Occupational Health and Safety is a discipline with broad scope involving many specialized fields. In its broadest sense it aims at the promotion and maintenance of the highest degree of physical, mental and social well being of workers in all occupations. More specifically, Occupational Health and Safety encompasses the social, mental and physical well being of workers, that is the “whole person”.
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With the alarming number of work-related sicknesses, diseases, injuries and accidents, the protection of workers against these has been found vital in the historical mandate of the International Labour Organisation (ILO guidelines 2001). The ILO celebrates world day for Health and Safety at Work on the 28th of April each year in the memory of workers who died at their workplace all over the world. One of ILO’s goal is thus to boost opportunities for employees in order to obtain decent and productive work. ‘Decent work’ means safe work- a positive factor which can boost up productivity and hence lead to economic growth.
In this modern era, technological advancement and fierce competition bring prompt changes in the conditions of work, work processes and the organization. It can be noted that though legislation is crucial, it is insufficient to keep pace with current hazards and risks. This is why it has been found necessary to take into account the guidelines on Occupational Safety and Health Management Systems (OSHMS) which can indeed support this effort.
With the introduction of the Occupational Safety, Health & Welfare Act of 1988(OSHWA 1988) which came into force in May 1989, followed by the Occupational Safety and Health Act of 2005(OSHA 2005) which was proclaimed on 1st September 2007 and replaced the OSHWA 1988, health and safety entered another dimension by binding the state. Health and safety started to gain more consideration in the agendas of the various stakeholders namely the Government, the employers, the employees and their trade unions, the non-governmental organisations as well as educational and training institutions. It is an undeniable fact that this has posed a need for creating health and safety awareness among the employees and employers and consequently leading to a continuous decrease in the number of work related accidents and illnesses among the Mauritian and foreign workers. In many organisations in Mauritius, there is a reactive approach to health and safety that is taking action to prevent the recurrence of an undesired event, comply with existing health and safety and other legislations. However, in other organisations such as the Pamplemousses/Riviere Du Rempart District Council (PRDC) health and safety is being dealt in a pro-active, effective and challenging way, that is, risks are being identified, assessed, and controlled before the first adverse event. Furthermore, health and safety is an integrated part of the management systems whereby at each level of management, health and safety is being looked with the same consideration as other organisational activities.
1.2 Problem Statement
Lot of emphasis has been put on the attribution of adverse health consequences and lack of safety arising from work. While the number of workplace injuries, illnesses and death are increasing, there is considerable evidence that these reported rates are under-estimates of the actual numbers of injuries and accidents. Dembe (2005) outlines that workplace injuries and illnesses affect those injured or ill in terms of physical impairment, functional limitations, lost wages and hence limiting the worker’s ability to do their job conveniently. With regard to the nature of work, it has been found necessary to note that individuals are chronically exposed to adverse psychosocial working environments (Bosma et al, 1998; Hemingway and Marmot 1999; Belkic et al, 2004). Job position is a major concern especially when dealing with manual handling. More specifically, regular moving of components from stores or lorries or while lifting heavy loads, workers can suffer from back pain, musculoskeletal disorders, cardiovascular disease and so on. For instance, the workers employed in the scavenging department at the PRDC are exposed to a series of hazards which can in turn lead to accidents if precautionary measures are not taken. It can be noted that though scavengers are provided with Personal Protective Equipment (PPE), they do not use them efficiently. But the fact remains that there is no proper hygiene and comfort as they have to practically linger in the wastes disposed at the back of the lorry. To some extent, lack of training and poor supervision might be the causes of the workers’ carelessness. Nevertheless, we cannot disregard the fact stated by Olsen and Lindee (2009) that the transfer of technology can increase the risks of new failures, misuse, accidents and unhealthy workplaces.
1.3 Aim and Objectives
The aim of this study is to evaluate the health and safety risks and hazards present at the PRDC refuse collection section and hence provide recommendations for improvement.
The set objectives are:
To identify risks and hazards present in the PRDC refuse collection section and assess the measures in place including policies and procedures.
To assess the importance of safeguarding Health and Safety at the District Council.
To determine the level of Health and Safety awareness.
To evaluate the Occupational Health and Safety Management System in place at the PRDC.
To propose recommendations to improve Health and Safety in the working environment at the PRDC.
1.4 Research Questions:
Does the District Council have a proper set of policies and procedures?
Are the employees aware of the Health and Safety Policy and procedures of the organization and the different arrangement in it?
How much is management committed towards the Health, Safety and Welfare of its employees?
Does the PRDC undertake Risk Assessments and keep proper records as well as monitoring of progress and action taken to eliminate risks and hazards?
What are the benefits brought to the PRDC by the implementation of OHSMS and barriers encountered in its implementation?
CHAPTER 2: LITERATURE REVIEW
2.0 Introduction to the chapter
In modern society, the collection of waste is often taken for granted. People put waste out and expect that it’s gone within a day, without even realizing how it is collected. However, for those who collect waste, the reality of the situation is very often different. Waste is an obvious public health hazard and waste collection is a very hazardous task to undertake.
There are a multitude of challenges that face Local Government worldwide in this new era; rapidly evolving technologies, managing staffs, forming partnerships by engaging new citizens, delivering services, lack of finance, dealing with health and safety issues at work and socio-economic demographics are some relevant examples. Aram (2009) strongly believes that developing countries are often exposed to exploitation since they lack safeguards and expertise that prevent harm to workers. He even elaborates on the fact that previous efforts to address workplace hazards in these countries have practically failed.
East Cambridgeshire District Council faces mainly the issue of air pollution. Similarly, more urban districts in Cambridgeshire have encountered air quality problems resulting from massive motor vehicle emission. It is necessary to monitor the adverse health issues in this modern era arising in the course of work. Ongoing research efforts are required regarding the magnitude of health effects associated with working conditions (Smulders et al.1996; Lavis et al.2001). For instance, an employer may implement engineering controls with the aim of eliminating a safety hazard and thus increasing productivity without even considering the direct value of health benefits. Notwithstanding these studies, clear opportunities exist to improve health and safety of workers through the improvement in work environment.
2.1 Definition of technical terms:
When we refer to ‘hazards’ in relation to Occupational Safety and Health, the most commonly used definition is “a hazard is a potential source of harm or adverse health effect on a person or persons”.
“Risk is the likelihood that a person may be harmed or suffers adverse health effects if exposed to a hazard”.
“An Occupational Health and Safety Management System (OHSMS) is defined as a framework whereby all hazards are identified, health and safety risks are controlled and the potential occurrences for accidents are reduced in a particular organization by putting in place all the existing control measures and continually improving its performance”. In other words, the content and scope of OHSMS is determined by the identification and hazards and implementation of corresponding measure or simply evaluating the measures already in place (Mearns K. and Flin R.).
“An Occupational Health and Safety (OH&S) Program is a definite plan of action designed to prevent accidents and occupational diseases/injuries”.
“An Occupational Health and Safety Policy is a statement of principles and general rules that serve as guides for action”.
“Safe work practice is a written instruction outlining the preferred method of performing a task/activity whilst emphasizing ways to minimize any risk(s) or hazard that makes a safe system of work”(University of Wollongong, 2011).
In developing countries, refuse collection is characterized by a dominance of manual handling tasks. According to National Occupational Research Agency, an estimate of 122, 000 workers are employed in waste collection (NORA, 2009). However, refuse collectors around the world are at risks for occupational illnesses and injuries (Kuijer et al., 2010). They have a higher risk of fatal occupational injuries than the general workforce (Dorevitch, 2001) and they account for about 80% of all reported injuries (HSE).
Until recently, relatively little research has focused on the hazards in the waste industry, even though waste collection is a “high-hazard” job with a fatality rate 10 times that of all workers (Drudi, 1997). Collecting waste has long been recognized to be a dirty and physical work. However, it is among the most fatal occupations.
The collection of solid waste has been found to be among the highest risk occupations in the United States (Englehardt et al., 2001). As refuse collection is done manually in Mauritius, the refuse collectors have direct contact with waste and are therefore exposed to infectious micro-organisms, toxic materials and other harmful substances. They are exposed to an extensive variety of health risks and hazards. Refuse collectors are working in a hard, unsafe and poor working condition with a lack of work protection equipment. However, the actual risk may be largely underreported since this population of workers has not been well studied.
2.2 Health and Safety hazards and risks among refuse collectors
Health and safety problem is an inevitable characteristic of the scavenging department. By its nature and variety of activities, scavenging has a bundle of hazards and unsafe situation and therefore refuse collectors are very much exposed to accident, workplace injuries and diseases.
Scavenging is a labour process involved in the initial collection and processing of recoverable materials (Loan 2002). In other words, scavengers collect materials that have been discarded as waste and add value to them by sorting, cleaning, and altering the physical shape to facilitate transport. Scavenging has some detrimental effects on the refuse collectors as they live in unhygienic conditions and the nature of their occupation exposes them to potentially pathogenic bio-aerosols that may lead to the spread of various diseases. Eye irritation, respiratory diseases, skin diseases, minor injuries from stepping on broken bottles or sharp objects in the refuse, backache from bending down most of the time and headaches arising from working in the sun are some examples. Offensive odours in waste disposal sites and the abundance of fleas, along with the lack of personal protective equipment, make working conditions even more unhygienic. Rag-pickers collect plastics, paper, cardboards, cans, glass bottles, rubber materials, ferrous and non-ferrous metals from public places, streets, dump sites or landfills can be risky as they are exposed to various infectious agents (Ray et al, 2004) and toxic substances that may cause illness. At times, they may face social abuse from certain elements of society, which may lead to social problems and hence creation of greater possibility that they get engaged into the consumption of alcohol and cigarette smoking.
From a study carried out in Thailand, it can be noted that the physical health problems of scavengers undertaking routine work, are low back pain and sprains, common colds, and skin rashes. Other problems include headaches, fatigue and shortness of breath. Some scavengers do not use PPE and thus risk their health while some eat food found at the dump site which can pose a serious problem to their own well-being. Scavengers with low levels of education have more work-related accidents (Khalil and Milhem, 2004).
All workplaces have hazards and risks. Hazards can cause harm, injury and can even lead to fatal accidents. Occupational Health and Safety is therefore a very essential part of every workplace as in most cases employees’ lives depend on it. Below are hazards that refuse collectors are exposed to:
2.2.1 Chemical hazards
Chemical hazards among refuse collectors arise from contamination with harmful chemicals like disinfectants, cleaning products and pesticides. It can be noted that these chemicals exist in form of solid, liquid and gas which can contaminate human body at the point of contact (NIOSH, 1985). Some of the common chemicals found at hazardous waste sites include asbestos, aromatic hydrocarbons, dioxins, hydrocarbons, heavy metals, herbicides, insecticides and polychlorinated biphenyls (NIOSH, 1985). These chemicals are associated with cardiovascular, dermal, gastrointestinal, neurologic and respiratory effects and cancer (NIOSH, 1985)
There is enough evidence that dust also represents a potential hazard to refuse collectors on site. In 2002, Krajewski et al. conducted a study in Poland so as to assess occupational exposure among workers employed in the municipal waste collection and the results revealed that workers were exposed to highest dust concentration on sites of refuse collection.
Refuse collectors are also exposed to vehicle exhaust fumes which may contribute to respiratory problems (Hansen et al., 1997). Furthermore, the engineering design of the refuse collection truck may cause several potential health hazards to the workers. We should note that the location of the exhaust pipes on most refuse collection trucks directs the fumes towards the work area and this can eventually result in over-exposure to carbon monoxide (Cimino, 1975).
2.2.2 Biological hazards
In 2006, a survey was carried out by Lavoie et al., in Canada among refuse collectors and the results showed that they are highly exposed to airborne bacteria and fungi (bio-aerosols). Most of the time refuse collectors come across medical wastes which are often encountered in hospitals, health centres and medical laboratories. Wastes generated from health care activities, more specifically, discarded syringes, needles, cotton swabs and other types of infectious waste are often not segregated. As a result, they are disposed in normal bins. These wastes contain infectious materials that can cause diseases, if exposed to (Morton, 2010).
A cross-sectional study was conducted by Rachiotis et al., 2012 among 208 Municipal Solid Waste Workers of a municipality in Central Greece in order to assess the prevalence of Hepatitis B (HBV), risk factors for infection and ways of virus transmission among them. The result demonstrated that occupational exposure to waste is a possible risk factor for HBV infection since prevalence of HBV infection was found to be 23%.
Medical waste contains a huge variety of pathogenic microorganisms (Morton, 2010). Pathogens in infectious waste may enter the human body in several routes:
Through the mucous membranes
Through a puncture, abrasion or cut in the skin
Contaminated sharps, mainly hypodermic needles are probably the waste items that represent the most acute potential health hazards. This may expose refuse collectors to communicable disease risks, including blood-borne viruses such as Hepatitis B and C and HIV (Morton, 2010). Moreover, sharps can cause cuts and punctures and as a result infect these wounds if they are contaminated with pathogens. Sharps are therefore regarded as a very hazardous waste class.
2.2.3 Physical hazards
Slip, trip and fall risks
Slip, trip and falls are common in almost all occupations, including refuse collection. The results from the Census of Fatal Occupational Injuries (CFOI) Program carried out by the U.S Bureau of Labour Statistics showed that fatal slips, trips and falls took the lives of 666 workers in 2011. The fact that scavenging task is carried out regardless of the weather conditions or slippery surface caused by rain, refuse collectors are often victim of slips and falls if enough attention is not paid to the surface on which they are walking.
Uneven paths, manhole covers and drains are potential tripping hazards, especially if refuse collectors are in a haste to complete the task. In addition, hurrying can also lead to refuse collectors endangering their lives by falling while climbing onto the back of the lorry to accelerate the loading. Refuse collectors suffering from a slip, trip or fall at work can result in pain and lead to a long-term disability, depending on the severity of the injury.
Exposure to noise at work can be detrimental to workers’ health and it can even increase the risk of accidents (European Agency for Safety and Health at Work, 2005). Scavenging task takes place during peak traffic hours most of the time, thus refuse collectors are exposed to noise. The workers usually work on roads with heavy traffic and in vicinity of noisy machinery. However, very often, the collection truck itself is the cause of noise problem. Annoyance due to road traffic noise created from beeping of horns by car drivers was found to be among the highest noise factors (Chowdhury et al., 2012)
Animals and Insects Bite
During waste collection, refuse workers often come across animals like dogs, cats, insects or stings which represent a potential danger to them. The refuse collectors are exposed mostly to dogs while collecting domestic wastes. Since dogs are very territorial, especially when stranger enters their property, this can result in violent personal attacks.
Moreover, both insects and rodents represent an occupational and public health hazards. Contact with rodents therefore can result in bites and this can lead to redness and swelling in the injured area and can even cause an allergic reaction. Insects and rodents can thus transmit diseases to workers by bites or by indirect contact.
The task of refuse collectors consists of extensive heavy lifting as well as other manual handling of containers and thus increasing the risk of musculoskeletal disorders (Rushton, 2003). Manual handling has been defined by the Manual Handling Operations Regulations 1992 as “â€¦any transporting or supporting of a load, including the lifting, putting down, pushing, carrying or moving thereof by hand or bodily force”.
The Health and Safety Executive(HSE) records show that more than a third of all accidents reported are injuries occurred from work and thus workers being absent for more than 3 days are related to manual handling at workplace. It can cause injury in the short term through accidents and in the longer term damage from bad handling techniques.
Manual handling includes any activity:
Involving forceful and repetitive movements.
Where the person always maintain constrained and awkward postures.
Examples of Manual Handling Activities include:
*Figure 1: Manual Handling Activities
The common types of manual handling injuries are as follows:
Arm, shoulder and wrist injuries.
Back injuries caused by unstable and heavy loads.
Hernias and strain injuries.
Injuries caused by prolonged repetition of work (for example, a refuse collector continually collecting refuse).
The above mentioned can affect an individual’s quality of life and also his ability to work. The cost of ill-health will therefore depend on the nature and extent of disease and illness that is prevalent.
Preventing Manual Handling Injuries
OSHA requires all employers who have a legal responsibility against employees to provide them with a safe and healthy workplace.
The National Standard for Manual Handling requires that all tasks involving Manual Handling at a particular workplace should be identified and risks and likelihood of injuries should be assessed accordingly.
Appropriate control measures should be introduced where there is a risk of injury.
Provision of adequate and sufficient training in the safe techniques and methods of manual handling and lifting.
Musculoskeletal disorders (MSDs) represent one of the principal causes of occupational injury, illness and disability within many countries and various occupations (Mehrdad et al., 2008)
MSDs are one of the most frequent work-related injuries among refuse collectors due to the heavy lifting, pushing, pulling and carrying activities involved in their daily duty of refuse collection (Ijzelenberg et al., 2004; Keyserling, 2000 & Hoozemans et al., 2004)
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A survey conducted in 2008 by Mehrdad et al. among a group of municipal solid waste collectors in Tehran revealed that the symptoms of MSDs experienced by the workers were; low back (45%), knees (29%), shoulders (24%), upper back (23%) and neck (22%).
Moreover, studies reveal that MSDs among refuse collectors are higher than most of the other workforces. Abou El Wafa et al., carried out a cross-sectional study in 2012 among 120 refuse collectors at the Western Municipality of Mansoura City, Egypt with a comparison group of 110 male service workers at the University in order to assess the percentage of musculoskeletal complaints and their possible risk factors among the refuse collectors. The result showed that musculoskeletal complaints were higher among the refuse collectors (60.8%) than the comparison group (43.6%).
Refuse collectors and store workers are often engaged in carrying and handling loads without proper lifting techniques which eventually causes stress on the back and musculoskeletal system. Repetitive actions worsen the situations. Some examples of handling loads would be: lifting, pulling, carrying, dragging and holding. Handling load is classified as heavy work which involves dynamic and static work.
In a study carried out by Olaogun et al (2002), their findings concluded that workers who are often engaged in lifting heavy objects were mostly afflicted by Low Back Pain. It was also reported that between 80% and 90% of all back pain is caused by faulty postural habits. The knowledge of how to prevent back pain was generally poor among the respondents.
Costs of Back Injuries
The most common injury is to the back and it can be very painful. If, a workers job involves heavy manual labour then back injuries can certainly damage his job prospects. In Mauritius back pain is among one of the major occupational disease. For instance, all cases of occupational and work related diseases diagnosed in hospital (Ministry of Health 2009) shows the result being 37% and 39% in 2007 and 2008 respectively.
It should be noted that measures taken to lessen or eliminate the problem of back pain can bring a lot of benefits to an organization (Managing sickness absences and returns to work 2005). Such measures are:
Better workplace relations.
Improved business performances.
Safe and healthy workplaces.
Retention of valued staffs.
Reduced compensation and rehabilitation costs.
Violence at work
HSE defines work related violence as “any incident in which a person is abused, threatened or assaulted in circumstances relating to their work”.
The most common causes of violence at work are personal conflicts, frustration due to workload and poor working conditions and environment. However, violence at work can lead to other problems such as minor injury, major injury and even fatal injury. Violence to refuse collectors can cause pain, distress, disability or even death. Nevertheless, serious or persistent verbal abuse can be a significant problem as it can pose serious complication to refuse collectors’ health through anxiety and stress.
Stress at work is the reaction of workers when work load and pressures become beyond their normal capability and becomes difficult for them to deal with (Semmer, 2007).
Most of the employees encounter stress to a certain degree in their daily work environment. Work related stress causes a negative impact on employees leading to poor physical and mental health state. According to the statistics of Health and Safety Executive (2005), over 500, 000 workers in United Kingdom advocated that their illness were due to stress at work and 15% of all the working population confirmed that their work was enormously stressful. However, it is widely acknowledged that work related stress is linked to elevate sickness absence, higher labour turnover and early retirement (Kerr et al., 2009)
2.2.6 Road Accidents
Refuse collectors have to collect wastes from both sides of a street. Their task involves climbing on and alighting from trucks, carrying trash containers and so on. Sometimes garbage causes obstruction which prevent their ability to see approaching vehicles and thus result in accident (Drudi, 1997). According to the National Solid Waste Management Association, in 2008 there were 31 refuse collectors killed on the job in Florida. The statistics from the HSE between 2001 and 2006 shows that 513 refuse collectors suffered over 3 days’ workplace transport injuries. This implies that their injuries from the accident were serious enough for they were given three days sick leave.
2.3 Occupational Disease
According to the Protocol of 2002 of the Occupational Safety and Health Convention, 1981 (No. 155), the term “Occupational disease” refers to any disease contracted as a result of an exposure to risk factors arising from work activity. Occupational diseases are the “icebergs” that challenge occupational health and safety experts. The number of cases of occupational disease reported for statistical surveys is just the tip of the iceberg. It should be noted that refuse collectors experience a variety of adverse health effect. The situation of refuse collectors in different developing countries is comparable as they are exposed to all risks than their counterparts in developed countries. A survey carried out in Bethlehem and Hebron Districts, among 209 refuse collectors revealed that they faced work related disease such as sore throat, diarrhea, shortness of breath and skin disease (Milhem, 2004). Based on Health Studies of refuse collectors carried out in India, tuberculosis, bronchitis, asthma and pneumonia are the most frequently experienced diseases among waste pickers (Huisman, 1994).
2.4 Occupational Injury
Occupational injury is defined as sudden, anticipated, and undesirable events during work, leading to harm or damage to at least one part of the body (Poulson et al., 1995). The job of waste collection is associated with a high risk of occupational injury and most often injuries among waste collectors was the back, followed by the knees, hands, and feet (Ivens et al., 1998). A study by Bourdouxhe et al. (1993) reported an even higher rate of injury among waste collectors: 74% of the waste collectors in municipality companies and 57% in private enterprise.
One essential component of good working conditions is good housekeeping. It helps to the prevention of occupational injuries and diseases. Good housekeeping also includes everyday cleanliness, tidiness and good order in all parts of the workplace and is important when it comes to good safety practice. The fact that housekeeping is a maintenance task; therefore it cannot be achieved without the participation of everyone in the workplace.
Hazards associated with poor housekeeping:
Slips, trips and falls
Objects fall from above causing injury to workers
Striking against unwanted sharp edges of objects causing injury
In America, around 300,000 disabling injuries occur every year resulting in death of 1400 workers. 15-20% of workers’ compensation claims are owing to slips, trips and falls at workplace. The United States Bureau of Labour Statistics (2012) declared 303,800 fall injuries at place of work in 2000. 15% of death is caused by slips, trips and falls at workplace.
2.6 Personal Protective Equipment
Personal Protective Equipment (PPE) is intended to protect individuals from the risks and injury creating a barrier against workplace hazards. PPE is not a substitute for good engineering controls, administrative controls or good working practices. Instead, it is used in conjunction with these controls to ensure the safety and health of workers. PPE should be used when it has been determined as its use will lessen the likelihood of occupational injury and/or illnesses when other protection methods are not available. PPE should always be worn when working with hazards.
PPE that refuse collectors should normally wear:
Hand protection (gloves)
The bureau of Labour Statistics of America (2012) revealed that 333, 272 eyes injuries were reported as occupational in the year 1985. Another study in connection to disabling injuries showed that there were 32, 000 hand and finger injuries, 70, 000 eye injuries, 70,000 head and face injuries and 110, 000 food and toe injuries in 1987. These figures represent 31.7% of the estimated 1, 800, 000 total disabling work injuries for the year 1987.
These reports which were examined by the Occupational Safety and Health Administrator department in America show that in only those cases where a worker was injured were:
Personal Protective Equipment was not being worn the vast majority of time.
Some types of the protective equipment worn by the worker did not protect him fully.
The importance of preventive measures
According to research conducted on Prevention of Work-Related Musculoskeletal Disorders as part of the Work-Related Musculoskeletal Disorder Consortium with the National Institute of Occupationa
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