Providing advice on the management of chemical, biological, radiological or nuclear incidents (CBRN) Center for Radiation, Chemical and Environmental Hazards: Radiation Protection Division 35_Smedley_Chap35.indd 712 1/2/2013 12:59:05 PM HEALTH PROTECTION AGENCY 713 Chemical Hazards and Poisons Division \200\224offering advice on chemical incidents including \201 res, chemical leaks and pollution (the Air Quality and Noise section is part of HPA); the National Poisons Information Service (NPIS) provides adv ice to NHS staff on the management of individual patients. National Institute for Biological Standards and Controls: the National Institute for Biological Standards and Controls (NIBSC) mission is to assure the quality of biological medicines. Relevant legislation The Health Protection Agency Act 2004. 35_Smedley_Chap35.indd 713 1/2/2013 12:59:05 PM CHAPTER 35 Environmental protection 714 Outdoor air pollution \200 Air pollution is a mix of different particles, gasses, and che micals, the proportions of which vary by source and by site The major contributors are anthropogenic, although there can be major contributions from natural sources under some circumstances \200 Control of air qua lity is exercised at national government level, but can only deal with locally produced anthropogenic emissions as natural sources are uncontro llable as, to a certain extent, is transportation of air pollution from one country to anot her Continued exposure to polluted air confers a greater risk to health than episodes, although the Great London Smog of December 1952, which killed at least 4000 individuals, was critic al as it led to the introduction of the Clean Air Act 1956. Content and sources Particles Sources \200 Vehicle emissions \200 Industry \200 Power generation \200 Natural: sea salt, disturbed dust, volcanoes Measures \200 Mass (expre ssed as g/m 3 of air) gravimetrically \200 PM 10 \200\224particulate matter <10 m in diameter \200 PM 2.5 \200\224particulate matter <2.5 m in diameter \200 re \202 ectance \200\224i.e. by measurement of blackness of a \201 lter (Black Smoke) light scattering \200\224expressed as PM 10 , PM 2.5 \200 numbers \200\224expressed as particle numbers per cubic centimeter of air. These measures are usually expressed as 24-h or annual means. Gasses \200 Sulfur dioxide: largely from industry or power generation \200 Nitrogen dioxide: 2 pollutant from vehi cles \200 Ozone: 2 pollutant from action of UV light on oxides of nitrogen and hydrocarbons Carbon monoxide: from vehicles. Gasses are expressed as ppb or g/m 3 and for the timesca le relevant to their air quality standard . Other substances \200 Carcinogens: \200 benzene \200 1,3-butadiene \200 PAHs Lead. 35_Smedley_Chap35.indd 714 1/2/2013 12:59:05 PM OUTDOOR AIR POLLUTION 715 Health effects Diffuse pollution \200 i Particles are associated with i mortality and i h ospital admissions for cardiopulmonary disease on a day-to-day basis Similar effects are seen with ozone and sulfur dioxide, but of lesser degree Effects on asthma are limited to hospital admissions and, inconsistently, to symptoms and lung function Effects of long-term exposure on disease prevalence and severity may be more marked Association with incidence of lung cancer but not other cancers shown in the USA. Point source pollution \200 Emissions from point sources can cause clusters of disease (e .g. soyabean dust emissions from the docks in Barcelona in the 1980s led to outbreaks of acute asthma) The worst recorded peacetime incident occurred in Bhopal, India, in 1984 when an incident a t the Union Carbide (India) Ltd plant led to the release of a cloud of methyl isocyanate ga s causing over 3800 deaths More usually, concerns arise about the potential for an identi \201 ed source to be a cause of disease clusters. See Chapter 34 in Investigation of disease cluste rs Many disease clusters are chance events unrelated to point sources of pollution, but unders tandably generate considerable public concern. Control \200 Air quality standards are based on health effects worldwide even though air pollution also impacts on crop yields and the integrity of buildings Responsibility for air quality falls to local councils in the UK. Relevant guidance and legislation \200 Clean Air Act 1993 (c. 11). Stationery Of \201 ce , London \200 Air Quality Limit Values Regulations 2001. Stationery Of \201 ce, London. Similar regulations apply across the UK The UK \200\231s archive of air pollution measurements. Available at: M http:// www.airquality.co.uk/archive/index.php The UK \200\231s air quality strategy can be viewed at: M http://www.defra. gov.uk/environment/quality/air/air-quality/approach/ 35_Smedley_Chap35.indd 715 1/2/2013 12:59:05 PM CHAPTER 35 Environmental protection 716 Indoor air pollution \200 In the developed world 90% of time is spent indoors \200 In p arts of the developing world much greater time is spent outdoors \200 Indoor air quality is not subject to legislation except in the workplace, where occupational exposure standards apply in some settings. Indoor pollutants \200 Environmental tobacco smoke (ETS) \200 Allergens, including mold s \200 Indoor penetration of pollutants from outside (notably particles) \200 Cooking f ume \200 Settled dust \200 Micro-organisms \200 Endotoxins \200 Nitrogen dioxide (N O 2 ) from gas cookers and \201 res \200 Carbon monoxide (CO) faulty gas appliances \200 Ozone \200 Kerosene products \200 Biomass fuel combustion, e.g. plant material or agricultural waste \200 VOCs, e.g. formaldehyde \200 Radon. Health effects \200 ETS exposure: respiratory symptoms in children \200 lung cancer Biomass fuel: lung cancer \200 chronic bronchitis/chronic obstructive pulmonary disease (COPD) Cooking fume: \200 lung cancer \200 possibly exacerbation of asthma Radon: lung cancer \200 Sick building syndrome occurs in arti \201 cially ventilated bui ldings: the exact cause is unknown but it appears to relate to air exchange rates and tempe rature. It presents with a range of symptoms (see b p. 334, Sick building syndrome): \200 headaches \200 tiredness \200 poor concentration \200 sore throats \200 nasal symp toms \200 tight chest \200 inability to wear contact lenses/dry eyes. 35_Smedley_Chap35.indd 716 1/2/2013 12:59:05 PM INDOOR AIR POLLUTION 717 Control \200 There are no indoor air quality standards. Such controls would raise issues of individual civil rights By law anyone installing or servicing gas appliances must be Gas Safe registered Landlords are required to have gas appliances serviced annually, keep records for two years and give new or existing tenants a copy of the current safety certi \201 cate. Relevant legislation and guidance Gas Safety (Installation and Use) Regulations 1998. Stati onery Of \201 ce, London. 35_Smedley_Chap35.indd 717 1/2/2013 12:59:05 PM CHAPTER 35 Environmental protection 718 Water pollution Safe drinking water 1 is essential for life. Microbiological contamination is well recognized, but contamination by metals, etc., also occurs. Pollution follows spill s, industrial discharges, mining (especially abandoned mines), agricultural run-off and lea chate from land \201 ll. Naturally occurring metals may affect water quality. Pollutants m ay be point sources such as indus- trial discharges or diffuse pollutants including agricul tural run-off of animal wastes. Contamination of estuarine and inland seas may lead to seve re impacts e.g. the Aral Sea disaster. Water is divided into surface waters (streams, river s, lakes) and ground water ( 98% of available fresh water). These are closely linked and ex change occurs between them. Arsenic Groundwater contamination is often from natural sources with i arsenic in parts of Bangladesh, Chile, India, etc. Chronic ingestion causes; \200 thickening of the skin (hyp erkeratosis) and i pigmentation \200 bladder cancer \200 pancreatic cancer \200 skin cancer \200 peripheral neuropathy \200 diabetes \200 \200\230Blackfoot disease \200 \231; peripheral vascular disease (Taiwan). Arsenic remediation \200 Test water for arsen ic and mark supplies with i arsenic \200 Educate people as to risks of drinking high arse nic water \200 Source low arsenic water: \200 rain water harvesting \200 deep borehol es to aquifers with low arsenic, \200 sand \201 ltration. Fluoride \200 High \202 uoride levels occur in areas near mountain ranges worldwide \200 Fluoride in drinking water at 1ppm prevents dental caries \200 Exposure to \202 uoride >2ppm as a child < 8-yr-old l dental \202 uorosis \200 Children > 8yrs cannot de velop dental \202 uorosis \200 Mild dental \202 uorosis l white spots on teeth (hypom ineralized enamel) \200 Severe dental \202 uorosis is rare l heavily mottled and staine d teeth \200 Chronic ingestion of water with >10ppm \202 uoride l osteo \202 uorosis. \200 Endemic osteo \202 uorosis: back pain, calci \201 ed ligaments, bone thickening Se vere cases of osteo \202 uorosis resemble ankylosing spondylitis. Fluoride remediation \200 Fluoride removal from water is expensive \200 Use low \202 uoride water supplies where possible \200 De \202 uoridation may be carried out using co ntact precipitation. 1 WHO (2011). Guidelines for drinking-water quality , 4th edn. WHO, Geneva. 35_Smedley_Chap35.indd 718 1/2/2013 12:59:05 PM WATER POLLUTION 719 Lead (Pb) \200 Water may be contaminated by inorganic lead in houses with lead pipes (pre-1970 \200\231s UK housing) or copper pipes joined with lead-solder Soft water areas l i lead levels as acidic water i plumbo-solvency \200 40% of UK houses still have lead water pipes 2 \200 10 \200\22320% of human Pb. exposure is from water. L ead remediation \200 Water suppliers d plumbo-solvency by adding lime to low pH supplies (to i pH) and/or orthophosphate (a corrosion inhibitor), if water at the consumer \200\231s kitchen tap is likely to have lead >10 g/L \200 Remove all lead pipes and tanks from po table water supplies \200 Run kitchen tap for 1min if it hasn \200\231t been used for >6h \200 Never use water from hot water taps for drinking or cooking \200 Do not use water from bathroom taps for drinking. Organic chemicals Pesticides \200 Spills or run-off from agriculture l ground water conta mination \200 Main threat is to aquatic life, rather than human health. Solvents Contamin ation of ground water by organic solvents may occur where chemicals spill or underground fu el storage tanks leak. Polychlorinated biphenyls PCBs are persistent organic pollutants (POPs) that may contaminat e water supplies e.g. PCBs from abandoned electrical equipment. Other contaminants Nitrates \200 Occur in ground water due to fertilizers and animal wast es \200 Nitrates l nitrites l methaemoglobinaemia ( \200\230blue baby syndrome \200\231) in bottle-fed infants <3 months age (see b p. 328, Methaemoglobinaemia) Nitrate remediation; reverse osmosis, distillation or anion exchange. By-products of water treatment \200 Water is often treated with chemicals such as chlorine or chloramines \200 Trihalomethane is generated by organic material reacting with chlorine. Whether expos ure causes birth defects or bladder cancer is disputed. Endocrine disruptors \200 Phthalates, human sex hormones and pharmaceutical agents in wat er have been linked with abnormal sexual developmental in some species Whether exposure leads to adverse effects in humans is unclear. 2 Chartered Institute of Water and Environmental Management. Position on Lead in Drinking W ater , August 2005. 35_Smedley_Chap35.indd 719 1/2/2013 12:59:05 PM CHAPTER 35 Environmental protection 720 Soil pollution Introduction \200 Soil pollution may occur due to industrial, military, or agricultural releases of pollutants Municipal waste disposal is a signi \201 cant source of soil pollution in many countries The source may be: \200 a point source or \200 diffuse, e.g. run-off from roads contami nated with lead, oils \200 Contamination may arise locally, but deposition of pollutants from distant sources may also occur, e.g. acid rain Industrial activities in an area may leave a legacy of soil pollution for future generations: \200 mining, e.g. mine tailings \200 metal re \201 ning \200 lea ther tanning (chrome) \200 demolition (asbestos) \200 town gas production Poor or non-existent records of waste disposal further complicate remediation in such cases. Soil contaminants \200 Heavy metals: \200 arsenic \200 chromium \200 cadmium \200 lead \200 mercury \200 nickel \200 Cyanide \200 Persistent organic pollutants: pesticides organic solvents \200\224chlorinated hydrocarbons, benzene \200 PCBs \200 PA Hs \200 dioxins \200 Asbestos. Examples of soil pollution Love canal \200 One of the best known examples of soil polluti on occurred in Love Canal (now called Black Creek Village) in upstate New York \200 Approximately 21,000 tons of chemicals, including 200 tons of trichlorophenol, were buried in a disused canal near a residential area over many years Chemicals leached into the basements of some of the homes 35_Smedley_Chap35.indd 720 1/2/2013 12:59:05 PM SOIL POLLUTION 721 Epidemiological studies of residents showed i miscarriages \200 Hundreds of families had to be evacuated \200 One consequence of the Love Canal episode was the creation of \200 \230Superfund \200\231 sites by the US Congress in 1980 set up to deal with contaminated la nd sites. Waste incinerators \200 Waste incinerators may be a point source of soil pollution downwi nd \200 Incinerators, if poorly run, may discharge heavy metals and dioxins into the atmosphere which contaminate the soil by deposition. Disposal of sludge and sediments \200 Disposal of sewage sludge which may contain heavy m etals, e.g. lead, on soil by direct application or soil injection l contamination Use of growth promoters containing copper in pig farming can lead to signi \201 cant coppe r contamination of soils when slurry is applied to land Similar concerns regarding heavy metal contamination arise in the disposal of silt and sediment dredged from harbors or river estuaries. 35_Smedley_Chap35.indd 721 1/2/2013 12:59:05 PM CHAPTER 35 Environmental protection 722 Food contamination Food may be contaminated at any stage during production, processing, or distribution. The potential for contamination of food by bacteria, viruses, fungi, parasite s, or toxins is well recognized and will not be considered further. Less commonly, chemical or metal contaminants lead to food poi- soning outbreaks. Thus, food acts as one pathway f or pollutants in the environment to act on human health. Animals may be affected by pollut- ants (e.g. lead-poisoned wildfowl), become ill and so easier to catch, and pose a hazard t o human health if eaten. Groups at i risk \200 Producers and their families who largely c onsume their own produce \200 Children and unborn children are at i risk if exposed to neurodevelopmental toxins, e.g. methyl mercury. How pollutants enter the food chain \200 Pollutants enter the food chain through contamin ation of air, soil, or water: \200 discharges from factories \200 mines (e.g. heavy metals) \200 agriculture (e.g. pesticides) \200 waste dumps Food may be contaminated during: production \200 processing \200 distribution \200 storage \200 preparation/cooking Sale of food not intended for human consumption \200 Intentional adulteration of foodstuf fs. Agents implicated \200 Cadmium -contaminated mine discharges entered the Jinzu River basi n in Japan. Use of this water for irrigation of rice paddies led to cadmium entering the fo od chain. Consumption of cadmium-contaminated rice has led to itai-itai ( \200\230ouch ouch \200\231) disease, principally among post-menopausal women. Sufferers developed osteoporos is and proximal renal tubular dysfunction Fish may absorb methyl mercury . Fishermen and their families who consume these catches are at special risk \200 in the Great Lakes area of North America m ercury contamination has lead to health advice being issued on \201 sh consumption in the 1950s, \201 shermen \200\231s families around Minamata Bay, Japan, ate \201 sh c ontaminated with methyl mercury l neurological illness. For several years an electronics fa ctory had discharged mercury in the bay, so contaminating marine life l ead \200\224rarely, lead poisoning may arise from food contamination (e.g. spices, \202 our). Flour can be contaminated when a damaged millstone is repaired with lead. Illegal al cohol (moonshine) may be 35_Smedley_Chap35.indd 722 1/2/2013 12:59:05 PM FOOD CONTAMINATION 723 lead contaminated; life-threatening poisoning can occur in heavy drinkers Consumption of adulterated oil sold as olive oil in 1981 led to Spanish toxic oil syndrome: severe myalgia, eosinophilia, and pulmonary in \201 ltration. Research points to the toxin being fatty acid esters of 3-(N-phenylamino)-1,2-propanediol (PAP). Ap proximately 20,000 people were affected and 300 died. Others were left with chronic paraest hesia and musculoskeletal and skin complaints \200\230Rice oil disease \200\231, termed yusho in Japan and yucheng in Korea, due to PCBs accidentally contaminating rice oil occurred in Japan in 1968 (1800 cases) and Korea in 19 78 ( 7 2000 cases). Unborn children exposed to PCBs and their breakdown products, polychlor inated dibenzofurans (PCDFs), showed developmental delay, behavioral problems, and d growth . Chloracne and liver disease occurred. Pesticides entering the food chain Organomercurials Following a series of bad harvests in t he late 1960s and early 1970s, Iraq imported wheat treated with mercurial fungicides. The w heat arrived too late for planting that year and so the people consumed seed never intended for human consumption. More than 10,000 people died and 7 100,000 people suffered long-ter m health effects. Adulteration of foods Unscrupulous producers, wholesalers, and shopkeepers may adulterate f oodstuffs to maximize pro \201 ts; this kind of fraud \202 ourishes where food testing a nd enforcement are weak. Activities such as adding illegal dye- stuffs to spices occasional ly come to light. Food adulteration is principally an economic issue, but depending on the adulterant used such food may affect human or animal health. 35_Smedley_Chap35.indd 723 1/2/2013 12:59:06 PM This page intentionally left blank Section 10 Safety science 36 Safety science 727 36_Smedley_Chap36.indd 725 1/2/2013 1:00:35 PM This page intentionally left blank 727 Chapter 36 Safety science Health and safety management framework 728 Health and safety specialists 730 Accident inves tigation and management 732 Cost and reporting of accidents 734 Accident data 736 Measuring performance in health and safety management 737 Fire safety 738 Electrical safety 740 Road safety 742 36_Smedley_Chap36.indd 727 1/2/2013 1:00:35 PM CHAPTER 36 Safety science 728 Health and safety management framework Employers are required to show evidence of operating an effective health and safety management system (see b p. 520, Management of Health and S afety at Work Regulations 1999). A framework for managing health and safety is provided by the HSE in the document Successfu l Health and Safety Management . The \201 ve key elements of successful health and safety management are shown in Fig. 36.1, which also illustrates the relationship between them. F urther details about some of the key steps are covered Chapter 9, Policies, and on b pp. 35 2 \200\22355, Quality and audit in OH, and b p. 737, Measuring performance. Key elements of successful health and safety management \200 Effective health and safety policies set a clear direction for the organization to follow Effective management structure and arrangements should be in place to deliver the policy Need for a planned and systematic approach to implementing the health and safety policy Need to measure performance against agreed standards to show when and where improvements are needed Through audits and reviews learn from relevant experiences and apply lessons. Further information HSE (1997). Successful health and safety management , HSG65. HSE Books, Sudbury. Available at: M http://www.hse.gov.uk/pubns/priced/hsg65.pdf HSE (2011). Managing health and safety- Five steps to success . Available at: M http://www. hse.gov. uk/pubns/indg275.pdf 36_Smedley_Chap36.indd 728 1/2/2013 1:00:35 PM HEALTH AND SAFETY MANAGEMENT FRAMEWORK 729 Information link Control link Policy development Policy Organizational development Organizing Planning and implementing Auditing Developing techniques of planning, measuring, and reviewing Measuring performance Reviewing performance Feedback loop to improve performance Fig. 36.1 Key elements of successful health and safety management. Reproduced from HSE (199 7). Successful health and safety management , HSG65, p. 4. HSE Books, Sudbury). Crown co pyright material is reproduced with the permission of the Controller of HMSO and Queen \200 \231s Printer for Scotland. 36_Smedley_Chap36.indd 729 1/2/2013 1:00:35 PM CHAPTER 36 Safety science 730 Health and safety specialists Training and quali \201 cations There are several routes of entry into health and safety. Most common are courses, accredited by the National Examinati on Board in Occupational Safety and Health (NEBOSH). These lead to membership of the Instit ution of Occupational Safety and Health (IOSH) and, after further experience, to chartered health and safety practitioner status. Occupational health professionals can also gain memb ership of IOSH. Recently, the UK Government accepted the recommendations out- lined in the report \200\230 Common Sense, Common Safety \200\231 to professionalize health and safety consultants. An O SHCR has been established which lists consultants who can offer advice to UK businesses to help them manage health and safety risks. The register is only open to health and safety co n- sultants who have met certain standards within their professional bodies, e.g. IOSH, BOH S. Duties of health and safety specialists Advice on health and safety policies Health and saf ety managers, advisers, and safety of \201 cers help to formulate policies related to: \200 Organizational assessment and management of health and safety risks \200 Safe plant and systems of work \200 Safe work environment to reduce physical injuries and ill healt h \200 Emergency procedures \200 Accident investigation and reporting procedures \200 Monitoring safety performance \200 Health and safety training programs Fire safety (see b p. 738, Fire safety). Other duties \200 Advising management on the design and safe use of plant and equipment Periodic inspections to identify unsafe plant, unsafe working conditions, and unsafe practices Communicating with safety reps or representatives of employee safety ( b p. 516) through the Health and Safety Committee Facilitating or undertaking risk assessments (including \201 re risks) \200 Advising on compliance with current and new legislation \200 Promoting and delivering safety educati on programs through toolbox talks, etc. Providing information on accident prevention techniques \200 Recording accident statistic s \200 Accident investigation \200 Advising about the need to report incidents to HSE i n compliance with RIDDOR (see b Appendix 4) 36_Smedley_Chap36.indd 730 1/2/2013 1:00:36 PM HEALTH AND SAFETY SPECIALISTS 731 Assessment of the work environment and work equipment \200 Audit of safety systems agains t international systems (BS 8800/OSHAS 18001) Presenting information on safety performance to management \200 Liaison with occupational health departments, government inspectors, local authorities, (including \201 re service s), and environmental protection agencies. Further information OSHCR. Available at: M http://www.oshcr.org/ Common Sense, Common Safet y. M http://www.number10.gov.uk/wpcontent/uploads/402906_ CommonSense_acc.pdf 36_Smedley_Chap36.indd 731 1/2/2013 1:00:36 PM CHAPTER 36 Safety science 732 Accident investigation and management De \201 nitions Accidents Accidents are de \201 ned as any unplanned events that give rise to ill health or injury, damage to property, plant, or products, production losses, or increased liabilities (HSE, 1997). Types of accidents i nclude: \200 Near miss \200 Minor injury \200 Major injury \200 Property damage. In cidents Incidents are all undesired circumstances and near misses, which could cause (poten tial) accidents. Purpose of accident investigation Accidents need to be investigated for the following reaso ns: \200 To collect data required for accident reporting/noti \201 cation \200 To coll ate information required to defend an insurance claim \200 To establish causes \200 To identify and take appropriate actions to prevent reoccurrence. Causes of accidents Most accidents involve multiple, interrelated causal factors and occur as a result of de \201 ciencies, errors, omissions, or unexpected changes. \200 Personal factors: knowledge and skill de \201 ciencies \200 physical and mental incapacities Unsafe act: operating at unsafe speed \200 operating without knowledge or authority \200 using equi pment unsafely \200 taking unsafe position \200 failure to use protection \200 failur e to warn or signal \200 failure to make secure Unsafe condition: inadequate guards \200 inadequate warning systems \200 poor housekeeping \200 unsafe equipment \200 excessive exposure to hazards. Consequences of accidents \200 Fatalities \200 Ill health and injuries \200 Loss of p roduction \200 Damage to plant and machinery, raw materials, and products \200 Breach o f legislation and prosecution 36_Smedley_Chap36.indd 732 1/2/2013 1:00:36 PM ACCIDENT INVESTIGATION AND MANAGEMENT 733 Civil claims \200 Environmental impact: spillages, discharge \200 Damaged reputation \200 Lowered employee morale. Outcome of accident investigation Accident prevention programs should be designed with the aim of reducing danger in the workplace (safe workplace) and increasing work- ers \200\231 perception of risks (safe person). Management actions as a result of accident investigation include the following: \200 Identi \201 cation of speci \201 c training needs \200 Need for detai led job safety analysis to identify the hazards and precautions Improving systems of work (safe design, safe work procedures, permit to work, safety rules, and review of risk assessments) Improve the level of supervision \200 Identify areas/tasks where PPE is required \200 P reparation of safety guidance notes for particular activities \200 Setting up committees and feedback to all concerned \200 Improvement in the working environment, e.g. lighting levels, ventilation Improvement in information and its provision \200 Review health and safety responsibiliti es. 36_Smedley_Chap36.indd 733 1/2/2013 1:00:36 PM CHAPTER 36 Safety science 734 Cost and reporting of accidents All organizations should determine the costs of accidents. This process helps to identify causes and consequences, as well as providing useful informa tion on strategies and drivers for future accident prevention. All accidents have both direct and indirect costs, and incur insured and uninsured costs. \200 Insured costs include: claims on employers and public liability insurance \200 damage to building, equipment, or premises Uninsured costs include: lost time \200 extra wages for overtime \200 sick pay \200 production delays \200 \201 nes \200 legal costs, and excess on any claims \200 investigation time. The total cost of an accident can be determined by considering both direct and indirect cos ts. Direct costs \200 Increase in liability premiums \200 Claims for injury, or for defecti ve or unsafe products \200 Fines and damages awarded in criminal courts for breaches of l aw \200 Court and legal costs. Indirect costs \200 Treatment: \200 \201 rst aid \200 transportation \200 hospita l attendance Lost time: injured person \200 management Production: loss of production \200 damage to plant \200 training \200 supervision Investigation (time and manpower): management \200 safety advisors \200 safety representatives \200 liaison with externa l agencies Others: administration \200 costs incurred by witnesses attending court. 36_Smedley_Chap36.indd 734 1/2/2013 1:00:36 PM COST AND REPORTING OF ACCIDENTS 735 Legal requirements to notify accidents and incidents \200 Reporting accidents, injuries, and dangerous occurrences: noti \201 able and reportable major accidents are listed in schedule 1 of RIDDOR dangerous occurrence is a major incidence which has the potential for loss of life and sign i \201 cant damage; these are listed in schedule 2 of RIDDOR Fatal and major injury accidents: as well as dangerous occurrences must be: \200 reported to the enforcing authority by the quickest practicable means, i.e. telephone, and reported in writing within 10 days to the enforcing authority on Form 2508. Reports to authorities \200 Over 7 day injuries to person at work: a written report must be sent to the enforcing authority within 15 days of the accident on Form 2508 Following receipt of a written report from a doctor, occupational diseases (schedule 2 of R IDDOR) are reported using Form 2508A. See b Appendix 4: List of Reporting of Injuries, Dise ases, and Dangerous Occurrence Regulations for a list of RIDDOR reportable diseases Gas incidents are reported on Form 2508G. Documentation Copies of all forms sent to the authorities must be kept. Further information See RIDDOR, b Appendix 4: List of Reporting of Injuries, Diseases, and Dangerous Occurrence Regulations HSE Costing accidents and ill health. Available at: M http://www.hse.gov.uk/economics/costi ng. htm HSE (2008). The cost to employers in Britain of workplace injuries and work related ill hea lth 2005/06. Available at: M http://www.hse.gov.uk/economics/research/injuryill0506.pdf Costs to Britain of workplace injuries and work-related ill health: 2009/10 update Avail able at: M http://www.hse.gov.uk/statistics/pdf/cost-to-britain.pdf 36_Smedley_Chap36.indd 735 1/2/2013 1:00:36 PM CHAPTER 36 Safety science 736 Accident data Accident rates enable analysis of trends, facilitating comparison between one organization and another, or between different parts of the same organization. Examples of accident rate measures \200 Incidence rate = (total number of accidents/numbe r of persons employed) \227 1000 Frequency rate = (total number of accidents/total number of man-hours worked) \227 100,000 Severity rate = (total number of days lost/total number of man hours worked) \227 1000 Duration rate = No. of man-hours worked/total number of accidents Standardization of accident data When comparing accident rates it is important to ensure th at the follow- ing elements are standardized: \200 De \201 nitions of what has to be rep orted \200 Reporting procedures \200 Methods of calculation. In addition to the industr y data, certain industry associations provide their members with accident statistics, which may be used for \200\230benchmarking \200\231, i.e. comparing performance data with compe titors. National accident statistics The HSE produces the Safety Statistics Bulletin which contains summary data on fatal injuries to workers, subdivided into employees and self- employed. N on-fatal injuries to workers are subdivided into: \200 Over 3-day injuries to workers \200 Injuries to the member of the public \200 Dangerous occurrences \200 Gas safety. Further information HSE (2011). Health and Safety Statistics . Available at: M http://www.h se.gov.uk/statistics/ 36_Smedley_Chap36.indd 736 1/2/2013 1:00:36 PM PERFORMANCE IN HEALTH AND SAFETY MANAGEMENT 737 Measuring performance in health and safety management Performance needs to be measured to a ssess how well risks are control- led. Monitoring also reinforces management commitment to health and safety. Two types of monitoring systems are used: \200 Active systems, which m onitor the design, development, implementation, and operation of management systems and compliance with standards, i.e. mon itoring achievement of speci \201 c plans and providing feedback on performance before acc idents or ill health occur Reactive systems involve monitoring incidents, accidents, cases of ill health, damage to property, and other evidence of de \201 cient health and safety performa nce, i.e. monitoring is triggered after an event. Active (proactive) monitoring data \200 Staff perception of management commitment to heal th and safety \200 Periodic review of documents, e.g. risk assessments, maintenance programs Exposure and health surveillance data to assess adequacy of controls \200 Extent of compl iance with standards \200 Observation of work and behavior \200 Training in health and safety: numbers trained and its effectiveness \200 Knowledge among staff of risks and con trols \200 Time taken to implement actions \200 Actual use of personal protective equip ment \200 Frequency of inspections, safety tours, audits \200 Competence of staff with responsibilities for health and safety \200 Number of staff suggestions for health and sa fety improvements \200 Staff attitudes to risk and use of controls. Reactive monitoring data \200 Regulatory agency enforcement action \200 Sickness absenc e data \200 Reported accidents and injuries (lost time, property damage) \200 Damage to property. Outcome of performance assessment For the risks that are identi \201 ed during active and reactive monitoring, actions should include the following: \200 Identify reasons for unde r-performance \200 Identify underlying failure in health and safety management systems \200 Prevent recurrence \200 Satisfy legal requirements, e.g. reporting under RIDDOR. Further information HSE website. Available at: M http://www.hse.gov.uk. Information about h ealth and safety manage- ment, including risk assessment tools for slips, trips, and falls, industry-speci \201 c advice on machine safety, and other aspects. 36_Smedley_Chap36.indd 737 1/2/2013 1:00:36 PM CHAPTER 36 Safety science 738 Fire safety \200 Fire is a constant threat to all premises. In the UK in 2008 there were 1800 \201 res in industrial premises For a \201 re to start there must be adequate fuel, a source of oxygen, and an ignition source Fires may start accidentally, but the threat of arson should also be considered and appropr iate measures taken to reduce this risk \200 Good housekeeping, effective maintenance (es pecially of electrical equipment), rigorous health and safety procedures, and effective \201 re detection, warni ng, and \201 re \201 ghting systems all reduce \201 re risks. Fire regulations \200 Current regulations governing \201 re prevention in England and W ales came into force from October 2006 \200\224the Regulatory Reform (Fire Safety) Order 20 05. Similar legislation applies in Scotland \200\224the Fire (Scotland) Act 2005 Fire authorities no longer issue \201 re certi \201 cates \200 The regulations cover n on-domestic premises: of \201 ces and shops \200 factories and warehouses \200 residential care \200 sleep ing accommodation \200 education \200 places of assembly \200 theaters/cinemas \200 outdoor events \200 health care \200 transportation facilities Enforcement of the Fire Safety Regulations is the responsibility of the local \201 re and rescue service, except for Crown property where HM Fire Safety inspectors take this role. Other relevant regulations Where a workplace contains dangerous substances which can create an explosive atmosphere, e.g. gasoline, gas, solvents, paints, \202 our or wood dusts th en DSEAR 2002 and the Equipment and Protective Systems intended for use in Potentially Expl osive Atmospheres Regulations 1996 will likely also apply. Main requirements The main requirement is to carry out a \201 re risk assessment. The Dep artment for Communities and Local Government guidance on \201 re safety identi \201 es \201 ve steps for \201 re risk assessment. Identify hazards \200 The person in control of premises must undertake a \201 re risk assessment This assessment should identify sources of: fuel \200 ignition \200 oxygen. 36_Smedley_Chap36.indd 738 1/2/2013 1:00:36 PM FIRE SAFETY 739 Identify people at risk \200 Employers need to consider all persons who may be affected i n the event of a \201 re on their premises, including staff, visitors, and the public Particular consideration needs to be given to making adequate provision for those at special risk: \200 disabled people \200 elderly people \200 ch ildren or parents with babies \200 lone workers. Evaluate, reduce, and remove risks The employer must provide adequate \201 re prevention measures and main- tain them. Record, plan, inform, instruct, and train \200 The main \201 ndings of the risk assessm ent, including those regarding people at special risk, must be recorded in writing Employers must prepare an emergency \201 re plan \200 Staff must be provided with suf \201 cient information, instruction, and training on \201 re prevention and the actions necessary in the event of a \201 re. Thi s may include measures such as training in the use of \201 re extinguishers, \201 re sa fety brie \201 ngs, and regular \201 re drills to rehearse \201 re evacuation procedur es. Review Any signi \201 cant changes, e.g. to premises or work practices, requires review of the \201 re plan. Legislation and guidance \200 National Archives. Available at: M http://webarchive.nation alarchives. gov.uk/+/http://www.communities.gov.uk/pub/394/Fireguidesseries_ id1500394.pdf Scottish Government. Available at: M http://www.infoscotland.com/ \201 relaw 36_Smedley_Chap36.indd 739 1/2/2013 1:00:36 PM CHAPTER 36 Safety science 740 Electrical safety Epidemiology According to HSE \201 gures approximately 25 people die fr om electric shock or electrical burns at work each year. General principles \200 Electrical equipment should be suitable for the environment in wh ich it is used In environments that are damp or wet, electrical equipment should be suitably insulated to prevent electrocution Where electrical equipment is to be used in areas where there is a potential for explosion, suitable equipment should be employed \200 Only competent persons should be allowed to w ork on electrical equipment or installations The normal policy should be that work is only undertaken on equipment or installations known to be dead and electrically isolated \200 Live system/eq uipment working should be the exception rather than the rule. It should only be carried out where it is unreasonable for work to be done on dead systems/equipment and where a suitabl e risk assessment has been carried out by a competent person Any equipment provided, e.g. voltage meters, should be suitable for use and adequately maintained Before commencing work on electrically isolated equipment it should