MMIS-103 Occupational Health & Hygiene

Unit-I PHYSICAL HAZARDS

Noise
Exposure to noise at work can harm workers’ health. The most well-known effect of noise at work is loss of
hearing; however, it can also exacerbate stress and increase the risk of accidents. This factsheet describes the
effects of workplace noise.

Hearing impairment
Hearing impairment can be due to a mechanical blockage in the transmission of sound to the inner ear
(conductive hearing loss) or damage to the hair cells in the cochlea, part of the inner ear (sensor neural hearing
loss). Rarely, hearing impairment may also be caused by central auditory processing disorders (when the
auditory centres of the brain are affected).
Noise-induced hearing loss
Noise-induced hearing loss (NIHL) is the most common occupational disease in Europe, accounting for about
one third of all work-related diseases, ahead of skin and respiratory problems.
It is usually caused by prolonged exposure to loud noise. The first symptom is normally the inability to hear
high-pitched sounds. Unless the problem of excessive noise is addressed, a person’s hearing will deteriorate
further, including difficulties detecting lower-pitched sounds.
Tinnitus
Tinnitus is a ringing, hissing or booming sensation in your ears. Excessive exposure to noise increases the risk
of tinnitus. If the noise is impulsive (e.g. blasting), the risk can rise substantially. Tinnitus can be the first sign
that your hearing has been damaged by noise.
Noise and pregnant workers
Exposure of pregnant workers to high noise levels at work can affect the unborn child. ‘Prolonged exposure to
loud noise may lead to increased blood pressure and tiredness. Experimental evidence suggests that prolonged
exposure of the unborn child. Exposure to loud noise during pregnancy may have an effect on later hearing and
that low frequencies have a greater potential for causing harm.
Increased risk of accidents
Noise can lead to accidents by: ˛ making it harder for workers to hear and correctly understand speech and
signals; ˛ masking the sound of approaching danger or warning signals (e.g. reversing signals on vehicles); ˛
distracting workers, such as drivers; ˛ contributing to work-related stress that increases the cognitive load,
increasing the likelihood of errors.
Disturbance of speech communication Effective communication is essential in the workplace, whether it is a
factory, building site, call centre, or school. Good speech communication requires a speech level at the ear of
the listener that is at least 10 dB higher than the surrounding noise level.
Stress Work-related stress occurs when the demands of the work environment exceed the workers’ ability to
cope with (or control) them. There are many contributors (stressors) to work-related stress, and it is rare that a
single causal factor leads to work-related stress. The physical work environment can be a source of stress for
workers. Occupational noise, even when it is not at a level that requires action to prevent hearing loss, can be a
stressor.
NOISE EXPOSURE REGULATION
The aim of the Noise Regulations is to ensure that workers' hearing is protected from excessive noise at their
place of work, which could cause them to lose their hearing and/or to suffer from tinnitus (permanent ringing
in the ears). NOISE POLLUTION ACT
Ambient Air Quality Standards in respect of Noise Area Code

Category of Area/Zone Day Time Night Time

Industrial area 75 70
Commercial Area 65 55
Residential area 55 45
Silence Zone 50 40
(Limits in dB (A) Leq)
1. Day time shall mean from 6.00 a.m. to 10.00 p.m.
2. Night time shall mean from 10.00 p.m. to 6 .00 a.m.
3. Silence zone is an area comprising not less than 100 meters around hospitals, educational institutions, courts,
religious places or any other area which is declared as such by the competent authority.
4. Mixed categories of areas may be declared as one of the four above-mentioned categories by the competent
authority.

OHSAS
 The level at which employers must provide hearing protection and hearing protection zones is now 85
decibels (daily or weekly average exposure)
 The level at which employers must assess the risk to workers' health and provide them with information
and training is now 80 decibels.
 There is also an exposure limit value of 87 decibels, taking account of any reduction in exposure
provided by hearing protection, above which workers must not be exposed.
 The accepted trading rule, which is 3 dB(A) in accordance with the ISO 1999 - 1990 standard (and for
most European countries) and 5 dB(A) for the OSHA Standard (USA). The 3 dB(A) trading rule is
consistent with the equal energy principle: 96 dB(A) during 2 hr providing the same energy as 93
dB(A) during 4 hours or 90 dB(A) during 8 hours. The 5 dB halving rate assumes that 90 dB(A) during
8 hours is equivalent to 95 dB(A) for 4 hours or 100 dB(A) for 2 hours.
SIX BASIC PROPERTIES OF SOUND
1. Frequency/Pitch
2. Amplitude/Loudness
3. Spectrum/Timbre
4. Duration
5. Envelope
6. Location

Frequency refers to how often something happens -- or in our case, the number of periodic, compression-
rarefaction cycles that occur each second as a sound wave moves through a medium -- and is measured in
Hertz (Hz) or cycles/second. The term pitch is used to describe our perception of frequencies within the
range of human hearing.
Amplitude/Loudness refer to how loud or soft the sound is.
Duration refers to how long a sound lasts.
Timbre (pronounced TAM-burr) refers to the characteristic sound or tone color of an instrument. A violin
has a different timbre than a piano.
Envelope refers to the shape or contour of the sound as it evolves over time. A simple envelope consists of
three parts: attack, sustain, and decay. An acoustic guitar has a sharp attack, little sustains and a rapid
decay. A piano has a sharp attack, medium sustain, and medium decay. Voice, wind, and string instruments
can shape the individual attack, sustain, and decay portions of the sound.
Location describes the sound placement relative to our listening position. Sound is perceived in three
dimensional space based on the time difference it reaches our left and right eardrums.
These six properties of sound are studied in the fields of music, physics, acoustics, digital signal
processing (DSP), computer science, electrical engineering, psychology, and biology. This course will
study these properties from the perspective of music, MIDI, and digital audio.

Risk Factors
Risk factor:

 A risk factor is any attribute, characteristic or exposure of an individual that increases the
likelihood of developing a disease or injury. Risk factors can be genetic or an aspect of
personal behavior, lifestyle or environmental exposure.
 Risk factors are inherent in every job or activity. Combining risk factors will exponentially
increase your risk of injury. Prolonged exposure to risk factors also increases your risk of
discomfort or injury.
 The risk factors can produce workplace musculoskeletal disorders (WMSDs),‡ which are
subtle and costly injuries and illnesses that can occur in any body part and happen over
time.
 Risk and risk factors are common concepts used in safety and applied ergonomics literature.
Risk includes a component of how likely or what the probability of an event is and the
seriousness of the consequence or what the severity is if something does occur. Risk is often
defined on how many injuries or accidents resulted for a given exposure. At the extremes,
injury risk can be viewed as very low probability but extremely high consequence.

They could include:

Tendonitis—inflammation of a tendon.
Tenosynovitis—inflammation of the tendon sheath.
Back injuries—from the neck to the base of the spine.
Ganglion cysts—Small cystic tumors containing fluid and connected with a joint membrane
or tendon sheath.
Carpal tunnel syndrome—located in a passage between the wrist and hand, it is a condition
caused by compression of the median nerve in the carpal tunnel and characterized by
weakness, pain and loss of sensation in the hand.
1.7 Sound Measuring Instruments
1.7.1
There are three types of SLMs as per ANSI standard.
Following are the different types of sound level meters (SLMs):
 Integrating meter and non-integrating meter.
 Class-1 and class-2 based on IEC standard.
 Type-0, Type-1 and Type-2.
 Noise Dosimeters.
 Personal sound level meter.
 Data Logging Noise Dosimeters.
 Basic Sound Level Meters.

1.7.1.1 Integrating meter: It is used to measure sound

level in Leq. (Equivalent Continuous Sound Level). It is
used in occupational and environmental noise level monitoring.

1.7.1.2 Non-integrating meter:

 It is used to display instantaneous noise level at one moment in time.
 It is suitable for spot checking and for steady sound level monitoring.
1.7.1.3 Both class-1 and class-2 SLMs are as per IEC standard.
Both have same functions but they have different tolerance errors.
Class-1: wider frequency range and tight tolerance
Class-2: narrower frequency range and light tolerance

1.7.1.4
I. Type-0: Used in laboratories
II. Type-1: Used in precision measurements in field, also used in the design of noise controls.
III. Type-2: Used for general purpose measurements

1.7.1.5 NOISE DOSIMETERS :

 Dosimeters are actually sound level meters having a DC output signal converted into a series of impulses
which are counted to provide the dose.
 This is a small, light and compact instrument clipped to the workers' clothes with the microphone close to
the ear. It measures the total A-weighted sound energy received and expresses it as a proportion of the
maximum A-weighted energy that can be received per day. This instrument is particularly useful whenever
the exposure varies appreciably during the working day. At the end of the sampling time, they indicate the
noise exposure dose acquired during that time.
 it is absolutely necessary that the dosimeter be calibrated on the basis of the adopted standard (e.g. 85
dB(A) or 90 dB(A) for an 8-hour exposure),
 The dose provided by the instrument is dependent on the duration during which the instrument is used. it
should first be corrected for an 8 hour period and then converted to the daily noise exposure (LEX,8) level.
 Noise dosimeters must be set up as follows:
 Criterion Level: Lc = 85 dBA
 Threshold Level: Lt = 80 dBA or “Off”
 Exchange Rate: q = 3 dB
 Time Constant = “Slow”
 Dosimeters must have the following minimum specifications:
 Classification: Type 2
 Weighting: A-weighting
 Dynamic Range: 50 dB
 Crest Factor: 30 dB

1.7.1.6 PERSONAL SOUND LEVEL METERS

 Personal sound level meters are in fact integrating sound level meters designed as dosimeters
in order to be worn by the worker during his regular work. These instruments make it
possible to record on almost any increment of time the equivalent level, the peak level or any
statistical parameter.
 These are definitely expected to replace dosimeters in the near future and in fact are already
referred to as dosimeters by some manufacturers and users. Personal sound level meters or
personal sound exposure meters conform to the IEC 61252 standard .

1.7.1.7
Data Logging Noise Dosimeters
 A noise dosimeter capable of recording the noise history is very useful in occupational noise
survey work. These “data logging” instruments usually output the exposure in a variety of
terms including % noise dose, LEX and Leq. (and many more).
 These dosimeters may also project the dose over 8 h from a partial shift exposure on the
assumption that the wearer will continue to receive noise energy at the same rate. These
instruments are versatile because they can be used as integrating-averaging sound level
meters. A sample output is included in Basic Noise Calculations.

1.7.1.8
Basic Sound Level Meters.
 Basic SLMs have limited averaging capabilities.
The standard “time constants” are 1/8 second
(known as “Fast”) and 1 second (“Slow”).
 These are exponential time constants and
give sufficient averaging only for relatively
steady noise signals.
 The exponential averaging times are often
much shorter than the representative time
needed to determine the rms level of many
industrial noises.
 If sound levels vary by more than about 6 dB, when using the “Slow” response, averaging by eye tends to
noticeably underestimate the Leq; the error increases with the amount of variation around the mean.

1.7.2

The various elements in a measuring system are:

a. thetransducer; that is, the microphone;

b. the electronic amplifier and calibrated attenuator for gain control;
c. the frequency weighting or analyzing possibilities;
d. the data storage facilities;
e. the display.
The two main characteristics are:

1. The frequency response: that is, the deviation between the measured value and the true value as a
function of the frequency. As the ear is capable of hearing sounds between 20 Hz and20 kHz, the
frequency response of the sound level meter should be good, with variations smaller than 1 dB, over
that range.
2. The dynamic range: that is, the range in dB over which the measured value is proportional to the true
value, at a given frequency (usually 1000 Hz). This range is limited at low levels by the electrical
background noise of the instrument and at high levels by the signal distortion caused by overloading the
microphone or amplifiers.

1.7.3 Usage

The following steps must be taken successively:

I. Batteries must be checked before use (see Section 6.9) and during long measuring sessions.
II. A wind shield must be used if the air velocity is noticeable. It should anyway be used all the time as
a dust shield .
III. The microphone should be oriented as described previously.
IV. All intruding objects such as the body of the sound level meter (SLM) or the operator itself will
degrade the frequency response of the microphone at high frequencies and directivity effects will
appear at much smaller frequencies. Therefore, the SLM should be, whenever possible, installed on
a stable and sturdy tripod equipped with resilient blocks to isolate the sound level meter from
vibration and consequent spurious readings. The operator should be at a reasonable distance (2-3 m)
behind the sound level meter.
V. Extension cables should be used if possible when measurements are to be made in a restricted area.
VI. When the instrument makes it possible, an extension rod should be used for the microphone.
VII. For walk-through surveys, the SLM should be held well away from the body.
VIII. The SLM must be calibrated before any measuring session using a calibrator described in
IX. If the temperature of the instrument is significantly different from the ambient temperature where it
will be used, it should be first warmed up before calibration and use. The calibration must be
checked at the end of the session. If the instrument is not calibrated anymore, the data might have to
be discarded and the reasons for this calibration change should be investigated as this might
indicate an important malfunctioning of the instrument.

1.7.4 STORAGE, HANDLING AND TRANSPORTATION

 It is obvious that great care must be taken of the instruments. They should not be exposed to extremes of temperature
or to direct sunshine. The limits that the instruments can stand are usually defined by the manufacturer.
 Instruments should also not be exposed to extremes of humidity, and any condensation should be carefully avoided.
 The equipment should also be stored in a normal temperature (10 to 25°C) and dry (30 to 70% relative humidity)
environment.
 Measuring instruments should be protected against dust. Portable instruments such as sound level meters, and
dosimeters, when not used, must be stored in their box. When used, they might be protected by either removing them
from the dusty area or using extension cables, or by enveloping them in tight plastic bags.
 Switches are very delicate items, especially on recent smaller instruments. They must be operated softly and without
pressure. As soon as they indicate any sign of malfunctioning, switches must be thoroughly cleaned and, if
necessary, replaced.
 The manual of each instrument might give special instructions concerning its handling, the storage and the
maintenance. Needless to say that this must not be overlooked but must be practiced during the entire life of the
instrument.

1.8 Octave Band Analyzer

Octave-band analyzers are sound level meters that can be used to:

 Help determine the adequacy of various types of frequency-dependant

noise controls.
 Select hearing protectors because they can measure the amount of
attenuation (how much a sound is weakened) offered by the protectors in the
octave bands responsible for most of the sound energy in a given situation.
 Divide noise into its frequency components
 Some sound level meters may have an octave or one-third octave band
filter attached or integrated into the instrument. Usually a Type 1 (precision) sound
level meter is used for octave and one-third octave analysis.
 The filters are used to analyze the frequency content of noise. They are
also valuable for the calibration of audiometers and to determine the adequacy of
various types of noise control.
 Frequency components may include:
Most octave-band filter sets provide filters with the following center
frequencies: 31.5, 63, 125, 250, 500, 1,000, 2,000, 4,000, 8,000, and 16,000 Hertz
(Hz).
 For a more detailed analysis, the spectrum is sometimes measured in one-
third octave bands.

1.8.1
i) Real-time analyzers or octave-band analyzers are:
Special sound level meters that divide noise into its frequency components. Electronic filter circuits are used to divide
the sound or noise into individual frequency bands. Most octave-band filter sets provide filters with the following
center frequencies: 31.5,63,125,250,500, 1,000,2,000,4,000,8,000and16,000 Hertz (Hz).For a more detailed analysis,
the spectrum is sometimes measured in one-third octave bands.
ii) Real-time analyzers or octave-band analyzers are used to:
Help determine the adequacy of various types of frequency-dependant noise controls.
Select hearing protectors because they can measure the amount of attenuation (how much a sound is weakened)
offered by the protectors in select octave bands.
Analyze the frequency content of noise.
They are also valuable for the calibration of audiometers and to determine the adequacy of various types of noise
control. The special signature of any given noise can be obtained by taking sound level meter readings at each of the
center frequency bands. The results may indicate octave-bands that contain the majority of the total sound power being
radiated.
1.8.2
iii) Instrument Care:
 Do not attempt to remove the mesh cover from the microphone as this will cause damage and affect the accuracy of
the instrument.
Protect the instrument from impact. Do not drop it or subject it to rough handling. Transport it in the supplied carrying
case.
Protect the instrument from water, dust, extreme temperatures, high humidity and direct sunlight during storage and
use.
Protect the instrument from air with high salt or sulfur content, gases and stored chemicals, as this may damage the
delicate microphone and sensitive electronics.
Always switch the instrument off after use. Remove the batteries from the instrument if it is not to be used for a long
period of time. Do not leave exhausted batteries in the instrument, as they may leak and cause damage.
Clean the instrument only by wiping it with a soft, dry cloth or when necessary, with a cloth lightly moistened with
water. Do not use solvents, abrasives, alcohol or cleaning agents.
{1. The decibel (dB) The range over which the human ear responds to sound pressure (noise) is extremely
large; in Pascal’s (Pa) it is 20µPa (the threshold of hearing) to 100 Pa (the threshold of pain). The
measurement of sound pressure has been made more convenient by the use of the decibel, which is
logarithmic. However, decibels are non-linear and therefore cannot be added together. A simple rule is that
doubling the amplitude of the noise under test causes the level to rise by 3dB.
2. SLM-sound level meter: Instantaneous sound pressure level (SPL) is used for spot checks to establish
instantaneous noise levels. SPL is defined by the logarithmic equation: SPL (in dB): 20 log10 P0 P Where P
= rms measured sound pressure level P0 = rms reference sound pressure level (20µ Pa)
3. Leq-level equivalent (continuous): Leq is used to assess the rms average noise level over a preset period of
time, often the starting point of a noise assessment. To take a Leq measurement the period of time over which it
is to be made must be selected. The longer the period of measurement time, the more accurate the Leq reading
will be, a typical period is 8 hours (the length of a working day).
4. SEL – Sound exposure level (LE) SEL measurements are almost identical to Leq measurements but
normalized or compressed to 1 second. This allows the total sound energy of an event, such as train passing a
platform, to be evaluated. Another event, such as the next train, which lasts for a different amount of time, can
be measured in the same way. The two readings can be compared to assess how much total noise the
passengers standing at the platform were exposed to by each train.}

1.9 Noise Networks

1.10 Noise Surveys

A noise survey takes noise measurements throughout an entire plant or section to identify noisy areas. Noise
surveys provide very useful information which enables us to identify:

Areas where employees are likely to be exposed to harmful levels of noise and personal dosimeter may
be needed.
Machines and equipment which generate harmful levels of noise.
Employees who might be exposed to unacceptable noise levels.
Noise control options to reduce noise exposure.

Noise survey is conducted in areas where noise exposure is likely to be hazardous. Noise level refers to the
level of sound. A noise survey involves measuring noise level at selected locations throughout an entire plant
or sections to identify noisy areas. This is usually done with a sound level meter (SLM). A reasonably accurate
sketch showing the locations of workers and noisy machines is drawn. Noise level measurements are taken at a
suitable number of positions around the area and are marked on the sketch. The more measurements taken, the
more accurate the survey is. A noise map can be produced by drawing lines on the sketch between points of
equal sound level. Noise survey maps, like that in Figure 2, provide very useful information by clearly
identifying areas where there are noise hazards.

Figure 2
The SLM must be calibrated before and after each use. The manual gives the calibration procedure. To take
measurements, the SLM is held at arm's length at the ear height for those exposed to the noise.
When the purpose of noise measurement is to assess the risk of hearing loss, the microphone position should
be as close as possible to the location of the ears of the employee for whose benefit the noise exposure data are
being taken. Shielding by presence of employee and other objects between the noise source and microphone
should be avoided. The employee need not be present during the measurement. For a stationary employee, the
microphone should be positioned above the shoulder or as near as feasible. The microphone should be located
within 0.5 metre of the employee's shoulder. If the employee works in a standing position, the microphone
should be positioned preferably 1.5 metres above the floor. If the employee works in a sitting position, the
microphone should be positioned at 1.1 metres above the floor.
A standard SLM takes only instantaneous noise measurements. This is sufficient in workplaces with
continuous noise levels. But in workplaces with impulse, intermittent or variable noise levels, the SLM makes
it difficult to determine a person's average exposure to noise over a work shift. One solution in such
workplaces is a noise dosimeter.

The principal reasons for doing an occupational noise survey are:

To identify which workers are exposed to noise harmful to their hearing
To provide information to determine corrective actions, which may include a hearing conservation program and
noise control.

1.11 Noise Control Program

Source Control :
 This may include source modification such as acoustic treatment to machine surface
,design changes, limiting the operational timing.
Transmission path Intervention:
  This may include containing the sources inside a sound insulating enclosure,
construction of a noise barrier or provision of sound provision of sound absorving
materials along the path.
Receptor Control :
 This includes protection of receiver by alerting the work schedule or provision of
personal protection devices such as ear plugs for operating noise machinery. The
measure may include dissipation and deflection method.
Lubrication :
 Proper Scheduled lubrication will reduce noise of the equipment.
Plantation Trees :
 Planting of trees may reduce noise.
Using Noise Absorbing Material/Sound Proofing Materials :
 Noise Absorbing materials such as : i)Acoustical Foam Panels,
ii)White Paintable acoustical wall panel
iii)Fabric wrapper Panel
iv)Acoustical wall covering
v)Ceiling Tiles
vi)Fiber Glass blankets & Roll
Banning on Honking of Horns
Noise can be reduced by
i. Prescribing noise limits for vehicular traffic ,
b. Ban on honking of horns ,
c. By using mass public transport system.

By Using Hearing Protection Equipment :

Hearing Protection Device Derating scale

Ear muffs 25% reduction

Formable ear plugs 25% reduction

All other earplugs or semi-aural devices 25% reduction

1.12 Industrial audiometric

Occupational Audiometry: Offers the most respected mobile audiometric screening
programmes established across the whole of globe. State of the art mobile screening units and a
team of qualified senior grade audiologists ensure you receive the most comprehensive and
professional service at affordable prices.

1.12.1The most important audiometric techniques are:

 Pure-tone audiometry the most widely used technique for quantitative hearing measurement;
 Speech audiometry a technique in which the pure tone is replaced by phonetically
selected test words.
1.12.2 Audiornetry equipment
The audiometer is the instrument employed for audiometric testing. It comprises three basic
units:
An electronic oscillator for generating alternating electric currents of desired
frequencies;
An amplifier with an attenuator;
Earphones for applying the sound to the listener's ear.

1.12.3 An audiometer has two fundamental controls.

 The first is the volume control or attenuator with which the intensity of the tone can be
varied.
 The second control is for frequency selection; frequencies are usually calibrated in octave
steps from 125-8 000 Hz but some audiometers have half-octave steps such as 3 000 and 6
000 Hz.

1.12.4 Calibration.
If reliable test results are to be obtained, it must be ensured that the noise intensities and
frequencies generated do, in fact, correspond with the control settings. Audiometers should
therefore be carefully calibrated before being used for the first time, and at regular intervals
thereafter.
1.12.5 Audiomotrie testing
Before testing starts the audiometer should be allowed to warm up for about 10 mm. The tester
should then ensure that the audiometer is correctly calibrated, either by applying the sound to
his own ears or to the ears of someone else with known normal hearing. Where a soundproof
room is available, the subject will be placed in the enclosure and the tester will observe from
outside through a window although eudiometry is often performed with the subject and tester
in the same room; in all cases, however, it is important that the tester can follow the subject's
reactions whereas the subject should not be able to observe the, tester's hands on the control
panel.
1.12.5.1 Speech audiometry
Although pure-tone audiometry can be used to measure hearing function, it does
not provide information on speech reception capacity. For this purpose, a
technique called speech audiometry has been developed in which the subject is
presented with recorded test words which he is asked to repeat.
Two syllable words (spondees) are most commonly used. The sensation level at
which the subject can repeat 50% of the words correctly is termed the "speech
reception threshold" or SRT.

1.12.6 Audiogram : The audiogram is a written record of the threshold at certain specified
frequencies and is generally presented in graph with frequency (In hertz) the ordinate. The
hearing loss, or threshold, at each frequency tested is plotted on the audiogram for each ear
separately.
1.13 Hearing Conservation Programs :
 The hearing conservation program requires employers to monitor noise exposure levels
in a way that accurately identifies employees exposed to noise at or above 85 decibels
(dB) averaged over 8 working hours, or an 8-hour time-weighted average (TWA).
  Employers must monitor all employees whose noise exposure is equivalent to or greater
than a noise exposure received in 8 hours where the noise level is constantly 85 dB.
1.14 Types :
General industry employers are required to create and administer a hearing conservation program
when employees are exposed to noise levels in excess of regulatory maximums. The general
industry hearing conservation program requirement, which is not present in the construction
standard, outlines the specific elements that must be included in a hearing conservation program.
Some of those elements may be of interest to roofing contractors in developing their safety
program.
These include:
Monitoring employee exposure
Instituting: engineering, work-practice and administrative controls
Fitting each employee exposed to excessive noises with hearing protection
Training each exposed employee to understand noise hazards and techniques to protect
themselves
Monitoring employee exposure through baseline and annual audiometry readings
Taking measures to prevent further hearing loss when any loss has been detected during
annual audiograms
Keeping records.
1.17 Surveying Procedure
The Initial Noise Survey
When a worker’s exposure to sound levels of 82 dBA or more is likely to last over the
entire shift of 8h, or its energy equivalent (see Trade-Off Rule), the employer is required
to conduct a noise survey. It’s a good idea to do an initial survey first before embarking
upon a full formal noise survey.
An initial survey should be considered an inexpensive “red flagging” exercise. The
report should be concise, but clear. A table (Appendix 1) is suitable for an initial noise
exposure report. You could make it more suitable for initial surveys by deleting most
noise reporting columns and expanding the “Comments.”
The initial survey will show whether the following actions are required:
• Below 82 dBA: no further action
• 82 to 85 dBA: inform the worker of the noise monitoring results, the minimal risk of
hearing loss, and the roles of hearing protection and audiometric testing
• Above 85 dBA: a more detailed noise survey and other requirements of the Noise
regulation, including education on the effects of noise on hearing and training on the use
of hearing protectors.
One way to start a survey is to walk through the premises to collect an impression of the
noise to be assessed, the types of noise generated (steady, intermittent, impulse, the
range of levels), and identify quiet areas that can be eliminated from further
consideration (e.g. offices). Other useful information would include the numbers of
workers, work patterns, break times, shift changes, and unusual conditions (in
production, seasonal, environmental) that could affect results.
A resurvey is required when significant noise making machinery is introduced, removed,
or modified and when walls are added or removed.
Who Can Do Initial Noise Surveys?
 The initial survey could be carried out by a person with little training. You could get
more definite information if you used a relatively inexpensive basic sound level meter
to help decide if a formal assessment is required (using more sophisticated
instrumentation).
A listening test you may find useful to indicate sound levels is:

to be clearly understood by someone at 1 m.

to be clearly understood by someone at m.

Noise surveyors must become familiar with their noise-measuring instruments’
limitations and proper use. This includes doing a field calibration, selecting the
appropriate response time constant(s) and the A-weighting.
The surveyor should understand how an increase in noise level can be “traded off”
against a reduction in exposure time to get the same noise dose.
When To Do A Formal Survey.
A formal survey will follow an initial survey when:

 The initial survey indicates the noise exposure level, LEX, is likely to be greater than 85
dBA, or noise exposure dose more than 100% per day
 An accurate value of workers’ noise exposure is required by Part 7 of the Occupational
Health and Safety Regulation (i.e., where LEX is greater than 85 dBA)
 More detailed information is required for noise exposure reduction methods
 More detailed information is required to select adequate hearing protection
For Genuine peak sound levels are above 140 dBA.
Who Can Do Formal Noise Surveys?
 If a survey incorrectly identifies a worker as being over-exposed to noise, the employer will
be involved in needless expense in complying with the Regulation.
 If the survey incorrectly identifies the exposure as acceptable, the worker’s hearing may be
put at risk.
 Both scenarios demand a competent surveyor.
 Companies seeking assistance from noise surveyors should carefully check the
qualifications of candidates. Experience has shown surveyors may use inappropriate
instrumentation, or adequate instruments in an incompetent fashion, leading to incorrect
measurements and conclusions. You can have candidate noise surveyors read this booklet
and ask them if they understand and can comply with its requirements. You could also ask
to see surveys they have prepared for other clients, check references, qualifications, courses
attended and enquire if they are members of any relevant learned societies. Powerful noise-
measuring instrumentation is available, which can produce large amounts of data baffling to
the untrained user, and which, without proper interpretation, may be valueless to the
company receiving the information.
 Surveyors should, for the sake of clarity, exclude unnecessary information from the formal
report. They should focus on the relevant noise descriptors only and ensure the reasons for
the survey are served (see AIM and NOISE DESCRIPTORS - Introduction).
 It is a simple matter to download and present large quantities of noise data from
dosimeters; it is another matter to infer valid conclusions for the company being
 surveyed to act upon.
1.19 Ionizing radiation : Ionizing radiation is any type of particle or electromagnetic wave that
carries enough energy to ionize or remove electrons from an atom. There are two types of
electromagnetic waves that can ionize atoms: X-rays and gamma-rays, and sometimes they
have the same energy. Gamma radiation is produced by interactions within the nucleus, while
X-rays are produced outside of the nucleus by electrons. There are officially two types of
ionizing radiation that are energetic particles emitted during an interaction within the nucleus.
1.20 Types:
These differ only in frequency and wave length.
Heat waves
Radio Waves
Infrared light
Visible light
Ultraviolet light
X rays
Gamma rays
Longer wave length, lower frequency waves (heat and radio) have less
energy than shorter wave length, higher frequency waves (X and gamma
rays). Not all electromagnetic (EM) radiation is ionizing. Only the high
frequency portion of the electromagnetic spectrum which includes X rays
and gamma rays is ionizing.
Internal exposure to ionizing radiation occurs when a radionuclide is
inhaled, ingested or otherwise enters into the bloodstream (for example, by
injection or through wounds). Internal exposure stops when the
radionuclide is eliminated from the body, either spontaneously (such as
through excreta) or as a result of a treatment.
External exposure may occur when airborne radioactive material (such as
dust, liquid, or aerosols) is deposited on skin or clothes. This type of
radioactive material can often be removed from the body by simply
washing.

Instrument Types Detection Principle Applications

Ion chamber (IC) Ionization of air Direct measurement of exposure or exposure rates, with minimal energy
(or other gases) dependence.

Geiger-Mueller Ionization of gas with Detection of individual events, i.e. alpha or beta particles & secondary
(GM) multiplication of electrons, for measuring activity (in samples or on surfaces) & detecting low
Proportional counter electrons in detector intensities of ambient x or gamma radiation; precautions required due to energy
(PC) dependence.

Solid state diodes Ionization of Detection & energy measurement of photons or particles; primarily for
semiconductor laboratory use.

Solid state diodes Ionization & Detection of individual events;

excitation
followed by light
 emission
-Solids - NaI (Tl) - photons; energy spectrometry

- ZnS (Ag) - alpha particles; detection only

-Liquid - Detection of low-energy beta emitters mixed with the scintillation fluid.

Photographic film Ionization of Ag Br Personal exposure monitoring.

Thermoluminescent Excitation of crystal; Personal and environmental exposure monitor

detector (TLD) light release by heating

1.21 Effects:
Health effects of ionizing radiation
 Radiation damage to tissue and/or organs depends on the dose of radiation received, or the absorbed
dose which is expressed in a unit called the gray (Gy). The potential damage from an absorbed dose
depends on the type of radiation and the sensitivity of different tissues and organs.
 Beyond certain thresholds, radiation can impair the functioning of tissues and/or organs and can
produce acute effects such as skin redness, hair loss, radiation burns, or acute radiation syndrome.
These effects are more severe at higher doses and higher dose rates. For instance, the dose threshold for
acute radiation syndrome is about 1 Sv (1000 mSv).
 If the radiation dose is low and/or it is delivered over a long period of time (low dose rate), the risk is
substantially lower because there is a greater likelihood of repairing the damage. There is still a risk of
long-term effects such as cancer, however, that may appear years or even decades later. Effects of this
type will not always occur, but their likelihood is proportional to the radiation dose. This risk is higher
for children and adolescents, as they are significantly more sensitive to radiation exposure than adults.
 Prenatal exposure to ionizing radiation may induce brain damage in foetuses following an acute dose
exceeding 100 mSv between weeks 8-15 of pregnancy and 200 mSv between weeks 16-25 of
pregnancy. Before week 8 or after week 25 of pregnancy human studies have not shown radiation risk
to fetal brain development. Epidemiological studies indicate that the cancer risk after fetal exposure to
radiation is similar to the risk after exposure in early childhood.
 Populations exposed to radiation, such as atomic bomb survivors or radiotherapy patients, showed a
significant increase of cancer risk at doses above 100 mSv. More recently, some epidemiological
studies in individuals exposed to medical exposures during childhood (paediatric CT) suggested that
cancer risk may increase even at lower doses (between 50-100 mSv).

Measuring Unit/Process:
 The effective dose is used to measure ionizing radiation in terms of the potential for causing harm. The
sievert (Sv) is the unit of effective dose that takes into account the type of radiation and sensitivity of
tissues and organs. It is a way to measure ionizing radiation in terms of the potential for causing harm.
The Sv takes into account the type of radiation and sensitivity of tissues and organs.
 The Sv is a very large unit so it is more practical to use smaller units such as millisieverts (mSv) or
microsieverts (μSv). There are one thousand μSv in one mSv, and one thousand mSv in one Sv. In
addition to the amount of radiation (dose), it is often useful to express the rate at which this dose is
delivered (dose rate), such as microsieverts per hour (μSv/hour) or millisievert per year (mSv/year).
1.22 Measuring Instrument:
 Many different devices are used to measure : radiation under a wide range of conditions. Three
categories of devices are personal dosimeters, hand-held detectors, and continuous sampling monitors.
(See Figure 1) People working in or visiting nuclear facilities usually wear personal dosimeters on their
clothing. These devices measure the radiation dose a person receives while in the facility. A film badge
is an example of a personal dosimeter. Hand-held detectors are used to measure the exposure rate from
 a specific object. The exposure rate from a package of radioactive waste or a piece of granite can be
measured with a hand-held detector such as a Geiger counter.
 Continuous sampling monitors can be set up to take samples of air or water in and around a low-level
radioactive waste disposal facility. Several different types of monitors are used. With one type, the
samples are collected and evaluated periodically to ensure the concentration of radioactive material in
the air or water is within limits set by federal and state regulations. Another type of continuous monitor
is designed to emit a signal when the amount of radiation present would give a dose higher than a
specified limit.

Personal Dosimeters Hand-Held Detector Continuous Sampling Monitor

1.23 Controlling Radiation Exposure

When working with radiation, there is a concern for two types of exposure: acute and chronic. An acute
exposure is a single accidental exposure to a high dose of radiation during a short period of time. An acute
exposure has the potential for producing both non stochastic and stochastic effects. Chronic exposure, which is
also sometimes called "continuous exposure," is long-term, low level overexposure. Chronic exposure may
result in stochastic health effects and is likely to be the result of improper or inadequate protective measures.

The three basic ways of controlling exposure to harmful radiation are:

1) Limiting the time spent near a source of radiation,
2) Increasing the distance away from the source,
3) and using shielding to stop or reduce the level of radiation.

Time
The radiation dose is directly proportional to the time spent in the radiation. Therefore,
a person should not stay near a source of radiation any longer than necessary. If a
survey meter reads 4 mR/h at a particular location, a total dose of 4mr will be received
if a person remains at that location for one hour. In a two hour span of time, a dose of
8 mR would be received. The following equation can be used to make a simple
calculation to determine the dose that will be or has been received in a radiation area.
Dose = Dose Rate x Time
When using a gamma camera, it is important to get the source from the shielded
camera to the collimator as quickly as possible to limit the time of exposure to the unshielded source. Devices
that shield radiation in some directions but allow it pass in one or more other directions are known as
collimators. This is illustrated in the images at the bottom of this page.
Distance
Increasing distance from the source of radiation will reduce the amount
of radiation received. As radiation travels from the source, it spreads
out becoming less intense. This is analogous to standing near a fire. The
closer a person stands to the fire, the more intense the heat feels from
the fire. This phenomenon can be expressed by an equation known as
the inverse square law, which states that as the radiation travels out
from the source, the dosage decreases inversely with the square of the
distance.
Inverse Square Law: I1/ I2 = D22/ D12

Shielding
The third way to reduce exposure to radiation is to place something
between the radiographer and the source of radiation. In general, the more dense the material the more
shielding it will provide. The most effective shielding is provided by depleted uranium metal. It is used
primarily in gamma ray cameras like the one shown below. The circle of dark material in the plastic see-
through camera (below right) would actually be a sphere of depleted uranium in a real gamma ray camera.
Depleted uranium and other heavy metals, like tungsten, are very effective in shielding radiation because their
tightly packed atoms make it hard for radiation to move through the material without interacting with the
atoms. Lead and concrete are the most commonly used radiation shielding materials primarily because they are
easy to work with and are readily available materials. Concrete is commonly used in the construction of
radiation vaults. Some vaults will also be lined with lead sheeting to help reduce the radiation to acceptable
levels on the outside.
Engineered Controls
Engineered controls such as shielding and door interlocks are used to contain the radiation in a cabinet or a
"radiation vault." Fixed shielding materials are commonly high density concrete and/or lead. Door interlocks
are used to immediately cut the power to X-ray generating equipment if a door is accidentally opened when X-
rays are being produced. Warning lights are used to alert workers and the public that radiation is being used.
Sensors and warning alarms are often used to signal that a predetermined amount of radiation is present. Safety
controls should never be tampered with or bypassed .

Administrative Controls
As mentioned above, administrative controls supplement the engineered controls. These controls include
postings, procedures, dosimeter, and training. It is commonly required that all areas containing X-ray
producing equipment or radioactive materials have signs posted bearing the radiation symbol and a notice
explaining the dangers of radiation. Normal operating procedures and emergency procedures must also be
prepared and followed. In the US, federal law requires that any individual who is likely to receive more than
10% of any annual occupational dose limit be monitored for radiation exposure. This monitoring is
accomplished with the use of dosimeters, which are discussed in the radiation safety equipment section of this
material. Proper training with accompanying documentation is also a very important administrative control.

1.24 OSHA standard on-ionizing radiations,

 1.25 ionizing radiations effects,
Health effects of ionizing radiation : Radiation damage to tissue and/or organs depends on the dose
of radiation received, or the absorbed dose which is expressed in a unit called the gray (Gy). The
potential damage from an absorbed dose depends on the type of radiation and the sensitivity of
different tissues and organs
1.27 Radar hazards

1.27.1HERO—HAZARDS OF ELECTROMAGNETIC RADIATION TO ORDNANCE

During on-loading or off-loading of ammunition, there is a danger that RF electromagnetic fields could
accidentally activate electro-explosive devices (EEDs) or electrically-initiated ordnance. This is a very real
hazard to the ordnance, the ship, and the crew.
1.27.2HERF-HAZARDS OF ELECTROMAGNETIC RADIATION TO FUELS
During fueling operations, RF electromagnetic fields with a large enough intensity could produce a spark that
could ignite the volatile combustibles. Therefore, certain radars may need to be shut down during fueling
operations.
1.27.3 Burn
voltages of enough potential to cause a burn injury can be induced on metallic items from nearby transmitting
antennas. However, there has to be actual physical contact for the burn to occur.
1.27.4 Energized Equipment
You may have to work on energized equipment on a hectic bridge, in a crowded CIC, or in a cramped radar
equipment room. These are not ideal safety environments. As these spaces are maintained by various people,
always check the rubber matting around your equipment.

(NEVER WORK ALONE ON ENERGIZED EQUIPMENT.)

1.27.5Much of the radar gear (if labeled correctly) will have radiation hazard (RADHAZ) warnings attached.
These labels indicate a radiation hazard producing RF electromagnetic fields intense enough to actuate electro-
explosive devices, cause spark ignition of volatile combustibles, or produce harmful biological effects in
humans. You will probably not be able to eliminate the hazards caused by normal operation of your radar
equipment. Therefore, you will need to minimize them during certain evolutions.
1.27.6 Anywhere a radar or transmitter is operating, there is a danger that the RF electromagnetic fields may
produce harmful biological effects in humans exposed to them. 20 to 39% of the radar workers reported
different problems such as needing a good tonic, feeling run down and out of sorts, headache, tightness or
pressure in the head, insomnia, getting edgy and bad-tempered. Furthermore, 47% of the radar workers
reported feeling under strain. In response to this question that if they have been able to enjoy their normal day-
to-day activities, 31% responded less than usual. It was also shown that work experience had significant
relationships with reaction time and short-term memory indices i.e., forward digit span, reverse digit span,
word recognition and paired words.
 1.28 Microwave
 Microwaves are a form of "electromagnetic" radiation; that is, they are waves of electrical and
magnetic energy moving together through space. Electromagnetic radiation spans a broad spectrum
from very long radio waves to very short gamma rays.
 Microwave radiation can heat body tissue the same way it heats food. Exposure to high levels of
microwaves can cause a painful burn. Two areas of the body, the eyes and the testes, are particularly
vulnerable to RF heating because there is relatively little blood flow in them to carry away excess heat.
Additionally, the lens of the eye is particularly sensitive to intense heat, and exposure to high levels of
microwaves can cause cataracts. But these types of injuries – burns and cataracts – can only be caused
by exposure to large amounts of microwave radiation.
 Microwaves turn on and off like a light bulb: when they are off, no waves are emitted,
and microwave energy cannot linger in the oven or in food. Although there is no clear evidence of
harm, many people are concerned that low levels of electromagnetic radiation may impact human
health over a long time
 As noted, microwave radiation may also cause damage to the male testes/reproductive organs.
Specifically, scientists have demonstrated that exposure to microwave radiation may result in partial or
permanent sterility. In addition, some scientific evidence suggests similar effects associated with
microwave exposure and female reproductive problems. Furthermore, the scientific literature indicates
a relationship between exposure to microwave radiation and birth defects, such as mongolism (Down's
Syndrome) and central nervous system damage.

1.28 Radiowave

 Exposure to radio wave radiation may result in a non-thermal reaction that causes similar molecular
interactions as in the thermal effect, but without the heating of the exposed tissue or organ. The site of
energy absorption varies with the frequency, that is, exposure to low frequency non-ionizing radio
frequency radiation will (theoretically) penetrate the skin and cause molecular interactions similar to
those caused by high frequency radio frequency radiation. Complicating such non-thermal reaction, the
body's heat and warning system may not provide protection because the energy is absorbed at locations
below the nerves.

Remedies :
 He most effective way to eliminate and/or minimize occupational exposure to radio frequency
microwave and radio wave radiation is through the use of engineering controls. For example, the source
of the potential problem, i.e., the radiation-emitting equipment, should be enclosed or effectively
shielded or the worker should be separated from the source. This requirement is equally important to all
workers exposed to microwave and radio wave radiation. Where engineering controls cannot be
implemented, personal protective equipment such as protective clothing and eyewear should be
provided and utilized.
 In addition, employers should provide comprehensive training regarding potentially hazardous working
conditions. Such a program might consist of written and/or audio/visual materials that detail potential
safety and health dangers, health effects of exposure, methods of control, first aid procedures, the use of
hazard warning signs and labels, and the identification of restricted areas.
 Employers should also institute medical surveillance programs that would provide workers with routine
medical examinations specific to any biological effects resulting from occupational radio frequency
radiation exposures. Potential benefits of medical surveillance would include: an assessment of
employees' physical fitness to safely perform the work (consisting of a medical and occupational
history as well as a physical examination), biological monitoring of exposure to a particular agent, and
early detection of any biological damages or effects. In addition, documented health effects would
allow the worker and her/his physician to make informed judgments about further exposures.
 1.29 Lasers
 Lasers have been classified by wavelength and maximum output power[19] into four classes and a few
subclasses since the early 1970s. The classifications categorize lasers according to their ability to
produce damage in exposed people, from class 1 (no hazard during normal use) to class 4 (severe
hazard for eyes and skin).

CLASS 1 LASER PRODUCT

A Class 1 laser is safe under all conditions of normal use. Class 1 may still pose a hazard when viewed with
a telescope or microscope of sufficiently large aperture.
A Class 1M laser is safe for all conditions of use except when passed through magnifying optics such as
microscopes and telescopes. A laser can be classified as Class 1M if the power that can pass through the
pupil of the naked eye is less than the AEL for Class 1
A Class 2 laser is considered to be safe because the blink reflex (glare aversion response to bright lights) will
limit the exposure to no more than 0.25 seconds. It only applies to visible-light lasers (400–700 nm). Class-
2 lasers are limited to 1 mW continuous wave, or more if the emission time is less than 0.25 seconds or if the
light is not spatially coherent. Intentional suppression of the blink reflex could lead to eye injury. Some laser
pointers and measuring instruments are class 2.
A Class 2M laser is safe because of the blink reflex if not viewed through optical instruments. As with
class 1M, this applies to laser beams with a large diameter or large divergence, for which the amount of light
passing through the pupil cannot exceed the limits for class 2.
A Class 3R laser is considered safe if handled carefully, with restricted beam viewing. With a class 3R laser,
the MPE can be exceeded, but with a low risk of injury. Visible continuous lasers in Class 3R are limited to
5 mW. For other wavelengths and for pulsed lasers, other limits apply.
A Class 3B laser is hazardous if the eye is exposed directly, but diffuse reflections such as those from paper
or other mattesurfaces are not harmful. The AEL for continuous lasers in the wavelength range from 315 nm
to far infrared is 0.5 W. For pulsed lasers between 400 and 700 nm, the limit is 30 mJ. Other limits apply to
other wavelengths and to ultrashort pulsed lasers. Protective eyewear is typically required where direct
viewing of a class 3B laser beam may occur. Class-3B lasers must be equipped with a key switch and a
safety interlock. Class 3B lasers are used inside CD and DVD writers, although the writer unit itself is
class 1 because the laser light cannot leave the unit.
Class 4 is the highest and most dangerous class of laser, including all lasers that exceed the Class 3B AEL.
By definition, a class 4 laser can burn the skin, or cause devastating and permanent eye damage as a result of
direct, diffuse or indirect beam viewing. These lasers may ignite combustible materials, and thus may
represent a fire risk. These hazards may also apply to indirect or non-specular reflections of the beam, even
from apparently matte surfaces – meaning that great care must be taken to control the beam path. Class 4
lasers must be equipped with a key switch and a safety interlock. Most industrial, scientific, military, and
medical lasers are in this category. Medical lasers can have divergent emissions and require awareness of
nominal ocular hazard distance (NOHD) and nominal ocular hazard area (NOHA).

 Thermal effects are the predominant cause of laser radiation injury, but photo-chemical effects can also
be of concern for specific wavelengths of laser radiation. Even moderately powered lasers can cause
injury to the eye. High power lasers can also burn the skin.
 Lasers can cause damage in biological tissues, both to the eye and to the skin, due to several
mechanisms. Thermal damage, or burn, occurs when tissues are heated to the point
where denaturation of proteins occurs.
 Another mechanism is photochemical damage, where light triggers chemical reactions in tissue.
Photochemical damage occurs mostly with short-wavelength (blue and ultra-violet) light and can be
accumulated over the course of hours
 The eye focuses visible and near-infrared light onto the retina. A laser beam can be focused to an
intensity on the retina which may be up to 200,000 times higher than at the point where the laser beam
enters the eye. Most of the light is absorbed by melanin pigments in the pigment epithelium just behind
the photoreceptors, and causes burns in the retina. Ultraviolet light with wavelengths shorter than
 400 nm tends to be absorbed by lens and 300 nm in the cornea, where it can produce injuries at
relatively low powers due to photochemical damage. Infrared light mainly causes thermal damage to
the retina at near-infrared wavelengths and to more frontal parts of the eye at longer wavelengths.

Remedies:
General precautions

Many scientists involved with lasers agree on the following guidelines:

 Everyone who uses a laser should be aware of the risks. This awareness is not just a matter of time
spent with lasers; to the contrary, long-term dealing with invisible risks (such as from infrared laser
beams) tends to reduce risk awareness primarily due to complacency, rather than to sharpen it.
 Optical experiments should be carried out on an optical table with all laser beams travelling in the
horizontal plane only, and all beams should be stopped at the edges of the table. Users should never put
their eyes at the level of the horizontal plane where the beams are in case of reflected beams that leave
the table.
 Watches and other jewelry that might enter the optical plane should not be allowed in the laboratory.
All non-optical objects that are close to the optical plane should have a matte finish in order to
prevent specular reflections.
 Adequate eye protection should always be required for everyone in the room if there is a significant risk
for eye injury.
 High-intensity beams that can cause fire or skin damage (mainly from class 4 and ultraviolet lasers) and
that are not frequently modified should be guided through opaque tubes.
 Alignment of beams and optical components should be performed at a reduced beam power whenever
possible.
 Interlocks and automatic shutdown : Some systems have electronics that automatically shut down
the laser under other conditions. For example, some fiber optic communication systems have circuits
that automatically shut down transmission if a fiber is disconnected or broken
1.30 TLV- cold environments

In a cold environment, the body tries to conserve heat and prevent heat loss by conduction and
convection; consequently, the flow of blood to the skin is reduced by constriction of the
peripheral
blood vessels. Workers suffering from a peripheral vascular disease such as Raynaud's
phenomenon, etc.,
may suffer damage to the exposed parts of the limbs if subjected to cold working conditions.
What are the most common cold induced illnesses/injuries?
 Hypothermia
 Frostbite
 Trench Foot
What is hypothermia? Hypothermia occurs when body heat is lost faster than it can be
replaced and the normal body temperature (98.6°F) drops to less than 95°F.
Hypothermia is most likely at very cold temperatures, but it can occur even at cool
temperatures (above 40°F), if a person becomes chilled from rain, sweat, or submersion
in cold water.
What are the symptoms of hypothermia?
 Mild symptoms:
An exposed worker is alert.
He or she may begin to shiver and stomp the feet in order to generate heat.
 Moderate to Severe symptoms:
As the body temperature continues to fall, symptoms will worsen and shivering will stop.
The worker may lose coordination and fumble with items in the hand, become confused
and disoriented
He or she may be unable to walk or stand, pupils become dilated, pulse and breathing
become slowed, and loss of consciousness can occur. A person could die if help is not
received immediately.
complaints of nausea, fatigue, dizziness, irritability or euphoria. Workers can also
experience pain in their extremities (hands, feet, ears, etc), and severe shivering. Workers
should be moved to a heated shelter and seek medical advice when appropriate
What can be done for a person suffering from hypothermia?
 Call 911 immediately in an emergency; otherwise seek medical assistance as soon as
possible.
 Move the person to a warm, dry area.
 Remove wet clothes and replace with dry clothes, cover the body (including the head
and neck) with layers of blankets; and with a vapor barrier (e.g. tarp, garbage bag).
Do not cover the face.
 If medical help is more than 30 minutes away:
Give warm sweetened drinks if alert (no alcohol), to help increase the body
temperature. Never try to give a drink to an unconscious person.
Place warm bottles or hot packs in armpits, sides of chest, and groin. Call 911 for
additional re-warming instructions.
 If a person is not breathing or has no pulse:
Call 911 for emergency medical assistance immediately.
Treat the worker as per instructions for hypothermia, but be very careful and do not try to give
an unconscious person fluids.
Check him/her for signs of breathing and for a pulse. Check for 60 seconds.
If after 60 seconds the affected worker is not breathing and does not have a pulse, trained
workers may start rescue breaths for 3 minutes.
Recheck for breathing and pulse, check for 60 seconds.
If the worker is still not breathing and has no pulse, continue rescue breathing.
Only start chest compressions per the direction of the 911 operator or emergency medical
services*
Reassess patient’s physical status periodically.
 Safety Tips for Workers
Your employer should ensure that you know the symptoms of cold stress.
Monitor your physical condition and that of your coworkers.
Dress properly for the cold.
 Stay dry in the cold because moisture or dampness, e.g. from sweating, can increase the rate of heat
loss from the body.
Keep extra clothing (including underwear) handy in case you get wet and need to change.
Drink warm sweetened fluids (no alcohol).
Use proper engineering controls, safe work practices, and personal protective equipment (PPE)
provided by your employer

 Personal Protection

i)Clothing
Protective clothing is needed for work at or below 4°C. Clothing should be selected to
suit the temperature, weather conditions (e.g., wind speed, rain), the level and duration
of activity, and job design. Clothing should be worn in multiple layers which provide
better protection than a single thick garment. The air between layers of clothing provides
better insulation than the clothing itself. Having several layers also gives you the option
to open or remove a layer before you get too warm and start sweating or to add a layer
when you take a break. It also allows you to accommodate level of activity, changing
temperatures and weather conditions.
If the work area cannot be shielded against wind, an easily removable windbreak
garment should be used. Under extremely cold conditions, heated protective clothing
should be made available if the work cannot be done on a warmer day.
Cotton is not recommended. It tends to get damp or wet quickly, and loses its insulating
properties. Wool and synthetic fibres, on the other hand, do retain heat when wet.

ii)Footwear

Felt-lined, rubber bottomed, leather-topped boots with removable felt insoles are best
suited for heavy work in cold since leather is porous, allowing the boots to “breathe” and
let perspiration evaporate. Leather boots can be “waterproofed” with some products that
do not block the pores in the leather. However, if work involves standing in water or
slush (e.g., fire fighting, farming), the waterproof boots must be worn

iii)Socks

You may prefer to wear one pair of thick, bulky socks or two pairs - one inner sock of
silk, nylon, or thin wool and a slightly larger, thick outer sock. Liner socks made from
polypropylene will help keep feet dry and warmer by wicking sweat away from the skin.
However, as the outer sock becomes damper, its insulation properties decrease. If work
conditions permit, have extra socks available so you can dry your feet and change socks
during the day. If two pairs of socks are worn, the outer sock should be a larger size so
that the inner sock is not compressed.

iv)Face and Eye Protection

In extremely cold conditions, where face protection is used, eye protection must be
separated from the nose and mouth to prevent exhaled moisture from fogging and
frosting eye shields or glasses. Select protective eye wear that is appropriate for the work
 you are doing, and for protection against ultraviolet light from the sun, glare from the
snow, blowing snow/ice crystals, and high winds at cold temperatures.

1.31 ind Chill Index

 The Wind Chill Temperature (WCT) index uses advances in science, technology, and
computer modeling to provide an accurate, understandable, and useful formula for
calculating the dangers from winter winds and freezing temperatures. The index does the
following: 1.Calculates wind speed at an average height of 5 feet, the typical height of
an adult human face, based on readings from the national standard height of 33 feet,
typical height of an anemometer.
 Is based on a human face model
 Incorporates heat transfer theory based on heat loss from the body to its surroundings,
during cold and breezy/windy days
 Lowers the calm wind threshold to 3 mph
 Uses a consistent standard for skin tissue resistance
 Assumes no impact from the sun, i.e., clear night sky.

From the user, we are given an air temperature (T) and a wind speed (Winds fc ).
In order to calculate the Wind Chill, the temperature must be converted to degrees Fahrenheit (°F).
In order to calculate the Wind Chill, the wind speed must be converted to miles per hour (mph).
Then, the Wind Chill can be calculated using this formula:
WindChill = 35.74 + (0.6215 × T) − (35.75 × Windsfc 0.16 ) + (0.4275 × T × Windsfc 0.16 )
Because the user might need the Wind Chill in Watts per meter squared , it can ( W m2 ) be calculated using an
air temperature in degrees Celsius (°C) and a wind speed in meters per second :
( s m ) WindChill = (12.1452 + 11.6222 × 1.16222 Wind √ Windsfc − × sfc) × (33 − T)

For working populations, the American Conference of Governmental Industrial Hygienists (ACGIH) also
provide recommendations. These recommendations were developed to protect workers from the severest
effects of cold stress (hypothermia) and cold injury. The recommendations also describe exposures to cold
working conditions under which it is believed nearly all workers can be repeatedly exposed without adverse
health effects. Included in these recommendations is the following wind chill chart.
 1.32 control measures- hot environments
The risk of heat-related illnesses can be reduced by:
Engineering controls to provide a cooler workplace.
Safe work practices to reduce worker exposure.
Training employees to recognize and prevent heat illnesses.
Table 3 (below) provides a summary of these controls.
1Engineering Controls
Engineering controls are the most effective means of reducing excessive heat exposure. The
examples which follow illustrate some engineering approaches to reducing heat exposure.

Reducing Metabolic Heat Production (heat produced by the body): Automation

and mechanization of tasks minimize the need for heavy physical work and the
resulting buildup of body heat.
Reducing the Radiant Heat Emission from Hot Surfaces: Covering hot surfaces
with sheets of low emissivity material such as aluminum or paint that reduces the
amount of heat radiated from this hot surface into the workplace.
Insulating Hot Surfaces: Insulation reduces the heat exchange between the source of
heat and the work environment.
Shielding: Shields stop radiated heat from reaching work stations. Two types of
shields can be used. Stainless steel, aluminum or other bright metal surfaces reflect
heat back towards the source. Absorbent shields, such as a water-cooled jackets made
of black-surfaced aluminum, can effectively absorb and carry away heat.
Ventilation and Air Conditioning: Ventilation, localized air conditioning, and
cooled observation booths are commonly used to provide cool work stations. Cooled
observation booths allow workers to cool down after brief periods of intense heat
exposure while still allowing them to monitor equipment.
Reducing the Humidity: Air conditioning, dehumidification, and elimination of
open hot water baths, drains, and leaky steam valves help reduce humidity.

Summary of Control Measures

Methods of Control Actions

Engineering controls

Reduce body heat production Mechanize tasks.

Stop exposure to radiated heat from Insulate hot surfaces. Use reflective shields, aprons, remote controls.
hot objects

Reduce convective heat gain Lower air temperature. Increase air speed if air temperature below 35°C. Increase
ventilation. Provide cool observation booths.

Increase sweat evaporation Reduce humidity. Use a fan to increase air speed (movement).

Clothing Wear loose clothing that permits sweat evaporation but stops radiant heat. Use cooled
protective clothing for extreme conditions.

Administrative controls
 Summary of Control Measures

Methods of Control Actions

Acclimatization Allow sufficient acclimatization period before full workload.

Duration of work Shorten exposure time and use frequent rest breaks.
Rest area Provide cool (air-conditioned) rest-areas.

Water Provide cool drinking water.

Pace of Work If practical, allow workers to set their own pace of work.

First aid and medical care Define emergency procedures. Assign one person trained in first aid to
each work shift. Train workers in recognition of symptoms of heat
exposure.
 Salt and Fluid Supplements: A person working in a very hot environment loses water and salt through
sweat. This loss should be compensated by water and salt intake. Fluid intake should equal fluid loss.
On average, about one litre of water each hour may be required to replace the fluid loss. Plenty of cool
(10-15°C) drinking water should be available on the job site and workers should be encouraged to drink
water every 15 to 20 minutes even if they do not feel thirsty. Alcoholic drinks should NEVER be taken
as alcohol dehydrates the body.

 Sport drinks, fruit juice, etc: Drinks specially designed to replace body fluids and electrolytes may be
taken but for most people, they should be used in moderation. They may be of benefit for workers who
have very physically active occupations but keep in mind they may add unnecessary sugar or salt to
your diet. Fruit juice or sport and electrolyte drinks, diluted to half the strength with water, is an option.
Drinks with alcohol or caffeine should never be taken, as they dehydrate the body. For most people,
water is the most efficient fluid for re-hydration.
 Emergency Action Plan: In extreme environments, an emergency plan is needed. The plan should
include procedures for providing affected workers with first aid and medical care.
 Get medical aid.

Stay with the person until help arrives.

Move to a cooler, shaded location.
Remove as many clothes as possible (including socks and shoes).
Apply cool, wet cloths or ice to head, face or neck. Spray with cool water.
Encourage the person to drink water, clear juice, or a sports drink.

1.33 Thermal Comfort

 To have “thermal comfort” means that a person wearing a normal amount of clothing feels neither too
cold nor too warm. Thermal comfort is important both for one's well-being and for productivity.
 Temperature preferences vary greatly among individuals and there is no one temperature that can
satisfy everyone. Nevertheless, an office which is too warm makes its occupants feel tired; on the other
hand, one that is too cold causes the occupants' attention to drift, making them restless and easily
distracted.
 Maintaining constant thermal conditions in the offices is important. Even minor deviation from comfort
may be stressful and affect performance and safety. Workers already under stress are less tolerant of
uncomfortable conditions.
 Thermal comfort is determined by six factors:
 Metabolic rate (of the persons in the room): varies with the number of occupants, and the
amount of activity done by occupants (e.g., sitting in a restaurant versus serving the customers).
Clothing: varies by individual’s choices in clothing or by work requirements (e.g., chemical
protective clothing or rain gear).
Air temperature.
Radiant temperature: a complex term, but generally described as how the heat transfers between
the body and other objects in the area (e.g., radiation is the process by which the body gains
heat from surrounding hot objects, such as hot metal, furnaces or steam pipes, and loses heat to
cold objects, such as chilled metallic surfaces, without contact with them).
Air speed (velocity): the rate of air movement.
Humidity: a general description of the moisture content of the air.

 Thermal comfort also depends on the metabolic rates (activities being done), the clothing a person
wears, and radiant temperatures of other surfaces.
 Metabolic rate (activities) and clothing will vary from person to person, even if every person wears the
same clothing and performs the same activity. Where possible, allow individuals to have some control
over clothing options and pace of work.

1.44 heat stress indices,

Heat stress" is the "net [overall] heat load to which a worker may be exposed from the combined contributions
of metabolic heat, environmental factors (i.e., air temperature, humidity, air movement, and radiant heat), and
clothing requirements." Metabolic heat is the heat produced by the body through chemical processes, exercise,
hormone activity, digestion, etc.
Heat may come from many sources. For example:

In foundries, steel mills, bakeries, smelters, glass factories, and furnaces, extremely hot or molten
material is the main source of heat.
In outdoor occupations, such as construction, road repair, open-pit mining and agriculture, summer
sunshine is the main source of heat.
In laundries, restaurant kitchens, and canneries, high humidity adds to the heat burden.

1.45 Heat Stress Indices

 The heat stress index is defined as the relation of the amount of evaporation (or perspiration) required
as related to the maximum ability of the average person to perspire (or evaporate fluids from the body
in order to cool themselves). When the heat stress index is high, humans can experience heat stress,
which can lead to particularly dangerous conditions in which people can actually die from being too
warm and unable to cool themselves properly. Severe dehydration and even death can result from
overexposure when the heat stress index is high.
 Understanding the heat stress index and having a portable meter to measure it while you are outdoors is
the key to preventing these types of deaths and overexposure. Knowing the heat stress index can help
to prevent fatigue, heat cramps, exhaustion and in some cases, even death. In addition to careful
monitoring of the heat stress index, staying hydrated and taking frequent breaks in the shade or in a
cooler indoor area can help to prevent injuries and fatalities related to the sun. Look for signs of heat
emergencies in yourself and in others when working or training outdoors during times when the heat
stress index is high. Excessive flushing of the skin, dizziness, confusion and fainting are all signs that a
person needs to immediately seek shade and hydration.
 It’s important for those who work with athletes and those who manage outdoor work sites to track the
heat index every day, throughout the day, in order to ensure the safety of others who are onsite. When
working outdoors can’t be avoided, set up a cooling area where individuals can take breaks and
 rehydrate. Possible risk factors for heat stress due to a high heat stress index include obesity, high
blood pressure, dehydration and alcohol consumption. For those who fall into any of those categories,
increased hydration and more frequent breaks may be needed in order to avoid heat stress issues.
 By allowing plenty of breaks and fluids throughout the day, and by avoiding work when both the sun
and heat stress index are at their highest, site managers, coaches, parents, and supervisors can ensure
that they are taking the proper precautions when it comes to be outdoors in hot weather.
1.46 Acclimatization
 is the process in which an individual organism adjusts to a change in its environment (such as a change
in altitude, temperature, humidity, photoperiod, or pH), allowing it to maintain performance across a
range of environmental conditions.
 Acclimatization occurs in a short period of time (hours to weeks), and within the organism's lifetime
(compared to adaptation, which is a development that takes place over many generations). This may be
a discrete occurrence (for example, when mountaineers acclimate to high altitude over hours or days) or
may instead represent part of a periodic cycle, such as a mammal shedding heavy winter fur in favor of
a lighter summer coat. Organisms can adjust their morphological, behavioral, physical, and/or
biochemical traits in response to changes in their environment.

 Methods
Biochemical
In order to maintain performance across a range of environmental conditions, there are several strategies
organisms use to acclimate. In response to changes in temperature, organisms can change the biochemistry
of cell membranes making them more fluid in cold temperatures and less fluid in warm temperatures by
increasing the number of membrane proteins.[8] Organisms may also express specific proteins called heat shock
proteins that may act as molecular chaperons and help the cell maintain function under periods of extreme
stress. It has been shown, that organisms which are acclimated to high or low temperatures display relatively
high resting levels of heat shock proteins so that when they are exposed to even more extreme temperatures the
proteins are readily available. Expression of heat shock proteins and regulation of membrane fluidity are just
two of many biochemical methods organisms use to acclimate to novel environments. Note: acclimation and
acclimatization are two very different terms that are not interchangeable. Acclimation is used under laboratory
conditions, while acclimatization is "in the field" or in nature.[9]
Morphological
Organisms are able to change several characteristics relating to their morphology in order to maintain
performance in novel environments. Examples may include changing of skin color or pattern to allow for
efficient thermoregulation, or a change in body size of offspring as a result of low food levels in the ecosystem.
1.47 Estimation And Control
Heat stress is a major occupational problem in India that can cause adverse health effects and reduce work
productivity. Estimation plays a critical role in modern diagnosis and control systems for heat stress. Early
detection of changes in industrial process can be used to plan or to choose a suitable control policy. These
changes are typically very subtle. They depend on operating conditions and on complex interactions of many
discrete and continuous variables. It is often difficult for a human operator to evaluate or diagnose the process
continuous.

Unit II
CHEMICAL HAZARDS.
2.1 Recognition of chemical hazards-dust, fumes, mist, vapor, fog, gases.
 Chemicals can affect your health by entering your body through breathing (e.g. dusts or pesticide
sprays), through skin absorption (e.g. some solvents such as kerosene or petrol) or through ingestion
(e.g. by eating or drinking the chemical).
 Chemical burns of the skin and, possibly, the subcutaneous tissue may result from contact with strong
alkalis or acid. Chemical eye injuries and possibly corneal opacities may be caused by corrosive gases,
mists or dusts.
A mist: is a suspension of liquid in any gas such as a fine spray. Most commonly, it is a natural phenomenon
of small water droplets suspended in the air. In the context of health and safety, mist is the suspension of
chemicals and combustible liquids in the air, especially those possess threats to human health and safety. A
classic example of mist is an aerosol spray.
Vapor: is the gaseous state of a substance that is either liquid or solid before it reaches its critical point. It may
be visible and described as fog, mist, smoke or fumes. Vapors from hazardous chemicals in the workplace pose
a threat to the health of workers. In addition, many substances that are not combustible while they are in their
original liquid or solid form may catch fire when they are in vapor form.
 Vapor is produced in a vaporization process where solid or liquid substances transform to gaseous state,
generally as a result of changes in pressure or temperature. Generally, if the temperature is gradually
increased, most substances change state from solid to liquid and then to vapor or gas. However, some
substances may also transform directly from solid to vapour or gas. This can cause issues like fire or
explosion depending on the chemical.
Dust: in the context of occupational health and safety, refers to suspended organic or inorganic particles in the
atmosphere. Some types of dust, such as those from chemicals, irritants or allergens, can have negative health
effects.
Fog: Anti-fog safety glasses are glasses with a special coating on the lens that reduces fogging by preventing
condensation of water on the surface. They protect workers' eyes and allow them to work without obstructed
vision from fogged-up lenses.
Exposure Vs. Dose:
 Exposure rate is the amount of ionizing radiation per hour in a person’s vicinity (measured in milli Roentgen
per hour, mR/h).
 Dose rate is the biological effect on the body from exposure to that radiation (measured in nano Sieverts per
hour, nSv/h). As an approximation, a radiological dose rate of 1 mR/h is roughly equal to an exposure rate of
10,000nSv/h.

TLV: The threshold limit value (TLV) of a chemical substance is believed to be a level to which a worker can
be exposed day after day for a working lifetime without adverse effects. Strictly speaking, TLV is a reserved
term of the American Conference of Governmental Industrial Hygienists (ACGIH).

Methods of Evaluation.
What is Field survey?
Collection and gathering of information at the local level by conducting primary surveys is called field survey. The
primary surveys are also called field surveys. They are an essential component of geographic enquiry.
It is a basic procedure to understand the earth as a home of humankind. It is carried out through observation, sketching,
measurement, interviews, etc.

Why is Field Survey Required?

i. Geography is a field science, thus, a geographical enquiry always needed to be supplemented through well –planned
field surveys.
ii. These surveys enhance our understanding about patterns of spatial distributions, their associations and relationships
at the local level.
iii. Further, the field surveys facilitate the collection of local level information that is not available through secondary
sources.
iv. Field surveys are required so that the problem under investigation is studied in depth as per the predefined
objectives.
v. It helps in comprehending the situation and processes in totality and at the place of their occurrence.
vi. Field Survey Procedure Steps:
Step 1. Defining the Problem: First the problem to be studied is defined precisely by statements indicating the
nature of the problem. The problem is the title and sub-title of the topic of the survey.
Step 2. Objectives: Objectives and purposes of the survey are outlined and in accordance to these, suitable tools of
acquisition of data and methods of analysis will be chosen.
Step 3. Scope: Scope of survey is the geographical area studied, time period of enquiry and if required themes of
studies to be covered are defined.
Step 4. Tools and Techniques of information collection: Various types of tools are required to collect information.
These include:
i. Recorded and Published Data: from government agencies are collected and these provide base
information about the problem. For example: Election Office can provide information about
households, persons. Similarly, physical features like relief, drainage, vegetation, land use, etc. can
be traced out from the topographical maps.
ii. Field Observation is very necessary to find the characteristics and associations of geographic
phenomena. Sketching and photography are helpful tools.
iii. Measurement: Some of field surveys demand on site measurement of objects and events. It
involves use of appropriate equipments.
iv. Interviewing: In all field surveys, personal interviews are needed to gather information about social
issues through recording the experiences and knowledge of each individual.
Step 5. Compilation and Computation: Information collected is organized for their meaningful interpretation and
analysis to achieve the set objectives. Notes, field sketches, photographs, case studies, etc. are first organized
according to subthemes of the study. Similarly, questionnaire and schedule based information are tabulated on the
spreadsheet.
Step 6. Cartographic Applications: Maps and diagrams are used for giving visual impressions of variations in the
phenomena.
Step 7. Presentations: The field study report is prepared in concise form and it contains all the details of the
procedures followed, methods, tools and techniques employed. At the end of the report, the summary of the
investigation is provided.

Sampling Methodology:
Sampling and analysis: Refer to the representative collection, detection, identification, and measurement of
agents found in environmental matrices such as air, water, and soil. In occupational and non occupational
environments, both indoors and outdoors, air is sampled (collected) to detect and identify physical, chemical,
and biological agents and to measure related levels. The most common matrix that is sampled and analyzed in
the occupational environment is the air.The data collected and analyzed are used to evaluate both actual and potential
external exposures to agents encountered by humans.
(i) Instantaneous or Real-Time Sampling
Instantaneous sampling refers to the collection of a sample for a relatively short period ranging from seconds
to typically less than 10 min. A major advantage of instantaneous sampling is that both sample collection and
analysis are provided immediately via direct readout from the sampling device. The data represent the level of
an agent at the specific time of sampling. Accordingly, instantaneous sampling is also referred to as direct
reading and real-time sampling. Real-time a more appropriate designation since there are some devices already
developed and being designed for integrated or continuous monitoring In addition, the main purpose of real-
time sampling is to reveal what a level of an agent is, at an immediate point of time or during real-time.
(ii) Integrated or Continuous Sampling Integrated sampling refers to the collection of a sample continuously
over a prolonged period ranging from more than 10 or 15 min to typically several hours. Integrated sampling is
also referred to as continuous monitoring reflective of the extended period of sample collection. Most work
shifts are 8 h and occupational exposure limits are most commonly based on an 8-h exposure period.
Accordingly, it is very common as well for sampling to cover the duration of the shift. Several strategies can
be followed.
The level of an agent can be determined during discrete times and locations within a workshift to assist in
identifying factors that influence elevated values of exposure or external exposure.

Calculation :Concentration (C) and corresponding sample time (T) data from one sample (C) or several
individual samples (C to C) can be time-weighted (C¥T) and averaged, by dividing by a specific time period
(e.g., 8 h), to provide a single overall TWA for the 8-h shift:

(iii) Personal Sampling

Personal sampling involves direct connection of an integrated monitoring device to a worker. The
device, in turn, will collect a sample or record the intensity of an agent in the specific area sand during
specific tasks conducted by a worker. Indeed, personal sampling is frequently a form of mobile
monitoring since the sampling device travels to the same areas and at the same times as the worker that
wears it.
If inhalation is the mode and the respiratory system the route of entry of an agent, the sampling device
or related sampling medium is positioned in the worker’s breathing zone. The breathing zone refers to
an area within a 9- to 12-in. distance (radius) from the worker’s nose and mouth.
(iv) Area Sampling
The focus of area sampling is to evaluate the levels of agents in a specific location, instead of
evaluating levels encountered by a specific worker. Area integrated monitoring devices are typically
positioned in a stationary location (Figure 1.3a). Stationary area integrated samples are often collected
at a height of approximately 4 ft from the floor or ground. The data from a stationary area integrated
sample represent the level of an agent in the specific area during the sampling period. Area
instantaneous or real-time monitoring, however, involves area sampling in either a stationary or mobile
mode,
(v) Active Flow Sampling
Presently, most monitoring techniques for actual collection of an air sample or contaminant from the air
involve active flow methods. Active flow sampling implies that energy, such as an electronically
powered (either AC or DC) device, is required to collect the sample. Air and airborne contaminants are
actively pulled through a collection medium or into a collection container.
(vi) Passive Flow Sampling
Passive flow sampling implies that neither electrical nor manual energy is required to operate the air
sampling device. The method applies to the collection of diffusible gases and vapors; collection of
settling particulates; measurement of temperature, pressure, and humidity; and the detection and
measurement of forms of ionizing and non ionizing radiation. In the case of gases and vapors,
collection using a passive monitor or dosimeter (if used for personal monitoring) relies on the
movement (diffusion) of a gas or vapor from an area of relative high concentration, such as the air, to
an area of relatively low concentration, the passive monitor.
(vii) Surface Sampling
Surfaces that are potentially or suspected to be contaminated with a toxic or pathogenic agent are
sampled. Moistened or pre-treated cellulose (paper) sheets (wipes) and sponge-cotton-tipped swabs are
commonly used to collect a sample from a surface. The media are then analyzed for the contaminant of
interest. Surface sampling is also referred to as wipe or swab sampling.
(viii) Bulk Sampling
Bulk sampling refers to collection of a representative portion of a matrix. For example, there are times
when actual collection of the air, not simply the contaminant separated from the air, is warranted.
Accordingly, a special glass or metal cylinder or plastic bag (e.g., Mylar) may be used to collect a bulk
sample of air.
(ix) Grab Sampling
Grab sampling refers to collection of a sample at a specific location and specific time. Thus, real-time
sampling is a form of grab sampling the air. The method, however, also can pertain to the random
collection of samples without regard to a specific time or location.
Industrial Hygiene calculations

Air Sampling Types,

Air Sampling Methods
Air sampling methods vary according to the contaminants you’re testing for. The most common types of
air sampling methods include the following:
Whole air sampling
Solid sorbent sampling (Active)
Solid sorbent sampling (Passive)
Impinger sampling
Filter sampling
In this post we will go over each of those air sampling methods in detail so you’ll know the correct way to
gather a sample depending on what kind of air quality testing you’ll be doing.
The 5 Types of Air Sampling Methods
Whole Air Sampling
This is the most simple of all air sampling methods. It involves collecting a whole air sample in a sample
bag or can. This method is perfectly acceptable for sampling permanent gases, such as oxygen.
The difficulty with this sampling method is that the holding time for bag samples is only around 1 to 3
days. That means a sample would need to be rushed to the laboratory immediately upon collecting the
sample to ensure best results.
Solid Sorbent Sampling (Active)
This method of air sampling involves drawing air through a tube filled with solid sorbent material. Any
contaminants that may be in the air are chemically absorbed within the material inside the tube.
It’s important to note that this is not a catch-all solution. There is no sorbent material designed to capture
all types of air contaminants at once. However, there are numerous types of sorbent materials available for
capturing the particular chemical or class of chemicals you’re testing for.
Solid Sorbent Sampling (Passive)
Select sorbent material can be used in passive mode. The difference between active and passive is that
passive mode means the contaminants are absorbed into the sorbent material via diffusion. Active mode
means having to actively pull the air through the sorbent material with a pump.
Passive sorbent sampling has a few advantages over active sampling. It is discreet, the sampling material
is easy to work with, and it’s a method that can be used for long-term sampling.
Investigating odors and ambient air perimeter (“fence line”) monitoring can be accomplished especially
well with passive solid sorbent sampling.
Impinger Sampling
Liquid impingers can be used to sample certain contaminants in the air. This method is very similar to
active solid sorbent sampling in the sense that it works by having contaminants chemically react with a
solution as a sample of air is bubbled through the liquid.
This method of air sampling is not as commonly used as it once was, there are now many alternative
methods which use treated sorbent tubes instead of impingers.
Filter Sampling
This method of air sampling is designed for collecting contaminants in the form of vapors. Collecting
contaminants in the vapor phase involves using chemically treated filter material designed to cause a
reaction when the contaminant you’re testing for passes through it.
This method is also similar to active sorbent sampling, in the sense that filter sampling involves using a
sampling pump to pull a known volume of air through a filter cassette
 Air Sampling Instruments,
Direct-Reading Instruments
 Direct-reading instruments were developed as early warning devices for use in industrial settings,
where a leak or an accident could release a high concentration of a known chemical into the
ambient atmosphere. Today, some direct-reading instruments can detect contaminants in
concentrations down to one part contaminant per million parts of air (ppm), although quantitative
data are difficult to obtain when multiple contaminants are present. Unlike air sampling devices,
which are used to collect samples for subsequent analysis in a laboratory, direct reading
instruments provide information at the time of sampling, enabling rapid decision-making.
 Direct-reading instruments may be used to rapidly detect flammable or explosive atmospheres,
oxygen deficiency, certain gases and vapors, and ionizing radiation. They are the primary tools of
initial site characterization. The information provided by direct-reading instruments can be used to
institute appropriate protective measures (e.g., personal protective equipment, evacuation), to
determine the most appropriate equipment for further monitoring, and to develop optimum
sampling and analytical protocols.
 All direct-reading instruments have inherent constraints in their ability to detect hazards:
· They usually detect and/or measure only specific classes of chemicals.
· Generally, they are not designed to measure and/or detect airborne concentrations below 1
ppm.
· Many of the direct-reading instruments that have been designed to detect one particular
substance also detect other substances (interference) and, consequently, may give false
readings.
 It is imperative that direct-reading instruments be operated, and their data interpreted, by qualified
individuals who are thoroughly familiar with the particular device's operating principles and
limitations and who have obtained the device's latest operating instructions and calibration curves.
At hazardous waste sites, where unknown and multiple contaminants are the rule rather than the
exception, instrument readings should be interpreted conservatively.
 The following guidelines may facilitate accurate recording and interpretation:
· Calibrate instruments according to the manufacturer's instructions before and after every
use.
· Develop chemical response curves if these are not provided by the instrument manufacturer.
· Remember that the instrument's readings have limited value where contaminants are
unknown. When recording readings of unknown contaminants, report them as "needle
deflection" or "positive instrument response" rather than specific concentrations (i.e., ppm).
Conduct additional monitoring at any location where a positive response occurs.
· A reading of zero should be reported as "no instrument response" rather than "clean"
because quantities of chemicals may be present that are not detectable by the instrument. ·
The survey should be repeated with several detection systems to maximize the number of
chemicals detected.

Laboratory Analysis :
 Direct-reading personal monitors are available for only a few specific substances and are rarely
sensitive enough to measure the minute (i.e., parts of contaminant per billion parts of air) quantities
of contaminants which may, nevertheless induce health changes. Thus to detect relatively low-level
concentrations of contaminants, long-term or "full-shift" personal air samples must be analyzed in a
laboratory. Full-shift air samples for some chemicals may be collected with passive dosimeters, or
by means of a pump which draws air through a filter or sorbent. Table 7-3 lists some sampling and
analytical techniques used at hazardous waste sites.
 Selection of the appropriate sampling media largely depends on the physical state of the
contaminants. For example, chemicals such as PCBs (polychlorinated biphenyls) and PNAs (poly
 nuclear aromatic hydrocarbons) occur as both vapors and particulate-bound contaminants. A dual-
media system is needed to measure both forms of these substances. The volatile component is
collected on a solid adsorbent and the nonvolatile component is collected on a filter. More than two
dozen dual-media sampling techniques have been evaluated by NIOSH .
 A major disadvantage of long-term air monitoring is the time required to obtain data. The time lag
between sampling and obtaining the analysis results may be a matter of hours, if an onsite
laboratory is available, or days, weeks, even months, if a remote laboratory is involved. This can be
significant problem if the situation requires immediate decisions concerning worker safety.
 Also, by the time samples are returned from a remote laboratory, the hazardous waste site cleanup
may have progressed to a different stage or to a location at which different contaminants or
different concentrations may exist. Careful planning and/or the use of a mobile laboratory on site
may alleviate these problems.
 Mobile laboratories may be brought on site to classify hazardous wastes for disposal. A mobile
laboratory is generally a trailer truck that houses analytical instruments capable of rapidly
classifying contaminants by a variety of techniques. Typical instruments include gas
chromatographs, spectro fluoro meters, and infrared spectrophotometers. When not in use in the
mobile laboratory, these devices can be relocated to fixed-base facilities. Onsite laboratory facilities
and practices should meet standards of good laboratory safety. Usually, a few of the field samples
collected are analyzed on site to provide rapid estimates of the concentration of airborne
contaminants.
 These data can be used to determine the initial level of worker personal protection necessary to modify
field sampling procedures and to guide the fixedbase laboratory analysis. If necessary, samples screened in the
mobile laboratory can be subsequently reanalyzed in sophisticated fixed-base laboratories. The mobile
laboratory also provides storage space, countertop staging areas for industrial hygiene equipment, and facilities
for recharging self contained breathing apparatus.
The Four Steps of gas and vapor moitoring :
The important considerations to make when establishing a hazardous gas detection system are:
 Select the proper sensor.
 Understand what will happen when a gas leak occurs.
 Install the sensor correctly.
 Connect sensors to an alarm system.
Properly following these four steps will result in a dependable detection system.
Step 1 - Selecting the Proper Sensor
The sensors used in area monitoring applications are typically “diffusion” in design. This means that the sensor does not
employ an active sampling system that draws the sample to the sensor, but instead relies on diffusion and convection to
obtain the sample. That is, the gas will mix with ambient air and diffuse through the sensor’s flame arrestor without the
use of a pump or aspirator.
The appropriate sensor to use in any application depends upon the gas or gases to be measured, the background gases
present, and the conditions around the sensor location. Flammable hazards are measured in the 0-100% Lower
Flammable Limit (LFL or LEL) range. Toxic hazards are measured in the low Parts Per Million range. Several sensor
technologies are available in diffusion designs: catalytic and infrared (IR) sensors for LFL range monitoring of
flammable gases; and electrochemical and solid state sensors for PPM monitoring.
Catalytic Sensors
Catalytic sensors are appropriate for detecting flammable gases and vapors in the LFL range. When a flammable gas
enters the sensor, it reacts with a catalyst coated electrical coil. The resulting resistance change offsets the balance of a
Wheatstone Bridge circuit. The output signal is proportional to the concentration of flammable gas. Catalytic sensors
have numerous strengths, including low cost, long-life, and simplicity of design. But they can be affected by “catalytic
poisons” which coat or corrode the sensor’s catalyst, such as silicones, plasticizers and sulfur compounds.
Infrared Sensors
The infrared sensor (point IR) has proven useful in monitoring methane in the LFL range. The point IR sensor’s chief
advantage over the catalytic sensor is that it is not subject to catalytic poisons such as hydrogen sulfide. Because it is an
optical device, however, care must be taken to prevent fouling of the optics. Its usefulness in LFL monitoring of gases
other than methane is limited to applications where gas mixtures and background interference are not issues.
Electrochemical Sensors
Electrochemical sensors are excellent for detecting low parts-per-million concentrations of a select gas. The
electrochemical sensor contains an electrolyte that reacts with a specific gas. The reaction produces an output signal that
is proportional to the amount of gas present. Electrochemical sensors exist for gases such as carbon monoxide, hydrogen
sulfide, and hydrogen. The number of gases that can be detected using this technology is relatively small, but is
increasing from year to year. These sensors cannot be used to measure hydrocarbons.
Solid State sensors
Solid State sensors, typically a tin oxide semiconductor, respond to gases by changing resistance. Solid state sensors are
used to measure numerous gases in the parts per million range. They are relatively low in cost and have a long operating
life. However, solid state sensors have low selectivity: background gases can create inaccurate readings. Also, the
sensor’s output signal is non-linear, which makes calibration more complicated.

Step 2 - Understanding What Happens During A Gas Leak

Dispersion Characteristics of Gases
When a gas leak occurs, the gas tends to disperse into the atmosphere based on its physical characteristics—most
importantly, its vapor density. The diffusion rate of a gas into air is proportional to their respective densities. Hydrogen,
for example, which has a much lighter density than air, will diffuse very rapidly into the air. The resulting hydrogen in
air mixture has a density lighter than the surrounding air; therefore convection currents lift the mixture in a manner
similar to smoke rising from a cigarette in an ashtray.
For gases denser than air, the inverse is true. Most of the gases heavier than air are generated by liquids and are referred
to as vapors. Gases with a density greater than air tend to settle along the ground or into a pit. Gases with densities very
close to air do not diffuse much and tend to follow local air currents.
Understanding Air Movement
In many cases, the movement of air is the greatest force in the dispersion of gas. When locating sensors, careful thought
must be given not just to the density of the gas but also to prevailing air flow. In some cases, it may be necessary to
locate sensors counter-intuitively.
Understanding Temperature Effects
In addition to density and air flow, temperature can also affect the dispersion of leaking gas. Most importantly, it can
change the way a gas might normally behave. If the temperature of the air at the ceiling is much hotter than the room air,
the ceiling air will have a lighter density (hot air rises). This “thermal barrier” may slow down the diffusion of the
leaking gas enough to delay or prevent detection at the sensor.
Also, many lighter-than-air gases are stored as compressed liquids. When these gases escape into the atmosphere, their
density may at first be heavier-than-air until they are warmed by the ambient temperature and become lighter than-air.
Understanding Dilution Effects
Figure 10 illustrates the dilution effect that occurs when several rooms are monitored by a single sensor placed in the
ventilation system. If the air volume moving through each room is roughly the same, a hazardous concentration in one
room would be diluted to one-third of its true value (at A) because of the air movement from the other two rooms.
Outdoor Monitoring Concerns
When locating sensors in outdoor applications, careful consideration must be given to prevailing wind conditions. It may
be necessary to monitor a single hazard (such as a storage tank) using several sensors (figure 11) so that an accidental
leak can be detected regardless of wind direction at the time of the leak (figure 12).
When monitoring gases and vapors in outdoor applications, wind and weather become of particular concern. The
equipment may be subjected to very hot and very cold temperatures in the course of the year, and may even experience
large shifts in temperature from daytime to nighttime. Equipment will be exposed to rain, snow, ice, dust and dirt. For
outdoor applications, a rugged, robust instrument and sensor are essential.
Also, it is important that the sensor always points down or at least never points above horizontal, to prevent rain from
entering the cell. When monitoring pump seals, pressure vessels, flanges, etc., it is possible to use hoods, tubing, or small
ducts to direct the escaping vapor toward the sensor.

Step 3 - Installing the Sensor Properly

Proper installation is the key to success
Installation is the most important aspect of the gas detection system. Just as an improperly installed seat belt will not
protect a driver, an improperly-installed gas detection system will not protect people and property from harm.
Calibration
All of the sensors mentioned in this Application Note require routine calibration in order to function properly.
Installation is not complete until the system has been installed, allowed to warm up and stabilize, and been calibrated.
Both the Zero and Span response of the sensor must be checked before putting the system into operation. Typically, clean
bottled air (or, in some cases, room air) is used to set the Zero. A known concentration of test gas must be used to set the
Span.
Sensor Quantity
There are no published guidelines or standards indicating the volume or area effectively protected by a diffusion gas leak
sensor. In fire protection, where diffusion smoke detectors are used, Underwriters Laboratories suggest a 900 square foot
ceiling space or less per detector. While this smoke detector guideline is helpful, it does not directly apply to gas
detectors. Lacking set rules based on area or volume, the total number of sensors required must be determined by
considering actual conditions, especially those highlighted in Step 2 – Dispersion Characteristics of Gases.
Once the approximate sensor location is defined, final placement should consider the concept of early warning. Early
warning is accomplished by placing the sensor near the most probable gas leak point while at the same time maintaining
overall coverage of the entire area. Early warning means that a gas leak will reach the sensor and cause an alarm before
the gas disperses into the entire protected volume.
In many instances, more than one sensor may be needed to monitor a single hazard. Each SmartMaxII continuously
monitors the readings from as many as four independent sensors. Sharing the SmartMaxII with more than one sensor
allows you to dramatically lower the cost of your gas detection system three ways: there is less equipment to buy, less
equipment to install, and less equipment to maintain. In many applications, costs can be cut as much as fifty percent.

Step 4 - Connecting to an Alarm System

Alarm Action
The sensors must be connected to a controller that is capable of producing alarms. All gas detection systems require three
levels of alarm. The first alarm level should provide early warning of a developing hazard and notify supervisory
personnel to initiate corrective actions. The second alarm level must warn personnel and automatically stop the process
or the flow of gas. If stopping the process is not feasible, then some action must be taken to control the hazard (for
example, a water deluge or curtain to confine the flow of vapor). The third type of alarm will warn operators of
malfunctions, loss of signal, loss of power to the system, or communication errors. Malfunction alarms should be
connected to either the Warning or Danger alarms so that corrective actions are taken as soon as possible.
Relays
The SmartMaxII includes three internal relays that can be programmed to activate external horns and lights—and to
indicate when the system is undergoing calibration. Built-in relays provide maximum safety and ensure that critical
alarms are initiated directly by the sensor. Direct action is more reliable than the use of a secondary device or an
intermediary connection.
Output Signals
The SmartMaxII is equipped with both a 4-20mA analog output and an RS-485 Modbus digital I/O port. This means that
you can easily transfer readings to your PLC, plant-wide data acquisition system or process control system. The digital
port also allows you to access and control many sensors from any PC or laptop, either directly or through a modem.

Dust sample collection devices

Gravimetric Dust Sampler :
Provides time-weighted-average respirable dust concentration
Dorr-Oliver cyclone separates respirable and oversize dust
Pump operated at 1.7 liters per minute in M/NM mines
Sampling with Gravimetric Samplers :
Filter is pre- and post-weighed to determine mass
gain and is used to calculate an average dust
concentration over sampling period .
Filter processed using XRD analytical technique
for silica content (NIOSH Method 7500)
Sufficient mass must be collected to have confidence in measurement
personalDataRAM (pDR)
Model 1000 AN passive sampler
Uses light scattering as measurement technology
Instantaneous readings correlated with time and
stored in internal memory.
pDR concentrations impacted by:
–size distribution of dust
–composition of dust
–water mist in air
OMSHR adjusts readings with ratio obtained from adjacent gravimetric samplers
Personal Dust Monitor (PDM)
Real-time measurement of respirable dust
Combines dust sampler and cap lamp into one unit
Sample inlet is mounted on cap lamp
Uses mass-based measurement to quantify dust concentration (TEOM)
Dust measurements are displayed on screen and stored internally for
later analysis
Principle of Operation
Exchangeable filter cartridge mounted on the
end of the tapered element collects particles as
sample stream flows through hollow tube
Tapered element oscillates at a known frequency, like a tuning fork
Frequency changes in direct relation to the mass collected on the filter
Measurement principle does not respond to other particle
characteristics such as size distribution or composition
(heated circuit removes moisture)

Real-time Data to Quantify Dust Sources for Mobile Workers

•Evaluate work tasks and associated dust
levels for mobile workers throughout their shift
•Merge active pDR 1500 sampling data and
video (Helmet Cam) to quantify highest
sources of dust generation for different tasks
•Develop controls and/or improved work
 practices to reduce mobile workers’ dust exposure.

Personal Sampling Methods of Control

- Engineering Control.
a. Wet method
b. Proper ventilaltion.
c. Portable Tool with dust exhaust
d. Control by Ventilation: Tuckpointing
e. Usage Substitute Abrasives with lesser dust
f. Alternate Abrasive Methods: Wet Blasting

Process/Exposure source Engineering control Additional procedural control

(i) Check controls are used

Cleaning with solvent on rag (i) Use a rag holder (ii) Safe disposal of waste

(ii) Provide a small bin with a lid for used

rags.
Dust spills from damaged Portable vacuum cleaners with HEPA filter (i) Ensure vacuum is maintained and available for
sacks use
(ii) Safe emptying of vacuum cleaner
Cutting-fluid mist from a lathe Put an enclosure around the lathe and (i) Train workers (e.g. It takes time for the mist to
extract and filter the air and discharge to a clear from the enclosures and this clearance time
safe place must be known)
(Protective gloves will also be required) (ii) Check and maintain fluid quality
(iii) Test and maintain controls
(iv) Carry out health checks
Dust from disc cutter on (i) Carry out the process in an enclosure (i) Test and maintain controls
stone worktop fitted with extraction, filter and extract to a
(ii) Train workers
safe place
(iii) Carry out health checks
Transfer of volatile liquids (i) Pumping rather than pouring Regular checks and maintenance (e.g. Check for
damage to lids seals)
(ii) Tight fitting lids to minimise evaporation
Evaporation of liquid from an A layer of plastic balls floating on the Check and maintain controls
electroplating tank surface to reduce both evaporation and
mists

Non-ventilation engineering controls

Non-ventilation controls have the capability to reduce or eliminate process emission rate, for example the use
of well fitting lids to liquid containers. They can range from enclosures, seals, jigs and handling aids. However,
engineering controls are frequently assumed to involve some form of ventilation control. This is unfortunate,
as whilst ventilation controls can be effective and are the most commonly applied control to airborne
contaminates, dismissing other non-ventilation engineering controls can be a costly mistake both in terms of
financial and health cost.
There is probably no single reason why non-ventilation methods of control are overlooked, but perhaps the
two main reasons are (i) the perceived need to alter the process and the potential ramifications this entails,
whereas ventilation is often seen as something that can be retrofitted to any process, with little or no process
modification. The reality is that this approach often leads to poor and erratic control. Designing a ventilation
system to effectively control airborne contaminants requires specialist advice. All too often ventilation systems
are badly designed and installed, poorly maintained and therefore frequently fails to provide adequate control;
(ii) Ventilation is seen as a low cost option, which is not true. As well as the capital cost required to buy and
install a ventilation system there are associated running costs. The latter includes power (required to drive the
air mover plus that required to heat/cool air that is brought into the workplace to replace the air extracted) and
the maintenance costs, such as replacement filter units.
Ventilation
Unlike non-ventilation control, ventilation is unlikely to affect the emission rate from a process; rather it is
designed to control the contaminant once it has been released.
As mentioned in Section 4.1, ventilation controls are probably the most widely used method to control
airborne contaminants in the workplace and can be divided in to two types: general ventilation and local
exhaust ventilation.
General Ventilation
General ventilation is the introduction of clean air into the workplace that eventually replaces the
contaminated air. General ventilation can be subdivided into two further types: dilution ventilation and
displacement ventilation.
The aim of dilution ventilation is to uniformly mix the clean air that is continually introduced in to the workplace
with the contaminated air in order to dilute the contaminant concentration to an acceptable level. Whilst this is
an accepted form of engineering control, its application is limited to low toxicity sources that are usually
diffused throughout the workplace and where the workers are a sufficient distance from the source(s).
Displacement ventilation is where air is introduced with the aim of replacing the contaminated air by clean air
with little or no mixing. In practice this is difficult to achieve, particularly over large areas and therefore needs
specialist assistance. Both of the above types of general ventilation tend to use a significant amount of air,
which usually needs to be heated or cooled; consequently this type of ventilation is an expensive solution.
Local Exhaust Ventilation
Local Exhaust Ventilation (LEV) is designed to capture, receive or contain the airborne contaminant at source
before it has chance to enter the workers breathing zone or mix with the workplace air. As the control is
applied as close to the source as possible, considerably less air is required when compared to general
ventilation and consequently LEV is typically more effective in both terms of effectiveness and cost. For this
reason LEV is preferred to general ventilation and should be considered to be higher in the hierarchy of
controls.
Design maintenance considerations
Design considerations
Whilst elimination or substitution of the chemical hazard is the most effective solution, it is
recognised that this is not always possible or straightforward. Often the process relies on the
chemical in question and therefore elimination or substitution will not be an option. Consequently
engineering controls are applied that either:
• Reduce the emission rate from a process, usually by process modification (non-ventilation
controls); or • Capture or containment of the emission once it has been released from the process,
usually by enclosing and air extraction (ventilation controls).
An example of reducing the contaminate emission rate is by the application of water to a stone
cutting disk. This significantly reduces the emission of dust, creating instead liquid slurry. It
should be noted in this example disposal of the liquid slurry may create a further hazard. An
example of removal of the contaminant once it has been generated would be by the application of
local exhaust ventilation. This would be achieved by enclosing the process as much as possible
and extracting the airborne contaminant with a relatively low volume, high velocity extraction
system. Interestingly these two forms of engineering control have similar effectiveness [6].
The examples above illustrate that there is always more than one engineering control approach that
can be applied to any process and therefore it is important that the various engineering controls are
collated and their suitability assessed before a solution is selected. When assessing the controls the
following need to be considered:
• Effectiveness
• Reliability
• Ease of use, and of course
• Financial cost.
Estimating the effectiveness of a control measure is not always easy and can easily be misjudged.
Figure 1 illustrates simply that as potential exposure risk increases, the control effectiveness must
also increase. Failure to do so results in what is often referred to as the ‘control gap’ and it is this
gap that results in worker exposure. The mismatch between the effectiveness of the engineering
controls and the process risk can occur for a number of reasons, ranging from a lack of
appreciation of the extent of the exposure risk from the process, to an over optimistic belief in the
capability of the control measure.
Before engineering controls can be contemplated it is necessary to understand how the
contaminant is being released into the workplace. This requires a full understanding of how the
process works and how workers interact with the process. Ideally workers should be involved in
the design and selection of the controls, as they will be using them on a daily basis. Failure to do
this often results in engineering controls that are unworkable resulting in poor exposure control.
Depending on the process, other disciplines may also need to be consulted, in particular the
engineering function, as their input may be required to ensure the more intricate nuances of the
process are considered and understood (for example quality of the final product is not affected by
the introduction of the control measure).
As well as considering the process, the reliability of any proposed control measures needs to be
addressed. There is little point designing and installing what is judged to be an effective control
solution that only works intermittently and is prone to malfunction.
Figure 1: Illustration of the consequence of mismatch between the risk of exposure and the engineering control
effectiveness

Additional benefits of good control

Clearly engineering controls are designed to reduce exposure and to assist companies in
complying with health and safety regulations and occupational exposure limits. However, it is
possible that they may help to reduce environmental pollution and, importantly can make an
economic impact by reducing company expenditure on such items as product consumables.
One of the examples was a printing facility that introduced covers on older, high-solvent, printing
machines. This engineering control required some thought, but hardly any capital expenditure. As
a result the solvent vapour levels were halved, saving 5,000 litres of solvent per week equating to
€74,400 a year. A clear case of an engineering control not only reducing worker exposure but
saving the company a significant amount of money.
design specifications
General Control Methods:
The Engineering and Design Phase
During the engineering and design phase of the dust control exhaust system, thought must be given
to operation and maintenance as well as to system performance and the project's budget.
Objectives need to be established in order to simplify the future operation and maintenance of the
system. The time to establish these objectives is during the engineering and design phase. Here are
some guidelines to follow:

Detailed Engineering Documents

Provide extra detail in the preparation of the engineering specifications and industrial dust control
exhaust system design drawings. Don't leave anything up to the imagination of the contractor. It is
not the contractor's job to be a dust control system expert. The contractor is a fabrication and
installation specialist. Give the contractor complete information so that the system is built right.

Detailed documents will also minimize the possibility of receiving a very low price during the
construction bid phase. If an unusually low bidder is awarded the project, poorly detailed
engineering and design documents will generate many construction extras and a poorly installed
system.

Selection of Construction Materials

Specify the right materials for construction for dust hoods and exhaust ductwork. The correct
metal gauge will lengthen the life of these components. If corrosive dusts are expected to be
involved, stainless steel may be better than galvanized steel.

Component Location
Position the exhaust system's components in the plant for ease of inspection and repair. This
simple but important matter is often overlooked. Components cannot be maintained without proper
access. The component manufacturer has information to help you determine proper access.

Original Equipment Manufacturer (OEM) Component Specifications

Specify dust collectors, exhaust fans and other OEM components based on your needs rather than
on the supplier's product line. Don't purchase unique items unless there is an absolute need. You
may be locked in to buying expensive spare parts in the future.

Service and Support For Your Ventilation Equipment

The ventilation equipment supplier should have a local representative to give you personal and
immediate attention in future operation and maintenance emergencies. The fabrication and
installation contractor should be local to your plant operation for efficient and effective service.
Working with a qualified local contractor will give you opportunities to interview his present
customers for an evaluation of the contractor's past performance.
 Preventative Maintenance Activities

Greasing fan bearings and emptying dust collector hoppers on schedule are important maintenance
activities. Replacing obsolete dust capture hoods and ductwork are absolutely necessary to
promote continued safe operating conditions. Repairing damaged dust control system components
keeps the ventilation system running at peak efficiency. But these and other component repair
activities are by no means sufficient to maintain top notch operating conditions. Here are four
critical activities that should be performed on a regular basis:

1. System Operating Characteristics

Periodic visual inspection of system components permits early detection of potential system
failure. As important as the visual inspection is, so is the scheduled checking of dust control
system component operating characteristics. Component static and velocity pressures should be
regularly measured and recorded. This data should then be compared to the data in the Component
Baseline Documentation recorded during the start-up phase. Deviations from Baseline data should
then be analyzed and corrected as necessary.

2. Explosion Protection Components

If the collected dust is organic or metallic in nature, an explosion relief or suppression system most
likely was installed on the dust collector. Inspection and maintenance of these components should
be done in accordance with the manufacturer's recommendations and applicable safety guidelines.
An important activity often neglected is the periodic sampling of the collected dust for an
explosivity determination. If the process has changed so that the particle size or shape of the
collected dust has changed, dust explosivity may be affected. If the chemistry of the processed
product has changed, dust explosivity may again be affected. If the collected dust shows an
increase in explosivity above the level for which the installed explosion venting or suppression
system was designed, immediate action must be taken to correct the deviation from the design
condition.

3. Processed Product Changes

Changes in the nature and quantity of the processed product can also affect the performance of the
dust control exhaust system. Raw material changes can dramatically change a well performing
dust control system into a maintenance nightmare. New hygroscopic ingredients can plug filter
media and drastically reduce air flow through the system. Finer powder can promote even finer
collected dust that may bleed through filter media and cause an air pollution or return air system
problem. Maintenance personnel must be included in the new product information loop so that
they do not waste time looking for the solution to a system component problem that does not exist.

4.System Air Balancing

The installing contractor is called upon to balance the air flow in the duct system so that the dust
capture hoods exhaust the designed air quantities. The procedures for air balancing, as described in
the Industrial Ventilation Manual published by the American Conference of Governmental
Industrial Hygienists, are the standards to be followed. Pitot tube readings of duct velocity
pressure in each duct connected to a dust capture hood provide the most accurate readings of
exhaust air quantities. Air system balancing must be done with all dust capture hoods installed and
connected to the dust control exhaust system ductwork.All the data taken during the system air
balancing should be recorded and filed for future reference as it is the baseline against which
future system performance will be measured.

5.Industrial Ventilation System Safety Components

If collected dust is flammable or explosive, the dust collector will have been installed with fire and
explosion protection components. These may include a sprinkler system, mechanical vents or
chemical suppression systems. These systems should be thoroughly checked out to assure they will
operate as intended. System pressure gauges, low flow, and overpressure alarm systems should be
checked out to assure compliance with the engineering and design documents. Any system which
does not read-out or operate as designed should be investigated to determine the cause and must be
corrected.

Personnel Training
Plant supervisory, production and maintenance personnel should be trained in the operation of the new
dust control ventilation system. The training topics should include:
Dust control system safety features and components.
System air meter read-outs and alarms.
Component baseline documentation.
Dust control equipment manufacturer's operating, maintenance instructions, and recommendations.
Operation and use of dust capture hoods and dampers.
Preventive maintenance program.

Unit-III
BIOLOGICAL AND ERGONOMICAL HAZARDS
 A "biohazardous agent" is generally an agent that is biological in nature, capable of self replication
and possesses the capacity to produce deleterious effects upon biological organisms. A biohazardous
material is any material that contains or has been contaminated by a biohazardous agent. In addition,
the University considers any material originating in medical areas, patient care, and research as
biohazardous.
 Biohazardous agents include, but are not limited to:
viruses and oncogenic viruses
bacteria
rickettsia
chlamydia
parasites
fungi
recombinant DNA (rDNA)
cultured animal cells and potentially biohazardous agents they may contain
 human clinical specimens (tissues, fluids, etc.)
tissues from experimental animals (including animal dander)

Basis for the Classification of Biohazardous Agents by Risk Group

Risk Group Risk to the Individual and the Community

Risk Group 1 (RG-1) Agents that are not associated with disease in healthy adult humans.

Risk Group 2 (RG-2) Agents that are associated with human disease which are rarely serious and for which
preventive or therapeutic interventions are often available.

Risk Group 3 (RG-3) Agents that are associated with serious or lethal human disease for which preventive
or therapeutic interventions may be available (high individual risk but low community
risk).

Risk Group 4 (RG-4) Agents that are likely to cause serious or lethal human disease for which preventive or
therapeutic interventions are not usually available (high individual risk and high
community risk)

Bacterial Agents :
is a bacterium, virus, protozoan, parasite, or fungus that can be used purposefully as a weapon
in bioterrorism or biological warfare (BW).[1] In addition to these living and/or
replicating pathogens, biological toxins are also included among the bio-agents. More than 1,200
different kinds of potentially weaponizable bio-agents have been described and studied to date.
Biological agents have the ability to adversely affect human health in a variety of ways, ranging from
relatively mild allergic reactions to serious medical conditions, including death. Many of these
organisms are ubiquitous in the natural environment where they are found in water, soil, plants, or
animals.[1] Bio-agents may be amenable to "weaponization" to render them easier to deploy or
disseminate. Genetic modification may enhance their incapacitating or lethal properties, or render them
impervious to conventional treatments or preventives. Since many bio-agents reproduce rapidly and
require minimal resources for propagation, they are also a potential danger in a wide variety of
occupational settings.

Rickettsial

Rickettsial infections are caused by various bacterial species from the genera
Rickettsia, Orientia, Ehrlichia, Neorickettsia, Neoehrlichia, and Anaplasma Rickettsia spp. are classically
divided into the typhus group and spotted fever group (SFG).

Transmission:
Most rickettsial pathogens are transmitted by ectoparasites such as fleas, lice, mites, and ticks. Organisms can
be transmitted by bites from these ectoparasites or by inoculating infectious fluids or feces from the
ectoparasites into the skin. Inhaling or inoculating conjunctiva with infectious material may also cause
infection for some of these organisms

EPIDEMIOLOGY
All age groups are at risk for rickettsial infections during travel to endemic areas. Both short and long-term
travelers are at risk for infection. Transmission is increased during outdoor activities in the spring and summer
months when ticks and fleas are most active; however, infection can occur throughout the year. Because of the
5- to 14-day incubation period for most rickettsial diseases, tourists often do not experience symptoms during
their trip, and disease onset may coincide with their return home or develop within a week after returning.

TREATMENT
Treatment of patients with possible rickettsioses should be started when disease is suspected and should never
await confirmatory testing, as certain infections can be rapidly progressive. Immediate empiric treatment with
a tetracycline, most commonly doxycycline, is recommended for all ages. Almost all other broad-spectrum
antibiotics are not helpful. Chloramphenicol may be an alternative in some cases, but its use is associated with
more deaths, particularly for R. rickettsii. In some areas, tetracycline-resistant scrub typhus has been reported.
Azithromycin may be an effective alternative. Anaplasma phagocytophilum infections may respond to
rifampin, which may be an alternate drug for pregnant patients. Expert advice should be sought if alternative
agents are being considered.

PREVENTION
No vaccine is available for preventing rickettsial infections. Antibiotics are not recommended for prophylaxis
of rickettsial diseases and should not be given to asymptomatic people.
Travelers should be instructed to minimize exposure to biting arthropods during travel (including lice, fleas,
ticks, mites) and to animal reservoirs (particularly dogs)

Chlamydia
 is a genus of pathogenic bacteria that are obligate intracellular parasites. Chlamydia infections are the
most common bacterial sexually transmitted diseases in humans and are the leading cause of infectious
blindness worldwide.
 The three Chlamydia species include Chlamydia trachomatis (a human pathogen), Chlamydia
suis (affects only swine), and Chlamydia muridarum (affects only mice and hamsters).
Additionally, three species that were previously classified as Chlamydia have since 1999 been
reclassified into the then newly created Chlamydophila genus: Chlamydophila
psittaci, Chlamydophila pneumoniae, and Chlamydophila pecorum.
Chlamydia may be found in the form of an elementary body and a reticulate body. The elementary body is the
nonreplicating infectious particle that is released when infected cells rupture. It is responsible for the bacteria's
ability to spread from person to person and is analogous to a spore. The elementary body may be 0.25 to
0.30 μm in diameter, and it mainly consists of C. trachomatis, C. pneumoniae, and C. psittaci. This form is
covered by a rigid cell wall . The elementary body induces its own endocytosis upon exposure to target cells.
One phagolysosome usually produces an estimated 100–1000 elementary bodies.

Pathology
Chlamydia can be detected through culture tests or nonculture tests. The main nonculture tests include
fluorescent monoclonal antibody test, enzyme immunoassay, DNA probes, rapid Chlamydia tests
and leukocyte esterase tests. Whereas the first test can detect the major outer membrane protein (MOMP), the
second detects a colored product converted by an enzyme linked to an antibody. The rapid Chlamydia tests
use antibodies against the MOMP, the leukocyte esterase tests detect enzymes produced by leukocytes
containing the bacteria in urine.

viral agents : are acellular organisms that contain nucleic acid in the form of RNA or DNA
(either double or single-stranded) surrounded by a protein coat known as a capsid. Some
viruses are further protected by a lipid bilayer (or membrane) with proteins planted in them
known as an envelope. Viruses are 20 to 100 times smaller than bacteria, and unlike bacteria,
they are not alive. Because they lack the machinery with which to replicate their nucleic acid,
viruses function parasitically and besiege living cells in order to thrive.
Invasion and Defense
A virus first approaches its host cell and uses its surface proteins to bind to the host's cell
surface receptor (viruses target specific hosts with the correct surface receptor). The virus
may enter the cell through a process called endocytosis in which the virus is enveloped by a
section of the cell's plasma membrane. Otherwise, nucleic acid is injected into the cell as the
virus melds its lipid envelope with the cell membrane. The virus then appropriates the cell's
ribosomes, enzymes, and reproductive machinery to assemble replica viruses. After
reproduction, the new viruses exit the cell either by leaving the cell a few at a time through
reverse endocytosis (budding) or by bursting forth from the cell (lysis). The process often
leads to cell death due to cell lysis or cell suicide.
In response to viral invasion, the infected cells produce interferons or cytokines. Interferons
are proteins that are released into the bloodstream, and they signal for other cells to produce
enzymes to counter the infection. Cytokines are proteins released by infected cells to urge
adjacent cells to mount their defenses against the viral invasion. Because it is difficult for
treatments to distinguish between the viral processes and a cell's natural processes, most
treatments address only viral symptoms. Viral infections generally do not respond to
antibiotics but may be responsive to antiviral compounds, of which there are few available,
and those that are available are of limited use.
Prevention against viruses consists of vaccinations. Killed or inactivated viruses are a major
form of vaccinations. This method bears little risk of infection but produces a weak immune
response. Live or attenuated viruses are also used, which induces a strong response, but
increases the risk of causing the disease as well. Acellular, subunit, toxins, and conjugated
vaccines are also used to elicit the appropriate immune response.
Biological Warfare Viral Agents
Arenaviridae Venezuelan Argentine/ Bolivian/ Lassa fever Lymphocytic
Family Hemorrhagic Fever Sabia-associated choriomeningitis
hemorrhagic fever (LCM)
Bunyaviridae Crimean-Congo Rift Valley Fever Hantavirus Hemorrhagic fever
Family Hemorrhagic Fever pulmonary with renal syndrome
(CCHF) syndrome (HPS)
Filoviridae Family Ebola Hemorrhagic Marburg Hemorrhagic
Fever Fever
Flaviviridae Kyasanur Forest Omsk hemorrhagic fever Tick-borne
Family disease encephalitis
Paramyxoviridae Hendra virus disease Nipah virus encephalitis
Family
Orthopoxvirus Smallpox Cowpox Monkeypox White pox
Family

Fungi-(Agri-workers)-Tinea-infections, Coccidiomycosis, Psittacoses, ornithosis, etc.

A fungus (plural: fungi[3] or funguses[4]) is any member of the group of eukaryotic organisms
that includes microorganisms such as yeasts and molds, as well as the more
familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate
from the other eukaryotic life kingdoms of plants and animals.
A characteristic that places fungi in a different kingdom from plants, bacteria, and some
protists is chitin in their cell walls. Similar to animals, fungi are heterotrophs; they acquire their
food by absorbing dissolved molecules, typically by secreting digestive enzymes into their
environment. Fungi do not photosynthesise. Growth is their means of mobility, except for
spores (a few of which are flagellated), which may travel through the air or water. Fungi are
the principal decomposers in ecological systems. These and other differences place fungi in a
single group of related organisms, named the Eumycota (true fungi or Eumycetes), which share
a common ancestor (form a monophyletic group), an interpretation that is also strongly
supported by molecular phylogenetics. This fungal group is distinct from the structurally
similar myxomycetes (slime molds) and oomycetes (water molds). The discipline
of biology devoted to the study of fungi is known as mycology (from the Greek μύκης mykes,
meaning "fungus"). In the past, mycology was regarded as a branch of botany, although it is
now known fungi are genetically more closely related to animals than to plants.
Infectious agents are capable of causing disease and can be classified according to size, properties, and
morphological characteristics (e.g. viruses, rickettsia, bacteria, fungi, protozoa, and helminths.

Infectious diseases are caused by pathogenic microorganisms, such as bacteria, viruses, parasites or fungi;
the diseases can be spread, directly or indirectly, from one person to another. Zoonotic diseases are infectious
diseases of animals that can cause disease when transmitted to humans.
1. Lassa fever
2. Tuberculosis
3. Measles
4. Meningococcal meningitis
5. Chikungunya
6. Malaria
 7. Plague
8. HIV/AIDS
9. Immunization coverage
10. Pneumonia
11. Rubella
12. Poliomyelitis
13. Rabies
14. Hepatitis B
15. Buruli ulcer
16. Hepatitis E
17. Hepatitis A
18. Millennium Development Goals (MDGs)
19. Soil-transmitted helminth infections
20. Foodborne trematodiases
21. Ebola virus disease
22. Hepatitis C
23. Yellow fever
1. Dengue and severe dengue
2. Trachoma
3. Chagas disease (American trypanosomiasis)
4. Lymphatic filariasis
5. Onchocerciasis
6. Trypanosomiasis, human African (sleeping
sickness)
7. Dracunculiasis (guinea-worm disease)
8. Echinococcosis
9. Japanese encephalitis
10.Vector-borne diseases
11.Avian influenza
12.Influenza (Seasonal)
13.Cholera
14.Yaws
15.Leprosy
16.Leishmaniasis
17.Diarrhoeal disease
18.Taeniasis/cysticercosis
19.Animal bites
20.Crimean-Congo haemorrhagic fever
21.Marburg haemorrhagic fever
22.Monkeypox
23.Rift Valley fever
24. Smallpox
Biohazard control program
A hazard is caused by biological waste, such as medical waste, micro organisms, viruses, etc. The biological
hazards can affect both human and animal life and health in a variety of ways. Some biohazards have the
 ability to change DNA structures. The gene mutation that results is one of the biological hazards. Among other
diseases that are caused by biological agents, anthrax is one of them. Others are Lassa fever, Glanders, etc..

 Safe Work Practices

The safe work practices listed below must be consistently followed to reduce the likelihood of
exposure when using biohazardous agents:
 Avoid hand to face contact, and don't use sharp items (needles, razor blades etc.) unless you
must.
 Handle needles and sharps (pasteur pipets, slides, capillary tubes, broken glass, etc.) carefully.
 Use engineered sharps protection (needle with protective device attached) when drawing
human blood.
 Dispose of sharp items in red ("medical waste") needle boxes if the sharps are biohazardous,
contaminated with human blood or blood products, or were used in research involving the
treatment or immunization of human beings or animals. Use beige needle boxes for all other
sharps. Contact the CNSM Safety Office (x55623) to obtain free sharps containers or to
arrange for container disposal.
 Use rigid plastic disposal containers for sharps; never use bags.
 Never bend or break needles.
 Never recap needles if at all possible; store syringe needle side down in test tube instead. If you
must recap the needle, place cap in a container (ex. styrofoam), open end up, then with ONE
HAND place the needle into the cap. NEVER use two hands to recap, you might stick
yourself!
 Wash hands after handling biohazardous materials, even when gloves were worn.
 Develop and use a method of decontamination based on surfaces and type of contamination
e.g. wipe bench tops down before and after use with a fresh 5 - 10% solution of bleach.
 Employ Universal Precautions: treat all human body fluids as infectious for HIV (see
"Special Biohazards" for more information).
 Engineering Controls
 Engineering controls must be used whenever appropriate; examples include biological
cabinets, mechanical barriers, needle boxes, engineered sharps protection on needles etc. If a
biological cabinet is required per the CDC/NIH guidelines, it must be certified according to
OSHA's Title 8, CCR 5154.1(a).
 Personal Protective Equipment
 Ensure that everyone concerned uses personal protective equipment (PPE) when needed to
shield skin, clothing and mucous membranes from contact with infectious materials. The PPE
must be appropriate and fit properly; consider:
 types of fluid or tissue involved
 potential exposure volume
 probable route of exposure e.g. eyes via splash; if the potential for a splash to the eye exists,
properly fitting and fully enclosed, indirect vented chemical splash goggles must be worn
 working conditions e.g. aerosol production might require biological cabinet use.
  Biohazardous Waste
 Biohazardous waste produced in a teaching or research lab cannot legally be treated and
disposed of as regular trash on the premises. The waste shall be placed in a leak-proof
container that is double-lined with red biohazard bags. CNSM safety will provide the container
and bags. Call the CNSM Safety Office for the appropriate container.
 Biohazardous waste s defined in the California Health and Safety Code section 117635 is:
Laboratory waste, including, but not limited to, the following: Cultures and stocks of infectious
agents from research and industrial laboratories. Wastes from the production of bacteria,
viruses, spores... and [contaminated] culture dishes and devices used to transfer, inoculate, and
mix cultures.
 These regulations define "infectious agents" to include any microorganism, bacteria, mold,
parasite, or virus, including, but not limited to, organisms managed as Biosafety Level 2
(BSL2), 3 or 4. The Chief of the Medical Waste Management Program at the California
Department of Public Health has concurred with this definition. Some of the cultures we work
with in microbiology, mycology, molecular biology, biochemistry and research labs are at BSL
2 level.
 Remember, NEVER put sharps in trash bags of any kind; always use rigid containers such as
cardboard containers or the freesharps containers provided by the CNSM Safety Office.
 Housekeeping
Housekeeping is another important issue for biohazard areas - keep your area clean. OSHA's
general sanitation laws in Title 8, section 3362, state that the workplace must be clean and
sanitary, and be in a condition not liable to give rise to harmful exposure. Make sure corridors
and eyewash/shower units are not blocked.
Special Biohazards
 Medical Waste
Ifyou or those you supervise work with human blood, human tissues or human blood-derived
products, you produce medical waste. This includes culture of most human cell lines. Medical
waste may NOT be autoclaved and/or disposed of on campus property. The regulations for the
collection and disposal of medical waste are quite stringent. Please call the safety office
immediately (x55623) if you think you might generate medical waste. We will set up your
program for you, and supply you with all the necessary information and free medical waste
bags, collection containers, etc. We will also coordinate the waste pick-up and disposal for
you.
 Bloodborne Pathogens
If you or those you supervise (including students) work with any human tissue or fluid - except
urine, saliva or cheek cells - your work is regulated by the Cal/OSHA bloodborne pathogen
standard. Improper handling could result in serious fines from the city of Long Beach. Please
call the safety office immediately (x55623) if you think your work might fall under the
bloodborne pathogen standard.
 TRAINING & EDUCATION
The most important element for controlling biohazards is strict adherence to standard
microbiological practices and techniques. Persons working with infectious agents or infected
materials must be aware of potential hazards and must be trained and proficient in the practices
and techniques required for safely handling such material. Students will receive training on the
handling of biohazards waste as required by laboratory curricula. Training on the content of
these procedures will also be provided. Faculty and graduate research assistants will receive
training consistent with the requirements of Chapter 296-823 for laboratory work involving
human blood or body fluids. Exposure incidents must be documented on the Incident Report
Form.
 MONITORING
The EH&S Department will be responsible for monitoring biohazardous and medical waste
contractors for compliance with the regulations, maintaining records on biohazard waste
disposal, and assisting with biohazard waste disposal as requested.
employee health program
Laboratory safety program :
General laboratory function
The opening section will provide a clear organization of personnel and assign responsibilities
for all who work in and support the containment laboratory. How access is controlled is of
primary importance. The laboratory director has ultimate responsibility. Access should be
restricted to only certified people who are absolutely necessary. Certified means they
understand the potential biohazard, have demonstrated proficiency in the laboratory’s
procedures, and have complied with the health and medical entry requirements. Proper entry
and exiting procedures for staff, visitors, and maintenance/ custodial workers are clearly
established in this section as well. Finally, procedures for identifying, reporting, and correcting
problems or violations of protocol are detailed.

Specific facility design and operational procedures

Specific laboratory layout and operations are described in this section. Included are security
access mechanisms; self-closing, lockable doors; and other security measures. Proper signage
indicating agents present, contact information for the principal investigator and other
responsible people, and any special requirements are posted at all access points. The design of
directional airflow from clean areas toward contaminated areas is described, and procedures for
checking proper operation by laboratory staff are outlined. Measures are included for checking
and ensuring that the surfaces of all walls, floors, and ceilings are smooth, impermeable, and
easily cleaned and that all penetrations are sealed. Pest management is addressed here as well,
with an appropriate insect and rodent control program.

Special laboratory safety equipment and PPE

This is arguably one of the most important parts of the exposure control plan. It should explain
the PPE that must be worn. Describe where PPE is stored as well as when and where it is used
and how it is removed and discarded. It should cover the proper types of gloves, eyewear, and
gowns or lab coats to be used. This section also addresses proper use and maintenance of the
lab’s safety equipment such as autoclaves, biosafety cabinets, eyewash stations, safety
showers, ventilation alarms, and other specially designed containment equipment. Procedures
for decontaminating equipment prior to maintenance work should also be included.
Laboratory research practices and procedures
The heart of the exposure control plan is contained in this section. It addresses safe handling
and storing of viable material, including biological safety cabinet use, handling frozen samples,
and use of secondary containers. Procedures for using and disposing of sharps, found in most
containment laboratories, are paramount. Addressed in this section are waste handling and
disposal, decontamination, and housekeeping (e.g., cleaning up at the end of the day or after
finishing a research protocol).

Health and medical monitoring requirements

The purpose of this section is to provide another level of protection against laboratory-acquired
illness by documenting necessary immunizations. Immune-suppressed individuals or persons at
increased risk should be strongly discouraged from entering the facility. Depending on the
agents present, vaccinations (hepatitis B), antibody testing (TB skin test), or serum storage may
be required. The exposure control plan should clearly define with a welldocumented rationale
what is required and who is covered.

Emergency procedures
This segment describes procedures for an accident, spill, release, or exposure that contaminates
or injures laboratory staff or the environment. A good reference for putting this section
together would be the OSHA bloodborne pathogen standard, 29CFR1910.1030.2 Everyone
working in the facility should be thoroughly versed in the emergency procedures. Spill kits
should be maintained and biohazard spills decontaminated and cleaned up as soon as possible
by properly trained and equipped staff. Any incident should be completely documented with a
written report.

Employee training
We wrap up our exposure control plan with the chapter covering employee training. The first
step is to make sure everyone who will be working in the containment facility has read and
understands this exposure control plan. They should be informed about each infectious agent
present, the risks associated with these, and the signs and symptoms of infection or disease.
This training, along with bloodborne pathogen training, should be renewed annually and
written documentation kept on record.

A safety cabinet or biological safety cabinet (BSC) is an enclosed and ventilated laboratory
workspace to provide safety when working with materials that are contaminated by pathogens.
These safety cabinets designed to meet diverse requirements in industrial, clinical,
pharmaceutical and life science laboratories and protect personnel, the environment and the
products in use and avoid contamination of any kind. There are several classes of cabinet with
different specifications designed for different bio-safety levels
Work Related Musculoskeletal Disorders.
Work related musculoskeletal disorder can take diff forms.The onset and development of these
injuries still unknown .WMSDs evolved because a structure is abused repetitively and is made
to endure a work load that it cannt tolerate without negative consequences, which develop
gradually,only to appear suddenly one day by worsening the situation to work stoppage..
Musculoskeletal disorders (MSDs) are conditions that affect the nerves, tendons, muscles and
supporting structures, such as the discs in your back. They result from one or more of these
tissues having to work harder than they're designed to.
Signs and symptoms:
 Symptoms of back pain
NHS Direct explains that ‘The symptom of low back pain is a pain or ache anywhere on
the back, in between the bottom of the ribs and the top of the legs. The majority of cases
of back pain usually clear up quite quickly. However, if you are worried or concerned
about back pain, seek medical advice.’ Find out more at NHS Direct.
 Symptoms of upper limb disorders
Pain is the most common symptom. Sometimes the sufferer also has joint stiffness,
muscle tightness, redness and swelling of the affected area. Some people experience
‘pins and needles’, numbness, skin colour changes, and decreased sweating of the hands.
WRMSDs may progress in stages from mild to severe.
 Early stage
Aching and tiredness of the affected limb occur during the work shift but disappear at
night and during days off work. No reduction of work performance.
 Intermediate stage
Aching and tiredness occur early in the work shift and persist at night. May also have
reduced capacity for repetitive work.
 Late stage
Aching, fatigue and weakness persist at rest. Inability to sleep and to perform light
duties.
Not everyone goes through these stages in the same way. In fact, it may be difficult to say
exactly when one stage ends and the next begins. The first pain is a signal that the muscles and
tendons should rest and recover. As soon as people recognise that they have a symptom, they
should immediately do something about it.
Common MSDs include:
 Carpal Tunnel Syndrome
 Tendonitis
 Muscle / Tendon strain
 Ligament Sprain
 Tension Neck Syndrome
 Thoracic Outlet Compression
 Rotator Cuff Tendonitis
 Epicondylitis
 Radial Tunnel Syndrome
 Digital Neuritis
 Trigger Finger / Thumb
 DeQuervain’s Syndrome
 Mechanical Back Syndrome
  Degenerative Disc Disease
 Ruptured / Herniated Disc,
 and many more.
Carpal Tunnel Syndrome
What are the symptoms?
 Carpal tunnel syndrome can cause tingling, numbness, weakness, or pain in the fingers or
hand. Some people may have pain in their arm between their hand and their elbow.
 Symptoms most often occur in the thumb, index finger, middle finger, and half of the ring
finger. If you have problems with your other fingers but your little finger is fine, this may be
a sign that you have carpal tunnel syndrome. A different nerve gives feeling to the little
finger.
 You may first notice symptoms at night. You may be able to get relief by shaking your
hand.

How is carpal tunnel syndrome diagnosed?

 Your doctor will ask if you have any health problems-such as arthritis, hypothyroidism,
or diabetes-or if you are pregnant. He or she will ask if you recently hurt your wrist, arm, or
neck. Your doctor will want to know about your daily routine and any recent activities that
could have hurt your wrist.
 During the exam, your doctor will check the feeling, strength, and appearance of your neck,
shoulders, arms, wrists, and hands. Your doctor may suggest tests, such as blood tests or
nerve tests.
Tendon pain disorders of the neck- back injuries
As it name indicates ,tendonitis is an inflammation of a tendon. Tendons are structure that
connects muscles to the skeleton. When the muscle contrast and shorten, it pulls on the
tendon and causes the neck to bend. Muscle strain or tension often causes neck pain ,the
body may try to repair it. The problem is usually overuse, such as from sitting at a computer
for too long. if the overuse persists, an injured tendon, swollen by inflammation, may be
even more vulnerable to overload. Sometimes you can strain your neck muscles from
sleeping in an awkward position or overdoing it during exercise. Falls or accidents,
including car accidents, are another common cause of neck pain. Whiplash, a soft tissue
injury to the neck, is also called neck sprain or strain.
 Unit-IV
OCCUPATIONAL HEALTH AND TOXICOLOGY:
Concept and spectrum of health
Functional Units & Activities Of Occupational Health
The joint international labor organization committee on Occupational health, 1950 defined occupational health
as “The highest degree of physical, mental and social well-being of workers in all occupations.” It represents
a dynamic equilibrium between the worker and his occupational environment
GOALS :
To reduce industrial accidents.
To prevent occupational hazards/ diseases.
To achieve maximum human efficiency and machine efficiency.
To reduce sick absenteeism.
OBJECTIVES
To maintain and promote the physical, mental and social well being of the workers.
To prevent occupational diseases and injuries.
To adapt the work place and work environment to the needs of the workers i.e application of
ergonomics principle.
It should be preventive rather than curative.
FUNCTIONS OF OCCUPATIONAL HEALTH SERVICES:
Pre-employment medical examination.
First Aid and emergency service.
Supervision of the work environment for the control of dangerous substances in the work environment.
Special periodic medical examination particularly for the workers in dangerous operations.
Health education for disseminating information on specific hazards and risks in the work environment.
Special examination and surveillance of health of women and children
Advising the employer or management for improving working conditions, and placement of hazards.
Monitoring of working environment for assessment and control of hazards.
Supervision over sanitation, hygiene and canteen facilities.
Liaison and cooperation with the safety committees
Liaison and cooperation with the safety committees
Maintenance of medical records for medical check-up and follow-up for maintaining health standards
and also for evaluation.
To carry out other parallel activities such as nutrition programme, family planning, social services
recreation etc., Concerning the health and welfare of the workers\
Components occupational health services
Medical treatment, First aid treatment in emergency.
Health education, First aid education.
Medical examination
Pre employment examination
Medical treatment, First aid treatment in emergency.
Health education, First aid education.
Medical examination
a. Pre employment examination
b. Periodic medical examination
c. Special medical examination
Pre-employment and post-employment medical examinations:-

Pre-Employment Physical Examinations

 Pre-employment screening has two major functions:
(1) determination of an individual's fitness for duty, including the ability to work while wearing
protective equipment, and
(2) provision of baseline data for comparison with future medical data. These functions are discussed
below. In addition, a sample pre employment examination is described.`
 The pre-employment medical examination (also referred to as a pre-placement examination) strives to
place and maintain employees in an occupational environment adapted to their physiological and
psychological capacities. The goal of the pre-employment examination is to determine whether an
individual is fit to perform his or her job without risk to himself or others.1 This is also conceptualized
within the practice of occupational medicine – it is assumed that the examiner is required to have
detailed knowledge of both working and health conditions..
 The objective of pre-employment examinations has traditionally been to ensure that prospective
employees can perform their jobs safely without placing co-workers at risk. Despite these focused
goals, pre-employment testing often exceeds this scope.6Indiscriminate testing inevitably yields
findings that are not relevant.7 The required follow-up or “clearance” for these findings can delay
employment, result in the spurious rejection of a candidate, divert resources from efforts that might be
beneficial to health outcomes, as well as cause unnecessary expense
 The examination components depend on the job type and work-site environment. For example, jobs
that require use of personal protective equipment (PPE), such as respiratory protection, often include a
pulmonary function test (breathing test) as part of the pre-placement exam. Those involved in interstate
trucking usually require a physical exam and a urine drug test.

 The pre-placement assessment also offers the opportunity for new staff to:
Understand their role more fully and be made aware of necessary precautions
Receive explanations regarding when personal protective equipment is needed, and how it is to be worn
Be introduced to the overall philosophy of health and safety in the organization.

 Benefits of pre-placement evaluations

Some of the benefits of pre-placement evaluations include:
Appropriate pairing of the applicant to the occupational requirements of the job.
Discovery of health condition(s) that may place the safety or health of the applicant or others at risk.
A basis for determining needs in the area of reasonable accommodation (for example, sensory aids,
special work stations, additional devices, relocation of a workstation, and/or special parking).
The introduction of a healthcare system that emphasizes wellness and a preventive care belief which, if
followed, can help to stop a premature onset of chronic disease or complications of a previously
existing disabling disorder.
A baseline of health status so future measurements can determine whether any workplace exposures
have proven detrimental to the employee's health.
Knowledge of family health problems so counsel (EAP/Employee Assistance Program) can be
provided, which can help reduce periods of employee absence, stress, or decreased productivity.
A basis for relationship with the employee's supervisors regarding potential emergency situations (for
example, insulin-dependent diabetes, convulsive disorders).
Compliance with state or local statutory requirements for certain job categories, such as primary
education and health care.
Measurement of psychological status so proper referral to counseling sources can avert future job-
related stress.
  All Pre/post employment medicals can consist of:
General Health History Questionnaires (any additional can be added to our standard).
Epworth Sleepiness Scale.
Kessler Patient Health Psychological Distress Scale (K10+).
Musculo-skeletal – ROM (range of movement).
Height, Weight, Blood Pressure, Pulse, Body Mass Index recordings.
Physical Examination (skin; sinus; extremities).
Audiometry (hearing) test.
Spirometry (lung function) test.
Vision Screen test.
Instant Drug & Alcohol Breathalyzer testing.
ESR Laboratory drug specimen collection.
Urinalysis to test blood, glucose, protein, nitrite & leucocytes.
Blood glucose and cholesterol prick test.
ECG – heart rate reading.

Occupational Related Diseases :

1) Silicosis (previously miner's phthisis, grinder's asthma, potter's rot and other occupation-related names) is a form
of occupational lung disease caused by inhalation of crystalline silica dust, and is marked by inflammation and
scarring in the form of nodular lesions in the upper lobes of the lungs.

2) Asbestosis is a lung disease that develops when asbestos fibers cause scarring in your lungs. The scarring
restricts your breathing and interferes with the ability of oxygen to enter your bloodstream. Other names for this
disease are pulmonary fibrosis and interstitial pneumonitis.

3) Pneumoconiosis is an occupational lung disease and a restrictive lung disease caused by the inhalation of dust,
often in mines and from agriculture. Of these deaths, 46,000 were due to silicosis, 24,000 due to asbestosis and
25,000 due to coal workers pneumoconiosis.

4) A work accident, workplace accident, occupational Accident, Or Accident At Work is a "discrete

occurrence in the course of work" leading to physical or mental occupational injury.[1] According to
the International Labour Organization(ILO), more than 337 million accidents happen on the job each year,
resulting, together with occupational diseases, in more than 2.3 million deaths annually.`

5) Hypersensitivity pneumonitis (HP; also calledallergic alveolitis or extrinsic allergic alveolitis, EAA) is an
inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dusts. Sufferers are
commonly exposed to the dust by their occupation or hobbies.

6) Repetitive strain injury (RSI) is a general term used to describe the pain felt in muscles, nerves and tendons
caused by repetitive movement and overuse. It's also known as work-related upper limb disorder, or non-
specific upper limb pain.

7) Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term used to describe progressive lung
diseases including emphysema, chronic bronchitis, refractory (non-reversible) asthma, and some forms of
bronchiectasis. This disease is characterized by increasing breathlessness.

8) Byssinosis, also called "brown lung disease" or "Monday fever", is an occupational lung disease caused by
exposure to cotton dust in inadequately ventilated working environments. Byssinosis commonly occurs in
workers who are employed in yarn and fabric manufacture industries.

9) Anthrax is an infection caused by the bacterium Bacillus anthracis. It can occur in four forms: skin, lungs,
intestinal, and injection. Symptoms begin between one day and two months after the infection is contracted.
 10) Metal fume fever, also known as brass founders' ague, brass shakes, zinc shakes, galvie flu, metal
dust fever, Welding Shivers, or Monday morning fever, is an illness primarily caused by exposure to
chemicals such as zinc oxide (ZnO), aluminum oxide (Al2O3), or magnesium oxide (MgO) which are
produced as byproducts in the fumes that result when certain metals are heated. Other common sources
arefuming silver, gold, platinum,chromium (from stainlesssteel), nickel, arsenic, manganese, beryllium,
cadmium, cobalt, lead, selenium, and zinc.

11) Occupational asthma is a lung disorder in which substances found in the workplace cause the airways
of the lungs to swell and narrow. This leads to attacks of wheezing, shortness of breath, chest tightness,
and coughing.

12) Brucellosis is a highly contagious zoonosis caused by ingestion of unpasteurized milk or undercooked
meat from infected animals, or close contact with their secretions. Brucella species are small, gram-
negative, non motile, non spore-forming, rod-shaped (coccobacilli) bacteria.

13) Coal workers' pneumoconiosis (CWP), also known as black lung disease or black lung, is caused by
long exposure to coal dust. It is common in coal miners and others who work with coal. It is similar to
both silicosis from inhaling silica dust and to the long-term effects of tobacco smoking.

14) Chronic solvent induced encephalopathy (CSE) is a condition induced by long-term

exposure to organic solvents, often but not always in the workplace, that lead to a wide variety of
persisting sensor motor polyneuropathies and neurobehavioral deficits even after solvent exposure has
been removed.

15) Lead poisoning occurs when you absorb too much lead by breathing or swallowing a substance
with lead in it, such as paint, dust, water, or food. Lead can damage almost every organ system. In
children, too much lead in the body can cause lasting problems with growth and development.

16) Prepatellar bursitis is an inflammation of the bursa in the front of the kneecap (patella). It occurs
when the bursa becomes irritated and produces too much fluid, which causes it to swell and put
pressure on the adjacent parts of the knee.

17) Hypersensitivity pneumonitis (HP; also called allergic alveoli is or extrinsic allergic alveoli is, EAA)
is an inflammation of the alveoli within the lung caused by hypersensitivity to inhaled organic dusts.
Sufferers are commonly exposed to the dust by their occupation or hobbies.

Levels of prevention of diseases.

 Prevention plays a dominant role in community nutrition practice. It is defined comprehensively to
include an array of activities that prevent, delay the onset or reduce the seriousness of disease and its
complications.
 Prevention is categorized as primary, secondary, and tertiary.

1. Primary prevention
Primary prevention activities promote health and protect against exposure to risk factors that lead to health
problems. Primary prevention focuses on reducing or removing risk factors by changing the environment
and the community, as well as, family and individual life styles and behaviors. This includes nutrition
education and anticipatory guidance to develop and maintain healthful food and exercise behaviors.
2. Secondary prevention
Secondary prevention focuses strategies to stop or slow the progression of disease. It includes screening and
detection for early diagnosis, treatment and follow-up. Secondary prevention activities target those who are
more susceptible to health problems because of family history, age, lifestyle, health condition, or
environmental factors. Examples include blood lipid screening and referral, and nutrition and physical
activity programs for overweight children.
3. Tertiary prevention
Tertiary prevention is directed at managing and rehabilitating persons with diagnosed health conditions to
reduce complications, improve their quality of life and extend their years of productivity. Feeding clinics for
children with special health care needs is an example of tertiary prevention.

Levels of Intervention
Nutrition intervention is a purposefully planned activity, program, policy, or other action designed with the
intent of changing a behavior, risk factors, environmental condition, or aspect of health status for an individual,
target group, community, organizations, or the population at large. It includes a range of planned change
efforts designed to ultimately improve the nutritional status of the population and prevent disease and
disability.

Intervention approaches are also categorized into three levels

individual-focused (personal health)
community-focused (population or subgroup)
system-focused (procedures, rules, regulations, policy and law)

1. Individual-focused interventions aim to produce changes in knowledge, behavior or health outcomes of

individuals either singly or in small groups. These interventions involve direct client contact including face
to face visits and other personalized contact such as by telephone or by interactive computer program. They
allow the greatest amount of tailoring and personalization to the client's needs. Examples include nutrition
counseling, home health visits, and prenatal classes.
2. Community-focused interventions aim to reach and bring about changes in large numbers of the population.
They are targeted to groups or subgroups of the community, but cannot be personalized. Examples include
cholesterol screening clinic with referral, media campaign to promote breastfeeding, and building of bike
paths.
3. System-focused interventions create changes in organizations, policies, laws or structures. The focus is not
on individuals or communities, but on the systems that serve them. Examples include revised school lunch
recipes to reduce fat content, food labeling regulations, standards for staffing of nutrition programs, and
development of guidelines for practice such as Bright Futures.
4. Effective community nutrition practice involves making appropriated and coordinated use of the levels of
prevention and the approaches to intervention to address important nutrition problems. A coordinated,
comprehensive plan for addressing a specific problem can be developed using the following Intervention
Matrix.

Notifiable occupational diseases:

Silicosis:
What Are the Symptoms of Silicosis?
Symptoms of silicosis can appear from a few weeks to many years after exposure to silica dust. Symptoms
typically worsen over time as scarring in the lungs occurs.
Cough is an early symptom and develops over time with exposure to silica that is inhaled.
In acute silicosis, you may experience fever and sharp chest pain along with breathing difficulty. These
symptoms can come on suddenly.
In chronic silicosis, you may only have an abnormal chest X-ray in the beginning and then slowly develop a
cough and breathing difficulty. More than a third of people with silicosis have phlegm production and cough.
Chronic bronchitis-like symptoms may occur, and the lungs have additional sounds called wheezes and
crackles. As extensive scarring progresses over time, you may see signs of chronic lung disease such as leg
swelling, increased breathing rate, and bluish discoloration of the lips.

What Causes Silicosis?

Silicosis is caused by exposure to crystalline silica, which comes from chipping, cutting, drilling, or grinding
soil, sand, granite, or other minerals. Any occupation where the earth’s crust is disturbed can cause silicosis. A
long list of occupations are known that expose workers to crystalline silica that is inhaled. These include:
 Various forms of mining, such as coal and hard rock mining
 Construction work
 Tunnel work
 Masonry
 Sand blasting
 Glass manufacturing
 Ceramics work
 Steel industry work
 Quarrying
 Stone cutting

What Are Risk Factors of Silicosis?

Breathing crystalline silica causes silicosis and the main risk factor is exposure to silica dust.
You can prevent silicosis by limiting exposure. There are national guidelines on exposure limits over a lifetime
of working.

If you work in a job that exposes you to silica dust, your employer must, by law, give you the correct
equipment and clothing you need to protect yourself. You are responsible for using it—always—and for taking
other steps to protect yourself and your family as you leave your job site and head home. NIOSH also
recommends that medical examinations occur before job placement or upon entering a trade, and at least every
3 years thereafter.

Patients with silicosis have an increased risk of other problems, such as tuberculosis, lung cancer, and chronic
bronchitis. If you are a smoker, quitting may help, as smoking damages the lungs.

When to See Your Doctor?

Any person who works in industries with exposure to inhaled silica should get regular health checkups and be
monitored for signs and symptoms of lung disease. In addition, if you have a cough, phlegm, or breathing
difficulty that is not improving, you should be closely evaluated by your doctor. Some people with acute
silicosis also have fever, weight loss, and fatigue
.
How Silicosis Is Treated ?
There is no cure for silicosis. Prevention is still the best way to avoid the disease. Once silicosis has
developed, your doctor will assess the degree of lung damage with tests. Some people may need urgent
treatment with oxygen and support for breathing. Others may need medicines to decrease sputum
production, such as inhaled steroids. Some may need inhaled bronchodilators, which relax the air tubes.
Once the disease advances, the management is similar to many other chronic lung diseases and needs a
multidisciplinary or team approach. To keep the disease from getting worse, it is important to stay away
from any additional sources of silica and other lung irritants, such as indoor and outdoor air pollution,
allergens and smoke. You may consider counseling to discuss changing occupations.
Acute silicosis may need to be treated with steroids, and a lung transplant may need to be considered.
Asbestosis :
Symptoms of Asbestosis
 When scar tissue forms around the lungs’ microscopic air sacs, it gradually becomes harder
for them to expand and fill with fresh air.
This can cause a series of symptoms, including:
Shortness of breath
Chest pain
Clubbing of the fingers
Cough
Nail abnormalities
Shortness of breath
Persistent dry cough
Chest tightness and pain
Fatigue
Loss of weight and appetite
Crackling sound when breathing
The stiffening of the lungs causes the coughing, discomfort and crackling sound associated with
asbestosis, and it also results in less oxygen being delivered to the blood, causing shortness of breath.
Because the body relies on oxygen for energy, chronic breathing difficulties lead to fatigue and weight
loss.
 Asbestosis is the most common form of the range of pneumoconioses diseases. It is a chronic
inflammatory disease which is caused by the inhalation and retention of asbestos in the lungs
which goes on to cause scar tissue (fibrosis) in the lung. Scarred lung tissue does not expand
and contract normally so the sufferer will have reduced lung function. Asbestosis is classed as
an occupational lung disease and can take several years for any symptoms to begin to
manifest themselves. Approximately 4,000 deaths in the UK are attributed to asbestos
exposure each year.
 Asbestosis symptoms can take several or tens of years to begin to show. The main initial
symptom that a sufferer may begin to feel is dyspnoea (shortness of breath) particularly when
indulging in some form of physical activity. Advanced forms of asbestosis can lead to
respiratory failure and an increased risk of lung cancers, especially mesothelioma.
Main symptoms that may be present in an asbestosis sufferer are -
Tightness in the chest
 There is no current cure for asbestosis, although stopping exposure to the source of the
asbestos is extremely important. To help sufferers, oxygen treatment is often prescribed to aid
breathing and also respiratory physiotherapy. Also certain immunizations can be administered
to attempt to prevent complications that can occur due to the asbestosis condition such as
pleural effusion and malignant mesothelioma.
 Since the dangers of asbestos to health were discovered there have been many instances of
workers claiming compensation for injuries sustained due to prolonged exposure to asbestos.
Legal cases have been traced as far back as from 1929 and worldwide there have been
settlements made by employers that total billions of pounds over the years.
  Lung transplants are most often considered when asbestosis is accompanied by more
severe lung diseases such as emphysema or lung cancer. It is a highly invasive, last-resort
treatment, and in order to be put on a lung-transplant waiting list, a patient has to undergo
extensive screening to determine the relative chances of success.
Pneumoconiosis
 Pneumoconiosis is one of a group of interstitial lung disease caused by breathing in certain kinds of
dust particles that damage your lungs.Because you are likely to encounter these dusts only in the
workplace, pneumoconiosis is called an occupational lung disease.
 Pneumoconiosis usually take years to develop. Because your lungs can't get rid of all these dust
particles, they cause inflammation in your lungs that can eventually lead to scar tissue.
 Types of pneumoconiosis
The disease appears in different forms, depending on the type of dust you inhale. One of the most common
forms is black lung disease, also known as miner's lung. It’s caused by breathing in coal dust. Another is
brown lung, which comes from working around dust from cotton or other fibers. Other types of dusts that
can cause pneumoconiosis include silica and asbestos. Diacetyl, the compound used to give movie popcorn
its buttery flavor, also can lead to the disease. This is known as popcorn lung.
Pneumoconiosis can be simple or complicated. Simple pneumoconiosis causes a small amount of scar
tissue. The tissue may appear on an X-ray as round, thickened areas called nodules. This type of the
disease is sometimes called coal worker pneumoconiosis, or CWP. Complicated pneumoconiosis is known
as progressive massive fibrosis, or PMF. Fibrosis means that a lot of scarring is present in the lungs.
For either simple or complicated pneumoconiosis, the damage causes the loss of blood vessels and air sacs
in your lungs. The tissues that surround your air sacs and air passages become thick and stiff from scarring.
Breathing becomes increasingly difficult. This condition is called interstitial lung disease.
 Symptoms
Symptoms of pneumoconiosis often depend on how severe the disease is. Simple CWP may have no or few
symptoms and show up only on an X-ray. PMF may cause mild to severe difficulty breathing. Symptoms
may include:
 Cough
 Lots of phlegm
 Shortness of breath
 Who's at risk
Being exposed to dust that can cause pneumoconiosis, in an everyday setting, is not enough to cause the
disease. But you could be at risk if you've worked around or directly with these dusts. Studies show that
about 16 percent of American coal miners may eventually develop interstitial fibrosis from coal dust. Other
dust exposures that may put you at risk include working with asbestos fibers or silica dust. Your risk may
also be increased by:
 Smoking
 Being exposed to a high level of dust
 Being exposed for a long time
 Diagnosis
You may be diagnosed with pneumoconiosis if you have lung symptoms, X-ray abnormalities, and a
history of working around coal, asbestos, or silica. You may also be diagnosed by having a routine X-ray
during the time you are employed. The Federal Mine Safety and Health Acts require that all underground
coal miners be offered a chest X-ray after three years and then at five-year intervals to look for the disease.
Your doctor may use any of these to help make a diagnosis:
 Personal history of work exposure
 Physical examination
 Chest X-ray or CT scan to look for lung nodules, masses and interstitial disease
 CT scan of the chest
 Pulmonary function studies, including blood gasses
 Biopsy
  Treatment
Pneumoconiosis can’t be cured. Once the disease has been diagnosed, treatment is aimed at keeping it from
getting worse and controlling your symptoms. A treatment plan may include:
 Not smoking
 Avoiding all dust exposure
 Using oxygen
 Taking medications called bronchodilators that open lung passages
 Complications
The main complication is when simple pneumoconiosis progresses to PMF. These are other possible
complications:
 Progressive respiratory failure
 Lung cancer
 Tuberculosis (but this is now rare)
 Heart failure caused by pressure inside the lungs
 Prevention
Prevention is important because the disease cannot be treated or reversed. The Occupational Safety and
Health Administration sets standard prevention rules for workers at risk for pneumoconiosis. These are
common prevention measures:
 Wearing a mask
 Washing areas of skin that come in contact with dust
 Safe removal of dust from clothing
 Washing your face and hands thoroughly before eating, drinking, or taking any medications
 Not smoking
 Letting your doctor and your employer know about any symptoms of pneumoconiosis
 Getting regular chest X-rays and physical exams
 When to call the doctor
Call your doctor if you have shortness of breath, a persistent cough, or a cough that produces lots of
phlegm.
 Living with pneumoconiosis
Pneumoconiosis is a chronic, long-term, lung disease. Learn as much as you can about your illness and
work closely with your medical team. Consider these tips to better manage your health:
 Get a flu shot every year to help protect your lungs and ask your doctor about getting the pneumonia
vaccine.
 Stop smoking and avoid secondhand smoke.
 Ask your doctor if a pulmonary rehabilitation program could help you.
 Try to get regular exercise and plenty of sleep.
 Eat a well-balanced diet. Try frequent, smaller meals if a full stomach makes it harder to breathe.
 Struggling to breathe can make you feel anxious and stressed. Talk about your feelings and seek help
from a mental health professional if necessary.
Siderosis:
  What Is Siderosis?
Siderosis, also known by the name of Welder's Lung is a pathological condition of the lungs caused by chronic
exposure to iron oxide dust, usually at the workplace. Siderosis can be identified on x-rays of the chest as
minute opaque spots on the lungs. Generally, Siderosis does not cause any symptoms but it can give rise to
other disease conditions which can cause significant symptoms. The major risk factor for developing Siderosis
is working at a place where iron is used extensively.

 Some of the industries where iron is used extensively are:

 Welding
 Iron rolling
 Making of steel
 Metal sheet working
 Mining.
 What Are The Causes Of Siderosis?
Siderosis as stated is caused by chronic exposure to iron oxide fumes at the workplace. This disease is usually
found in welders and miners. Iron foundry workers and hematite miners are also at increased risk for
developing Siderosis.
What Are The Symptoms Of Siderosis?
Siderosis usually does not cause any symptoms. It can also be called as a benign form of pneumoconiosis. It
has still not been completely established whether Siderosis causes any symptoms, because if any symptoms are
caused it is usually due to other medical conditions similar to Siderosis.
How Is Siderosis Diagnosed?
Siderosis/Welder's Lung can easily be diagnosed with the help of radiographic studies:
 X-rays: Chest x-rays will show extremely minute nodules seen mostly in the middle-third part of the lungs
or the lower lungs. These nodules disappear after exposure to the offending metal is removed.
 CT Scan: A CT scan of the chest will show minute nodules with extremely fine branching lines distributed
diffusely in the lung.
 What Are Treatments For Siderosis?
Siderosis is preventable disease condition. Since this disease does not cause any significant symptoms hence
no medications are given to treat this disease. In case of some respiratory illness as a result of this disease,
medications like bronchodilators or corticosteroids may be given to free up the airways.
What Are The Ways To Prevent Siderosis?
The main way to prevent development of Siderosis is to eliminate exposure to iron oxide fumes. In case of
professional welders or miners, they need to make sure to take appropriate safety measures when they start
working like wearing a facemask. Apart from this the following steps can be taken:
 Adequate ventilation of the workplace
 The employer should make sure that all workers get regular checkups with the physician so as to detect any
lung damage early and slow down the progression of the disease process
 In case if an individual is a smoker, then he or she needs to avoid smoking in the workplace and even better
quit smoking altogether.
 Anthracosis
 Anthracosis: A condition characterized by the accumulation of carbon in the lungs caused by inhaled
smoke or coal dust.
Anthracosis, also called black lung disease or coal worker’s pneumoconiosis, is caused by the
accumulation of carbon deposits in the lungs. Simple anthracosis shows small lung opacities.
Complicated anthracosis exhibits massive fibrosis in the lungs.
 Etiology
Anthracosis results from inhaling smoke or coal dust. Workers in the coal mining industry are those
most likely to develop the disease. Anthracosis frequently occurs with silicosis. Exposure of 15 years or
longer is usually required before symptoms develop.
 Signs and Symptoms
Exertional dyspnea, productive cough with inkyblack sputum, and recurrent respiratory infections are
common symptoms.
 Diagnostic Procedures
A thorough medical history and physical examination revealing exposure to coal dust are essential and
may reveal a barrel chest, rales or crackling sounds in the lungs, a rattling in the throat (rhonchi), and
wheezing. Chest x-rays, pulmonary function studies, and arterial blood gas analyses will confirm the
diagnosis.
 Treatment
Treatment is strictly symptomatic and typically includes the use of bronchodilators and corticosteroid
drugs. Chest physical therapy will help remove secretions, and careful management of respiratory
complications, such as TB or silicosis that usually occur in association with anthracosis, is important.
 Complementary Therapy
See Silicosis.
 Prognosis
The prognosis varies. Simple anthracosis is selflimiting. The complicated form is chronic, progressive,
and worsens the prognosis. Complications can be disabling.
 Prevention
Prevention of anthracosis involves avoidance of coal dust.

Aluminosis
 Aluminosis or "aluminum light" - is pneumoconiosis, which is caused by the inhalation
of fumes and dust of aluminum metal and its compounds.
 This disease occurs in workers who are engaged in the
production of aluminum, in addition, they also develop catarrh
upper respiratory tract (rhinitis, pharyngitis, laryngitis).
 The most serious poisoning aluminum observed in workers
who are employed in the aircraft industry, as the industry
is widely used aluminum.
 The pathological picture aluminosis lung celebrated the development of intermediate
sclerosis with the growth of connective tissue in mezhalveolyarnyh partitions, around the
vessels and bronchi. Aluminum accumulates in the alveolar lumens. It often
bronchiectasis, small- and large focal emphysema, besides at aluminosis bifurcation
lymph nodes are enlarged and sealed by the development of fibrous tissue.
Symptoms
aluminosisCharacteristic symptoms aluminosis appear very bright, as at the early stages of the
disease there are complaints of shortness of breath, chest pain, coughing, general weakness,
loss of appetite, and sometimes there is pain in the stomach, nausea, constipation, "tearing"
pain throughout the body, dermatitis. During the examination revealed signs of chronic
bronchitis and emphysema. With the progress of the disease shows signs of respiratory distress.
Diagnosis aluminosis
To put a correct diagnosis is necessary to conduct X-ray examination. In this review on chest
radiograph revealed amplification and strain lung pattern, seen numerous uzelkovopodobnye
education rounded form with clear contours, the size of which is about 3 mm. The nodules
scattered on a background of deformed lung picture, also revealed symmetrical changes in the
structure of the roots of the lungs. Lymph nodes are moderately enlarged bifurcation of the
trachea, dense, gray-black with strands of connective tissue gray-white color. Heart enlarged,
the wall of the right ventricle is hypertrophied. Radiographs of patients aluminosis show that
the workers can develop the phenomenon of pneumoconiosis stage I and II after working with
aluminum for 10-15 years.
Treatment
1. The first step is to exclude any contact with aluminum dust. Patients prescribed oxygen
therapy and breathing exercises, in addition alyuminioz means carrying bronchoalveolar
lavage. When obstructive syndrome prescribed bronchodilators.
2. If tuberculin skin tests are positive, then the patient should take anti-TB drugs. In severe
disease with the development of massive fibrosis arises the need for surgery, which is
lung transplantation.
3. Aluminosis treatment is necessary as untreated disease causes a lot of complications
and provokes the appearance of related respiratory diseases, such as pneumothorax,
pulmonary hypertension, emphysema, tuberculosis, fungal lung infection. Forecasts of
treatment depends largely on the nature of the disease and its stage.

Prevention
Prevention aluminosis is that when working with
aluminum powder used in mandatory personal
protective equipment such as respirators, goggles, dust-proof clothing.
Anthrax
1. Anthrax is an infection by bacteria, Bacillus anthracis, usually transmitted from animals.
2. Anthrax causes skin, lung, and bowel disease and can be deadly.
3. Anthrax is diagnosed using bacterial cultures from infected tissues.
4. There are four types of anthrax: cutaneous, inhalation, gastrointestinal, and injection.
5. Anthrax is treated by antibiotics.
6. Pulmonary anthrax is often lethal.
7. It is possible to prevent anthrax.
8. Sadly, the greatest threat of anthrax today is through a bioterrorist attack.
9. Federal, state, and local agencies are working hard to deal with this bioterrorist threat.

 What is anthrax? Is anthrax contagious?

1. Anthrax is a life-threatening infectious disease caused by Bacillus anthracis that
normally affects animals, especially ruminants (such as goats, cattle, sheep, and horses).
Anthrax can be transmitted to humans by contact with infected animals or their products.
In recent years, anthrax has received a great deal of attention as it has become clear that
the infection can also be spread by a bioterrorist attack or by biological warfare. Anthrax
does not spread from person to person and is not considered contagious.
2. There have been a number of outbreaks over the years that are usually localized. Most
recently in 2016, in Siberia, Russia, there was a major outbreak of anthrax that sickened
at least 13 Siberian people and killed over 2,000 reindeer. Authorities believe that the
melting permafrost unburied a reindeer that died of anthrax 75 years ago, causing the
release of anthrax spores.

 What causes anthrax?

The agent of anthrax is a bacterium called Bacillus anthracis. While other investigators
discovered the anthrax bacillus, it was a German physician and scientist, Dr. Robert
Koch, who proved that the anthrax bacterium was the cause of a disease that affected
farm animals in his community. Under the microscope, the bacteria look like large rods.
However, in the soil, where they live, anthrax organisms exist in a dormant form called
spores. These spores are very hardy and difficult to destroy. The spores have been
known to survive in the soil for as long as 48 years. The bacteria secrete toxins
composed of three proteins termed protective antigen, lethal factor, and edema factor.

 How is anthrax contracted?

Anthrax can infect humans in three ways. The most common is infection through the
skin, which causes an ugly, dark sore. Humans and animals can ingest anthrax from
carcasses of dead animals that have been contaminated with anthrax. Ingestion of
anthrax can cause serious, sometimes fatal disease. The most deadly form is inhalation
anthrax. If the spores of anthrax are inhaled, they migrate to lymph glands in the chest
where they proliferate, spread, and produce toxins that often cause death.

 How common is anthrax? What are risk factors for anthrax infection?
Anthrax is now rare in humans in the United States and developed countries. It still
occurs today, largely in countries lacking public-health regulations that prevent exposure
to infected goats, cattle, sheep, and horses and their products. In the last few years, there
 have been rare cases of anthrax in people exposed to imported animal hides used to
make drums. Drum players, drum makers, and their family members have been infected
in this way. The major concern for those of us in western countries (who don't play
drums) is the use of anthrax as an agent of biological warfare. Individuals who are at
higher risk to become infected with anthrax include

veterinarians,
livestock producers and farmers,
travelers to areas where anthrax is endemic,
handlers of animal products (for example, animal hides),
laboratory personnel that study anthrax, and
mail handlers, military personnel, and individuals trained to respond to bioterrorists
and/or biological warfare.

 How long is the incubation period with anthrax?

The incubation period (the period between contact with anthrax and the start of
symptoms) may be relatively short, from one to five days. Like other infectious diseases,
the incubation period for anthrax is quite variable and it may be weeks before an
infected individual feels sick.

 What specialists treat anthrax?

Although primary-care doctors and pediatricians can treat anthrax, consultation with an
infectious-disease specialist is suggested. Other doctors who may help diagnose and/or
treat the various types of anthrax include emergency-medicine specialists,
pulmonologists, critical-care specialists, and physicians who are experts in treating
biologic agents used in warfare.

 How is the diagnosis made of anthrax?

The history, including the occupation of the person, is important. The bacteria may be
found in cultures or smears in cutaneous (skin) anthrax and in throat swabs and sputum
in pulmonary anthrax. Chest X-rays may also show characteristic changes in and
between the lungs. Once the anthrax is disseminated, bacteria can be seen in the blood
using a microscope. Of course, if anthrax is deliberately spread, the manifestations of the
disease may be unusual. Indeed, in the bioterrorism attack in the U.S. in 2001, anthrax
spores were spread through the postal system as a white powder mailed with letters.

 What is the treatment for anthrax?

In most cases, early treatment can cure anthrax. The cutaneous (skin) form of anthrax
can be treated with common antibiotics such as
penicillin, tetracycline, erythromycin (Ilotycin, Ery-Ped, Ery-Tab),
and ciprofloxacin(Cipro). The pulmonary form of anthrax is a medical emergency. Early
and continuous intravenous therapy with antibiotics may be lifesaving. In a bioterrorism
attack, individuals exposed to anthrax will be given antibiotics before they become sick.
A vaccine exists but is not yet available to the general public. Most experts think that the
vaccine will also be given to exposed individuals who are victims of a bioterrorist attack.
 Of note, anthrax is a reportable disease. That means that local or state health agencies
must be notified if a case of anthrax is diagnosed. These agencies can better characterize
the anthrax so that the affected individual can receive the most effective treatment for
that particular organism.
Individuals exposed to aerosolized spores (bioterrorism scares or attacks, for example)
can participate in postexposure prevention of anthrax. Four antibiotics are recommended
by the FDA: doxycycline (Doryx, Oracea, Monodox), ciprofloxacin, levofloxacin
(Levaquin, Quixin, Iquix), and parenteral procaine penicillin G. In addition to these
antibiotics, a three-dose series of anthrax vaccine should be started as soon as possible
after exposure.

Lead- Toxicity
Lead production workers, battery plant workers, welders and solders may be
overexposed to lead if proper precautions are not taken. Lead is stored in the bone but
may affect any organ system. The effects of lead poisoning varies depending on the age
of the individual and the amount of exposure.
In children, symptoms vary depending upon the degree of exposure to lead. Some
affected individuals may not have any noticeable symptoms. Symptoms usually develop
over a three to six week time period. Lead overexposure may cause children to be less
playful, clumsier, irritable, and sluggish (lethargic). In some cases, symptoms include
headaches, vomiting, abdominal pain, lack of appetite (anorexia), constipation, slurred
speech (dysarthria), changes in kidney function, unusually high amounts of protein in the
blood (hyperproteinemia), and unusually pale skin (pallor) resulting from a low level of
iron in the red blood cells (anemia). Neurological symptoms associated with lead
overexposure include an impaired ability to coordinate voluntary movements (ataxia),
brain damage (encephalopathy), seizures, convulsions, swelling of the optic nerve
(papilledema), and/or impaired consciousness. Some affected children experience
learning or behavioral problems such as mental retardation and selective deficits in
language, cognitive function, balance, behavior, and school performance. In some cases,
symptoms may be life-threatening.
In adults, overexposure to lead may cause high blood pressure and damage to the
reproductive organs. Additional symptoms may include fever, headaches, fatigue,
sluggishness (letheragy), vomiting, loss of appetite (anorexia), abdominal pain,
constipation, joint pain, loss of recently acquired skills, incoordination, listlessness,
difficulty sleeping (insomnia), irritability, altered consciousness, hallucinations, and/or
seizures. In addition, affected individuals may experience low levels of iron in the red
blood cells (anemia), peripheral neuropathy, and, in some cases, brain damage
(encephalopathy). Some affected individuals experience decreased muscle strength and
endurance; kidney disease; wrist drop; and behavioral changes such as hostility,
depression, and/or anxiety. In some cases, symptoms may be life-threatening.
Lead is excreted in urine and feces. However, it may also appear in hair, nails, sweat,
saliva, and breast milk.
 The diagnosis of lead poisoning may be suspected based upon appreciation of the causative factors, a
high index of suspicion, and certain laboratory tests for levels of lead in the blood. Other indicators of lead
poisoning include an elevation of free erthrocytic protoporphyrins, inhibition of ALA-D activity, elevated
lead in the hair, increased lead content of deciduous teeth, estimation of urinary coproporphytins, zinc
protoporphyrin levels.

Nickel Toxicity
Like all toxic substances, the adverse health effects of nickel on the human body depend on the
route of exposure. For example, studies in both humans and animals have shown that the
respiratory system to be the primary target of nickel toxicity if the metal is inhaled
Too much exposure to this toxic metal places more pressure on our already over-burdened
systems that are busy fighting off all the other toxins from our modern-day, industrial
environment. Fortunately, nickel can be detoxed (7)! But if nickel is not cleansed from the
body, it can lead to some pretty harmful results.
When researchers at Michigan State University conducted a study on nickel’s affect on the
body, they found that it presented a multi-tiered toxic attack. First, nickel causes essential
metal imbalances and severely disrupts enzyme action and regulation. It also contributes to a
high amount of oxidative stress. (9)
Once it enters the body, nickel targets a number of organs, including the kidneys, lungs, and
liver, and produces multiple toxic effects (9, 13). Some of these toxic symptoms include:
Abdominal pain (6)
Asthma (1)
Blue color may appear on the skin (3)
Bronchitis (1)
Cancer – oral, lung, or intestinal (11)
Cyanosis (6)
Chronic Cough (6)
Chronic Inflammation (24)
Decreased lung function (1)
Depression (11)
Dizziness (3)
Diarrhea (1, 6)
Dyspnea, or difficulty breathing (6)
Eczema (1)
Fever (3)
Gastrointestinal distress (1)
Headache (3, 6)
Heart attack (11)
Heart palpitations (6)
Hemorrhages (11)
Insomnia (6)
Itching (1, 3, 7)
Irritability (6)
Kidney damage and dysfunction (1, 11)
Low blood pressure (11)
Lung damage (1)
Malaise (11)
 Muscle pain and tremors (11)
Nausea (1, 6)
Paralysis (11)
Rash or nickel dermatitis consisting of an itching of the fingers, hands, and forearms (3)
Respiratory distress or shortness of breath (3, 6, 9)
Suicidal thoughts (11)
Tachycardia (6)
Tetany (11)
Tightness in the chest (6)
Vertigo (6)
Visual disturbances (6)
Vomiting (1, 6)
Health Conditions Caused by Nickel
Nickel is the most common metal allergen. This toxic metal has been known to trigger more
delayed type T cell hypersensitive (allergy) reactions than any other (20); up to 15% of the
population suffers from some form of nickel allergy and women are those most commonly
affected (8). One study even revealed that nickel allergy has a contact allergy rate “of 20-40%
of female population and only 3-5% of male population” (21).
If you are allergic to nickel, your nickel toxic symptoms will likely be far more severe than
someone that is not allergic to nickel. If you suffer from a nickel allergy, it’s important to be
aware that nickel ingested from nickel-contaminated foods or beverages, or eating with
stainless steel cookware or utensils, may cause a flare of dermatitis. (8)
Nickel is a harmful carcinogenic substance (5, 9, 6, 7). Studies conducted by the International
Agency for Research on Cancer (IARC) and the U.S. Department of Health and Human
Services found that all nickel compounds (save one, metallic nickel) are human carcinogens
(6). Researchers at the Dominican University of California have linked nickel exposure to
breast cancer (9). That’s right, nickel toxicity can cause cancer!
As if cancer wasn’t enough, research put out by the New York University School of Medicine
warned that chronic exposure to nickel has been connected with increased risk of
cardiovascular disease, neurological deficits, developmental deficits in childhood, lung cancer,
and high blood pressure (9).
Note that nickel also contributes to the development of autoimmune disease (18, 19, 23). In
fact, environmental factors are increasingly being recognized as the silent perpetrators when it
comes to allergic and autoimmune diseases. This includes the external pollutants of metals, as
well as the metal ions released from dental restorations (or from other body implants), which
can trigger inflammation (18).
These are a few health conditions resulting from nickel toxicity:
 Apoptosis, or cell death (13)
 Autoimmune disease (18, 19, 24)
 Birth defects (9)
 Breast cancer (9)
 Death (3)
 Depression (11)
 Chronic Fatigue (8, 24)
 Fibrosis (9)
 Infertility (9)
 Lung cancer (1, 9)
 Miscarriage (6, 9)
 Nasal cancer (1)
 Nervous system defects (9)
 Pneumonitis (3)
 Renal edema (1)

MANGANESE TOXICITY
Manganese is used as a purifying agent in the production of several metals. Symptoms
associated with overexposure to manganese may include damage to the central nervous system
and pneumonia. Additional symptoms and physical findings include weakness, fatigue,
confusion, hallucinations, odd or awkward manner of walking (gait), muscle spasms
(dystonia), rigidity of the trunk, stiffness, awkwardness of the limbs, tremors of the hands, and
psychiatric abnormalities.
Manganese poisoning may be caused by chronic inhalation and ingestion of manganese
particles. Occupational exposure to manganese in mining and separating manganese ore may
also occur. Signs of toxicity may appear within months and can continue for years. Initial signs
of manganese toxicity usually include headache, disorientation, speech disturbances, memory
loss, and acute anxiety. Prompt removal of the affected person from the source of manganese
exposure usually results in reversal of most of the symptoms; however, the symptoms will
increase and eventually become irreversible if the individual continues to be exposed to high
manganese concentrations
The following disorders may be associated with heavy metal poisoning as secondary
characteristics. They are not necessary for a differential diagnosis.
 Fanconi’s anemia is a blood disorder, which is a familial form of aplastic anemia. Children with this
disorder bruise easily and experience nosebleeds. It may be caused by genetic and environmental
interactions. Fanconi’s syndrome can be acquired instead of inherited due to acute lead poisoning. (For
more information on this disorder, choose “Fanconi’s Anemia” as your search term in the Rare Disease
Database.)
 Wilson’s disease is a genetic disorder characterized by excess storage of copper in the body’s tissues,
particularly in the liver, brain and corneas of the eyes. The disorder occurs without overexposure to
copper and is due to a metabolic defect. (For more information on this disorder, choose “Wilson
Disease” as your search term in the Rare Disease Database.)
Treatment

 The main treatment of heavy metal poisoning is termination of exposure to the metal.
Treatment also consists of the use of various chelating agents that cause the toxic (poison)
element to bind with the drug and be excreted in the urine. Three common drugs for
treatment of metal poisoning are: BA. (Dimercaprol), Calcium EDTA (Calcium Disodium
Versenate) and Penicillamine. Each of these work by binding actions that permit the metals
to be eliminated from the body through the urine.

 Treatment should also be symptomatic and supportive. In some cases, pumping of the
stomach (gastric lavage) will remove some ingested metals. In the case of inhaled poisons,
affected individuals should be removed from the contaminated environment and their
respiration supported.

 Occupational exposure to heavy metals requires prevention through the use of masks and
protective clothing.
 Carbon monoxide (CO) Poisoning :
Is an odorless, colorless, non-irritant gas. It is the most common cause of fatal poisoning,the signs and symptoms
associated with carbon monoxide poisoning are not easy to diagnose as they often mimic many other conditions.
To overcome this deadly killer requires improved awareness among the public of the risks and dangers of carbon
monoxide poisoning and increased vigilance on the part of healthcare professionals in its detection.
How does carbon monoxide cause poisoning?
Haemoglobin takes up oxygen as blood passes through the lungs, and at the same time carbon dioxide, produced by the
body’s metabolism, is released from the blood into the exhaled breath. The combination of oxygen with haemoglobin is
called oxyhaemoglobin and this ‘oxygenated’ blood is carried away from the lungs through the bloodstream to all the
tissues of the body.
Carbon monoxide can also bind to haemoglobin but does so about 240 times more tightly than oxygen, forming a
compound called carboxyhaemoglobin. This means that if both carbon monoxide and oxygen are inhaled, carbon
monoxide will preferentially bind to haemoglobin. This reduces the amount of haemoglobin available to bind to oxygen,
so the body and tissues become starved of oxygen.
Symptoms :
Severity of the poisoning depends on:
how much carbon monoxide is actually present in the environment.
the duration you are exposed to carbon monoxide.
the age of the individual concerned – elderly, children and the foetus are all at greater risk.
the general state of health.
the extent of physical activity – effects are increased with higher activity levels.
The commonest symptoms (with frequency of occurrence in brackets) include:
headache (90 per cent)
nausea and vomiting (50 per cent)
vertigo (50 per cent)
altering states of consciousness (30 per cent)
weakness (20 per cent).
The likely symptoms in adults, children and infants are shown below:
Symptoms Adult Child Infant
General Dizziness, fatigue, weakness Not feeling
well
Neurological Headache, drowsiness, Headache, drowsiness, fits,
disorientation, fits uncoordinated movement
Stomach/intestine Nausea, vomiting, stomach pains Vomiting, stomach pains, anorexia, Loss of
diarrhoea appetite
Heart Chest pain, wheeziness, Hyperventilation
palpitations, hyperventilation
Treatment :

The best way to treat CO poisoning is to breathe in pure oxygen. This treatment
increases oxygen levels in the blood and helps to remove CO from the blood. Your
doctor will place an oxygen mask over your nose and mouth and ask you to inhale.
Spending time in a pressurized oxygen chamber. In many cases, hyperbaric oxygen
therapy is recommended. This therapy involves breathing pure oxygen in a chamber in
which the air pressure is about two to three times higher than normal. This speeds the
replacement of carbon monoxide with oxygen in your blood.
 Prevention :
Simple precautions can help prevent carbon monoxide poisoning:

Install carbon monoxide detectors. Put one in the hallway near each sleeping area in
your house. Check the batteries every time you check your smoke detector batteries —
at least twice a year. If the alarm sounds, leave the house and call 911 or the fire
department. Carbon monoxide detectors are also available for motor homes and boats.
Open the garage door before starting your car. Never leave your car running in your
garage. Be particularly cautious if you have an attached garage. Leaving your car
running in a space attached to the rest of your house is never safe, even with the garage
door open.
Use gas appliances as recommended. Never use a gas stove or oven to heat your home.
Use portable gas camp stoves outdoors only. Use fuel-burning space heaters only when
someone is awake to monitor them and doors or windows are open to provide fresh air.
Don't run a generator in an enclosed space, such as the basement or garage.

Ammonia Poisining :
Ammonia is a strong, colorless gas. If the gas is dissolved in water, it is called liquid ammonia. Poisoning may
occur if you breathe in ammonia. Poisoning may also occur if you swallow or touch products that contain very
large amounts of ammonia.
Ammonia can be found in:
 Ammonia gas
 Some household cleaners
 Some liniments
 Some fertilizers
Symptoms
Symptoms can affect many parts of the body. Exposure to high concentrations of ammonia in air causes
immediate burning of the eyes, nose, throat and respiratory tract and can result in blindness, lung damage or
death. Inhalation of lower concentrations can cause coughing, and nose and throat irritation.

Airways, lungs, and chest: Heart and blood:

 Cough  Rapid, weak pulse
 Chest pain (severe)  Collapse and shock
 Chest tightness 
 Difficulty breathing Nervous system:
 Rapid breathing  Confusion
 Wheezing  Difficulty walking
Body-wide symptoms:  Dizziness
 Fever  Lack of coordination
 Restlessness
Eyes, ears, nose, mouth, and throat:
 Stupor (altered level of consciousness)
 Tearing and burning of eyes
 Temporary blindness  Skin: Bluish-colored lips and fingernails
 Throat pain (severe) Severe burns if contact is longer than a
 Mouth pain few minutes
 Lip swelling Stomach and gastrointestinal tract:
 Severe stomach pain
 Vomiting
Coal Dust Toxicity :
Pulmonary disease (e.g. coal workers' pneumoconiosis (CWP) and chronic obstructive pulmonary disease
(COPD) such as bronchitis and emphysema.
The lungs are protected by a series of defense mechanisms in different regions of the respiratory tract.
What happens when we breathe in dust?
When a person breathes in, particles suspended in the air enter the nose, but not all of them reach the
lungs. The nose is an efficient filter. Most large particles are stopped in it, until they are removed
mechanically by blowing the nose or sneezing.
Some of the smaller particles succeed in passing through the nose to reach the windpipe and the
dividing air tubes that lead to the lungs [more information about how particles entering the lungs].
These tubes are called bronchi and bronchioles. All of these airways are lined by cells. The mucus
they produce catches most of the dust particles. Tiny hairs called cilia, covering the walls of the air
tubes, move the mucus upward and out into the throat, where it is either coughed up and spat out, or
swallowed.
The air reaches the tiny air sacs (alveoli) in the inner part of the lungs with any dust particles that
avoided the defenses in the nose and airways. The air sacs are very important because through them,
the body receives oxygen and releases carbon dioxide.
Dust that reaches the sacs and the lower part of the airways where there are no cilia is attacked by
special cells called macrophages. These are extremely important for the defense of the lungs. They
keep the air sacs clean. Macrophages virtually swallow the particles. Then the macrophages, in a way
which is not well understood, reach the part of the airways that is covered by cilia. The wavelike
motions of the cilia move the macrophages which contain dust to the throat, where they are spat out or
swallowed.
Besides macrophages, the lungs have another system for the removal of dust. The lungs can react to
the presence of germ-bearing particles by producing certain proteins. These proteins attach to
particles to neutralize them.
How to protect Form Dust/Coal ?
To avoid respiratory or other problems caused by exposure to dust, hazardous substances should be
substituted with non-hazardous substances. Where substitution is not possible, other engineering control
methods should be introduced.
Some examples are:

use of wet processes

enclosure of dust-producing processes under negative air pressure (slight vacuum compared to the air
pressure outside the enclosure)
exhausting air containing dust through a collection system before emission to the atmosphere
use of vacuums instead of brooms
good housekeeping
efficient storage and transport
controlled disposal of dangerous waste
Use of personal protective equipment may be vital, but it should nevertheless be the last resort of
protection. Personal protective equipment should not be a substitute for proper dust control and should
be used only where dust control methods are not yet effective or are inadequate. Workers themselves,
through education, must understand the need to avoid the risks of dust
Cardiopulmonary resuscitation (CPR): Can Help Save A Life During A Cardiac Or Breathing
Emergency. However, Even After Training, Remembering The CPR Steps And Administering Them Correctly
Can Be A Challenge. In Order To Help You Help Someone In Need.
 Indications CPR should be performed immediately on any person who has become
unconscious and is found to be pulse less. Assessment of cardiac electrical activity via rapid
“rhythm strip” recording can provide a more detailed analysis of the type of cardiac arrest, as
well as indicate additional treatment options.
 Equipment CPR, in its most basic form, can be performed anywhere without the need for
specialized equipment. Universal precautions (i.e. gloves, mask, gown) should be taken.
 Technique
In its full, standard form, CPR comprises the following 3 steps, performed in order:
Chest compressions
Airway
Breathing
For an unconscious adult, The provider should do the following:
 Give 30 chest compressions
 Perform the head-tilt chin-lift maneuver to open the airway and determine if the patient is breathing
 Before beginning ventilations, look in the patient’s mouth for a foreign body blocking the airway
Chest compression :
CPR Steps :
1.Push hard, push fast. Place your hands, one on top of the other, in the middle of the chest.
Use your body weight to help you administer compressions that are at least 2 inches deep and
delivered at a rate of at least 100 compressions per minute.

2.Deliver rescue breaths. With the person's head tilted back slightly and the chin lifted, pinch
the nose shut and place your mouth over the person's mouth to make a complete seal. Blow
into the person's mouth to make the chest rise. Deliver two rescue breaths, then continue
compressions.
Note: If the chest does not rise with the initial rescue breath, re-tilt the head before delivering the second
breath. If the chest doesn't rise with the second breath, the person may be choking. After each subsequent set of
100 chest compressions, and before attempting breaths, look for an object and, if seen, remove it.

3.Continue CPR steps. Keep performing cycles of chest compressions and breathing until the
person exhibits signs of life, such as breathing, an AED becomes available, or EMS or a
trained medical responder arrives on scene.
1) Place the heel of one hand on the patient’s sternum and the other hand on top of the first,
fingers interlaced
2) Extend the elbows and the provider leans directly over the patient (see the image below)
3) Press down, compressing the chest at least 2 in
4) Release the chest and allow it to recoil completely
5) The compression depth for adults should be at least 2 inches (instead of up to 2 inches, as in
the past)
6) The compression rate should be at least 100/min
7) The key phrase for chest compression is, “Push hard and fast”
8) Untrained bystanders should perform chest compression–only CPR (COCPR)
9) After 30 compressions, 2 breaths are given; however, an intubated patient should receive
continuous compressions while ventilations are given 8-10 times per minute
10) This entire process is repeated until a pulse returns or the patient is transferred to definitive
care
 11)To prevent provider fatigue or injury, new providers should intervene every 2-3 minutes (i.e.
providers should swap out, giving the chest compressor a rest while another rescuer
continues CPR.
To perform the mouth-to-mouth technique, the provider does the following:
1) Pinch the patient’s nostrils closed to assist with an airtight seal
2) Put the mouth completely over the patient’s mouth
3) After 30 chest compression, give 2 breaths (the 30:2 cycle of CPR)
4) Give each breath for approximately 1 second with enough force to make the patient’s chest
rise
5) Failure to observe chest rise indicates an inadequate mouth seal or airway occlusion
6) After giving the 2 breaths, resume the CPR cycle

Audiometric tests:
An audiometry exam tests your ability to hear sounds. Sounds vary, based on their loudness (intensity) and
the speed of sound wave vibrations (tone). Hearing occurs when sound waves stimulate the nerves of the
inner ear. The sound then travels along nerve pathways to the brain.

Why is audiometry done?

One way to test for hearing loss is through the use of audiometry.An eudiometry exam tests how well your
hearing functions. It tests both the intensity and the tone of sounds, balance issues, and other issues related
to the function of the inner ear. ... A healthy human ear can hear quiet sounds such as whispers.

How the Test is Performed

1) The first steps are to see whether you need an audiogram. The procedure most often involves
blocking one ear at a time and checking your ability to hear whispers, spoken words, or the sound of a
ticking watch.

2) A tuning fork may be used. The tuning fork is tapped and held in the air on each side of the head to
test the ability to hear by air conduction. It is tapped and placed against the mastoid bone behind each
ear to test bone conduction.

3) Audiometry provides a more precise measurement of hearing. For this test, you wear earphones
attached to the audiometer. Pure tones of controlled intensity are delivered to one ear at a time. You
are will be asked to raise a hand, press a button, or otherwise indicate when you hear a sound.

4) The minimum intensity (volume) required to hear each tone is graphed. A device called a bone
oscillator is placed against the bone behind each ear (mastoid bone) to test bone conduction.

Normal results include:

The ability to hear a whisper, normal speech, and a ticking watch is normal.
The ability to hear a tuning fork through air and bone is normal.
In detailed audiometry, hearing is normal if you can hear tones from 250 to 8,000 Hz at 25 dB or lower.

Abnormal Results :
There are many kinds and degrees of hearing loss. In some types, you only lose the ability to hear high or low
tones, or you lose only air or bone conduction. The inability to hear pure tones below 25 dB indicates some
hearing loss.The amount and type of hearing loss may give clues to the cause, and chances of recovering your
hearing.
The following conditions may affect test results:
1) Acoustic neuroma
2) Acoustic trauma
3) Age-related hearing loss
4) Alport syndrome
5) Labyrinthitis
6) Ménière disease
7) Occupational hearing loss
8) Otosclerosis
9) Ruptured or perforated eardrum

Eye Tests :
These usually are performed using a projected eye chart to measure your distance visual
acuity and a small, hand-held acuity chart to measure your near vision.
 Color Blindness Test
A screening test that checks your color vision often is performed early in a
comprehensive eye exam to rule out color blindness.
In addition to detecting hereditary color vision deficiencies, color blind tests also can
alert your eye doctor to possible eye health problems that may affect your color vision.

Cover test to check eye alignment.

 Cover Test
While there are many ways for your eye doctor to check how your eyes work together,
the cover test is the simplest and most common.
During a cover test, your eye doctor will ask you to focus on a small object across the
room and will then cover each of your eyes alternately while you stare at the target. The
test is then repeated with you looking at a near object.
During these tests, your eye doctor will assess whether the uncovered eye must move to
pick up the fixation target, which could indicate strabismus or a more subtle binocular
vision problem that could cause eye strain or amblyopia ("lazy eye").
  Ocular Motility (Eye Movements) Testing
Ocular motility testing is performed to determine how well your eyes can follow a
moving object and/or quickly move between and accurately fixate on two separate
targets.
Testing of smooth eye movements ("pursuits") is more common. Your eye doctor will
have you hold your head still and ask you to follow the slow movement of a hand-held
light or other target with just your eyes. If quick eye movements ("saccades") also are
tested, your eye doctor might have you move your eyes back and forth between two
targets positioned some distance apart from each other.

 Stereopsis (Depth Perception) Test

Stereopsis is the term used to describe eye teaming that enables normal depth perception
and appreciation of the 3-dimensional nature of objects.
In one commonly used stereopsis test, you wear a pair of "3D" glasses and look at a
booklet of test patterns. Each pattern has four small circles, and your task is to point out
which circle in each pattern looks closer to you than the other three circles. If you can
correctly identify the "closer" circle in each pattern, you likely have excellent eye
teaming skills that should enable you to experience normal depth perception.
 Retinoscopy
Your eye doctor may perform this test early in the eye exam to obtain an approximation
of your eyeglass prescription.
In retinoscopy, the room lights will be dimmed and you will be asked to focus on a large
target (usually the big "E" on the eye chart). As you stare at the "E," your eye doctor will
shine a light at your eye and flip lenses in a machine in front of your eyes. This test
estimates which lens powers will best correct your distance vision.
Based on the way the light reflects from your eye, your doctor is able to "ballpark" your
prescription — sometimes right on the money!
This test is especially useful for children and patients who are unable to accurately
answer the doctor's questions.

Manual refraction with a phoropter.

  Refraction
This is the test that your eye doctor uses to determine your exact eyeglass prescription.
During a refraction, the doctor puts the instrument called a phoropter in front of your
eyes and shows you a series of lens choices. He or she will then ask you which of the
two lenses in each choice looks clearer.
Based on your answers, your eye doctor will continue to fine-tune the lens power until
reaching a final eyeglass prescription.
The refraction determines your level
of hyperopia (farsightedness), myopia (nearsightedness), astigmatism and presbyopia
Vital Function Tests.
Lung Function Tests:
There are several types of lung function tests. A single type of lung function test cannot
determine all of the lung function values, so more than one type of lung function test may be
needed.
In addition, some of the tests may be repeated after you inhale a bronchodilator to open your
airways. Now, your doctor can compare your test results with and without medication, and it
will help your doctor develop an individualized treatment plan.
Spirometry Tests

During spirometry, you breathe into a tube attached to a machine called a spirometer.
Spirometry measures your airflow. These measurements include how much air you inhale and
exhale as well as how quickly you can exhale. Forced vital capacity (FVC) and forced
expiratory volume in one second (FEV1) are two important measurements gained from
spirometry.
FEV1 and FVC results give doctors valuable information about how your lungs work. FVC is
the total amount of air you can breathe out after taking the deepest breath possible. FEV1 is the
amount of air you can forcefully exhale during the first second of the FVC test.
Body Plethysmography Tests
Body plethysmography measures how much air is in your lungs after taking a deep breath. It
also measures how much air remains in your lungs after you exhale as much as possible. Total
lung capacity (TLC) is the total amount of air your lungs can hold, and residual volume (RV) is
the amount of air still in your lungs after you exhale as much as you can.
Body plethysmography shows your doctor how well your lungs function. Like spirometry,
your doctor may perform multiple body plethysmography tests to compare results, to measure
the progression of your chronic lung disease and to develop or modify your treatment plan.
During body plethysmography, you sit in an enclosed, clear box that looks like a telephone
booth. Then, you will wear a nose clip and breathe into the mouthpiece while measurements
are recorded.
Gas Diffusion Tests

Gas diffusion tests show doctors the amount of oxygen and other gases that move through the
lungs’ tiny air sacs (alveoli). These types of lung function tests measure how well gases, such
as oxygen, are being absorbed into your blood from your lungs.
Two common types of gas diffusion tests include the arterial blood gas test and the carbon
monoxide diffusion capacity test (DLCO).
The arterial blood gas test (ABG) measures the amount of oxygen and carbon dioxide in your
blood. ABG shows how well your lungs bring oxygen to the bloodstream and remove carbon
dioxide from your bloodstream. For the ABG test, blood is drawn from an artery.
The DLCO test shows how well your lungs transfer a small amount of carbon monoxide (CO)
into the blood. DLCO measurements are taken after you breathe a very small amount of carbon
monoxide. The measurements are either taken while you inhale or as you exhale.
Exercise Tolerance Tests
Exercise tolerance tests provide your doctor with valuable information about your exercise
capacity. Many people with chronic lung diseases experience shortness of breath, especially
during exercise. However, exercise has been shown to improve quality of life, strength and
stamina in many people with lung disease. Understanding how exercise affects your lungs
helps doctors develop a well-rounded treatment plan.
The 6-minute walk test measures the distance you can walk on a flat, hard surface in six
minutes. Doctors use the 6-minute walk test to understand your ability to perform daily
physical activities.
Cardiopulmonary exercise tests evaluate your exercise capacity and are especially useful in
assessing decreased exercise capacity and causes of shortness of breath. During
cardiopulmonary exercise tests, you walk on a treadmill or ride a stationary bicycle while your
heart and lung functions are monitored. In general, your heart and lungs are watched while at
rest, during warm-up, during a short exercise period and during the recovery phase.
Pulse Oximetry Tests

Pulse oximetry tests measure your oxygen saturation level in your blood. The test is simple and
painless. In general, a finger-clip type device is placed over your finger or on your earlobe. The
light inside the device measures the amount of oxygen in your blood.
Often, people with chronic lung diseases have trouble maintaining an adequate blood oxygen
level. Your doctor will use the information gathered from pulse oximetry to make sure you’re
receiving enough oxygen. If your blood oxygen level is too low, your doctor may prescribe
oxygen therapy. Oxygen therapy can help improve your blood oxygen level.
Industrial toxicology :
1.is the study of the harmful effects on humans by chemicals used in the workplace, the
products produced by companies, and the wastes created in manufacturing
2.Industrial toxicology is a division of the broader science of toxicology that deals with the
adverse effects of all forms of chemicals, physical agents, and processes, including drugs and
medications. Originally, toxicology was known as the study of poisons, a focus that marked
this science since its earliest beginnings. Only in the middle of the twentieth century did this
area of scientific inquiry expand and become more specialized.
3. Industrial chemicals that cause the most harm to the body are classified as irritants,
asphyxiants, and systemic poisons. Generally, each grouping corresponds to a common route
of entry: the skin and eyes, the lungs, and the digestive system. These sites are the places
where absorption of the chemical occurs.

IRRITANTS. Irritants are substances that cause inflammation, rashes, or corrosion of skin.
They can also cause pain, swelling, mucus secretion, and muscle constriction. These chemicals
can also irritate the lining of lungs and the digestive system, and are called irritants because the
corrosive effects occur on epithelial (skin) cells within these organs. IRRITANTS. Irritants are
substances that cause inflammation, rashes, or corrosion of skin. They can also cause pain,
swelling, mucus secretion, and muscle constriction. These chemicals can also irritate the lining
of lungs and the digestive system, and are called irritants because the corrosive effects occur on
epithelial (skin) cells within these organs.
ASPHYXIANTS Asphyxiants are aerosols or airborne chemicals that are inhaled through the
mouth and nose. These chemicals displace oxygen within the lungs, thus inhibiting the amount
of oxygen being transported throughout the body to nourish cells. Nitrogen and helium, used to
flush vats and tanks before routine maintenance, are examples of simple asphyxiants. They
replace oxygen in the atmosphere surrounding a worker.
SYSTEMIC POISONS
Systemic poisons are chemicals that are ingested and absorbed by the digestive tract. They are
grouped according by their action or by a specific organ of the body that they target. Narcotics
and anesthetics reduce central nervous system function, and include organic solvents that make
effective anesthetics. One such solvent, diethyl ether, was taken out of the industrial sector and
used in surgical procedures because of its anesthetic uses. Other neurotoxic agents may cause
irreversible damage to the central or peripheral nervous system and include alcohols, mercury,
carbon disulfide, and organometallics, such as tin used in antifungal coatings. Some chemicals,
such as organic solvents and some metals, target the kidneys and liver. Since these organs are
the body's toxin filters, they have more contact with ingested poisons and suffer greater
damage. Another group of systemic poisons, include benzene, lead, and arsenic, which affect
the bone marrow and can produce too few red blood cells (anemia) or too many white blood
cells (leukocytosis). Certain agents, such as mercury, lead, and carbon disulfide, target
reproductive organs. They can alter male fertility or cause spontaneous abortion. Mercury has
been linked with birth defects.
Dose-response relationship
As Paracelus noted,there is a fine line between a beneficial amount of a substance and a
harmful amount. That distinction is determined by the doseresponse relationship or the amount
of a substance that a worker can be exposed to that is safe and the point at which the substance
becomes a threat. The dose-response relationship of a given chemical is characterized by five
different categories. The dose threshold is the minimum amount of the substance needed to
produce an effect. The lethal dose (LD) is the amount that will cause death. The toxic dose low
(TDL), the lowest dose that causes poisoning symptoms for nonairborne toxins, is found in
safety manuals and journal articles. The lethal concentration (LC) is the amount that is lethal. It
often has a subscript attached, such as LC50, meaning 50% of those exposed died from this
specific amount. Finally, the toxic concentration low (TCL) is the lowest published
concentration that produces toxicity for airborne substances.
Health effects
Acute effects occur after brief exposure and appear immediately. Some types of exposure,
however, can produce delayed effects. Chronic effects happen after repeated or prolonged
exposure, and can appear differently than acute exposure to the same chemical. Most
carcinogens produce chronic effects. Repeated exposure can result in cumulative toxicity. As a
worker is exposed to repeated doses of a substance, it can build up over time to toxic levels in
the body, causing damage or even death. In addition, exposure to two or more substances can
result in a more intense effect than exposure to each substance alone. This is called a
synergistic response.
Carcinogenic:
Safe Work Practices Extreme care should be taken when handling these chemicals.
General Requirements:
• All persons using highly toxic chemicals should do so only with permission from the
laboratory supervisor.
• Procedures for handling and safety should be reviewed by the laboratory supervisor on a
regular basis to ensure that updated information is included. Storage and Transport
Requirements
• The chemicals must be stored securely in a segregated area from other general chemicals.
• All carcinogenic / toxic substances should be stored in screw cap containers or ampoules at
the appropriate temperature and labelled clearly to indicate their carcinogenic risk. Information
on the label should also indicate handling procedures such as wearing gloves and mask.
• During transport these chemicals must be packaged securely and sealed to prevent accidental
breakage or damage. Handling Requirements
• Suitable laboratory equipment must be used, such as centrifuges with containment covers
etc.
• Work surfaces must be covered with a protective bench coat that will absorb and trap any
spills of toxic or carcinogenic material. This coating must be replaced on a regular basis, and
after any spill.
• All experiments involving the creation of dust, vapour or aerosols must be carried out in an
appropriate containment facilities. A cytotoxic drug-handling cabinet which complies with AS
2567 should be used in cases where there is a need to maintain the sterility of the product. A
standard biological cabinet must not be used as personnel who maintain these cabinets are not
trained to handle carcinogenic substances.
• Where animals are being treated with carcinogenic or highly toxic materials, care must be
taken that the cages, bedding, water and food waste are handled using personal protective
equipment.
Personal Protection: • All personal protective equipment should be assessed for its suitability
for handling carcinogenic and toxic substances, the equipment must be non porous. Rubber,
PVC or polyethylene gloves, coats and safety glasses should be worn as a minimum.
• Approved respirators should be made available to staff where required if the process cannot
be adequately contained. Other control measures such as isolation of the area while work is
being undertaken should also be considered. Maintenance and Cleaning:
• Cleaning of contaminated equipment and clothing should only be undertaken by a qualified
organisation with appropriate procedures for handling such contamination.
Personal Hygiene and Decontamination:
• Always wash hands thoroughly after using carcinogenic materials
• Glassware and equipment should be washed thoroughly in an appropriate chemical cleaner
• Contaminated benches should be wiped down regularly
• Any maintenance work required on equipment that has been in contact with carcinogenic or
toxic materials should be conducted only after decontamination has been done Waste Disposal
• Laboratory supervisors should be aware of Environmental, Health and Safety legislative
requirements for the disposal of carcinogenic and highly toxic waste. Carcinogens Page5
• Carcinogenic waste must be disposed of through University contractors, and must be stored
prior to disposal in a segregated area to reduce the risk of exposure to staff.
• Waste liquids must be packaged and sealed to prevent leakage or spillage. Appropriate labels
denoting the carcinogenic status of the waste must also be affixed to the packages.
• Carcasses and other solid waste should be double bagged and labelled. Emergency
Arrangements
• If a significant spill occurs, the area should be evacuated immediately. Trained personnel
only should be called in to clean up the spill.
• The following procedure should be implemented in the case of an exposure to a staff member
or student:
• Report contamination immediately to the laboratory supervisor or laboratory manager
• Report the incident after medical treatment (if required) has been administered
• Treat skin or other contact by washing the area with cool water for at least 5 minutes
• Check the Material Safety Data Sheet for other requirements

Unit-V
OCCUPATIONAL PHYSIOLOGY
Man as a system component
When a man is said to be functioning as part of a man-machine unit, the word 'machine' is used to imply any
piece of equipment with which an individual accomplishes some purpose. The pencil with which we write, the
racket with which we play squash or the spade with which we dig the garden are, in this sense, just as much
'machines' as the car we drive or the lathe on which we may be working.
A man-machine unit has three basic functions:
I) an input function which conveys information to the man's senses,
(2) a control function carried out by man in the central mechanism,
(3) an output function which will usually, though not invariably, be achieved by the activation of the man's
motor system and the application of muscular force. When there is no direct link between the output and the
input, the unit is an open bop, but when the output may have some influence on the input, the unit functions as
a closed loop in which the man is acting as a control element.
In pressing the start button on a machine in response to a decision that the time has now come for the machine
to be started up, the operator is acting as part of an open loop (Fig. 40), but should the machine be a lathe on
which a cut is to be taken by hand, the rate at which the crank which drives the saddle is turned will depend on
information coming through the eyes from the nature or color of the swerve or through the ear from the sound
of the tool cutting. The speed of turning will be modified through this feedback to attain the optimum rate of
cutting and the most satisfactory cut. The man is then acting as part of a closed loop (Fig. 37) and thus, in its
simplest form, the closed loop is giving him immediate information on the effect of his action. Another kind of
closed loop is that in which an operator has to control steam pressure continuously against a varying load by
opening or closing a valve in order to restore the pointer on the pressure gauge to the desired position. If this
response is continuous, the man is exercising a function which is generally known as tracking. Tracking takes
two forms, compensatory tracking in which an index has to be maintained at a pre-determined position as in
the example above, or pursuit tracking in which a control index is kept in alignment with an index which may
be moving in a random fashion. Because tracking is a task which is easy to study and because it is possible to
build various types of circuit characteristics, including delays, into the function of the controls it is one of our
main sources for understanding the functioning of the human operator as a controller.
Allocation Of Functions,

Function Allocation
Function allocation (also known as task allocation) is a classic human factors method for deciding
whether a particular function will be accomplished by a person, technology (hardware or software) or
some mix of person and technology. To do this, the investigator considers error rates, fatigue, costs,
hazards, technological feasibility, human values, ethical issues, and the desire of people to perform
the function.
Advantages
Function allocation is useful for determining the degree of automation that is optimal for a system.
Disadvantages
 Function allocation guidelines are often simplistic and provide only limited heuristics for
allocating functions among people, hardware, and software.
 Function allocation can affect important human values. For example, automated systems that
do not allow much human intervention can lower user satisfaction.
Appropriate Uses
Tasks should be allocated to humans and machines in a way that best combines human skills with
automation to achieve task goals, while supporting human needs.
Procedure
Prior information
Context of use analysis and task analysis should be used to identify the task structure and demands,
the knowledge needed to perform the tasks, environmental constraints, functional and safety
requirements, and any other relevant issues.
Mandatory allocation
Mandatory allocation can be identified from the task model, e.g.
Allocate functions to humans when there are technical limitations, ethical constraints, or safety
considerations.
Allocate functions to machines when task demands exceed human capabilities or when the
system must be operated in a hostile environment
Provisional allocation
Permanently allocate tasks based on factors such as task criticality, cost, training or knowledge
requirements, or task unpredictability.
Dynamically allocate tasks based on factors such as human workload, the need for cognitive
support, individual differences in users, changing capacity of the user, or organisational
learning.
Jobs must be designed from the tasks based on factors such as responsibility, task variety,
interference between and within tasks, communication between users, and individual
capability.
Evaluation
The provisional allocations and jobs should be evaluated based on factors such as: safety,
system performance, usability, cost, job satisfaction and human well-being, acceptance by
users, management and society and social impact. The evaluation findings should be used to
review and revise the provisional allocations which should then be re-evaluated.
 Efficiency each element of the 5M’s effects the efficiency of your organization.


Manpower »
Great people make great products. Increase the efficiency of your workforce by following
some best-practices in manpower management.
a) Skilled, Satisfied Workers Increase Efficiency
b) Qualifications
c) Experience
d) Self-Discipline
e) Institutional Habits

Materials »
Careful material selection and monitoring lead to significant increase in efficiency over your entire
process.
f) Quality
g) Cleanliness
h) Performance
i) Environmental-Efficiency
Increase the efficiency of your manufacturing operation by maintaining
a clean and healthy environment both outside and inside your organization.
Environmentally friendly materials are characterized by:
i. Reduced Waste
ii. Less Scrap Material
iii. Decreased Contamination
iv. Time Savings
v. Energy Efficiency
vi. Increased Health & Safety

Machines »
Design, installation, and maintenance of durable precise machines reduces waste, saves money,
creates more precise products.
Tooling
You’ve got to have the right tools for the job at hand.
Work Holding
Workholding systems ensure tools are held more concentrically
and accurately in the holder for greater precision and increased tool life.
The result is a better finish, less processing, and increased cost efficiency
Application
 Time Studies
 Process Design
 Tooling Selection
 Application Programming
 Program Installation
  Process Training
 Application Support
 Lean Manufacturing
 Maintenance
Methods »
By combining the latest methods in green manufacturing with time-tested methods from history,
you can create a lean, efficient manufacturing process.
1) Processes Effective process development requires extensive experience in all methods
available across the spectrum of manufacturing systems. Expert application engineers and lean
manufacturing consultants at 5ME are available to help you create the optimum process for
your project. Consultants have decades of experience working for original equipment
manufacturers and machine manufacturers. Once a process is in place, careful monitoring of
its effectiveness ensures it always performs to your expectations.
2) Error Proofing If proper testing is done and processes are fully thought through and
documented, it is possible to avoid many common errors in your production process. Careful
error proofing can ensure that you have processes in place to overcome behavors that cause
errors.
3) Statistical Process Control (SPC) Once designed and implemented, processes are variable
and must be measured, monitored, and refined as they begin to deteriorate. Done manually,
SPC is a nearly impossible task that involves gathering and analyzing data often from multiple
machines and comparing it to application specifications.
4) Failure Mode Effect Analysis (FMEA)
Developed by the aerospace industry, FMEA is a powerful tool that will analyze design,
process, and system for any manufacturing application. Using this step-by-step process, you can
avoid all possible failures in your manufacturing systems.

Money »
Precise measurement of statistics within machines and across the manufacturing floor provides
feedback to help you keep your systems performing at their peak.
 Asset Utilization  Scheduled Down Time
 Asset Availability  Delay Time
 Performance  Repair Time
 Quality  Not In-Cycle Process Time
 Plant Shut-Down Time  In-Cycle Time
Measuring Overall Equipment Effectiveness (OEE)
The combination of availability, performance, and quality, OEE is the ultimate measure of a
manufacturing process’ efficiency. This measurement quantifies how well a manufacturing unit
performs relative to its designed capacity, during the periods it is scheduled to run. Carefully
monitoring this metric will provide insight into how your materials, manpower, machinery, and
methods are affecting your operations.
Measurements are no use if they are out-of-date or too in depth to provide any useful insight. Instead,
metrics should be easily accessed in real-time, with useful analysis presented to a variety of
audiences. Only when monitoring current trends will you be able to maintain maximum efficiency.
Powerful, Flexible Manufacturing Efficiency Software
5ME’s Freedom eWARE provides an all-inclusive software solution for monitoring OEE in real time
from anywhere you need it. A comprehensive suite of brand agnostic software integrates with any
asset to provide exceptional analysis with customizable presentation through any Internet-ready
device. Connect your entire plant with a single system, or monitor a particular cell to prevent loss of
precision.
Capacity – Aerobic And Anaerobic Work

Difff Betn Aerobic And Anaerobic Work :

It's any activity that stimulates your heart rate and breathing to increase but not so much that you can't sustain the
activity for more than a few minutes. Aerobic means "with oxygen," and anaerobic means "without oxygen."
Anaerobic exercise is the type where you get out of breath in just a few moments, like when you lift weights for
improving strength, when you sprint, or when you climb a long flight of stairs.

health benefits of aerobic exercise?

Cancer prevention Osteoporosis

Osteoporosis is a disease characterized by low bone density, which can lead to an increased risk of fracture. The good
news is that exercise may increase bone density or at least slow the rate of decrease in both men and women. It may
not work for everyone, and the precise amount and type of exercise necessary to accrue benefits is unknown, but there
is evidence that it can help. In children there is good news, too. It seems that active children have greater bone density
than sedentary children and that this may help prevent fractures later in life.

Depression

Most of us who exercise regularly understand that exercise can elevate our mood. There have been a number of
studies investigating the effects of exercise on depression. In one of the most recent studies, it was shown that three to
five days per week for 12 weeks of biking or treadmill for approximately 30 minutes per workout reduced scores on
a depression questionnaire by 47%. It's not a substitute for therapy in a depression that causes someone to be unable to
function (in which case medication and/or psychotherapymay be necessary), but for milder forms of depression, the
evidence is persuasive that it can help.

Diabetes

No study has been more conclusive about the role of lifestyle changes (diet and exercise) in preventing diabetes than
the Diabetes Prevention Program. It was a study of more than 3,000 individuals at high risk for diabetes who lost 12-
15 pounds and walked 150 minutes per week (five 30-minute walks per day) for three years. They reduced their risk
of diabetes by 58%. That's significant considering there are 1 million new cases of diabetes diagnosed each year.
Aerobic exercise can also improve insulin resistance. Insulinresistance is a condition in which the body doesn't use
insulin properly, and this condition can occur in individuals who do and do not have diabetes. Insulin is a hormone
that helps the cells in the body convert glucose (sugar) to energy. Many studies have shown the positive effects of
exercise on insulin resistance. In one, 28 obese postmenopausal women with type 2 diabetes did aerobic exercise for
16 weeks, three times per week, for 45-60 minutes, and their insulin sensitivity improved by 20%.

Cardiovascular disease

The list of studies that show that aerobic exercise prevents or reduces the occurrence of cardiovascular disease is so
long that it would take this entire article and probably five others just like it to review all of the research. One of the
most important is one of the earliest. In a study of more than 13,000 men and women, it was shown that the least fit
individuals had much higher rates of cardiovascular disease than fit individuals -- in some cases, the risk was twice as
high. Aerobic exercise works in many ways to prevent heart disease; two of the most important are by reducing blood
pressure and allowing blood vessels to be more compliant (more compliant means that they become less stiff and it's
less likely for fat to accumulate and clog up the vessels). Results like these have been proven over and over again.

Obesity and weight control

Aerobic exercise is believed by many scientists to be the single best predictor of weight maintenance. You can lose
weight without exercise by reducing your caloric intake enough so that you burn more calories than you consume, but
it takes a regular dose of exercise to keep your weight off. How much is not clear, but somewhere between 30 and 40
minutes of vigorous exercise several times per week, to 45 to 75 minutes of moderate intensity exercise five or more
days per week is probably about right. Your mileage will vary, and so once you get to the weight that you want to be
at you'll need to experiment with different amounts of exercise until you find the one that works for you. The
American College of Sports Medicine recommends that overweight and obese individuals progressively increase to a
minimum of 150 minutes of moderate intensity physical activity per week, but for long-term weight loss, overweight
and obese adults should eventually progress to 200 to 300 minutes per week of moderate-intensity physical activity.
These are general guidelines, and so again, you need to experiment to see what works for you.

Aerobic exercise definitely burns lots of calories. Below is a table of minutes of continuous activity necessary to
expend 300 calories based on your body weight.

Osteoporosis

Osteoporosis is a disease characterized by low bone density, which can lead to an increased risk of fracture. The good
news is that exercise may increase bone density or at least slow the rate of decrease in both men and women. It may
not work for everyone, and the precise amount and type of exercise necessary to accrue benefits is unknown, but there
is evidence that it can help. In children there is good news, too. It seems that active children have greater bone density
than sedentary children and that this may help prevent fractures later in life.

Depression

Most of us who exercise regularly understand that exercise can elevate our mood. There have been a number of
studies investigating the effects of exercise on depression. In one of the most recent studies, it was shown that three to
five days per week for 12 weeks of biking or treadmill for approximately 30 minutes per workout reduced scores on
a depression questionnaire by 47%. It's not a substitute for therapy in a depression that causes someone to be unable to
function (in which case medication and/or psychotherapymay be necessary), but for milder forms of depression, the
evidence is persuasive that it can help.
Diabetes

No study has been more conclusive about the role of lifestyle changes (diet and exercise) in preventing diabetes than
the Diabetes Prevention Program. It was a study of more than 3,000 individuals at high risk for diabetes who lost 12-
15 pounds and walked 150 minutes per week (five 30-minute walks per day) for three years. They reduced their risk
of diabetes by 58%. That's significant considering there are 1 million new cases of diabetes diagnosed each year.
Aerobic exercise can also improve insulin resistance. Insulinresistance is a condition in which the body doesn't use
insulin properly, and this condition can occur in individuals who do and do not have diabetes. Insulin is a hormone
that helps the cells in the body convert glucose (sugar) to energy. Many studies have shown the positive effects of
exercise on insulin resistance. In one, 28 obese postmenopausal women with type 2 diabetes did aerobic exercise for
16 weeks, three times per week, for 45-60 minutes, and their insulin sensitivity improved by 20%.

Cardiovascular disease

The list of studies that show that aerobic exercise prevents or reduces the occurrence of cardiovascular disease is so
long that it would take this entire article and probably five others just like it to review all of the research. One of the
most important is one of the earliest. In a study of more than 13,000 men and women, it was shown that the least fit
individuals had much higher rates of cardiovascular disease than fit individuals -- in some cases, the risk was twice as
high. Aerobic exercise works in many ways to prevent heart disease; two of the most important are by reducing blood
pressure and allowing blood vessels to be more compliant (more compliant means that they become less stiff and it's
less likely for fat to accumulate and clog up the vessels). Results like these have been proven over and over again.

Obesity and weight control

Aerobic exercise is believed by many scientists to be the single best predictor of weight maintenance. You can lose
weight without exercise by reducing your caloric intake enough so that you burn more calories than you consume, but
it takes a regular dose of exercise to keep your weight off. How much is not clear, but somewhere between 30 and 40
minutes of vigorous exercise several times per week, to 45 to 75 minutes of moderate intensity exercise five or more
days per week is probably about right. Your mileage will vary, and so once you get to the weight that you want to be
at you'll need to experiment with different amounts of exercise until you find the one that works for you. The
American College of Sports Medicine recommends that overweight and obese individuals progressively increase to a
minimum of 150 minutes of moderate intensity physical activity per week, but for long-term weight loss, overweight
and obese adults should eventually progress to 200 to 300 minutes per week of moderate-intensity physical activity.
These are general guidelines, and so again, you need to experiment to see what works for you.

Aerobic exercise definitely burns lots of calories. Below is a table of minutes of continuous activity necessary to
expend 300 calories based on your body weight.

Benefits:
Aerobic exercise can strengthen your heart and reduce your resting heart rate, while increasing the number of red
blood cells that help distribute oxygen throughout your body. It also helps with weight loss if you combine it with a
healthy, calorie-controlled diet. Aerobic exercise also can potentially reduce your chances of developing heart disease,
strokes, high blood pressure, diabetes and some forms of cancer; and it can improve your immune system and
stamina. Results do vary based on individual, though, and again, always consult your doctor to help determine the best
diet and exercise plan for your particular situation.
 Anaerobic exercise
is a form of high-intensity exercise that increases a substantial oxygen deficit. When performing at elevated intensity
levels, your cardiovascular system has a challenging time delivering the oxygen requirement needed to your muscles
fast enough. Since muscles require oxygen to maintain prolonged exertion, anaerobic exercises can only continue for
short periods of time. Examples of anaerobic activity include sprinting, high-intensity interval training, powerlifting
and most athletic sports.

High-Intensity Interval Training

Powerlifting
Sports

Anaerobic Benefits
Anaerobic exercise can strengthen your bones, decreasing your risk of osteoporosis. It can also improve the strength
of your tendons and ligaments while also improving joint function. It can reduce the risk of potential injuries and
improve your cardiac function. Lastly, anaerobic exercise can elevate your levels of good cholesterol (HDL). Again,
these benefits are obtained in combination with a healthy diet, and results vary by individual.

Parameters Of Measurements
categorization of job heaviness
Work Organization
The organization of work includes many aspects, such as pace of work (speed of an assembly line,
quotas), work load, number of people performing a job (staffing levels), hours and days on the job,
length and number of rest breaks and days away from work, layout of the work, skill mix of those
workers on the job, assignment of tasks and responsibilities, and training for the tasks being
performed. When work is restructured, these aspects of work organization can be changed
dramatically. Work is restructured by management to achieve the goals of standardization of the
work, which in turn is used by management to increase their control over work.

Some common terms for work organization/reorganization include:

• Lean Production: An overall approach to work organization that focuses on elimination of any
“waste” in the production/service delivery process. It often includes the following elements:
“continuous improvement”, “just-intime production”, and work teams.

• Continuous Improvement: A process for continually increasing productivity and efficiency, often
relying on information provided by employee involvement groups or teams. Generally involves
standardizing the work process and eliminating micro-breaks or any “wasted” time spent not
producing/serving.

• Just-in-Time Production: Limiting or eliminating inventories, including work-in-progress

inventories, using single piece production techniques often linked with efforts to eliminate “waste” in
the production process, including any activity that does not add value to the product.
• Work Teams: Work teams operate within a production or service delivery process, taking
responsibility for completing whole segments of work product. Another type of team meets
separately from the production process to “harvest” the knowledge of the workforce and generate,
develop and implement ideas on how to improve quality, production, and efficiency.

• Total Productive Maintenance: Designed to eliminate all nonstandard, non-planned maintenance

with the goal of eliminating unscheduled disruptions, simplifying (de-skilling) maintenance
procedures, and reducing the need for “just-in-case” maintenance employees.

• Outsourcing/Contracting Out: Transfer of work formerly done by employees to outside

organizations.

Personal Hygiene.
The human body can provide places for disease-causing germs and parasites to grow and multiply. These places
include the skin and in and around the openings to the body. It is less likely that germs and parasites will get inside
the body if people have good personal hygiene habits.

Maintaining personal hygiene is essential for more than one reason; social, health, personal, psychological or just as
a way of life. Maintaining a good standard of hygiene helps keep infections, illnesses and bad odors at bay. The
importance of hygiene should be taught from an early age to help cultivate good habits. Personal hygiene can be
defined as an act of maintaining cleanliness and grooming of the external body. Maintaining good personal hygiene
consists of bathing, washing your hands, brushing teeth and sporting clean clothing. Additionally, it is also about
making safe and hygienic decisions when you are around others.

One of the most fool proof ways to safeguard yourself and others from illness is through good personal hygiene.
This means cleaning your hands, especially, but additionally your body. Good personal hygiene not only enhances
your overall appearance, its importance is directly related to prevention of diseases, infections, and unpleasant
odors.

Good personal hygiene

Good personal hygiene habits include:

1) Washing The Body Often. If Possible, Everybody Should Have A Shower Or A Bath Every Day. However,
There May Be Times When This Is Not Possible, For Example, When People Are Out Camping Or There Is A
Shortage Of Water
2) If This Happens, A Swim Or A Wash All Over The Body With A Wet Sponge Or Cloth Will Do
3) Cleaning The Teeth At Least Once A Day. Brushing The Teeth After Each Meal Is The Best Way Of Making
Sure That Gum Disease And Tooth Decay Are Avoided. It Is Very Important To Clean Teeth After Breakfast
And Immediately Before Going To Bed
4) Washing The Hair With Soap Or Shampoo At Least Once A Week
5) Washing Hands With Soap After Going To The Toilet
6) Washing Hands With Soap Before Preparing And/Or Eating Food. During Normal Daily Activities, Such As
Working And Playing, Disease Causing Germs May Get Onto The Hands And Under The Nails. If The Germs
Are Not Washed Off Before Preparing Food Or Eating, They May Get Onto The Food
7) Changing Into Clean Clothes. Dirty Clothes Should Be Washed With Laundry Soap Before Wearing Them
Again
8) Hanging Clothes In The Sun To Dry. The Sun's Rays Will Kill Some Disease-Causing Germs And Parasites
 9) Turning Away From Other People And Covering The Nose And Mouth With A Tissue Or The Hand When
Coughing Or Sneezing. If This Is Not Done, Droplets Of Liquid Containing Germs From The Nose And
Mouth Will Be Spread In The Air And Other People Can Breathe Them In, Or The Droplets Can Get Onto
Food

Fig. 3.17: Washing the body helps keep it free of disease-causing germs

Fig. 3.18: Cleaning teeth helps keep gums and teeth healthy.

Fig. 3.19: Washing hands after going to the toilet helps stop the spread of germs.
Fig. 3.20: Washing hands before preparing food helps keep germs out of our bodies.

Fig. 3.21: Washing hands before eating food helps stop germs getting into our bodies

Fig. 3.22: Washing clothes helps keep them free of disease-causing germs.
 Fig. 3.23: Hanging clothes in the sun helps to kill some disease-causing germs and parasites.

Fig. 3.24: Covering the nose and mouth when sneezing helps stop the spread of germs.

7.2 Overcrowding
When there are too many people in any house, the likelihood of them getting disease is greater than if the house is not overcrowded. This is
because people in an overcrowded house will be much closer to each other and it is therefore easier for any germs to spread from one to
another. For example:

 sneezing and coughing in crowded rooms makes it easier to spread cold and flu germs

 sharing towels can spread trachoma germs and other germs which cause eye infections (runny or sore eyes)

 several children sleeping in the same bed makes it easier to spread a scabies infection
Fig. 3.25: Overcrowding helps spread germs and parasites such as scabies.

Each house is designed to allow a particular number of people to live there comfortably. This number will depend upon the number and size of
the rooms, especially bedrooms, and the size of other facilities such as the sewage system and washing and cooking areas.

If the number of people living in the house is greater than the number it was designed for, these facilities will not be able to cope properly. For
example, large numbers of people using the toilet may mean that the septic tank will not be big enough to take and treat the additional load of
sewage.

For good health and comfort, the number of people who should live in a house depends upon the factors outlined below.

The number and size of bedrooms

While most people who live permanently in a house will have a bedroom to themselves or share one with one or two other people, other rooms
are often used as bedrooms. The number of people who should sleep in a room will depend upon the amount of air which is available to each
person. The law requires that each adult person has at least 13 cubic metres of air and each child has at least 10 cubic metres of air in a
sleeping area.

Stress
 is your body’s way of responding to any kind of demand or threat. When you sense danger—whether
it’s real or imagined—the body's defenses kick into high gear in a rapid, automatic process known as
the “fight-or-flight” reaction or the "stress response".

 Stress can also help you rise to meet challenges. It’s what keeps you on your toes during a
presentation at work, sharpens your concentration when you’re attempting the game-winning free
throw, or drives you to study for an exam when you'd rather be watching TV. But beyond a certain
point, stress stops being helpful and starts causing major damage to your health, your mood, your
productivity, your relationships, and your quality of life.

 Signs and symptoms of stress overload

The most dangerous thing about stress is how easily it can creep up on you. You get used to it. It starts to feel
familiar — even normal. You don’t notice how much it’s affecting you, even as it takes a heavy toll. That’s why
it’s important to be aware of the common warning signs and symptoms of stress overload.
Cognitive symptoms
 Memory problems
 Inability to concentrate
 Poor judgment
 Seeing only the negative
 Anxious or racing thoughts
 Constant worrying
Emotional symptoms
 Depression or general unhappiness
 Anxiety and agitation
 Moodiness, irritability, or anger
 Feeling overwhelmed
 Loneliness and isolation
 Other mental or emotional health problems
Physical symptoms
 Aches and pains
 Diarrhea or constipation
 Nausea, dizziness
 Chest pain, rapid heart rate
 Loss of sex drive
 Frequent colds or flu
Behavioral symptoms
 Eating more or less
 Sleeping too much or too little
 Withdrawing from others
 Procrastinating or neglecting responsibilities
 Using alcohol, cigarettes, or drugs to relax
 Nervous habits (e.g. nail biting, pacing)

Causes of stress
The situations and pressures that cause stress are known as stressors. We usually think of stressors as being
negative, such as an exhausting work schedule or a rocky relationship. However, anything that puts high
demands on you can be stressful. This includes positive events such as getting married, buying a house,
going to college, or receiving a promotion.

Improving your ability to handle stress

Get moving
Connect to others
Engage your senses
Learn how to relax
Eat a healthy diet
Get your rest

Muscle Strain Symptoms

Symptoms of muscle strain include:

 Swelling, bruising, or redness due to the injury

 Pain at rest
 Pain when the specific muscle or the joint in relation to that muscle is used
 Weakness of the muscle or tendons
 Inability to use the muscle at all
  Take nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen or ibuprofen to
reduce pain and improve your ability to move around. Do not take NSAIDS if you
have kidney disease or a history of gastrointestinal bleeding or if you are also taking
a blood thinner -- such as Coumadin -- without first talking with your doctor. In that case, it
is safer to take acetaminophen, which helps lessen pain but does not reduce inflammation.
 Protection, rest, ice, compression, and elevation (known as the PRICE formula) can help the
affected muscle. Here's how: First, remove all constrictive clothing, including jewelry, in
the area of muscle strain.

Then:

 Protect the strained muscle from further injury.

 Rest the strained muscle. Avoid the activities that caused the strain and other activities
that are painful.
 Ice the muscle area (20 minutes every hour while awake). Ice is a very effective anti-
inflammatory and pain-reliever. Small ice packs, such as packages of frozen vegetables
or water frozen in foam coffee cups, applied to the area may help decrease inflammation.
 Compression can be gently applied with an Ace or other elastic bandage, which can both
provide support and decrease swelling. Do not wrap tightly.
 Elevate the injured area to decrease swelling. Prop up a strained leg muscle while sitting,
for example.
 Activities that increase muscle pain or work the affected body part are not recommended
until the pain has significantly improved.

Fatigue: is a feeling of tiredness or exhaustion or a need to rest because of lack of energy or

strength.Fatigue may result from overwork, poor sleep, worry, boredom, or lack of exercise. It is a symptom
that may be caused by illness, medicine, or medical treatment such as chemotherapy.

 There are numerous potential causes of fatigue as a major complaint. They range from those that
cause poor blood supply to the body's tissues to illnesses that affect metabolism, from infections and
inflammatory diseases to those that cause sleep disturbances. Fatigue is a common side effect of
many medications. While numerous patients with psychological conditions often complain of fatigue
(physical and mental), there are also a group of patients where the cause of fatigue is never
diagnosed
Signs And Symptoms
Fatigue is a symptom of an underlying disease and is described in many ways from feeling weak to being
constantly tired or lacking energy.
There may be other associated symptoms depending upon the underlying cause.
 Individuals with heart disease, lung disease, or anemia may complain of associated shortness of breath or tiring
easily with minimal activity.
 Persons with diabetes may complain of polyuria (excess urination), polydypsia (excess thirst), or change of
vision.
 Those who have hypothyroidism may also have symptoms of feeling cold, dry skin and brittle hair.
 Other associated symptoms with fatigue include:
weight loss,
chest pain and shortness of breath,
vomiting and diarrhea,
 fevers and chills,
muscle weakness or pain, and/or
anxiety and depression.

Initial screening blood tests may include:

 CBC (complete blood count that includes a red blood cell, white blood cell and platelet count);
 electrolytes (sodium potassium, chloride, carbon dioxide, and sometimes calcium and magnesium);
 glucose (blood sugar);
 BUN/creatinine (to measure kidney function);
 TSH or thyroid stimulating hormone;
 monospot;
 ferritin;
 tests for deficiencies in vitamins B12, D, folic acid, and iron;
 CPK (elevated in illnesses that cause muscle inflammation); and/or
 ESR or erythrocyte sedimentation rate (non specific blood marker for inflammation in the body).