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Industrialization is one of the key challenges that public health faces in the twenty-first century. It is a major theme that is confronting many fields of public policy, but it is the health field that particularly illustrates the shared consequences of a globalising world, both its potential rewards and hazards. While development has provided opportunities for employment, education and socio-economic development, it has also brought about a number of adverse health and environmental problems. (R. Parker, 2006)
The effect of health determinants on individuals is complex and the control of these determinants is often outside the responsibility and capacity of the health sector. In order to take effective action to solve urban health problems, it is necessary to integrate the efforts of various sectors such as other government departments, non-governmental organizations, large private companies and the communities themselves. (WHO, 2000)
Governments of rapidly developing cities usually have less revenue allotted to the provision of basic services and the rapid growth of industries strains their capacity to provide adequate health and safety measures where needed. Since multinational corporations are a powerful force in the provision of occupational health and safety, they may be more influential than governments and even local cultures and communities in solving this problem. (University of Michigan, 2006)
The occupational health and safety policies in Metropolis during the 80's are uncertain. It is therefore safer to assume none were in place. The ecological, environmental, occupational and public health risks associated with those industries are daunting and the health of the present population is questionable. Previously abandoned industries will constitute a high number of hazardous sites. These are steel manufacturing, textile industry and coal mining.
Exposure to hazards could be as a result of previous contamination; therefore care needs to be taken in demolishing, digging and rebuilding. Those involved in demolition work, asbestos abatement, building repair and maintenance may be exposed to higher levels of asbestos as disturbing such materials releases fibres into the air. Illegal disposal of contaminated scrap and waste, spillage and leaks can also increase present exposure and furthermore cause future exposure in cases of demolition, landfills and abandoned sites. (International labour organization, 2005)
Wastewater is by far, the largest waste stream for the textile industry and the largest contributor to water pollution. Large volume wastes including wash water from preparation and continuous dyeing, alkaline waste from preparation, and batch dye waste contain large amounts of salt, acid, or alkali and other VOCs. (EPA, 1997)
Surface mining of coal completely eliminates existing vegetation, destroys the soil profile, displaces or destroys wildlife and habitat, degrades air quality and alters land use; often resulting in a scarred landscape with little scenic value. (Kate Catlin, 2009; Khondar Abdus Saleque, 2009). Mine tunnels on the other hand can collapse, causing subsidence of land surfaces. Mine tailing dumps produceÂ acid mine drainageÂ which can seep into waterways, with consequences onÂ ecologicalÂ and human health. (Kate Catlin, 2009; C. Costello, 2003)
Life-threatening environments are often associated with emerging cities. These problems may be confounded by high population densities. In emerging megacities, infrastructural growth often takes precedence over the environmental and public health; modern hazards are therefore related to development that lacks health and environment safeguards. (Siemens A.G., 2007). An emerging megacity with a booming tourism industry, a new airport, a computer component production and pulp/paper industry is prone to health and environmental hazards.
Poor planning of industrial infrastructure is a prerequisite for disaster. Industrial building plans need to be approved by the Health and Safety Executive/Local Authorities Enforcement Liaison Committee (HELA). The health and safety management team in each industry is responsible for the health of their employees as well as the general population. The local environmental and health protection agency are responsible for ensuring these industries adhere to health and safety policies. Most important, all industries need to work together with the local agency and community to uphold public health. (EA; HSE, 2010)
Major challenges faced by occupational health and safety include
Industrial location: According to Alfred Weber's theories of industrial location, Industries tend to be located where the cost of transporting raw materials and final product to and from market is at a minimum. (David Fearon, 2009) However planning laws and regulations do not always make it possible to establish in the preferred location. In metropolis for example, the new airport is a major contributor to noise pollution and would be best situated on the outskirt of the city. Other chemical industries like the pulp and paper industry must be located down wind and downstream of residential area to prevent air pollution from wood dust and water pollution from bleach and wastewater.
Each industry should have a health and safety organizational structure. Working safely should be a condition for employment and every employee should understand they have a legal duty to comply with the health and safety policy. Working guidelines on health and safety should be clearly displayed and explained to employees. Incentives and disincentives will encourage adherence and allow for feedback. (HSE, 2009)
HEALTH AND SAFETY MANAGER
HEALTH AND SAFETY OFFICERS
30% of the workforce in developed countries may be exposed to a heavy physical workload or ergonomically poor working conditions. (WHO, 1997) According to health and safety policy, industries should ensure they provide ergonomically correct furniture, lightings, and surfaces. (HSE, 2009) For example proper lighting will be required for computer components production, appropriate surfaces, floors and walls for tourist facilities etc in order to prevent eyestrain, musculoskeletal disorders, slips and falls.
Every industry is responsible for proper classification, labelling and packaging of transported and stored chemicals. All chemicals should be labelled according to the HSE's approved classification and labelling guide or the Globally Harmonized System of Classification and Labelling of Chemicals (GHS). (HSE, 2010;UN, 2009)
Source: (National Chemical Emergency Centre, 2010)
The Management of Health and Safety at Work Regulations 1999 states that employers should provide clear information, supervision and training for employees and ensure that suitably competent people are appointed who are capable of carrying out the tasks entrusted to them. (HSE, 2010) For these technically advanced industries, training and capacity building should be provided for employees on chemical use, risks and exposure, emergency incidents and first aid management.
Communication between local authorities, developing industries and the community is essential for maintaining public confidence. Seveso II Directive necessitates that all chemical industries supply communities liable to be affected by a major chemical incident with information on safety measures and the appropriate steps to take in the event of an accident. (Jürgen Wettig, Sam Porter, 1999)
All accidents must be recorded and reported to the appropriate authorities. Every incident should be thoroughly investigated to prevent recurrence. Surveillance programs for incidents and employee's health can help monitor exposures and impacts. For example, coal workers diseases surveillance programs offers chest X-rays to coal workers every 3years for early detection of lung disease(NIOSH, 2007)
Waste management, sewage treatment and disposal systems is a major challenge. Computer scraps waste piles should be located away from residential areas, and measures taken to ensure they are not accessible to the general population especially children, for example fencing with clear instructions to keep away.
Work contributes to good health and economic achievement. However, the work place may expose employees to health risks such as mechanical injuries, respiratory illnesses, cancer, musculoskeletal disorders, reproductive disorders, allergies, mental and neurological illnesses, psychological stress, eye damage and hearing loss. Exposure to bacteria, fungi, moulds and organic dusts can occur in some working environments such as pulp and paper industry. Physical factors in the airport and computer component production industry such as noise, vibration, radiation and microclimatic conditions can also affect health adversely if not controlled. (WHO, 1997)
Metropolis will be confronted by other public health issues such as overcrowding as a result of immigration for employment and tourists. This will put a strain on available services such as air transport, water resources etc. causing air and water pollution. Land contamination will result from improper disposal of computer component waste and poor sewage treatment systems will bear its toll on water pollution.
Table 1 shows the various hazards associated with each industry, their possible pathway, potentially exposed population and risks involved.
POINT OF EXPOSURE
ROUTE OF EXPOSURE
Asbestos, Carbon monoxide,Â Lead,Â Nitrogen oxides,Â Particulate matter,Â Sulphur dioxide, Manganese compounds, Phenol, Naphthalene and Benzene
Demolition, building and repair
Workers in steel industries
Skin irritations and burns
Noise, Radiation, Contaminated land, Water and Air pollution
Waste waters, Municipal and ground water
Workers in the textile industry
Children and local residents
Eye and throat irritation
Workers involved in transportation, grinding and crushing of coal
Coal workers pneumoconiosis
Air pollution, contaminated and abandoned land, mine drainage and water pollution
Waste waters, Surface waters
Children and local residents
Allergic respiratory symptoms
Eye, nose and throat irritation
Air pollution, Water pollution, deforestation
Computer components production
Lead in circuitry
Cadmium in computer batteries
Mercury in fluorescent tubes
Workers in computers components industries
Residents and children
Impairment of senses
Air pollution, Land contamination, Waste piles
Household and Industrial waste
Residents and children
Air pollution, Water pollution, Land sprawling
Workers involved in fuelling planes
Local residents and children
Air pollution, water pollution, Noise pollution
RISK ASSESSMENT OF CHEMICAL HAZARDS
Metropolis is a rapidly developing city with numerous hazards. Some hazards may have additive or even synergistic effects, making it difficult to attribute specific effects to individual hazards.
In undertaking a risk assessment for chemicals in Metropolis, one needs to identify the past industries, possible contaminated land and sites, the present industries, chemical hazards involved and the perceived future health impact. Community involvement and local health agencies will provide information about possible contamination sites and various health concerns.
Hazardous agents will also be identified from range of data sources including
Biological monitoring e.g. Serum Lead levels
Disease surveillance e.g. cancer registry, congenital malformations etc.
Health monitoring e.g. mortality/morbidity data, hospital admission data
Potential hazardous sites will include abandoned factory sites, tanks and buried wastes, landfills and waste piles, disposal pits and trenches as well as all present chemical industries
Peter Calow's "Handbook of Environmental Risk Assessment and Management" highlights four crucial steps in Risk assessment.
Adapted from: (USEPA, 2010)
Will identify the adverse health effects associated with the chemicals in question. Information on town planning will be gathered. This will include
Present and past industrial and nonindustrial activities/uses with details of raw materials, intermediate products, by products and wastes
Waste Disposal Practices and Locations: Locations of solid waste disposal areas and liquid waste lagoons, settling tanks and dumps
Sewer and underground service plans
Relevant history of complaints
Local knowledge of residents and staff
Details of building and related permits, licences, approvals and trade waste agreements
At this stage, certain limitations will be apparent e.g. complex combination of hazards, variable exposure over time, complex causality of many health conditions etc. (USEPA, 2010; WHO, 2009)
Dose Response Assessment
Each identified chemical hazard will be analysed, focusing on response relationships including:
Effect levels (e.g. LD50, LC50, ED10), no observed adverse effect levels (NOAELs) and lowest observed adverse effect level (LOAEL)
Margins of safety
Therapeutic indices (EnHealth, 2002)
Sources of toxicological and tolerable intake data will include National Health and Medical Research Council documents, HPA compendium of chemical hazards, WHO/ILO/UNEP International Programme on Chemical Safety (IPCS), Concise International Chemical Assessment documents (CICADs), and US Agency for Toxic Substances and Disease Registry (ATSDR).
Exposure assessment will determine the magnitude, frequency, extent, character and duration of exposures in the past, currently, and in the future. It will also identify exposed populations and potential exposure pathways. (ATSDR, 2010)
PATHWAYS OF EXPOSURE
Source: (WHO, 2009)
â€¢ will describe the risks to individuals and populations in terms of nature, extent and severity of potential adverse health effects
â€¢ will communicate results of the risk assessment to the risk managers and policy makers
Once hazards have been identified and possible exposure pathways certified within the population, risk mitigation practices will be employed. (USEPA, 2010)
PLANNING AND PREPAREDNESS
Careful planning and thorough preparedness are prerequisites for an effective response to a chemical incident. At the national level, government needs to set up the procedures and organisations necessary to ensure the effective and comprehensive public health management of any chemical incident. (WHO, 1999)
At the local level, local public health / environmental health officials in Metropolis will be engaged in
1. Setting up multi-disciplinary integrated emergency management teams.
2. Conducting a baseline health and environmental risk assessment
3. Liaising between the local community, the public services and the local chemical industries by using public meetings, community advisory panels, mass mailing, public warning systems etc.
4. Drawing up an emergency services chemical incident plan
5. Establishing 24 hour access to information sources, databases and people with expertise
6. Assessing the comprehensiveness of the local health care facilities to cope with major chemical incidents
7. Pursuing measures to reduce the probability of incidents and reduce their health effects.
For Chemical industries and identified hazardous sites in Metropolis. Improvements will need to be made to reduce the chances of an incident
â€¢ Chemical emergency plan coordinated with the local authority's chemical incident plans
â€¢ Appropriate labelling of chemical hazards and proper storage
â€¢ Training for employees on hazards and safety procedures
â€¢ Monitoring levels of gas emissions or waste releases
â€¢ Surveillance and incident reporting systems
â€¢ Improved specifications for vehicles carrying hazardous substances.
Once measures have been taken to reduce the chances of an incident, industries must always ascertain a state of "Always prepared"
Training and simulation exercises should be conducted for emergency services, as well as other health professionals and employees at local chemical plants. This will promote proper management of chemical incidents, help understand the responsibilities of other professionals and to minimise the risks to themselves and members of the public. (WHO, IPCS, 1997)
Mandatory notification of all chemical releases, and public observation through environmental change e.g. smell, eye irritation etc. can ensure early recognition of incidents
In the event of a chemical incident, systems must be put in place to allow for early activation of public health management control teams and emergency services. Health care services should be alerted, and the public needs to be warned via the media or other alerting mechanisms. Information about protection, shelter or evacuation should be circulated early.
Remediation, restitution and rehabilitation should begin as soon as a chemical incident takes place. This involves the physical collection of the contaminated medium and its safe removal, cleaning and disposal, or other measures to reduce the toxicity of the chemical. (WHO, 1997)
Proper recording and reporting of incidents contributes to national and international incident surveillance by accumulating data about chemical incidents, the magnitude of morbidity or mortality associated with them.
For industrial development to become more environmentally friendly, three issues must be addressed. In planning for new industry, environmental considerations must be a priority. Secondly, greater emphasis should be placed on building a legal framework that promotes the "polluter pays" principle, and producers of hazardous materials should be responsible for them from conception to safe disposal. (WHO, 1997)