practice \200\231 such that: \200 data are fairly processed \200 processing is for limi ted purposes \200 data are adequate, relevant, and not excessive \200 data are accurate and up to date \200 data are retained only for as long as necessary \200 data processi ng is in line with subjects \200\231 rights \200 data are secure \200 data are not tran sferred out with the European Economic Area except to a country with adequate data protection laws*. Privacy laws in the USA differ from the EU, and so the US \200\223European Union Safe Harbo r Framework was set up. US companies that self-certify to the US EU Safe Harbor Framework d emonstrate that their organization provides \200\230adequate \200\230 privacy protection, as de \201 ned by the Directive, so allowing data transfers from EU countries to that US c ompany. Legislation and guidance \200 Website of the Information Commissioner. M http://www.ico.g ov.uk/ \200 The Employment Practices Code 2005 \200 Data Protection Act 1998 \200 Con \201 dentiality: NHS Code of Practice, Department of Health, 2003. \200 Website of Busi ness USA detailing the Safe Harbor framework. Available at: M http://export.gov/safeharbor/ 27_Smedley_Chap27.indd 579 1/2/2013 12:43:03 PM CHAPTER 27 Legislation related to oh records 580 Access to Medical Reports Act 1988 Purpose This Act gives a person a right of access to med ical reports regarding themselves prepared by a medical practitioner, who has provided care to them, for the purposes of employment or insurance. Application in occupational health The Act applies to any person or organization that wishe s to obtain a medical report on an individual for employment or insurance purposes. Reports requested by an OH professional The Act clearly applies when an Occupational Health professional requests a report from an employee \200\231s doctor. Reports produced by an OH professional (cid:2) Some have argued that this legislation does not apply to reports pro- duced by OH professionals as they do not provide care. However, t here may be situations where they do provide care and the Act does apply: see the Faculty o f Occupational Medicine \200\231s Guidance on Ethics for examples. In addition: \200 It i s good practice to discuss with an employee the contents of any medical report to an employ er. Failure to do so can undermine the doctor \200\223patient relationship The individual can request access to a medical report under the Data Protection Act The GMC has produced guidance for doctors stating that a patient must have the right of acc ess to any reports written about them for insurance or employment purposes, including recei ving a copy (if they wish) before the report is released: \200 the GMC do not explicitly allow a 21-day period for the patient to have access to the report before it is sent although the GMC guidance does not strictly apply to OH nurses, it is good practice for them to follow these principles. De \201 nitions \200 Applicant: the person requesting a medical report \200 Medical re port: a report regarding the physical or mental health of an individual prepared by a medic al practitioner responsible (now or in the past) for the clinical care of that individual. Main requirements \200 An employer wishing to obtain a medical report on an employee or prospective employee can only do so with his/her consent. (This should be in writing and a copy of the signed consent provided to the medical practitioner.) The employee must be informed of his/her rights under the Act and most employers will provi de this information in writing. The employee \200\231s rights are: \200 to withhold conse nt for the report 27_Smedley_Chap27.indd 580 1/2/2013 12:43:03 PM ACCESS TO MEDICAL REPORTS ACT 1988 581 to have access to the report before consenting to its submission to the employer to make a written request to the medical practitioner for amendment of any part of a report which he/she considers wrong or misleading to have access to the report up to 6 months after submission. \200 Where an employee wish es to see the medical report the applicant must advise him/her that they have requested the report so that the individual can contact the medical practitioner to see the report withi n 21 days Having seen the report, the employee may decide to withhold consent for the report to be provided to the applicant If an individual indicates that he/she wants to see the report but then fails to contact th e doctor within 21 days to see it, the doctor can submit the report to the applicant If an individual believes a report is wrong or misleading and the medical practitioner does not agree to amend the report, the individual may request that a statement of his/her view s be attached to the report before he/she consents to release the report. Alternatively, th e employee may decide to withhold consent to release the report \200 A doctor can withhol d access to any part of a report he/she believes may cause serious harm to the individual \200\231s health. The doctor should inform the individual of his/her decision to deny acces s. In practice it is rare to withhold access to part of a report A medical practitioner can withhold access to any part of a report where it would reveal the identity of a third party who had provided information about the individual unless that third party consents or is a health care worker and the information was imparted as part of his/her job The individual has a right of access to a medical report for a period of 6mths, and so the medical practitioner must retain a copy for 6mths after the report is provided. Legislation and guidance \200 Access to Medical Reports Act 1988 \200 Faculty of Occupa tional Medicine (2006). Guidance on Ethics for Occupational Physicians , 6th edn. FOM, London. BMA (2009). Access to medical reports \200\223 guidance from the BMA Medical Ethics Department . Available at: M http://www.bma.org.uk/ethics/ health_records/accessmedr eports.jsp GMC (2009). GMC supplementary guidance. Con \201 dentiality: disclosing information for insurance, employment and similar purposes . available at: M http://www.gmc -uk.org/static/documents/content/Con \201 dentiality_ disclosing_info_insurance_2009.pdf 27_Smedley_Chap27.indd 581 1/2/2013 12:43:03 PM CHAPTER 27 Legislation related to oh records 582 Freedom of Information Act 2000 The Freedom of Information Act 2000 provided for public acc ess to information held by, or on behalf of, publicly funded bodies in England, Wales, and Northern Ireland. Similar legislation applies in Scotland: the Freedom of Information (Scot land) Act 2002. These pieces of legislation were intended to create a culture of openness a mong public bodies. The Freedom of Information Act 2000 created the Information Commissione r \200\231s Of \201 ce (ICO) whose role is to enforce the Act. The Act was subsequently up dated by the Environmental Information Regulations 2004 (EIR). In Scotland the Scottish Inf ormation Commissioner ful \201 ls the ICO \200\231s role. De \201 nitions \200 Public authorities include: \200 central government \200 local authorities \200 police \200 prison service \200 health authorities \200 NHS GPs, d entists, opticians, and pharmacists \200 educational establishments. Main requirements \200 All public bodies must produce a publication scheme (approved by t he Information Commissioner) stating what information they routinely make available (e.g. a nnual reports, committee minutes) and how to obtain it An information request may be made verbally, in writing, or by email. \200 Public bodies must respond promptly to such information requests and in any event within 20 days There are 23 exemptions from disclosure in the Act. Some are absolute while others are quali \201 ed exemptions: \200 information covered by an absol ute exemption includes personal information information covered by a quali \201 ed exemption may only be withheld where the public interest is best served by withholding it. The presumption is that disclos ure is preferred Where a public body refuses to release information application may be made to the Informati on Commissioner to review the decision. Where the ICO disagrees with the decision not to re lease information, the public body can be required to release the information Where an individual or a public body disputes the ICO \200\231s decision, an appeal can be made to the Information Tribunal Failure to comply with a decision of the Information Tribunal may be held to be contempt of court. Legislation and guidance \200 HMSO (2000). Freedom of Information Act 2000 , Chapter 36. Stationery Of \201 ce, London. 27_Smedley_Chap27.indd 582 1/2/2013 12:43:03 PM FREEDOM OF INFORMATION ACT 2000 583 HMSO (2002). Freedom of Information (Scotland) Act 2002 , asp 13. Stationery Of \201 ce, London. HMSO (2004). The Environmental Information Regulations 2004 . Stationery Of \201 ce, London. Information Commissioner \200\231s Of \201 ce. M http://www.ico.gov.uk/ \200 Scottish In formation Commissioner M http://www.itspublicknowledge. info/ 27_Smedley_Chap27.indd 583 1/2/2013 12:43:04 PM This page intentionally left blank 585 Chapter 28 Environmental legislation Environmental Protection Act 1990 586 The Environment Agency 588 Control of Major Accident Hazards Regulations 1999 590 Environmental impact assessment 592 28_Smedley_Chap28.indd 585 1/2/2013 12:44:15 PM CHAPTER 28 Environmental legislation 586 Environmental Protection Act 1990 The Environmental Protection Act 1990 aimed to improve co ntrol of pollution arising from industrial processes by integrating pollution con- trol (IP C). It represents the most recent in a series of laws that began with the Alkali Acts in th e Nineteenth century. This legislation covers air, water, and soil pollution, and also cove rs the release of genetically modi- \201 ed organisms. The Act gave the Secretary of Stat e power to prescribe substances subject to controls on their release into the environment. The Act was subsequently updated by the Environment Act 1995, which created the Environment Agency (England and Wales) (see b p. 588, The Environment Agency) and its equivalent Scott ish body, the Scottish Environment Protection Agency. De \201 nitions \200 Pollution: of the environment means release into air, water, or lan d of any substance capable of causing harm to living organisms, e.g. humans Release: includes emissions into the air, discharge of substances into water, and the disposal, deposit, or keeping of substances in or on land Waste: includes any scrap material, ef \202 uent, or unwanted substance \200 Controlled waste: means household, industrial, or commercial waste \200 Special waste: is controlled waste that is so dangerous to keep, treat, or dispose of, that special provision is requir ed for dealing with it. Main requirements \200 No-one may carry out a prescribed process unless authorized by the enforcing authority (Regulation 6) When carrying out a prescribed process, the operator should employ the best available techn iques, not entailing excessive cost ( \200\230Batneec \200\231) to prevent the release of p rescribed substances, to minimize any release or to render harmless any substance released (Regulation 7) \200 If a prescribed process has not been carried out for >12mths, the enf orcing authority may revoke the authorization (Regulation 12) \200 If a prescribed proces s is carried out in breach of its authorization, an enforcement notice can be served If there is an imminent risk of serious pollution, a prohibition notice may be served An appeal against an enforcement or prohibition notice may be made to the Secretary of State The enforcing authorities are required to maintain a register of prescribed processes available for inspection by the public (Regulation 20) \200 Any organization th at carries on a prescribed process without authorization, fails to notify a transfer of und ertaking involving a prescribed process, or fails to comply with a prohibition or enforceme nt notice is liable on conviction to a \201 ne not exceeding 20 000, or if convicted on indictment to a \201 ne and/or imprisonment for up to 2yrs Disposal of controlled waste is prohibited (Regulation 33) except in accordance with a Waste Management License. This excludes storage of household waste in dom estic premises 28_Smedley_Chap28.indd 586 1/2/2013 12:44:15 PM ENVIRONMENTAL PROTECTION ACT 1990 587 Transportation by road of controlled waste, except in accordance with the controls imposed by a Waste Management License, is an offense \200 Regulation 34 creates a duty of care fo r any person or organization producing, carrying, keeping, or disposing of controlled waste , to prevent the escape of waste from his control, and on transfer of the waste to ensure t he transfer is only made to an authorized person \200 A written description of the waste must be provided to the Waste Collection Authority or a holder of a Waste Management licens e Where controlled waste is deposited on land in breach of the regulations, the enforcing authority may require the occupier to remove the waste. Where th e occupier did not deposit the waste, the authority may remove the waste from the land. Legislation and guidance \200 Environmental Protection Act 1990, Chapter 43. Stationery O f \201 ce, London. Environment Act 1995, Chapter 25. Stationery Of \201 ce, London. 28_Smedley_Chap28.indd 587 1/2/2013 12:44:15 PM CHAPTER 28 Environmental legislation 588 The Environment Agency Background \200 The Environment Agency (EA) and the Scottish Envir onmental Protection Agency (SEPA) were created by the Environment Act 1995 and came into being in 19 96 The Environment Agency is a non-departmental public body of the Department of Environment, Food and Rural Affairs (DEFRA) and an Assembly Sponsored Public Body of the National Assembly for Wales \200 The Agency exists to protect the environment of England and Wales. It covers all of England and Wales including the land, rivers, and coastal waters SEPA has a similar role in Scotland to the Environment Agency south of the border. Both agencies work with the HSE in the licensing of major industrial sites under the Contro l of Major Accident Hazards Regulations 1999 (COMAH) (see b p. 530). Structure of the environment agency \200 Supervised by a board of 12 members: Eleven members are appointed by the Secretary for Environment, Food and Rural Affairs one member is appointed by the National Assembly for Wales Managed by a Chief Executive and six directors \200 Employs 7 12 000 staff \200 Operate s through six regional of \201 ces in England and one in Wales (Environment Agency Wales) and 21 area of \201 ces. Role of the Environment Agency The Environment Agency is a regulatory body which has a wide remit covering issues such as the following: \200 Water resources and water quality \200 Flood prevention and management \200 Leisure and recreation \200 Navigation \200 Fisheries \200 Soil quality and land contamination \200 Air quality and air pollution \200 Waste transportation and disposal \200 Radioactive substances \200 Pollution pr evention and control (PPC), which involves the enforcement of environmental regulations in a range of industries: \200 agriculture \200 chemical \200 food and drink \200 power stations, fuel stores, etc. \200 metals \200 minerals, e.g. cement works \200 nuclear waste 28_Smedley_Chap28.indd 588 1/2/2013 12:44:16 PM THE ENVIRONMENT AGENCY 589 radioactive substance users \200 pulp and paper \200 wood \200 waste management \200 textiles and tanneries. Relevant legislation Environment Act 1995, Chapter 25. Stationery Of \201 ce, London. Avai lable at: M http://www.opsi.gov.uk/acts/acts1995/Ukpga_19950025_En_1.htm 28_Smedley_Chap28.indd 589 1/2/2013 12:44:16 PM CHAPTER 28 Environmental legislation 590 Control of Major Accident Hazards Regulations 1999 Purpose COMAH implements the European Co mmission \200\231s Seveso II directive on the control of installations that may pose a majo r accident hazard. The aims of the regulations are: \200 To identify sites where a major accident may occur \200 To put in place control measures to prevent such an accident \200 To mitigate the impact of an accident should it occur. Application The COMAH regulations apply to any lower tier or top tier site as de \201 ned in the regulations. De \201 nitions \200 Competent authority . Because of the overlap between workplace heal th and safety and environmental protection, the competent authority for the COMAH regulatio ns comprises: \200 HSE and the Environmental Protection Agency (EPA) in England and Wales HSE and SEPA in Scotland Major accident: means an uncontrolled event at a site covered by the COMAH regulations that leads to serious danger to people or the environment, and involves an agent de \201 ned i n the regulations. Main requirements \200 Operators shall take all measures needed to prevent accidents (Regulation 4), and to limit the harm caused by any accident that may occur, by reducing ri sk to a level as low as is reasonably practicable (ALARP) All operators must produce a major accident prevention policy (MAPP) and keep it up to date (Regulation 5) Operators of new or planned installations must notify the competent authority as soon as possible, to allow planning of assessments Operators of existing installations must notify the competent authority if a signi \201 ca nt change is anticipated, such as an increase in dangerous substances on site, a change to processes, or closure of the site \200 Where an installation is a top-tier site, its oper ator must prepare a safety report (Regulation 7) demonstrating that all necessary measures to prevent an accide nt have been taken The safety report must be revised: \200 every 5yrs (Regulation 8) \200 when there is a change in the safety management system \200 when new knowledge dictates that a review is needed. 28_Smedley_Chap28.indd 590 1/2/2013 12:44:16 PM CONTROL OF MAJOR ACCIDENT HAZARDS REGULATIONS 1999 591 Legislation and guidance HSE A Guide to the Control of Major Accident Hazards Regulations 1 999. HSE Books, Sudbury. 28_Smedley_Chap28.indd 591 1/2/2013 12:44:16 PM CHAPTER 28 Environmental legislation 592 Environmental impact assessment European Council Directive 97/11/EC on the assessment of th e effects of certain public and private projects on the environment came into force in 1999 . It extended the range of development projects for which Environmental impact assessment ( EIA) was required under Council Directive No. 85/337/EEC. A range of planning regulations h as since imple- mented the amended directive in the UK, and The Town and Country Planning ( EIA) Regulations 2010 and its Scottish equivalent are expected to come in to force in 2011. Purpose \200 To ensure that the planning authority, when giving consent for a project, is aware of any likely environmental impacts of the development \200 EIA is a procedure f or systematically assessing the environmental impacts of land use change (development), inc luding i noise, i pollution, i traf \201 c, etc. It is a multidisciplinary activity that r equires a range of expertise, as each project raises different issues EIA may indicate the ways in which a project can be modi \201 ed to d or eliminate adverse impacts, ideally by designing out the nuisance at source. Application \200 Planners may require developers to prepare an EIA prior to giving develo pment consent . It is the developer who then commissions and pays for the EIA All schedule 1 projects must have an EIA carried out. Schedule 1 includes major hazards suc h as oil re \201 neries and nuclear power stations, as well as motorways, waste incinerati on plants, and large quarries Schedule 2 projects are only required to have an EIA if the project is likely to cause signi \201 cant environmental impact. 1 De \201 nitions \200 EIA, when applied to the environmental impact of government or other public policy, is termed strategic environmental assessment (SEA) \200 Development consent : the decision of the competent planning authority to allow the development to proceed The competent authority is the public body giving the primary consent for a particular project Economic impact assessment (cost-bene \201 t analysis) forms part of an EIA in some circumstances Health impact assessment (HIA): the requirements for this component of an EIA in the UK var y depending on the speci \201 c development, but broadly cover two areas: 28_Smedley_Chap28.indd 592 1/2/2013 12:44:16 PM ENVIRONMENTAL IMPACT ASSESSMENT 593 social effects of a development (e.g. i access to amenities from a new bridge). These can b e bene \201 cial or deleterious, and will embrace quality of life as well as more direct o utcomes adverse effects of the development (e.g. i hospital admissions due to i factory emissions). Main requirements \200 EIA can be: prospective for a new development \200 retrospective for an existing situation In some cases, prospective assessments should include a monitoring component to quantify th e actual impact , and compare that with the estimate of impact made in the EIA. Quanti \201 cation of impacts Should be attempted wherever possible. Use established effec ts size coef- \201 cients, as has been done for air pollution, applying these to the spec i \201 c population at risk. (cid:2) Bear in mind the dangers of applying health data gath ered from one population to a different population. Relevant guidance and legislation This is not an exhaustive list of the regulations relatin g to EIA. \200 Town and Country Planning (Environmental Impact Assessment) (England and Wales) Regulations 1999 The Environmental Impact Assessment (Scotland) Regulations 1999 \200 Planning (Environmen tal Impact Assessment) Regulations (Northern Ireland) 1999. 1 See Town and Country Planning (Environmental Impact Assessment) (England and Wales) Regul ations 1999 for a full list of schedule 1 and 2 projects. 28_Smedley_Chap28.indd 593 1/2/2013 12:44:16 PM This page intentionally left blank Section 6 Occupational hygiene 29 Occupational hygiene overview 30 Monitoring exposure 31 Biological monitoring 32 Prevent ion and control of exposure 597 603 623 633 29_Smedley_Chap29.indd 595 1/2/2013 12:49:35 PM This page intentionally left blank 597 Chapter 29 Occupational hygiene overview Role and function of occupational hygienists 598 Classi \201 cation of occupational hazard s 599 Use of occupational hygiene exposure data 600 Epidemiological study 602 29_Smedley_Chap29.indd 597 1/2/2013 12:49:35 PM CHAPTER 29 Occupational hygiene overview 598 Role and function of occupational hygienists Introduction Occupational hygienists have a role in identi \201 cation, evaluation, and management of w ork-related hazards, as part of an OH team. De \201 nition of occupational hygiene The BOHS de \201 nes occupational hygiene as \200 \230The applied science con- cerned with the identi \201 cation, measurement, appraisal of risk and control to acceptable standards of physical, chemical, and biological factors ari sing in or from the workplace, which may affect the health or wellbeing of those at work, o r in the community \200\231. The Faculty of Occupational Hygiene (FOH) within BOHS develops and maintains the professional standards of occupational hygienists. Scope and functions \200 Hazard identi \201 cation: anticipate and recognize health hazards that may result from operational processes, work tasks/method, equipment, tools and the work environment identify the location and nature of hazards and number exposed \200 understand the possib le routes of entry of hazardous agents into the human body, and the potential health effect s of such agents Exposure evaluation: evaluate work processes and methods of work so as to understand exposure pathways and factors affecting the level of exposure design suitable sampling strategies \200 assess workers \200\231 exposure to hazards, inc luding exposure measurement (personal or static) and interpretation of data Management/control of hazards: evaluate effectiveness of administrative, organizational and engineering controls used to m inimize exposure to hazards advise on risk control strategies, including prioritization and ranking of risks advise on the selection of risk management measures \200 understand the legal framework f or occupational hygiene practice \200 educate, train, inform, and advise persons at all l evels in all aspects of hazard and risk communication record \201 ndings and review Environmental risk management: recognize agents and factors that may have environmental imp act; understand the need to integrate occupational hygiene practice with environmental prot ection. Code of ethics Codes of ethics for certi \201 ed occupational hygienists exist in the USA and UK, relating to the responsibility of professional occupational hygienists to employers and clients. BOHS code of ethics available at: M www.bohs.org 29_Smedley_Chap29.indd 598 1/2/2013 12:49:35 PM CLASSIFICATION OF OCCUPATIONAL HAZARDS 599 Classi \201 cation of occupational hazards Hazards in the working environment can be divid ed into \201 ve main catego- ries (Table 29.1). These may produce an immediate or delayed response dictated largely by their inherent characteristics and the intensity and fre- que ncy of exposure. Table 29.1 Types of occupational hazard Hazard category Examples Chemical Solids (dusts), liquids, \201 bres, gasses, vapors, fumes, mists, and smoke Physical Noise, vibration, ionizing and non-ionizing radiation, extremes of temperature, humidity, p ressure, electricity, illumination, and visibility Biological Viruses, bacteria, fungi, protozoa, nematodes Ergonomics and mechanical Loading/lifting, repetitive action, posture, traps, impact, contact, entanglement, ejection Psychosocial and organizational Individual characteristics, work demand and conditions, work environment, organization 29_Smedley_Chap29.indd 599 1/2/2013 12:49:36 PM CHAPTER 29 Occupational hygiene overview 600 Use of occupational hygiene exposure data Exposure monitoring may be conducted for the foll owing reasons: \200 To identify hazards \200 To demonstrate compliance with occupationa l exposure limits (OEL) \200 As part of health risk assessments/investigations \200 Whe n conducting epidemiological studies \200 When designing and selecting appropriate contro l measures \200 When assessing the effectiveness of control measures \200 To identify i ndividuals for inclusion in health surveillance programs \200 Litigation and insurance pu rposes. Hazard identi \201 cation \200 Information sources/techniques include inventories of mat erials and material safety data sheets, understanding processes and work environments, and observi ng actual work practices This may not enable the identi \201 cation of all hazards, particularly those generated from non-routine activities or as a result of chemical processing, e.g. the rmal degradation. Exposure monitoring can provide useful information on the location and spread of contaminants in the workplace. Monitoring compliance \200 The most common reason for sampling is to determine whether th e exposure of an individual or group of individuals exceeds an OEL \200 In the case of ha zardous substances, monitoring is necessary in the following circumstances as de \201 ned in the COSHH Regulations 2002 (amended): \200 when failure or deterioration of the contro l measures could result in a serious health effect because of the toxicity of the contaminant, or the extent of pot ential exposure, or both when measurements are necessary to ensure that WELs are not exceeded, and always in the cas e of the substance or process speci \201 ed in schedule 5 of COSHH as an additional check on the effectiveness of the control measures provided when any changes occur in the conditions affecting employees \200\231 exposure, which could mean that adequate control is no longer being maintained. Standard setting Occupational exposure data are used to draw and understand dose \200\223 r esponse relationships when deriving OELs for different hazards. Dose- response data are use d to determine the no adverse effect level (NOAEL). The measured exposure level for the haz ard is compared with its derived NOAEL to determine whether it presents a risk to health fo r de \201 ned workplace scenarios (see b Chapter 33). 29_Smedley_Chap29.indd 600 1/2/2013 12:49:36 PM