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2.5.6 Occupational health and safety Cheat Sheet (DRAFT) by

This is a draft cheat sheet. It is a work in progress and is not finished yet.

What is occupa­tional health and safety (OH&S)?

Occupa­tional health and safety is a discipline with a broad scope involving many specia­lized fields. In its broadest sense, it should aim at:
Promotion and mainte­nance of the highest degree of physical, mental and social well-being of workers in all occupa­tions;
Prevention among workers of adverse effects on health caused by their working condit­ions;
Protection of workers in their employment from risks resulting from factors adverse to health;
Placing and mainte­nance of workers in an occupa­tional enviro­nment adapted to physical and mental needs;
Adaptation of work to humans.
In other words, occupa­tional health and safety encomp­asses the social, mental and physical well-being of workers, that is the “whole person”.
Occupa­tional Health and Safety has more recently become known as Work Health and Safety (WHS), although the term OH&S is still commonly used.
Successful occupa­tional health and safety practice requires the collab­oration and partic­ipation of both employers and workers in health and safety progra­mmes, and involves the consid­eration of issues relating to occupa­tional medicine, industrial hygiene, toxico­logy, education, engine­ering safety, ergono­mics, psycho­logy, etc.
Occupa­tional health issues are often given less attention than occupa­tional safety issues because the former are generally more difficult to confront. However, when health is addressed, so is safety, because a healthy workplace is by definition also a safe work place. The converse, though, may not be true - a so-called safe workplace is not necess­arily also a healthy workplace.
The important point is that issues of both health and safety must be addressed in every workplace. By and large, the definition of occupa­tional health and safety given above encomp­asses both health and safety in their broadest contexts.

The cost of workplace safety

Work-r­elated accidents or diseases are very costly and can have many serious direct and indirect effects on the lives of workers and their families. For workers some of the direct costs of an injury or illness are:
Pain and suffering of the injury or illness; Loss of income; Possible loss of a job; Health­-care costs.
It has been estimated that the indirect costs of an accident or illness can be four to ten times greater than the direct costs, or even more. An occupa­tional illness or accident can have so many indirect costs to workers that it is often difficult to measure them. One of the most obvious indirect costs is the human suffering caused to workers' families, which cannot be compen­sated with money.
The costs to employers of occupa­tional accidents or illnesses are also estimated to be enormous. For a small business, the cost of even one accident can be a financial disaster. For employers, some of the direct costs are:
Payment for work not performed; Medical and compen­sation payments; Repair or replac­ement of damaged machinery and equipment; Reduction or a temporary halt in produc­tion; Increased training expenses and admini­str­ation costs; Possible reduction in the quality of work; Negative effect on morale in other workers.
Some of the indirect costs for employers are:
Injure­d/ill worker has to be replaced; New worker has to be trained and given time to adjust; Time before the new worker is producing at the rate of the original worker; Time must be devoted to obligatory invest­iga­tions, to the writing of reports and filling out of forms; Accidents often arouse the concern of fellow workers and influence workplace elations in a negative way; Poor health and safety conditions in the workplace can also result in poor public relations.
Overall, the costs of most work-r­elated accidents or illnesses to workers and their families and to employers are very high.
On a national scale, the estimated costs of occupa­tional accidents and illnesses can be as high as three to four per cent of a country's gross national product. In reality, no one really knows the total costs of work-r­elated accidents or diseases because there are a multitude of indirect costs which are difficult to measure besides the more obvious direct costs.
Health and safety programmes
It is crucial that employers and all employees are committed to health and safety and that:
Workplace hazards are controlled - at the source whenever possible; Records of any exposure are maintained for many years; Both workers and employers are informed about health and safety risks in the workplace; Active and effective health and safety committee that includes both workers and manage­ment; Health and safety efforts are ongoing.
Effective workplace health and safety programmes can help to save the lives of employee by reducing hazards and their conseq­uences. Health and safety programmes also have positive effects on both employee morale and produc­tivity, which are important benefits. At the same time, effective programmes can save employers a great deal of money.

Relevant Laws, Guideline and Codes

There are many relevant laws, guidelines and codes that relate to OHS in the workplace, some at the federal government level and others at the state government level.
Under the Australian Work Health and Safety Act 2011 (WHS Act) and the Work Health and Safety Regula­tions 2011 (WHS Regula­tions) all workplaces are required to manage risks to health and safety by elimin­ating them as much as reasonably practi­cable. Codes of Practice offer practical guidance to achieve the standards of health, safety and welfare required by the WHS Act and WHS Regula­tions. An approved code of practice would comply with the legal obliga­tions to provide a safe work place.
Codes of Practice that may be relevant to radiation therapy include:
Hazardous Manual Tasks – lifting and transf­erring patients, or bulky equipm­ent.; Managing risks of falls; Prepar­ation of safety data sheets for hazardous Chemicals – eg: Chemot­herapy drugs.; Managing risks of hazardous chemicals in the workplace – eg: Chemot­herapy spills; First Aid in the workplace – having a first aid officer and management plan.
The 5 key elements for effici­ently managing health and safety risks within the workplace are:
1) Governance – is the organi­sat­ional framework proced­ures, policies and processes at a strategic level.
2) Prevention – this includes training and education, inspec­tions & testing, hazard reporting arrang­ements and auditing.
3) Response – the steps to remove the hazard and implement changes to prevent it happening again
4) Managing hazards – not all hazards can be removed, so management needs to be in place to identify hazards and minimise them before they cause an injury or illness.
5) Recovery When a worker is injured the employer has respon­sib­ilities under the Safety Rehabi­lit­ation and Compen­sation Act 1988 (SRC Act) to manage this injury or illness.

OH&S in the healthcare enviro­nment

In the healthcare enviro­nment, specif­ically in a radiation therapy depart­ment, the following are major risks for OH&S.
a) Manual Handling
Manual handling is the use of your body to exert force through jobs that include lifting, pushing, bending, reaching or carrying things.
Manual handling can result in muscul­osk­eletal injuries at work. Muscul­osk­eletal injuries can also occur due to slips, trips and falls. These muscul­osk­eletal injuries describe a range of conditions that include: Back pain, muscle sprains, fractures and disloc­ations, abdominal hernias, carpal tunnel syndrome and tendon­itis. Muscul­osk­eletal injuries can occur suddenly (such as an injury caused by a patient pulling on your arm to help themselves from falling) or develop over time (repet­itive manual work that causes wear and tear on the body – also known as occupa­tional overuse syndrome, OOS, or repetitive strain injury, RSI).
Some strategies to reduce your risk of injury include:
 Adjust the working height of the patient table to suit your height.  Do not lean over the patient or table, use your partner on the other side to assist you or move around the table.  Work as a team – get assistance  Do not carry more than you should because you are in a hurry  Use the correct transfer of patient proced­ures. You should never transfer a patient until you have been trained in your hospital’s policies and proced­ures.  Wear approp­riate clothing and shoes  Assess your patient’s mobility status – are they able to assist or are they dependent?  Assess the weight of the patient / object. Many hospitals have specific procedures for obese/­bar­iatric (>1­50kg) patients.  Assess your enviro­nment – check for space, hazards (wet floor, patient with socks but not shoes on, sheets or equipment on the floor)  Explain the transfer process to the patient, make sure that they know what they need to do and watch to make sure that they cooperate with your instru­ctions.  If you have to lift something – bend your knees, keep your back straight, keep the movement smooth,  Use equipment where possible – many hospitals have a no-lift policy, so use things like pivot stands, slide sheets, pat slides, hover-mats or lifting hoists.
b) Infection control
Infection control is important for patients and healthcare workers. Infections can be classified into 4 categories of microo­rga­nisms: Bacteria, Fungus, Viruses and Parasites. Infection can be caused by immune suppre­ssion (important for cancer patients during treatm­ent), diabetes, external temper­ature, unhealthy diet, inadequate exercise, illicit drugs, wound or trauma.
To avoid the spread of infection hospitals utilise standa­rd/­uni­versal precau­tions.
 Hand washing / antiseptic rub for at least 15 seconds  Personal protective equipment (gloves, gowns if open wounds)
Other strategies to minimise infections for both patients and staff include:
 Management of sharps  Immuni­sation of health care workers  Use of masks during resusc­itation  Cleaning of equipment
Needle stick injuries occur when you are exposed to blood, body fluids, excretions or secretions from a needle stick or sharp instru­ment. Every hospital has processes in place to deal with needle stick injuries, but prevent should be a priority.
 Never walk up behind someone whilst they are handling a needle  Dispose of sharps immedi­ately - always make sure you have a sharps disposal container close by to limit the need to walk with a needle in your hand.  Do not recap a needle after use
c) Radiation Safety
Occupa­tional exposure to radiation is obviously a risk within a radiation therapy depart­ment.
This national standard has many requir­ements, but some of the more recogn­isable of these in a radiation therapy department include:
a) Radiation monitoring: This is the reason why you are all required to wear a personal dosimeter whilst on clinical placement. This is one method to monitor individual occupa­tional exposure – but it cannot record any exposure if you forget to wear it! ARPANSA runs a Personal Radiation Monitoring Service (PRMS) that supplies TLDs and maintains lifetime radiation dose histories.
b) Control of exposure – through the use of shielding (bunker design, interlocks on doors and gates), safe work practices (time, distance and shielding)
c) Respon­sib­ilities – appoin­tment of radiation safety officers, approp­riate training, induction and superv­ision.
Within ARPANSA there is also the Australian Clinical Dosimetry Service (ACDS). The role of ACDS is to provide an integrated national approach to safety and quality in radiation therapy. They complete indepe­ndent checks of equipment and the doses being delivered by this equipment. This has obvious advantages for not only radiation therapists but for our patients too.