Occupational And Environmental Health Notes !!~!!

STABILIZATION POND (Mnemonics – FAM)

-        Known as oxidation pond or sewage lagoon

-        Used in most housing project with more than 100 unit of houses

-        Sewage purified by natural process

Operation

1.      Facultative Lagoon

a.      Sewage -> Discharge Pond -> Undergo natural process by microorganism -> CO₂ -> Algae convert CO₂ to O₂ -> O₂ used to convert and stabilized sewage into harmless product and deodorized.

2.      Maturation Lagoon

a.      Further process known as polishing lagoon

b.      Further reduce BOD, bacteria

3.      Anaerobic Lagoon

a.      Used to decompose settled solid before transfer to facultative lagoon or maturation lagoon

BIOCHEMICAL OXYGEN DEMAND (BOD)

-        Chemical procedure used in water quality management and assessment, ecology and environmental science

-        Used to determine how fast microorganism in water use up dissolve oxygen

-        BOD were measured by DO₅-DO₀

Use

-        To determine the oxygen demand of waste water

-        To determine the quality of water

-        Evaluate efficiency of water treatment system

-        Evaluate effectiveness of water treatment plan

Test

1.      Sample of water were taken

2.      Sample were then labeled and measured for initial DO (DO₀)

3.      Sample diluted with de-ionized oxygenated water

4.      An aliquot seed were inserted in sample

5.      Sample were incubated in dark room with temperature of 20^OC to prevent photosynthesis

6.      On day 5, the DO (DO₅) were measured

7.      BOD is the difference between DO₅ and DO₀

Interpretation

-        High DO – Oxygen uptake is low

-        Low DO – High uptake of oxygen, possible source of contamination

-        BOD Level (in ppm)

o    1 – 2 = Very Good

o    3 – 5 = Moderate Clean

o    6 – 9 = Somewhat Polluted

o    10+ = Very Polluted

WATER QUALITY TEST

Dissolve Oxygen – BOD, COD

Total Suspended Solid – TSS capture by filter

Bacteriological – Total Coliform, Chlorine Residual

Test

1.      Total coliform

2.      Pseudomonas

3.      Naegleria Fowleri

4.      BOD

5.      MPN

6.      COD

WASTE WATER TREATMENT

Municipal

-        Domestic, pretreated industrial, run-off, sewage system

Industrial

-        Industrial used water need to be treated before discharge to environment

DRINKING WATER QUALITY  (Mnemonic – PCRV3B)

Quality

a.      Physical

a.      Color, Smell, Solid, Turbidity, Taste

b.      Chemical

a.      Any substance that alter potability (e.g. fluoride, arsenic)

c.      Biological

a.      Any organism such as algae, protozoa

d.      Bacteriological

a.      Any contamination by bacteria such as e-coli, coliform, streptococcal faecalis must not be detectable

e.      Viral

a.      Any contamination by viral source

f.       Radiological

a.      To detect the alpha and beta activity

g.      Biochemical

a.      BOD and COD

WATER INFECTIONS

- Infection of water source that can be transmitted to living organism such as humans and animals

- Coliform – Infected form fecal material, Pseudomonas, Naegleria Fowleri – Brain eating organism, Streptococcus Faecalis

Source

1.      Water Treatment Plan

2.      Water Delivery System

3.      Water Collection System

4.      Water Preparation

Transmission

a.      Water-Borne

a.      Pathogen in water, drunk by humans and get infected

b.      Water-Washed

a.      Water that is contaminated by usage of water

b.      Can be used by increase the volume of water used for hygienic purpose

c.      Water-Based

a.      Disease which the pathogen spend part of lice in a water (e.g. parasite, helminthes)

d.      Insect-Vector

a.      Disease that is spread by organism breeding or bite near water

REFUSE DISPOSAL (MIB-CRIL)

Onsite (MIB)

-        Manure pit (lubang sampah biasa and kambus hari-hari)

-        Burial – Suitable for camp

-        Incineration – High temperature burning (toxic, infectious)

Offsite (CRIL)

-        Landfill – Dispose at open land and cover with soil every day

-        Incineration – Burn high temperature

-        Recycle

-        Compositing

Final Disposal

1.      Open Dumping – Dumped in low-lying areas (water, air pollution)

2.      Dumping at Sea – Can use for claiming land

3.      Controlled Tipping – Same as dumping but put in trench, compacted and covered with soil (less pollution except for leachate)

4.      Sanitary Landfill

a.      Modern landfill

b.      Proper fencing, grading, stockpiling material, leachate collection and extraction system, treatment and monitoring system

c.      Advantage

                                                i.     Can generate electricity

                                               ii.     Reclaim Land

                                              iii.     No Pollution of ground water

d.      Disadvantage

                                                i.     Required land for long period

                                               ii.     Fire hazard, pollution if not maintained properly

INCINERATION

-        A method of onsite and off site disposal of refuse

-        High infectious, toxic, flammable refuse were collected with proper collection system

-        Burned with high temperature

-        Suitable when there is limited land

Advantage

-        Can generate energy

-        Safe space / land

-        Efficient

-        No air pollution if temperature in more than 1000⁰C

Disadvantage

-        Need proper control of dioxin

-        Can and bottle still available

-        Cost to maintain is high

HEALTH HAZARD OF SOLID WASTE

Solid Waste Source (Mnemonics - DICAH)

-        Domestic – Plastic, Cans, Paper, Leftover

-        Industrial – Chemical, Raw Material

-        Community – Same as domestic but in large scale

-        Agricultural

-        Healthcare – Toxic waste, Human Parts, Sharps, Pharmaceutical, Drugs

Health Hazards

1.      Air Pollution

a.      From open burning causes pollution to air, effect the respiratory system

2.      Water Pollution

a.      May cause pollution in ground water, contaminated, thus higher chance of infection

3.      Soil Pollution

a.      Leachate pollute soil

4.      Infection

a.      Waste provides optimal food for rodents, vector of other communicable disease.

5.      Fire Hazard

a.      Burn, spontaneous fire at disposal site

6.      Physical Injury

a.      Physical trauma or injury from landslide due to solid waste disposal

RECYCLING

-        A method of solid waste disposal

-        Solid waste were sorted according to groups at household, commercial, industrial, as well as agricultural level

-        Based on a concept of 3 R, Reduce, Reuse, Recycle

-        Advantage

o    Did not require usage of large land – selected and sorted at source, only unrecyclable were disposed

o    Reduce cost of waste disposal

o    Save energy

o    Reduce air and water pollution

-        Disadvantage

o    Expensive to recycle some material

o    Need proper set up and participation of community

o    Limited to certain waste only

-        Steps

o    Collection and Separation

o    Manufacturing – reuse recyclable material (e.g. tissue paper)

o    Purchasing recycle product – complete the recycle loop

FOOD ADDITIVES

-        Any substance that is added into food during food processes

-        Aim to improve quality of food, shelf life, added color, taste, and odor

-        Anti-oxidants, preservatives, coloring, artificial flavor, food conditioner

HAZARD ANALYSIS CRITICAL CONTROL POINT (HACCP) IN FOOD QUALITY CONTROL

-        Food quality control system

-        Ensure food is properly prepared, transported, stored and delivered

-        Ensure food free from contamination

-        Use critical controlling point

-        IDENTIFY & PREVENT

Hazard Analysis – identification of food items and preparation process that might cause contamination or illness

Critical Control Point – steps where contamination is likely to occur and control measures is used to prevent, eliminate, minimize hazard

Principles (Mnemonics – HaCLiMCoVD)

1.      HAZARD - Conduct hazard analysis

2.      CRITICAL POINTS - Identify critical points

3.      LIMITS - Set standard / limit for critical points

4.      MONITOR - Set monitoring requirements of critical points

5.      CORRECTIVE - Corrective action

6.      VERIFICATION - HACCP working procedure verification

7.      DOCUMENTATION - Record keeping

Advantage (Mnemonic - PESEO)

-        Prompt

-        Efficient

-        Systematic

-        Economical

-        On the spot

FOOD QUALTIY CONTROL

Aim:

-        To ensure consumption of safe and wholesome food

-        To prevent distribution of unwholesome food

-        To reduce spoilage

1.      Control at source

2.      Control at processing

3.      Control at transportation

4.      Control at storage

5.      Control at retail / distribution point

6.      Control at preparation

Control Measures

-        Heat – Pasteurization of milk

-        Dehydration – Dried fruits, fish

-        Cold – Meat, Fish

-        Acidification – Vinegar and pickles

-        Chemical – Chlorine in water

-        Antibiotic – Nissin in cheese

-        Irradiation – Water with UV

-        Gases – Vegetables with carbon dioxide

AIR POLLUTION (API)

-        Occurs when the air contains gasses, fume, dust, particulate matter, odor in harmful amounts

-        Monitored by DOE, ASMA

-        API

o    Air pollution index

o    Tell us how bad is the pollution associated to health

o    It’s an index which capture major pollutants which can cause potential harm to health

o    Type of pollutant

§  Ozone, PM10, carbon monoxide, sulfur dioxide, nitrogen dioxide

o    The Index

§  0 – 50            = Good = No ill effects

§  51 – 100        = Moderate = No ill effects

§  101 – 150      = Unhealthy = Mild, high-risk

§  151 – 200      = Very Unhealthy = Significant risk, all

§  300 - 500       = Hazardous = Severe, danger

§  > 500             = Emergency

CLIMATE CHANGE

Climate: The atmosphere condition over long period

-        Climate Change

o    Increased Precipitation

o    Increased Humidity

o    Increased Global Temperature

-        Causes

o    Mainly Pollution (Air) – Ozone depletion, UV rays

o    Deforestation – Haze, Increase temperature

o    Technological Advancement – Green house effects

o    Development – Green house effects

o    Loss of Biodiversity – Disharmony of environment

-        Effects

o    Increase global temperature

o    Increase water level

o    Vector breed

o    Flood

o    Extreme weather – cold / hot

o    Draught

-        Health Effects

o    Skin diseases / cancer

o    Infection

o    Heat Related Illness

o    CVD / Stroke

-        Measures

o    Adaptation – adapting to the change, anticipate, change and prepare

o    Mitigation – effect to slow, stabilize or reverse climate change by reducing green house gasses (green house gas create low level ozone, block uv, heat to be disperse to space, retain heat -> green house effects)

DENGUE VECTOR CONTROL

Dengue – Mosquito borne infection by Aedes species

Control Measures

(Elimination, Substitution, Engineering, Administrative, PPE)

Steps

1.      Identify Hazard – Dengue Outbreak

2.      Risk Assessment – Dengue high morbidity and rising mortality

3.      Control

a.      Elimination – Source reduction, eliminate breeding site, larvacidal, fish (gambusia affinis)

b.      Substitution – None

c.      Engineering – Genetic modification (male only mosquito), Insecticide net, larva trap

d.      Administrative – Surveillance, law enforcement

e.      PPE – Avoid going out at dusk and dawn, mosquito repellent cream

HEIRARCHY OF CONTROL

Elimination

Substitution

Engineering

Administrative

PPE

PRE-EMPLOYMENY EXAMINATION

-        Medical examination conducted before job employment

-        Look at general health

-        Benefits

o    Cost effective

o    Reduce absenteeism

o    Legal obligation

Objectives

-        Measure medical fitness

-        Ability to perform work without hazard to others

-        Baseline record of employee health status

Content

1.      General Examination

2.      Chest X-Ray

3.      Urine Analysis

4.      Blood Analysis (Upon request)

HEALTH SURVEILLENCE LEAD

Lead

-        Listed in USECHH regulation 2008

-        Exposure = lead battery manufacture, PVC compound, ship-breaker welders, soldering

-        Effects

o    Developmental delay

o    Anemia

o    GI symptoms

o    Abortion

o    CNS and PNS (Paresis, Encephalopathy)

Medical Surveillance

-        Any worker exposed to level of airborne lead 10% from PEL

-        Blood and urine, routine and follow up

-        Levels

o    PEL = 50 ug/m³

o    Biological Exposure Indices = 30 ug/100ml blood

-        Removal (FMA 1984)

o    Blood sampling >80 ug/100ml blood

o    Average 3x blood sampling of 75 ug/100 ml blood

o    Female childbearing >40 ug/100 ml blood

o    Pregnant and breast feeding

-        Prevention

o    Elimination, Substitution, Engineering, Administrative, PPE

RISK ASSESSMENT

Risk: Likelihood of harm to occur (Risk = Hazard x Exposure)

Hazard: Source of potential harm

Exposure: Time contact with substance

Risk Assessment (DGDIECCIRR): Process to estimate the magnitude of risk, and control measures taken

1.      Decide Assessor

2.      Gather Information

3.      Divide into groups

4.      Identify Hazard

5.      Evaluate Exposure

6.      Control Measures

7.      Conclude Risk

8.      Identify Action

9.      Report Writing

10.    Review

Hazard Rating

1.      No injury / not affecting work performance

2.      Minor injury / affecting work performance

3.      Major injury / affecting work performance

4.      Permanent total disability

5.      Death

Exposure Rating

1.      Exposure less than once a year

2.      Exposure more than once per year

3.      Exposure more than once per month

4.      Exposure more than once per week

5.      Exposure more than once per day / shift

Risk Rating - Conclusion from risk matrix to grade risk

-        1 and 2 = Not Significant

-        3 and 4 = Significant but lower priority

-        5 = Significant and Intolerable

Conclusion

1.      C1 = Risk not significant / likely not increase

2.      C2 = Risk significant / adequate control

3.      C3 = Risk significant / inadequate control

4.      C4 = Uncertain about risk / insufficient information

5.      C5 = Uncertain about risk / degree ad extend of exposure

PERMISSIBLE EXPOSURE LIMIT

-        Is a legal limit for exposure of an employee to a substance

-        Expressed in PPM

-        Usually given as time weighted average (TWA)

-        TWA = average exposure over a specific time (8 Hours)

Noise

-        Unwanted sound

-        Sound = Vibration that can be heard by human ear

-        PEL

o    TWA = continuous 90dB for 8 hours

o    Short Term Exposure Limit = not more than 15 min exposure to 115 dB

o    Ceiling Limit = continuous, impulsive or intermittent more than 140 dB at any time

-        Side effects

o    Auditory (NIHL)

§  Short term hearing loss

§  Long term hearing loss (Permanent Threshold Shift)

o    Non-auditory

§  Headache, sleep disturbance

WALK THROUGH SURVEY

-        Process to identify hazard and exposure by going through the work process on the ground

-        Steps

o    Meet the management

o    Discuss about the purpose

o    Review health complains

o    Process work flow diagram in hand

o    Walk through survey form

o    Perform work through survey

§  Get briefing regarding work process

§  Assess worker and workplace

§  Check materials

§  Listen to workers, observe, interview

§  Attention to non-routine work

§  Note down

§  Assess effectiveness of control measures

§  Attention to hazards

OCCUPATIONAL HEALTH HAZARD

Physical

Chemical

Biological

Mechanical

Psychosocial

CONTACT ALLERGIC DERMATITIS

Definition: Inflammation of the skin due to prolong contact with allergenic substance

Symptoms: Red, dry, itchiness, scaly

-        Occur due to frequent contact of skin with chemical, material

-        The degree of allergic depends on the individuals immune system reaction as well as the strength of the materials / substance

Detection

-        Victims consult doctor

-        Get more history (time started, how long, aggravating factor)

-        Get occupational history (workplace, material used or exposed, PPE)

-        Skin test

-        Confirm diagnosis

-        Treatment, Control (Hierarchy of control) and Prevention

PNEUMOCONIOSIS

Definition: Group of condition resulting from mineral dust deposition in lung leading to lung tissue reaction

Silicosis

-        Parenchymal lung disease due to inhalation of silica dust

-        Common in miners, sandblasters, silica production

-        Patterns

o    Chronic Simple Silicosis

§  Exposure >10 years

§  Characteristic

·       Silicotic nodule at lung parenchymal and hilar nodes

·       Rare sign and symptoms in simple, (complicated = dyspnea)

o    Sub-acute Silicosis

§  Similar with chronic but shorter exposure duration and heavier exposure (2-3 years)

o    Acute Silicosis

§  Rare but fatal

§  Intense exposure within month

§  Occur due to inadequate respiratory protection

§  Characteristic

·       Lung consolidation without silicotic nodule

·       Alveolar space filled with fluid

o    Complicated Chronic Silicosis

§  Reduction in lung volume

Asbestosis

-        Diffuse interstitial pulmonary fibrosis due to inhalation of asbestos fiber

-        Characteristic

o    Bilateral pleural thickening

o    Diaphragmatic calcification

o    Pericardial calcification

Coal Miners Pneumoconiosis

-        Parenchymal disease of lung due to inhalation of coal dust

-        Risk -> underground coal miner, exposure <20 o:p="" years="">

HAND ARM VIBRATION SYNDROME

Definition: Combination of symptoms in fingers, hands and arms caused by prolonged use of vibration equipment

Symptoms: White finger, numbness, ache, and pain

Prevention: Anti vibrating handle, reduce exposure, health education, and medical surveillance

OCCUPATIONAL ASTHMA

Definition: Asthma that occur due to workplace exposure, worker free from asthma before start working

Types

1.      Sensitizer-induced asthma / Allergic Asthma

2.      Without sensitizer / Non-Allergic Asthma

DISASTER MANAGEMENT

Phase

1.      Pre-Emergency

2.      Impact & Flight

3.      Acute Emergency

4.      Post Emergency

5.      Rehabilitation

6.      Reconstruction

7.      Mitigation