Flour dust is classified as a hazardous substance (COSHH regulation 2002) associated with occupational asthma, sensitization, allergic rhinitis and inflammation. Flour dust could also give rise to distress temporary respiratory, nasal and eye symptom, or it may exacerbate an asthma attack in those with pre-existing sickness.( Elm etal 2004)
In the UK, flour dust is the next most frequently named agent linked with occupational asthma. (Ross etal 1997) Overall working with flour is indispensable activities and food processing involving flour dust in a bakery typically would not be considered by many to be unsafe nevertheless, if a bakery employee are exposed to airborne flour dust over a long period, life threatening illness can occur, with these rapid increase in occupational respiratory illness associated with flour dust exposure in May 2001 a maximum exposure limit (MEL) for flour dust was placed in the UK at 10 mg/m3 [8 h time-weighted average (TWA)] with a short-term exposure limit (STEL) of 30 mg/m3 (HSE 2002)
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In a bakery where worker complain of respiratory symptoms which they believe are work related different factor will be considered before confirmation. Investigating, evaluating and identification of different source and aspect relating to exposure to flour dust should be consider this may include individual grounds such as occupational history, types of baking flour being used ,nature of the job ,other medical condition, age, types of respiratory protective equipment worn , pre employment assessment, length of service will be vital for confirmation.
Question A
Many studies have shown that exposure to flour dust is associated with development of respiratory symptoms and varying degree of reduction in lung function. These depend on work environment and duration of exposure, Identifying if the symptom are work related, different cause must be put in place and efficient analysis of different factors such as personal and family history of allergy, smoking habit, existence of nasal, ocular, respiratory symptoms , duration of employment at the factory, previous jobs, chronology of symptoms and other medical conditions, the use of protective method, and link of symptom to certain part within the bakery and leisure activities should be critically evaluated as individual entities to ascertain the relationship of the workplace and the symptoms this factors will be analyse as individual body,
For instance occupational history is a vital part of this assessment a poor occupational history may perhaps result in classifying a disease as occupational when it is, or vice-versa. The consequence may result in a mislaid judgment losing an opportunity in improving the fate of other employees. A full occupational history detailing their current and previous job, what type of job the employee actually does or has done before and any other previous jobs and activities such as voluntary jobs, are they newly employed or have they being working for the company for over five years, the nature of the job, have they frequently changed job depending on the answer other variable question could be asked during individual interrogation before validating this symptom as occupational.
Furthermore Symptoms and other medical conditions should be questioned because respiratory diseases have related suggestion and exhibit vague symptoms and physical sighs. If the worker has other medical condition what medication are they taking prescribed as well as non prescribed use, do they have any specific allergy and it relationship with the symptoms should be assessed,
what occupation are family member engaged in, as any household member engage with hazardous material that they might have brought home such as pesticide, are there new furniture or carpet or recent home renovation or has their home just being fumigated or have they just moved home does the timing of the symptoms have relationship with the activities listed above does it get worse or better at work or at home and vice versa has any other household member or neighbour suffer similar conditions is there any consistence with days off does the symptom get triggered at night or weekends.
Occupational Exposure is another factor which should be well understood, quantifying the extent and intensity to which the body as experience a particular hazard, the greater the exposure the greater the risk of an undesirable effect on health . An estimate of factors including the duration of exposure, pattern of exposure, and concentration of a substance inhaled the intensity of exposure, current and previous exposure.
Occupational exposure can be obtained in various ways ranging from a detailed history taking plus a workplace visit to the use of sophisticated background or personal monitoring devices. What matters most is the actual ‘personal’ exposure of the worker and this in turn determines the uptake of the potentially harmful agent, questions like do the five employees work with the same machine, work in the same area, are they exposed to more flour dust exposure in there working area compared to others. .
Information about the type of flour being used is very essential. Flour is a complex organic dust with a large diversity of antigenic or allergenic components. (AlaEldin etal 2009) The antigens involved can be wheat flour proteins, flour parasites or technical additives such as enzymes. Baker’s occupational asthma is frequently caused by sensitization to flour allergen. Wheat flour consists of water- soluble albumins, salt-soluble globulins, gliadins and glutens. Albumins and globulins appear to be the most important proteins contributing to immediate hypersensitivity
reactions in employees. Many studies have shown that flour dust exposure causes respiratory symptoms and is associated with impairment of lung function. (AlaEldin Hassan Ahmed 2009) work related asthma type symptoms were linked to having antibodies (IgE) to wheat flour, storage mite and house dust mite. Sensitisation to wheat, rye and mite was associated with work related nasal symptoms. Those with work related symptoms were significantly more likely to be sensitised to workplace allergens than those without symptoms.
The type of respiratory protective equipment worn would be examine and most be suitable for the purpose of it use , a check into the required type of RPE specified for working with flour dust would be identified, a test which involve use, maintenance, disposal, and replacement would be reviewed to confirm if required HSE standard are met.
Age is also a common factor which affects all as we grow, age is characterised by a decline in the ability of individuals to adapt to environmental stress, immune function decline (Takashi 1980). Sometimes decline in immune function can be a factor of high prevalence of susceptibility to illness even at standard occupational exposure limit. Therefore looking at ages of employee will be a yardstick to determine if age is a factor to the illness.
A clinical questionnaire will also be required to assess the apparent likelihood of the symptoms to being occupational also a clinical examination, including blood sampling, skin prick test, lung function tests such as spirometry, methacholine challenge test, will be perform to examine signs of nasal obstruction and any difficulty in uptake and exhale of air to explore the diagnosis of asthma following the completion of the clinical questionnaire, this is because clinical question does not differentiate the workers with asthma symptoms. Basically, the lung function test allows recognize cases of asthma amongst employees that cannot be detected by the clinical question, while positive skin pricks and blood sampling recognize antibodies, which may be present in a sensitised person (HSE, 2002).
Leisure activities, smoking and hobbies
Generally work related symptoms will be defined as those described as worse at work or improving on rest days, nevertheless, (Elm et al., 2003) have reported that a number of individuals may only suffer night time attack and illness such as coughing and other respiratory symptoms after a extensive period and not necessary at work. This may perhaps pose a restrictive factor in determining the probability of work relatedness. Therefore depending on the clinical investigation and other individual assessment such as personal exposure limits, allergy and other factors mentioned, there is a likelihood the respiratory symptoms reported by the five employees are work related if the exposure limit are not met or if the RPE are not the specified ones for working with flour dust and are not being worn and correctly maintained. Nevertheless, conclusion will be achieved by evaluating exposure data collected by external occupational hygienist and the effectiveness of control measure in the bakery and appropriate staff training.
Question 2
Occupational exposure monitoring data are projected towards assisting industry in fulfilling their legal obligations and ensuring the safety of worker against illness. in a bakery to begin with copies of the bakery occupational hygiene data for the last two year will be appraise. There should be a qualitative assessment of data, which will include description of operation, visual inspection, a check in the work environment and process for safety hazard related to flour dust and biological agent such as flour sensitizer e.g. amylase, air monitoring provided by the occupational hygienist showing various and thorough examination of all parts of the engineering control system, lev devices such as the filter, the air mover drive mechanism e.g. fan belts, are working correctly, logs for checking for indications of effectiveness (e.g. deposited dust). air sampling which will include personal air monitoring of workers, measurements of air velocities, Duct velocities, Capture velocities, Face velocities, measurements of static pressure and at suitable test points, type of hood required for individual task and maintenance, general information concerning the number of male and female workers, assigned spaces assigned to the individual baking task, major equipment assigned to the task, A table listing the operations performed, stressors involved, number of persons exposed, frequency and duration of the operation, types of controls in use, and whether the controls are considered adequate, recommendations relevant to each operation in the table. Workplace assessment of RPE used Although elimination or reduction of respiratory hazards through substitution or engineering controls is preferred, there may be instances in which workers require the use of appropriate respiratory protection for work, which involves exposure to potentially hazardous environments, respiratory protective equipment selection analysis required to fit with individual task ,Respiratory Protection Summary A summary table listing the allotment where personnel who need to use respirators work, the work tasks that produce exposures requiring the use of respirators, and the minimum type of respirator required for adequate protection for this task. Medical log for reported illness or symptoms, analysis of sample of workers exposure to chemical and biological agent and airborne exposure concentration of flour dust in the bakery compared with regulatory standard and accepted occupational exposure level, results of any exposure monitoring conducted in past years. Medical Surveillance Exposure Monitoring Results Summary providing the results of air monitoring in relationship with past symptoms or illness. If other types of exposure monitoring are performed they should be summarized too. Local exhaust Ventilation measurements evaluated list the location of the system, the hazard it controls, whether the system meets health and safety requirement and a brief description of what action is required. measurements of each LEV system installed i.e., for contaminant control, a statement of the design criteria for that system, an assessment of whether the system meets the criteria, and recommendations for corrective action LEV examination records of at least every 12 to 14 month and visual weekly check, if needed. Exposure Monitoring Plan A table summarizing all exposure monitoring recommended to include the location, work task, stressor, monitor location and measurement method, number of samples and frequency of sampling, and the estimated time to accomplish the sampling. Inspecting the reliability, suitalbility and the quality of the exposure data provided it will be expected different control identification; maintenance sampling mention earlier must be well summarised, organised and presented
Question 3
Observing the effectiveness of the control measure provided by the company Health and safety Regulation oblige employers to carry out a risk management assessment at the workplace. As a health and safety manager an ample on-site hygiene examination will be conducted when products preparation is in full swing, this will include a walk-through study to assess the bakery as well as an exposure control assessment, consistent occupational hygiene reports produced by the occupational hygienist for each task will be appraised, These reports example fig 1 provides conditions and specifics of the bakery such as size of the bakery, dimension ,control measures in place, local exhaust ventilation, working practices, awareness of UK policy and training provided, From these assessment, the effectiveness of control in place can be reviewed to ascertain whether the control measures is sufficient to cut exposure to 10mg/m3 8 h MEL and 30 mg/m3 15 min STEL or below.
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Efficiency of control measure in place will be assessed by examining relevant flour-based task, engineering controls, as well as personal air monitoring which will involve collection of breathing zone samples of randomly selected workers in different job task including those with the symptoms using a calibrated IOM sampling heads. The IOM Head will allow the collection of various dust fractions at the same time, As well as by using correct combination of foams it is possible to collect combinations of Inhalable, Thoracic or Respirable dust. The filters will be kept under stable temperature and humidity weighed before and after sampling then dust exposure of 8 hours working shift calculated using C1T1+C2T2+…CnTn / 8 where C1is the occupational exposure and T1 is the associated exposure time in hours in any 24 hour period
Different job categories such as filling, Sack disposal, hand dusting, will be observed. An excellent marker of poor practice is settled flour on surfaces, If bad practice is assumed, a dust lamp can be used to view the airborne dust generated. Considering what cleaning technique are used for dealing with spillages and cleaning flour contaminated surfaces dust will be assessed methods such as a vacuum cleaner should be expected to be used rather than brushes. Information, guidance and instruction employee have received on the health risk related with flour dust will be appraised.
Respiratory protective equipment (RPE) should not be needed if the extraction is in placed correctly and working properly. COSHH Regulations state the need to prevent or control exposure to hazardous substances by using a firm hierarchy of controls. Where adequate control cannot be achieved then the use of correctly chosen and correctly fitted RPE in conjunction with control measures is permissible. In a bakery correct RPE requires an assessment of the properties of the hazardous substances used, consideration of the task, and consideration of the individual wearing it. there are other limitation which should be taken in to account in a hot bakery RPE might lead to a risk of oxygen deficiency , RPE only protects those workers who are wearing it correctly and those who are not wearing it remain unprotected Incorrectly fixed, incorrectly used or incorrectly maintained RPE will not provide sufficient protection and could cause more harm RPE may be uncomfortable to wear and may interfere with some work tasks thereby some worker take it off and are exposed to dust . university safety office,(2009) as the health and safety manager RPE used by employees must be checked if they are of the appropriate type, fit tested, well maintained and appropriate training given in wearing, removal, storage and replacement (HSE, 2002). It must be noted that to ensure optimum effect, the RPE must always be worn as brief exposure will result in a much higher risk of becoming sensitised and developing occupational respiratory disease (Cullinan, et al., 2001).
Local exhaust ventilation is an engineering control system used in reducing airborne contaminant such as dust, mist, fume, vapour or gas in a workplace.”It is important and a legal obligation that LEV systems are tested regularly as engineering controls is routinely used to minimise potential exposure of employees to hazardous substance (HSE hand book 2008) . Local exhaust ventilation will be assessed using the producer performance requirement to know if the extractions are working properly for signs of damage to the ducting, air ¬lter, extraction system and gauge with no dust leaks. If this information isn’t accessible, an experienced ventilation engineer will be required to examine the system thoroughly and test its performance the engineer’s report must show the target air flow velocity and pressure a personal dust sampling analysis from employee will also be required to assess the suitability of the type of lev in place with the work process, maintenance logbook including annual 14 months check of the lev will be required to check how often cleaning process, such as changing of filters and training giving to staff on maintenance are provided.
Confirmation can be made on whether the control measures in place are adequate to reduce exposure to well below the 8 h MEL and 15 min STEL exposure limit, if personal hygiene is being followed and there are evidence that substitution has been considered and effected where possible, effective engineering controls and local exhaust ventilation have been provided and maintained and suitable RPE is provided, and there are evidence of appropriate training provided regarding use and maintenance of engineering controls and RPE. As well as there were only 5 employees lately complained of respiratory symptoms that maybe occupational, this signify that the bakery has tolerable control method that would lessen exposure below the MEL and STEL exposure limit. This suggests that the affected employees could have being exposed to other source of inhalable hazardous dust which are not work related due to change of furniture, change of environment or RPE are not worn by this few employee’s correctly or this few employee have low immunity or it might be due to medications if they are taken one
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