Category: Health

Work Place Stress

We hear a lot about stress, but what is it? Taber’s Cyclopedia Medical Dictionary defines stress as “the result produced when a structure, system or organism is acted upon by forces that disrupt equilibrium or produce strain”. In simpler terms, stress is the result of any emotional, physical, social, economic, or other factors that require a response or change. It is generally believed that some stress is okay (sometimes referred to as “challenge” or “positive stress”) but when stress occurs in amounts that you cannot handle, both mental and physical changes may occur.

“Workplace stress” then is the harmful physical and emotional responses that can happen when there is a conflict between job demands on the employee and the amount of control an employee has over meeting these demands. In general, the combination of high demands in a job and a low amount of control over the situation can lead to stress.

Stress in the workplace can have many origins or come from one single event. It can impact on both employees and employers alike.

Cause stress at the workplace:

In the workplace, stress can be the result of any number of situations. Some examples include:

Stress cause health effects:

Yes, stress can have an impact on your overall health. Our bodies are designed, pre-programmed if you wish, with a set of automatic responses to deal with stress. This system is very effective for the short term “fight or flight” responses we need when faced with an immediate danger. The problem is that our bodies deal with all types of stress in the same way. Experiencing stress for long periods of time (such as lower level but constant stressors at work) will activate this system, but it doesn’t get the chance to “turn off”. The body’s “pre-programmed” response to stress has been called the “Generalized Stress Response” and includes:

  • increased blood pressure.
  • increased metabolism (e.g., faster heartbeat, faster respiration).
  • decrease in protein synthesis, intestinal movement (digestion), immune and allergic response systems.
  • increased cholesterol and fatty acids in blood for energy production systems.
  • localized inflammation (redness, swelling, heat and pain).
  • faster blood clotting.
  • increased production of blood sugar for energy.
  • increased stomach acids.

From: Basic Certification Training Program: Participant’s Manual, Copyright© 2006 by the Workplace Safety and Insurance Board of Ontario.

Stress can contribute to accidents/injuries by causing people to:

  • sleep badly.
  • over-medicate themselves and/or drink excessively.
  • feel depressed.
  • feel anxious, jittery and nervous.
  • feel angry and reckless (often due to a sense of unfairness or injustice).

When people engage in these behaviours or are in these emotional states, they are more likely to:

  • become momentarily (but dangerously) distracted
  • make errors in judgment.
  • put their bodies under physical stress, increasing the potential for strains and sprains.
  • fail in normal activities that require hand-eye or foot-eye coordination.

Stress can also lead to accidents or injuries directly by not giving the person the control necessary to stop the threat to their physical well-being.

Luckily, there are usually a number of warning signs that help indicate when you are having trouble coping with stress before any severe signs become apparent. These signs are listed below.

Interpretation of your score (based on the number of “Yes” selections):

0-5:  There are few hassles in your life.  Make sure though, that you are not trying to deliberately avoid problems.

6-10: You’ve got your life in fairly good control.  Work on the choices and habits that could still be causing you some unnecessary stress in your life.

11-15: You are approaching the danger zone.  You may be suffering stress-related symptoms and your relationships could be strained.  Think carefully about choices you’ve made and take relaxation breaks every day.

16-25: Emergency!  It is critical that you stop and re-think how you are living; change your attitudes and pay careful attention to diet, exercise and relaxation.

Signs or symptoms happen all at once and what level of help should be sought?

No, not normally. The signs and symptoms from stress tend to progress through several phases or stages. The phases can be described as below:

Improve my overall mental health:

Good mental health helps us to achieve balance and cope with stressful times.

Other mental fitness tips include:

  • Give yourself permission to take a break from your worries and concerns. Recognize that dedicating even a short time every day to your mental fitness will reap significant benefits in terms of feeling rejuvenated and more confident.
  • “Collect” positive emotional moments – Make a point of recalling times when you have experienced pleasure, comfort, tenderness, confidence or other positive things.
  • Do one thing at a time – Be “present” in the moment, whether out for a walk or spending time with friends, turn off your cell phone and your mental “to do” list.
  • Enjoy hobbies – Hobbies can bring balance to your life by allowing you to do something you enjoy because you want to do it.
  • Set personal goals – Goals don’t have to be ambitious. They could be as simple as finishing a book, walking around the block every day, learning to play bridge, or calling your friends instead of waiting by the phone. Whatever goal you set, reaching it will build confidence and a sense of satisfaction.
  • Express yourself – Whether in a journal or talking to a wall, expressing yourself after a stressful day can help you gain perspective, release tension, and boost your body’s resistance to illness.
  • Laugh – Laughter often really is the best medicine. Even better is sharing something that makes you smile or laugh with someone you know.
  • Treat yourself well – Take some “you” time – whether it’s cooking a good meal, having a bubble bath or seeing a movie, do something that brings you joy.

Silica Safety

Introduction

Crystalline silica is an important industrial material found abundantly in the earth’s crust. It is a mineral that occurs in several forms. Quartz, the most common form, is a component of sand, stone, rock, concrete, brick, block, and mortar. Many of these materials are used every day across a wide variety of industrial settings, including construction, mining, manufacturing, maritime, and agriculture.

Occupational exposure to crystalline silica often occurs as part of common workplace operations involving cutting, sawing, drilling, and crushing of concrete, brick, block, rock, and stone products (such as in construction work). Operations using sand products (such as glass manufacturing, foundries, and sand blasting) can result in worker inhalation of small (respirable) crystalline silica particles from the air. These types of exposures can lead to the development of disabling and some times fatal lung diseases, including silicosis and lung cancer. Processes historically associated with high rates of silicosis include sandblasting, sand-casting foundry operations, mining, tunneling, cement cutting and demolition, masonry work, and granite cutting.

This page offers guidance that may be useful to workers and employees across a number of industries. Resources for general industry and construction are highlighted where appropriate

OSHA regulations for occupational exposure to crystalline silica are addressed in specific standards for general industry, shipyard employment, and the construction industry.

General Industry

  • Ventilation
  • Air contaminants
    • Mineral dusts

Shipyard Employment

  • Mechanical paint removers
  • Air contaminants

Construction Industry

  • Gases, vapors, fumes, dusts, and mists
    • Gases, vapors, fumes, dusts, and mists
  • Ventilation

Silica Hazardous?

Silica, often referred to as quartz, is a very common mineral.  It is found in many materials common on construction sites, including soil, sand, concrete, masonry, rock, granite, and landscaping materials.

The dust created by cutting, grinding, drilling or otherwise disturbing these materials can contain crystalline silica particles.  These dust particles are very small. You cannot see them. This respirable silica dust causes lung disease and lung cancer. It only takes a very small amount of airborne silica dust to create a health hazard.

Recognizing that very small, respirable silica particles are hazardous, the Occupational Safety and Health Administration (OSHA) regulation 29 CFR 1926.55(a) requires construction employers to keep worker exposures at or below a Permissible Exposure Level (PEL) of 0.1 mg/m3 (click here to learn more about the PEL).  The National Institute for Occupational Safety and Health (NIOSH) has a lower Recommended Exposure Level (REL) of 0.05 mg/m3.

OSHA regulates silica exposure using the permissible exposure limit (PEL), which is the maximum amount of airborne dust an employee may be exposed to during a full work shift.

The PEL is dependent on the amount of crystalline silica that is present in the dust. The equation for this calculation is given below. For the most part, OSHA is more concerned with the respirable fraction of the sample because it is more hazardous; however, both respirable and total dust equations are shown. The following parameters are necessary to calculate the PEL and the exposure level.

  • % crystalline silica in the air samples (if the laboratory reports the silica concentrations in units of mass convert the mass to percent – e.g., [sample weight (mg) ÷ dust weight (mg) ] × 100% ):
    • % quartz
    • % cristobalite
    • % tridymite
  • Total weight of the dust collected in the air samples in milligrams.
  • Total volume of air sampled for each sample in cubic meters (1000 liters = 1 cubic meter).
  • Total sampling time for each air sample in minutes.

What are the possible exposure sources?

Crystalline silica can be found in certain types of natural materials, such as:

  • Sand
  • Soil and rock
  • Gravel
  • Sandstone
  • Slate
  • Granite
  • Clay

Typical construction materials made from these natural ingredients include:

  • Ceramic and terracotta tiles
  • Concrete and concrete block
  • Manufactured stone
  • Roof tiles
  • Bricks and blocks
  • Grouts and mortar
  • Some joint compounds
  • Abrasive materials

These become some of the sources of exposure associated with a number of the construction trades.

Exposure Levels:

Airborne exposure to crystalline silica dust can depend on a number of things, such as:

1. Types of activities

  • Cutting, drilling and coring
    • Concrete
    • Roof tile
    • Tile backer board
    • Brick and block
    • Granite
  • Grinding, Sanding and Sandblasting
    • Sack and patch
    • Tuck point grinding
    • Scabbing/scarifying
    • Drywall mud sanding
    • Hand-held surface grinding
  • Pulverizing
    • Jack and chipping hammers
    • Cement truck cleaning
    • Concrete recycling
    • Road milling
    • Backhoes, excavators
    • Demolition
  • Mixing (dry)
    • Cement
    • Plaster and grout
  • Cleaning up
    • Dry sweeping (versus wet)
    • Compressed air (versus vacuum)
    • Hauling

2. Location

  • Outside or in a wide open area versus inside or an enclosed area

3. Materials being used

  • The percentage of silica present varies a lot. The higher the content, the more likely overexposure will occur

4. Types of equipment used

  • Cutting using wet methods versus dry methods
  • Types of blades or abrasives used
  • Use of local ventilation that prevents or reduces the amount of dust you breathe

5. How long the dust-generating activity goes on in a shift

  • The longer the duration of exposure, the greater the chance of overexposure

6. Weather conditions

  • Presence of moisture
  • The lighter the wind the less likely airborne dust generated will move away from the breathing zone and be quickly diluted. On the flip side, wind currents can move the hazard away from one person to another.

WISHA exposure levels

Allowable Exposure Levels:

Cal/OSHA has established regulatory permissible exposure levels for silica that varies depending on the form of silica (quartz, fused, tripoli, tridymite and cristobolite) and particle sizes present. These allowable exposure levels are reflective of an employee’s average exposure throughout an 8-hour shift. There is a difference between “total” and “respirable” silica dust, in that “respirable” silica dust is more likely to get into the deep parts of the lungs and cause more serious damage.

Cal/OSHA’s Permissible Exposure Levels over an 8-hour average basis

  • Respirable crystalline silica (quartz, fused, tripoli), 0.1 mg/m3 – 0.1 milligrams of Silica in 1 cubic meter of air.
  • Total crystalline silica (quartz), 0.3 mg/m3.
  • Respirable cristobolite and tridymite, 0.05 mg/m3.

Who’s At Risk?

Each year, hundreds of workers die from illnesses caused by breathing in silica and thousands more become ill.

Any construction worker who performs one or more of the following tasks with any of the materials listed below is at risk of being exposed to hazardous levels silica dust.  If you work close by someone generating silica dust you may be at risk.

Task Construction   Material
Abrasive blasting
Bush hammering

Cutting/sawing

Demolishing/disturbing

Drilling

Earth moving

Grinding Jack

hammering

Milling

Mixing

Polishing

Roofing

Sacking/patching

Sanding

Scabbing

Scarifying

Scraping

Sweeping/cleaning up

 Asphalt (for paving)
Brick

Cement

Concrete

Concrete Block

Drywall

Fiber Cement products

Grout

Paints containing silica

Gunite/Shot crete

Mortar

Plaster

Refractory Mortar/Castables

Refractory Units

Rock

Roofing tiles & paves

Sand

Soil (fill dirt and top soil)

What are the Health Effects?

Inhaling crystalline silica can lead to serious, sometimes fatal illnesses including silicosis, lung cancer, tuberculosis (in those with silicosis), and chronic obstructive pulmonary disease (COPD). In addition, silica exposure has been linked to other illnesses including renal disease and other cancers.

Inhalation of respirable crystalline silica particles has long been known to cause silicosis, a disabling, non-reversible and sometimes fatal lung disease. Respirable crystalline silica also causes lung cancer. The International Agency for Research on Cancer has designated crystalline silica as carcinogenic to humans, and the U.S. National Toxicology Program has concluded that respirable crystalline silica is known to be a human carcinogen. The National Institute for Occupational Safety and Health (NIOSH) has also recommended that respirable crystalline silica be considered a potential occupational carcinogen. In addition, exposure to respirable crystalline silica has been associated with other respiratory diseases, such as chronic obstructive pulmonary disease (including bronchitis and emphysema), as well as kidney and immune system diseases.

Signs & Symptoms

Silica causes permanent lung damage that can be disabling and potentially lead to death. When workers inhale crystalline silica, the lung tissue reacts by developing fibroid nodules and scarring around the trapped silica particles. If the nodules grow too large, breathing becomes difficult.

Silica exposure can cause silicosis and people with silicosis are also at a higher risk of developing tuberculosis. There is no cure for silicosis, but it is 100% preventable. The three types of silicosis are:

  • Chronic silicosis, which usually occurs after 10 or more years of exposure to crystalline silica at relatively low concentrations;
  • Accelerated silicosis, which results from exposure to high concentrations of crystalline silica and develops 5 to 10 years after the initial exposure; and
  • Acute silicosis, which occurs where exposure concentrations are the highest and can cause symptoms to develop within a few weeks to 4 or 5 years after the initial exposure.

Silica and other dusts also cause COPD. COPD includes chronic bronchitis, emphysema, bronchitis, and chronic airway obstruction. In 1999, COPD ranked as the fourth leading cause of death with over 124,000 deaths. COPD is projected to become the third most common cause of death worldwide by 2020.

Symptoms from both silicosis and COPD may not be obvious and can initially include shortness of breath, chest pain, or a persistent cough.  Silicosis and COPD can be severe enough to cause respiratory failure, which may eventually lead to death.

Screening & Treatment:

To make sure your doctor is aware that you may have been exposed to silica on the job, and is well informed on the signs, symptoms, and diagnosis of silica related illness, we recommend bringing a Physician’s Alert to your appointment.

Your medical examinations should include:

  • Chest x-ray – classified according to the International Labour Office (ILO) International Classification of Radiography for Pneumoconioses
  • Pulmonary function test
  • Annual evaluation for tuberculosis – Purified protein derivative (PPD) skin test – for everyone with silicosis

There is no specific treatment for silicosis. Workers are advised to avoid further exposures to silica to prevent the disease from getting worse, limit exposure to irritants, and quit smoking. Antibiotics are prescribed for respiratory infections as needed. Those with a positive skin test for tuberculosis (TB) generally need treatment with anti-TB drugs. Any change in the appearance of the chest x-ray may be a sign of TB.  Patients with severe silicosis may need to have a lung transplant.

Treatment of COPD includes inhaled bronchodilators, anti-cholinergic agents or steroids, with antibiotics prescribed for respiratory infections as needed.  As with silicosis, it is important to limit exposure to irritants and quit smoking.

In 1996, the World Health Organization – International Agency on Cancer Research (IARC) first classified silica as a known human carcinogen and in 2009, IARC reaffirmed its position noting “[an] increased risk of lung cancer [from silica exposure] was observed across various industries and processes.”

The National Cancer Institute completed a study in 2011 showing that lung cancer screening saves lives.  Based on that study the American Lung Association recommends lung cancer screening with low-dose CT scans for current or former smokers who are between 55 to 74 years, with a smoking history of at least 30 pack-years (that is, an average of a pack a day for 30 years) and with no history of lung cancer.

Controlling Exposures in Construction While:

drilling-rigs

hand-oprated-grinders

jack-hammers

mansonary-saw

osha_fs-3627

rotary-hammers

tuck-pointing-mortar-removal

 

Control plan:

Controlling the exposure to silica in construction can be done through engineering controls, administrative actions,& personal protective equipment (PPE),similar to practices in other industries. Engineering controls include such things as replacing silica with another material (substitution), isolating an exposure source, and using ventilation systems. Administrative actions include limiting workers’ exposure time and providing showers. Use of PPE includes wearing proper respiratory protection and protective clothing. The following references aid in controlling crystalline silica hazards in the workplace.

You must implement the best possible permanent solution to reducing or eliminating the hazard. If such a solution cannot be enacted immediately, then you are required to implement a temporary control to protect your workers until the permanent solution is put in place.

The following solutions are listed in order of preference. (Depending on the work site a higher choice may actually be less effective.):Abatement

Most preferred, least preferred

Use a silica substitute

Use engineering controls

Improve work practices

Use personal protective equipment

Silica Substitutes:

The most sure way to eliminate the silica hazard is to eliminate the silica!

This is especially important for sandblasters, where the abrasive blasting is often done outside and in different locations, making it impossible to install an engineering control. The most severe silica exposures occur in abrasive blasting.

Eliminating the silica means using a different, safer material in place of the silica-containing substance.  It is true that in some cases it is not possible to use a substitute in place of silica, but for many operations, such as abrasive blasting, there are many possible substitutes, including those below.

Alumaglass                                            Garnet                                    Starblast XL
Aluminum Oxide                                  Glass Beads                           Steel Grit
Aluminum Shot                                    Melamine Plastic                  Steel Shot
Ambient Polycarbonate                      Novaculite                              Urea Plastic
Armex                                                     PC+                                          Visigrit
Apricot Pits                                           Polycarbonate                         Walnut Shells
Corn Cobs                                             Silicon Carbide                        Wheat Grain
Cryogenic Polycarbonate                   Stainless Cast Shot                 White Aluminum Oxide
Emery                                                    Stainless Cut Wire                   Zircon

Advantages

  • Complete elimination of any health hazard related to silica
  • Eliminates the need to implement or maintain engineering controls
  • These substances are not as dense as silica products which makes them easier to transport
  • They can be moved from job site to job site

Disadvantages

  • May be slightly more expensive than silica products
  • These substances are generally not as hard as silica products which may mean more is needed to do the job

Engineering Controls:

Keep silica out of the air

  • Install a water hose to wet down the dust at the point of generation
  • Install local exhaust ventilation
  • During rock drilling, flow water through the drill stem
  • Install dust collection systems onto machines or equipment that generates dust
  • Use concrete/masonry saws that provide water to the blade

Advantages:

  • If working properly will eliminate the potential hazard
  • Must be installed only once
  • Requires little training of workers
  • Places no physical burden on workers

Disadvantages

  • Can be expensive to implement
  • Requires routine maintenance

Work Practices

What employees can do to reduce silica intake

  • Know which work operations can lead to silica exposure
  • Participate in any air monitoring or training programs offered by the employer
  • If possible, change into disposable or washable work clothes at the worksite; shower (where available) and change into clean clothing before leaving the worksite.
  • Do not eat, drink, use tobacco, products, or apply cosmetics in areas where there is dust containing crystalline silica.
  • Wash your hands and face before eating, drinking, smoking, or applying cosmetics outside of the exposure area.
  • If using respirators, do not alter the respirator in any way.
  • Use type CE positive pressure abrasive blasting respirators for sandblasting
  • For other operations where respirators may be required, use a respirator approved for protection against crystalline silica-containing dust.
  • If using tight-fitting respirators do not grow beards or mustaches

Advantages:

  • They can reduce the chance for exposure.
  • They may be cheaper in the short run.

Disadvantages

  • They require training of all new employees.
  • They require employees to use the practices appropriately.
  • They require monitoring of employees at workers.

Personal Protective Equipment

Personal protective equipment against silica includes respirators and masks.  Respirators should be used only when the dust controls cannot keep dust levels below the NIOSH Recommended Exposure Level.

There are many types of respirators,  from air-purifying to air-supplying and from a nose and mouth covering to a full body respirator.  You can receive guidance on selecting a respirator from:

Advantages:

  • They can reduce the chance for exposure.
  • They may be cheaper in the short run.
  • Useful as a temporary control while the long term solution is being implemented.

Disadvantages:

  • They require training of all new employees.
  • They require employees to use the equipment appropriately.
  • They require setting up a formal PPE program to validate their proper use.
  • They require monitoring of all the PPE to insure proper maintenance.
  • They can be a health hazard by themselves.

Silica Exposure

Deadly Dust – Silica

Click the below link to download more documents about silica safety

 crystalline-factsheet

 health-effect-silica

 silica-construction-dust

Q Fever

Q fever and what causes it?

Q fever (Query fever) is an infectious disease that spreads from animals to humans. Q fever is caused by a microbe called “Coxiella burnetii.” This microbe can survive for months and even years in dust or soil.

Animals such as cattle, sheep, and goats can carry the Q fever microbe in tissues involved in birth–the uterus, placenta, and birth fluids. Infected animals also release the microbe in milk and manure. People acquire the infection by inhaling infectious aerosols and contaminated dusts generated by animals or animal products.

Many infections are without symptoms (asymptomatic). Common symptoms resemble a serious case of the flu with high fever, chills and sweating. In some cases, people develop liver and heart disease.

Q fever transmitted:

People usually contract Q fever when they breathe in the Q fever microbe. It is very infectious. As few as ten Q fever microbes can start an infection. People can also get Q fever by drinking infected milk, and through skin contact but most infections are spread through the air. Person to person transmission occurs rarely, if ever.

What are the symptoms of Q fever:

People can have Q fever without knowing it or mistake it for mild flu. Often, it is impossible to tell without laboratory tests.

Sometimes, Q fever strikes as a sudden illness, affecting a large number of people in the same workplace. Common signs and symptoms resemble a serious case of the flu:

  • sudden onset of high fever
  • fatigue
  • muscle pain
  • chills and sweating
  • headache
  • general feeling of sickness and loss of appetite

Some patients develop a slight, dry cough because of a lung inflammation known as pneumonitis. Most symptoms disappear after 7-10 days. However, afflicted people can feel generally ill with loss of appetite for several weeks.

A small percentage of patients develop hepatitis or liver disease and jaundice, a yellowing of the skin and darkening of the urine, caused by a malfunctioning of the liver.

Other rare clinical syndromes including endocarditis, an inflammation of the lining of the heart cavity, have been reported.

There may be regional differences in the way the disease presents itself. It is not clear why but animal studies suggest different strains may be a factor.

Q fever an occupational concern:

Q fever is an occupational concern for workers who have contact with animals, animal products, or animal waste. Those workers with heart valve problems or suppressed immune systems are at higher risk.

Workers can get Q fever from a variety of different animals:

  • wild animals.
  • farm livestock–especially cattle, sheep, and goats.
  • laboratory animals–especially sheep.
  • household pets–especially cats

Blood-sucking ticks spread the Q fever microbe to wild animals, but seldom to humans. Farm livestock, laboratory animals, and pets however can pick up Q fever directly from other infected animals or from contaminated surroundings.

Q fever is a special concern with pregnant animals, especially around the time they give birth or abort because of the disease. In pregnant animals, the Q fever microbe builds up to enormous numbers in certain tissues and fluids. These include:

  • the uterus or womb,
  • the placenta, which surrounds the offspring in the womb,
  • the mammary glands or udders,
  • birth fluids, and
  • milk.

Studies show that one gram of placenta from an infected sheep can contain over one billion Q fever microbes.

These microbes become airborne in tiny droplets of mists or aerosols and spread to workers:

  • when animals give birth,
  • during processing of infected tissues from slaughtered animals,
  • at milking or during the processing of milk, or
  • during animal surgery.

After giving birth, animals usually eat their placenta and other tissues of afterbirth. When this happens, the Q fever microbes survive digestion. They pass along the animal’s intestine and become discharged with the manure. This allows Q fever to spread widely throughout the environment.

The Q fever microbe easily becomes airborne with dust from infected animal tissues, manure, or soil. As a result, workers can become exposed to Q fever by contacting various infected materials such as

  • dust from animals, bedding, or manure,
  • soil near animal pens,
  • animal hides, wool, and furs, and
  • clothes from workers who were exposed to infected animals or materials.

Occupations are at increased risk for Q fever:

Q fever spreads easily throughout agricultural regions affecting anyone who works outdoors in contact with infected soil or dust. Airborne particles containing the Q fever microbe may be carried downwind for a considerable distance–one-half mile or more.

Q fever also spreads easily within buildings from room to room. Workers in research facilities can catch Q fever even if they only visit a contaminated room or hallway once or twice.

General medical staff do not normally get Q fever from infected patients.

Some of the occupations at increased risk for Q fever include the following:

  • farmers, ranchers, and farm workers in contact with cattle, sheep, and goats,
  • stockyard workers, truck drivers, personnel who service the trucks, and visitors to animal auctions,
  • meat packers, rendering plant workers, hide and wool handlers,
  • hunters and trappers,
  • laboratory animal researchers and support staff,
  • workers who care for pets and livestock–veterinary personnel, pet shop workers and zoo attendants, and
  • certain groups of medical and health care personnel who have contact with blood, sputum or tissue from infected patients.

Prevent Q fever in the workplace:

For most effective prevention, the Q fever microbe should be eliminated from animals. Eradications programs, however, are not yet available because Q fever spreads so effectively among animals. So far, research on vaccination programs for animals has not had practical success.

Workers who have even remote contact with animals, animal products, and animal waste should be informed about the disease, its characteristics, and the nature of the risk. Workers who start jobs with increased risk of Q fever should be offered blood tests to determine if they have resistance to Q fever or whether they should consider vaccination. The possibility of Q fever should be investigated in high risk workers who develop an unexplained feverish illness, especially if lung infections develop. Q fever is a reportable disease in most Canadian jurisdictions.

The risk of infection from the workplace can be reduced by:

  • vaccination of workers,
  • personal precautions, and
  • workplace hygiene.

Vaccination of workers

A vaccine is available to protect workers exposed to the Q fever microbe. The use of this vaccine should be limited to those at high risk of exposure whose blood tests for resistance to Q fever are negative. Before vaccination, workers must also have a skin test to determine if they are allergic to the vaccine.

Personal precautions

Personal precautions can reduce exposure to the Q fever microbe and possibly prevent it from spreading within the workplace:

  • Access to workplaces with increased risk of Q fever should be restricted to workers required to be there.
  • Protective clothing should be worn by workers exposed to animal tissue. Contaminated clothing should be labelled with a biohazard warning and washed using laundry procedures for disinfection.
  • No eating, drinking, smoking, or nail biting should be allowed in animal holding facilities. Hands should be washed frequently.
  • Animal tissue should be handled with care, especially tissue involved in birth.
  • Production and exposure to aerosols from animal tissues should be minimized.
  • Respiratory protection devices suitable for preventing aerosol inhalation should be used by workers at increased risk of inhaling contaminated droplets.
  • Acceptable laboratory techniques as outlined in “Laboratory Biosafety Guidelines” should be used in research or diagnostic laboratories that process blood and tissue from animals or patients with Q fever. “Laboratory Biosafety Guidelines” and other biosafety references are listed elsewhere on this web site.

Workplace hygiene:

Procedures should be developed to prevent the release and spread of the Q fever microbe within the workplace. Each workplace should have procedures to disinfect or sterilize areas that may be contaminated with the Q fever microbe.

  • In medical research laboratories associated with hospitals, animals should be kept in separate facilities to reduce the possibility of the Q Fever microbe spreading to staff and patients. Use of common elevators and loading docks should be avoided.
  • Pregnant ewes should not be used in research laboratories unless they have negative antibody tests for Q Fever.
  • Biosafety containment equipment and facilities should be used in laboratories as recommended in “Laboratory Biosafety Guidelines”.
  • When livestock give birth, they should be confined and closely observed. The placenta and other birth tissues should be collected before the animals eat them and disposed of safely.
  • Infectious waste should be packaged in puncture-proof, leakproof containers that are clearly labelled and sterilized before disposal according to procedures developed for biological hazards.
  • Surfaces, floors, and walls contaminated with fluids or dust from animals should be disinfected using procedures established for infection control.

Heat Stress

Heat stress

Workers at risk of heat stress include outdoor workers and workers in hot environments such as firefighters, bakery workers, farmers, construction workers, miners, boiler room workers, factory workers, and others. Workers at greater risk of heat stress include those who are 65 years of age or older, are overweight, have heart disease or high blood pressure, or take medications that may be affected by extreme heat resulting in heat stress.

Prevention of heat stress in workers is important. Employers should provide training to workers so they understand what heat stress is, how it affects their health and safety, and how it can be prevented.

Heat Stroke:

Heat stroke is the most serious of health problems associated with working in hot environments. It occurs when the body’s temperature regulatory system fails and sweating becomes inadequate. The body’s only effective means of removing excess heat is compromised with little warning to the victim that a crisis stage has been reached.

A heat stroke victim’s skin is hot, usually dry, red or spotted. Body temperature is usually 105_F or higher, and the victim is mentally confused, delirious, perhaps in convulsions, or unconscious. Unless the victim receives quick and appropriate treatment, death can occur. Any person with signs or symptoms of heat stroke requires immediate hospitalization. However, first aid should be immediately administered.

This includes removing the victim to a cool area, thoroughly soaking the clothing with water, and vigorously fanning the body to increase cooling. Further treatment at a medical facility should be directed to the continuation of the cooling process and the monitoring of complications which often accompany the heat stroke. Early recognition and treatment of heat stroke are the only means of preventing permanent brain damage or death.

Heat Exhaustion:

Heat exhaustion includes several clinical disorders having symptoms which may resemble the early symptoms of heat stroke. Heat exhaustion is caused by the loss of large amounts of fluid by sweating, sometimes with excessive loss of salt.

A worker suffering from heat exhaustion still sweats but experiences extreme weakness or fatigue, giddiness, nausea, or headache. In more serious cases, the victim may vomit or lose consciousness. The skin is clammy and moist, the complexion is pale or flushed, and the body temperature is normal or only slightly elevated.In most cases, treatment involves having the victim rest in a cool place and drink plenty of liquids.

Victims with mild cases of heat exhaustion usually recover spontaneously with this treatment. Those with severe cases may require extended care for several days. There are no known permanent effects.CAUTION Persons with heart problems or those on a low sodium diet who work in hot environments should consult a physician about what to do under these conditions.

Heat Cramps

Heat cramps are painful spasms of the muscles that occur among those who sweat profusely in heat, drink large quantities of water, but do not adequately replace the body’s salt loss. The drinking of large quantities of water tends to dilute the body’s fluids, while the body continues to lose salt. Shortly thereafter, the low salt level in the muscles causes painful cramps. The affected muscles may

Transient Heat Fatigue:

Transient heat fatigue refers to the temporary state of discomfort and mental or psychological strain arising from prolonged heat exposure. Workers unaccustomed to the heat are particularly susceptible and can suffer, to varying degrees, a decline in task performance, coordination, alertness, and vigilance. The severity of transient heat fatigue will be lessened by a period of gradual adjustment to the hot environment (heat acclimatization).

Fainting:

A worker who is not accustomed to hot environments and who stands erect and immobile in the heat may faint. With enlarged blood vessels in the skin and in the lower part of the body due to the body’s attempts to control internal temperature, blood may pool there rather than return to the heart to be pumped to the brain. Upon lying down, the worker should soon recover. By moving around, and thereby preventing blood from pooling, the patient can prevent further fainting. Heat Rash Heat rash, also known as prickly heat, is likely to occur in hot, humid environments where sweat is not easily removed from the surface of the skin by evaporation and the skin remains wet most of the time. The sweat ducts become plugged, and a skin rash soon appears. When the rash is extensive or when it is complicated by infection, prickly heat can be very uncomfortable and may reduce a worker’s performance. The worker can prevent this condition by resting in a cool place part of each day and by regularly bathing and drying the skin.

Hazard Control:

Engineering Controls:

  • Ensure all inside areas have adequate ventilation
  • Provide shaded awnings for outside work when possible
  • Provide portable ventilation when possible

Administrative Controls:

  • Provide training to all affected employees
  • Provide adequate and sanitary drinking facilities and utensils
  • Rotate workers during high heat operations

Protective Equipment:

  • Provide cooling PPE when appropriate

How the Body Handles Heat:

The human body, being warm blooded, maintains a fairly constant internal temperature, even though it is being exposed to varying environmental temperatures. To keep internal body temperatures within safe limits, the body must get rid of its excess heat, primarily through varying the rate and amount of blood circulation through the skin and the release of fluid onto the skin by the sweat glands. These automatic responses usually occur when the temperature of the blood exceeds 98.6ºF and are kept in balance and controlled by the brain. In this process of lowering internal body temperature, the heart begins to pump more blood, blood vessels expand to accommodate the increased flow, and the microscopic blood vessels (capillaries) which thread through the upper layers of the skin begin to fill with blood. The blood circulates closer to the surface of the skin, and the excess heat is lost to the cooler environment. If heat loss from increased blood circulation through the skin is not adequate, the brain continues to sense overheating and signals the sweat glands in the skin to shed large quantities of sweat onto the skin surface. Evaporation of sweat cools the skin, eliminating large quantities of heat from the body.

Safety Problems

Certain safety problems are common to hot environments. Heat tends to promote accidents due to the slipperiness of sweaty palms, dizziness, or the fogging of safety glasses. Wherever there exists molten metal, hot surfaces, steam, etc., the possibility of burns from accidental contact also exists.Aside from these obvious dangers, the frequency of accidents, in general, appears to be higher in hot environments than in more moderate environmental conditions. One reason is that working in a hot environment lowers the mental alertness and physical performance of an individual. Increased body temperature and physical discomfort promote irritability, anger, and other emotional states which sometimes cause workers to overlook safety procedures or to divert attention from hazardous tasks.

Health Problems

Excessive exposure to a hot work environment can bring about a variety of heat-induced disorders.

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First aid video for heat stroke-1

First aid video for heat stroke-2

Cold Environment

Cold Environment-General

Working in cold environments can be not only hazardous to your health but also life threatening. It is critical that the body be able to preserve core body temperature steady at + 37°C (+ 98.6°F). This thermal balance must be maintained to preserve normal body functioning as well as provide energy for activity (or work!). The body’s mechanisms for generating heat (its metabolism) has to meet the challenge presented by low temperature, wind and wetness – the three major challenges of cold environments.                                                                       

lose heat to the environment?

Radiation

Radiation is the loss of heat to the environment due to the temperature gradient. In this case, it is the difference between the temperature of the air and the temperature of the body (your body’s core temperature is +37°C). Another factor important in radiant heat loss is the size of the surface area exposed to cold.

Conduction

Conduction is the loss of heat through direct contact with a cooler object. Heat loss is greatest if the body is in direct contact with cold water. The body can lose 25 to 30 times more heat when in contact with cold wet objects than in dry conditions or with dry clothing. Generally, conductive heat loss accounts for only about 2% of overall loss. However, with wet clothes the loss is increased 5 times.

Convection

Convection is the loss of heat from the body to the surrounding air as the air moves across the surface of the body. The rate of heat loss from the skin by contact with cold air depends on the air speed and the temperature difference between the skin and the surrounding air.  At a given air           temperature, heat loss increases with wind speed. However, the effect of wind speed does not increase at speeds above 64 km/h or 50 mph since the air is not in contact with the body long enough for more body heat to be transferred to the air.

Evaporation

Evaporation is the loss of heat due to the conversion of water from a liquid to a gas. In terms of human physiology, it is:

  • Perspiration/Sweating – evaporation of water to remove excess heat.
  • “Insensible” Perspiration – body sweats to maintain humidity level of 70% next to skin. Particularly in a cold, dry environment, you can lose a great deal of moisture this way and not notice that you have been sweating.
  • Respiration – air is heated as it enters the lungs and is exhaled with an extremely high moisture content.

It is important to recognize the strong connection between fluid levels, fluid loss, and heat loss. As body moisture is lost through the various processes, the overall circulating volume is reduced which can lead to dehydration. This decrease in fluid level makes the body more susceptible to hypothermia and other cold injuries.

We produce and retain heat within the body:

In order to survive and stay active in the cold, the constant heat loss has to be counterbalanced by the production of an equal amount of heat. Heat is both required and produced at the cellular level as a result of complex metabolic processes that convert food – a primary source of energy – into glycogen. Glycogen is a substance (biochemical compound) that is the “fuel” for biochemical processes underlying all life functions, heat production included.

Factors important for heat production include:

  • Food intake.
  • “Fuel” (glycogen) store.
  • Fluid balance.
  • Physical activity.
  • Shivering – a reflex reaction, which increases the body’s heat production (up to 500%) when necessary. This reaction is limited to a few hours because of depletion of muscle glycogen and the onset of fatigue.

Heat retention and tolerance to cold also depends on the body’s structure, certain reflex and behavioral mechanisms that retain heat within the body as well as what you are wearing. They are:

  • Size and shape of the body (surface to volume ratio).
  • Layer of fat under the skin (Subcutaneous adipose tissue).
  • Decreased the blood flow through the skin and outer parts of the body.
  • Insulation (layering and type of clothing).

Maintain thermal balance:

Cold challenges the body in three major ways (temperature, wind and wetness). Depending on the severity of cold conditions, heat loss can occur. The body maintains its heat balance by increasing production of the heat and activating heat retention mechanisms.

Thermal Balance

In the situation where more heat is lost than the combined heat production processes and heat

retention mechanisms can generate, the core body temperature drops below +37°C. This decrease causes hypothermia which can impair normal muscular and mental functions.

Hypothermia

Examples of jobs in which cold may be an occupational hazard:

Workers at risk of suffering due to the cold include:

  • Outdoor workers including:
    • Road builders, house builders and other construction workers.
    • Hydro and telecommunications linemen.
    • Police officers, fire fighters, emergency response workers, military personnel.
    • Transport workers, bus and truck drivers.
    • Fishers, hunters and trappers.
    • Divers.
  • Workers in refrigerated warehouses.
  • Meat packaging and meat storage workers.
  • Outdoor recreation workers (and enthusiasts).

Factors that determine an individual’s response to the cold?

Response in Men and Women

Studies have shown that response to cold in women can differ from that of men. While the core body temperature cools more slowly in women, women are not usually able to create as much metabolic heat through exercise or shivering. In addition, the rate of cooling of the extremities (feet, hands) is faster among women. As a result, women are generally at a greater risk of cold injury.

Predisposing Conditions

Susceptibility to cold injury varies from person to person. In general, people in good physical health are less susceptible to cold injury. While anyone working in a cold environment may be at risk, the following conditions may make the risk of cold injury greater:

  • Age (infants less than one year, and older adults are more susceptible).
  • Diseases of the blood circulation system.                           
  • Injuries resulting in blood loss or altered blood flow.
  • Previous cold injury.
  • Raynaud’s Phenomenon.
  • Fatigue.
  • Consumption of alcohol or nicotine (smoking).
  • Use of certain drugs or medication.

First aid can I do if someone has frostbite:

First aid for frostbite, as well as immersion or trench foot, includes:

  • Seek medical attention.
  • If possible, move the victim to a warm area.
  • Gently loosen or remove constricting clothing or jewellery that may restrict circulation.
  • Loosely cover the affected area with a sterile dressing. Place some gauze between fingers and toes to absorb moisture and prevent them from sticking together.
  • Quickly transport the victim to an emergency care facility.
  • DO NOT attempt to rewarm the affected area on site (but do try to stop the area from becoming any colder) – without the proper facilities tissue that has been warmed may refreeze and cause more damage.
  • DO NOT rub area or apply dry heat.
  • DO NOT allow the victim to drink alcohol or smoke.

Hypothermia:

In moderately cold environments, the body’s core temperature does not usually fall more than 1°C to 2°C below the normal 37°C because of the body’s ability to adapt. However, in intense cold without adequate clothing, the body is unable to compensate for the heat loss and the body’s core temperature starts to fall. The sensation of cold followed by pain in exposed parts of the body is one the first signs of mild hypothermia.

As the temperature continues to drop or as the exposure time increases, the feeling of cold and pain starts to diminish because of increasing numbness (loss of sensation). If no pain can be felt, serious injury can occur without the victim’s noticing it.

Next, muscular weakness and drowsiness are experienced. This condition is called hypothermia and usually occurs when body temperature falls below 33°C. Additional symptoms of hypothermia include interruption of shivering, diminished consciousness and dilated pupils. When body temperature reaches 27°C, coma (profound unconsciousness) sets in. Heart activity stops around 20°C and the brain stops functioning around 17°C.

Signs of hypothermia:

Mild Hypothermia

  • 37.2-36.1ºC(99 – 97ºF)Normal, shivering may begin.
  • 36.1-35ºC(97 – 95ºF)Cold sensation, goose bumps, unable to perform complex tasks with hands, shivering can be mild to severe, hands numb.

Moderate Hypothermia

  • 35-33.9ºC(95 – 93ºF)Shivering, intense, muscles incoordination becomes apparent, movements slow and laboured, stumbling pace, mild confusion, may appear alert. Use sobriety test, if unable to walk a 9 meter (30 foot) straight line, the person is hypothermic.
  • 33.9-32.2ºC(93 – 90ºF)Violent shivering persists, difficulty speaking, sluggish thinking, amnesia starts to appear, gross muscle movements sluggish, unable to use hands, stumbles frequently, difficulty speaking, signs of depression, withdrawn.

Severe Hypothermia

  • 32.2-30ºC(90 – 86ºF)Shivering stops, exposed skin blue of puffy, muscle coordination very poor, inability to walk, confusion, incoherent/irrational behavior, but may be able to maintain posture and appearance of awareness
  • 30-27.8ºC(86 – 82ºF)Muscle rigidity, semiconscious, stupor, loss of awareness of others, pulse and respiration rate decrease, possible heart fibrillation.
  • 27.8-25.6ºC(82 – 78ºF)Unconscious, a heart beat and respiration erratic, a pulse may not be obvious.
  • 25.6-23.9ºC(78 – 75ºF)Pulmonary edema, cardiac and respiratory failure, death. Death may occur before this temperature is reached.

First aid for hypothermia:

Hypothermia is a medical emergency. At the first sign, find medical help immediately. The survival of the victim depends on their co-workers ability to recognize the symptoms of hypothermia. The victim is generally not able to notice his or her own condition.

First aid for hypothermia includes the following steps:

  • Seek medical help immediately. Hypothermia is a medical emergency.
  • Ensure that wet clothing is removed.
  • Place the victim between blankets (or towels, newspaper, etc.) so the body temperature can rise gradually. Body-to-body contact can help warm the victim’s temperature slowly. Be sure to cover the person’s head.
  • Give warm, sweet (caffeine-free, nonalcoholic) drinks unless the victim is rapidly losing consciousness, unconscious, or convulsing.
  • Quickly transport the victim to an emergency medical facility.
  • Do not attempt to rewarm the victim on a site (e.g., do not use hot water bottles or electric blankets).
  • Perform CPR (cardiopulmonary resuscitation) if the victim stops breathing. Continue to provide CPR until medical aid is available. The body slows when it is very cold and in some cases, hypothermia victims that have appeared “dead” have been successfully resuscitated.

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