DETECT PHARMACEUTICAL HEALTH

HAZARDS AND ACT

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 Objective

 Define hazards and risk

 Classify hazards that may occur at work place
 Manage OHS risk, exposure and hazards in Pharmacy
 Manage pharmaceutical OHS information and records 
 Manage pharmaceutical OHS participative processes 
 Manage OHS continuous improvement process

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 UNIT-1
 MANAGING OCCUPATIONAL HEALTH &
SAFTY( OHS) RISK, EXPOSURE AND
HAZARDS IN PHARMACY SERVICE

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 Introduction

 Hazard:

 Hazard is simply a condition or a set of circumstances that

present a potential for harm.
 Hazards are the main cause of occupational health and safety
problems,
 Therefore, finding ways of eliminating hazards or controlling
the risks is the best way to reduce workplace injury and illness

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 Workplace hazards can come from a wide range of sources.
 General examples include any substance, material, process,
practice, etc that has the ability to cause harm or adverse health
effect to a person under certain conditions
 Risk: The likelihood, or possibility, that harms (injury, illness, death,
damage etc) may occur from exposure to a hazard

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What is health ?
 According to WHO, health is state of complete physical , mental
and social well-being and not merely the absence of disease.
Physical health
 obtained through - regular exercise

-balance diet & adequate rest.

-reducing the risk of an injury or health issue

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 Mental health
 refers to persons emotion, social , psychological wellbeing
 it is not only the absence of depression , anxiety disorder
 it includes on ability to:

- enjoy life
- bounce back after difficult experiences
- feel safe and secure
- achieve your potential
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 Social Health
 It is the ability of individuals to form healthy and rewarding interpersonal
relationships with others
signs of good social health
 Balancing your social and personal time
 Staying true to yourself in all situations
 Adapting to social situations
 Engaging with people in your community
 Treating others with respect
 Maintaining and building strong relationships with others.
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Q. What is welfare?
 It is availability of resources & presence of conditions required for reasonably,
healthy and secure living.
 It is the provision of a minimal level of well-being and social support for
citizens and other eligible residents.
 In most developed countries, welfare is mainly provided by the government
from tax revenue, and to a lesser extent by NGO charities, informal social
groups, religious groups, and inter-governmental organizations.

Q. What is safety ?
 The condition of being protected from or unlikely to cause danger, risk, or
injury
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 Types of hazards

1.Biological hazard:
 It is due to viruses, bacteria, parasites, fungi and molds.
 It is also include insects, pests, rodents, mammals and their toxins e.g.
lice, bedbugs, fleas, flies, cockroaches, ticks and mites, as well as rats
and mice, plants
2. Chemical hazards:
 This is due to exposure to hazardous chemicals that may lead to
damage to body systems
eg. Dusts, Mists, Fumes, Vapors, Gases, etc
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3. Mechanical hazards:
 It is resulting from unshielded machinery, unsafe structures in the
workplace and dangerous tools
It can be caused by exposure to a heavy physical workload
poor working conditions
involving heavy item lifting and moving, or repetitive manual
tasks
4. Psychosocial hazards: -
 Psychological stress is caused by time and work pressures
 Psychological stress and work overload have been associated
with sleep disturbances, burn-out syndromes, depression,
cardiovascular disorders and hypertension
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5. Physical hazards:
 high pitch noise, vibration, ionizing and non-ionizing radiation,
electric and electromagnetic fields, extreme cold and heat are
some of physical hazards
 Ultraviolet radiation and ionizing radiation are known
carcinogens

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 Dealing with Hazards

 There are 3 basic steps to follow when dealing with hazards

1. Identify

2. Assess

3. Control

IDENTIFY
 The inspection checklist should have identified any hazards in

your work area.

 If you notice a hazard, report it !
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 ASSESS
 Complete a Hazard Report

1. Rank the risk by probability - the likelihood of the hazard

resulting in injury, illness, damage or loss
2. Rank the risk by consequence - the potential for injury,
illness, damage or loss
3. Prioritize the risk for control - indicate the ranking of importance
when control measures are to be implemented

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 CONTROL
 Now that the risk has been identified and assessed decisions need to
be made about how best to eliminate or reduce the risk as much as
possible.
 The following hierarchy of controls provides the steps to making the
right decisions in this process. It is important to start at #1 and work
though to #6 (ie. PPE is not the first control to put in place)

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1. Elimination (remove the hazard)
2. Substitution (use an alternative)
3. Isolate (separation from hazard)
4. Redesign (change equipment or process)
5. Administration (change work practices)
6. Personal Protective Equipment (ie gloves, glasses, hearing
protection)

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 Common terms
 Hazard
Potential source of harm
 Risk
Probability of the occurrence of harm and the severity of
that harm.
 Risk Analysis
Systematic use of available information to identify
hazards and estimate risk.
 Risk Evaluation
Based on the risk analysis, a judgment of whether a risk
is acceptable based on societal values.
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 Risk Assessment
Process of completing risk analysis and risk evaluation.

 Risk Control
Process through which decisions are reached and protective
measures are implemented for reducing or maintaining risks

within specified levels.

 Residual Risk
Risk remaining after protective measures have been taken.
 Risk Management
Systematic application of management policies, procedures, and
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practices toward analyzing, evaluating, and controlling risk 18
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 1.1 Introduction to Occupational safety and health

Definition
 The joint international labor organization committee on
Occupational health, 1950 defined occupational health as
“The highest degree of physical, mental and social well-
being of workers in all occupations”

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 What is occupational health care?

 Occupational health care is preventive health care, which is

provided on the basis of the Occupational Health Care Act
 Occupational safety and health (OHS) is an extensive
multidisciplinary field, invariably touching on issues related
to scientific areas such as medicine

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 As the term "occupational safety and health" implies, there are
two aspects to this field
 Safety: This seeks to make workplaces safe for workers
so that they do not suffer injuries
Health; the goal is to prevent the occurrence of illnesses
among workers because of exposures at their place of
work.

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 Key objectives of occupational safety and health
 To promote and maintenance of the highest degree of physical,
mental and social wellbeing of workers in all occupations
 To prevent among workers of adverse effects on health caused
by their working conditions
 To protect workers in their employment from risks resulting from
factors adverse to health

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 To placing and maintenance of workers in an occupational
environment adapted to physical and mental needs
 To prevent occupational diseases and injuries.
  To adapt the work place and work environment to the needs
of the workers i.e application of ergonomics principle

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 Successful occupational health and safety practice requires
the collaboration and participation of:
o both employers and workers in health and safety programs,
and Involves the consideration of issues relating to
occupational, industrial hygiene, physiology and toxicology,
ergonomics, physics, medicine and chemistry etc.

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 Core Occupational safety and health principles
 Basic principles of Occupational safety and health include the
following:
o All workers have rights
o Workers, as well as employers and governments, must
ensure that these rights are protected and must strive to
establish and maintain decent working conditions and a
decent working environment.

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More specifically:
o work should take place in a safe and healthy working
environment
o conditions of work should be consistent with workers’ well-
being and human dignity
o work should offer real possibilities for personal achievement,
self-fulfillment and service to society
o Occupational safety and health policies must be established.

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o Such policies must be implemented at both the national
(governmental) and enterprise levels.
o A national system for occupational safety and health must
be established.
o A national program on occupational safety and health
must be formulated
o Once formulated, it must be implemented, monitored,
evaluated and periodically reviewed

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o Occupational safety and health programmes and policies must aim at
both prevention and protection
o Workplaces and working environments should be planned and

designed to be safe and healthy.

o The collection and dissemination of accurate information

on hazards and hazardous materials
o surveillance of workplaces, monitoring of compliance with
policies and good practice
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 Cont..

• Health promotion is a central element of occupational health

practice
• Efforts must be made to enhance workers’ physical, mental and
social well-being

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 Health and safety policy and legal regulations

The Workplace Health and Safety Act.

An Act to promote occupational health and safety in the Territory
 to prevent workplace injuries and diseases

 to protect the health and safety of the public in relation to work

activities
 to promote the rehabilitation and maximum recovery from incapacity
of injured workers.

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 to provide financial compensation to workers incapacitated
from workplace injuries or diseases and to the dependants of
workers who die as the results of such injuries or diseases.
 to establish certain bodies and a fund for the proper
administration of the Act, and for related purposes

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 The issue of governing safety and health at work on legal basis
in Ethiopia dates back to 1940s
 The first legal instrument Proclamation No. 58/1945 was
promulgated
 The origin of this legislation was a result of the advent of
industrialization that took place in the country
 A more comprehensive legislation on occupational Safety
and Health management replaced this in 1964 i.e.
Proclamation232/1964 in order to address the change occurred.
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 The parent legislative frame work of the land is the constitution
of the Federal Democratic Republic of Ethiopia Proclamation
No. 1/1995 (21st August, 1995)
 This grand legislation has several articles pertaining to matters
of Decent Work in general and of Safety, Health and Working

Environment in particular.

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 Unlike many countries, Ethiopia has one comprehensive labor
law (The Labor proclamation No 377/06) that is in action to
address all aspects of ensuring labor relation to be governed
with basic fundamental rights and obligation focusing on
industrial peace in all work places.
 This law is also formulated in order to guarantee and maintain
all fundamentals rights at work and to define the powers and
duties of the organ charged to enforce the implementation of the
idea of the law which is tantamount to the labor inspectorates.
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 The law applies to all employer employee relationship or
undertaking that employs one or more persons
 One of the major chapters of this labor law is dealing with
Occupational safety, health and working environment
 In the same law it is clearly stipulated that no worker may interfere
with remove, displace, damage or destroy any safety devices
 or other appliances furnished for his/her protection or the protection
of others and may not obstructs any method or process adopted with
a view to minimizing occupational hazard

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• Ethiopia has its own occupational health and safety policy
• According to the labor proclamation no. 377/2003 the ministry
of labor and social affairs
• So based on this, PFSA has established its own Health and
safety committee.
• The purpose and objectives of the committee should be declared
in the company’s safety policy statement in conformity to health
and safety
1. Legislation. (Occupational Health Safety Act)
2. The committee may establish its own mission statement
specifying its purpose, goals, and objectives

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• For instance
Create awareness and accident prevention; promote awareness
about health and safety issues
Promote cooperation between management and employees in
dealing with health and safety issues
Identify problems, evaluate risks and recommend control measures
Monitor and improve workplace health and safety
 Plan, conduct, report and monitor workplace inspections which
are part of the overall occupational health and safety program.

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 1.2 Manage First Aid Policy
 First aid is the provision of immediate care to a victim with an injury
of illness before emergency medical treatment is available by a lay
person
 performed within a limited skill range.
 The first-aid provider in the workplace is someone who is trained in the
delivery of initial medical emergency procedures
 using a limited amount of equipment to perform a primary assessment
and intervention while awaiting arrival of emergency medical service
personnel.

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 The first aider, on approaching a victim should have:
1. Put their gloves on
2. Checked for danger
3. Checked for responsiveness

4. Looked at the scene for clues about what has happened

5. Gained history on the incident
6. Assessed to see how responsive the victim is.

7. If the victim is unconscious, the first aider should immediately call an

ambulance

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 Hazard Identification
 This process is about finding what could cause harm in work
task or area.
 Work areas include:
 Machine workshops, laboratories, office areas, stores and
transport, and teaching spaces etc.
 Work Tasks can include:
 Audio and visual equipment, industrial equipment, hazardous
substances and/or driving a vehicle, construction.
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 Elements of the work environment
 There 4 basic elements of the work environment.

-the worker
- the tool
-the process
-the work environment

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a. The worker
 In developing countries, workers are at greater risk of occupational
hazards for a variety of reasons because of low education and literacy
rates; unfamiliarity with work processes and exposures
 inadequate training

 high prevalence of endemic (mainly infections) diseases and malnutrition

 inadequate infrastructure and human resources to diagnose.
 Workers at great risk of occupational hazard includes:
- Women, Children's , & Migrants

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b. The Tool
 Tools can range from very primitive tools like a hammer, chisel, and

needle, to automated equipment.

c. The process
 In the process, materials used can be toxic.
 The process itself can affect the potential harmfulness of the materials

 For example, the particle size or physical state (solid, liquid and gas) of
potentially harmful substances can determine to a large extent what ill

effects in workers may develop from those substances.

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d. The work environment.
 Occupational environment means the sum of external
conditions and influences which prevail at the place of work
and which have a bearing on the health of the working
population
Q. What are the three types of interaction in the working
environment?

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 Basically, there are three types of interaction in a working
environment: -
1. Man and Physical, chemical and biological agents

- noise, heat & humidity, radiation , bacteria's, fungi, etc

2. Man and machine

3. Man and his psychosocial environment

-Work stability, Service conditions, Job satisfaction.

-Security, motivation and incentives. 
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 1.3. Classification of OHS in pharmacy services
1. Chemical

2. Biological
3. Physical
4. Ergonomic(mechanical)

5. Psychosocial

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1.3.1 Biological hazards and controls
 Exposure to biological hazards may occur for any
pharmacy staff in contact with patients or the public or
through contaminants found in the ventilation system,
water or food.
These could be:
 Exposure to blood borne pathogens
 Exposure to pathogens transmitted in body fluids or
secretions to mucous membranes by contact with
contaminated surfaces.
 Exposure to environmental biological contaminants from
ventilation systems, water or food.
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The major Control strategies includes three mechanisms

 Engineering control

Administrative control
Personal protective equipment control

1. Engineering Controls
In the hierarchy of controls, it is the highest level of control that is directed
at the source.
 From an occupational health perspective, the highest level of control may
be immunization of workers who may come in direct contact with
infected patients.
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 Good engineering controls such as
Vaccines

proper ventilation
safety engineered sharps
biological safety cabinets

effective biological waste containment also contribute to

minimizing the transmission of infectious agents.
 Engineering controls, once designed and implemented, are not under
the control of the worker, but are directed at the source of the hazard.
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2. Administrative Controls
 Because it is not always possible to eliminate or control the hazard at
the source
 administrative controls are frequently used for biological hazards in
healthcare
 Administrative controls focus on ensuring that:
the appropriate prevention steps are taken
pharmacy staff are trained to use the proper procedures
all proper work procedures are documented, and their use is
enforced.
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 Administrative controls related to the prevention of exposure to
biological hazards include:
- the development of infection prevention and control
guidelines (equipment decontamination and
safe work procedures)
 Surfaces must be decontaminated after any spill of potentially
infectious materials and at the end of the working day.

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3. Personal Protective Equipment (PPE)
 Personal protective equipment such as gloves, respiratory
protection and eye protection should be used based on the risk
assessment.
 PPE is often used in conjunction with other controls
(engineering and administrative) to provide additional
protection to workers.

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 The primary types of PPE are designed to protect the worker
from infectious disease by breaking the chain of infection at the
“portal of entry or exit” of the microorganisms.
-this means that all PPE is designed to reduce exposure
via specific routes of transmission
 Example:
Gloves, gowns and other protective clothing-
-reduce exposure through the dermal (skin) contact route

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Eye and face protection:

- reduce exposure through mucous membrane contact.

Masks worn by patients

- reduce exposure through droplet containment at the source

 Respirators worn by health care workers reduce exposure to
the respiratory system.

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1.3.2 Chemical Hazards and Controls
 Health care environment can house a vast array of chemicals.
 Examples of hazardous Chemicals may include:
 formaldehyde: - used for preservation of specimens for pathology
 ethylene oxide, glutaraldehyde, and para acetic acid - used for
sterilization;
 anesthetic gases , laboratory reagents and other numerous chemicals
used in healthcare.
 Alcohol hand sanitizers : may cause hand dryness , flammable
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 Detergents : used for cleaning a variety of surfaces

-Its hazard is as possible eye, skin and respiratory irritants.

 Even some drugs administered to patients can be harmful to
staff if not properly handled e.g. cytotoxic drugs( anticancer
drugs).
-they may be mutagenic or carcinogenic, also teratogenic or
have reproductive effects

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Engineering controls
 Many engineering controls are available for controlling the
hazard at the source and along the path of transmission.
 For chemical hazards, common engineering controls include:

i. Elimination:
 avoid the most hazard chemical substance eg the anti pain
thalidomide has eliminated due to its teratogenic effect
ii. Substitution:
 Substitute with less harmful product.
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iii. Local exhaust :
 used to minimize exposure to chemicals in the air

- the machine captures contaminants at the point where

they are released or generated and mechanically removes
them before workers can inhale them
Eg. Biological Safety cabinets are specialized local exhaust
ventilation devices often used in pharmacies

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IV. Isolation/enclosed processes
 Isolating the source or location of the hazard helps to reduce exposure.
 When isolation is physical (separate rooms, closed doors..), the isolated
area must be maintained at a negative air pressure relative to the
surrounding areas.
 This will allow air to flow into the isolated area, keeping the
contaminant within the space.
V. Proper chemical storage
 Chemicals must be stored properly to reduce risks of fire, explosion,
chemical reactions, and worker exposure.
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Administrative Controls
• Administrative controls used for reducing exposure to
chemical hazards include:
 Monitoring the environment for chemical hazards
 Work scheduling
 Health surveillance and follow-up procedures for exposed
workers
Safe work procedures including chemical waste handling
and disposal
Training related to awareness of effects of drugs and other
chemicals

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Personal Protective Equipment (PPE)
 The personal protective equipment most commonly used in pharmacies
to protect against chemical exposures includes
 gloves,
gowns,
eye protection
respirators- to protect pharmacy workers from exposure to certain
biological agents or chemicals by inhalation.
 PPE should be chosen based on a careful consideration of tasks and the
nature of the drugs or chemicals used.
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1.3.3. Physical hazards and controls
 Physical hazards comprise of extremes of temperatures, extremes of
pressures, noise, vibration and radiation.
 Cuts are also common pharmacy injuries, often sustained when coming
into contact with broken glassware or sharp tools or equipment.

Engineering Controls
 Modify the design of workstations, hand tools, equipment, etc. to
reduce the hazard
 Substitution of medical sharps with safety engineered medical devices.

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 using insulating materials and shields as appropriate for
extreme temperature works.
Administrative Controls
 Administrative controls include policies, procedures, work
practices, rules, training, and work scheduling, including:
 Provide training programs to educate workers regarding
biomechanical risk factors, signs and symptoms and safe
work practices
 Safe disposal of all sharps, including broken glass
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 Personal Protective Equipment (PPE)
 Eye protection,
 protective clothing, and

 Gloves
 Appropriate footwear with gripping soles and good support as
per hazard assessment.

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1.3.4. Ergonomic(mechanical) hazards and controls
 Healthcare personnel are also exposed to many ergonomics risk factors due
to the nature of their work.
 Common examples of ergonomic risk factors are found in jobs requiring
 repetitive, forceful
 prolonged exertions of the hands
 frequent or heavy lifting
 pushing, pulling, or carrying of heavy objects.
 Jobs or working conditions presenting multiple risk factors will have a
higher probability of causing a musculoskeletal problem.
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Engineering control
 Ergonomically designed workstations to minimize reaching.
 Work surfaces of appropriate heights and adequate storage
space.
 Ergonomically designed equipment and appropriate materials
handling equipment such as carts, trolleys, etc. For lifting,
carrying, pulling, pushing heavy objects.
 Replace manual with automated processes whenever
practicable for repetitive works.
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Administrative control
 Worker education regarding ergonomic hazards and control
strategies.
 Safe work procedures.
 Job rotation and variation of tasks.
 Early reporting of signs and symptoms of ergonomic concerns

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1.3.5 psychosocial hazards and control
 Violence
 working with severely ill patients
 shift work, qualitative and quantitative overload/ under load
 Violence or aggression from patients
 staff and clients could take the form of physical

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 emotional and/or mental abuse.
 Most health care settings require some sort of shift work
 But that Shift work can be very stressful to workers and their
families.
 Additionally working alone
 drug and alcohol abuse as well as economic factors are other
forms of psychological hazards.
 Working with people who are seriously or even terminally ill
 Since a number of people working in health care are women
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 conflicts with competing and changing roles in the family
 as well as from work issues, can cause tremendous stress.
(work-life conflict)
Engineering controls
 For psychosocial hazards from violence, provide isolated area
for agitated client.
 Furniture arrangement to prevent entrapment
 Provide communication devices for alone working workers

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Administrative controls
 Management policies and procedures related to no tolerance of
violence or abuse.
 Worker education in violence awareness, avoidance de-escalation
procedures.
 Well trained security guards
 Worker education about substance abuse.
 Shifts designed, so workers get enough rest between shifts.

 Train workers and management in fatigue and shift work issues.

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 How we decrease psychosocial hazards??????
 Use counseling services
 Healthy life style
 Adequate sleep
 Increase awareness of substance abuse consequences
 Manage time effectively for work life conflict

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1.4 . Financial and social implications of an unsafe workplace
 Unsafe work place has an impact on financial, social and other
life condition of the worker & the employer
 Financial impact on the employer could be,
 Salary of the absent injured employee
 Lost business opportunities
 Expense reimbursed to the injured employee
 Retraining costs

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 Financial impact on the employee
 loss of salary
 Loss of overtime payment
 Medical travel or other expenses
 Lost savings
Social impact on the employee
 feelings of frustration , depression and social
isolation.
 damaging impact on personal & family life.
 frustration & anxiety about the future.

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1.5 Methods of identifying OHS
 Identifying workplace hazard is an important first step toward
preventing work related injuries or illness.
 Hazard identification and assessment means taking a thorough
look at what could harm workers and hence setting priorities for
preventing or controlling exposure of workers to the identified
hazards.

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 Performing hazard assessment
 identifies the need for worker training
 identifies poor or missing procedures
 increases worker participation and ownership of workplace
health and safety.
 reduces production loss and damage to equipment and property.

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 Assessment should be done at intervals that anticipate problems
before the safety and health of worker is affected.
How to conduct a hazard assessment
 There are a number of ways to find hazards in the work place:

1. walk around and look at your work place and

observe how work is done.

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2. Ask questions what they consider unsafe or unhealthy

3. Review any information you may have on a particular piece

of equipment or chemical to see what it says about safety
precautions

4. Talk to others in similar works to find out what sort of

incidents they have had

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 More formal process for conducting a hazard assessment may
include:
i. Physical inspection :
 using a checklist or job task hazard assessment and identify the
hazards involved with each task.
ii. Health care providing process analysis:-
 following a process from start to end of a particular task ,
identify the hazards at each stage.

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iii. Incident investigation:
 results of incident investigation and analysis of first aid

records may identify the hazards involved.

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