or tightness in your
throat
Depression  Chills
 Hot flashes
It is a mood disorder that causes a persistent  Nausea
feeling of sadness and loss of interest.  Abdominal cramping
 Chest pain
Also called major depressive disorder or  Headache
 Dizziness, light-headedness or faintness
clinical depression, it affects how you feel, think and
 Numbness or tingling sensation
behave and can lead to a variety of emotional and  Feeling of unreality or detachment
physical problems.
Symptoms of Depression Work-related Stress: The adverse reaction people
have to excessive pressures or other types of demand
 Low mood
placed on them at work."
 Feeling helplessness
 Feeling hopelessness Stress is not an illness – it is a state or reaction.
 changes in sleep,
 appetite,

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However, if stress becomes too excessive and
prolonged, mental and physical illness may develop.
Work-related stress develops because a
person is unable to cope with the demands being
placed on them. Stress, including work-related stress,
can be a significant cause of illness and is known to
be linked with high levels of sickness absence, staff
turnover and other issues such as more errors.
Post-traumatic stress disorder (PTSD):
It is a mental health condition that's
triggered by a terrifying event — either experiencing
it or witnessing it. Symptoms may include
flashbacks, nightmares and severe anxiety, as well as
uncontrollable thoughts about the event.
Most people who go through traumatic
events may have temporary difficulty adjusting and
coping, but with time and good self-care, they usually
get better. If the symptoms get worse, last for months
or even years, and interfere with your day-to-day
functioning, you may have PTSD.
Getting effective treatment after PTSD symptoms
develop can be critical to reduce symptoms and
improve function
PTSD symptoms are generally grouped into four
types: intrusive memories, avoidance, negative
changes in thinking and mood, and changes in
physical and emotional reactions.
However, symptoms can vary over time or vary
from person to person.
The Causes of, and Controls
for, Work-Related Mental Ill-
Health
Causes of work-Related Mental
Ill-Health
The basic workplace stressors are:
Demands: unrealistic performance targets or
insufficient training, job insecurity or fear of
redundancy;
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Control: lack of control over work, Working
condition, cramped, dirty and untidy workplace;
unsafe practices; lack of privacy or security;
inadequate welfare facilities; threat of violence;
excessive noise, vibration or heat; poor lighting; lack
of flexibility in working hours to meet domestic
requirements and adverse weather conditions for
those working outside;
Support: Lack of support, poor communication,
consultation or supervision, negative health and
safety culture, lack of support in a crisis
Relationship: unhappy relationship between
workers, bullying, sexual and racial harassment.
Role: Lack of clarity, boring or repetitive
Change: The threat of change, technological
changes, management change, insecurity, etc.
Home–Work Interface:
Commuting, Childcare Issues,
Relocation, Care of Frail
(Vulnerable) Relatives
The Home- Work Interface
Stress can also be caused by various external
factors interfacing to regular work.
This may be because of excessive travel
time / distances, child care issues, work relocation,
etc.
There may be family issues with an
individual like, bereavement, separation, family
illness, but these issues should not be taken as work
related issues.
However, such issues shall also affect the
workplace and therefore, should not be ignored.
Staying in Work
Prolonged absence/long leave from the work
also has negative impact of person‘s health.
Employees, taken leave for long period of time
become less active failed to maintained social contact
and become isolated.
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They may suffer a loss of self -confidence

and will have low self-esteem and will lead to mental
health and condition of anxiety and depression.

Control measures
Demands: should be reasonable and realistic

Control: they should have some control and

empowerment

Support: Support to be given by supervision,

communication, motivation, guidance etc.

Relationship: unhappy relationship between

workers, bullying, sexual and racial harassment
should not be tolerated.

Role: Role and responsibility should be clear

Change: While doing the job, insecurity because of

change should not be arised

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Violence at work is known to cause pain,

5.5 Violence at Work
Introduction
All assaults or threats which occurred
while the victim was working and were perpetrated
by members of the public.
During Violence at Work, a person is
abused, threatened, intimidated or assaulted in his
or her employment.
Types of violence at work
Following are the types of workplace
violence:
Rumors, swearing, verbal abuse, bullying,
pranks, arguments, property damage, vandalism,
sabotage, pushing, theft, physical assaults,
psychological trauma, anger-related incidents, rape,
arson and murder are all examples of workplace
violence.
Any incident, in which a person is abused,
threatened or assaulted in circumstances relating to
their work. This can include verbal abuse or threats
as well as physical attacks.
Risk of violence can be managed by
providing workplace security measure, establishing
Safe Systems of Work (SSW), providing information
and needful training.
Jobs and activities which
increase the risk of violence
suffering, anxiety and stress, leading to financial
costs due to absenteeism and higher insurance
premiums to cover increased civil claims. It can be
very costly to ignore the problem.
Risk Factors for Violence
Certain occupations involved increased risk of
violence
 handle money / Cash handling;
 provide a service to the public (such as shop
workers, teachers and nurses);
 lone workers;
 Representing authority (such as police,
traffic wardens and even school crossing
patrols).
Many people resort to violence due to
frustration. Common causes of such frustration are
the following:
 dissatisfaction with a product or service,
including the cost;
 perception of being unreasonably penalized
over an incident such as car parking; and
 a general lack of information following a
problem, such as aircraft delays or long
delays at hospitals.
The following workers particularly affected are:
 social welfare workers
 healthcare professionals
 police officers
 Hospital accident and emergency staff
 Bus and taxi drivers.

Risk Factors and Control  Fire-fighters and paramedics.

Measures  Traffic wardens.

Violence at work, particularly from  Railway staff.
dissatisfied customers, clients, claimants or patients,  Teachers.
can cause stress and in some cases injury.

This is not only physical violence as people

Control measures to reduce
may face verbal and mental abuse, discrimination, risks from violence at work
harassment and bullying. Fortunately, physical
violence is still rare, but violence of all types has
risen significantly in recent years.

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Control Measures for Violence:  Closed circuit television

 Alarms
Risk Assessment  Minimizing queues and waiting time
The following four point action plan: Risk  Clear announcement about waiting time
Assessment  Training to staffs
 Pleasant environment
1. Find out there is a problem;
2. Decide on what action to take;
3. Take the appropriate action
4. Check the actions is effective.

This involves a risk assessment to determine

what are the real hazards are. It is essential to ask
people at the workplace and, in some cases, a short
questionnaire may be useful. Record all incidents to
get a picture of what is happening over time, making
sure that all relevant details is recorded. The records
should include:

 a description of what happened;

 details of who was attacked, the attacker and
any witness
 The outcome including how people were
affected and how much time was lost;
 Information on the location of the event.

Owing to the sensitive nature of some aggressive

or violent actions, employees may need to be
encouraged to report, incidents and be protected from
future aggression.

All incidents should be classified so that an analysis

of the trends can be examined.

Consider the following:

 Fatalities
 Major injury
 Less severe injury or shock which requires
first –aid treatment, outpatient treatment,
time off work or expert counseling
 Threat of feeling of being at risk or in a
worried or distressed state.

Preventing the violence at work can be achieved by:

 Zero Tolerance policy and prosecution of

offenders
 Security staff
 CCTV Cameras
 Access control to protect people and
property

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5.6 Substance Abuse at Risk to Health and Safety from

Substance Abuse at Work
Work Following effect may happen

Introduction  sudden mood changes

Alcohol, drugs and substance abuse has serious  unusual irritability or aggression
implications for employees, if there is a problem with  a tendency to become confused
alcohol or drug misuse in workplace can cause  abnormal fluctuations in
serious health and safety consequences. concentration and energy
 impaired job performance
A successful drug misuse policy will benefit  poor time-keeping
the organization and employees by reducing  increased short-term sickness leave
absenteeism, poor productivity and the risk of  a deterioration in relationships with
accidents & work place violence: colleagues, customers or
 sudden mood changes management
 unusual irritability or aggression  Dishonesty and theft (arising from
 a tendency to become confused the need to maintain an expensive
 abnormal fluctuations in habit).
concentration and energy
 impaired job performance Control Measures to Reduce
 poor time-keeping
 increased short-term sickness leave Risk from Substance Abuse at
 a deterioration in relationships with Work
colleagues, customers or
1. Investigation of the size of the problem:
management
Examination of sicknesses, behavioral and
 Dishonesty and theft (arising from
productivity changes and accident and
the need to maintain an expensive
disciplinary records is a good starting point.
habit).
2. Planning actions: Develop an awareness
Risks to Health and Safety program for all staff and a special training
from Substance Abuse at Work program for managers and supervisors.
Employees with a drug problem should be
encouraged to seek help in a confidential setting.
Types of Substances Abused at
Work
Alcohol (beer, wine, spirits): impaired judgment, 3. Taking action: Produce a written policy that
slowed reflexes, impaired motor function, sleepiness includes everyone in the organization and names
or drowsiness, coma, overdose may be fatal the person responsible for implementing the
policy. It should include details of the safeguards
Drugs (sleeping medicines, sedatives, some to employees and the confidentiality given to
tranquilizers): nattention, slowed reflexes, anyone with a drug problem. It should also clearly
depression, impaired balance, drowsiness, coma, outline the circumstances in which disciplinary
overdose may be fatal action will be taken (the refusal of help, gross
misconduct and possession/dealing in drugs).
Nicotine (cigarettes, chewing tobacco, snuff):
initial stimulant, later depressant effects 4. Monitoring the policy: The policy can be
monitored by checking for positive changes in the
Solvents: Hazardous chemicals, solvents, paints,
measures made during the initial investigation
could be health hazardous.
(improvements in the rates of sickness and

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accidents). Drug screening and testing is sensitive

issue and should only be considered with the
agreement of the workforce (except in the case of
pre-employment testing). Screening will only be
acceptable if it is seen as part of the health policy
of the organization and its purpose is to reduce
risks to the misuse's and others.

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