When the "right" glove is the wrong glove

There are many situations where people at work can have direct skin contact with chemicals, particularly hand contact. It is often taken for granted that tasks such as cleaning will involve wiping down with cloths, or something similar, soaked with a solvent or other chemical which are held in the hand. Many of these chemicals can cause skin problems or can be absorbed through the skin contributing to the overall body burden. The panacea in such cases is to provide chemical protective gloves. The trouble is, this can create more problems than it solves.

With any personal protective equipment it is important to understand the limitations and know how and when the protection is likely to fail, because when it does it "fails to danger" - there is no back up. In the case of gloves, and other chemical protective clothing, failure can occur in three main ways

• penetration -where there is physical damage to the material resulting in a physical breach in the protection
• degradation - where the glove material is attacked by the chemical or is affected by other factors such as sunlight
• permeation - where the molecules of the chemical work their way through the molecules that make up the glove material

The time taken for the chemical to permeate through a particular glove or garment is known as the breakthrough time. This is dependent on both the permeation rate (the rate at which the particular chemical permeates through the material, which depends on the type of polymer used) and the thickness of the garment. The thicker the glove material the greater the chemical resistance. But thick gloves can impair grip, dexterity, and safety.

Many chemicals, particularly common solvents such as trichloroethylene, toluene and xylene pass through most common polymer materials very rapidly. Depnding on the glove material and design, the breakthrough time is can be as low as 10 minutes and rarely greater than two hours. If gloves have to be used, it's important to make sure that the "right" one has been selected - one that will offer appropriate protection against the chemical of concern. The breakthrough time gives the effective usage time for the glove which should be changed on ths basis.

Too often, even where appropriate gloves have been selected the maximum usage time is not specified. Workers continue to wear the gloves until they spot obvious faults. However, this presents a problem as that the user will not know that breakthrough has occured. Its easier to spot degradation (although this often ill only happen after breakthrough has occured). Large tears and holes can e spotted fairly easily, but small "pinpricks" may not be noticeable.

Often workers continue to use gloves long after breakthrough has occured. In many cases I have encountered they use them for several weeks or months before replacing them - even though they are unlikely to offer proper protection after more than a few hours at best. The trouble is, people wearing gloves think they are protected and have a false sense of security - adopting practices they wouldn't think of using if they knew that they weren't protected. And once the chemical has permeated through the material it is in direct contact with the skin and the risk of harm can actually be increased. So in these cases, the "right" glove can be the "wrong" glove

Personal protection has to be a last resort, and this is just as relevant to gloves as other types of personal protection. Where thre is a risk of skin contact with cjemicals the best approach is to look to change the working method tso that skin contact doesn't occur, or is a least minimised to the lowest level practicable. For example, rather than using a solvent soaked cloth held directly in the hand, simple applicators could be used (something like a roller or "paint pad"might be options). A litle imagination is all that is needed.

Stressful Challenge

One issue occupational hygienists don't usually get involved with is mental health, yet this is a major cause of ill health associated with work. The best estimate from the Health and Safety Executive is that In Great Britain there were at least 5,750 new cases of work-related mental health problems in 2007, although this is likely to be a significant underestimate of the true incidence. A survey of the British workforce suggested that in 2007/08 an estimated 442 000 individuals in Britain, believed that they were experiencing work-related stress at a level that was making them ill. These figures are comparable to the numbers affected by more traditional types of occupational ill health.

The nature of work in Western Europe is changing. Traditional industry is shutting up shop and moving to cheap labour economies. The number of people exposed to chemical and physical stressors in Western Europe and the USA has reduced and will probably continue to do so for the foreseeable future. In the developing economies occupational hygienists will continue to face the same types of problems that hygienists have been dealing with for many years. But elsewhere, the nature of work related illness is changing and will continue to do so with mental stress probably becoming even more important. This is a challenge that will need to be addressed. There are other professions that view mental health as "their" territory - particularly medical professionals. But they are focused on treatment rather than prevention.

Preventing stress at work is largely about work organisation and the social, rather than physical, environment. These issues often fall into the remit of ergonomists but most occupational hygienists don't get too involved in them. However, the principles of control are the same, whatever the stressor and I believe that most hygienists have to skills to apply the principles of good control practice to the prevention and control of mental stress. Where we are likely to have difficulties is in the recognition and evaluation of the problem and if we are to begin to become involved in tackling the issue this is where we are likely to have to develop new knowledge and skills and learn how to apply our existing skills to a new problem. HSE have some interesting material on their website including tools that can be used for the identification and assessment of work related stress.

Occupational hygiene is about preventing ill health and if the causes and nature of work related illness changes perhaps we need to change our focus and adapt our skills to the new challenges posed in the recognition, evaluation and control of stress at work. This wouldn't be easy, but perhaps its something we ought to be thinking about.

My bloody eardrums

There was an interesting article in the Guardian today about noise exposure of rock musicians and their audience (Come on, feel the noise).

One particularly interesting quote came from Kevin Shields of My Bloody Valentine when asked about whether he was concerned about using potentially harmful sound levels

"It does bother me, that's why I made sure earplugs were available and that we play within tried and tested sound pressure levels with a limit of 119dB(A). We also never overdrive the PA, which can provide spike of distortion up to 130dB. We'd like to say that it is cool to wear earplugs; it's not cool to get your hearing damaged. And anyway, feeling the music is a great experience."

European noise legislation includes a Limit Value of 87 dB(A). This is a daily "average" which must not be exceeded, although the protection provided by any ear defenders worn can be taken into account when assessing compliance with the limit. At 119 dB(A) the daily noise dose would exceed the Limit Value in less than a minute!

Ear defenders would have to provide 32 dB attenuation to make sure exposure was below the limit, and there are not many devices that can provide such a high level of protection. And its worth bearing in mind that as the protection provided by ear defenders is frequency dependant so they also distort what the wearer hears - with higher frequencies being reduced more than low frequencies. So is he really serious about it being "cool" to wear earplugs?

Audiences exposed to this level could experience ear damage even if they only attend one concert. The band, exposed to this sort of noise level regularly, certainly will.

Recognition

The first step in resolving a problem is to recognise that one exists. So to be successful in controlling risks to health we need to make sure that we've identified any potential health hazards.

The traditional scope of occupational hygiene covers chemical, physical and biological agents, with an occasional nod towards ergonomics (at least the musculoskeletal injury aspects). In fact there is quite a bit of overlap with ergonomics, and consideration of this is probably worth a post sometime in the near future.

Chemical agents are probably the main concern for most practising hygienists. With the advent of new European wide legislation (REACH )on the control of chemicals it will continue to be a major issue for the foreseeable future. (Having said that REACH isn't just about occupational health and it won't necessarily fall into the lap of occupational hygiene, a subject for a future post, I think). Of the physical agents noise and vibration are probably the only two that most hygienists get involved with, but they do account for a considerable proportion of occupational ill health (in Great Britain about half a million people suffer to some degree from occupational deafness while there are around 288,000 cases of vibration white finger) . Some may get involved with heat and cold stress and non-ionising radiation, but, truth be told, not that many know that much about them.

The nature of work in Western Europe is changing. Traditional industry is shutting up shop and moving to cheap labour economies. The number of people exposed to chemical and physical stressors in Western Europe and the USA has reduced and will probably continue to do so for the foreseeable future. In the developing economies occupational hygienists will continue to face the same types of problems that hygienists have been dealing with for many years. But elsewhere, the nature of work related illness is changing and will continue to do so. Occupational hygiene may need to change and start to address the new issues and challenges.

I could waffle on here as there are certainly a number of issues worth exploring, for example:

• what skills do occupational hygienists need in relation to recognising hazards? Should cram our brains with information on the harmful effects of lots of chemicals and other agents (which is our current professional qualifications require)? Alternatively, should we be aware of broader principles which allow us to recognise the types of agents that are likely to cause harm and develop the skills to use the wide range of information sources to find out about the effects?
• One issue we don't get involved in is mental health, yet this is a major cause of ill health associated with work. Should occupational hygienists should be more involved in helping to prevent mental health problems associated with work?
• How should occupational hygienists relate to REACH requirements on identifying hazards from chemicals? How do we make sure we aren't sidelined?

These issues warrant reflection in the near future.

What's in a name?

I'm an occupational hygienist. Don't worry if you don't know what that is - nobody ever does. I'm sure most people think that its something to do with cleaning out the works toilets or possibly cleaning teeth.

What is occupational hygiene about then? Well the definition of hygiene provided by the online dictionary http://dictionary.reference.com/ is

1. The science that deals with the promotion and preservation of health.
   
2. Conditions and practices that serve to promote or preserve health

In other words its about preventing ill health, so occupational hygiene is simply about preventing ill health caused by work.

In Great Britain, according to official statistics, 229 workers were killed at work in 2007/8 due to accidents. Its relatively easy to gather this sort of information - its very difficult to hide the fact that somebody has been killed. But its considerably more difficult to obtain accurate figures on the number of people who die due to a disease they've contracted due to their work. As most industrial disease takes many years to develop the individuals may have moved job, or even retired. Some diseases can have more than one cause (some work related, others not) and its not always easy to decide exactly what caused it. So statistics on ill health at work are not absolutely certain. One fatal disease that is almost always work related is mesothelioma of the pleura, a cancer of the lung lining which is caused by exposure to certain types of asbestos. In 2006, two thousand and fifty six (2056) people in Great Britain died due to mesothelioma, almost ten times as many as were killed by accidents at work. (The numbers are increasing and are expected to peak at around 2450 deaths in 2015.) And that's only one work related disease. There are others including other types of cancer, other lung diseases, such as silicosis, and diseases affecting other organs. On an international scale, the World Health Organisation estimates that there are around two million work-related deaths per year.

Of course not everyone dies from disease. Work related ill health can have other impacts on life, causing discomfort, pain and disability. Its difficult to obtain reliable statistics on this, but a survey by the UK Health and Safety Executive indicated that 2.1 million people in Great Britain suffer from an illness they believed was caused or made worse by their current or past work.

So ill health caused by work is a serious problem, even if its not as visible as the results of accidents at work. Occupational hygienists work to reduce the number of people affected. We do that by

• recognising where there are potential problems that could cause ill health
• evaluating the degree of risk - i.e. how serious the problem is in practice
• finding ways to control the risk

I'll explore each of these in my next few posts.

To Blog or not to Blog

According to an article in the Guardian on New Year's day, a poll of Internet users indicated that 7% of UK users had a blog. Well I've been using the Internet for quite a long time now and recently have found myself reading blogs more and more, so its perhaps time I had one too.

There are probably plenty of things I could blog about - personal interests, random observations, rants on all sorts of issues. But I guess the most productive use of my time would be to link a blog into my professional activities. "Reflective practice" has become quite trendy in professional circles (although my own profession hasn't caught up with it yet). Its really only about thinking about what you do and learning lessons from your experience which can be put into practice later on. I like to think that I do reflect on my work and learn from my experiences, but up to now I haven't done this in a structured way. I also spend quite a lot of time trying to keep up to date and expanding my knowledge relating to my work - reading books, journals, websites and blogs, attending meetings etc. But usually don't stop to think systematically about what I've learned.

Perhaps the best way I can use a blog is to treat it as a "reflective journal". By thinking about my experiences, reading and learning in a more structured way and writing down my thoughts and conclusions, I hope I'll be able to crystallise my ideas and improve my knowledge and practice. In that way the time spent writing the posts and maintaining the blog won't be wasted - even if nobody else reads what I've produced! If one or more people stumble on my ramblings and get something useful from them, well that will be a bonus. Even better, if I develop some new contacts.

So I'll write about my reflections on

• my work as a consultant in occupational hygiene
  
• my experiences as a trainer
• the stuff I read
• anything else I find myself thinking about

I'll make a proper start tomorrow.