Evidence of heart attacks due to secondhand smoke

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According to a media release from the Institute of Medicine (IOM) in the United States, a new research report says:

“Smoking bans are effective at reducing the risk of heart attacks and heart disease associated with exposure to secondhand smoke, says a new report from the Institute of Medicine.  The report also confirms there is sufficient evidence that breathing secondhand smoke boosts nonsmokers’ risk for heart problems, adding that indirect evidence indicating that even relatively brief exposures could lead to a heart attack is compelling.”

iStock_000008022857Large match lowThe report claims to have undertaken “a comprehensive review of published and unpublished data and testimony on the relationship between secondhand smoke and short-term and long-term heart problems”.  It has looked at “animal research and epidemiological studies” and “data on particulate matter in smoke from other pollution source”.

The study was sponsored by the U.S. Centers for Disease Control and Prevention which has summarised the report on a new webpage.  SafetyAtWorkBlog has been unable to obtain a copy of the full report.

The report is unlikely to help those safety professionals who need to control the hazard of secondhand smoke in the workplace.  Legislation has been in some States of America for over thirty years identifying where people cannot smoke and around the world the major control measures are moving smokers outside and encouraging them to quit.

The IOM report seems to confirm the seriousness of the issue but provides no new ideas for control.  This would be like producing a new research report that says mercury, lead or asbestos are harmful – like duh?

US OSHA provides some data on legislative interventions on tobacco smoke but new information on this hazard in the workplace setting is thin.  The US Cancer Institute issued a monograph in 1999 defining ETS as

“…an important source of exposure to toxic air contaminants indoors. There is also some exposure outdoors in the vicinity of smokers.  Despite an increasing number of restrictions on smoking and increased awareness of health impacts, exposures in the home, especially of infants and children, continue to be a public health concern.  ETS exposure is causally associated with a number of health effects.”

More recent monographs are available at the Tobacco Control Research site.

The UK Health & Safety Executive provides this specific environmental tobacco smoke advice

  1. Employers should have a specific policy on smoking in the workplace.
  2. Employers should take action to reduce the risk to the health and safety of their employees from second hand smoke to as low a level as is reasonably practicable.
  3. Smoking policy should give priority to the needs of non-smokers who do not wish to breathe tobacco smoke.
  4. Employers should consult their employees and their representatives on the appropriate smoking policy to suit their particular workplace.

The status of workplace smoking and secondhand smoke in most westernised countries seems to have plateau-ed or perhaps got to the point where every control measure that is reasonably practicable has been done.

That people continue to die directly and indirectly from tobacco smoke illustrates the flaw in the reasonably practicable approach to safety legislation and management which is “so what do we do next?”  Perhaps the attention being given to nano particles may help but is it the particulates in secondhand smoke that is the problem or the fumes themselves? Regardless, a new approach is needed to control this persistent workplace hazard.  Shoving smokers onto the streets and balconies is not enough.

Kevin Jones

What Trevor Keltz gets right

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Madonna has just released another greatest hits CD.  Trevor Kletz has done similar in releasing the fifth edition of “What Went Wrong?” He admits that almost all of the content has appeared elsewhere.  It’s been almost 20 years since I had to read Kletz’s books and articles as part of working in a Major Hazards Branch of an OHS regulator in Australia.  Not being an engineer, the books informed me but were a chore.  This is not the case with the last edition.

Kletz has two parts to the book.  The first is a collection of short case notes recording as he says

“…the immediate technical causes of the accidents and the changes in design and methods of working needed to prevent them from happening again”.

The second discusses the weaknesses of management systems.  In short, the book reflects the expanding nature of safety management over the last forty years.  Kletz may be from the Olde School of safety engineers (he is 87 years old) but often one needs a fresh perspective on a profession and coming from a person with such extensive experience, Kletz is worth listening to.  Thankfully, he does not sound like a grumpy old man.

Kletz notes that process industry lessons seem to fade after a few years.  In my opinion this may be an effect of the transience of modern careers where corporate memory is often fragmented.  It may also be due to the shipping of manufacturing and process industries off-shore and the establishment of large complexes in countries with different (lax) safety requirements.  It may also be due to a corporate performance regime where maintenance is not valued or understood as that supports long term thinking rather than quite returns on investment.

Regardless of the cause, the short-term memory makes the need for such books as this as more important than never.

In anticipation of his look at management systems he notes in his preface, that management systems need maintaining and, more importantly, reading.  In some circumstances, too much faith is placed in the system (I would refer to the Esso Longford explosion as an example).  Kletz says all systems have limitations.

“All they can do is make the most of people’s knowledge and experience by applying them in a systematic way.  If people lack knowledge and experience, the systems are empty shells.”

What Kletz does not write about is human error because, as he says, “all accidents are due to human error”.  He avoids making the weak logic jump that the behaviouralists make where, “if all accidents are due to human error then fix the human and you fix the hazard”.  Kletz devotes a whole chapter to his classification of human errors as

  • Mistakes;
  • Violations or noncompliance;
  • Mismatches;
  • Slips and lapses of attention.

This edition of “What Went Wrong?” provides a baseline for the safety concepts we have come to accept but also a critical eye on safety and manufacturing management shortcomings.  The style is very easy to read although occasionally repetitive.  Thankfully the process technicalities are avoided unless they relate to the technical point Kletz is making.  I found part B hugely useful but it is recommended for all safety professionals.

Kevin Jones

When ATV helmets are “best practice”

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A recent media statement from the New Zealand Department of Labour on all-terrain vehicle (ATV) safety is annoying and disappointing.

On 15 September 2009, the Palmerston North District Court today fined farmer Trevor Mark Schroder $25,000 and ordered him to pay reparation of $20,000 to his employee John Haar over an  ATV accident on 26 November 2008 that left Mr Haar with serious head injuries.

Dr Geraint Emry, the DoL Chief Adviser for Health and Safety, says

“…Mr Haar was riding an ATV supplied by Mr Schroder when he apparently drove into a wire used to direct cows into specific areas of the farm.  Mr Haar had not been wearing a helmet and the severity of his injuries increased as a consequence.  Nor had he been told that the wire he rode into had been put across the race.”

atvguide2 coverThe statement goes on to state

“The Agricultural Guidelines – Safe Use of ATVs on New Zealand Farms – advise that the wearing of helmets by quad bike riders is considered best practice.”

SafetyAtWorkBlog strongly knows that New Zealand is very active in ATV safety but finds it hard to believe that the “wearing of helmets…is considered best practice”.  This admits that, in using ATVs, personal protective equipment is the best hazard control option available.

The guidelines mentioned above are from 2003 and do mention ROPS:

“Until such time as there is evidence to the contrary, farmers have the right to choose whether or not they fit ROPS to their ATVs.”

The NZ DoL and, by inference, the Chief Adviser are quoting a 2003 guideline as best practice in 2009?!

Relying on helmets may be the reality but is also an admission of defeat with ATV designers and manufacturer.  In many circumstances ATVs cannot be fitted with roll-over protective structures (ROPS) due to the nature of the work – orcharding for example.  But Australia and New Zealand insist on ROPS for tractors, with similar criteria and exceptions to ATVs.

VWA Farm_ROPs coverIn one ROPS FAQ from the NZ DoL it says

“Evidence both in New Zealand and overseas has shown that the risk of injury in a tractor overturn can be substantially reduced when the tractor is fitted with ROPS of the appropriate standard.”

and

“Where the nature of the operation makes it not practical for ROPS to be fitted to an agricultural tractor, then, under the terms of this code of practice, the General Manager, Occupational Safety & Health Service, may issue a notice excluding the tractor from the requirement to have a ROPS.”

Some States in Australia have had rebate schemes for ROPS for many years.

It is suggested that a better level of driver protection from rollovers is evident on forklifts through the use of seatbelt and an integrated protective structure.  Applying logic to safety is fraught with danger but the rollover hazard is the same whether in a warehouse or a paddock and having only a helmet for a forklift driver would be absurd and unacceptable.  Why is only a helmet considered best practice for ATV drivers?

Rather than comparing ATVs to motorcycles as in this 2003 report, the comparison should be between ATVs and tractors or, maybe, forklifts.

The New Zealand Transport Agency says this about ROPS and ATVs in June 2008:

Many ATVs have a high centre of gravity, and are prone to tipping over when cornering or being driven on a slope. Rollover is the leading cause of injury associated with ATVs – riders can be crushed or trapped under an overturned machine.

If you attach a rollover protection structure (ROPS) to your ATV, make sure it’s securely fastened, doesn’t interfere with rider mobility and doesn’t raise the ATV’s centre of gravity. Contact OSH for guidelines on how to fit ROPS safely, and make sure the ROPS is strong enough to protect you.

So why aren’t ROPS considered best practice by the DoL?

The ATV injury case quoted above is unlikely to have occurred if the ATV had some form of structure around the driver or, admittedly, the wire was more visible or known to the driver.  The relevance in this case was that the helmet most probably reduced the severity of the injury but would not have avoided contact with the wire.

Research is occurring on ROPS for ATVs but the rollover hazard has existed for as long as ATVs have existed.  Are ATVs simply unsuitable for the work they are being used for?  Is the design wrong for workplace use?  Are they being advertised or promoted for inappropriate use?  Should farm workers be encouraged legislatively or financially to fit ROPS?  Perhaps the only safe ATV is a tractor?

Is the requirement for ROPS for tractors, but only helmets for ATVs, an acceptable double standard for workplace safety?

Kevin Jones

Meditation is a proven stress reduction method for workplaces

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Meditation is not on the regular agenda at SafetyAtWorkBlog.  If there was time to meditate, the time would probably be spent losing weight in the gym but there is fascinating research that provides some evidence of meditation’s benefit  in reducing work-related stress.

At the Safety Conference in Sydney at the end of  October 2009, Dr Ramesh Manocha of Sydney’s Royal Hospital for Women will release research that

“found that after eight weeks of mental silence meditation training called sahaja yoga, occupational stress scores improved [decreased?] 26 per cent.  A non-mental silence relaxation program reaped a 13 per cent gain, while a waiting list control group lifted just 1 per cent.”

The language sounds slightly “new-age” but what makes the difference in this circumstance is that the initial research was undertaken with three groups mentioned above and, importantly, with a control group.

Below is a TV interview with Dr Manocha on the first stage of research.

When looking at workplace stress, people reduce stressors but Dr Manocha says this often requires impossible organisation restructuring due to internal political pressures.  These techniques can be applied on a personal level that employees can take with them through their various life-stages.

Dr Manocha then applied the meditation training in real corporate situations.  According to a media release provided in the lead-up to the conference:

“In a later field trial of mental silence meditation by 520 doctors and lawyers, more than half of the participants whose psychological state (K10) scores indicated they were “at risk” were reclassified as “low risk” after two weeks of meditation.”

It’s the application of this meditation in the workplace context that gained the attention of  SafetyAtWorkBlog and what will be presented at the conference.  The gentle skepticism evident in the TV interview above is understandable but in a time when safety professionals demand evidence, we must look seriously at evidence when it is presented.

More information on The Safety Conference is available HERE.

Kevin Jones

Learning Lessons from the Santika Nightclub Fire

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For many years SafetyAtWorkBlog and its forerunner Safety At Work magazine reported on various tragic fires in crowded nightclubs around the world.  Several in recent memory include the 2003 Rhode Island fire that killed 100 patrons and for which, according to an Associated Press report from the time,

Superior Court Judge Francis Darigan Jr sentenced 29-year-old Daniel
Biechele to 15 years, but suspended 11 years of that sentence, and
also ordered three years of probation.

“Superior Court Judge Francis Darigan Jr sentenced 29-year-old Daniel Biechele to 15 years, but suspended 11 years of that sentence, and also ordered three years of probation.”

A brief report on the Rhode Island fire is in the OSHA media archives.

In March 2006, Safety At Work included an AFP report saying

“The municipal council has impeached Buenos Aires Mayor Anibal Ibarra after finding him guilty of dereliction of duty following a December 30, 2004 nightclub fire that killed 194 people.”

An earlier report on the mayor’s response is include at the CrowdSafe website.

Engineering and design company ARUP have provided SafetyAtWorkBlog with an article that analyses recurring elements of nightclub fires using the Santika fire in Bangkok from 1 January 2009 as a most recent incident.  Below is the introduction to the article which can be found in full in the pages listed above.

Our thanks to ARUP for the terrific article.

Kevin Jones

LEARNING LESSONS FROM THE SANTIKA NIGHTCLUB FIRE

by Dr Marianne Foley and Travis Stirling, Arup Fire, Sydney

In the early hours of New Years Day 2009, fire engulfed Bangkok’s Santika nightclub, killing 64 people and injuring more than 200.  Our knowledge of the events of that night is based on media reports and publicly available information, and the precise cause of the fire is still unclear.  However, we do know that there are strong correlations between this and many similar tragedies at entertainment venues dating back as far as the first half of the twentieth century.  While we wait for the results of the official investigation and coronial enquiries, it’s timely to ask questions about these fires.  Why do they happen over and over again?  Why do so many people lose their lives?  What lessons can be learnt?  And what practical measures can be implemented to stop them happening?

RECURRING MISTAKES

Arup’s analysis of case studies has revealed six themes that commonly contribute to the severity of high-fatality nightclub fires: insufficient exits, the presence of highly flammable materials, a lack of good fire safety systems, confusing environments, pyrotechnics and open flames, and buildings used inappropriately and maintained poorly.  By addressing each of these themes, we aim to provide design solutions that could mitigate the risk of future nightclub disasters.

[The themes in the full article are

  • Insufficient exits
  • Highly flammable materials
  • Fire safety systems
  • Confusing environments
  • Pyrotechnics and open flames
  • Buildings used inappropriately or maintained poorly]