Health Risk Assessment

Good Practice
Guidance on
Occupational
Health Risk
Assessment
Good Practice Guidance on Occupational Health Risk Assessment
Good Practice
Guidance on
Occupational
Health Risk
Assessment
List of Acronyms
4
HIA
Health Impact Assessment
HIRA
Hazard Identification and Risk Assessment
HOC
Hierarchy of Control
HRA
Health Risk Assessment
OEL
Occupational Exposure Limit
PPE
Personal Protective Equipment
SEG
Similar Exposure Groups
HEG
Homogeneous Exposure Groups
Contents
5
Section 1:
Section 2:
Section 3:
Section 4:
Introduction
1.1. Purpose of the Guide
10
1.2. Occupational Health Impacts of Mining and Metals
14
1.3. Occupational Health Risk Assessment
16
Identification of Issues
25
2.1. Identifying Health Hazards
26
2.2. Identifying Exposed Workers
30
2.3. Identifying Exposed Processes, Tasks and Areas
32
Assessment
35
3.1. Estimating Exposure Levels
36
3.2. Assessing the Effectiveness of Control Measures
40
Analysis and Reporting
43
4.1. Analysing the Health Risks and Prioritising Actions
44
4.2. Documenting and Communicating the HRA
50
4.3. Review and Quality Assurance of the HRA
52
4.4. Links between HRA and Health Impact Assessment (HIA)
54
Sources of Further Information
57
Useful Websites
59
Appendix
60
Foreword
7
Healthy workers are essential to the success of mining and metals companies, and
ICMM member companies are driven in their protection of the health and wellbeing
of both workers and local communities by ICMMs Sustainable Development
Principle 5: To seek continual improvement of our health and safety performance.
ICMM has developed a set of tools to help site practitioners assess and address the
risks posed by hazards in the mining and metals sector this Good Practice
Guidance on Occupational Risk Assessment provides those practitioners with the
information and tools they need to assess the health and wellbeing of employees
and contractors. A sister publication, Good Practice Guidance on Health Impact
Assessment allows responsible companies to substantively assess the impacts of
their operations on the health of the local communities, alongside environmental
and social impacts.
Workforce protection should be seen in the context of a vision of Zero Harmensuring that a workplace culture is embraced that recognizes occupational
illnesses are preventable, that ensures repeat occurrences of occupational disease
do not occur, and promotes the setting and implementing a consistent set of
standards to prevent occupational illness.
This Good Practice Guidance identifies the occupational health impacts of mining
and metals processing, outlines good practices in the identification of hazards and
exposed workers, assists practitioners in estimating exposure levels and assessing
the effectiveness of controls and explains the importance of quality analysis and
reporting. The ICMM publication HERAG Health Risk Assessment Guidance for
Metals (2007) and its fact sheets provide detailed scientific support on metalsspecific issues to the processes laid out here.
It is our intention that this publication provides a practical tool to assist companies
in protecting the health and wellbeing of their workforce, and it aims to represent
leading practice for companies operating in the mining and metals sector today.
Dr R. Anthony Hodge, President
SECTION 1:
Introduction
1.1 Purpose of the Guide

10
This guide is an information resource for conducting Occupational Health Risk
Assessments (HRAs). It is intended for mining and metals managers and advisors
who are responsible for ensuring the occupational health and wellbeing of
employees and third party contractors. Though the guidance focuses on the
occupational heath risks to employees and contractors in a mining and metals
operation it is important to note that these risks can also affect the wider community
living around that operation.
The aim of occupational HRAs is to systematically and proactively identify health
hazards in the workplace, assess their potential risks to health and determine
appropriate control measures to protect the health and wellbeing of workers. The
HRA process is a partnership between occupational health advisors, occupational /
industrial hygiene advisors, managers and operational staff with each - depending
on the circumstances - using their knowledge, experience and skills to support the
HRA process.
HRAs within the mining and metals sector is especially complex because of the
breadth and range of the mining lifecycle which includes (See Figure 1):
exploration
design
construction
operation/extraction
processing
engineering services and maintenance
closure
rehabilitation / remediation.
This lifecycle also encompasses the movement of products, equipment and
personnel by road, rail, air and sea and the associated transportation networks and
distribution facilities, (e.g. ports and warehouses) as well as the manufacturing,
recycling and disposal of goods made from the metals and minerals extracted from
mines.
11
Figure 1 The mining and minerals lifecycles1
Design
Exploration
Construction
Rehabilitation
Mining
Life Cycle
Extraction
Closure
Processing
Engineering
services &
maintenance
Trade
Disposal
Manufacture
Minerals
Life Cycle
Use
Recycling
There are no specific figures for the international mining and metals sectors but
every year, across all industries around the world, 160 million suffer occupationrelated illnesses2 3. The worlds biggest workplace killers are cancer (32 per cent of
all work-related deaths), circulatory diseases (23 per cent), injuries (19 per cent) and
communicable diseases (17 per cent).
1 Adapted from International Institute for Environment and Development (IIED), World Business Council for Sustainable
Development (WBCSD) and London School of Hygiene and Tropical Medicine. (2001). Worker and Community Health
Impacts Related to Mining Operations Internationally: a rapid review of the literature. Mining, Minerals and Sustainable
Development Project (MMSD).
2 International Labour Organization. (2003). Safety in Numbers: pointers for a global safety culture at work. Geneva.
3 International Labour Organization. (2007). Safe and healthy workplaces making decent work a reality. Geneva.
12
Workers are an important and valued part of the mining and metals sector and that
places a moral obligation on the sector, alongside the legal obligations placed on
them, to protect the health and wellbeing of their workers.4 This moral obligation is
increasingly being embedded within the sector through the adoption of the vision of
zero occupation-related harm within a wider health and wellbeing at work policy.
The vision of zero occupation-related harm encompasses three key aspects:
Developing a workplace culture across an organization which recognises that
all occupation-related illnesses are preventable.
Making a consistent and sustained effort to ensure that there are no repeat
occurrences of occupational diseases in any workplace setting of an
organization.
Setting and implementing a simple, consistent and non-negotiable set of
health and safety standards across an organization that aim to prevent
occupation-related illnesses.
In addition to the cost of occupational ill health in terms of preventable human
suffering, which affects not just workers but their families and communities, workrelated illness also directly impacts on the productivity and bottom line of companies
in the mining and metals sector. This is usually through:
higher presenteeism and absenteeism
under-utilization of expensive production plants
decreases in economies of scale
lower worker morale
higher turnover rate
loss of skilled and experienced workers
loss of investment in training and development
difficulties in recruiting new high-quality workers.
Alongside this, companies in the sector will also have to bear the costs of:
health care for the affected workers
compensation and/or damages to sick or disabled workers or to the families
of workers that are killed
higher insurance premiums
legal advice
regulatory fines
damage to premises and equipment
disputes and protracted negotiations with trade unions, public authorities
and/or local residents
loss of reputation
loss of business
loss of competitiveness
in high-profile cases the, complete or partial, loss of the licence to operate.
4 See ICMM Sustainable Development Principle 5 www.icmm.com
13
Photo courtesy Newmont

1.2 Occupational Health Impacts

14
Introduction
There are a large number of hazards in the mining and metals sector that can pose
a potential risk to health and wellbeing.
This section illustrates the range of health problems that can occur in relation to the
various types of exposure in mining and metals workplaces. The list is not
exhaustive and the risk profile of any particular worker will depend on the exact
nature of their role and their individual exposures.
The Physical Environment

The physical environment where exploration, mining, ore extraction and processing
takes place can cause health impacts in the following ways:
Physical injury from accidents involving moving machinery, movement of
mining products and from working with explosives and detonating devices
Musculoskeletal disorders associated with various work activities e.g. where
manual handling is a feature or repetitive motion are required and whole-body
vibration
Noise-induced hearing loss associated with occupationally related excessive
noise exposure
Hand arm vibration syndrome and other musculoskeletal consequences from
hand-arm transmitted vibration
Skin cancer from working outdoors in direct sunlight
Effects from both ionising and non-ionising radiation e.g. cataracts
Heat exhaustion, hypothermia and various other health effects from
exposure to extremes of temperature
The Effects of Hazardous Substances

Exposure to some of the major hazardous substances encountered in the mining and
metals sector can result in a number of important health effects. These are listed
below to illustrate the range of potential problems.
Skin disorders (burns, contact dermatitis, cancer) from contact with a wide
range of chemicals including acids, alkalis, solvents, fuels, lubricants and
resins. For example:
Irritant contact dermatitis from some fuels, solvents, lubricating oils
and greases
Allergic contact dermatitis from epoxy resins used in adhesives and the
salts of some metals including nickel and chromium (e.g. in cement)
Intoxication, through to asphyxiation and death can result from the inhalation
of some gases and vapours including the toxic gases hydrogen sulphide,
carbon monoxide and sulphur dioxide
Acute pneumonia may result from exposure to blasting fumes
15
Damage to the respiratory tract from exposure to airborne chemicals (dusts,
gases and aerosols) eg. Silicosis, coal worker's pneumoconiosis and
asbestosis arising from exposure to crystalline silica, coal dust and asbestos
respectively, lung cancer and mesothelioma from exposure to asbestos and
nasal sinus cancer from exposure to nickel subsulphide and acid mists.
Damage to internal organ systems such as the lung, kidney, liver, bone
marrow and brain from the absorption of chemicals and metals through the
skin, respiratory and digestive tracts.
Onset of symptoms in relation to exposure

When considering how to monitor for the development of adverse health effects from
exposures in the workplace it is important to consider the timeframe over which the
health effects manifest themselves.
Acute health effects are those that are more likely to be immediately obvious to the
individual and where it is often possible to attribute cause and effect. Acute health
effects usually appear within hours of exposure. For example, contact with an
irritant vapour may lead to watering eyes, sneezing, coughing, irritation and, in
extreme cases, respiratory distress.
Chronic health effects are ones that can develop over a longer period of exposure.
On occasions these will be conditions where the severity of the symptoms or
disease, or the risk of harm, is related to the accumulative exposure to the hazard
over a period of months or years. Chronic health effects usually occur after repeated
exposure over days, weeks and months. Examples of such conditions would be
noise-induced hearing loss and hand arm vibration syndrome.
Long latency is a feature of many occupationally acquired diseases where the
development of the signs and symptoms of the condition occur many years after the
exposure that is implicated in causation. Examples include the development of
mesothelioma (following asbestos exposure), other lung cancers and
pneumoconiosis (silicosis, coal workers pneumoconiosis, asbestosis) which can
occur decades after exposure has ceased.
Other occupational hazards to health

The mining and metals sector, as with all
employment sectors will on occasions encounter
cases of stress and other adverse mental health
and wellbeing effects which are attributable to, or
contributed to by, occupational factors, including
shift work. A further potential adverse health effect
is chronic fatigue brought about by the intense
physical demands of mining and metals activities.
Photo courtesy Lung Health

Image Library/Pierre Virot
1.2 Occupational Health

Risk Assessment
16
Introduction
Health risk assessment involves four key elements:
identification of hazards,
examination of the potential health effects,
measurement of exposures and
characterisation of the risk.
An Occupational Health Risk Assessment (HRA) is therefore the structured and
systematic identification and analysis of workplace hazards with the aim of reducing
the risks of exposure to these hazards through the development and implementation
of avoidance, control and control failure recovery measures. In the occupational
setting, it is the preliminary component to health risk management.
Health risk management is the decision-making process involving considerations of
political, social, economic and engineering factors combined with risk assessment
information to develop, analyze and compare options and to select between them.5
Steps in an HRA
An HRA is generally a cyclical and iterative process rather than a simple linear one.
An HRA is generally made up of the following steps:
1
Identify the health hazards and their harmful health effects
Identify the exposed individuals and groups (i.e. Similar Exposure Groups)6
Identify the processes, tasks and areas where hazardous exposures could
occur
Assess, measure or verify the exposures
Analyze the effectiveness of existing control measures
Analyze the potential health risks of the hazardous exposures (e.g. compare
against occupational exposure limits)
Prioritize the health risks (high, medium and low)
Anticipate potential new and emerging health risks
Establish a risk register
10
Set priorities for action
11
Develop, implement and monitor a risk control action plan or review existing
risk control action plan
12
Maintain accurate and systematic records of the HRA or amend existing Risk
Control Action Plan and use alternative and/or additional control measures
13
Review and amend at regular intervals or earlier if changes to processes or

new developments are proposed
5 International Council of Metals and the Environment. (2001). Risk assessment and risk management of non-ferrous
metals: realizing the benefits and controlling the risks.
6 The term Similar Exposure Groups (SEGs) is now increasingly accepted and is used throughout this guidance
document in place of the older term Homogenous Exposure Groups (HEGs). HEGs is a term commonly applied in South
Africa. Both terms refer to workers exposed to similar risks.
17
Figure 2 provides a flow diagram of the above steps and how the health risk
assessment cycle works for both new and existing operations.
Types of HRA
There are three broad types of HRAs that are each conducted at different levels and
at different times:
Baseline HRAs
Issues based or targeted HRAs
Continuous HRAs
A baseline HRA is used to determine the current status of occupational health risks
associated with a facility. This tends to be a very wide ranging assessment that
encompasses all potential exposures.
An issues-based or targeted HRA is designed to provide a detailed assessment of
specific processes, tasks and areas that have been identified as priorities in the
baseline assessment.
A continuous HRA is an ongoing monitoring program or a schedule of regular
reviews to determine whether conditions have remained the same, whether changes
in processes, tasks or areas have occurred and whether these changes have
modified any hazardous exposures and hence any potential health risks. A
management of change program can also be considered as being part of a
continuous HRA program.
An HRA can be qualitative involving a qualitative assessment of exposures and/or
risks (e.g. baseline HRAs) or quantitative involving the measurement of exposures
and/or the quantification of the potential health risks (e.g. issues based HRAs).
Photo courtesy Oz Minerals

18
Figure 2: The health risk assessment cycle for new and existing
operations
BASELINE HRA
Review the operating process both from the process flow
sheet and by physical inspection of the site
Identify hazards and

their harmful
health effects
Identify exposed
processes, tasks and
areas where hazardous
exposure could occur
Identify
exposed
workers
Assess, measure or
verify the exposures
Analyse the
effectiveness of existing
control measures
CONTINUOUS HRA
Review and amend
at regular intervals
or earlier
if changes to
processes or new
developments are
proposed
Analyse the potential

health risks of the
hazardous exposure
Prioritise the health

risks (High, medium, low)
Establish a risk
register & set
priorities for action
Develop, implement and monitor

a Risk Control Action Plan
or
Review existing Risk Control Action Plan
LOW
RISKS
MEDIUM &
CRITICAL RISKS
CONTINUOUS HRA
Manage as part of the continuous
improvement process within the
overall occupational health risk
action/management system and
through existing set of control
measures, where present
ISSUES BASED OR TARGETED HRA

Quantitatively assess exposures using validated
statistical sampling techniques, and assessment
methodology as well as assessing whether
proposed or existing control measures are
adequate and appropriate to control health
risks to below agreed upon standards
e.g. occupational exposure limits (OELs)
Maintain accurate and

systematic
HRA records
Amend existing Risk

Control Action Plan and
use alternative and/or
additional control measures
19
When to do an HRA
All three types of HRA are generally undertaken in the mining and metals sector
although each is conducted at different points in time during the HRA cycle. A
baseline HRA is conducted first - this identifies priority hazards, risks and areas that
need additional assessment. An issues-based or targeted HRA is then instigated.
The development of an exposure sampling strategy and control monitoring program
within a continuous HRA provides data that further informs the original baseline
HRA. A new issues-based HRA may then be undertaken, and so on, in an ongoing
and iterative process.
An HRA, or the review of an existing HRA, should be considered in the following
situations:
All routine and non-routine new activities and developments (exploration,
design and construction)
All existing operations (operation and extraction)
Where there are changes to existing activities (expansion, replacing an old
process with a new one)
Post-operating activities (closure and remediation/rehabilitation)
Following an incident/accident.
New developments, processes, activities and working methods

A baseline or issues-based HRA, undertaken at the conceptual and detailed design
stages of new developments, processes and activities, provides an opportunity for
the implementation of the most cost-effective approaches for the elimination and
reduction of hazards in the workplace.
This HRA should generally focus on the plans and process descriptions and
discussions with design engineers, occupational health and hygiene specialists and
operational staff to identify:
Potential health hazards
Tasks and activities where workers might be exposed to these hazards
Likely levels of exposure
Appropriate exposure limits
Likely baseline health and well-being of
potential workers.
This information should then be used as a key
input into the overall design of a mine, allowing the
design of exposure controls, the implementation of
appropriate standards for such controls, and the
development of operating procedures.

20
Existing Operations
A continuous HRA is more suitable for existing operations with a focus on potential
exposures during both routine and non-routine operational activities as well as
normal, abnormal and emergency conditions. It is important that the possibility of
long latency diseases is assessed and that adequate data is collected to ensure
appropriate controls, in the first instance, and to provide for the follow up of
employees upon closure.
Change to Existing Activities

Changes in processes and tasks, as well as additional development, should trigger a
review of the existing baseline and continuous HRAs. This review would generally
focus on whether there is a need to conduct a full HRA of the whole operation; an
HRA of that specific process or task; or the incorporation of the change into the
existing HRA through minor amendments to the HRA and the existing risk control
action plan.
Closure and post-operation

An issues-based HRA should generally be undertaken when a mine or other facility
is closed. Closure brings a different set of health issues concerned with dismantling
plant, buildings and equipment. These include residues, hazardous materials,
naturally occurring radioactive substances, asbestos, etc. There is also likely to be a
need to clean up any contaminated land before divestment. The closure HRA should
also consider the possibility of long latency diseases and provide for the follow up of
employees with the relevant exposures. Lastly, workers in the mine are likely to lose
their jobs and this may lead to anxiety, stress, depression and other mental health
and wellbeing effects.
Following an incident
Should there be an incident, e.g. failure of a control measure, then a review of the
existing baseline and continuous HRAs should be undertaken to ascertain the
causes of the incident and prevent future occurrences. Incident data should inform
the calculation of the frequency of exposure although it is also important to review
incidence data from the mining sector as a whole.
New versus existing operations

A baseline HRA will be needed for all new operations. However for existing
operations it is likely that a baseline HRA has already been done this should be
reviewed and an issue-based HRA instigated as necessary. It is worthwhile for new
operations to review HRAs conducted for similar existing operations. This can fast
track the progression from baseline to issues-based HRA though conducting a
baseline HRA for any new operation is vital.
21
Scope of an HRA
It is important to define the objectives and boundaries of the HRA. This judgement
should be made after discussions with managers and worker representatives.
The major boundary for any HRA are the physical boundaries. Some examples of
physical boundaries are:
A complete operational site with a well-defined activity, such as an individual
mine, a set of clustered mines or an office block or operational complex
An individual process unit within a large mining complex
A group of functions which support a single business process
Other aspects that should be considered include whether the focus is on specific
processes, tasks or workers and whether exposures will be estimated qualitatively
or measured and quantified (i.e. whether the HRA will be qualitative or quantitative)
which is very dependent on past experience and exposure data collection from
similar processes or tasks. Section 3.1 provides further guidance.
Setting up an HRA team or advisory group

Ideally the HRA should be carried out by a multi-disciplinary team with a range of
specialist skills, including those associated with the process or task being assessed.
The exact number of people involved in the HRA and the range and level of skills
required depends on:
The size and complexity of the facility, process or area being assessed
The nature and severity of the hazards and health risks involved
In some circumstances, there may be only one occupational health or hygiene
practitioner on site and in this case an advisory group should be established to
support the process and scope the HRA. In general, where an HRA team or advisory
group is set up it should include:
An occupational health or hygiene advisor with experience of conducting HRAs
A management representative from the facility, process or area being
assessed
A worker representative with knowledge of the facility, process or area being
assessed
Other specialist staff as required e.g. designers, engineers, toxicologists or
ergonomists
A management representative is worthwhile as early engagement can ensure that
the findings of the HRA are acted upon quickly. A worker representative can be a
valuable part of an HRA team or advisory group as they can bring detailed
knowledge of the process, activity or area being examined, as well as insights as to
how tasks are actually performed. This helps to ensure that the analysis of the
potential health risks is accurate. In addition, their involvement in the HRA is likely
to increase their understanding and appreciation of health hazards and support the
development of a zero harm mindset among workers.
22
Additional specialists can be part of the core HRA team, part of the wider support
base that are consulted when needed, or may act as peer reviewers of the final draft
HRA before it is finalized.
Key competencies needed to conduct an HRA

The key individual and team competencies needed to undertake HRAs successfully
are shown in Table 1.
Table 1:
Key competencies for undertaking occupational HRA
Domain
Competency
Knowledge
An understanding and experience of conducting HRAs.

An understanding of the workplace operations being assessed.
An understanding of the methods for controlling exposures
and reducing risks in mining and associated workplaces.
Organizational
The ability to collect information systematically and

comprehensively.
Scientific
The ability to predict any potential departures from expected

or observed practice and understand its significance.
The ability to undertake simple diagnostic tests, for example
using a smoke tube to test air movement, simple sound level
metering or using colorimetric tubes, etc.
The ability to identify and review the relevant scientific and
technical literature.
The ability to look critically at existing arrangements.
The ability to observe so that you can clearly appreciate the
activity being performed and the significance of what you are
seeing, particularly where written procedures are not being
followed.
The ability to assess exposures and estimate the potential
health risks arising from them.
The ability to develop credible, statistically valid and robust
conclusions from the analysis of health risks.
Medical
Knowledge and understanding of the health effects of major

physical, chemical, biological, ergonomic and psychological
exposures in the mining and metals sector.
23
Domain
Competency
Managerial
The ability to investigate, and pursue with management,

whether hazardous exposures need to occur in the first place.
The ability to perceive the range and limitations of possible
control measures and their relative reliability.
Communication
The ability to ask the right questions to operational staff,

managers and advisors and understand the significance of the
answers.
The ability to specify and follow up on the type of control
measures needed and their implementation.
The ability to record findings in an understandable manner.
Personal
An awareness of the limits of own competence and the

confidence and persistence to be able to ask for, and get,
specialist assistance when required.
Photo courtesy Anglo

American/Vismedia
24
25
SECTION 2:
Identification
of issues
2.1 Identifying Health Hazards

26
Introduction
Mines are complex workplaces involving the entire spectrum of extraction, crushing,
milling, flotation, smelting and refining as well as engineering processes from the
operation of chemical processes, heavy equipment and electrical maintenance to
electronics. Operations are often located in remote environments and it will be
important to also consider issues around security, the potential for natural
catastrophes, travel risks, medical evacuation capability, the standards of local
health facilities etc. The range of potential exposures is therefore extensive. Figure 3
illustrates the main elements of the mining and mineral process and how they
influence the types of hazards found.
Figure 3: Illustrative flowchart for a mining operation
Primary
Benefication
Mining
Secondary
Benefication
ENGINEERING SERVICES
Underground
or open cast
Crushing,
milling, flotation,
leaching,
concentration
Smelting,
electro-winning,
refining
For the various stages of a mining operation the categories of

hazards remain the same:
Physical environment
Chemical
Biological
Ergonomic
Psychological
However, the particular types of hazards which predominate

within each of the above five categories changes at the mining,
primary beneficiation and secondary beneficiation stages as well
as for each of the activities within these stages.
27
STEP 1: DESK-TOP ANALYSIS
The first step in identifying health hazards is a desktop analysis. This is particularly
useful where records of previous HRAs and other employment records are available.
Some examples of the types of records that might be available are:
Incident reports
Audit reports
Previous HRAs
Occupational illness and injury reports
Equipment maintenance and fault reports
Health surveillance records7
Sickness absence reports
Previous occupational hygiene surveys
Site inspections
Minutes of health and safety meetings
Material Safety Data Sheets (MSDS)
A review of the design of the facility, together with blueprints and schematics of the
individual area or process, and related health records will help to systematically
identify the potential health hazards that are present or might occur. A simple
checklist such as the one shown in Table A1, in the Appendix, can be useful in doing
this.
STEP 2: WALK THROUGH SURVEY

A walk-through survey of the area, process or task enables the assessor to get a
sense of the types of potential health hazards, the levels of exposure, the types of
workers and workers general levels of health and physical and mental functioning
through the careful use of the senses vision, hearing, smell and feel.
Some key aspects to be considered

Physical environment issues
What noisy equipment or processes are present?
Are cutting and welding activities carried out which emit infra-red or ultraviolet light radiation? Is any equipment used which emits ionising radiation?
What tasks involve exposure to hand arm transmitted or whole body vibration?
Are there any working areas where extremes of heat, cold or humidity are
present or could occur?
Are there any specialist tasks involving changes in atmospheric pressure, e.g.
tunnelling work under compressed air?
Is ventilation adequate? Is there a good supply of fresh air and extraction of
potentially harmful gases?
7 Health surveillance can vary from simple questions from trained supervisors to comprehensive medical supervision
undertaken by an occupational health physician. It is important to assess the strength of evidence and determine the
appropriate weighting given to the information that is available. An adverse report from a responsible person undertaking
screening skin inspections will generally have less weight than of an occupational physician or a dermatologist who
diagnoses an occupational skin disorder.
28
Chemical agents
Are workers exposed to chemicals that could affect normal physical or mental
functioning in the short or long term?
What chemicals are being used? Review the site hazardous chemicals register
if available.
Does the process allow for chemicals to be mixed and could that give rise to a
hazard?
What products, by-products and wastes (gaseous, liquid or solid) are being
produced?
What potentially hazardous building construction materials have been used?
Biological issues
What systems are present for drinking water, effluent, sanitation and sewage?
What is the potential for pathogenic microorganisms?
What washing facilities are present? Are they adequate for the number of
workers and are they cleaned regularly?
Does the site have a legionella management and control program?
In restaurants and canteens and eating places, what is the potential for
insects, rodents and microorganisms?
Are there air-conditioning systems? What is the potential for pathogenic
microorganisms?
Are there any disease carrying insect or rodent vectors in the local
environment e.g. malaria carrying mosquitoes, leptospirosis and plague
carrying rats, etc?
Ergonomic issues
Do workers have to carry out heavy manual tasks?
Are workers involved in repetitive, awkward or unnatural movements; or do
they have to remain in a static position for long periods?
Do they wear occlusive protective clothing that restricts free movement or
requires greater exertion?
Does the job require immediate mental alertness and agility? Could fatigue,
distraction and the use of medication create a hazard?
Psychological issues
Is the job organization, in terms of shift patterns, rotations, resources and
workload likely to lead to sleep disturbance and/or mental stress?
Is there harassment, discrimination, bullying or violence either explicit or
implicit?
Is there restructuring of the organization or business unit and/or a change or
redeployment of workers?
29
Are workers isolated from family, friends and other social support networks
or working alone?
Are there culture, faith and language issues?
Is there a lack of leisure and recreation opportunities?
Is there a system in place for workers to pass on issues and complaints? How
well is it used?
STEP 3: RATING HAZARDS

Hazards can also be numerically rated in terms their likely health effects as shown
in Table 2. This supports the accurate assessment and prioritization of risks by
highlighting those hazards that could give rise to significant harm to workers.
Table 2:
Illustrative example of criteria to rate hazards

(see also Tables 5-7)
HAZARD RATING
DEFINITION
1 Minor health effects
Exposure at this level is unlikely to lead to

harm.
Non-life threatening reversible health effects.
Adverse health effects that are permanent but

do not significantly affect quality of life or
longevity. Health effects that may be mildly
limiting or disabling and therefore could lead to
a change of occupation and lifestyle.
4 Significant and
severe health effects
Adverse health effects that are generally

permanent and could lead to a significant
reduction in quality of life and/or longevity.
Continued exposure is generally likely to lead to
permanent physical or mental disability or a
long term limiting illness.
2.2 Identifying Exposed Workers

30
Introduction
Where there are large numbers of workers it may not be practical to assess the
risks for each individual worker. In such cases it is more effective and efficient to
identify groups of workers with similar exposure levels. These groups are generally
referred to as Similarly Exposed Groups (SEGs).
Identifying exposed workers by Similar Exposure Groups

A sensible approach is to divide workers by process or areas of work and then to
subdivide them by occupation and generate groups of workers with similar
exposures i.e. Similar Exposure Groups (SEGs). In this way the exposure and risks to
workers can be better captured and assessed accurately. SEGs may be based upon
tasks or area of work depending on the structure of the working environment, and
should include third party contractors where exposed.
It is important to develop a reasonable number of SEGs, not too many and not too
few, as too few will not differentiate the exposures of workers narrowly enough and
too many will become difficult to manage. The exact number will depend on the
ranges of different processes and hence categories of exposure under consideration.
Typical examples of occupational groups by process or area of work are:
Ore extraction worker
Ore transfer truck drivers
Smelting plant maintenance staff
Office administrative staff
Laboratory technicians
Mine geologists and engineers
It is important when developing SEGs to list all the key processes and tasks that are
undertaken by workers doing similar jobs so that hazards can be systematically and
comprehensively identified. It is useful to draw on workers own experiences and to
discuss with workers the activities that they are undertaking in a particular area of
work to ensure that all the potential exposures have been identified. As a general
rule of thumb a worker should be assigned to a SEG based on which areas and/or
processes where he/she spends 80% of their time.
Identifying exposed workers by susceptibility

It is also worthwhile identifying whether there are any workers that are potentially
more susceptible or vulnerable to some hazards than other workers such as:
Pregnant women and nursing mothers
New recruits or temporary workers because they do not know what hazards
are present and how to avoid or deal with them
Workers with pre-existing occupational and non-occupational illness and any
other form of physical or mental limitation identified by the medical
surveillance program.
31
Workers operating in high hazard areas or processes
Ageing workforce
Smokers or other substance users, including medications, where this may
increase the health risk from an occupational hazard
Photo courtesy Anglo

American/Vismedia
2.3 Identifying Potentially

Hazardous Processes, Tasks and Areas
32
Introduction
To systematically identify and assess processes, tasks and areas where exposure to
hazardous agents may occur and to assign workers to the most appropriate SEGs, it
is important to review:
processes and tasks
equipment and machinery
environment and location
medical surveillance records and trends8
Processes and tasks

When reviewing processes and tasks some important things to consider are:
Routine, non-routine and emergency situations
Hours of work
Shift rotation
Control measures already in place
Equipment and machinery

When reviewing equipment and machinery some important things to consider are:
Its design and condition
How it is used and the training being provided
Whether it is malfunctioning or inoperable
Whether it is being maintained
Its location in relation to other activities
Associated hazards e.g. dust, noise, vibration, radiation, heat or exhaust
emissions
Environment and location

When reviewing the environment and location some important things to consider
are:
Adequacy of ventilation
Appropriate temperature regulation
Humidity
Ergonomic design of the work space
Lighting
Physical space available to move around in
8 These records are held by the occupational health clinic and only concern medical examinations and tests done in
relation to exposures in the workplace. They thus differ from personal medical records that are held by the employees
personal doctor or primary care records that may be held by the occupational health clinic. Personal medical records are
confidential but there may be some access to anonymised medical surveillance records. In general, consolidated data or
information that has had the identification removed may be viewed. Should it be necessary to view an individuals record
without removing their identity then the employees permission will need to be sought.
33
Controls
What controls are in place?
At what level in the hierarchy of controls are they? (See section 3.2)
Are they effective?
Are they being maintained?
If PPE is used:
Is it appropriate and effective?
Has training been provided?
Is its use monitored?
Is it maintained?
Photo courtesy Xstrata

34
35
SECTION 3:
Assessment
3.1 Assessing Exposure Levels

36
Introduction
The aim of estimating exposure levels is to characterize exposures in terms of their
intensity and duration for SEGs, processes, tasks and areas. Exposures can be
estimated indirectly and qualitatively or quantified by direct measurement. All
exposure measurements should follow a validated statistical sampling and
assessment methodology as well as quality control procedures. Figure 4 provides a
decision flowchart to aid decision-making on which exposure measurement strategy
to use in a particular context.
Indirect qualitative assessment of exposures

Indirect qualitative assessment of exposure can be made either during a walk
through survey to identify the potential health hazards, or based on previous direct
quantitative measurements of exposure, or a combination of the two. The level of
exposure is assessed by taking into account the hazards that have been identified,
the SEGs that have been defined and the processes, tasks and areas that have been
considered through the review of documents, the walk through survey and
discussions with managers and workers.
Direct quantitative assessment of exposures

Direct measurement of exposures to health hazards should be considered when:
Doubts arise about compliance with recognized exposure limits
Excessive exposure could involve serious health effects
Justification is needed to implement control measures
The choice of control measures depends on the levels of exposure
The effectiveness of a control measure needs to be evaluated
Workers concerns need to be alleviated
It is, or has become, a regulatory requirement
Investigating or responding to reported health effects
Key questions to consider when estimating exposures

The following points can help in estimating exposure levels:
Are levels of exposure consistently high or low, are there peaks and troughs in
the levels of exposure and are they continuous or intermittent?
Note any aspects of processes and tasks that may increase exposure
Speak to staff to understand their perceptions and experience of the task and
the associated hazards
Review non-routine and intermittent activities, e.g. maintenance operations,
loading and unloading and changes in production cycles
Take account of unplanned but foreseeable events such as interruptions in
work activity, potential for accidental exposure and machinery failure
Review whether the medical emergency response arrangements are
37
appropriate e.g. first aid measures and transfer of victims to specialist
facilities
Consider whether workers not directly involved in a particular activity but
present in the vicinity are exposed to a hazard.
Rating exposures
Exposures can then be rated using a scale based on an Occupational Exposure Limit
(OEL) or other health standard (See Table 3). When rating exposures it is important
to consider:
All the relevant routes of exposure
Potential cumulative exposures
Any limitations in health standards if the standard does not consider all
routes. For example, potential dermal or ingestion risks are generally not
taken into account when OELs are set.9
NB: For carcinogens and reproductive toxicants (known and suspected), meeting an
OEL is not adequate; exposures must be As Low As Reasonably Achievable or
Practicable (ALARP).10 There must be an annual documented review of exposure
controls for these substances.
Table 3 uses a simple exposure rating system for illustrative purposes. In practice,
exposure ratings can range from negligible through low, medium/moderate, and
high to very high/critical.
Table 3:
Illustrative example of criteria for rating exposures
EXPOSURE
RATING
OEL EXPOSURE
BAND
Low
Less than
50% of OEL
(<0.5 x OEL)
DEFINITION
ACTION ZONE
Frequent contact with the potential

SUPERVISORY
hazard at low concentrations, or
infrequent contact with the potential Sampling strategy is
hazard at moderate concentrations. aimed at routine
checks
Frequently can expect the exposure
to be less than 10% of the OEL, or
infrequently can expect the exposure
to meet or exceed 10% of the OEL,
but less than 50% of the OEL).
Exposures are at or well controlled
to below the OEL, there are less
likely to be breaches of the OEL and
this level of exposure is likely to
cause little or no adverse health
effect.
9 ICMM and IEH. 2007.The Setting and Use of Occupational Exposure Limits: current practice.
10 HSE UK. ALARP at a glance. http://www.hse.gov.uk/risk/theory/alarpglance.htm
38
EXPOSURE
RATING
Medium/
Moderate
OEL EXPOSURE
BAND
DEFINITION
Between
50-100% of OEL hazard at moderate concentrations,
or infrequent contact with the
(>0.5 - 1 x OEL) potential hazard at high
concentrations.
ACTION ZONE
CONTROL
Workplace sampling
strategy is aimed at
quality control and
checking on controls
Frequently can expect the exposure

but less than 50% of the OEL, or
infrequently can expect the exposure Medical surveillance
of workers exposed
but less than 100% of the OEL
at >50% of OEL
Exposures are at or controlled up to
the OEL, there is a potential for
breaches of the OEL and this may
cause an adverse health effect in
some workers e.g. vulnerable
groups.
High
At or greater
than OEL
(>OEL)

INTERVENTION
hazard at high concentrations, or
infrequent contact with the potential Controls must be put in
hazard at very high concentrations.
place according to the
hierarchy of controls.
Frequently can expect the exposure The objective should be
to meet or exceed 100% of the OEL. to reduce exposure to
below the OEL
Exposures are above and/or not
controlled to the OEL and are likely
to cause adverse health effects in
the majority of workers exposed
either in the short or long term.
OEL = Occupational Exposure Limit (or other health standard)
39
Figure 4: When to use the different types of direct exposure
measurement surveys
3.2 Assessing the Effectiveness

of Control Measures
40
Introduction
Control measures are the interventions and actions - equipment, techniques,
processes, protocols and education - that help to eliminate or reduce the levels of
hazardous exposure.
Hierarchy of Control
There are several levels of control measures that can be put in place to deal with
adverse exposures. These are generally termed the Hierarchy of Control (HOC). In
order of reliability, effectiveness and likelihood of reducing exposures they are:
Elimination
Substitution
Engineering (including isolation)
Administration (including education and training)
Personal protective equipment
Increasing reliability,
effectiveness and
likelihood of reducing
hazardous exposures
Ideally, all hazards would be eliminated from the workplace, but in reality a mixture
of lower level controls in the hierarchy of control will be applied. For example,
whilst education and training approaches alone are unlikely to achieve adequate
control they are usually an essential element in ensuring that other measures are
applied and used correctly. The HOC can be applied to all health hazards and one or
more control measures from the different levels usually need to be put in place i.e.
multi-level controls. However, not all the levels of control are applicable to every
potential health hazard. An iterative process of reviewing hazards and controls
should be implemented to ensure that a continuous drive up the hierarchy of
control is embedded in the operational culture.
Though personal protective equipment (PPE) should only be used as a last resort it
can be a valuable addition to any hazard control program and, in some instances,
may be the only effective option. When it is used it should be associated with a well
planned program of training, routine maintenance and replacement.
The following are examples of how the hierarchy of control might work in a specific
instance.
Elimination
Remove a major emission source of particulates and various gases by replacing
diesel powered equipment, with electrically powered equipment.
Substitution
Electrically powered tools such as rock drills can emit lower levels of noise and
vibration than pneumatically powered ones.
Engineering (including isolation)
In some areas such as ore processing plants, enclosures around screens and other
noisy equipment can reduce noise levels in the remainder of the plant. Vibration
reducing mountings and damping can reduce both vibration and noise levels. The
41
cabin design on mobile equipment plays a large role in improving operator comfort,
reducing exposure to noise, dust, muscular stresses, extreme temperatures and
reducing fatigue. Work refuges or cabins can be used in a variety of locations to
isolate workers from hazards such as dust, noise, chemicals and heat.
Administration (including training and education)

Making changes to work procedures e.g. restricting when work is carried out or the
number of hours worked, more frequent rotation of tasks and work permits to allow
workers into designated areas can reduce exposure to hazards. Education and
training to understand hazards and the measures taken to combat them are also
important, especially where health hazards are linked to the proper use of
equipment or a particular task e.g. manual handling.
Personal protective equipment
The use of personal protective equipment e.g. hearing protection devices, face
masks, body suits, etc. can also protect workers from noise, dust and chemical
exposures. However, this can never be regarded as an effective control as its
effectiveness is very dependent on the user.
Key questions to consider when assessing control measures
Existing control measures can be either assessed directly on their ability to
eliminate or reduce the levels of exposure through the measurement of exposures
with and without control measures; or they can be inferred indirectly from existing
information e.g. previous exposure measurements, the walk through survey and any
available health records.
What are the current standards used to determine the level and nature of the
control measures?
Are there existing control measures for processes, tasks and areas with high
levels of exposure to hazards? Have these control measures been set up,
operated and maintained appropriately?
Are there high levels of exposure despite the control measures in place
functioning effectively?
Are working practices and the use of control measures different from that
prescribed by workplace protocols and guidance?
Are control measures part of an on-going maintenance program?
Is there a regular assessment of the effectiveness of controls?
Rating control measures

Control measures can be rated in a similar way to exposures with a scale that
classifies the level of inadequacy of the control measures currently in place and the
potential need for action to remedy this (See Table A2 in Appendix).
42
43
SECTION 4:
Analysis
and Reporting
4.1 Analysing the Health Risks

and Prioritising Actions
44
Introduction
Once the exposures have been estimated by hazard, SEG and by process, task or
area then it is time to analyze the potential health risks and the significance of those
health risks categorised. This is often best done through the use of a risk rating
table or risk assessment matrix
Risk rating table or risk assessment matrix

The rating table classifies the exposures identified by their potential health
consequences for SEGs (See Tables 5, 6 and 7). A rating or ranking is obtained by
plotting the potential health consequence of each identified health hazard with the
likely levels of exposures to it and by the likelihood of the hazard occurring or being
present. The risk rating can be qualitative by assigning a rating as shown in Tables 5,
6 and 7 or it can be quantitative by using a pre-defined numerical ranking by using
the formula:
RR
RR
C
PrE
PeE
U
PrE
PeE
Risk Rating
Consequence
Probability of exposure
Period of Exposure
Uncertainty
The numeric values for each function of the equation can be found in table 8. As
stated previously, the qualitative exposure ratings can be made up of three, four or
five categories e.g. negligible, low, medium/moderate, high and very high/critical.
The exposure and likelihood ratings assigned should generally be based on a worst
case scenario. In this context it is important to take into account any regulations and
company guidance before finalizing a risk rating.
Risk control action plan

Once the exposures have been assigned a risk rating, a risk control action plan can
be developed which identifies the key priority areas for action and highlights what
aspects need to be modified in the risk register for the process, task or area. This
action plan should be integrated into the overall health risk management plan for
the organization or business unit.
45
Table 5: Illustrative example of a risk rating table for hazards by
likelihood of occurrence of a health hazard
Likelihood of Occurrence of
an Exposure to a SEG or in a
process, task or area
Low
Health
risk
rating
1
Unlikely to
occur
Description
Exposure at this level is
unlikely to lead to harm.
Non-life threatening
reversible health effects.
Adverse health effects that

are permanent but do not
significantly affect quality of
life or longevity. Health effects
that may be mildly limiting or
disabling and therefore could
lead to a change of occupation
and lifestyle.
Medium
High
Likely to
Likely to
occur
occur often
sometimes
NO/VERY
LOW
RISK
LOW
RISK
MEDIUM
RISK
LOW
RISK
MEDIUM
RISK
CRITICAL
RISK

are generally permanent and
could lead to a significant
reduction in quality of life
and/or longevity. Continued
exposure is generally likely to
lead to permanent physical or
mental disability or a long
term limiting illness.
46
Table 6: Illustrative example of a risk rating table for assessing the
adequacy of existing control measures
Levels of Exposure with Existing
Control Measures Exposure Band
OEL/ Standards-based
Health
risk
rating
1
Description

and lifestyle.
Low
Medium
High
0-50%
of OEL
50-100%
of OEL
Above
OEL
NO/VERY
LOW
RISK
LOW
RISK
MEDIUM
RISK
LOW
RISK
MEDIUM
RISK
CRITICAL
RISK

47
Table 7: Illustrative example of an action identification and/or
information gathering table based on the extent of the potential
health risk and the certainty of the exposure assessment
Uncertainty rating
Health
risk
rating
Certain
Description
Uncertain
Highly
uncertain

No action
needed
Information Information
gathering
gathering
needed
needed
No action
needed
gathering
gathering
needed
needed

and lifestyle.
Control
needed
Information Control &

gathering Information
needed
gathering
needed
Control
needed
Control &
Control &
gathering gathering
needed
needed

48
Table 8: Illustrative example for assessing the adequacy of existing
control measures11
RR
RR
C
PrE
PeE
U
PrE
PeE
Risk Rating
Consequence
Probability of exposure
Period of Exposure
Uncertainty
Consequence
Numerical Rating
Exposure at this level is unlikely to lead to harm.
Non-life threatening reversible health effects.
15
Adverse health effects that are permanent but do not

significantly affect quality of life or longevity. Health
effects that may be mildly limiting or disabling and
therefore could lead to a change of occupation and lifestyle.
50
Adverse health effects that are generally permanent and

could lead to a significant reduction in quality of life and/or
longevity. Continued exposure is generally likely to lead to
permanent physical or mental disability or a long term
limiting illness.
100
Probability of exposure (as the likelihood of exceeding OEL)
Numerical Rating
Low
Medium
High
10
Period of exposure
Numerical Rating
Rare (once per year)
0.5
Unusual (a few times a year)
Short periods of time (a few times per month)
Continuous for between 2 and 4 hours per shift
Continuous for 8 hour shift
10
11 Adapted from SIMRAC. (2001). Handbook of occupational health practice in the South African Mining Industry
49
Uncertainty in extent of hazard risk and exposure assessment Numerical Rating

Certain
Uncertain
Very Uncertain
Calculated risk rating
Classification of risk
Action
400 and above
Intolerable risk
Requires immediate
discontinuation/shutdown
200-399
Very high risk
Requires immediate mitigation

action with a program to
develop a permanent solution
70-199
High risk
Requires mitigation action

as soon as possible
20-69
Potential risk
Requires mitigation action

and/or monitoring
Under 20
Tolerable risk
Requires monitoring

4.2 Documenting and

Communicating the HRA
50
Introduction
Maintaining systematic and accurate records of the HRA and the priorities for action
- as well as communicating the findings - are vital for ensuring that progress is
made in reducing exposures and developing a zero harm culture in the workplace.
Maintaining an auditable trail of information also facilitates future evaluations and
assessments of the workplace risks to health.
Maintaining systematic and accurate HRA records

A written record of an HRA should be kept in a format that is decided on by your
organization based on legal requirements. These records should:
Contain sufficient information to ensure an audit trail on how the HRA was
undertaken, the rationale for the approach used and how conclusions were
arrived at.
Include the findings of any exposure monitoring and health surveillance.
Meet legal and organizational requirements
Be readily retrievable when needed, for example, for internal/external audits,
review by local or national authorities or periodic internal review.
Be kept for at least 30 years or as long as required by national laws as these
records will enable the evaluation of individual health effects and the accurate
assessment of future insurance or liability claims for chronic health risks.
Communicating the HRA

The findings of the HRA should be communicated to all staff as part of a hazard and
risk communication program. This could be through email, company intranet,
company newsletter, bulletin on a notice board and through worker health and
safety meetings.
It is also imperative that training materials are updated when there is new
information from an HRA. When new control measures are identified they should
become part of the existing monitoring program.
51

4.3 Review and Quality

Assurance of the HRA
52
Introduction
It is important to quality assure and progressively improve the quality of the HRA
process and the documentation of the HRA process over time. This can be done at
the level of the individual HRA as well as a business unit and organizational level
through the health management system.
Review of HRAs
Individual HRAs should be fully reviewed and revised every 3-5 years as a minimum.
Where, for instance, HSE Annual Reports are published these require updates on the
progress of HSE and HRA action plans. Any significant change which may have an
impact on health risks, including changes in the work processes and activities or in
the understanding of specific hazards and risks, should trigger a review of the HRA.
Subsequently, there should be a review of any new control measures put in place.
Quality Assurance of HRAs
Within their quality assurance plans, companies and business units should have
procedures in place to ensure that the requirements of current best practice in
relation to assessing health risks are being met. The HRA process and individual
HRAs should be regularly audited and appraised through a process of internal and
independent external auditing. The scope of such an audit could include:
The management system for conducting and implementing HRAs.
The resources available to carry out and implement HRAs.
The quantity and quality of HRA records.
Remedial actions taken following HRAs.
The effectiveness and maintenance of controls.
Areas of non-compliance with occupational exposure limits.
The documentation of work and health histories.
Evaluation of the quality of the HRA by experienced and independent
occupational health and hygiene professionals.
The ICMM Sustainable Development Framework requires third party assurance in a
number of areas, and a specific procedure has been established to assist member
companies in meeting their commitments. It is recommended that any external
assurance for HRAs should be developed with consideration of the overall corporate
assurance procedure.
53

4.4 Links between HRA and

Health Impact Assessment (HIA)
54
Introduction
When carrying out an initial assessment of health related risks at a site associated
with a new project, a major modification or prior to closure of an existing project, or
prior to mine or operation closure, it is important to consider the health impacts on
local community and the wider society. An assessment that assesses these types of
risks or impacts is referred to as a Health Impact Assessment (HIA). This is a
separate assessment to an HRA though there can often be important overlaps in the
health risks faced by workers of a mining or metals operation and surrounding
communities. Occupational HRAs assess the potential health risks or impacts
within the fence of a mining and metals operation and HIAs assess the potential
health risks or impacts outside the fence which are linked to the operation.
Please also see the companion ICMM report Good Practice Guidance on Health
Impact Assessment.
Definition of HIA
The Gothenburg definition of HIA is a combination of procedures, methods and tools
by which a policy, program or project may be judged as to its potential effects on the
health of a population, and the distribution of those effects within the population.12
HIA is the systematic analysis of the differential health and wellbeing impacts of
proposed plans, programs and projects so that positive health impacts are
maximized and negative health impacts minimized within an affected community. It
works within an explicit value framework that promotes an assessment process that
maximizes the health of a population and is democratic, equitable, sustainable and
ethical in its use of evidence.
HIA is, therefore, about health protection, health improvement and health equity /
inequality.
When are HIAs conducted?

Health Impact Assessments (HIA) are generally conducted where a project or
operation has the potential to impact on the health of the local communities living
nearby and before the project or operation is started. This can be a separate
assessment but is now more usually undertaken as part of an integrated
Environmental, Social and Health Impact Assessment (ESHIA).
The potential impacts on human health of industrial development are numerous and
cut across many specialist concerns. Most industrial development projects are
expected to have an indirect beneficial effect on health by increasing the resources
available for food, education, employment, water supplies, sanitation and health
services. Sometimes the indirect impacts include unexpected negative effects on
health, although many of these can be avoided by careful planning. Adverse health
impacts are most likely to affect the most vulnerable social groups, and this may
serve to amplify the overall adverse effects. Such impacts can reduce the social and
economic benefits expected from industrial development.
Experience shows that the Environmental and Social Impact Assessment (ESIA)
often do not pay due attention to the health component. Health Impact Assessment
offers an opportunity to identify health hazards in advance, and to coordinate with
ESIA activities. The analysis of community health risks provides an opportunity both
to implement risk controls and to incorporate health-promoting measures.
12 The Gothenburg Consensus on health impact assessment (1999) was the product of a joint effort between the World
Health Organization Regional Office for Europe and the European Centre for Health Policy and has been adopted
worldwide
55
HIA methodology
HIA follows a similar methodology to EIA and SIA. The HIA process is generally made
up of eight overlapping stages:
Screening;
Scoping;
Baseline and community profiling, evidence gathering;
Stakeholder involvement;
Analysis of impacts;
Develop mitigation and enhancement measures and/or making
recommendations;
Writing the HIA statement and presenting to decision-makers; and
Follow up (monitoring of the health impacts and evaluation of the HIA
process).
Though the steps above are presented as linear, HIA tends to be an iterative process
where findings and issues that emerge in later steps mean that earlier steps are
revisited and the scope and analysis amended accordingly.
Benefits of the Health Impact Assessment

Just as HRA demonstrates the value and care an organization has for its workers so
HIA demonstrates an organizations care and concern for the welfare of the local
communities. HIA can help to structure the thinking about how best to support,
alongside local and national governments, the health and wellbeing of local people.
56
57
Sources of
Further Information
Sources of Further
Information
58
HERAG Health Risk Assessment Guidance for Metals. ICMM, EBRC, EUROFER and
EuroMetaux. 2007.
HERAG Fact sheet 1, Assessment of occupational dermal exposure and dermal
absorption for metals and inorganic metal compounds. ICMM, EBRC, EUROFER and
EuroMetaux. 2007.
HERAG Fact sheet 2. Assessment of occupational inhalation exposure and systemic
inhalation absorption. ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 3. Indirect exposure via the environment and consumer exposure.
ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 4. Gastrointestinal uptake and absorption, and catalogue of
toxicokinetic models. ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 5. Mutagenicity. ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 6. Quality screening procedures for health effects literature.
ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 7. Essentiality. ICMM, EBRC, EUROFER and EuroMetaux. 2007.
HERAG Fact sheet 8. Choice of assessment factors in health risk assessment for
metals. ICMM, EBRC, EUROFER and EuroMetaux. 2007.
The Setting and Use of Occupational Exposure Limits: current practice. ICMM and
IEH. 2007.
Environmental, Health and Safety Guidelines for Mining. IFC. 2007.
Good Practice in Emergency Preparedness and Response. ICMM and UNEP. 2005.
Risk Assessment and Risk Management of Non-Ferrous Metals Realizing the
Benefits and Controlling the Risks. ICME. 2001.
Occupational Health and Safety Management Systems Requirements. Occupational
health and safety assessment series. BS OHSAS 18001:2007. BSI. 2007.
Occupational Health and Safety Management Systems Guidelines for the
implementation of OHSAS 18001. BS OHSAS 18002:2000. BSI. 2002.
Guide to Data Gathering Systems for Risk Assessment of Metals and Metal
Compounds. ICME. 1999.
Useful Websites
59
ICMM Library
http://www.icmm.com/library
Library and archive of the publications of the International Council on Mining and
Metals and its predecessor organizations.
Minerals Industry Risk Management Gateway

http://www.mirmgate.com/
This website enables users to find carefully-chosen good practice risk management
information, identify hazards through the entire life cycle of operations and get
decision-making help for both long and short term problems.
Good Practice Sustainable Development in the Mining Sector

http://www.goodpracticemining.org/
This website has been jointly developed by the International Council on Mining and
Metals (ICMM), the United Nations Conference of Trade and Development (UNCTAD),
the United Nations Environment Program (UNEP), and the UK Department for
International Development (DfID) to provide access to a library of good practice
guidelines, standards, case studies, legislation and other relevant material that are
leading examples of their kind globally.
Likely to be found
Yes/No/Not Sure
Details of specific
hazard
Likely harmful Acute/ Hazard rating Where located

effects
long
area/process/task
latency
Contact with domestic and wild

animals and insects
Biological hazards (contact with viruses, bacteria, fungi, protozoan and worms)
Fibres
Gases
Liquids (e.g. acids)
Mists
Vapours (e.g. solvents)
Fumes (e.g. diesel)
Dusts
Chemical hazards
Heat and cold
Radiation
Pressure
Vibration
Noise
Physical
Potential Hazard
Appendix
60
Table A1: Checklist for identifying potential hazards
Equipment design (e.g. cab

and control design in
mobile equipment)
Poor hygiene and waste disposal

practices and facilities
Poor working postures and

repetitive motion (e.g. within
the mine and in offices
and warehouses)
Job organization (i.e. shift

patterns, sleep deprivation,
rotations)
Job design (i.e. control, content,

workload)
Ergonomic hazards
Poor hygiene and waste disposal

practices and facilities
Ingestion of contaminated
food and drink
Contact with infected workers

and other people in the
workplace
Potential Hazard
Likely to be found
Yes/No/Not Sure
Details of specific
hazard

effects
long
area/process/task
latency
61
Substance abuse/dependence
and smoking
Leisure and recreation

opportunities
Culture, faith/religion,
local customs
Bullying and harassment
Discrimination
Communication problems (e.g.

shyness, language problems)
Overcrowding and lack of privacy
Social Isolation (i.e. contact with

family and friends and access
to social support)
Isolation (e.g. lone workers

in some areas
Poor risk perception and

risk-taking behaviour
Psychological hazards
Potential Hazard
Likely to be found
Yes/No/Not Sure
Details of specific
hazard

effects
long
area/process/task
latency
62
63
Table A2: Checklist for rating control measures
Process/
Task/Area
Are there
existing
control
measures
in place
Yes/No
What are
the specific
measures in
terms of HOC
Levels of
Exposure
(Critical,
Medium,
Low)
Effectiveness
of Control
Measures
in Place
(Poor,
Adequate,
Good)
64
65
List of contributors
ICMM Working Group
Frank Fox, Anglo American (Chair)
Violaine Verougstraete, Eurometaux
Henry Moorcroft, Goldfields
John McEndoo, AngloGold Ashanti
Mel Mentz, Lonmin
Wes Leavitt, Newmont
Manoel Arruda, Rio Tinto
Rob Barbour, Barrick
Tom Chism, Barrick
Dries Labuschagne, Chamber of Mines of South Africa
Selene Valverde, Vale
Project Team
Salim Vohra, Institute of Occupational Medicine
Christine Copley, International Council on Mining and Metals
Front cover photo courtesy James Lauritz

66
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reasonable precautions have been taken to verify the information
contained in this publication as at the date of publication, it is being
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("ICMM") be liable for damages or losses of any kind, however
arising, from the use of, or reliance on this document. The
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should note that this publication does not constitute a Position
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whatsoever on the part of ICMM concerning the legal status of any
country, territory, city or area or of its authorities, or concerning
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This disclaimer shall be construed in accordance with the laws of
England.
Published by International Council on Mining and Metals (ICMM),
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logo is a trade mark of the International Council on Mining and
Metals. Registered in the United Kingdom, Australia and Japan.
Reproduction of this publication for educational or other noncommercial purposes is authorized without prior written permission
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