HEALTH, SAFETY & ENVIRONMENT

Prepared by

Abdul Qadir

Department of Mechanical Engineering

NED UNIVERSITY OF ENGINEERING & TECHNOLOGY

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 Table of Contents
Description Page No.

1. Personnel Protective Equipment (PPE) 3

2. Safety Precautions on working at Height 10

3. Slips & Trips 13

4. Fire hazard & Fire Extinguishers 15

5. Various Injuries Relating to Manual Handling 19

6. Various Injuries & use of standard first aid kit 22

7. Various Types of dressings, Bandages & Techniques 29

8. Safe management of Industrial steam and hot water boilers 38

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 CHAPTER # 01
Personnel Protective Equipment (PPE)
PPE is equipment that will protect the user against health or safety risks at work. It can
include items such as safety helmets, gloves, eye protection, high-visibility clothing, safety
footwear and safety harnesses. It also includes respiratory protective equipment (RPE).

Eyes
Hazards 
Chemical or metal splash, dust, projectiles, gas and vapor, radiation

Options 
Safety spectacles, goggles, face screens, face shields, visors.

Note 
Make sure the eye protection chosen has the right combination of impact/dust/splash/molten
metal eye protection for the task and fits the user properly

Head and neck

Hazards 
Impact from falling or flying objects, risk of head bumping, hair getting tangled in machinery,
chemical drips or splash, climate or temperature.

Options 
Industrial safety helmets, bump caps, hairnets and firefighters' helmets.

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Note
 Some safety helmets incorporate or can be fitted with specially-designed eye or hearing
protection.

 Don't forget neck protection, e.g. scarves for use during welding.

 Replace head protection if it is damaged.

Ears
Hazards 
Noise – a combination of sound level and duration of exposure, very high-level sounds are
hazardous even with short duration.

Options 
Earplugs, earmuffs, semi-insert/canal caps.

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Note
 Provide the right hearing protectors for the type of work, and make sure workers know
how to fit them.

 Choose protectors that reduce noise to an acceptable level, while allowing for safety
and communication.

Hands and arms

Hazards 
Abrasion, temperature extremes, cuts and punctures, impact, chemicals, electric shock,
radiation, vibration, biological agents and prolonged immersion in water

Options 
Gloves, gloves with a cuff, gauntlets and sleeves that cover part or the entire arm.

Note
 Avoid gloves when operating machines such as bench drills where the gloves might get
caught.

 Some materials are quickly penetrated by chemicals – take care in selection.

 Wearing gloves for long periods can make the skin hot and sweaty, leading to skin
problems. Using separate cotton inner gloves can help prevent this.

Feet and legs

Hazards 
Wet, hot and cold conditions, electrostatic build-up, slipping, cuts and punctures, falling
objects, heavy loads, metal and chemical splash, vehicles

Options 
Safety boots and shoes with protective toecaps and penetration-resistant, mid-sole wellington
boots and specific footwear, e.g. foundry boots and chainsaw boots.

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Note
Footwear can have a variety of sole patterns and materials to help prevent slips in different
conditions, including oil - or chemical-resistant soles. It can also be anti-static, electrically
conductive or thermally insulating.

 Appropriate footwear should be selected for the risks identified.

Lungs
Hazards
 Oxygen-deficient atmosphere, dust, gases and vapors.

Options – respiratory protective equipment (RPE)

 Some respirators rely on filtering contaminants from workplace air. These include
simple filtering face pieces and respirators and power-assisted respirators

 Make sure it fits properly, e.g. for tight-fitting respirators (filtering face pieces, half and
full masks)

 There are also types of breathing apparatus which give an independent supply of
breathable air, e.g. fresh-air hose, compressed airline and self-contained breathing
apparatus

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Note
 The right type of respirator filter must be used as each is effective for only a limited
range of substances.

 Filters have only a limited life. Where there is a shortage of oxygen or any danger of
losing consciousness due to exposure to high levels of harmful fumes, only use
breathing apparatus – never use a filtering cartridge.

 You will need to use breathing apparatus in a confined space or if there is a chance of an
oxygen deficiency in the work area.

Whole body
Hazards 
Heat, chemical or metal splash, spray from pressure leaks or spray guns, contaminated dust,
impact or penetration, excessive wear or entanglement of own clothing.

Options 
Conventional or disposable overalls, boiler suits, aprons, chemical suits

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Note
 The choice of materials includes flame-retardant, anti-static, chain mail, chemically
impermeable, and high-visibility

 Don't forget other protection, like safety harnesses or life jackets

Emergency equipment
Careful selection, maintenance and regular and realistic operator training is needed for
equipment for use in emergencies, like compressed-air escape breathing apparatus, respirators
and safety ropes or harnesses.

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Maintenance
PPE must be properly looked after and stored when not in use, e.g. in a dry, clean cupboard. If it
is reusable it must be cleaned and kept in good condition.

Think about:
 Using the right replacement parts which match the original, e.g. respirator filters

 Keeping replacement PPE available

 Who is responsible for maintenance and how it is to be done

 Having a supply of appropriate disposable suits which are useful for dirty jobs where
laundry costs are high, e.g. for visitors who need protective clothing

Employees must make proper use of PPE and report its losses or destruction or any faults in it.

Monitor and review

 Check regularly that PPE is used. If it isn’t, find out why not

 Safety signs can be a useful reminder that PPE should be worn

 Take note of any changes in equipment, materials and methods – you may need to
update what you provided.

Case Study
A commercial gardener was using a petrol-driven strimmer to trim undergrowth. He hit a piece of
unseen debris, which was thrown into the air and caught him in the eye. He lost the sight in that
eye because he was not wearing protective goggles, which was advised in the manufacturer's
written instructions for using the strimmer.

How similar accidents can be prevented

Ensure those operating strummers are trained to recognize the hazards posed by unseen debris
and wear appropriate PPE, including protective goggles.
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 CHAPTER # 02
Safety Precautions on working at Height
Working at height remains one of the biggest causes of fatalities and major injuries. Common
cases include falling from ladders and through fragile surfaces. ‘Work at height’ means working
on any place where, if there were no precautions in place, a person could fall a distance liable
to cause personal injury (for example a fall through a fragile roof).

 Must make sure work is properly planned, supervised and carried out by competent people
with the skills, knowledge and experience to do the job. You must use the right type of
equipment for working at height.

Take a sensible approach when considering precautions. Low-risk, relatively straightforward

tasks will require less effort when it comes to planning and there may be some low-risk
situations where common sense tells you no particular precautions are necessary.

Control measures
First assess the risks. Factors to weigh up include the height of the task, the duration and
frequency, and the condition of the surface being worked on.

Before working at height work through these simple steps:

 Avoid work at height where it's not reasonably practicable to do so

 Where work at height cannot be easily avoided, prevent falls using either an existing
place of work that is already safe or the right type of equipment
 Minimize the distance and consequences of a fall, by using the right type of equipment
where the risk cannot be eliminated

For each step, always consider measures that protect everyone at risk (collective protection)
before measures that only protect the individual (personal protection).

Collective protection is equipment that does not require the person working at height to act for
it to be effective. Examples are permanent or temporary guardrails, scissor lifts and tower
scaffolds.

Personal protection is equipment that requires the individual to act for it to be effective. An
example is putting on a safety harness correctly and connecting it, with an energy-absorbing
lanyard, to a suitable anchor point.

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 Dos and don’ts of working at height
Do….
 As much work as possible from the ground
 Ensure workers can get safely to and from where they work at height
 Ensure equipment is suitable, stable and strong enough for the job, maintained and
checked regularly
 Take precautions when working on or near fragile surfaces
 Provide protection from falling objects

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 Consider emergency evacuation and rescue procedures
Don’t…
 Overload ladders – consider the equipment or materials workers are carrying before
working at height. Check the pictogram or label on the ladder for information
 Overreach on ladders or stepladders
 Rest a ladder against weak upper surfaces, e.g. glazing or plastic gutters
 Use ladders or stepladders for strenuous or heavy tasks, only use them for light work of
short duration (a maximum of 30 minutes at a time)
 Let anyone who is not competent (who doesn’t have the skills, knowledge and
experience to do the job) work at height

Case Study
Preventing falls from ladders
A large, independent installer of digital terrestrial and satellite equipment recognized it
could be doing more to tackle falls, especially as engineers were installing aerials and
dishes at a variety of heights from portable leaning ladders and roof ladders.

The solution
They took measures including making sure ladders were secured using an eyebolt and
ratchet strap, and equipping appropriately trained workers with specialist kit, such as a
flexible safety line that can be attached to the secured ladder.

CHAPTER # 03
Trained workers now wear a fall-arrest harness that can be attached to the line and the
ladder. This means that the ladder cannot slip during use and, even if the engineer slips
and falls from the ladder, the fall will be stopped.
Slips & Trips
Most slips occur when floors become wet or contaminated and many trips are due to poor
housekeeping.

The solutions are often simple and cost-effective and a basic assessment of the risks should
help to identify what you can do to tackle slips and trips risks.

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Slips and trips are the most common cause of injury at work. On average, they cause over a
third of all major injuries and can lead to other types of accidents, such as falls from height or
falls into machinery.

What should we do?

 Prevent floors from getting wet or contaminated in the first place

 Have procedures in place for both routine and responsive cleaning

 If a spillage does happen, clean it up quickly

 If floors are left wet after cleaning, stop anyone walking on them until they are dry and
use the right cleaning methods and products

 Look out for trip hazards, such as uneven floors or trailing cables, and encourage good
housekeeping by your workers

 Make sure workers wear footwear that is suitable for the environment they are working
in

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Case Study
An NHS trust recognized they had problems with slips and trips on wet hospital floors. In a two-
year period, 100 members of staff had reported slips or trips on wet, recently cleaned floors.
How was the problem tackled?
HSE recommended a dry mopping system, using microfiber mops that reduce the amount of
residue left on the floor during and after mopping. The staff was also advised to mop and dry
the floor in sections before moving onto the next part of the ward, to provide safe access
around the area.

Since the trust implemented the system, it has seen an 85% reduction in slips and trips from the
100 reported in the previous two years.

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 CHAPTER # 04
Fire hazard & Fire Extinguishers
Most fires are preventable. Those responsible for workplaces and other buildings to which
the public have access can avoid them by taking responsibility for and adopting the right
behaviors and procedures.

General fire safety hazards

Fires need three things to start – a source of ignition (heat), a source of fuel (something that
burns) and oxygen:

 Sources of ignition include heaters, lighting, naked flames, electrical equipment,

smokers’ materials (cigarettes, matches etc), and anything else that can get very hot or cause
sparks
 Sources of fuel include wood, paper, plastic, rubber or foam, loose packaging materials,
waste rubbish and furniture
 Sources of oxygen include the air around us

Things to do:
 Carry out a fire safety risk assessment
 Keep sources of ignition and flammable substances apart
 Avoid accidental fires, e.g. make sure heaters cannot be knocked over
 Ensure good housekeeping at all times, e.g. avoid build-up of rubbish that could burn
 Consider how to detect fires and how to warn people quickly if they start, e.g. installing
smoke alarms and fire alarms or bells
 Have the correct fire-fighting equipment for putting a fire out quickly
 Keep fire exits and escape routes clearly marked and unobstructed at all times
 Ensure your workers receive appropriate training on procedures they need to follow,
including fire drills
 Review and update your risk assessment regularly

What are the hazards?

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Many substances found in the workplace can cause fires or explosions. These range from the
obvious, e.g. flammable chemicals, petrol, and cellulose paint thinners and welding gases, to
the less obvious – engine oil, grease, packaging materials, and dusts from wood, flour and
sugar.

It is important to be aware of the risks and to control or get rid of them to prevent accidents.

Types of Fire & Fire Extinguishers

 Identify the type of materials in the area 

Class A:  SOLIDS such as paper, wood, plastic etc

Class B:  FLAMMABLE LIQUIDS such as paraffin, petrol, oil etc

Class C:   FLAMMABLE GASES such as propane, butane, methane etc

Class D: METALS such as aluminum, magnesium, titanium etc

Class E: Fires involving ELECTRICAL APPARATUS

Class F: Cooking OIL & FAT etc

Types of fire extinguisher

Water Fire Extinguishers:

The cheapest and most widely used fire extinguishers. Used for Class A fires. Not suitable
for Class B (Liquid) fires, or where electricity is involved.

 Foam Fire Extinguishers:

More expensive than water, but more versatile. Used for Classes A & B fires. Foam spray
extinguishers are not recommended for fires involving electricity, but are safer than water
if inadvertently sprayed onto live electrical apparatus.

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 Dry Powder Fire Extinguishers:
Often termed the ‘multi-purpose’ extinguisher, as it can be used on classes A, B & C fires.
Best for running liquid fires (Class B). Will efficiently extinguish class C gas fires, but beware,
it can be dangerous to extinguish a gas fire without first isolating the gas supply.  Special
powders are available for class D metal fires.

Warning: when used indoors, powder can obscure vision or damage goods and
machinery. It is also very messy.

 CO2 Fire Extinguishers:

Carbon Dioxide is ideal for fires involving electrical apparatus, and will also extinguish class
B liquid fires, but has NO POST FIRE SECURITY and the fire could re-ignite.

Wet chemical 
Specialist extinguisher for class F fires.

For Metal Fires: A specialist fire extinguisher for use on Class D fires - metal fires such as
sodium, lithium, manganese and aluminum when in the form of swarf or turnings.

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 Color Coding

Prior to 1st Jan 1997, the code of practice for fire extinguishers in the UK was BS 5423,
which advised the color coding of fire extinguishers as follows:

Water - Red

Foam - Cream

Dry Powder - Blue

Carbon Dioxide (CO2) - Black

Holon - Green (now 'illegal' except for a few exceptions such as the Police, Armed Services
and Aircraft).

Case Study
A worker was using highly flammable cellulose thinners in an open-topped container to wash
paint-spraying equipment. He knocked the container over, splashing the thinners over his
trouser leg and shoe.

He went into a nearby room to clean himself up, but the room happened to contain drying
ovens. These ignited the flammable vapors coming from the thinners, which set his trouser leg
and shoe on fire, causing serious burns to his leg and foot.

How this incident could have been avoided

It could have been easily prevented if the employer had carried out a risk assessment to
identify that cellulose thinners should not have been used in this way, and instructed the
worker accordingly.

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 CHAPTER # 05
Injuries Relating to Manual Handling
Manual handling causes over a third of all workplace injuries. These include work-related
musculoskeletal disorders (MSDs) such as pain and injuries to arms, legs and joints, and
repetitive strain injuries of various sorts.
The term manual handling covers a wide variety of activities including lifting, lowering, pushing,
pulling and carrying. If any of these tasks are not carried out appropriately there is a risk of
injury.

Why is dealing with manual handling important?

Manual handling injuries can have serious implications for the employer and the person who
has been injured. They can occur almost anywhere in the workplace and heavy manual labour,
awkward postures, repetitive movements of arms, legs and back or previous/existing injury can
increase the risk.

What should we do?

To help prevent manual handling injuries in the workplace, you should avoid such tasks as far as
possible. However, where it is not possible to avoid handling a load, employers must look at the
risks of that task and put sensible health and safety measures in place to prevent and avoid
injury.

For any lifting activity

Always take into account:

 individual capability

 the nature of the load

 environmental conditions

 training

 work organization

If you need to lift something manually

 Reduce the amount of twisting, stooping and reaching

 Avoid lifting from floor level or above shoulder height, especially heavy loads

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  Adjust storage areas to minimize the need to carry out such movements

 Consider how you can minimize carrying distances

 Assess the weight to be carried and whether the worker can move the load safely or
needs any help – maybe the load can be broken down to smaller, lighter components

If you need to use lifting equipment

 Consider whether you can use a lifting aid, such as a forklift truck, electric or hand-
powered hoist, or a conveyor

 Think about storage as part of the delivery process – maybe heavy items could be
delivered directly, or closer, to the storage area

 Reduce carrying distances where possible

Good handling technique for lifting

There are some simple things to do before and during the lift/carry:

 Remove obstructions from the route.

 For a long lift, plan to rest the load midway on a table or bench to change grip.
 Keep the load close to the waist. The load should be kept close to the body for as long as
possible while lifting.
 Keep the heaviest side of the load next to the body.
 Adopt a stable position and make sure your feet are apart, with one leg slightly forward
to maintain balance

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Think before lifting/handling. Plan the lift. Can handling aids be used? Where is the load going
to be placed? Will help be needed with the load? Remove obstructions such as discarded
wrapping materials. For a long lift, consider resting the load midway on a table or bench to
change grip.

Adopt a stable position. The feet should be apart with one leg slightly forward to maintain
balance (alongside the load, if it is on the ground). Be prepared to move your feet during the lift
to maintain your stability. Avoid tight clothing or unsuitable footwear, which may make this
difficult.

Get a good hold. Where possible, the load should be hugged as close as possible to the body.
This may be better than gripping it tightly with hands only.

Start in a good posture. At the start of the lift, slight bending of the back, hips and knees is
preferable to fully flexing the back (stooping) or fully flexing the hips and knees (squatting).

Don’t flex the back any further while lifting. This can happen if the legs begin to straighten
before starting to raise the load.

Keep the load close to the waist. Keep the load close to the body for as long as possible while
lifting. Keep the heaviest side of the load next to the body. If a close approach to the load is not
possible, try to slide it towards the body before attempting to lift it.
Avoid twisting the back or leaning sideways, especially while the back is bent. Shoulders
should be kept level and facing in the same direction as the hips. Turning by moving the feet is
better than twisting and lifting at the same time.

Keep the head up when handling. Look ahead, not down at the load, once it has been held
securely.

Move smoothly. The load should not be jerked or snatched as this can make it harder to keep
control and can increase the risk of injury.

Don’t lift or handle more than can be easily managed. There is a difference between what
people can lift and what they can safely lift. If in doubt, seek advice or get help.

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Put down, and then adjust. If precise positioning of the load is necessary, put it down first, and
then slide it into the desired position.

Case Study

A manufacturing company kept bulk chemicals stored in heavy tubs at floor or shoulder height.
This meant that the operators were continually reaching down or up, both of which increase the
risk of injury.

The solution

To address the risk, the company drew up guidelines on the storage of heavy loads to ensure they are
now stored at waist height, which makes lifting and handling easier.

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 CHAPTER # 06
Injuries & use of standard first aid kit
First aid is the assistance given to any person suffering a sudden illness or injury, with care provided to
preserve life, prevent the condition from worsening, and/or promote recovery.

First aid, or emergency first aid is the care that is given to an injured or sick person prior to treatment by
medically trained personnel. Some self-limiting illnesses or minor injuries may only require first
aid intervention, and no further treatment.

First Aid Box

The decision on what to provide will be influenced by the findings of the first-aid needs
assessment. As a guide, where work activities involve low hazards, a minimum stock of first-aid
items might be:

 individually wrapped sterile plasters (assorted sizes), appropriate to the type of work
(hypoallergenic plasters can be provided if necessary);
 sterile eye pads;
 individually wrapped triangular bandages, preferably sterile;
 safety pins;
 large sterile individually wrapped unmediated wound dressings;
 medium-sized sterile individually wrapped unmediated wound dressings;
 Disposable Latex gloves.

This is only a suggested contents list.

It is recommended that you don't keep tablets and medicines in the first-aid box.

First aid at work does not include giving tablets or medicines to treat illness. The only exception
to this is where aspirin is used when giving first aid to a casualty with a suspected heart attack,
in accordance with currently accepted first-aid practice. It is recommended that tablets and
medicines should not be kept in the first-aid box.

Some workers carry their own medication that has been prescribed by their doctor (e.g. an
inhaler for asthma). If an individual needs to take their own prescribed medication, the first-
aider's role is generally limited to helping them to do so and contacting the emergency services
as appropriate.

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 What to do in an emergency

Priorities

 Assess the situation – do not put yourself in danger;

 Make the area safe;
 Assess all casualties and attend first to any unconscious casualties;
 Send for help – do not delay;
 Follow the advice given below.

Check for consciousness

If there is no response to gentle shaking of the shoulders and shouting, the casualty may be
unconscious. The priority is then to check the Airway, Breathing and Circulation. This is
the ABC of resuscitation.

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 A: Airway
To open the airway:

place one hand on the casualty’s forehead and

gently tilt the head back;
remove any obvious obstruction from the
casualty’s mouth;
lift the chin with two fingertips.

B: Breathing
Look along the chest, listen and feel at the mouth, for signs of normal breathing, for no more
than 10 seconds.

If the casualty is breathing:

place in the recovery position and ensure

the airway remains open;
send for help and monitor the casualty
until help arrives.

If the casualty is not breathing:

 Send for help;

 Keep the airway open by maintaining the head tilt and chin lift;
 Pinch the casualty‘s nose closed and allow the mouth to open;
 Take a full breath and place your mouth around the casualty’s mouth, making a good
seal;
 Blow slowly into the mouth until the chest rises;
 Remove your mouth from the casualty and let the chest fall fully;
 Give a second slow breath, then look for signs of a circulation (see opposite);
 If signs of a circulation are present, continue breathing for the casualty and recheck for
signs of a circulation about every 10 breaths;
 If the casualty starts to breathe but remains unconscious, put them in the recovery
position, ensure the airway remains open and monitor until help arrives .

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 C: Circulation
Look, listen and feel for normal breathing, coughing or movement by the casualty, for no more
than 10 seconds.
If there are no signs of a circulation, or you are
at all unsure, immediately start chest
compressions:

lean over the casualty and with straight

arms, press vertically down 4–5 cm on the
breastbone, then release the pressure;
give 15 rapid chest compressions (a rate
of about 100 per minute) followed by two
breaths;
Continue alternating 15 chest
compressions with two breaths until help arrives
or the casualty shows signs of recovery.

Severe bleeding

 Apply direct pressure to the wound;

 Raise and support the injured part (unless broken);
 Apply a dressing and bandage firmly in place.

Broken bones and spinal injuries

If a broken bone or spinal injury is suspected, obtain expert help. Do not move casualties unless
they are in immediate danger.
Burns

Burns can be serious so if in doubt, seek medical help. Cool the part of the body affected with
cold water until pain is relieved. Thorough cooling may take 10 minutes or more, but this must
not delay taking the casualty to hospital.
Certain chemicals may seriously irritate or damage the skin. Avoid contaminating yourself with
the chemical. Treat in the same way as for other burns but flood the affected area with water
for 20 minutes. Continue treatment even on the way to hospital, if necessary. Remove any
contaminated clothing which is not stuck to the skin.

Eye injuries

All eye injuries are potentially serious. If there is something in the eye, wash out the eye with
clean water or sterile fluid from a sealed container, to remove loose material. Do not attempt
to remove anything that is embedded in the eye.

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 If chemicals are involved, flush the eye with water or sterile fluid for at least 10 minutes, while
gently holding the eyelids open. Ask the casualty to hold a pad over the injured eye and send
them to hospital.

Record keeping

It is good practice to record in a book any incidents involving injuries or illness which have been
attended. Include the following information in your entry:

 date, time and place of incident;

 name and job of injured or ill person;
 details of injury/illness and any first aid given;
 what happened to the casualty immediately afterwards (for example went back to work,
went home, went to hospital);
 Name and signature of the person dealing with the incident.

This information can help identify accident trends and possible areas for improvement in the
control of health and safety risks.

Responsibilities of a first aider:

 Preserve life and provide initial emergency care and treatment to sick or injured people
 Protect the unconscious
 Prevent a casualty’s condition from becoming worse
 Promote the recovery of the casualty.

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 CHAPTER # 07
dressings, Bandages & Techniques
A dressing is used to protect a wound and prevent infection, but also to allow healing. A dressing should
be large enough to totally cover the wound, with a safety margin of about 2.5 cm on all sides beyond the
wound. A sterile dressing may be used to control bleeding from a major wound or to absorb any
discharge from a minor wound.

Dressings vary greatly in nature and size, so it is important to select the correct dressing for use on a
specific wound. A sterile dressing which is past its expiry date should NOT be used.

A bandage is used in combination with a dressing where a wound is present. A roller bandage is used to
secure a dressing in place. A triangular bandage is used as an arm sling or as a pad to control bleeding. It
may also be used to support or immobilize an injury to a bone or joint or as improvised padding over a
painful injury. A tubular gauze bandage is used to retain a dressing on a finger or toe.

Dressings

Sterile wound dressings

Wound dressings will be in a sterile packet, which should be opened carefully by a person with clean or
gloved hands. Then, to avoid contamination of the sterile dressing, it is not removed from the opened
packet until the wound is ready to be covered.

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Dressings used to control bleeding must be bulky to ensure that adequate pressure is applied over the
injured area. The most common dressing is made of combined wool or cellulose, covered in a light
cotton woven fabric, and these are generally known as ‘combine dressings’.

Some major wound dressings are labelled as BPC or BP (because they are listed in the British
Pharmacopoeia) and consist of a sterile combine dressing with attached bandage. They are ideal  to fill
crater wounds or to control severe bleeding.

Sterile gauze squares are used mainly for cleaning a wound. Cotton wool should NOT be used because of
loose cotton fibers that might stick to the wound during healing.

Sterile non-adherent dressings

Very light dressings are used on a minor wound to aid healing and most have a non-adherent surface. A
non-adherent dressing is often covered on one or both sides with a plastic film containing many
perforations. If only one side has a plastic film, that is the side to be placed against the wound. This
allows fluids to pass through into an absorbent layer, to keep the wound dry.

Other types of non-adherent dressing have a special synthetic coating on one or both sides to prevent
adhesion to the wound surface. The non-adherent layer is always placed against the wound. To reduce
confusion and incorrect use, some manufacturers make both sides on adherent.

Non-adherent dressings are used for extensive surface wounds such as an abrasion (graze) or burn.

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Improvised dressings

In an emergency a dressing may be improvised from a range of materials. To control bleeding a bulky
pad may be made from a bundle of several facial tissues or from any clean, non-fluffy material.

For a minor burn or scald, a piece of clean plastic kitchen wrap may be used initially. However, if the
burn is serious, it is vital to use only sterile coverings to avoid the risk of infection. Cooling should be
continued until a sterile dressing is available.

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Bandages

Roller bandages

Roller bandages vary greatly depending on how they are to be used.

A roller bandage is used to:

• hold a dressing in place on a wound
• maintain pressure over a bulky pad to control bleeding
• support an injured limb or joint
• apply pressure to a limb

Roller bandages are made from lightweight cotton, crepe or elasticized crepe, depending on the
pressure to be achieved. A lightweight cotton bandage is used to hold a dressing in place, whereas a
crepe or elasticized crepe bandage is used for applying support or firm pressure to a soft tissue injury.

Applying roller bandages

A roller bandage needs to be chosen carefully to ensure that it is the correct width for the body part
involved. As a general guide, the following widths are recommended:
• Lower arm, elbow, hand and foot – 75 mm.
• Upper arm, knee and lower leg – 100 mm.
• Large leg or trunk – 150 mm.
It is best to use a bandage with some degree of stretch in the weave. This will make the bandage easy to
use and more likely to stay in place for many hours. However, the correct application technique is
essential to provide comfort and adequate support for the affected part.

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 Basic steps to successful use of a roller bandage:

 Bandage the part in the position of greatest comfort to the patient. Support the part adequately
before starting to apply the bandage.
 Hold the tightly rolled bandage with the ‘head’ of the bandage on top and wrap the ‘tail’ around
the body part without unrolling more than a few centimeters at a time.
 Begin with a locking turn to hold the start of the bandage securely under each following turn.
 Work from the middle of the body or limb in an outwards direction.
 Work from the narrowest part below the dressing and work upwards.
 Ensure that each turn covers two-thirds of the previous turn.
 Cover totally any dressing and padding used.
 Finish with a straight turn at the end of the bandage.
 Secure the bandage with a safety pin or adhesive tape. Avoid the use of metal clips because they
are less secure and can fall out during activity.

Applying a roller bandage to the lower arm or leg:

 Apply a dressing or padding over the affected area.

 Start with a diagonal, locking turn below the dressing or padding to secure the dressing.
 Continue up the limb, covering two-thirds of each previous turn.
 Finish with a straight turn to secure the bandage and fasten it with a pin or adhesive tape.

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 Applying a roller bandage to the elbow or knee:

 Apply a dressing or padding over the affected area.

 Start with a full turn over the point of the elbow or knee to secure the bandage.
 Make a second turn just below the first, exposing one-third of the initial turn over the point of
the elbow or knee.
 Make a third turn just above the first, again exposing one-third of the initial turn over the point
of the elbow or knee.
 Continue with one or two more turns alternately working from below to above the affected
joint, until the dressing or padding is fully covered.
 Avoid any extra turns that will cause pressure on the inside surface of the joint.
 Finish with a full turn above the elbow or knee and secure the bandage with a safety pin or
adhesive tape.

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 Applying a roller bandage to the hand or foot:

 Apply a dressing or padding over the affected area.

 Start with a diagonal, locking turn around the wrist or foot.
 Carry the bandage across the back of the hand or foot to the base of the little finger or little toe
and then make a complete turnaround the fingers or toes.
 Make another turn across the back of the hand or foot from the fingers/toes to the wrist/ankle.
 Repeat these turns working upwards with each turn until the dressing or padding is covered.
 Finish with a circular turn around the wrist ankle and secure the bandage with a safety pin or
adhesive tape.

Triangular bandages

Triangular bandages are usually made from a meter square of cotton or calico that is cut in half
diagonally. The bandage can be used in various ways as a sling or for immobilization of broken bones
and soft tissue injuries.

Sling

 In the open form as a sling to support an upper body injury.

Broad-fold bandage

 As a broad-fold bandage with the apex folded down to the base twice to immobilize a lower
body injury.

Narrow-fold bandage

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 As a narrow-fold bandage with the broad fold bandage folded in half to control severe bleeding,
or for immobilization of a lower limb.
 As a collar-and-cuff sling for an upper body injury.

Pad

 As a folded pad after the ends of the narrow fold bandage have been brought into the centre
three times, and for use on a major wound or as padding.

Tying a reef knot with a triangular bandage

When using a triangular bandage it is important to use a reef knot to secure it in place. A reef knot is a
flat knot that will not slip undone and, if correctly placed on the body, is comfortable for the patient.

1. Wrap the left end of the bandage over and then under the right end to start the knot.
2. Wrap the right end over and then under the left end to complete the knot.
3. Pull the knot tightly from both sides to ensure that it will lie flat.

It is easy to untie a reef knot without jarring or hurting the patient. Simply choose two paired ends as
they come out of the knot at one side. Then pull the ends apart steadily until two loops form and can be
slipped off one end.

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 Arm sling

This sling is used to support a lower arm or hand injury and for rib or collarbone fractures.

 Encourage the patient to hold the affected arm across the body in the position of greatest
comfort.
 First hold the bandage with the base running down the centre of the body and the point to the
elbow on the affected side. Gently slip the top point under the supported arm and wrap it around the
back of the neck until it rests on the shoulder of the affected side.
 Lift up the lower point and take it to meet the upper point at the side of the neck on the
affected side.
 Use a reef knot (see above) to tie the ends together just above the collarbone to avoid any
pressure on the back of the neck.
 Adjust the sling so that the fingertips are clearly visible and then bring the point forward and
fasten it to the sling with a safety pin.
 Finally, check the circulation in the fingers and compare the tissue color with the fingertips on
the unaffected arm. If there are any signs of an impaired circulation, loosen or remove the sling and any
underlying bandages.

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 Elevation sling

This sling is used for an arm or finger injury where the patient needs the hand and arm to be held in an
elevated position.

 Encourage the patient to hold the affected arm across the body with the fingers pointing to the
opposite shoulder tip.
 First hold the bandage with the base running down the centre of the body and the point to the
elbow on the affected side. Gently place the bandage over the supported arm and carry the top end
around the front of the neck until it rests on the unaffected shoulder.
 Gently wrap the lower half of the bandage along the affected arm. Carry the free end of the
bandage from the elbow across the back to the opposite shoulder tip.
 Gently twist the top point around the fingers, but avoid placing pressure on any injury. Tie the
two ends together with a reef knot (see above) and place it just above the collarbone to avoid any neck
pressure.
 At the point of the elbow smooth the loose fabric forwards along the arm under the sling.
Secure the sling firmly at the elbow with a safety pin or tape.

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 Collar-and-cuff sling

This sling is used to hold the lower arm and hand in an elevated position where a full elevation sling is
either not required, or for patient comfort in very hot weather. The sling is made with a narrow fold
bandage used as a clove hitch.

 Make a clove hitch with two large loops of the bandage. One loop is made with the bandage end
pointing upwards and the other end pointing downwards.
 Fold the two loops inwards towards the middle, ensuring that both ends are trapped between
the loops.
 Encourage the patient to hold the affected arm across the body with the fingers pointing to the
opposite shoulder tip. Then gently slide the two loops over the hand and lower arm with the ends
hanging downwards.
 Carry the two bandage ends up on either side of the limb and around the patient’s neck. Adjust
the bandage so that it is possible to tie a
reef knot (see above) just above the collarbone on one side to avoid any pressure on the neck.
 The knot may be placed on either side of the neck depending on the location of the injury and
the comfort of the Patient.

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 CHAPTER # 08
Safe management of Industrial steam and hot water boilers
Accidents involving exploding boilers have killed people, damaged plant and affected
production. These accidents resulted from problems such as inadequately designed boilers,
wrongly sited or wrongly installed boilers as well as boilers that were not correctly operated or
maintained.

As the stakeholder of a workplace, you have a duty to manage the risks associated with that
workplace. If there is a boiler installation on your premises, you must ensure it remains safe.

An efficient, reliable boiler is an essential requirement for many businesses, and the downtime
caused by a failed boiler can have a major effect on production, plant and people.

The word ‘boiler’, in everyday use, covers a wide range of equipment, from simple domestic hot
water boilers to boilers housed within a power generation plant to convert fossil fuel to
electricity. Generally, domestic hot water boilers do not produce steam and should operate at low
pressure. While some combination boilers now operate at the pressure of the incoming cold
water mains, this is still far below the normal operating pressure of steam-raising boilers.

Steam-raising plant and boilers

Figure 1 shows a sectional view of a typical steam-raising boiler. This is known as a shell and
tube boiler and is the most common type. The hot gases from the burner go through the furnace
tube and then back through the smoke tubes and out of the flue. The water is heated by the tubes
and is contained by the main pressure containing part, the shell.

Figure 2 shows a typical vertical boiler found in a number of factories for either generating very
hot water or steam.

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40
All of the above factors need to be in place and adequately addressed to ensure the safe operation
of a boiler. If one or more of these stops working, or is inadequate, or absent, this could result in
the boiler breaking down or failing catastrophically, causing injuries and damage to property.

What do you need to do?

You need to determine if the risks from your boiler are at acceptable levels or if any additional
measures are required to achieve this. This will require a systematic assessment of any risks that
may be present and the control measures in place to address them.1 A risk assessment does not
need to include excessive detail; however, the findings and any actions taken should be recorded.
In some cases, you may need to contact the manufacturer, installer or other experts for the
required information to complete the assessment. The exact considerations will depend on the
site (site-specific) but may include the following:

■ The boiler specification, condition and its associated plant.

■ The manner in which the boiler is operated and maintained.
■ Any safe systems of work, including management and supervision.
■ How competent your workers are and how they have been trained.
■ How reliable your electronic control system is.
■ How regularly your boiler is examined and tested.
■ The boiler house in general.

Boiler specification, operation and maintenance

In dealing with this issue, you may find it helpful to consider the following:
■ Is there any existing documentation relating to your boiler plant?
■ Does this documentation state how the boiler should be operated (including operating limits)
and maintained?
■ Can you establish (from the documentation or the manufacturer) that the boiler is suitable for
the way it is intended to be operated or maintained? Look at things like process demands or
cyclic operation.
■ Is the boiler being operated and maintained in accordance with the documentation?
■ Can you demonstrate that the people operating and maintaining your boiler are suitably trained
and competent?

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