Health and Safety Research and Practice

Journal of Health and Safety Research and Practice

Vol 5 Issue 2 • September 2013

Inside this issue Cytotoxicity and Genotoxicity of Ultrafine Iron-ore Dust

Musculoskeletal Disorders at work: Using evidence to guide practice

UV Radiation exposure among off-shore petroleum workers in Western Australia: A pilot study

Simplified noise labelling for plant or equipment used in workplaces

A publication for members of the Safety Institute of Australia Ltd The JHSRP is an international publication of the Safety Institute of Australia Ltd. It is aimed at health and safety practitioners, researchers and students.

The journal aims to: > Promote evidence and knowledge-based practice in health and safety; > Share information about health and safety interventions; > Share information about solutions to health and safety problems; > Encourage intellectual debate around propositions for improvements in practice. All published papers have been subjected to a double-blind refereeing process by at least two referees. The journal is distributed free-of- charge to members of the Safety Institute of Australia. Members may also access electronic copies of articles via www.sia.org.au. Published articles are available freely (open-source) via www.sia.org.au 6 months after publication. Journal of Health and Safety Research and Practice Vol 5 Issue 2 • September 2013

Editorial Board Editor in Chief Dr Stephen Cowley Executive Editors Dr David Borys, Dr Susanne Tepe Board Members Dr Liz Bluff Professor Niki Ellis Dr George Rechnitzer FSIA (Hon) Dr Jenny Job Prof. Rod McClure Prof. Andrew Hopkins FSIA Dr Geoff Dell CFSIA Prof. Dennis Else FSIA (Hon) Prof. Derek Smith FSIA Dr Felicity Lamm Prof. Michael Quinlan FSIA Derek Viner FSIA (Hon) Dr Barry Gilbert FSIA

Guidelines for authors Guidelines for authors are available at www.sia.org.au Subscriptions The journal is distributed free-of-charge to members of the Safety Institute of Australia. Members mayalso access electronic copies of articles via www.sia.org.au. Published articles are available freely (open-source) via www.sia.org.au 6 months after publication. Subscribers will receive printed copies of each volume of the journal at the time of publication and will be granted access to the electronic copies of the latest articles. In addition to receiving the JHSRP, subscribers will also receive the OHS Professional magazine, which is published quarterly. Subscriptions rates are available via www.sia.org.au. Correspondence Correspondence should sent to: The Editor in Chief Journal of Health & Safety Research & Practice, Safety Institute of Australia Ltd PO Box 2078, Gladstone Park, Victoria 3043 [email protected] ISSN 1837-5030

in this issue

Cytotoxicity and Genotoxicity of Ultrafine Iron-ore Dust Xiaohui Liu, Dino Pisaniello, Barbara Sanderson, He Wang — Pages 2–6

Musculoskeletal Disorders at work: Using evidence to guide practice Wendy Macdonald and Jodi Oakman — Pages 7–12

UV Radiation exposure among off-shore petroleum workers in Western Australia: A pilot study Nataša Rizmanoska and Joseph Maté — Pages 13–17

Simplified noise labelling for plant or equipment used in workplaces Warwick Williams & Zoran Sukara — Pages 18–22

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 1 Cytotoxicity and Genotoxicity 2009). However, the cancer risk has been attributed to crystalline silica exposure, of Ultrafine Iron-ore Dust underground radon gas or smoking behaviour rather than iron-containing Xiaohui Liu1, Dino Pisaniello1, Barbara Sanderson2, He Wang1 component of dust exposure (Jorgensen, Kolmodin-Hedman et al. 1988; Banerjee, Abstract Wang et al. 2006; Bjor, Burstrom et al. Iron ore mining has been associated with cardiorespiratory diseases, and mainly 2009). attributed to contaminants, rather than iron ore. However, the potential toxic There is increasing interest in human contribution of iron ore ultrafine particles (UFP) has not been explored.This in exposure to ultra fine particles (UFPs, vitro study sought to clarify the cytotoxicity and genotoxicity of ultrafine iron ore size ≤ 100nm). Due to the unique size using. twelve iron ore dust samples collected from 6 locations at an iron ore mine. and larger surface area of these small The mineral and elemental compositions were determined and the cytotoxicity particles, it is suggested that they are more and genotoxicity of the UFP component of these samples were tested on WIL2- toxic than larger particles (Oberdorster NS and A549 human cell lines using the Thiazolyl Blue Tetrazolium Bromide, 3-(4, 2001; Donaldson and Stone 2003; Englert 5-dimethylthylthiazol-2, 5-diphenyltetrazolium bromide (MTT) Assay, the Crystal 2004). Exposure to ultrafine particles Violet Assay and the Cytokinesis-block micronucleus (CBMN) Assay. in the iron ore mine may be generated Cytotoxicity was only found for plant fines, and this was comparable to the response from combustion, drilling and blasting of WIL2-NS to ultrafine quartz. No significant chromosome damage was detected by processes, and diesel exhaust from the CBMN Assay for any samples for either cell line. There was no apparent relation- transportation. As a consequence of the ship between elemental content or mineralogical content of mine samples and cytotox- range of the activities, adverse health icity. Reconstruction dosing experiments with soluble ferric or ferrous iron, indicated effects from exposure to fine and UFPs that leaching of iron was not a major explanatory factor. It is concluded that the UFP may vary substantially. However, the component of these iron ore dust samples did not show significant cytotoxicity and independent toxic contribution of ultrafine genotoxicity and that further work should be supplemented with electron microscopy iron ore particles has not been explored. and surface chemistry techniques. Materials and Methods Source of iron ore dust samples Introduction Twelve iron ore dust samples were Iron ore mining is one of the most collected at six different sites of an iron important industries in Australia. mine in Western Australia. The dust Production in Australia is around 500 Mt samples were scooped up from stockpiles (Geoscience Australia 2011). In 2010, and other areas and sieved to 200 µm. Cite this article as: $47.2 billion worth iron ore was exported These samples were labelled as EAP (East Liu, X., Pisaniello, D., Sanderson, B. from Australia. Although occupational Pit operation) 3 A&B, Haul Road A&B, & Wang, H., (2013), Cytotoxicity and hygiene has been improved in the last 30 Low Grade Stockpile A&B, Plant Fines Genotoxicity of Ultrafine Iron-ore Dust, years, dust exposure still poses a potential A&B, Stockyard (Tail end of Co09) A&B, J Health & Safety Research & Practice, health hazard to mine workers and the Waste Dump (North West Waste Dump) 5(2), 2-6 general public living near mining and port A&B. There was no difference between A operations (Banerjee, Wang et al. 2006). and B as they were taken from the same Key Words: The airborne dusts arising from iron location. The dust samples were further ultrafine particle, iron ore, exposure ore handling consists mostly of iron ore dried and mechanically sieved to 45 µm as well as clays (aluminosilicate and iron before toxicological assessment Correspondence: silicate) and quartz. The iron ore mainly Dr Dino Pisaniello comprises the iron oxide minerals such Characterisation of dust samples

Level 8, Hughes Building as hematite, Fe2O3 (70% Fe); goethite, X-ray Diffraction (XRD) and X-ray

The University of Adelaide, Fe2O3s H2O, (63% Fe); limonite, a mixture Fluorescence (XRF) were conducted by South Australia 5005 of hydrated iron oxides (up to 60% Fe); Australia’s Commonwealth Scientific

Email: [email protected] and magnetite, Fe3O4 (72% Fe). and Industrial Research Organisation Numerous epidemiological studies (CSIRO) to determine mineralogy and 1. Discipline of Public Health, School of Population indicated that dust exposure at iron elemental composition. Health, University of Adelaide, South Australia, 5005 ore mines is associated with cardio- 2. Department of Medical Biotechnology, Faculty respiratory diseases (Chau, Benamghar et Preparation of iron ore dust samples of Health Science, Flinders University of South al. 1993; Hedlund, Jarvholm et al. 2004; for bioassays Australia, 5042 Su, Guan et al. 2006; Bjor, Burstrom et al. The iron ore dust samples were suspended

2 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013 in RPMI 1640 culture medium (Trace MTT into purple formazan dye (Young, Cytochalasin-B was added to each cell Biosciences, Melbourne, Australia), Phungtamdet et al. 2005). culture at 4.5 μg/ml and the cultures were supplemented with 5% foetal bovine Briefly, after 24hours treatment, 1 × 104 incubated for 26 hours at 37ºC. The cells serum (FBS, Trace Bioscience) and 50 WIL2NS cells were seeded into wells of were collected onto slides by cytospin at IU/ml streptomycin/penicillin (Thermo a 96-well microplate. MTT solution was 600 rpm for 5 min, air dried, fixed for Trace, Melbourne, Australia). The added to each well at 0.5 mg/ml, and then 10 min in DiffQuick Fixative and then mixture was firstly vortexed for 5 minutes incubated at 37ºC for 18 hours. Then stained with 10 × 1 second dips of Dif- and sonicated for 5 minutes to ensure a acidified 20% Sodium Dodecyl Sulfate fQuick Stain 1 then Stain 2. The slides uniform suspension. The mixture was then (SDS) in 0.02 M HCl was added to each were scored under light microscopy (mag- centrifuged at 1000 rpm for 5 minutes. The well and mixed. The plates were placed nification × 250). Micronucleated bi- supernatant was removed, then filtered in the dark at room temperature for 1.5 nucleated cell (MNed BNC) frequency with a disc filter (pore size 0.10 µm, hours. Optical density (OD) was read on was determined in 1000 BNC on dupli- PVDF, Durapore) to sterilise and separate an ELISA plate reader at 570 nm, with 630 cate slides according to established cri- to ultrafine size. The concentrations of nm as a reference wavelength. ODs were teria (Fenech, Chang et al. 2003). On the iron ore in suspension were estimated converted to cells/well using a standard same slides, the frequency of necrotic by spectrophotometer measurement at curve run with each experiment. Survival cells and cells with nucleoplasmic bridg- wavelength 570 nm, in comparison with percentage was calculated by comparing es can also be scored (Fenech, Chang et iron oxide nano powder (size <5 µm, cells/well of exposed and unexposed al. 2003). 3 replicates were carried out for Sigma Aldrich) as reference. cultures. 3 replicates were carried out for each sample.

each dust sample for this assay. Ultrafine Quartz and TiO2 were chosen Cell line and Cell culture details as positive control for both cytotoxicity WIL2NS (American Type Culture Crystal Violet Assay and genotoxicity assessment. Collection (ATCC), CRL 8155), a human The Crystal Violet Assay is a sensitive B-cell Lymphoblastoid cell line, was bioassay to measure cell proliferation for Preliminary experiments with soluble maintained in RPMI 1640 culture media monolayer cell culture by crystal violet Fe2+and Fe3+ plus 5% FBS, 50 IU/ml strep/penicillin at staining (Kueng, Silber et al. 1989; Alfaro- A serial of preliminary experiments o 37 C in a 5% CO2 atmosphere. Media was Moreno, Martinez et al. 2002). In this study, were first conducted to differentiate the renewed every 2-3 days. A549 (ATCC, Crystal Violet Assay was used to determine independent potential toxicity of soluble

CCL-185), a human lung carcinoma the cytotoxicity of A549 cell line. iron. Iron (III) Chloride (FeCl3,) and epithelial cell line, was maintained in After 24 hours treatment with iron ore Iron (II) Sulfate Heptahydrate were both RPMI 1640 culture media plus 10% FBS, dust samples, 50 µl 0.5% Crystal Violet tested by 2 cell lines. The cytotoxicity and 50 IU/ml strep/penicillin at 37oC in a 5% solution was added to each well, staining genotoxicity of soluble iron was assessed

CO2 atmosphere. Cells were subcultured for 10mins. The Crystal Violet solution by the same bioassays at concentration of every 3 days. Cells at 5 x 105cells/ml was gently washed away and air dried 1mM, 0.5mM, 0.1mM, 0.05mM, 0.01mM. were incubated with a range of doses for 2-3 hrs. 50 µl 33% acetic acid was of particles for 24 hrs. Cells were then added to each well to dissolve the staining Statistical Analysis washed and assayed as outlined below. formation and incubated on bench for 10 The experiments were repeated at least 3 mins. OD was read on an ELISA plate independent times. Statistical analysis of Bioassays reader at 570 nm with 630 nm as reference the cytotoxicity and genotoxicity results The bioassays applied in this study have wavelength. OD values were converted to were carried out using ANOVA, followed been validated by the biotechnology cells/well using a standard curve run with by Tukey’s HSD post hoc test (equal laboratory at Flinders University for each experiment. Survival percentage variances) or Dunnett’s T3 post hoc test testing cytotoxicity and genotoxicity of was calculated by comparing cells/well (unequal variances); otherwise, the potential toxic substances. The published of exposed and unexposed cultures. 3 nonparametric Kruskal–Wallis test was studies have used the same protocol to replicates of each sample were done for used. The analysis allowed for comparison test nanosize quartz and TiO2 (Wang, this assay. within dose levels, and across samples. Sanderson et al. 2007; Wang, Wang et al. These tests were performed using SPSS 2007). CBMN Assay software, version 12. Differences were The CBMN assay is used to assess chro- considered statistically significant when MTT Assay mosome damage based on occurrence the P-value was less than 0.05 Thiazolyl Blue Tetrazolium Bromide, rates of micronuclei in dividing cells. 3-(4, 5-dimethylthylthiazol-2, 5-dipheny- This assay was validated and conducted Results ltetrazolium bromide (MTT) Assay is using published protocols (Fenech 1993; Characterisation of dust samples based on the activity of mitochondrial Fenech 2007), with minor modifications The XRD analysis results are summarised dehydrogenase in viable cells converting as follows. Briefly, following treatment, in Appendix 1. It presents mineralogical

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 3 Table 1:

Comparison of IC30 between iron ore dust samples and positive controls with WIL2NS Cell Line by MTT Assay

Low Low Stock- Stock- Haul Haul Plant Plant Waste Waste EAP 3 EAP 3 Grade Grade yard yard Nano Sample Road Road Fines Fines Dump Dump Quartz TiO A B Stock- Stock- (Tail of (Tail of 2 Fe O A B A B 2 3 pile A pile B A B Co09) A Co09) B

IC30 30 N/A 55 55 N/A 70 35 50 70 40 N/A N/A 43 100 500 (µg/ml)

*N/A means even at the highest concentration, the dust sample could not inhibit cells proliferation by 30%. component of these 12 samples. The (p< 0.05) detected by CBMN Assay for any samples majority of these samples are composed For the cytotoxicity experiments with for either cell line, which indicated that with hematite (Fe2O3, 25.9%-56.7%), A549 cell line by Crystal Violet Assay, ultrafine iron oxide did not show any DNA goethite (FeOOH, 39.7%-58.1%) and there was no consistent linear dose- damage in vitro. The same finding were quartz (SiO2, 0.7%-14.8%). response relationship. Thus IC50 or IC30 also reported by Guichard (2012) and The XRF elemental analysis results could not be predicted by the dose- colleagues. They used the Comet Assay are presented in Appendix 2. The major response curve. to detect potential DNA damage following elements (%) include Fe2O3, SiO2, Al2O3, exposure of Syrian hamster embryo (SHE)

P2O5, SO3, CaO, TiO2, Mn3O4, MgO and Genotoxicity Results cells to nano size Fe2O3. After 24 hours

K2O. The minor elements (ppm) included Compared with the positive controls exposure, no significant micronuclei

SnO2, V2O5, Cr2O3, Co3O4, NiO, CuO, ZnO, (quartz and TiO2), the iron ore dust samples induction was occurring.

As2O3, PbO, BaO, Cl and Na2O. The main showed no significant genotoxicity for There are several limitations to this component of these iron ore dust samples either cell line (p > 0.05). There were no study. Bulk dust samples were collected are iron oxide (Fe2O3, 58% -87%), SiO2 micronuclei observed for A549 cell line from the mine site, and therefore do

(2.91%-19.67%) and Al2O3 (2.20%-9.39%). after exposure to 12 iron ore dust samples not represent airborne dust samples.

Except for EAP3 A with Fe2O3 content for 24 hours. No significant differences in Mechanically sieving to 45 µm was

58.2%, the content of Fe2O3 was higher genotoxiciy between the 12 iron ore dust carried out to separate dust that may than 78%. Due to limited sample numbers, samples was detected for the WIL2NS cell have been airborne and then settled. statistical analysis was not feasible. line (p > 0.05). Ultrafine particles were then separated by membrane filter filtration, but there was no Preliminary experiments results Discussion information on particle size distribution in of soluble Fe2+and Fe3+ The main finding was that the UFP solution. One possible complication relates Within the soluble iron concentration component of the iron ore dust samples to the aggregation of ultrafine iron oxide ranging from 0 to 5mM, both Fe3+ and Fe2+ did not show significant genotoxicity particles in solution which is dependent on did not show significant cytotoxicity or in comparison to the positive controls. pH and ionic strength(Baalousha 2009). genotoxicity effect (no micronuclei were Cytotoxicity was found for some samples, Electron microscopy and surface chemistry observed) on both WIL2NS and A549 cell which, in the case of Plant fines, was techniques could be used to explore these lines. comparable to the response of WIL2-NS issues in the context of particle-cell to ultrafine quartz. There was no apparent interactions. Only three assays on two Cytotoxicity Results relationship between elemental content cell lines were conducted. More biological

Table 1 illustrates the IC30 (Inhibitory or mineralogical content of samples and endpoints and cell lines could be explored concentration 30%) results for the 12 iron toxicity. to elucidate dose response relationships. ore dust samples with the WIL2NS cell Reconstruction dosing experiments line by MTT assay. The positive controls with soluble ferric or ferrous iron Conclusions were nanosized quartz and titanium indicated that leaching of iron was not a The UFP component of these iron ore dust dioxide. Nanosize iron oxide is also major explanatory factor. These results samples did not show appreciable cytotoxiciy presented for comparison. are consistent with the work of Caicedo and genotoxicity when compared with Compared with quartz no significant (2008) who compared cytotoxicity and positive controls. The findings are consistent cytotoxicity was detected with the iron genotoxicity of several metal ions by using with other evidence from epidemiological ore samples (p > 0.05). However, based Jurkat T-lymphocyte, using the same dose and toxicological studies. on statistical tests, samples EAP3 A, range as the current experiment. Caicedo Haul Road A&B, Plant Fine A&B, (2008) found that iron Fe3+ did not show This paper was first presented to the Stockyard B were more toxic in significant cytotoxicity and genotoxicity. 30th AIOH annual conference Adelaide comparison to TiO2 and nano Fe2O3. No significant chromosome damage was 1-5 December 2012

4 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013

lung diseases in iron ore miners: report References Donaldson, K. and V. Stone (2003). “Current from the obstructive lung disease in hypotheses on the mechanisms of toxicity Alfaro-Moreno, E., L. Martinez, et al. (2002). northern Sweden studies.” Eur J Epidemiol of ultrafine particles.” Ann Ist Super Sanita “Biologic effects induced in vitro by PM10 19(10): 953-958. 39(3): 405-410. from three different zones of Mexico City.” Jorgensen, H. S., B. Kolmodin-Hedman, et al. Environ Health Perspect 110(7): 715-720. Englert, N. (2004). “Fine particles and human (1988). “Follow-up study of pulmonary health--a review of epidemiological Baalousha, M. (2009). “Aggregation and function and respiratory tract symptoms studies.” Toxicol Lett 149(1-3): 235-242. disaggregation of iron oxide nanoparticles: in workers in a Swedish iron ore mine.” Influence of particle concentration, pH and Fenech, M. (1993). “The cytokinesis-block J Occup Med 30(12): 953-958. natural organic matter.” Sci Total Environ micronucleus technique: a detailed Kueng, W., E. Silber, et al. (1989). 407(6): 2093-2101. description of the method and its “Quantification of cells cultured on 96-well application to genotoxicity studies in Banerjee, K. K., H. Wang, et al. (2006). plates.” Anal Biochem 182(1): 16-19. human populations.” Mutat Res 285(1): “Iron-Ore Dust and its Health Impacts.” 35-44. Oberdorster, G. (2001). “Pulmonary effects of Environmental Health 6(1): 11-16. inhaled ultrafine particles.” Int Arch Occup Fenech, M. (2007). “Cytokinesis-block Bjor, B., L. Burstrom, et al. (2009). “Fifty- Environ Health 74(1): 1-8. micronucleus cytome assay.” Nature year follow-up of mortality among a Protocols 2(5): 1084-1104. Su, L. P., H. Y. Guan, et al. (2006). “[Cohort cohort of iron-ore miners in Sweden, with mortality study of dust exposed miners specific reference to myocardial infarction Fenech, M., W. P. Chang, et al. (2003). in iron mine].” Zhonghua Lao Dong Wei mortality.” Occup Environ Med 66(4): “HUMN project: detailed description of the Sheng Zhi Ye Bing Za Zhi 24(6): 360-363. 264-268. scoring criteria for the cytokinesis-block micronucleus assay using isolated human Wang, J. J., B. J. Sanderson, et al. (2007). Caicedo, M., J. J. Jacobs, et al. (2008). lymphocyte cultures.” Mutat Res 534(1- “Cyto- and genotoxicity of ultrafine TiO2 “Analysis of metal ion-induced DNA 2): 65-75. particles in cultured human lymphoblastoid damage, apoptosis, and necrosis in human cells.” Mutat Res 628(2): 99-106. (Jurkat) T-cells demonstrates Ni2+ and Geoscience Australia, (2011). “Iron Fact Sheet.” Wang, J. J., H. Wang, et al. (2007). “Ultrafine V3+ are more toxic than other metals: from http://www.australianminesatlas.gov. Quartz-Induced Damage in Human Al3+, Be2+, Co2+, Cr3+, Cu2+, Fe3+, au/education/fact_sheets/iron.jsp. Lymphoblastoid Cells in vitro Using Three Mo5+, Nb5+, Zr2+.” J Biomed Mater Res Guichard, Y., J. Schmit, et al. (2012). Genetic Damage End-Points.” Toxicol A 86(4): 905-913. “Cytotoxicity and genotoxicity of Mech Methods 17(4): 223-232. Chau, N., L. Benamghar, et al. (1993). nanosized and microsized titanium dioxide Young, F. M., W. Phungtamdet, et al. (2005). “Mortality of iron miners in Lorraine and iron oxide particles in Syrian hamster “Modification of MTT assay conditions (France): relations between lung function embryo cells.” Ann. Occup Hyg 56(5): to examine the cytotoxic effects of and respiratory symptoms and subsequent 631-644. amitraz on the human lymphoblastoid cell mortality.” Br J Ind Med 50(11): Hedlund, U., B. Jarvholm, et al. (2004). line, WIL2NS.” Toxicol In Vitro 19(8): 1017-1031. “Respiratory symptoms and obstructive 1051-1059.

Appendix 1: Iron ore dust samples XRD analysis results

Low Low Stock- Stock- Plant Plant Waste Waste Haul Haul Grade Grade yard yard Sample Label EAP 3A EAP 3B Fines Fines Dump Dump Road A Road B Stock- Stock- (Tail of (Tail of A B A B pile A pile B Co09) A Co09) B

Quartz 14.8 1.4 1.6 1.1 1.6 1.5 1 0.8 0.9 0.7 0.7 0.7 (SiO2)%

Hematite 25.9 56.7 44.9 47.9 40 36.7 55.4 56.7 52.9 53.1 49.3 49.1 (Fe2O3)%

Goethite 43.4 39.7 51.8 49.6 55.2 58.1 41.7 40.8 44.1 44.4 48.7 48.9 (FeOOH)%

Kaolin 12.5 2.2 1.7 1.4 3.2 3.7 1.9 1.7 2.1 1.8 1.3 1.3 (Al2Si2O5(OH)4)%

Mica 3.4 ------(KAl2(Si,Al)4O10(OH)2)%

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 5 Appendix 2. Iron ore dust samples XRF analysis results

Low Low Major Plant Plant Stockyard Stockyard Waste Waste Haul Haul Grade Grade Elements EAP 3 A EAP 3 B Fines Fines (Tail of (Tail of Dump Dump Road A Road B Stock- Stock- (%) A B Co09) A Co09) B A B pile A pile B

Fe2O3 58.52 86.98 83.21 84.75 79.14 78.29 87.29 87.86 85.81 85.86 86.70 87.38

SiO2 19.67 3.40 3.85 3.51 7.00 7.45 2.93 2.95 3.10 3.14 2.91 2.96

Al2O3 9.39 2.36 3.08 2.80 4.10 4.42 2.20 2.23 2.66 2.66 2.26 2.26

P2O5 0.22 0.20 0.21 0.21 0.13 0.13 0.18 0.18 0.21 0.21 0.19 0.19

SO3 0.03 0.02 0.17 0.15 0.19 0.20 0.06 0.07 0.07 0.08 0.06 0.07

CaO 0.02 0.02 0.03 0.02 0.03 0.03 0.01 0.01 0.01 0.01 0.01 0.01

TiO2 0.42 0.09 0.10 0.09 0.15 0.17 0.07 0.07 0.08 0.08 0.06 0.06

Mn3O4 0.69 0.15 0.12 0.12 0.09 0.10 0.08 0.08 0.12 0.12 0.10 0.09

MgO 0.46 0.10 0.08 0.06 0.06 0.08 0.06 0.07 0.07 0.06 0.06 0.06

K2O 0.63 0.04 0.03 0.02 0.02 0.02 0.01 0.01 0.01 0.01 0.01 0.01

*Lower Limit of Detection (LLD) for major elements: Fe2O3 0.001, SiO2 0.002, Al2O3 0.002, P2O5 0.001, SO3 0.002, CaO 0.001, TiO2 0.002, Mn3O4 0.001, MgO 0.007, K2O 0.001

Low Low Minor Haul Haul Plant Plant Stockyard Stockyard Waste Waste EAP 3 EAP 3 Grade Grade Elements Road Road Fines Fines (Tail of (Tail of Dump Dump A B Stock- Stock- (ppm) A B A B Co09) A Co09) B A B pile A pile B

SnO2 0 0 0 0 0 0 0 0 0 0 0 0

V2O5 90 0 0 0 0 0 0 0 0 0 0 0

Cr2O3 37 0 0 0 10 5 0 0 0 0 0 0

Co3O4 5 0 0 0 0 0 0 0 0 0 0 0

NiO 91 6 0 19 6 11 6 0 13 6 2 14

CuO 40 0 0 3 1 13 9 9 0 10 0 0

ZnO 112 15 109 140 8 18 12 23 172 172 11 21

As2O3 35 0 0 0 1 0 0 0 0 0 0 0

PbO 28 17 7 27 19 23 17 37 33 30 20 42

BaO 28 70 0 0 189 50 68 0 82 62 0 0

Cl 29 72 129 146 299 363 153 179 71 83 119 135

Na2O 232 153 220 199 333 393 156 175 143 161 144 163 TOTAL 90.15 93.40 90.91 91.77 91.01 90.97 92.93 93.58 92.19 92.29 92.38 93.13 (%)

*Lower Limit of Detection (LLD) for minor elements: SnO2 16, V2O5 8, Cr2O3 7,Co3O4 6,NiO 10,CuO 9,ZnO 8,As2O3 6,PbO 6,BaO 13,Cl 8,Na2O 1

6 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013

Musculoskeletal Disorders at work: over 40 percent of all compensation claims for serious work-related injuries or Using evidence to guide practice diseases (Safe Work Australia, 2012), and a similar situation prevails in Europe (Eu- Wendy Macdonald1 and Jodi Oakman1 ropean Agency for Safety and Health at Work, 2010). Clearly, work-related MSDs Abstract present a major challenge to occupational Work-related musculoskeletal injuries and disorders (MSDs) present a major problem health and safety (OHS) professionals throughout the world. Strategies to control this risk typically focus on re-design throughout the world – particularly to of tasks, workstations or equipment to reduce the biomechanical loads that people occupational ergonomists who are seen as experience during work performance. Training workers in “safe” manual handling specialists in this field. techniques is another popular strategy, despite strong evidence that it is ineffective. In fact, it is now evident that to focus workplace risk management strategies only on Current risk management workstation design and people’s physical actions during task performance is not the practices optimal way to reduce MSD risk. This articles outlines research evidence identifying Little published information is available key work-related causes of MSDs and requirements for effective interventions. concerning ‘real world’ MSD risk Examples of current approaches to MSD risk management are described, including management practices. Research in the progress on two projects currently being conducted under the auspices of the workplaces of four large Melbourne International Ergonomics Association (IEA). companies found a strong focus on controlling risk from hazards associated with ‘manual handling’ (Macdonald et al., 2007). In two of these four workplaces Nature and extent of the there was particular emphasis on training problem workers in ‘safe’ movement techniques Musculoskeletal disorders (MSDs) are despite strong research evidence that this a diverse group of injuries and disorders typically does not reduce WMSD risk which in a workplace context are (Hignett, 2003). Similar findings have sometimes referred to as repetitive strain been reported from the UK (Whysall, injuries, cumulative trauma disorders, 2004), where consultant ergonomists or occupational overuse syndrome were found to focus on assessing and (Australian Safety and Compensation controlling risk from manual handling Council, 2006). According to the World hazards. This situation is not surprising Health Organisation (2003): in light of the strong orientation of Standards, Codes of Practice and Musculoskeletal disorders are the Associated Guidance Materials in a wide most frequent causes of physi- range of countries towards identifying, Cite this article as: cal disability, at least in developed assessing and controlling risk from this Macdonald, W. & Oakman, J. (2013), countries. As mortality from infec- type of hazard (Macdonald et al., 2003). Musculoskeletal Disorders at work: tious diseases reduces worldwide, In light of this situation it is not surprising Using evidence to guide practice, J Health the global population is ageing and that workplace risk management strategies & Safety Research & Practice, 5(2), 7-12 the numbers of people in the old- typically focus on designing work tasks, est age groups are increasing. As the workstations and associated equipment to Key Words: prevalence of many musculoskele- reduce the biomechanical loads that people work-related; musculoskeletal; risk tal disorders increases with age, the experience during work performance. management; toolkit; physical; likely result is that there will be a However, there is now strong evidence psychosocial growth in the number of people with that to focus workplace risk management chronic disabling disorders. strategies only on workstation design Correspondence: and people’s physical actions during task Centre for Ergonomics & Human Factors It has been estimated that “37 percent performance is not the optimal way to School of Public Health & Human of all back pain worldwide is attributable reduce MSD risk, as described below. Biosciences, La Trobe University to work, resulting in an estimated Melbourne, Australia 800,000 DALYs lost, a significant loss Work-related factors influencing Email: [email protected] of time from work, at a high economic MSD risk cost”(Nelson et al., 2005). In Australia, One of the most extensive reviews of re- 1 La Trobe University work-related MSDs are responsible for search evidence on this topic was by an

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 7 expert committee of the USA National general characteristics of the task itself Research Council and Institute of Med- (e.g. requirement for percussive force or Social context: psychosocial hazards icine (NRC) (2001). The committee static posture). Other physical hazards The term ‘psychosocial hazard’ is often grouped work-related hazards for MSDs influencing MSD risk include vibration used to include the organisational factors into three categories as described below, (e.g. from a hand tool affecting just the described in section B above, particular- and depicted in the conceptual model de- hand and arm, or a vehicle causing whole- ly in relation to risk of psychological in- veloped by that committee, shown in Fig. body vibration) and environmental factors juries and mental disorders. However, 1. The model shows that hazards within such as low temperatures. for MSD risk management it is useful to all three categories interact with each distinguish effects of work organization other, and affect both processes internal Organisational factors: hazards arising and job design factors from effects of to the individual (internal biomechanical from work organization and job design work’s social context, including the at- loading, physiological responses) and MSD risk is influenced by how work is titudes and behaviours of managers, su- personal outcomes (discomfort, pain, organised and how tasks are combined pervisors and co-workers. Psychosocial impairment, disability). to create whole jobs. Hazards of this type hazards are categorized in different ways include highly repetitive movements, high based on different theoretical frameworks. External or physical loads experienced workload, high work rates, inadequate According to the European Framework for during task performance personal control or autonomy, role Psychosocial Risk Management (Leka & The physical demands of task performance conflicts, lack of variety, social isolation, Cox, 2008), these include factors related are usually the most obvious work-related inadequate rest breaks, excessively to: Job content, Workload and workpace, cause of MSDs. Hazards of this type are long working hours, night shifts, and so Work schedule, Control, Organisation- task-specific, stemming from the postures on. Many of these factors can increase al culture and function, Interpersonal re- adopted and forces exerted during task exposures to external loads and related lationships at work, Role in organisation, performance, which in turn are influenced physical hazards (section A above), Career development, and Home-work by the design of workstations and tools, as well as increasing the likelihood of interface. characteristics of objects handled such workers experiencing chronic fatigue and/ as their weight, size and shape, and more or prolonged stress. Role of work-related psychological stress in MSD causation Figure 1. In the report outlined above (Nation- Conceptual model of factors influencing MSD risk [10, p.353] al Research Council, 2001) the importance of psychological stress and its The Workplace The Person physiological and behavioural correlates in MSD aetiology was clearly acknowl- Biomechanical Loading edged. Although stress is not mentioned Internal in Fig. 1, it is implicit there within Loads ‘physiological responses’. As described External Loads by Cox (1978), the individual’s ‘stress response’ is multidimensional, including Physiological a complex physiological dimension along Responses with behavioural, cognitive and affective dimensions. Consistent with this, a 1995 Internal Tolerances model of work-related determinants of MSD risk included a ‘patho-physiology’ Mechanical Organisational Strain component within which was “Distress Factors with hormonal, endocrine and immune system response” (Kuorinka & Forcier, 1995), Fatigue and more recent research has confirmed the important role of stress in MSD aetiology

Individual Factors (Marras, 2008; Marras et al., 2009). Stress is sometimes presented as a Pain psychosocial hazard affecting the risk Social Discomfort of various occupational health problems Context including MSDs. However, at workplace Impairment level where a key goal is to identify Disability and control risk from work-related hazards, it is arguably more useful to

8 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013 view stress as a product of such hazards Some of this variability is undoubtedly This work has recently been extended to which, in combination with individual due to differences between studies in three organizations within the healthcare factors, partially mediates the effects of the particular hazards assessed and the sector, and results to date are similar to workplace hazards on MSD risk (Eatough measures used to quantify them. those found previously. Employees from et al., 2012). Job satisfaction, which has Furthermore, considering the huge two hospital networks and from a large also been shown to influence MSD risk variety of work undertaken and the organisation of paramedics were surveyed (Schoenfisch & Lipscomb, 2009), can associated hazards and risks it is reasonable and results from each organization were be seen to play a similar role – although to expect that variations will be large. analysed using hierarchical logistic reducing rather than increasing risk. A current Australian research program is regressions with age and gender entered comparing the influence on MSD risk of a first, followed by scores on the physical Relative importance of different wide range of physical and organisational/ hazards and organisational/psychosocial types of hazards psychosocial hazards in workplaces across hazards scales used previously. Beta values There is wide variability in the relative several industry sectors. for these two scales are shown in Table 1; influence of the above factors on MSD The first phase involved four workplaces it can be seen that in all three organizations risk, but the evidence is clear that – two in the manufacturing sector and two the physical hazards score accounted for organisational and psychosocial hazards in warehousing – were assessed using a more variance than the organisational/ can have a large impact on risk that is of- common set of survey items to quantify all psychosocial hazards score, with the ten of comparable magnitude with that of types of hazard. MSD risk was quantified difference between the two being much physical hazards (Macdonald & Evans, using a Discomfort/Pain score derived greater for hospital network B. The reason 2006). Following an extensive review of from the rating scales shown in Fig. 2; total for this hospital network being different epidemiological studies by Marras et al. score (out of 60) was the sum of scores out from the other two organizations may (2009), they reported: of 12 for each of five body regions (each lie in the different occupations included such score was the product of discomfort/ within the samples: the network B sample between 11% and 80% of low-back pain frequency rating on a scale from zero had a smaller proportion of professionally injuries and 11–95% of extremi- to 4 and severity rating on a scale from 1 qualified staff than the other two. Clearly ty injuries, are attributable to work- to 3). Results from hierarchical multiple there is a need for further investigation of place physical factors, whereas, be- regression analyses to identify the main occupational differences in the relative tween 14% and 63% of injuries to predictors of MSD risk demonstrated influence of physical versus organisational/ the low back and between 28% and that the contributions of physical and psychosocial hazards. Nevertheless, in all 84% of injuries of the upper extrem- organisational/psychosocial hazard scores seven of the workplaces investigated to date, ity are attributable to psychosocial were of similar magnitude to each other, the organisational/psychosocial hazards factors ... (p.16) and that this held true separately for each score accounted for a very substantial workplace (Macdonald, et al., 2007). proportion of variance in MSD risk.

Figure 2. Rating scales used to create a Discomfort/Pain score out of 60 (from [6])

How Often For each body area where there’s been some discomfort or pain (i.e. marked as 1 or higher) Never Occasionally Sometimes Often Almost always circle a number below to show HOW BAD Neck, Shoulders Neck, Shoulders Mild 1 0 1 2 3 4 Moderate 2 Severe discomfort 3 Hands, Fingers Hands, Fingers Mild 1 0 1 2 3 4 Moderate 2 Severe discomfort 3 Arms Arms Mild 1 Moderate 2 0 1 2 3 4 Severe discomfort 3 Middle to lower Middle to lower Mild 1 Back Back Moderate 2 0 1 2 3 4 Severe discomfort 3

Hips, Hips, Bottom, Mild 1 0 1 2 3 4 Bottom, Legs, Legs, Moderate 2 Feet Feet Severe discomfort 3

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 9 Table 1. hazard management – identifying hazards, Benefits of a participative approach in Relative contribution of physical assessing risk from each identified hazard, MSD risk management have also been versus organisational/psychosocial and taking any necessary steps to control demonstrated in a systematic review hazards to MSD risk in three different risk from each hazard separately. This evaluating ‘participative ergonomics’ organisations, as indicated by Beta approach is appropriate for hazard-specific approaches (Cole et al., 2005). values from hierarchical multiple diseases and disorders such as noise- Participative ergonomics has been defined regression analyses. induced hearing loss, or mesothelioma due (Wilson & Haines, 1997) as to asbestos exposure. However, a more β value: β value: Physical Organisation- holistic approach is required to achieve The involvement of people in plan- Organisation Hazards al/Psychosocial effective control of diseases and disorders ning and controlling a significant Score Hazards Score for which risk is determined by multiple, amount of their own work activities, Hospital network .30 .26 A (n = 252) diverse hazards – as is the case for MSDs. with sufficient knowledge and pow- Hospital network For example, a particular posture might be er to influence both processes and .42 .19 B (n = 160) rated as low risk if considered alone, but outcomes in order to achieve desir- Paramedic service .34 .26 the risk could be higher for workers who able goals. (n = 957) are chronically fatigued or stressed due to long working hours, tight production Its practical manifestation can vary Importance of interactions schedules with few rest breaks, and considerably (Haines et al., 2002), but between hazards supervisors perceived as unsupportive. most workplace interventions entail the For occupational health outcomes arising In other words, risk management must be formation of a project team which includes primarily from just one type of hazard, based on assessment of risk from the com- representatives of all key stakeholders. risk can be estimated in terms of the bined effects of the hazards identified as Clearly, some such process is likely severity of the hazard and the extent of most relevant in the particular situation, to be necessary in order to customise exposure to it. For example, risk from taking account of the hazards’ additive interventions to local needs ... bearing in hazardous chemicals is generally a direct and possibly interacting effects. minds that ‘local needs’ include those of function of the extent of exposure to the For the above reasons, a key the workers themselves. particular chemical. In contrast, MSD risk requirement for effective MSD risk is influenced by a large and diverse range management is a multidisciplinary, ho- Development of a Toolkit to of hazards as described above. Further, it listic approach that assesses and controls support MSD Risk Management has been shown that interactions between risk from the particular combination of A review by Macdonald & Evans (2006) of a number of hazards and related factors workplace causal factors found to be rele- the methods available for assessing MSD can substantially affect MSD risk (Ber- vant in a given situation. In addition to its risk concluded that none of the existing nard, 1997; Marras, 2008; National Re- basis in research evidence of the causes of tools provided comprehensive coverage search Council, 2001) Consequently, work-related MSDs, this requirement was of all the main MSD hazards. The toolkit the extent of exposure to a particular also identified by the European Agency project described below should help to hazard, if considered independently of for Safety and Health at Work (European address this problem. other exposures, is not necessarily a good Agency for Safety & Health at Work, The International Ergonomics indicator of overall MSD risk. 2008) in a review of research evidence Association (IEA) is a member of the World Importantly, this means that MSD risk concerning the effectiveness of workplace Health Organisation (WHO) network of cannot be adequately assessed simply interventions to reduce MSD risk. Their Collaborating Centres in Occupational by assessing the severity of each hazard report stated that: Health, and as part of its contribution to this in isolation from the other hazards network it is currently supporting a project present – which further implies that … interventions that are based on sin- to formulate, implement and evaluate a the output of many existing methods gle measures are unlikely to prevent toolkit to support more effective MSD risk for assessing risk related to adverse MSDs, but … a combination of sev- management. At a meeting during the 2009 postures or biomechanical load should be eral kinds of interventions (multidis- IEA Congress in Beijing it was agreed understood as an indication of the severity ciplinary approach) is needed, includ- that prescriptive guidance focusing on or ‘riskiness’ of the particular hazard, ing organisational, technical and per- risks from single hazards, out of context, rather than as an indicator of overall sonal/individual measures. It is not is inappropriate, and that the WHO con- MSD risk. known how such measures should be cept of such a toolkit was applicable here. combined for optimal results. (p.34) That is, it should be practicable and user- Requirements for effective MSD friendly advice for non-experts to apply in risk management The report concluded that strategies ordinary workplaces, without expert assis- The conventional approach to OHS needed to be tailored and participative in tance; required training or guidance mate- risk management has been to focus on their approach to maximise effectiveness. rials should be included within the toolkit.

10 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013

It should explain basic MSD risk manage- tools (e.g. OCRA Checklist, RULA, etc) evaluate the success of interventions ment requirements and the general pro- should be included via links to web- and identify potential barriers to cesses to be followed, based on a specified based resources, or when necessary in an implementation of controls. conceptual model grounded in current re- appendix. search evidence. Such an approach – focusing on Acknowledgements Among the most important intended users principles and general processes rather Support for the Australian research of such a toolkit are people in emerging than on details regarding specific tools or program outlined in Section IV has been economies and developing nations, and interventions – is particularly important in provided by SafeWork Australia and in those in small and medium enterprises. the case of MSD risk management, given part by funding of a Development Grant The toolkit should assist such users to the need to consider a very wide range from WorkSafe Victoria and the Transport work through the full risk management of potential hazards for each of which Accident Commission (TAC), through the cycle within their own workplace, as the potential means of reducing risk are Institute for Safety, Compensation and shown in Fig. 3. It can be seen there that likely to depend on the specific workplace Recovery Research (ISCRR). worker involvement is central to the risk context. management process – consistent with a For example, a current IEA References ‘participative ergonomics’ approach and “Lighthouse” project in Nicaragua Australian Safety and Compensation Council. under the leadership of Dr Barbara (2006). Work-related musculoskeletal Silverstein, conducted in collaboration disease in Australia. Commonwealth of Figure 3. with the University of Nicaragua-Leon Australia, ISBN 0 642 326770. The WHO risk management and a local organisation (Pueblos en Bernard, B. (Ed.). (1997). Musculoskeletal framework for use in toolkits. Accion Communitaria), has focused on disorders (MSDs) and workplace factors. Cincinnati: National Institute for (From a WHO network draft assessing and reducing risk stemming Occupational Safety and Health. document) from equipment design, since this type Cole, D., Rivilis, I., van Eerd, D., Cullen, of intervention was most immediately Mobilize K., Irving, E., & Kramer, D. (2005). practicable in the local context. The project Effectiveness of participatory ergonomic Improve Assemble team and representatives of the workers interventions: a systematic review. Institute Leadership together developed new coffee harvesting for Work and Health. Toronto, Ontario Engagement bags to replace the baskets traditionally Cox, T. (1978). Stress. London: Macmillan Evaluate ETHICS Assess used when harvesting coffee in Nicaragua. VALUES Eatough, E., Way, J., & Chang, C. (2012). Project aims were to reduce current high Worker Understanding the link between Involvement levels of back and shoulder MSDs, and to psychosocial work stressors and work- related musculoskeletal complaints. Do Prioritize improve productivity. The methods used were highly participatory, with workers Applied Ergonomics, 43(3), 554-563 Plan contributing actively to both the design European Agency for Safety & Health at Work. and evaluation of the new bag. Production (2008). Work-related musculoskeletal of the new bags will commence once they disorders: Prevention report. Luxemborg. Office for Official Publications of the the need for customization of interventions have been further field tested during the European Communities. as discussed above. Fig. 3 also specifies 2011/2012 harvest. European Agency for Safety and Health at the importance of leadership engagement, Work. (2010). OSH in figures: Work- based on research evidence from many Conclusions related musculoskeletal disorders in the EU sources concerning requirements for The evidence reviewed in this paper and - facts and figures. Luxemborg. effective OHS interventions. the research program outlined provides Haines, H., Wilson, J., Vink, P., & Kongsveld, At the 2012 IEA Congress a meeting of support for a change in the way MSD risk E. (2002). Validating a framework for the MSDs Technical Committee, which management is approached. The literature participatory ergonomics. Ergonomics, has responsibility for this project, it was provides unequivocal support for a 45(4), 309-327 agreed that it would be inappropriate for multidimensional approach to MSD risk Hignett, S. (2003). Intervention strategies to this toolkit to recommend any specific tool management that includes identification reduce musculoskeletal injuries associated as the most appropriate for a particular and subsequent control of both physical with handling patients: A systematic review. Occupational and Environmental purpose. Similarly, a 2012 meeting of the and psychosocial hazards and risks. The Medicine, 60(e6) WHO network of Collaborating Centres toolkit approach outlined in this paper Kuorinka, I., & Forcier, L. (1995). Work-related in Occupational Health agreed that such a is one way to achieve these goals. If we musculoskeletal disorders: A reference toolkit should focus on the underpinning are to effectively reduce MSD risks and book for prevention. London: Taylor & principles and processes to be followed, subsequent claims we need to adopt new Francis rather than specifying details related to a practices using an evidence informed Leka, S., & Cox, T. (2008). PRIMA-EF: particular tool. Rather, details of particular approach. More work is required to Guidance on the European Framework

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 11 for Psychosocial Risk Management. World Whysall, Z. J., Haslam, R. A., and Haslam, C., Health Organisation. http://www.who.int/ . (2004). Processes, barriers, and outcomes occupational_health/publications/PRIMA- described by ergonomics consultants in EF Guidance_9.pdf preventing work-related musculoskeletal Macdonald, W., & Evans, O. (2006). disorders. Applied Ergonomics, 35, Research on the prevention of work- 343-351 related musculoskeletal disorders: Stage Wilson, J., & Haines, H. (1997). Participatory 1 literature review. Retrieved August ergonomics. In G. Salvendy (Ed.), 2012 http://www.safeworkaustralia.gov. Handbook of human factors and au/AboutSafeWorkAustralia/WhatWeDo/ ergonomics (pp. 490-513). New York: John Publications/Documents/512/Research_ Wiley & Sons Prevention_Workrelated_Musculoskeletal_ World Health Organisation. (2003). The bur- Disorders_Stage_1_Literature_review.pdf den of musculoskeltal conditions at the Macdonald, W., Evans, O., & Armstrong, start of the new mileninum. Technical Re- R. (2007). A study of a small smale port Series 919. Geneva: World Health of workpaces in high risk industries. Organisation (p.158). http://www.latrobe.edu.au/ergonomics/ attachments/stage2-report-ssos.pdf (accessed 30th April 2012) Macdonald, W., Munk, K., & Evans, O. (2003). Ergonomics approaches to the prevention of work-related musculoskeletal disorders. An analysis and critical review of existing national, and regional standards and guidelines: A report prepared on behalf of the International Ergonomics Association for the International Labour Organisation. Marras, W. (2008). The working back: A systems view. New Jersey: John Wiley Marras, W., Cutlip, R., Burt, S., & Waters, T. (2009). National occupational research agenda (NORA) future directions in occupational musculoskeletal disorder health research. Applied Ergonomics, 40(1), 15-22 National Research Council. (2001). Musculoskeletal disorders and the workplace: Low back and upper extremities: National Academy Press. Nelson, D. I., Concha-Barrientos, M., Driscoll, T., Steenland, K., Fingerhut, M., Punnett, L., et al. (2005). The global burden of selected occupational diseases and injury risks: Methodology and summary. American Journal of Industrial Medicine, 48(6), 400-418 Safe Work Australia. (2012). Compendium of Workers’ Compensation Statistics Australia 2009-10. Canberra, Australia. http://www. safeworkaustralia.gov.au/sites/SWA/ AboutSafeWorkAustralia/WhatWeDo/ Publications/Documents/661/Compendium 2009_10 report.pdf. (Accessed October 19, 2012). Schoenfisch, A. L., & Lipscomb, H. (2009). Job characteristics and work organization factors associated with patient-handling injury among nursing personnel. Work: A Journal of Prevention, Assessment and Rehabilitation, 33s(1), 117-128

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UV Radiation exposure among throughout their period offshore. Off the Western Australia coast, in off-shore petroleum workers in particular Karratha which is situated Western Australia: A pilot study within the tropic of Capricorn and located at 20.7°S, 116.8°E, is a key region for drilling and exploration of oil and gas. Nataša Rizmanoska1,2 and Joseph Maté1,2 Australia’s offshore petroleum industry is vast and the workforce is continually Abstract growing with greater number of workers There is strong evidence to suggest that prolonged exposure to ultra violet radiation in this region being exposed to high (UVR) can increase the development of melanoma. With minimal protection against or extreme levels of UVR (Bureau of sun and concomitant UVR reflection from the ocean surface, offshore platform workers Meteorology, 2011). are highly exposed. To quantify UVR exposure among petroleum workers during spring Information on UVR exposure in the in accord with the universal UVR index scale, five Integrated Ratings workers and offshore industry is limited. For exam- five Roustabout workers on a petroleum platform wore a personal UVR data logger ple, the nearest weather station to off- throughout their work shift. An additional logger was placed in direct sunlight through shore drilling areas in the Karratha region the day to serve as a control. The Integrated Ratings and Roustabout workers did not is at the town itself, over one hundred ki- receive (P<0.05) the maximum potential UVR exposure as measured by the control. lometres away (weather station number –

Mean UVR exposure values between groups were different (P<0.05) with Roustabouts 004083) (Bureau of Meteorology, 2012). receiving greater UVR exposures. Mean control UVR index values were 11 while The local weather reports and more spe- mean Integrated Ratings and Roustabouts UVR index levels were 6 and 9 respectively. cifically UVR index readings may not Although workers perform their respective jobs within a limited work area, lower quanta provide accurate UVR predictions which of UVR was measured for both groups compared to the control; however, the risk of relate to production platforms. Therefore, extreme exposure is possible. Therefore, vigilance to UVR exposure and protection is the aim of the study was to provide the necessary amongst all groups especially in the summer months. Australian offshore industry with baseline UVR levels during the spring season.

Introduction Methodology Health effects as a result of exposure to Subjects greater and prolonged intensities of UVR Ten off-shore oil production workers can include skin cancers, photokeratitis, volunteered to participate in the study cataracts, photodermatoses (ARPNSA, following the approval being given by the 2006) and erythema (Vecchia et al , 2007). Edith Cowan University research ethics Cite this article as: In 2007, more than 1,700 Australians died committee, and platform managerial Rizmanoska, N. & Mate, J., (2013), from skin cancer of which, approximately staff. Data collection took place during UV Radiation exposure among off-shore 99% of the non-melano skin cancers and the third week in September of 2011 petroleum workers in Western Australia: 95% of the melanomas were the result which coincides with the spring months A pilot study, J Health & Safety Research of direct exposure to UVR (Safe Work in the southern hemisphere. Operations & Practice, 5(2), 13-17 Australia, 2010). undertaken on the platform during this The Australian Radiation Protection month were typical of required general Keywords: and Nuclear Safety Agency (ARPNSA) duties of daily operations. Spring was sun exposure, oil and gas, UVR indicated that outdoor workers experience selected for data collection so that minimal exposure, off shore, Western Australia five to ten times more UVR than those UVR exposure levels could be measured. who work indoors (Safe Work Australia, Volunteers were divided into two simi- Correspondence: 2010). In the building and construction lar exposure groups (SEG’s) whose duties Joseph Maté industry in Queensland, it was found require them to predominately be outside School of Exercise and Health Sciences that 90% of outdoor pavers and tilers on the production platform deck in di- Edith Cowan University experienced the highest levels of UVR rect sunlight. Duties include but are not 270 Joondalup Drive and also exceeded the daily recommended limited to; lifting operations (crane oper- Joondalup, WA, Australia 6027 exposure limits (Gies et al., 2009). The ations), painting, and general deck main- E-mail: [email protected] offshore oil and gas industry provides a tenance. One SEG was the Integrated similar work environment where direct Ratings (n=5) and the other Roustabouts 1 School of Exercise, Biomedical and Health Sciences UVR exposure is common and, depending (n=5). The Integrated Ratings are respon- Edith Cowan University Joondalup, WA, Australia 2 Occupational Health Research Group Edith Cowan on the offshore workers’ location, there is sible for over-seeing general maintenance University Joondalup, WA, Australia a potential for significant UVR exposure of the decks and daily lifting operations

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 13 while the Roustabouts conduct most of the was placed on the helideck after volunteers was set at an α level of 0.05. If differences daily maintenance tasks. had been fitted with loggers. Prior to the were observed, a Tukey’s post-hoc anal- The Integrated Ratings and Roustabouts departure or arrival of a helicopter the ysis was performed. Morning and after- typically work a twelve hour day. Integrat- control was removed and then replaced noon comparisons were made within each ed Ratings work 2400hrs to 1200hrs and so it did not get damaged. During the group by using a student’s t-test. All anal- the Roustabouts 1200hrs to 2400hrs. The period control logger was removed from ysis was performed using IBM SPSS sta- operations on board are 24 hours but the the helideck, every attempt was made tistics software version 19. 1800hrs to 0600hrs shift was not investi- to keep it exposed to direct sunlight. gated as they predominantly are in darkness Control measurements took place from Results and early hours of the day where the UVR 0600hrs to 1800hrs. Data collection took Duration of Possible Exposure exposure is considered minimal. With the place during September which equates to Total maximal UVR exposure for the Roustabouts working approximately half the beginning of the spring season in the morning was represented by the control of their work shift in the dark, UVR mea- southern hemisphere. measurement (324.8 ± 29.0 min) with surements were performed in two sections; the mean Integrated Ratings (IR) and morning measurements were collected be- Data Analysis Roustabout (RA) UVR exposures tween 0600hrs to 1200hrs while the after- Data was collected in thirty second inter- measured to be 247.3 ± 80.5 min and noon measurements were collected between vals throughout the work day, which was 228.5 ± 55.3 min respectively. Roustabout 1200hrs to 1800hrs. manually smoothed by removing noise exposure was significantly less (P<0.05) and indoor recordings and then averaged than IR and control. No UVR exposures Equipment into 15 min intervals. When generalis- differences were measured between IR and Personal UVR data loggers (UVMicrolog, ing results for the entire platform, both control (P>0.05). During the afternoon Germany) were used to monitor workers’ Integrated Ratings and Roustabouts were portion of the work shift, exposure to UVR exposure during the work shift. The combined to produce a new group; IRRA UVR were not different (P>0.05) between loggers were worn around the participants’ (n=10). The UVR measurements are pre- IR, RA and control; 206.5 ± 65.3 min, upper arm and one logger was placed on sented in accordance to the universal UVR 250.5 ± 36.3 min and 325.0 ± 30.1 min the helideck as a control. Index scale (WHO). The UVR Index val- respectively. Exposure to UVR intensities ue of 0 indicates absence of UVR whereas in the morning and afternoon were similar Protocol a hypothetical value of 11 indicates an ex- within SEG’s. Approximately 73 to 76% At the beginning of the work shift, treme level of UVR. A one-way repeated of control measurements were observed volunteers were fitted with the data logger measure ANOVA was employed to de- to be in the extreme (11+) range, IR were and instructed to log the time they entered termine if any differences were recorded measured a high (6 – 7) for 82 to 85% of and exited indoor areas which included between SEG’s and control in UVR ex- the shift and RA was measured as very acquiring work permits, rest periods and posure measurements during the morning high (8 – 10) intensities for 75 to 96% of bathroom breaks. The control data logger and afternoon time periods. Significance the work day. The mean percentage of time during the Table 1. work day which workers were exposed Percent of work day exposed to various categories of UVR to each UVR category as defined by the Australian Bureau of Meteorology (BOM) (Bureau of Meteorology, 2006) can be seen in Table 1. UVR measures in categories 1 – 2 (low) and 3 – 5 (moderate) were not observed during this data collecting period. The greatest UVR exposure duration in the work day for CON was measured to be extreme (11+) with IR being 6 – 7 (high) and RA 8 – 10 (very high) ranges. The aggregate of IR and RA UVR exposure was nearly equally divided between UVR categories of high and very high.

UVR Intensities Minimal UVR measurements were recorded at dawn and dusk. Peak/maximal values were not observed at the sun’s

14 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013 zenith due to cloud cover. This can be Figure 1: seen in Figure 1A. Despite the same Mean UVR measurements from beginning to end of work day exposure duration between SEG’s, UVR Note: Integrated Ratings (IR), Roustabouts (RA) and amalgamation of Integrated Ratings and Roust- exposures between Integrated Ratings and abouts (IRRA) Roustabouts were different (P<0.05) with Roustabouts receiving higher levels of exposure. When combining SEG’s, UVR exposure values were different (P<0.05) to the control. In Table 2, the recorded UVR means between Integrated Ratings and Roustabouts was approximately 2 and 3 for the morning and afternoon time periods respectively. The mode UVR measurements for Integrated Ratings, Roustabouts and IRRA were 6, 9 and 6 respectively for both morning and afternoon time periods.

Discussion The overall aim of this study was to quantify the levels of UVR exposures experienced by workers in the offshore petroleum industry. There were three major findings within this study. Firstly, the maximum possible UVR exposure levels as based on control readings were not achieved by either SEG; secondly, duration of exposure to UVR levels was different between SEG’s and lastly, the exposures to the upper portion of the UVR intensity scale were different between SEG’s and significantly less than control. Work in the off shore petroleum industry requires the personnel to be apt at performing many different types of tasks and consequently, this entails Table 2. personnel moving around both inside Descriptive analysis of exposure to UVR in index units and outside on the platform. These continuous movements subsequently reduce the risk of exposure to high levels of UVR. Each SEG wore similar types of clothing/personal protective equipment (full length coveralls, hard hat, gloves, protective eyewear and steel capped boots). Therefore, the amount of skin which could possibly be exposed to UVR or additional PPE such as sun block and/or personal protective equipment (PPE), was the same amongst all participants. As wide brimmed hats should be considered. education (Occupational Safety and each SEG are well protected (Gies et al., Exposures to UVR throughout the Health Act 1984) and experience, the 2009) against UVR with 100% of work work day by each SEG were significantly use of additional PPE such as sun block clothes being compliant, faces and hands less than the control but similar to each was limited amongst this cohort. This were therefore intermittently exposed and other. Of a possible 100% exposure as practice coincides with the findings is assumed to be equal between groups. compared to the control values, Integrated of Stepanski and Mayer (1998) who To further attenuate UVR exposure Ratings workers received more exposure noted that the majority of United States while working, erecting work canopies to (19 min) than Roustabouts’s. Despite transportation and postal workers did not provide shade, modification of work shifts having sufficient sun safety knowledge, protect their faces and forearms while

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 15 working. The International Commission UVR levels while the afternoon exposures which increases the likelihood of workers on Non-Ionizing Radiation Protection were 0.52, 0.79 and 0.67 respectively. being over exposed to excessive UVR suggests that in instances where protective Thus, workers are being exposed to UVR levels. With the data collecting period coverings are insufficient in providing levels less than the recorded maximum. being conducted during the spring, protection for exposed skin (i.e. face and From our findings, the mean UVR in- the risk of greater levels of exposure neck) then the use of topical sunscreen tensity measured by the control moni- during the summer months is probable. should be encouraged (ICNIRP, 2004). tor was 11+ (extreme), 6 - 7 (high) for Therefore, additional monitoring of UVR With extended UVR exposure dura- Integrated Ratings and 9 (very high) for during each season is suggested in order tions, it was recommended by Kütting and Roustabouts. According to the Australian to better describe the UVR exposure Drexler (2010) that UVR be avoided as it Radiation Protection and Nuclear Safe- levels for off shore workers. Health is a potential risk factor for non-melano- ty Agency (ARPANSA), the limit of di- promotion interventions targeting the use ma skin cancer. Elimination of UVR ex- rect sun exposure at the respective UVR of sunscreen, PPE and appropriate hats posure is not practical as operations and intensities are approximately 7, 13 and 9 should also be implemented. maintenance must be conducted. How- minutes respectively (ARPANSA, 2006). ever, when possible those tasks which With Integrated Ratings working predom- expose workers to direct UVR should inantly during daylight hours (dawn to be performed at dusk, dawn or evenings dusk) and Roustabouts spending 6 hours where UVR levels are the lowest or ab- of either finishing or beginning the their sent. When a task of high importance work shift during peak UVR intensi- is required and its delay is not possible, ties, the likelihood that they will exceed workers should be encouraged break regu- these exposure times are great (Lucas et larly or minimise UVR exposure by work- al, 2006). In addition to the length of the ing under a canopy (Weber et al., 2007). workday, the geographic location of this Exposure durations to the varying UVR production platform, will typically experi- intensities were different (P<0.05) be- ence very high to extreme levels of UVR tween SEG’s. Integrated Ratings’ UVR (Bureauof Meteorology, 2011, 2012) irre- exposure was less than that experienced spective of season. With the high and very by Roustabouts during the first and last high levels of UVR measured in our study, quarter of the work day. Integrated Rat- summer UVR measurements are expect- ings were also recorded to be less exposed ed to be even greater. Therefore, workers to UVR 11+ (extreme) than Roustabouts. need be aware of the risks associated with From these results, the time of day when UVR exposure when working outdoors. work is conducted is an important factor The findings of this pilot study high- to consider as the intensity of solar UVR light Integrated Ratings and Roustabouts typically peaks between the hours of 1000 in the off shore production platform in- hr and 1600 hr (Césarini, 2001). Work- dustry are generally exposed to solar UVR ers are exposed to periodic doses of UVR loads that are classified as high or very throughout the day and pending task as- high during the beginning of spring; how- signment, the exposure intensity will vary. ever, the potential for exposure to extreme This variability in UVR exposure within UVR levels still exists. Future investiga- each group is highlighted in the standard tions which include larger and different deviations depicted in Figure 1A and 1B. cohorts are recommended to confirm the Variability in UVR exposure between findings. Additionally, those platforms SEG’s has been seen in other industries which are situated in the northernmost re- where workers are in close proximity to gions of the North West Shelf and summer one another. Gies et al (2009) observed recordings would increase the scope and a median range of 1.14 times to 0.015 understanding of UVR exposures in plat- times the possible ambient exposure lev- form personnel. els among construction workers with most measurements being approximately 0.30 CONCLUSION times the recommended exposure levels. Both groups studied spent the majority of Similar to Gies et al (2009), this study their work day at UVR levels classified identified Integrated Ratings, Roustabouts as high or very high. Peak UVR levels and IRRA groups morning exposures to during the collection period were be 0.55, 0.83 and 0.71 times the control recorded between 1000hr and 1600hr

16 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013

REFERENCES workers. J Occup Environ Med, 40(1), ARPNSA (Australian Radiation Protection 43-48. and Nuclear Safety Agency). (2006). Vecchia P, Hietanen M, Stuck BE, van Deventer Radiation Protection Standard: E, & Niu, S. (2007). Protecting Workers Occupational exposure to Ultraviolet from Ultraviolet Radiation. Geneva: Radiation Radiation Protection Series (Vol. International Commission on Non-Ionizing Publication No.12.). Barton, Australia: Radiation Protection in collaboration with Australian Radiation Protection and International Labour Organization & World Nuclear Safety Agency Health Organization. Safe Work Australia. (2010). National hazard Weber, M., Uller, A., Schulmeister, K., exposure worker surveillance: Exposure Brusl, H., Hann, H., & Kindl, P. (2007). to direct sunlight and the provision of sun Outdoor Workers’ Acceptance of Personal exposure in Australian workplaces. Barton, Protective Measures Against Solar Australia: Commonwealth of Australia. Ultraviolet Radiation. Photochemistry and Bureau of Meteorology. (2011). Twelve monthly Photobiology, 83(6), 1471-1480. solar exposure for Western Australia. WHO (World Health Organization) (2012). Retrieved April 2011, from http:// Ultraviolet radiation and the INTERSUN www.bom.gov.au/jsp/awap/solar/index. Programme, WHO, Geneva. http://www. jsp?colour= colour&time =history%2Fwa who.int/uv/intersunprogramme/activities/ %2F2011040120110930&step=1&map=so uv_index/en/. larave&period=12month&area=wa Bureau of Meteorology. (2012). Monthly climate statistics for “Karratha Aero”. from http://reg.bom.gov.au/climate/averages/ tables/cw_004083.shtml Césarini, J. (2001). Impact of ultraviolet radiation on humans. Indoor Built Environment, 10(5), 310-316. Gies, P., Watzl, R., Javorniczky, J., Roy, C., Henderson, S., Ayton, J., et al. (2009). Measurement of the UVR Exposures of Expeditioners on Antarctic Resupply Voyages[dagger]. Photochemistry and Photobiology, 85(6), 1485-1490. doi: 10.1029/2005jd005857. ICNIRP (International Commission of Non- Ionizing Radiation Protection). (2004). ICNIRP Guidelines on limits of exposure to ultraviolet radiation of wavelengths between 100nm to 400nm (incoherent optical radiation). Health Physics, 87(2). . Kütting, B., & Drexler, H. (2010). UV-induced skin cancer at workplace and evidence- based prevention. International Archives of Occupational and Environmental Health, 83(8), 843-854. doi: 10.1007/ s00420-010-0532-4 Lucas, R., McMichael, T., Smith, W., & Armstrong, B. (2006). Solar Ultraviolet Radiation: Global burden of disease from solar ultraviolet radiation. Geneva; World Health Organization;. viii, 250 p McKenzie, R., Connor, B., & Bodeker, G. (1999). Increased Summertime UV Radiation in New Zealand in Response to Ozone Loss. Science, 285(5434), 1709- 1711. doi: 10.1126/science.285.5434.1709 Occupational Safety and Health Act 1984. Stepanski, B. M., & Mayer, J. A. (1998). Solar protection behaviors among outdoor

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 17 Simplified noise labelling for plant seen. In Australia such labelling is not or equipment used in workplaces mandatory. Those responsible for workplaces Warwick Williams1 & Zoran Sukara2 are required to provide appropriate information to workers to make them Abstract aware of noise hazards and minimise In a co-operative project, the National Acoustic Laboratories and WorkCover New excessive noise exposure. One method South Wales developed ‘A practical guide for assessing noise generated by plant or of providing appropriate information equipment in the workplace’. The guide provides the users of plant or equipment with could be to label plant or equipment after a labelling system. The aim of labelling is to indicate the approximate level of noise conducting noise assessments. Combined that plant or equipment generates while in operation through the display of a coloured with effective control measures provided label at a prominent location on the plant or equipment itself. A before-and-after study by management, such as ‘buy quiet’ was implemented to assess changes and effects with respect to workplace noise through procedures for plant and equipment, the introduction of the guide and the labels. The results indicate statistically significant workers provided with information may changes in workplace noise assessments; the use of noise labels; the inclusion of noise have increased self-efficacy and thereby at site induction and training; and noise assessments of plant or machinery newly initiate some preventative noise exposure introduced to the workplace. Workplace management noted that individuals were more reduction action (Gilliver & Williams: aware of workplace noise with the labels acting as gentle reminders. 2009). Previous investigations have shown that excellent improvement in protective behaviour involving the use of personal protective equipment and through the Introduction use of engineering and administrative In Australia designers, manufacturers, noise exposure reduction techniques suppliers, importers and installers of plant can be gained with the provision of that could be used for work must ensure simple information (Williams: 2004). that noise emission from that plant is as This behaviour will not necessarily be low as is reasonably practicable (Work further improved with the presentation of Safe Australia: 2012) with the ultimate more detailed and complex information aim of reducing noise, noise injury (Williams, et al: 2004; Williams et al: (Williams: 2004) and hearing loss in the 2007; Safe Work Australia: 2010). Thus workplace. the information on any labels should be WorkCover New South Wales’s simple and direct in nature acting as a (NSW) Code of practice “Managing form of ‘warning sign’ – a gentle reminder Cite this article as Noise and Preventing Hearing Loss at that preventative action may need to be Williams, W. & Sukara, Z., (2013), Work”, based on the national model code taken (Milhinch & Dineen: 1997). Simplified noise labelling for plant of practice from Safe Work Australia Burgess & Lai (1999) in their or equipment used in workplaces, (WorkCover NSW: 2011), requires a extensive study “Noise Management J Health & Safety Research hierarchy of control measures to be for the Building Industry” in NSW, & Practice, 5(2),18-22 followed for addressing noise starting recommended that along with the supply with elimination and ending with the of noise data and promotional material, Key Words provision of administrative controls and “… mandatory warning signs for noise noise exposure; noise labelling; noise personal protective equipment. The code hazard to be fixed to all plant … ” (p exposure reduction; construction also specifies the provision of information 77). While the new Work Safe Australia industry; utilities industry. to workers by various parties in the (2011) code of practice recommends that workplace, but does not specifically cover noise information should be provided Correspondence the issue of noise labelling for plant or to potential users of noisy machinery, Warwick Williams equipment in workplaces. there is no recommendation of a practical National Acoustic Laboratories There are existing International (ISO presentation for the every-day user to 16 University Avenue 7574) and Australian Standards (AS receive this information. Macquarie University 3781; AS 3782) concerning sound power During 2011 the National Acoustic Lab- NSW 22109 Australia emissions from plant and machinery. oratories (NAL) and WorkCover NSW, in Email: [email protected] However, these tend to be overly complex consultation with NSW construction and and difficult for everyday users in the utilities industry representatives, devel- 1 National Acoustic Laboratories workplace to use and interpret, are of oped a document named A practical guide 2 WorkCover Authority of NSW limited practical value and rarely, if ever, for assessing noise generated by plant or

18 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013 equipment in the workplace (available at - The division between potentially than 85 dB a green label is selected oth- NAL/WorkCover: 2011). The document hazardous and minimal potential hazard erwise a red label is selected. The labels contains practical direction on assessing is a measurement of the equivalent resulting from this process are to be dis- the noise emitted by plant or equipment continuous A-weighted noise level played as suggested in the guide. The two in the workplace; an outline for putting in (LAeq) of 85 dB based on an assumption labels available are presented in Figure 1. place appropriate control measures; and of an eight hour work shift; a simple, easy-to-understand noise label- - The measurement of the noise level is Figure 1: ling system. This labelling system indi- to be taken over a typical event duration Noise labels resulting from the labelling cates whether plant or equipment emits (for details see NAL/WorkCover: process as described in the text. a measured equivalent continuous A- 2011); weighted noise level (LAeq) of less than 85 - The measurement is to be taken dB or equal to or greater than 85 dB. For during what would be considered the this exercise the consideration of impulse noisiest activity of the item of plant or noise with the criteria of an LCpeak equal to equipment; or greater than 140 dB was not included. - There are two labels only; This paper reports the processes used to - One red indicating a potential hazardous develop the noise labels and an evaluation noise; and one green indicating minimal of their use in the workplace. potential hazard;

- The measured noise level (LAeq) is not Method displayed on the label; To develop the practical guide for assessing - The labels are different shapes noise generated by plant or equipment (rectangular and circular) to in the workplace and the labels, a series accommodate individuals who may be of consultative meetings including Work colour-blind; and Health and Safety (WHS) professionals - The date of testing is included on the from companies and unions involved in label. the construction and utilities industries Detail of the measurement process is were held during 2010 - 2011. These provided in the guide itself (NAL/Work- meetings included: WorkCover’s Industry Cover 2011). An iPhone® or iPad® App Reference Groups for both the construction modelled on the guide and developed and utilities industries; the Construction by one of the industry participants (Kell Safety Alliance; the Construction Safety 2012) is currently available to assist with Education Forum; and numerous interested this process. The methodology and pro- individual construction, utilities and plant cesses used in the guide were the result and equipment hire organisations. of extensive discussion, revision, com- The intention was to introduce the sim- promise and agreement during the consul- plified system of noise labelling outlined tative meetings. The resulting document in the guide to a selection of work sites was not intended to be scientifically exact for trialling and feedback from the indus- but rather to represent a risk management try participants. The labels were intend- approach to noise level measurement. ed to indicate at a glance whether an item Noise level measurements are required of equipment used in daily tasks exposed to be taken at four equally spaced loca- workers to hazardous noise levels. The la- tions around the particular machine of bels were not intended as a comprehen- interest and, if present, the operator’s po- This noise assessment tool was not de- sive source of information on the noise sition. The measurements are to be taken veloped to replace accepted rigorous engi- from the labelled item or as a replacement with a relatively simple sound level meter neering and scientific methodology (AS/ to current occupational noise management avoiding the expense of consultants and NZS 1269.1: 2005), but rather to provide procedures, but rather as a simple source highly technical equipment. The machine a simplified assessment method that can of information regarding the existence of is to be operating in an open area, free of provide a first line of action to noise expo- a possible noise hazard. The effectiveness other noisy machinery, under what would sure in the workplace. of the labelling was ascertained through a be considered typical operating conditions Input was also sought from those at- series of pre- and post-trial questionnaires in the workplace. tending the consultative meetings not only given to workplace participants. From the measurements above the loud- to develop the guide but also to assist with Some specific points to note with the est is selected to represent to noise pro- identifying work sites willing to partici- design of the labels are: duced by the machine. If the level is less pate in an intervention using the labelling.

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 19 To evaluate this intervention a question- Table 1: Table 2: naire was employed to compare pre- and Participant groups pre Questions with significant positive post-intervention beliefs, attitudes and be- and post demographic data. changes between pre- and post-test haviours. The questionnaire was devel- examination oped by NAL and employed questions Years in Significance Average age Years in Question current level (p) previously used in other research (Wil- (years) industry position liams: 2011; Gilliver & Williams: 2009; Workplace existing plant noise Pre-trial 0.004 Williams et al: 2004, 2007) 38.2 15.3 7.0 assessments (SD) (12.5) (11.7) (8.3) Noise labels used in The questionnaire was employed at the N = 32 0.007 participating sites pre and post implemen- workplace Post-trial 38.0 16.9 7.4 Noise covered in induction tation of noise labelling. It was distributed (SD) 0.021 (10.1) (10.0) (6.1) and training to individual workers and collected upon N = 29 Workplace new plant completion by the site works supervisors. 0.045 noise assessments The post implementation questionnaire was employed around three to four months post A t-test comparison of data summarised in Labelling is a good idea 0.061* I know the levels when implementation. Questions gathered demo- Table 1 showed with respect to age, work 0.093* graphic information (no personally identi- experience and current work position there to use HP fying details); information about hearing was no statistically significant difference Note: * not statistically significant at the p = 0.05 level health; knowledge and attitudes to noise in between the two groups. the workplace; and any preventative action Considering all participants in general, The assessment of plant and equipment for excessive noise exposure. the average age was 38 years (median 35) noise was seen to statistically significantly with a range of 22 to 60 years. Educational increase from pre- to post-trial results (p Subject recruitment background tended to be dominated = 0.004); the observation of noise labels Participants in the trial were employed in by ‘trade’ experience (19), ten having increased (p = 0.007): the inclusion seven organisations operating at 13 work Diplomas or Advanced Diplomas and of noise in induction and other on-site sites located within a radius of 150 km seven participants with formal education training increased (p = 0.021); and the from Sydney and included sites within to a minimum of year 10. The remainder observance of workplace noise level the Central Business District, metropoli- were a mixture of Higher School assessment increased (p = 0.045). tan and semi-rural areas. The participating Certificate and Certificate IV. Similarly there were positive trends, industries were self-nominating and while For questions that enquired about their though not significant at the 5% level: that they represented small, medium and large hearing health: 47% responded that they individuals should be concerned about ex- businesses from the construction (5) and felt they experienced hearing difficulties; cessive workplace noise; there was more utilities industries (2) no more than 20 in- 48% replied that family or close friends comprehension by individuals that hear- dividuals worked at any site. During the had told them that they thought that ing protectors were not necessarily the intervention two worksites closed leaving the participant had hearing difficulties; best solution to personal noise exposure 11 to participate in the post-intervention 52% experienced difficulty following a reduction; that it may be preferable to re- questionnaire completion. conversation in background noise; and duce noise levels in the workplace by The trials were run from late June until 35% experienced tinnitus to some degree. means other than hearing protectors; and early November 2011. Statistical analysis that workers are motivated to assist with was carried out using Statsoft® Statistica Questionnaire results solutions to workplace noise reduction. (Version 7). Ethics approval was obtained All respondents (pre- and post-) indicated While only 13% of respondents agreed from the Australian Hearing Human Re- that WHS was seen as a priority at their or strongly agreed that “it is difficult to search Ethics Committee. work site while the majority indicated that do my job while wearing hearing protec- noise levels of plant and equipment were tors”, statistically there was no difference Results & Discussion regularly assessed. Also noise was well between pre and post attitudes to hearing Participants understood to be a potential hearing health protector use (p = 0.45). Interestingly the In total 61 individuals took part, Thirty- hazard in the construction and utilities majority of individuals (80%) agreed with two (32) pre-intervention and 29 post-in- industries with only one response indicating the statement that “hearing protection is tervention questionnaires were completed noise was not such a problem “once you the best way to reduce exposure to noise”. by 59 males and, one female and one gen- got used to it”. Table 2 summarises the This is disturbing as clearly it would be der undeclared. Given the overwhelming significant changes in response to pre- and preferred that individuals did not see HP number of males in the sample there was post-labelling trial questions. use as the primary solution to noise expo- no attempt to examine gender differences. sure in their hierarchy of controls but this Table 1 provides the data on the two (pre is a discussion for another place. and post) groups. All questionnaire respondents indicated

20 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013 that occupational health and safety was a developed an ‘App’ currently suitable for addresses this point to some extent. priority in their workplaces. an iPad® or iPhone® which offers a semi- iii) The use of noise labelling does not automated process that produces a la- replace an appropriate risk assessment Post-trial discussions bel with a minimum of paperwork (Kell process as prescribed in the WHS A post-trial debrief discussion was held 2012). Regulation, but is useful in informing with those representatives (local managers The initial intention of equipment noise it and as a first approximation. and supervisors who did not complete the labelling was to inform individuals how iv) Plant and equipment can grow noisier questionnaires) from the construction and much noise can be expected from the use with ageing and wear to the extent utility companies that participated in the of a particular machine and that preventa- that after some time the label may labelling trial and who were instrumental tive action may be required. A secondary not be as accurate and additional in their organisations’ participation. This effect is to subtly raise the profile of noise measurements may be required. participation involved the introduction exposure as a workplace health hazard by v) The use of an App or this simplified of noise labelling to the site and the frequently presenting a small visible re- labelling system does not substitute distribution then collection of completed minder that noise exposure has a long for a survey complying with the questionnaires. During this process they term detrimental effect on hearing health. requirements and procedures as set gathered many formal and informal Individuals working in construction and out by AS/NZS 1269.1: 2005. comments and impressions from their utilities tend to be aware that long term respective workplaces, some of which are noise exposure is a WHS issue but ev- Conclusion recorded here. ery day on the job results in acute physi- The results of this project indicate that The strongest message from these dis- cal injury taking precedence over possible the introduction of a simple labelling cussions was that the labelling process action on long term, slow onset hearing system for noisy plant and equipment in essentially resulted in awareness raising, health problems (Milhinch & Dineen: the construction and utilities industries making noise more ‘visible’ in the work- 1997; Burgess & Lai; 1999; Gilliver & did have an overall positive effect on the place. In particular there was an increased Williams: 2009). awareness of noise exposure. Statistically awareness of noisy equipment as a work- significant changes were noted between place problem and the perspective that Limitations pre and post intervention in: workplace noise is a health problem as opposed to The limitations of the study were the noise assessments; the use of noise labels; an injury problem. This is significant be- number of worksites involved and the inclusion of noise at site induction and cause at construction awareness of noise the relatively short time available for training; and noise assessments of plant was also seen by many as being of long- workplace trials. Both of these factors or machinery newly introduced to the term benefit for the individual rather than were the result of the extended time workplace. The significant observations the short-term benefit for workplace com- absorbed through the consultation process from management and supervisors closely pliance. to arrive at an acceptable measurement involved with the workplaces was that There were two points commonly and labelling process. A balance needed individuals were more aware of noise and raised in connection with the use of the la- to be taken between those who desired the presence noise labels acted as a gentle bels. The first was ‘what do we do if there a precision process and those who saw reminder of the importance of hearing are multiple noisy items?’. While this is the need for simplicity of the application health maintenance. not currently addressed, the suggestion is process. This seems to have been done to set priorities from the noisiest and more satisfactorily without alienating too many Acknowledgements frequently used machines to the least used from either side. The authors would like to acknowledge and quietest then work on solutions for There are obviously some limitations the support and assistance of many replacement or relocation from the top to the application of such a simplistic organisations including: Built, Erraring of the list down. The second point raised noise labelling system itself. The most Energy, Hansen & Yunken, Kell & suggested that in the long term it would be important limitations are: Rigby, Paynter & Dixon, Sydney Water more satisfactory for the end users if the i) Occupational noise exposure should and Watpac. Also a special thanks to suppliers, manufacturers, distributors or be measured as close to the affected James Kell and Gary Mansfield for the installers could carry out the noise label- individual’s ear as possible. The development of the Construction Sound ling before purchase, hire or installation as actual noise emission of the item is Meter App®. is currently recommended in the new code not the prime consideration it is rather of practice (WorkCover 2012). the amount of noise the individual The only substantial complaint came receives. from those who saw more paperwork gen- ii) Noise exposure is dependent on the erated through the labelling process. This receiving individual’s location and point is, in fact, currently being addressed their surroundings, though setting by one of the companies involved who has minimum distances as the labels do,

Volume 5 Issue 2 • September 2013 Journal of Health and Safety, Research and Practice 21 References Australian/New Zealand Standard AS/ Safe Work Australia (2010) Occupational NZS 1269.1: 2005 Occupational noise Noise-Induced hearing Loss in Australia: management Part 1: measurement and Overcoming barriers to effective noise assessment of noise immission and control and hearing loss prevention, Safe exposure, Standards Australia, Sydney Work Australia, Canberra Australian Standard AS 3781: 1990 Acoustics Williams, W (1994) Noise Management in the - Noise labelling of machinery and workplace, Proceedings of the 12th Annual equipment, Standards Australia, Sydney Audiometry Conference of the Community Audiometry Association, Warwick Farm, Australian Standard AS 3782: 1990 Acoustics 12th - 14th October 1994 - Statistical methods for determining and verifying stated noise emission values Williams, W (2004) Instruction and the of machinery and equipment, Standards improvement of Hearing Protector Australia, Sydney Performance, Noise & Health 2004, Vol 7(25): 41 – 47 Burgess, M & Lai, J (1999) Noise Management for the Building Industry; Current practices Williams, W, Purdy, SC, Murray, N, Dillon, H, and practices for improvement, a report LePage, Challinor, K & Storey, L (2004) prepared under a grant (GR 96/0015) from Does the Presentation of Audiometric WorkCover NSW, Acoustics and Vibration Test Data have a Positive Effect on the Unit, ADFA, Canberra Perception of Workplace Noise and Noise Exposure Avoidance?, Noise & Health ISO 7574:1985 Acoustics - Statistical methods 2004, 6; 24, 75 – 84 for determining and verifying stated noise emission values of machinery and Williams, W, Purdy, S, Storey, L, Nakhla, M equipment, International Organisation for & Boon, G (2007) Towards more effective Standardisation, Geneva methods for changing perceptions of noise in the workplace, Safety Science, Vol 45, Gilliver, M & Williams, W (2009) Noise Issue 4, April: 431 – 4 exposure and the construction industry, J Occup Health Safety - Aust NZ, Vol 25(3): WorkCover NSW (2011) Managing Noise 187 – 196 and Preventing Hearing Loss at Work, WorkCover Authority of NSW, Sydney Kell, J (2012) Construction Sound Meter – an iPhone®, iPad®, iTouch® App accessed at Milhinch, J & Dineen, R (1997) Noise and Hearing in the Construction Industry – A study of workers’ views on noise and risk on a Victorian site, a report on a study funded by Incolink, Melbourne, Victoria (privately published) National Acoustic Laboratories – NSW WorkCover Authority (2011) A practical guide for assessing noise generated by plant or equipment in the workplace, available at National Occupational Health & Safety Commission (2000) Occupational Noise, National Standard [NOHSC: 1007(2000)], Canberra, ACT Safe Work Australia (2011) Managing Noise and Preventing Hearing Loss at Work - Code of Practice, Safe Work Australia, December 2011, Canberra

22 Journal of Health and Safety, Research and Practice Volume 5 Issue 2 • September 2013

Journal of Health and Safety, Research and Practice IS PUBLISHED BY THE SAFETY INSTITUTE OF AUSTRALIA LTD A publication for members of the Safety Institute of Australia Ltd