SAIOH Annual Conference 2016 Caring for our Wellbeing

 26 - 28 October 2016

Blyde Canyon – A Forever Resort – Mpumalanga

Introduction

The 2016 SAIOH Annual Conference was organised by the Mpumalanga Branch of SAIOH and was hosted in the beautiful setting of Graskop, Mpumalanga, and against the awe-inspiring backdrop of the Three Rondavels, along the pristine Panorama Route. The programme consisted of two professional development courses (PDCs), four keynote addresses, and 33 oral and poster presentations.

 

Abstracts

A. Professional Development Courses (PDCs)

PDC 1: Fundamentals in whole-body vibration assessments and evaluation

Presenter: Duane Bester, MPH, Registered Occupational Hygienist

Affiliation: Gijima Holdings (Pty) Ltd - Occupational Hygiene and Environmental Services, South Africa

Currently, no South African legislation has been drafted dealing with the identification, risk assessment, monitoring and management of employees exposed to vibration-emitting sources. More worrisome is the fact that vibration assessment work is performed without core fundamental knowledge on the subject matter, resulting in the incorrect assessment of exposures and/or misinterpretation of obtained results. Current approaches seem to focus on assessing vibration emission of all vibrating tools and/or vehicles, and not the exposures of Similar Exposure Groups (SEGs) for specific at-risk activities. This leads to an inaccurate estimation of exposure levels for specific SEGs, resulting in incorrect classification  of risk profiles. This pre-conference Professional Development Course (PDC) aims to address issues relating to the practicality of measuring whole-body vibration according to the International Organization for Standardisation (ISO) 2631 standard series, fundamentals regarding sampling parameters and their correct interpretation, correct evaluation of SEG-specific exposures and identifying system faults contributing to the exposure of employees. In addition, basic control measures, their limitations and the importance of system-specific dynamics, and how these aspects relate to the individual, will be discussed. The interactive session will address misconceptions regarding the basic monitoring of whole-body vibration and will assist the occupational hygiene professional in developing confidence in conducting whole-body vibration assessment work.

 

PDC 2: Biological risk management

Presenters: Dr Tanusha Singh,1,2,3 Onnicah Matuka,1,2 Lufuno Muleba,1 Thabang Dube1

Affiliations: 1Department of Immunology and Microbiology, National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg, South Africa; 2Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, Johannesburg, South Africa; 3Working Group on Occupational Infectious Agents, International Commission on Occupational Health (ICOH)

Background: Workers in many different jobs may be exposed to various infectious biological agents, either intentionally or incidentally, contributing to the burden of occupational disease.  Therefore, adequate control measures for eliminating or containment of the source, coupled with best practices and appropriate training, are fundamental to managing hazardous biological exposure in the workplace. The pre-conference Biorisk Management Professional Development Course (PDC) is designed to provide information for creating a healthy and safe environment for workers, through the application of the Hazardous Biological Agents (HBAs) Regulations of South Africa.

Methods: The PDC will contribute to the knowledge and skills of technical staff involved in risk identification and monitoring of biological agents, as well as professionals in occupational health and safety. The PDC will combine lectures, demonstrations and problem solving through interactive and small group and/or individual activities. The sessions will be presented by expert scientists in HBAs from the National Institute for Occupational Health (NIOH).

Results: On completion of the PDC, the participants will be able to recognise occupational exposure to biological hazards; conduct HBAs risk assessment of a workplace; recommend intervention strategies for reducing exposure; and understand the pros and cons of different sampling and analytical techniques for HBAs.

Conclusions: Managing the risk of exposure to biological agents through hazard identification, environmental monitoring and control measures plays a critical role in occupational health and safety of the workforce.

B. Keynote addresses

Keynote address 1: Five years on from the Constitutional Court decision in the matter of Thembikile Mankayi v AngloGold Ashanti: A reflection on its impact and ramifications

Presenter: Richard Spoor

Affiliation: Richard Spoor Inc. Attorneys, South Africa

The focus of Richard Spoor Inc. Attorneys is the field of occupational health and safety. The law firm has represented workers and trade unions in enquiries into some of the country’s worst industrial disasters in the chemical, construction, industrial and mining sectors. Over the last couple of decades, the Richard Spoor legal team has negotiated a number of pioneering settlements between employers and workers, or their dependants, in relation to occupational injuries and disease following major mining and industrial accidents and occupational disease epidemics. Given that the silicosis litigation and the approval of a class action structure are such high profile topics across the mining industry specifically, and of special interest to the world of work more broadly, this keynote presentation will cover the following:

•   A concise summary of the judgment;

•    A short summary of the President Steyn and Qhubekha silicosis litigation against Anglo Gold and Anglo American South Africa;

•    A brief survey of the silicosis class action litigation, its implications and direction;

•   The industry and State response:

o  Project Ku-Riha and the crisis in the Medical Bureau for

    Occupational Disease (MBOD)

o  The proposed Integration of the Occupational Diseases in

      Mines and Works Act (ODMWA) and the Compensation for

    Occupational Injuries and Diseases Act (COIDA) and the

    implications for occupational health and safety; and

•     A better way forward?

 

Keynote address 2: Hazardous biological agents: current and future trends

Presenter: Dr Tanusha Singh

Affiliations: Department of Immunology and Microbiology, National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg, South Africa; Department of Clinical Microbiology and Infectious Diseases, University of the Witwatersrand, Johannesburg, South Africa; Working Group on Occupational Infectious Agents, International Commission on Occupational Health (ICOH)

Workers in various settings may be intentionally or incidentally exposed to a broad spectrum of biological agents, adding to an under-estimated and under-reported occupational burden of disease. Congregate settings, inadequate ventilation, poor personal hygiene and lack of awareness increase the likelihood of disease. A fundamental lesson learnt from the recent Ebola outbreak in West Africa was the lack of occupational health and safety (OHS) within various sectors.  Occupational health (OH) should thus be an integral part of infection control, aligned to relevant legislative requirements.

The transmission of biological agents is a weak link in the disease cycle where mitigation strategies may increase prevention through the implementation of a hierarchy of controls.  Several challenges jeopardise the mitigation of risk, including compliance with the Hazardous Biological Agents (HBAs) Regulation in non-laboratory settings; mixed exposures through diversification of workplaces; poor work practices; long working hours; poor communication; a general lack of maintenance, occupational exposure limits, availability of appropriate personal protective equipment (PPE), and human and financial resources

Epidemiological studies are also limited and some biological hazards are not well understood. The high rate of disease attributed to HBAs reinforces the need to strengthen the implementation of robust prevention and control strategies through a systematic, multidisciplinary approach.These strategies are complex and depend on the agent and its association with ill health outcomes, work processes, and worker behaviour. 

Active participation of workers is important, to build and sustain sound OHS practices. Complementary elements are needed in implementing effective interventions and transform future trends against the current backdrop of HBA related diseases. These include innovative service delivery models, improved information dissemination, capacity development of OH professionals, surveillance and OHS policy. The success of mitigating biological risks is underpinned by an understanding of the transmission dynamics, but more importantly, by the willingness of employers and employees to effect change.

Keynote address 3: Solar UV radiation-induced skin cancer as an occupational reportable disease: can international experience inform South Africa?

Presenter: Dr Caradee Y Wright

Affiliations: Environment and Health Research Unit, South African Medical Research Council (MRC); Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa

Background: Skin cancer has been deemed one of the large, unmet challenges to modern medicine given that it is the most frequently occurring and fastest growing malignant disease in terms of incidence and prevalence. Occupational solar ultraviolet radiation (UVR) exposure is a skin cancer risk factor. Outdoor workers have long exposure hours and are in need of photo-protection against solar UVR, a group 1-defined carcinogen. In South Africa, skin cancers account for one third of all histologically-diagnosed cancers. Physiological presentation of non-melanoma skin cancers (NMSC) is most common on the head in all population groups. It is expected that occupational exposure plays a role in NMSC aetiology in South Africa, although such data are presently lacking. Recognising solar UVR-inflicted skin cancer as an occupational disease occurs in some countries. We consider the experience of other countries in including NMSC as an occupational disease to draw on lessons learnt and consider a similar approach nationally.

Methods: Using mixed methods, we performed a literature review using PRISMA guidelines to source articles in English on NMSC as an occupational disease. We sent an open-ended email information request to nine international academic experts, from different countries, identified from literature. Data on background, legislation, reporting, notification and occupational sectors of concern were analysed.

Results: Several countries, including Denmark and Germany, include NMSC in their lists of occupational diseases. Despite this, under-reporting is still significant. Agriculture, construction and public service sectors report most commonly, compared to other sectors in Germany. National awareness campaigns, careful legal management and improved healthcare services for patients are key.

Conclusions: Outdoor workers, including in South Africa, run an increased risk of developing NMSC. Should we wish to register NMSC as a reportable occupational disease, significant efforts relating to epidemiology, exposure assessment, legal and insurance management and policy-making, will need to be considered.

 

Keynote address 4: The implementation and management of an effective Fatigue Management Strategy in the workplace

Presenter: Dr André van Jaarsveld

Affiliation: BSS Africa

Fatigue is a state of impaired mental and/or physical performance and lowered alertness which can affect employees at every level of the organisation. It is caused by a wide variety of factors, including inadequate restorative sleep, hard physical or mental work, health and psychological factors.  It is also a significant cost that most businesses simply bear because it is part of ‘working hard’ and often difficult to accurately identify.  Fatigue can have deadly consequences, especially in environments where a loss of alertness can threaten the health and safety of the employee or others.

The management of fatigue has been a contentious issue in the workplace in recent years. This has given rise to three key misconceptions that have limited the effectiveness of the workplace’s efforts to address this issue. These are that:

•  Fatigue can be effectively addressed by a focus on rosters and hours of work (or the other so called ‘work related’ causes of fatigue);

•  Efforts to control fatigue should have as their primary focus the establishment of workplace ‘systems’ that reduce the role of the individual in managing fatigue; and

•  There will soon be a technological ‘silver bullet’ that will solve all fatigue problems.

In contrast to the above, we take the approach that:

•  The primary cause of fatigue is inadequate or poor quality sleep; and

•  The effective management of fatigue depends more on the management of the organisation’s culture and on the promotion of self-management, and less on technological solutions.

Recruitment processes identify candidates with a potential for fatigue (e.g. those with sleeping disorders). Thereafter:

•  There is a regular review and improvement of organisational issues and practices (including shifts and rosters) to minimise the potential for fatigue,1

•  Employees develop the attitudes and skills necessary to manage their fatigue;

•  Employees are willing to monitor and intervene when a colleague appears fatigued; and

•  Supervisors have the knowledge, skills and willingness to actively monitor and manage fatigue, and to foster a culture that supports employee self-management.

1The recently released West Australian ‘Extended Hours of Work Review’ provides a useful framework for this process.

 

C. Conference presentations (oral presentations)

 

Presentation 1: Reducing occupational hygiene exposures in the South African mining industry through the setting of milestones

Authors: Brian Mongoma, 1 Vijay Nundlall 2

Affiliations: 1 Chamber of Mines of South Africa; 2 Sibanye Gold

 

Background: In 2003, the South African Mining Industry (SAMI) tripartite stakeholders held a tripartite health and safety summit, and agreed upon health milestones. During 2013, SAMI tripartite stakeholders reviewed the progress made to date, through systematically analysing the collected occupational hygiene data for the purpose of measuring SAMI’s performance towards achieving the 2003 milestones.

Following the analysis, the occupational hygiene milestones were revised in 2014, to the following:

•   By December 2024, 95% of all exposure measurement results will be below the milestone level for respirable crystalline silica of 0.05 mg/m3

•  By December 2024, 95% of all exposure measurement results

    will be below the milestone level for platinum mine dust respirable particulate of 1.5 mg/m3 (<5% crystalline silica)

•   By December 2024, 95% of all exposure measurement results will be below the milestone level for coal dust respirable particulate of 1.5 mg/m3 (<5% crystalline silica)

NB: The milestones are based on individual readings, not the averaged results .

The tripartite stakeholders also agreed on the activities that will assist the SAMI to achieve the 2024 occupational health milestones.

Methods: Occupational hygiene statutory data as well as data submitted to the Mine Health and Safety Council in 2013 were reviewed and interviews were also conducted with different mining industry’s mandating committees.

Results: In 2014, the mining industry’s performance towards the occupational hygiene milestone on airborne pollutant was measured, and such data assisted in reviewing the milestones as well as collectively agreeing on the activities that will assist the mining industry to achieve the 2024 milestone targets.

Conclusions: Using data to craft milestones and linking these to the identified activities is envisaged to assist the industry to reduce exposures and thus ultimately reduce occupational disease.

Presentation 2: Exploring recent global developments in compliance testing and South African practice: Results of a pilot study

Author: Derk Brouwer1, Cas Badenhorst2

Affiliation: 1School of Public Health, Faculty of Health Sciences, University of the Witwatersrand; 2Lead Occupational Health and Hygiene, Anglo American Ltd, Johannesburg, South Africa

Background: Recent developments in occupational exposure limit (OEL)-compliance testing, e.g. the revised EN 689, emphasizes the need for an evaluation of the current practice in South Africa. Critical issues are homogeneous or similar exposure groups (H(S)EGs), distribution of exposure data, sample size, and OEL exceedance criteria. To study the potential impact of these developments, a comparison is imperative between the leading approaches in SA mining and non-mining industry, i.e. the Code of Practice (CoP) and NIOSH OESSM, respectively. A pilot study was conducted to investigate the feasibility of such a study.

Methods: A dataset of 856 eight-hour time weighted average (TWA8h) coal dust data was analysed using Statistica V12 and EXPOSTATS (http://www.expostats.ca/). The measurements were conducted in 2015 and comprised of 49 HEGs and 39 job titles across mines. Box plots and Quantile-Quantile plots were used to evaluate homogeneity. Descriptive statistics of HEGs and job titles (N≥ 15) were performed to derive the 90th percentile of the distribution and the estimated 95th percentile (90% Cl), to test according to CoP and OESSM exceedance criteria, respectively. Selected data sets were imported in EXPOSTATS to test according to EN 689 (70% upper CI). In addition, ten random subsamples (n = 9 observations) were taken of the largest HEGs (n = 124) and job title group (n=167) to investigate the effect of a limited number of observations (Clerc & Vincent, 2014).

Results: In general, homogeneity of the HEGs with regard to TWA8h could not be observed; this was slightly better for the job titles. As expected, the sensitivity of the 10% portion exceedance criterion (CoP) was low compared to the OESSM and CEN 689 criteria. Similar results on exceedance of OEL were obtained for the subsamples compared to the entire HEG or job title group.

Conclusions: The pilot study indicates that divergent results will be obtained by the various approaches; however, a comprehensive analysis should confirm these preliminary conclusions.

Presentation 3: Keeping the engineering controls honest: Real-time monitoring of dust in the South African mining industry

Author: Dr Audrey Vukosi Banyini

Affiliation: MOSH Dust Adoption Specialist – Chamber of Mines

 

Background: The Mining Occupational Safety and Health (MOSH) Adoption System (www.mosh.co.za) is a systematic approach for identifying leading practices with the highest impact in health and safety, and for facilitating widespread adoption in the mining industry, by focusing on the ‘people’ issues  to overcome resistance.

Background: The continuous real-time monitoring of engineering controls for airborne pollutants at ultra-deep gold and open cast colliery source mines was identified as ‘leading practice’ in MOSH Dust Leading Practice, with the highest potential to reduce and prevent exposure at source.

Methods: Qualitatively and quantitatively documenting the practice, the benefits and the value case of the MOSH Adoption System.

Results: The ability to manage the effectiveness of the engineering controls 24/7, the immediate mitigation of the cause of exposure to dust, and the prevention of over-exposure.

Conclusions: The adoption of this leading practice will assist the mining industry in keeping the engineering controls honest.

Presentation 4: How systems like GHS, REACH and others will fundamentally change the practice of occupational hygiene

Author: Garth Hunter

Affiliation: Engen Oil, South Africa

 

Background:

•  GHS (Globally Harmonized System of Classification and Labelling of Chemicals)

•  REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals)

•  Model Regulations for Transport of Dangerous Goods

•  IMO (International Maritime Organization) Dangerous Goods Code

•  ICAO (International Civil Aviation Organization) Technical Instructions for the Transport of Dangerous Goods

These standards all have application to chemical safety, require partial or full application of the Occupational Health and Safety Act in terms of mandate, and are used in carrying out health risk assessments in terms of the Regulations for Hazardous Chemical Substances. Further, changes are taking place at a rapid pace in industry, both nationally and internationally, where GHS and REACH, in particular, represent both threats and opportunities to industry. These threats and opportunities arise largely through the use of GHS and REACH as trade barriers.  Similarly, it is likely that the Occupational Hygiene field is not sufficiently aware of how these standards impact on health risk assessments.

Methods: This presentation will review and explain the application of the various standards.

Results: There will be a clearer understanding of the risks and opportunities that the enforcement of these standards represents to the occupational hygiene profession in South Africa.

Conclusions: In terms of these standards, the world has changed, regulations have largely changed internationally and it is reasonable to expect that these changes will have significant impacts on the South African legislation (some legislation has already changed).  

For the hygienist there is a lot to learn, since an understanding of these standards is likely to become necessary, in the near future, for the practice of occupational hygiene in South Africa.

 

Presentation 5: Human factors management key to sustainable development: A case study for the railway industry in South Africa

Authors: Matselanyane Makwela,1 F Tshidada2

Affiliations: 1Manager: Safety Standards; 2Specialist: Health and Safety – Railway Safety Regulator, South Africa

Background: Globally, the railway industries are being transformed, and the South African railway industry is no exception. This transformation serves as a global economic intervention to address challenges such as road traffic congestions, excessive exhaust emissions and environmental pollution, through the growth and development of the railways.

Throughout the Southern African Development Community (SADC), and South Africa in particular, huge investments have been committed towards railway transformation through capital projects, such as the upgrading of railway infrastructure and procurement of new rolling stock. These investments are mainly aimed at supporting economic growth and development and ensuring that railways remains a safe, economic, and preferred mode of transportation. In South Africa, the current Railway Safety database reflects an escalating number of railway occurrences impact negatively on the success and sustainability of this envisaged railway growth and development. Further investigations have revealed that inadequate and/or poor management of human factors still remain among the highest causes of railway occurrences.

Methods: The management of human factors in the railway industry, particularly the physical, chemical, ergonomic and psychological factors, therefore remain central and core towards the success and sustainability of the industry.

Results: The railway industry in South Africa has identified a need to close this gap, in support of the national transport strategies. Hence, the ‘Human Factors Management’ approach has been adopted by to ensure effective mitigation of these risks.

Conclusions: This presentation reports on a study conducted in the railway industry,  to highlight the positive impact of the “Human Factors Management” approach,  the practical aspects in the integration of this approach throughout the railway life cycle phases, and the positive aspects that have resulted from its implementation.

Presentation 6: Safe container unloading procedures: an obligation or not important?

Author: Steven Verpaele1,2

Affiliations: 1Belgian Center for Occupational Hygiene - Abdijstraat 13 - 8470 Gistel, Belgium; 2Mensura EDPB - Laurentide Gaucheretstraat 88/90 - 1030 Brussels, Belgium

European legislation related to exposure to chemical agents is becoming stricter. Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) and CLP (a European Union regulation on classification, labelling and packaging of substances and mixtures) have ensured that more substances are being classified as dangerous, and there are also more substances being added to authorisation and restricted lists. It is clear that the industry has to deal with this development, such that exposure to chemicals can be considered to be under control.

Over the past few years, warehouse workers have become more aware of and concerned with their occupational exposure to chemical agents. Fatal accidents which have occurred with fumigated containers have been the trigger for increased concern and awareness in terms of chronic exposures to chemical mixtures. In several European countries, procedures have been introduced for monitoring sea freight containers and measuring exposure to chemical agents. These procedures are mainly based on non- or semi-selective methods and focus on 16 specific chemical agents and total volatile organic compounds (VOCs).

A study carried out across different warehouses yielded some remarkable results. Less than 1% of the total inbound flow of containers was being fumigated, and this was not being done deliberately. A shift in personal exposure was seen when comparing seasonal monitoring campaigns. In winter, it was noted that there is more background exposure; and in summer the peak exposure when opening a container was found to be higher.

An investigation into the monitoring procedures introduced to date in several European countries, has shown the need for a proper risk assessment to be undertaken, before a safe unloading process can be carried out. The defined group of 16 chemical agents and total VOCs is far from what is required to properly assess workers exposure.

Presentation 7: Using the present to shape the future of SAIOH: A socratic approach

Authors: Norman Khoza, J Pieterse, C Nogueira, C Badenhorst, K Hlungwane

Affiliation: Southern African Institute for Occupational Hygiene (SAIOH)

Background: The Southern African Institute for Occupational Hygiene (SAIOH) has been in existence for over 23 years, and currently the Institute has in excess of 700 members in the Southern African Development Community (SADC) Region, the majority being in South Africa. The organisation is well recognised by the national Departments of Labour (DoL) and Mineral Resources (DMR), and international organisations such as the International Occupational Hygiene Association (IOHA). Over the past two years SAIOH has signed Memoranda of Understanding (MoUs) with international authorities in occupational health and hygiene such as the British Occupational Hygiene Society (BOHS), the American Industrial Hygiene Association (AIHA), and the National Institute for Occupational Safety and Health (NIOSH), USA. Accredited by the South African Qualifications Authority (SAQA) and recognised by the IOHA Certification Board, the SAIOH Professional Certification Committee (PCC) has recently introduced new developments in the registration and assessment process for professional certification, with a strong focus on guidance, learning tools, mentorship and a volunteer system to support trainees. This presentation seeks to propose enhanced regional structures to promote growth and development of SAIOH’s membership, strategies and operational plans.

Methods and Results: Notwithstanding the abovementioned efforts to sustainably improve the functioning of the Institute, SAIOH has only four provincial branches (Mpumalanga, Gauteng, KwaZulu-Natal and Western Cape), making the SAIOH objectives and strategies difficult to achieve within the constraints of the current structure. The main barriers and constraints to the development of the Institute will be discussed, and a new SAIOH regional

structure will be proposed.

Conclusions: Within its membership and steering committees, SAIOH has extensive expertise and experience to continuously develop the organisation’s membership, knowledge, professional certification and standing. This can only be achieved through coordinated efforts and innovation amongst its members and leadership, within an efficient regional structure.

Presentation 8: Presentation on the newly established ‘AIA Forum’

Authors: Philip van Dyk, Dawie van den Heever, Jaco van Rensburg

Affiliations: Directors of ‘AIA Forum’, to become known as ‘OHAIA Association’, South Africa

Brief history of the Approved Inspection Authorities (AIAs) System:

•   Reason for the Department of Labour (DoL) to establish Occupational Hygiene (OH) AIAs

•   Original requirements for establishing an AIA

•   Special requirements placed on members/employees of an AIA

•   Recent developments regarding South African National Accreditation System (SANAS) accreditation and re-registration, for DoL approval

Development of the need for unification of AIAs and the establishment of an ‘AIA Forum’:

•   Initial communication amongst prominent role players in the AIA fraternity

•   Eventual, successful first kick-off meeting – testing the waters to establish support for such a forum, and to establish broad goals

•   Application for the registration as a non-profit company (NPC), known as: ‘Association for Occupational Hygiene Approved Inspection Authorities NPC (‘AiA’)’

•   Second meeting – First meeting of the official Forum:

    o Announcement of confirmation that the Forum receives support               

      from more than 60% of AIAs, for the Forum to officially repre-

      sent AIAs

    o Nomination and election of Directors of the Forum – elected:

        Dawie van den Heever, Philip van Dyk and Jaco van Rensburg

•   Confirmation of representation of AIAs at the SANAS Scientific Technical Committees (STC)

•   Tabling of the Constitution and discussion

Objectives:

•   To promote and advance the function of the OH AIA, for the benefit of the AIA and the industry that it serves

•   To provide meaningful input and constructive comments on policies, instructions, rules and legislation imposed by governing bodies such as DoL, SANAS and SAIOH, that may affect the AIA, its employees and the Industry it serves

•   To actively participate in drafting of OH related policies, instructions, rules and legislation

Strategy:

•   To seek formal recognition, collaborate and regularly meet with all parties with a mutual interest in OH and/or governing any aspect of OH, or providing OH and related services

•             To grow membership and to anticipate and inform members regarding developments that may affect AIAs and the OH service industry; to respond on behalf of the AIAs

Presentation 9: Organisation of occupational medicine practitioners in southern Africa

Author: Prof. Daniel (Daan) Kocks

Affiliation: President - South African Society of Occupational Medicine (SASOM), sister organisation of SAIOH

Background: The South African Society of Occupational Medicine (SASOM) is a professional society, established in 1948 as a non-profit organisation, to further occupational medicine in South Africa and to build a global bond. SASOM is registered as a special interest group with the South African Medical Association (SAMA), and affiliated to the International Commission on Occupational Health (ICOH). Through its networking capability, SASOM provides support to a variety of specialist groups in the fields of Occupational Health and Environmental Medicine. Among SASOM’s main aims are the development of Occupational Medicine as a distinct and recognised multi-disciplinary activity; and the contribution to national and international occupational health strategies and policies.

Deliverables: Occupational health as a service for any employer or employee organisation in South Africa shall consists of two (2) different components i.e. Occupational Medicine and Occupational Hygiene; the latter being represented by the Southern African Institute for Occupational Hygiene (SAIOH). Occupational Medicine is the discipline of the medical doctor and nursing sister. The medical doctor trained in the discipline of Occupational medicine is known as an Occupational Medical Practitioner (OMP), and the profession is regulated by a statutory body, namely the Health Professions Council of South Africa (HPCSA), and a non-statutory organisation, which is SASOM. The Society advocated recognition of Occupational Medicine as a medical speciality long before it was finally recognised as such by the HPCSA in 2004. SASOM is the peer review organisation of OMPs. This presentation will focus on the role of the OMP and the marketing function performed by SASOM in South Africa, including closer collaboration with the sister organisations in occupational health.

Presentation 10: Where is the link between occupational hygiene and

occupational health?

Author: Jana Maritz

Affiliation: South African Society of Occupational Health Nursing Practitioners (SASOHN), sister organisation of SAIOH; Chair - SASOHN Mpumalanga Branch

Background: The link between occupational hygiene and occupational health is the ‘art’ of prevention of occupational injury, illness and disease.

Methods: The link between the two disciplines is also in the scientific process of identifying, controlling and preventing health and / or injury risks in the workplace.

Discussion: Scientific measurements and mathematical calculations of existing risks in the workplace environment form the basis of the hygiene survey. The hygiene survey dictates the risk profile and engineering control methods required to reduce and/or eliminate risks and prevent potential health hazards. The hygiene survey is also referenced in the compiling of a medical surveillance matrix, indicating what biological and psychological factors should be evaluated before considering an employee medically fit to enter into a specific work zone or performing specific occupational tasks. For example, a person with uncontrolled epilepsy could be at risk of causing damage to company equipment/property or injury to him/herself or others, to the extent of causing a fatality, if allowed to enter a job category where he / she is expected to work at heights. The hygiene survey also guides the medical risk matrix towards routine medical tests required for employees, such as audiometric testing, six monthly [if exposed to noise levels ≥ 104 dB(A)], or annually [if exposed to noise levels ≥ 85 dB(A)], to establish the effectiveness of preventative methods/programmes that are in place for the management of noise-induced hearing loss (NIHL). Furthermore, sound scientific methods and their results, in combination with current applicable legislative guidelines, assist in the prevention of unfair subjective human decision making regarding employment, enabling emotional stability in terms of fairness and job security in a workforce.

Conclusions: A sound marriage of the fields of occupational health and occupational hygiene not only crafts, but sustains, a healthy and safe workforce.

Presentation 11: Occupational hygiene . . . an art and science

Author: Martin Coetzee

Affiliation: Gijima Holdings (Pty) Ltd - Occupational Hygiene and Environmental Services, South Africa

‘An art and science…’ Most probably some of the very first words many of us ever heard when we met with Occupational Hygiene (OH) …

And most probably most of us wondered about the ‘art’ part …

OH is an in-depth science … all of us agree ... but there is an ART in it, without which the science will not come into its own right.

The 20 ARTS of OH:

The science is in the mind, ... the art is in the heart

The science is in the intellect, ... the art is in the virtue demonstrated

The science is theory, ... the art is to practice what you preach

The science is clinical laboratory work, ... the art is caring for others

The science is acquired in a short time, ... the art is developed over a lifetime

The science is practiced for money, ... the art is living a passion

The science takes lives, ... the art saves lives

The science is in the method … the art is to interpret

The science is in the office … the art is in the workplace

The science is multi-disciplinary ... the art is to stand alone

The science is in the law ... the art is in converting management…

The science is in the strategy ...  the art is to measure representative

The science is in literature review ... the art is to observe and anticipate

The science is compiling the sampling train ... the art is to convince the bearer

The science may require millions ... the art is to control with the available

The science is knowledge ... the art is logic and common sense

The science implies accountability ... the art is to act like the reasonable man

The science is rigid ... the art is taking the best decision under the circumstances

The science is to measure ... the art is to write a report

The science is to train ... the art is to empower

The science is to prove ... the art is to persuade

We need some OH artists, please!

Presentation 12: Accreditation of Occupational Hygiene Risk Assessments:             The long and winding road

Author: Kevin Renton

Affiliation: Honorary Lecturer, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa  

 

Many Approved Inspection Authorities (AIAs) are grappling with accreditation through the South African National Accreditation System (SANAS). This monologue attempts to describe the big picture and give hope to AIAs which have become despondent. The first part focuses on the advantages of accreditation including sustainability, as well as the disadvantages of accreditation, such as challenges due to the artistic part of the nature of occupational hygiene. Some ideas on a way forward will be discussed, using examples of surveys and risk assessments.

Qualitative Risk Assessment, required by the Occupational Health and Safety (OHS) Act, does not need to be accredited at present and yet is very important in promoting the culture of occupational health and safety. All efforts to improve working conditions should begin with a study of process risks, and if  necessary, proceed to measurement. Occupational hygiene is seen as an agent for change, which with progressive management and adequate resources may not even need any measurement.

Presentation 13: Reproductive health hazards in laboratory work

Authors: Gabriel E Mizan,1,2 David Rees,1,2  Kerry Wilson1

Affiliations: 1National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg, South Africa; 2School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Background: Laboratory workers are exposed to various occupational hazards during the course of their work, which may affect the reproductive health of both men and women. These hazards may be chemical, biological and physical in nature, and include ergonomic and psychosocial risk factors. The aim of this paper is to revisit the question of whether reproductive health deserves special consideration in the workplace, using studies conducted on laboratory workers to illustrate the points made.

Methods: A literature search was conducted using PubMed; search terms included ‘reproductive health hazard’, ‘reproductive health risk’, developmental health hazard/risk’, ‘congenital malformations’, ‘laboratory work/er’, ‘health hazard’, ‘pregnancy outcome/s’, ‘maternal/paternal/parental exposure’, ‘shift work’, ‘organic solvents’, ‘radiation’, ‘biological hazards’ and ‘pathology laboratory’. The studies reviewed were classified according to: chemical hazards, ergonomic and shift work, hazardous biological agents and ionising radiation.  

Results: Although the mechanisms by which reproductive health outcomes are produced often remain uncertain, many of the studies reviewed concluded that there is sufficient data to warrant special consideration of reproductive health in the workplace. Specific hazards, such as exposure to chemicals (especially organic solvents), heavy physical work and irregular work schedules, may require the implementation of special measures to protect, in particular, but not exclusively, pregnant workers.

Conclusions: Reducing occupational reproductive hazards in the workplace should be part of a comprehensive health and safety programme. The first step is to conduct a reproductive health risk assessment which includes assessing the hazards, the individual worker and the work environment. Such programmes should cover all employees of reproductive age. It is important that interventions are implemented even before pregnancy is confirmed, to prevent potential exposure during the crucial period of early foetal growth.

 

Presentation 14: Safety fume cupboard evaluation

Author: Harold Gaze

Affiliations: Chartered Member and Vice President of the South African Institute of Occupational Safety and Health (Saiosh); Chartered Member of the Institution of Occupational Safety and Health (IOSH); Chartered Member of the British Occupational Hygiene Society (BOHS); Member of the American Conference of Government Industrial Hygienists (ACGIH)

Background: Occupational hygienists have been involved in the identification, evaluation and recommendation for mitigation measures for biological hazardous agents for years. Many have evaluated safety fume cupboards for compliance or for efficiency using various methods and/or procedures. The Department of Labour (DoL) has determined that this work must be performed by a competent occupational hygienist and that the work must be accredited by the South African National Accreditation System (SANAS). Some AIAs have achieved this accreditation. Evaluating biological safety fume cupboards has the potential to present many obstacles and those performing or wishing to perform this evaluation need additional training/education, and to study the subject. SANAS accreditation suggests that those performing these assessments are competent.

Methods: What and how should this accreditation be applied to the evaluation of safety fume cupboards? This paper will discuss the evaluation of all safety fume cupboards (Biological Safety Class I, Class II and Class III), in three phases. This assessment will explain the methods used to evaluate and identify problems in a systematic approach which can be applied to all other occupational hygiene assessments.

Phase one – anticipate and recognise

•  Quality Assurance Plan

•  Project Plan

•  Project Plan Review

Phase two – determine if the project can be performed

•  Field requirements

•  Allocation of resources

•  Project test plan

•  Acceptance of test plan

•  Final requirements and specifications

•  Phase review and approval

Phase three – evaluate and report

•  Perform survey

•  Identify and evaluate

•  Define interface requirements

•  Determine sample (measurement) analysis

•  Obtain data and interpret

•  Integrate data and determine risk

•  Draft report

•  Final report

•  Phase review and approval

Results and Conclusions: Biological safety fume cupboards serve a purpose. The implementation of a structural approach will enable the occupational hygienist to comply with SANAS and legal requirements, and to ensure that the employees using these devices can be adequately protected.

 

Presentation 15: Occupational dermal exposure to nanoparticles and nano-    

enabled products – exploration of exposure processes and methods of assessment

Author: Derk Brouwer

Affiliation: School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Background: Over the past decade, the primary focus of nanotoxicology and nano environmental health and safety efforts has been largely on inhalation exposure to engineered nanomaterials. Dermal exposure to nanomaterials and the associated health impact have been studied to a much lesser extent, and mostly in the context of intentional exposure to nano-enabled products, such as in nanomedicine, cosmetics and personal care products. A study was conducted to address the likelihood and relevance of occupational dermal exposure to such nanoparticles and nano-enabled products, and to provide guidance for the evaluation of exposure and associated potential for skin penetration and inadvertent ingestion.

Methods: The conceptual framework for dermal exposure (Schneider et al, 1999) was adjusted for exposure to nanoparticles. Parameters of exposure, nanomaterial and skin were identified as relevant for the penetration, permeation and inadvertent ingestion due to dermal exposure to nanoparticles. Evidence of dermal exposure in workplace settings was attained by literature search. Experimental scoping work was conducted to explore the feasibility of dermal exposure measurement methods for nanoparticles.

Results: Processes resulting in dermal exposure were evaluated from the perspective of nanomaterials, where transfer from contaminated surfaces was considered of primary interest. Particle size, likelihood of ion release and disrupted skin were amongst the relevant factors for skin penetration or skin effects. High risk job titles were identified by combining job titles with high likelihood of dermal exposure to nanomaterials and those that met favourable conditions for penetration/permeation, e.g. in health and personal care and in the construction industry. Although adjustments of commonly used interception and removal techniques showed promise, quantitative measurements remain challenging.

Conclusions: A stepwise systematic approach was developed which provides guidance for occupational hygienists for desktop and workplace evaluation of potential risk associated with occupational exposure to nanomaterials.

Presentation 16: Skin contamination to metals in precious metal refineries:

A case study

Authors: Anja Franken,1 Marilize Tredway,2 Stefan Linde,1 Johan du Plessis1

Affiliations: 1Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa; 2Anglo American Platinum Base Metal Refinery, Waterval Farm, Old Main Road, Rustenburg, South Africa

Background: The dermal route of exposure has been overlooked in research as well as in workplaces, underestimating this exposure route. This case study investigated the dermal exposure to Platinum Group Metals (PGMs) in two precious metal refineries.

Methods: A removal method was used to collect samples from the skin and workplace surfaces by wiping the surface with a commercially available wipe (GhostWipeTM). Workers from production and non-production areas were included. Wipe samples were collected prior to the shift, prior to tea and prior to lunch and at the end of the work shift. Anatomical areas sampled included the palm of the hand, wrist, neck and forehead.

Findings: Detectable levels of the PGMs were found on all skin areas sampled. In addition to metals expected, other metals such as lead, nickel, cobalt and copper were found. The workers’ skin was contaminated with PGMs before the start of the shift. Highest exposure occurred during processing where workers would handle the matt or powder and during pulverisation. In contrast, non-production workers, such as administration, laundry and security workers, also had detectable levels of the metals on their skin. Highest skin exposure was found on the wrist and palm of the hand.

Conclusions: The majority of skin exposure is as a result of deposition from airborne contamination onto the skin, as well as by transfer from contaminated surfaces or personal protective equipment (PPE) onto the skin. Contamination of the wrist occurred as a gap between the overall and gloves left the skin unprotected. The palm of hand was exposed when workers removed the thick outer glove for better dexterity leaving only a cotton glove. Alternatively, the palm was contaminated when workers handled contaminated gloves with their bare hands. The findings of this case study are applicable to all industries for considering skin exposure, especially the effectiveness and procedures for handling PPE.

Presentation 17: Urinary platinum excretion following occupational dermal

and respiratory exposure to soluble platinum

Authors: Stefan Linde, Anja Franken, Johan du Plessis

Affiliations: Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa

Background: Soluble forms of platinum, such as hexachloroplatinate and tetrachloroplatinate, are among the most potent allergens and sensitisers known, and represent the most dangerous chemical forms of platinum. The objective of the study was to evaluate the dermal and respiratory exposure of precious metal refinery (PMR) workers to soluble platinum, and to quantify the absorbed platinum concentration excreted via the urine.

Methods: Dermal exposure samples were collected on the dominant palm and wrist, and the neck and forehead using GhostWipes. Respiratory samples were collected using an Institute of Occupational Medicine (IOM) inhalable aerosol sampler. Wipe and respiratory samples were analysed according to Methods for the Determination of Hazardous Substances (MDHS) 46/2 using Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The dermal and respiratory exposures of 19 workers from different areas in the PMR were measured simultaneously on two consecutive days. Urine samples were collected on the morning of the first day and on the following two mornings and analysed using ICP-MS.

Results: The degree of dermal and respiratory exposure varied considerably between workers in different production and non-production areas of the PMR. Most workers experienced dermal and respiratory exposure to soluble platinum above the detection limit (dermal = 0.00021 µg/cm 3;  

respiratory = 0.005 µg/m 3) with 26% of the respiratory exposures exceeding the 8-hour occupational exposure limit of 2 µg/m3. Spearman correlation analyses showed statistically significant (p ≤ 0.05) very strong positive monotonic relationships between (i) average dermal exposure and average respiratory exposure (r = 0.885), (ii) average dermal exposure and average platinum urinary concentration (r = 0.850), and (iii) average respiratory exposure and average platinum urinary concentration (r = 0.875) for each worker.

Conclusions: The concentration of platinum in the urine (total platinum body burden) of workers is determined by both the dermal and respiratory exposure routes. The dermal route is, therefore, a valid route of exposure for soluble platinum and should not be ignored.

Presentation 18: Comprehensive Occupational Health and Hygiene Programme to reduce occupational disease

Author: D Jabu Mhlophe

Affiliation: South African Department of Labour: Inspection and Enforcement Services,

Chief Directorate: Occupational Health and Safety, Directorate: Occupational Health and Hygiene

Background: The aim is to develop criteria for all Occupational Health Service Providers (OHSPs) to register with the Department of Labour (DoL), to ensure provision of comprehensive occupational health services, as required in terms of the Occupational Health and Safety Act (OHSA, 85 of 1993) and its Regulations.

Priority Issue: Currently, the DoL does not have juristic control over the establishment of OHSPs in the country, though it is the legislative requirement for occupational health services to be provided for employees. This lack of control has created an opportunity for OHSPs who do not have competency to test employees, thus providing employers with results which are not credible. The DoL therefore, seeks to ensure that these examinations are of a uniform high standard and are provided by practitioners and organisations with the appropriate skills, resources and training.

Goal: To introduce the registration and approval process for OHSPs and maintain a database of such providers. Only those OHSPs with appropriate facilities, human resources and equipment will be allowed to apply to the DoL for permission to become listed OHSPs, and thereby perform the approved functions.

Implementation strategy: Advocacy and awareness among stakeholders will be conducted through pamphlets and flyers. These requirements will also be incorporated into the General Administrative Regulations. A transition period will be allocated for the OHSPs to register with the DoL and audits will be conducted to check whether the OHSPs are delivering the service in line with the requirements.

Conclusions: OHSPs will have to apply and prove that they are competent before they can get approval from the DoL. The latter will then maintain a database of all OHSPs who are providing comprehensive occupational health services nationally.

Presentation 19: Success and benefits of implementing engineering controls

Author: Warren Mallon

Affiliation: Principal Inspector: Occupational Health and Hygiene and Registered Occupational Hygiene Technologist: SAIOH #0769; South African Department of Labour: Inspection and Enforcement Services, Chief Directorate: Occupational Health and Safety,

Directorate: Occupational Health and Hygiene

Background: Often in occupational hygiene, recommendations are made with regard to implementing engineering control measures to reduce an exposure to an occupational stressor. However, many employers are reluctant to implement engineering control measures and opt instead to issue personal protective equipment (PPE), as it is deemed to be cheaper.This case study will demonstrate that the implementation of engineering control measures to control one stressor, can have the additional benefit of controlling another stressor.

Methods: After conducting a routine inspection at a company in the chemical sector, the employer was issued with a prohibition notice in terms of the Regulations for Hazardous Chemical Substances (HCS) 13 (b) – as far as reasonably practicable; no person shall use compressed air or permit the use of compressed air to remove particles of an HCS from any surface or person.

Results: However, the use of compressed air was vital to the employer’s process as it is used to thoroughly clean impurities from the product. The Inspector, together with an approved inspection authority, re-evaluated the process and a specific control measure was introduced to control the exposure to crystalline silica dust. This included semi automating and enclosing the process.

Conclusions: The implementation of the controls not only resulted in reducing the exposure to crystalline silica to a tenth of the Occupational Exposure Limit (OEL), but also reduced the exposure to noise from over 105 dB(A) to less than 100 dB(A).

Presentation 20: Ergonomics Programme: A tool to a safe and healthy working environment

Author: Bulelwa Huna

Affiliations: South African Department of Labour: Inspection and Enforcement Services,

Chief Directorate: Occupational Health and Safety, Directorate: Occupational Health and Hygiene; Member of the Ergonomics Society of South Africa (ESSA)

Background: The control of risks associated with poor working conditions is similar to the control of many other hazards in occupational health and safety, and requires a systematic approach, with commitment to continual improvement. 

Priority issue: Basic elements for implementation of sound ergonomics principles which will positively impact on the quality of life of employees and improve productivity. These elements include management commitment, employee participation, identifying risk factors in jobs, worksite evaluations, setting priorities, control of ergonomic risk factors, education and training, as well as evaluation and adjustment of the Ergonomics Programme.

Goal: The development of an Ergonomics Programme that will have a continued coordinated approach, with resources that include personnel from Employee Health and Wellness, Occupational Health and Safety, Human Resources and Supply Chain, with the employer as the main sponsor. The inclusion of the different resources ensures that participatory ergonomics is practiced at all times, resulting in employee wellness and increased productivity.

Implementation strategy: As real work systems are hierarchical in nature, this means that the main task is made up of subtasks and is governed by higher level constraints. These higher level constraints manifest as production targets, style of supervision, type of work organisation, working hours and shift work, to name a few. Taking into consideration this hierarchical nature of a real work system, the ergonomics team that is championing the development and implementation of the Ergonomics Programme needs to consider the unique needs of the company.

Conclusions: The inclusion of personnel from Employee Wellness, Human Resources, Occupational Health and Safety and Supply Chain is crucial as all these stakeholders play a pivotal role in the success of the Ergonomics Programme, to ensure a future reaching effect.

Presentation 21: Ergonomics case study: Disabled employees at the Department of Labour and Sheltered Employment Enterprises

Author: Milly Ruiters

Affiliations: South African Department of Labour: Inspection and Enforcement Services,

Chief Directorate: Occupational Health and Safety, Directorate: Occupational Health and Hygiene; Member of SAIOH and the Ergonomics Society of South Africa (ESSA)

Background: Ergonomics is a science that deals with fitting worker capabilities to task demands. It is already difficult for employers to fit able bodied workers’ capabilities to the demands of their respective tasks. With disabled workers, where the workers’ disabilities need to be taken into account, fitting worker capabilities to the task becomes even more complicated. Therefore, the Department of Labour (DoL) has embarked on developing an Ergonomics Programme specifically for disabled workers at the DoL and its subsidiary, Sheltered Employment Enterprises (SEE).

Objective: The purpose of this case study was to demonstrate how the change of workstations through the implementation of an Ergonomics Programme can improve the health, productivity and morale of disabled employees.

Methods: The employees’ working environments and equipment were assessed utilising the following tools: a self-developed ergonomics checklist, a discomfort survey questionnaire, and a rapid office strain assessment (ROSA).

Results: The results of the assessment indicated that an awkward body posture was the main risk factor for ergonomic strain, due to the poor design and layout of the workstation, as these didn’t take the disabilities of the employees into account.

Conclusions: Improvement recommendations were made and a new workstation was designed for one particular employee; workstations were also improved for other employees. A post-implementation assessment was conducted to determine if the ergonomic interventions were successful and if they contributed to improving and sustaining the workers’ health, morale and productivity.

Presentation 22: Exposure to occupational hygiene stressors during diving activities

Author: Nozi Maphoto

Affiliation: Principal Inspector: Diving; South African Department of Labour: Inspection and Enforcement Services, Chief Directorate: Occupational Health and Safety, Directorate: Occupational Health and Hygiene

Background: Commercial diving is one of the professions that are often seen through the lens of a recreational or sporting activity, hence diving as an occupation is often neglected.  Diving falls within any other category of work, the only difference being that the work is performed underwater. Just like any category or type of work, divers are exposed to physical, chemical and biological stressors, as well as ergonomic risk factors; and yet, exposure measurements for noise, chemicals and biological agents are unheard of.

Priority issue: Inspections conducted in this sector have revealed that risk assessments carried out prior to diving operations do not address occupational hygiene risk factors, although the divers will be exposed to such risks in their routine work. Most of the clients and agents, who commission diving work, are not familiar with the contents of water bodies, or the biological and chemical agents that may be present in the water. Examples are supervisors failing to address the noise levels that divers can be exposed to and which can lead to hearing loss; and workers who dive into water with unknown contaminants, and hence not considered as occupational risks. Ergonomic risk factors, such as posture and fatigue, are often not included in diving risk assessments, and hence are not managed.

Outcome: As divers are exposed to similar stressors that are prevalent in any work environment, risk based assessments and appropriate medical surveillance are key components in ensuring a comprehensive occupational hygiene programme.

Conclusions: A professional judgement on occupational hygiene stressors with respect to diving activities is key in determining the actual exposure of divers to such stressors, and their management. Therefore, to ensure the protection of divers’ health and wellbeing in the course of their employment, a comprehensive occupational hygiene programme should be implemented as the compass and guideline, to steer all involved parties on the right course.

Presentation 23: Characterisation of nickel in platinum refining process dust

(Winner: Best Student Oral Presentation)

Authors: Renier Nortjé,1 Alicia van der Merwe,1 Cas J Badenhorst,1,2 Johan du Plessis1

Affiliations: 1Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa; 2Anglo American Ltd

Background: Insoluble nickel compounds, including nickel subsulphide, are known human carcinogens causing nasal and lung cancer. Physical (particle size) and chemical (species) characteristics largely determine particle deposition and absorption in the human body. Submicron particles have the ability to distribute throughout the body. Mining processes liberate nickel, exposing employees to various particle sizes and nickel species.

Aim: The study aimed to determine the particle size and species of nickel present in ambient airborne particulate matter at a primary Platinum Group Metals (PGM) smelter.

Methods: The furnace building and slag cleaning furnace paste floors, as well as the slow cooling and crusher area at the converting process, were included in this study. Institute of Occupational Medicine (IOM) samplers were used to determine the inhalable and respirable dust fractions. Dynamic light scattering was utilised to determine particle size and the presence of submicron particles. Sample filters were analysed for their insoluble and soluble nickel content, as well as for the individual nickel species present, by means of X-Ray Powder Diffraction (XRD). 

Results: The highest mean inhalable and respirable dust concentrations were measured at the slag cleaning furnace, 63.09 ± 49.64 mg/m3 and 5.73 ± 3.02 mg/m3 , respectively. The slow cooling area, furnace building and slag cleaning furnace had the highest percentage of submicron particles. The highest mean insoluble, as well as soluble nickel concentrations, for the inhalable and respirable particle size fractions, were measured at the crusher area. The insoluble inhalable and respirable nickel concentrations were 0.66 ± 1.07 mg/m3 and 0.09 ± 0.12 mg/m3, respectively. The soluble inhalable and respirable nickel concentrations were 0.32 ± 0.41 mg/m3 and 0.05 ± 0.06 mg/m3, respectively. Nickel speciation by means of XRD indicated the presence of nickel subsulphide.

Conclusions: Workers present in these areas may be exposed to submicron insoluble and soluble nickel species. Exposure to inorganic nickel compounds, including nickel subsulphide, poses a carcinogenic risk.

Presentation 24: Evaluation of exposure to extremely low frequency magnetic fields in the residential areas of Mangaung Metropolitan Municipality

Authors: Phoka C Rathebe,1 C Weyers,1 SF Raphela2   

Affiliations: 1Department of Life Sciences, Central University of Technology, Bloemfontein, Free State, South Africa; 2Department of Clinical Sciences, Central University of Technology, Bloemfontein, Free State, South Africa 

Background: In South Africa, there is a dearth of data on the exposure levels of extremely low frequency (ELF) magnetic fields in residential environments. This further results in undetected exposure levels in residential environments and a lack of public alertness. This study aimed to evaluate the exposure levels of ELF magnetic fields in the residential environments of Mangaung Metropolitan Municipality.

Methods: Due to unequal geographical proportions within Mangaung, 15 residential sites were randomly selected in Bloemfontein: nine in Botshabelo and six in Thaba Nchu areas. Measurements were collected at the distances of three, six and nine metres outside electrical substations, near every corner, using a Trifield meter model XE 100.The exposure levels were also measured from four different corners inside substations, near barrier screening, and these measurement points were referred to as a distance of zero metres.

Results: The results indicate a non-significant difference amongst 15 residential environments in Bloemfontein (BRE1 to BRE15) and six in the Thaba Nchu area (TNRE1 to TRNE6). The exposure levels of magnetic fields was significantly higher in one residential site (BORE1) (0.55 μT), as compared to other residential sites in Botshabelo (p < 0.001).The results obtained from the measurements also show a statistically significant difference between the residential environments BORE4 and BORE8 (p < 0.01), as well as BORE4 and BORE9 (p < 0.006). The four distance interims also demonstrated a highly significant difference (p < 0.0001), when compared to one another. The Tukey Test shows a statistically significant difference for exposure levels recorded at distances of three, six and nine metres,  in comparison to zero metres (p <0.01). The exposure levels recorded at a distance of three metres are significantly different to those recorded at six metres (p < 0.05) and nine metres (p < 0.01).

Conclusions: The exposure levels measured at all distances are below the values set by the guidelines of the International Commission on Non-Ionising Radiation Protection (ICNIRP), and the fields decrease rapidly with an increased distance from the source.

Presentation 25: A case study of best practice in occupational hand hygiene and sanitising

Authors: Karl Weber,1 Stephen Burrow2

Affiliations: 1Deb Group; 2 HSE Hy-Med Solutions

Background: The conversation regarding infection and contamination control is clearly trending towards prevention, behaviour, and compliance to sound practice; this in direct reaction to the ever increasing challenges of microbial resistance and its downstream costs and risks. Hands are a principal route for cross infection, but frequent hand washing can be detrimental to skin condition, leading to lower compliance to hand hygiene regimes. Hand hygiene regimes, behaviour and ethical, effective products are key to best practice and occupational hygiene outcomes. Alcohol hand sanitisers help reduce the number of hand washes required during a working day, and skin restoration is not given the significance it deserves. The presentation, supported by scientific and case study material, demonstrates best practice in the area of hand hygiene and skin health.

Methods: Ongoing research, innovation and occupational practice inform best practice regarding hand hygiene, skin health and risk reduction, especially in areas where infection and contamination control are key. The ‘WHO 5 Moments’ form the main guideline.

Results: Scientific and international case studies show that:

•   Regime and behaviour are imperative

•   Aesthetics, systems, training and support material drive compliance to best practice

•   Skincare providers can make available leading edge solutions (product formulation, dosages, monitoring, and placement / systems) that reduce acquired infections and combat microbial resistance.

Conclusions: Best practice hand hygiene and care clearly reduces dermatitis, maintains health, and is imperative in reducing risk and its related costs.

 

D. Conference presentations (poster presentations)

 

Presentation 26: A retrospective analysis of nickel exposure data at a South            African base metal refinery

Authors: Monica M Young, CJ van der Merwe, SJL Linde, JL du Plessis

Affiliation: Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa

Background: Refinery workers in base metal refineries are occupationally exposed to soluble nickel, hence controlling soluble nickel exposure is essential. Control measures have improved over time, and may consequently result in trends in soluble nickel exposure, which can be identified with a retrospective analysis of the exposure data. This study aimed to analyse soluble nickel exposure data from a South African base metal refinery, to identify trends in the exposure data from 1982 until 2014 in two tankhouses (i.e. Tankhouse 1 and 2).

Methods: Soluble nickel exposure data (area and personal) were presented in an exposure matrix, which described exposure profiles for the sections inside tankhouses and the different occupations independently. One-way analyses of variances (ANOVA) were conducted to identify significant differences in exposures from 1982 until 2014, and the trends illustrated with linear regression. Differences between sections inside the tankhouses, as well as the different occupations, were evaluated, and the percentage of measurements above the time-weighted average occupational exposure limit (TWA-OEL), were calculated.

Results: Significant downward (p ≤ 0.0001) trends were identified in area exposure in Tankhouse 1 between 1982 and 2011; however, this significant decline in exposures was attributed to the sharp decline in exposure between 1982 and 1986. After 1986, no significant downward trend was identified in area exposure. Furthermore, personal exposure significantly decreased (p ≤ 0.0001) by a factor of three between 1991 and 2014, in Tankhouse 1. No significant trends were identified in area and personal exposure in Tankhouse 2. The highest percentages of OEL exceedances were determined for Cell workers (Tankhouse 1, 64%; Tankhouse 2, 32%) and Crane drivers (Tankhouse 1, 64%; Tankhouse 2, 19%).

Conclusions: Downward trends in Tankhouse 1 were identified and may be ascribed to the implementation of various control measures and process changes. No exposure trend was established in Tankhouse 2, as only four years of exposure data were available.

Presentation 27: Skin barrier function of precious metals refinery workers

Authors: Sané Jansen van Rensburg,1 Anja Franken,1 Jeanetta du Plessis,2 Johan du Plessis1

Affiliations: 1Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa; 2Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa

Background:  The primary function of the skin is to act as a barrier, protecting against loss of nutrients and water from the body, and preventing permeation of xenobiotics through the skin.  In occupational settings where workers are exposed to hazardous substances, the skin barrier function may be impaired, leading to insufficient protection.  The effectiveness of the skin barrier is assessed by measuring transepidermal water loss (TEWL), stratum corneum hydration (SCH) and skin surface pH (SSpH). The purpose of this study was to evaluate whether there is an acute change in the skin barrier function of precious metals refinery workers during a work shift.

Methods: TEWL, SCH and SSpH of nineteen refinery workers were measured using standardised skin bioengineering methods.  Measurements were taken before and after the work shift on six anatomical positions, and the percentage change over the work shift was calculated.

Results: TEWL results showed non-significant (p > 0.05) increases on all anatomical positions, with the exception of the neck.  The most prominent decrease in TEWL indices was on the wrist (14.52%) and back of the hand (20.13%).  SCH decreased statistically significantly (p < 0.05) on the wrist (12.29%), palm (27.58%) and back of the hand (22.18%).  SSpH decreased statistically significantly (p ≤ 0.05) on all anatomical positions, with the most prominent changes on the neck (22.04%), wrist (19.49%) and back of the hand (17.44%).

Conclusions: Predominant increases in TEWL and decrease in SCH are indicative of a decreased skin barrier. Low SSpH could indicate reduced skin integrity and wellbeing. A decreased barrier function in chemically and mechanically damaged skin would not provide sufficient protection and could lead to increased permeability of salts of Platinum Group Metals (PGM) and other chemicals, especially in an acidic environment.

Presentation 28: Particle size and metal composition of gouging and lancing fumes

(Winner: Best Student Poster Presentation)

Authors: Marelé Keyter,1 Alicia van der Merwe,1 Anja Franken, 1 Cas J Badenhorst, 1,2 Zoe Selenati-Dreyer2

Affiliations: 1Occupational Hygiene and Health Research Initiative (OHHRI), Faculty of Health Sciences, North-West University, Potchefstroom Campus, South Africa; 2Anglo American Ltd.

Background: The processes of gouging (used for preparation of the weld groove) and lancing (severs or removes metal) liberate metal fumes, to which mining maintenance workers are exposed. The particle sizes and composition of these metal fumes are unknown. Metal fumes are comprised of a complex mixture of various toxic metals that may cause adverse health effects such as neurological dysfunction (manganese), pulmonary fibrosis and sensitisation (nickel), via inhalation.

Aim: The study aimed to determine the potential presence and size of particles in the various fractions, as well as the metal composition of fumes emitted during gouging and lancing processes.

Methods: Randomised side-by-side area samples of metal cutting fumes were collected in three workshops at a mine in South Africa using IOM samplers (inhalable fraction), GK2.69 cyclones (thoracic fraction), aluminium cyclones (respirable fraction), NRD samplers (nano-size fraction) and open-face filter cassettes (for particle size distribution).

Results: Particles were present in all fractions of the metal fumes emitted during gouging and lancing. Ambient workplace concentrations of the nano-size fraction indicated a range of 1.01 – 3.40 mg/m3 in the workshops. A total of 26 metals were present in the various particle fraction sizes and included arsenic, chromium, cobalt, lead, manganese, mercury and nickel. Lead was mostly found during lancing; manganese and nickel were found in all of the workshops and fractions. Lancing processes emit smaller particles than gouging processes.

Conclusions: Particle size fractions within the inhalable, thoracic, respirable as well as nano-size fractions were present in the metal fumes. Lancing could be considered more hazardous than gouging, since mean particle sizes are smaller than with gouging, in terms of nanoparticles. Since nanotoxicology remains an unfamiliar field, it is possible that there may be adverse health effects outside of the respiratory system. Some metals (mercury and cobalt) were only found in smaller particle size fractions. Therefore, all particle size fractions, including the nano-size fraction, should be included in personal exposure assessments and monitoring.

 

Presentation 29: Efficient dust evaluation and control measures for specific         crystalline silica exposure scenarios: A literature review

Authors: Norman Khoza and Derk Brouwer

Affiliation: School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Background: The main aim of any silica dust control programme is the prevention of the development of silicosis and other disease associated with exposure to crystalline silica. Exposure monitoring and dust control technologies have been introduced in South African mining industries, but these efforts have yet to yield results that match the investments. Such studies are lacking in the South African railway industry.  In both industries, there have been few studies regarding the full characterisation of health relevant particle sizes. The aim of the study is to identify appropriate exposure assessment methods and control technologies to efficiently monitor and control submicron dust particles.

Methods: A desktop literature review was conducted using electronic databases of peer-reviewed journal articles and research reports published in the public domain, and unpublished internal reports, by both national and international sources. The keywords used were: ‘particle size (silica dust) exposure assessment tool(s), control method(s)’, ‘health relevant dust fractions’, ‘crystalline silica dust’, ‘submicron dust evaluation and control method(s)’. Examples of databases used are: Science Direct, Medline (Pubmed), Springlink, Interscience, Scopus, Global Health and Google Scholar, including CSIR and MHSC reports repository.

Results: There is evidence that the surface area concentration or particle number concentration of dust retained in the alveoli would be an appropriate indicator of the severity of crystalline silica dust exposure, as smaller particles are more reactive and occupy a larger surface area of the lungs. In vivo studies in rats have shown that exposure to quartz particles of different sizes predispose to different risks for developing silicosis: ˂2 µm particles increase the risk by 82%; similarly, 2-5 µm and >5 µm particles are associated with an increased risk of 67% and 25%, respectively.

Conclusions: Particle size and concentration of the inhaled dust determines the toxicity. A diffusion charger-based personal device was identified as the personal device to estimate ‘Lung Deposited Surface Area’, and the foam dust suppression system was identified as an effective method to capture submicron dust fractions.

Presentation 30: Particulate matter and respiratory symptoms in waste reclaimers at a South African landfill site: Preliminary findings

Authors: Tebogo Maeteletja,1,2 Jeanneth Manganyi,1 Kevin Renton,1 Janine Wichmann2

Affiliations: 1National Institute for Occupational Health (NIOH), National Health Laboratory Service (NHLS), Johannesburg, South Africa; 2School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa

Background: Waste reclaimers have become a common sight in most cities and municipal landfill sites worldwide. This form of income generation has been found to be effective in reducing the amount of waste disposed at landfills in developing countries, thus prolonging the use of landfill sites. Hazardous exposures in this population are not well understood due to the very limited studies conducted to date. This study aims to determine if there is any association between respirable dust personal exposure of waste reclaimers and their respiratory symptoms.

Methods: Particulate exposure assessment was carried out at a South African landfill site for nine days. The site had on average 200 waste reclaimers working daily. A total of 68 samples of partial shift sampling were collected according to the National Institute of Safety and Health, USA (NIOSH) 0600 sampling method.

Results: Respirable dust levels were found to be below the South African and the American Conference of Governmental Industrial Hygienists (ACGIH) occupational exposure limits (OELs) of 5 mg/m3 and 3 mg/m3, respectively. Participants were interviewed and completed a questionnaire on their respiratory symptoms.

Conclusions: The study had recruitment and sampling duration challenges due to the discomfort associated with carrying the pump. Other observations and results found during sampling will be discussed, including possible diesel particulate exposure.

 

Presentation 31: Proper control of chemical agent exposure at the workplace:         storage and maintenance of controls

Authors: Elize Lourens, Warren Mallon

Affiliations: South African Department of Labour: Inspection and Enforcement Services,

Chief Directorate: Occupational Health and Safety, Directorate: Occupational Health and Hygiene; SAIOH Occupational Hygiene Technologists

Background: The chemical industry is considered to be one of the high risk sectors in South Africa. In 2013, the Department of Labour (DoL) signed an Occupational Health and Safety (OHS) Accord with the Social Partners in the Chemical Sector, with the mission to enhance working relations and promote and integrate OHS into business and strategies. A ‘snap shot’ of inspection conducted by the DoL in 2014-2016 within the industry revealed some common issues that hinder proper control of chemical agent exposure. The risk that hazardous chemical agents hold should be considered along the full value chain of chemical handling. The lack of proper health risk assessments, maintenance of controls, availability of Material Safety Data Sheets (MSDSs), training of employees, and supervision are areas of great concern.

Methods: Issues of concern found during inspections across the chemical industry were flagged for investigation. Negative trends were identified in the handling of hazardous chemical agents along the full value chain, and research was conducted into proper handling and storage methods.

Results: A total of 21 inspections were conducted at chemical plants, and 32 notices issued. The notices revealed that control measures failed to span the full value chain of chemical agents, resulting in high and dangerous exposures for employees. Occupational hygiene monitoring should include assessment of the actual methods used by employees for handling and storage of chemical agents.

Conclusions: General standards should be implemented by manufactures, transporters and users of hazardous chemical agents to protect against exposure and adverse health effects. The chemical compatibility and the actual methods of handling chemical agents should be thoroughly supervised and observed, to ensure compliance with safe procedures. Considerations such as the use of MSDSs, classification and compatibility of chemicals, risk assessments and exposure monitoring are important steps in laying the foundations for proper control. The Occupational Hygienist has a critical role to play as an ‘agent’ of the DoL.

 

Presentation 32: The relationship between the use of occupational hygiene

performance metrics and organisational performance

Author: Mfanimpela G Kubheka

Affiliations: Eskom; Registered Occupational Hygiene Technologist (SAIOH, PHASA)

Background: Occupational hygiene forms an integral part of any organisation’s occupational health and safety management system. Performance measurement and management have been part of the business world for centuries; key performance indicators such as sales and profit are amongst the most used. This study will assess the impact of using occupational hygiene performance metrics at the South African parastatal, Eskom. The recommendations and information derived from this study will assist management in making better and informed decisions on the management of occupational hygiene, and assist the organisation in realising its goal of ‘Zero Harm’.

Methods: Empirical research is being conducted by the collection of data using tools such as survey questionnaires and interviews. Data is being collected from Eskom sites which form part of Eskom’s current Approved Inspection Authority (AIA). Data is being quantitatively analysed using correlation tests, linear regression and factor analysis. Data collection is based on performance metrics specific to occupational hygiene.

Results: The preliminary data collected shows that the use of occupational hygiene performance metrics in South Africa is still at its infant stage. This is supported by the lack of studies on this topic in South Africa. Some international studies have shown a positive correlation and benefits. On the other hand, others have reported negative results and raised concerns such as the tendency of organisations to focus on performance measurement at the expense of performance management. 

Conclusions: Further studies on this topic are required in order to fully understand the relationship between the use of occupational hygiene performance metrics and organisational performance in South African entities. This will enable managers to make informed decisions on occupational hygiene matters, provide a business case for occupational hygiene and ultimately assist organisations in meeting their occupational health and safety targets and objectives.

Presentation 33: An upside down hierarchy of control: An alternative path to              occupational health and safety improvement

Author: Evelyn R Maponya

Affiliation: Gijima Holdings (Pty) Ltd. – Occupational Hygiene and Environmental Services, South Africa

Background: Over the past years, concrete approaches of control have been proposed and implemented for chemical, physical, and biological hazards commonly experienced in occupational settings in industry. The monitoring of such hazards, to check for compliance with legislated occupational exposure limits (OELs), is one of the most common approaches applied by occupational hygienists. Linked to monitoring is the need for recommendations of hazard control, which normally follow a widely accepted hierarchy; elimination, substitution, engineering controls, administrative controls and personal protective equipment (PPE), which are listed in order of priority in terms of effectiveness. While in an ideal world elimination is considered the most effective control, it is difficult and in most cases almost impossible to implement such a control measure immediately. In contrast, while PPE is considered the least effective in control, feasibly speaking, PPE is the easiest to implement, and can thus be given the highest of preference for various reasons.

Methods: While occupational hygienists aim to have the hierarchy of control prioritised from the top down, which will take some time and efforts to carry through in industry, efforts can rather be focused on having the ‘least effective’ control measure, PPE, being used to its full potential in order to fulfil our ultimate goal, which is to protect the workers’ well-being.

Results: Specific standard/basic PPE should be used by law (the Departments of Mineral Resources and Labour; DMR and DoL) for specific hazards, especially those that are known to be a nuisance in South Africa. Legal enforcement and thorough training will promote appropriate functioning and assigning of PPE.

Conclusions: PPE will be used properly and effectively. This temporary control solution takes into consideration employee well-being, while further efforts are made to reasonably follow the hierarchy, as ideally required.

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