PHYSICAL HAZARDS
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Transcript of PHYSICAL HAZARDS
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PHYSICAL PHYSICAL HAZARDSHAZARDS
H.R.Sarreshtahdar, MDH.R.Sarreshtahdar, MD
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Physical hazards
Heat
Cold
Vibration
Radiation
Atmospheric pressure changes
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HEAT
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How does body get rid of heat?
Conduction
Convection
Radiation
Evaporation
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Factors affect body temperatureo Air temperature
o Radiation
o Air motion
o Humidity
o Type of clothing
o Time exposed
o Workload
o Age/sex/raceo Mass/weighto Health status
DiseasesDrugs
o Acclimatization status
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WBGT index The most important index of workplace
heat exposure
Calculation:
• Air temp.
• Air motion
• Radiant heat
• humidity
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Heat Balance
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Body response to heat
Peripheral vasodilatation
Sweating
Change in metabolic rate
Increased plasma & fluid volume
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Occupational exposure to heat
Outdoor
o Farmers
o Postage workers
o Ranchers
o Military personnel
o Fishers
o Construction workers
Indoor
o Foundry
workers
o Steel workers
o Oven/Furnace
workers
o Glassblowers
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Heat-related syndrome
Heat stroke
Heat exhaustion
Heat cramps
Heat syncope
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Heat stroke Signs and symptoms:
Cerebral dysfunction and altered mental status Hyperpyrexia (core temperature → 41.1°C) hot, dry skin (classic), or moist skin (exertional) Seizure, coma, tachycardia, hypotension
Laboratory: ↑leukocytes, ↓ serum K, Ca, P, ↑ BUN, CPK, ALT,
AST Concentrated urine with myoglobinuria, pr.uria,
tubular casts Hyperuricemia, DIC, thrombocytopenia
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Heat stroke Treatment: Rapid reduction of body temperature: In the workplace:
Shady cool place removing clothes use evaporative cooling (The best method):
spraying entire body with cool water, blowing cool air to the body Or Use ice packs, or water immersion
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PreventionPrevention Avoid reexposure to heat at least for 4 weeks
Work-rest regimens according to heat TLV
acclimatization
Engineering controls
Special suits
Shaded rest areas
Cool drinking water or electrolyte/carbohydrate
solutions
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Heat exhaustion Strenuous work in hot climates
Volume/electrolyte depletion
Core temperature > 38°C
Symptoms and signs:
Intense thirst, weakness, nausea, headache,
confusion, tachycardia, profuse sweating, moist skin
Important: may progress to heat stroke
Treatment: placing the patient in a cool and shaded
area, provide hydration and salt (oral or IV)
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Heat cramp Salt deficiency (replacement of sweat loss with
water) Symptoms and signs:Painful muscle contractions, weakness, nausea,
vomitingMoist and cool skinEuthermiaElevated CPKMove the patient to a cool environment + balanced
salt solutions (4tsp salt per gallon of water)1-3 days rest + salt supplementation
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Heat syncope
Sudden unconsciousness after strenuous
work
Cutaneous vasodilation
Cool, moist skin
Hypotension
Treatment:
cooling and liquids
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Prevention
Worker selection
Acclimatization
Work-rest cycles
Availability of cool places
Availability of cool drinks
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COLD STRESS IN THE WORKPLACE
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Body reaction to cold environment
Increase heat generation
Shivering
Decrease heat loss
Vasoconstriction
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Risk factors
Alcohol
Opium
CNS depresants
Alpha agonists & antagonists
Direct vasodilatator
Beta antagonists
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Cold-induced diseases
Systemic
Local
Freezing
Frost bite
Non-freezing
Immersion foot
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Systemic hypothermiaBody core T <35°C
Mild
Moderate
Severe
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Treatment
Remove wet garments
Protect against heat loss
Maintain horizontal position
Avoid excess movements
Monitor core temperature
Monitor cardiac rhythm
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Treatment Pulse present:
Adequate ventilation and O2 administration Electrolyte and acid-base correction Blood pressure correction Rewarming:
Passive rewarming Active external rewarming (warm blankets, warm baths) Active internal rewarming (blood, peritoneal dialysis,
heated air)
Pulse absent: CPR until core T> 35 rewarming
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PreventionPrevention Wind chill index
Temperature Wind velocity
Prevent core T from falling below 36°C Work-rest cycles according to WC index
and work intensity Suitable clothes Wind-protected, warm shelters Available hot food and drinks
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FrostnipFrostnipFrostnip is the freezing of upper layers of the
skin.
Characterized by:- white, waxy skin.- general numbness
Frostnip is generally reversible and does no major tissue damage.
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Frostnip - treatmentFrostnip - treatmentGently warm area by blowing warm air on it
or by placing it near a warm body part.
DO NOT rub the area! Rubbing can rupture frozen cells, causing extensive damage.
• Frostnip is a warning sign of possible frostbite
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FrostbiteFrostbiteFrostbite is a freezing of the surface and
deep layers of tissue.
Characterized by:- white, and feels “woody”- numbness, possible anesthesia- deep frostbite can affect bone and muscle- purple/black color is from ruptured blood vessels
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Frostbite - treatmentImmerse affected area in 40-42 degrees C
water until thawing is complete.- part will be extremely painful
Wrap affected part in sterile gauzeAffected part should not be used for
anything- keep part from refreezing
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Immersion Foot – trench footImmersion foot is caused by prolonged exposure of
the feet to wet, cool conditions.
Characterized by:- yellowish, smelly feet- possibly numb- sloughing of skin tissue/itching
*Immersion foot may cause permanent damage to foot tissues, leaving person susceptible to cold injuries in future.
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Immersion Foot - treatment- Careful washing and drying of feet.
- Keep feet dry as much as possible.
- Keep off feet as much as possible until healed.
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VIBRATION
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Types
Whole- body vibration
Segmental vibration
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WBV A kind of cummulative trauma
Jobs: drivers, miners, heavy equipment
operators
Frequency: 1 – 80 Hz (esp. below 20 Hz)
Two types: vertical (4-8Hz)
horizontal (1-2Hz)
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Disorders Musculoskeletal (LBP, Disk degeneration,
disk calcification, …) Neurological (decreased visual acuity,
Labyrinth disorders, insomnia,…) Circulatory Digestive Reproductive (abortion, congenital
malformation, …)
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Prevention
↓ exposure duration
↓ unnecessary exposures
Isolation
Careful maintenance of machines
Resting after exposure
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Segmental Vibration
Frequency: 5-5000 Hz (esp. 125-300 Hz)
Jobs: work with chain saw, grinder, sander,
pneumatic drill, jackhammer
Disorders: HAVS (Vibration-induced white
finger)
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HAVS A kind of secondary Raynaulds
phenomenon Signs and symptoms:
numbness and tingling → blanching →cyanosis → atrophy → ulceration → gangrene
Advanced disease: bone and cartilage degeneration, joint stiffness, clumsiness
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Treatment
Removing from more exposure
Massage, Shaking, Warm water
Nifedipine
PGE
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Prevention Better tool design
Anti-vibration gloves
HAV standards
Work practices
Medical surveillance
Work/rest cycles
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Work practices A/V gloves
Adequate clothing
Keep the hands warm
Avoidance from wetting the hands
Avoidance from smoking
Let the tool do the work
Maintain tools carefully
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Types of radiationTypes of radiation Ionizing
Electromagnetic energy X-ray Gamma ray
Subatomic particles Electron Proton Α particle
Non-ionizing
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Definition: energy in the form of particles or waves
Types of radiation Ionizing: removes electrons from atoms
Particulate (alphas and betas) Waves (gamma and X-rays)
Non-ionizing (electromagnetic): can't remove electrons from atoms
infrared, visible, microwaves, radar, radio waves, lasers
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Radiation wavelength in angstrom units
108 106 104 102 1 10-2 10-4 10-6
X-RaysRadio Infrared Visible
Ultra-VioletLight
Gamma Rays
Cosmic Rays
10-10 10-8 10-6 10-4 10-2 1 102
Photon energy in million electron volts (MeV)
22 4 10