Workplace skin cancer risk remains high

The July 2004 edition of SafetyATWORK magazine contained an interview with Sam Holt the CEO of Australian company Skin Patrol.  The fascinating service of Skin Patrol was that they travelled the outback of Australia with a mobile skin cancer testing unit.  That is a big area to cover but with the increasing incidence of skin cancer and the acceptance of ultraviolet exposure as an OHS problem, the service seemed timely.

(The interview is available HERE)

SafetyAtWorkBlog was contacted by Skin Patrol in early December 2009 as it was releasing the findings of a survey of 1,000 outdoor workers.  Its survey has these key findings:

  • 2.5 times the national reported incidence of malignant melanoma
  • One in 10 patients had a lesion highly suspicious of skin cancer
  • 26% of patients were diagnosed with moderate to severe sun damage
  • 70% of patients diagnosed with a lesion suspicious of skin cancer were aged 40 years or greater
  • Over 90% of workers who attended the Skin Patrol clinic because they were worried about a particular spot or the condition of their skin had not had their skin checked in the past 12 months prior to the onsite clinic.

The company’s media release also states:

“The incidence of melanoma for all Australians currently sits at 46 in 100,000, however for those that work outdoors that figure jumps to 100 in 100,000.”

The risks from exposure to ultraviolet are well established and our understanding of the risks have changed considerably within one generation.  The Australian culture has changed to one of sun-worshipping to one where the wearing of hats is enforced at school, hard hats have wide brim attachments, and outdoor work is undertaken in long pants and long-sleeved shirts.  Occupational control measures have been introduced.

Of course, particularly in the construction industry, principle contractors still struggle in a getting compliance with the UV-protection policies but that’s the case for many OHS policies.

Skin cancer risks through high UV exposure are well-established OHS Issues but the reality still does not mean that controlling the hazard is easy to manage.  Culturally we still want to have a tanned complexion even if it is sprayed on.  Tanned skin is still synonymous with good health even though the medical evidence differs.

Skin cancer risks in the workplace are simply another of those workplace hazards that are ahead of the non-workplace culture and that safety professionals need to manage.  The attraction with this hazard is that there is no disputing the evidence.

Kevin Jones

Shoemaking in South East Asia – book review

Some of the best OHS writing comes from the personal.  In a couple of days time a new book will go on sale that illustrates big issues from a niche context and brings to the research a degree of truth from the personal experiences of the author.

Pia Markkanen has written “Shoes, glues and homework – dangerous world in the global footwear industry” which packs in a range of issues into one book.  The best summary of the book comes from the Preface written by the series editors.

“Pia Markkanen’s extraordinary first hand investigation of the dangers of home work in the shoe industry in the Philippines and Indonesia is an important contribution to our understanding of work, health and the global economy. She also carefully documents the intersection of gender relations and hierarchy with the social relations of “globalised” economic development and reveal as the important implications for the health of women, men and children as toxic work enters the home.”

As one reads this book, local equivalents keep popping into the reader’s head.  For instance, Markkanen’s discussion of the home as workplace raises the definition of a “workplace” that is currently being worked through in Australia.  She briefly discusses the definition in her chapter “Informal Sector, Informal Economy” where she refers to an ILO Home Work Convention, and usefully distinguishes between the homeworker and the self-employed, a distinction that Australian OHS professionals and regulators should note.

Markkanen does not impose a Western perspective on her observations and acknowledges that regardless of the global economic issues and social paradigms, “shoemakers felt pride for their work”.  This pride goes some way to explaining why workers will tolerate hazards that others in other countries would not.  In many OHS books this element is often overlooked by OHS professionals and writers who are puzzled about workers tolerating exposure and who look to economic reasons predominantly.

In South East Asia, limited knowledge can be gleaned from literature reviews as the research data is sparse.  Markkanen interviewed participants first hand and, as mentioned earlier, this provides truth and reality.  She describes the shoe makers’ workshops in Indonesia:

“Shoe workshops are filled with hazardous exposures to glues, primers, and cleaning agents, unguarded tools, and dust.  Work positions are often awkward, cuts and burns are common, as are respiratory disorders.  Asthma and breathing difficulties are widespread when primers were in use.  Workers were reluctant to visit doctors because of the expense.”

She then reports on the interviews with Mr. Salet, a shoe manufacturer, Ms. Dessy, the business manager, Mr Iman, the business owner, Mr Ari, a skilled shoemaker, and many others.

Markkanen also illustrates the shame that the minority world and chemical manufacturers should feel about the outsourcing of lethal hazards to our fellows.  In the chapter, “Shoemaking and its hazards”, she writes:

“Shoe manufacturing will remain a hazardous occupation as long as organic solvents are applied in the production.  It is notable that in 1912, the Massachusetts Health Inspection report declared that naphtha cement, then in use for footwear manufacturing, was considered hazardous work.  The 1912 report also referred to a law which required the exclusion of minors from occupations hazardous to health – the naphtha cement use was considered such hazardous work unless a mechanical means of ventilation was provided and the cement containers were covered…. minors were prohibited from using the cement.  Almost a century later, hazardous footwear chemicals are still applied – even by children – in the global footwear industry.”

There is little attention given to the OHS requirements of majority world governments by OHS professionals in the West, partly because the outsourcing of manufacturing to those regions has led to the reporting of OHS infringements and human rights issues more than information about the legislative structures.

Markkanen provides a great section where she describes the OHS inspectorate resources of the Indonesian Government and the fact that Indonesian OHS law requires an occupational safety and health management system.  Granted this requirement is only for high-risk industries or business with more than 100 employees but there are many other countries that have nothing like this.  Markkanen quotes Article 87 of the Manpower Act 2003:

“Every enterprise is under an obligation to apply an occupational safety and health management system that shall be integrated into the enterprise’s management system.”

It is acknowledged that this section of legislation is hardly followed by business due to attitude and the lack of enforcement resources but we should note that safety management is not ignored by majority world governments.

Lastly, Markkanen provides a chapter on the gender issues associated with the shoemaking industry.  She makes a strong case for the further research into the area but it is a shame that to achieve improvements in women’s health the reality is  that

“women’s health needs female organizers and female women trade union leaders who understand women’s concerns”.

Some male OHS professionals may be trying to be “enlightened” but this seems to not be enough to work successfully in some Asian cultures.

Overall this book provides insight by looking at a small business activity that illustrates big issues.  The book is a slim volume of around 100 pages and it never becomes a difficult read because it is concise and has a personal presence that other “academic” books eschew.  As with many Baywood Books, the bibliographies are important sources of further reading.

At times it was necessary to put the book aside to digest the significance of some of the information.  Occasionally the reality depicted was confronting.  Baywood Books could do well by encouraging more writers to contribute to it Work, Health & Environment Series.

Kevin Jones

[SafetyAtWorkBlog received a review copy of this book at no charge.  We also noted that, according to the Baywood Books website, the book is available for another couple of weeks at a reduced price.]

Quad Bikes – industry response

On 30 November 2009, the CEO of The Federal Chamber of Automotive Industries, Andrew McKellar, responded to some of the issues raised in recent SafetyAtWorkBlog articles concerning the safety of quad bikes.

McKellar emphasised that a balanced approach to ATV safety discussions is required.  He said:

“In terms of a statistical outcome, the results show that, on balance, [ROPS] does not result in a safer outcome, in some situations people are going to be killed where otherwise they would have been fine.  In other circumstances, they will survive an accident or a rollover accident where they might have been seriously injured if they hadn’t had it…….There is no clear safety benefit from putting such structures on those vehicles.”

As has been shown in previous articles many Australian and New Zealand OHS regulators have not recommended ROPS for quad bikes.  This indicates that there must be some convincing evidence that ROPS are inappropriate.  But that leaves the same problem with quad bikes in 2009 that existed decades ago, people are becoming injured or are dying from the (mis)use of these vehicles.

In most other vehicle and manufacturing circumstances consistent misuse would indicate that the vehicle itself and the interaction between driver and vehicle requires considerable investigation and/or redesign.  The investigation by Ralph Nader was referred to in an earlier article as an example of unsafe design being engineered out.

Equipment designers in a range of industries strive to make their equipment foolproof but there does not seem to be same motivation in the quad bike manufacturing industry which still advocates helmets as the best hazard control option.  This option is supported by calls for safe driving courses and keeping within the manufacturers’ specifications.

Helmets may be best practice at the moment but it is hard to believe that that is where the situation should stay.  By not progressing beyond this control option, manufacturers and safety regulators are focusing on rider awareness in a sector, agriculture, that is renowned for taking (inventive) shortcuts and whose principal workforce are men who have a macho dismissive attitude to safety.  A new approach is required.

Kevin Jones

Australian research figures into quad-bike deaths and injuries

A SafetyAtWorkBlog reader drew our attention to a research report on quad bike safety by one of Australia’s most well-known researchers into agricultural safety, Lyn Fragar.

The report entitled “ATV Injury on Australian Farms – The Facts – 2006” details a compilation of police, hospital and injury data from many years concerning ATVs or quad bikes.  Recommendations and observations are made but curiously the design of the vehicles is not considered as a contributory factor in rollovers and rollover protection structures are not mentioned.

Kevin Jones

Further quad bike safety information

In January 2003, the Federal Chamber of Automotive Industries (FCAI)  issued the following media statement outlining its initiatives to reduce the injuries associated with quad bikes on farms in Australia.

SafetyAtWorkBlog is following up with the FCAI for further information on quad bike safety and any objections the FCAI has to roll-over protection structures.  An earlier article on quad bike safety is available HERE.

“The peak industry body representing the major motorcycle and All Terrain Vehicle (ATV) distributors has reinforced its support for on-going safety campaigns to help reduce ATV accidents.

The FCAI Motorcycle Group is concerned that a number of recent ATV accidents may have been the result of overloading or a lack of understanding of ATV operation.

The FCAI strongly recommends ATV operators should adhere to the following safety measures based on ATV manufacturers’ instructions:

  • always wear a helmet
  • do not carry passengers
  • do not exceed recommended maximum load and towing capacities
  • comply with the manufacturer’s recommended minimum user age for the vehicle
  • never operate an ATV under the influence of alcohol or drugs
  • follow the manufacturer’s maintenance procedures

The FCAI advises ATV operators who do not have a copy of the manufacturer’s instructions to seek a replacement from their nearest dealer.

The FCAI said recognising the risks associated with overloading an ATV and the dangers of carrying a passenger could significantly reduce ATV accidents.

“Appropriate speed for conditions and avoidance of riding on steep slopes could also further reduce ATV accidents,” said Mr Peter Sturrock, chief executive of the Federal Chamber of Automotive Industries.

An average of 10,000 ATVs have been imported annually into Australia over the past five years, according to figures from the Federal Chamber of Automotive Industries.

“Some ATVs are designed for competition and recreational riding but the greater majority of ATVs imported to Australia are agricultural ATVs sold directly to the farming sector,” Peter Sturrock added.

The FCAI Motorcycle Group has been actively involved in the promotion of ATV safety to consumers since 1997.

The Group committed $25,000 production costs to the first edition of a safety video “You and Your ATV” in 1998.

The video focuses on safe and responsible riding practices for ATVs and includes safe loading and securing methods.

More than 35,000 copies have been distributed free to ATV purchasers and owners.

The FCAI Motorcycle Group allocated $29,000 in 2002 to a second edition of the video.

The Group also provided expert advice and assistance to the development of an ATV Training Course for TAFE farm students.

The FCAI has also provided the services of its Motorcycle Manager Ray Newland to attend meetings of state and federal WorkCover Authorities for examination and progress of ATV safety issues.

In November of last year, the FCAI conducted a ‘field day’ for key national stakeholders involved with ATV safety.

The FCAI represents ATV importer/distributors Honda, Kawasaki, Polaris, Suzuki and Yamaha.”

ROPS and Quad Bikes – the failure of ATV manufacturers and OHS regulators

The Hierarchy of Controls has some questionable OHS applications to psychosocial hazards but it applies very well to “traditional” hazards, those involving plant.  The Hierarchy also emphasizes that the first step in any hazard control is to consider whether the hazard can be eliminated.  But what happens when the designers of equipment and plant know that a design can be made safer but do nothing to improve it?

For almost two decades some Australian OHS regulators have provided rebates to farmers to fit roll over protective structures (ROPS) to tractors to prevent deaths and injuries to the drivers from rollover or flips.  In 2009, one would be hard pressed to find a tractor that does not have its safety features emphasised as a sales benefit.  ROPS on tractors have been compulsory since 1998 in most States.

On 17 November 2009, Workplace Standards Tasmania issued a safety alert which, like the New Zealand ATV guidelines, advocates helmets and not ROPS even though OHS legislative principles say that elimination of hazards is the aim. The Tasmanian safety alert outlines the reasons for the safety alert

“Recent information shows there are, on average, 15 fatalities a year associated with using quad bikes in the Australian rural industry sector. Many more people are injured.

A recent coronial inquest into seven fatal incidents involving quad bikes (two in Tasmania and five in Victoria) has sparked a renewed call for improved safety on quad bikes.

As a result, Workplace Standards Tasmania has adopted a policy of zero tolerance of breaches of duty of care responsibilities with quad bikes.”

Zero tolerance of breaches of duty”?  The Tasmanian OHS Act places this duty on the designers of plant

(1) A person who designs, manufactures, imports or supplies any plant or structure for use at a workplace must so far as is reasonably practicable –

(a) ensure that the design and construction of the plant or structure is such that persons who use the plant or structure properly are not, in doing so, exposed to risks to their health and safety;…..

SafetyAtWorkBlog is awaiting comments from Workplace Standards Tasmania on the elimination of ATV rollover hazards.

As a terminological aside, there is a growing movement to rename All Terrain Vehicles as Quad Bikes because the fatality and injury data clearly shows that the vehicles cannot be driven in “all terrains”.

Five recent fatalities involving quad bikes, mentioned in the safety alert, should spark some investigation into whether the design of the plant contributed in any way to the fatalities.  Yet the safety alert makes no mention of design other than, tenuously, encouraging farmers to make sure

“…your quad bike is properly maintained and used according to the manufacturer’s specifications.”

This is a reasonable statement but if it was possible to make the vehicle safer, to save one’s own life and livelihood, by adding a ROPS, why wouldn’t you?

The manufacturer’s specifications are certain to be suitable to that quad bike but what if the quad bike design is itself not “fit for purpose”?  Plenty of other machines and vehicles are being redesigned to accommodate poor or inappropriate driver behaviour.  What makes quad bike so sacrosanct?

Victoria had a major opportunity for reform in this area through a parliamentary inquiry into farm deaths and injuries in August 2005.  Many farm safety advocates had high hopes for major change on ATV safety but design changes were not recommended.

According to the farm safety report

“Some witnesses suggested that roll over protection structures for ATVs should be made compulsory. Others, particularly representatives on behalf of the ATV industry, argued that fitting of a roll over protective structure to an ATV would adversely affect the handling and utility characteristics of these vehicles.”
Extensive research was undertaken by the Monash University Accident Research Centre which found
“…that, in the event of an ATV accident, “if the occupant is adequately restrained [with a suitable safety harness] within a protective roll over structure, the severity of [injuries caused during] the roll over event is dramatically reduced.”
Contrary evidence on ROPS was presented on behalf of the vehicle manufacturers.  The Parliamentary Committee understandably found
“To the Committee’s knowledge, there is no existing example of a roll over protective structure device that satisfies requirements for driver protection without substantially reducing the handling characteristics of ATVs. This report cannot, based on available evidence, make any recommendations concerning the fitting of roll over protective structures to ATVs.”
The UK’s Health & Safety Executive in 2002 undertook a detailed survey on the issue of ROPS and, among many recommendations said
“The use of the “safe cell” technology offers a number of imaginative approaches as alternatives to traditional structures, particularly for smaller machinery, and should not be overlooked.  Their contribution could be invaluable if relevant techniques were validated and became legally acceptable.”
Farmers, equipment manufacturers and OHS advocates are understandably confused when there is conflicting information (but then uncertainty breeds stagnation which is likely to advantage those who do not want change).
An investigation into ATV safety funded by the New Zealand Department of Labour in 2002 provided the following conclusion

“… it appears that the risk of using ATVs is significant, however there are some possible measures that could be put in place to reduce injuries, particularly those that are more severe and/or fatal. It seems that appropriate training is the most promising factor particularly because of the strong impact human behaviour has on the outcomes of the accidents.

In addition, the high risk for a fatal outcome when ATVs are rolled over, pinning the driver Reducing Fatalities in All-Terrain Vehicle Accidents in New Zealand underneath, suggests that further consideration and research is needed regarding the use of ROPS and/or any other measures that can prevent an ATV from rolling over.”

One Australian manufacturer accepted the challenge and has designed a ROPS for ATVs that shows enormous promise. QB Industries has developed the Quadbar, a passive roll over protection structure.  A demonstration video is available to view online.
It is understood that the Australian distributors of ATVs are not supportive of the safety innovation of QB Industries.  Apparently the distributors believe that the Quadbar increases the risk to the rider and that the safety claims are misleading.  The distributors are also concerned that the Quadbar may jeopardise the manufacturer’s warranty.
These concerns may be valid but surely these need to be independently tested and, if the device saves the lives and limbs of farmers and other riders, incorporated into the design in such a way that the vehicles become safer, regardless of the actions of the individual.  After all, the safer design of motor vehicles has progressed substantial from the days of Ralph Nader’s investigations in the 1960’s to such an extent that safety is a major sales strategy.
One independent test conducted for QB Industries by the University of Southern Queensland reported this about the QuadBar:
  1. The Quad Bar did not impede rider operation of the quad bike during normal operation (based on limited riding by the Chief Investigator).
  2. In low speed sideways roll over, the Quad Bar arrests the roll over and prevents the ATV from resting in a position that could trap and asphyxiate the rider.
  3. In higher speed sideways rollover, the Quad Bar impedes the roll over and prevents the ATV from resting in a position that could trap and asphyxiate the rider. In all tests the Quad Bar provided some clearance between the ground surface and the ATV seat so the rider would be unlikely to be trapped in this space.
  4. In all back flip tests, the Quad Bar arrested the back flip and the quad bike fell to one side.
  5. There were no conditions where the ATV with the Quad Bar fitted rested in a position that was more detrimental to rider safety than the ATV without protection.
If this device did not exist, the advocacy of helmets as the best available safety device  may have been valid but this design has the potential to eliminate the hazard and not just minimise the harm.  Surely it is better to have a farmer walk away from an ATV rollover that to break a neck or have a leg crushed.
The battle that QB industries has had, and continues to have, with quad bike vehicle manufacturers is beginning to reveal tactics by the manufacturers that are reminiscent of those of James Hardie Industries with asbestos and the cigarette manufacturers over lung cancer.
The approach of the OHS regulators to ROPS for ATVs must be reviewed because the dominant position seems to be that helmets are good enough, that no one is striving to eliminate the hazard or and that the Hierarchy of Controls does not apply.
QB Industries has followed the OHS principles and has designed a ROPS that warrants investigation, and the support and encouragement of OHS regulators.  The longer this investigation is ignored, the more people will be killed and injured when using these vehicles.  To not investigate this design would be negligent.

EHS workshop report and Australian nanoparticles reports

In October 2009 a workshop was held on worker safety by the  Worker Education and Training Program (WETP), a part of the US National Institute of Environmental Health Sciences.  Many of the topics raised in the workshop – REACH, Globally Harmonized System (GHS) of Classification and Labeling of Chemicals, and nanotechnology would be issues or hazards familiar to most SafetyAtWorkBlog readers.

EffectivenessReport coverThis report on the workshop, released in November 2009, is highlighted here because it is a very good example of a basic report on a workshop that makes the reader regret that they couldn’t be there.  This respond encourages readers to make the extra effort for the next set of workshops – a major benefit of such reports and, sometimes, the main reason.

The mention 0f nanotechnology is a good link to two new reports on the issue released by Safe Work Australia on 4 November 2009.

Engineered nanomaterials: Evidence on the effectiveness of workplace controls “explores the effectiveness of workplace controls to prevent exposure to engineered nanomaterials.”  According to a media release on the reports this report found:

  • “current control and risk management methods can protect workers from exposure to engineered nanomaterials
  • enclosure of processes involving nanomaterials and correctly designed and installed extraction ventilation can both significantly reduce worker exposure to nanomaterials, and
  • a precautionary approach is recommended for handling nanomaterials in the workplace.”

Pages from ToxicologyReview_Nov09The lack of available health effects data has directly led to the precautionary position in recommendations but it is good to see that the hierarchy of controls (old technology) is being applied to new technology. The report gets to a point of recommending a combination of

“…controls [that] should provide a robust regime through which nanomaterials exposure to workers will be reduced to very low levels.”

The bibliography in this report is also excellent and includes a comparative table of the research reports and papers analysed.

Engineered nanomaterials: A review of toxicology and health hazards was a literature review that  reports:

  • “there is no conclusive evidence to suggest that engineered nanomaterials have a unique toxicity. However, sufficient toxicity tests have not yet been conducted for most engineered nanomaterials
  • nanoparticles tend to be more bio-reactive, and hence potentially more toxic, than larger particles of the same material, and
  • carbon nanotubes are potentially hazardous to health if inhaled in sufficient quantity.”

Nanotechnology is a difficult area of OHS study as there is so much research material coming through that it is (probably more than) a full-time job just to stay current.  The literature review into toxicology makes a point that it is important to remember in this field.

“A wide variety of in vitro and in vivo experimental protocols have been used to assess biological responses to NPs, some of these yield more useful data for occupational risk assessment than others.  Some are potentially misleading.” [emphasis added]

The second of these reports was a good introduction to the general issues of health risks but must be stressed that these reports deal with engineered nanoparticle(s) (ENPs) which are defined as

“A nanoparticle with at least one dimensions between approximately 1 nm and 100 nm and manufactured to have specific properties or composition. “

Increasing research into any issue almost always leads to a fragmentation of the discipline into subsets.  That research into engineered nanoparticles is different from regular nanoparticles needs to be remembered.  As the report itself says

“…the major thrust of the research is in relation to identifying potential hazards for assessment of occupational safety since working with ENPs is likely to be where most exposure occurs. In contrast to ambient particulate air pollution, where health effects have been observed and research has been aimed at discovering the causative agents and mechanisms, the reverse is true for ENPs.”

Tom Phillips AM, chair of the Safe Work Australia Council said , in a media statement,

“Safe Work Australia has requested that the National Industrial Chemicals Notification and Assessment Scheme undertake a formal assessment of carbon nanotubes for hazard classification to clarify regulation of these nanomaterials.

“We have also requested that CSIRO develop guidance for the safe handling and disposal of carbon nanotubes, which will be a useful resource for OHS managers.”

It is good to see Safe Work Australia (now an independent statutory body) take one of the ACTU recommendations from its 2009 factsheet.

Kevin Jones

Concatenate Web Development
© Designed and developed by Concatenate Aust Pty Ltd