This presentation covers the topics of

FIRST AID & MEDICAL TREATMENT CLASSIFICATION OF INJURY & INCIDENT PROBLEMS OF HEAT BALANCE IN HOT WEATHER

FIRST AID: Any one time treatment and observation of minor scratches, cuts and burns which do not ordinarily require medical care. Such treatment and observation are considered first aid.

The following are generally considered as first aid treatments & should be recorded:

Application of ANTISEPTICS during first visit to medical personnel. Treatment of FIRST DEGREE BURN(S). Application of BANDAGE(S) during any visit to medical personnel. Use of ELASTIC BANDAGE(S) during 1st visit to medical personnel.

Removal of FOREIGN BODIES FROM WOUND; if procedure is UNCOMPLICATED, & is, e.g., by tweezers or other possible technique. Use of NON-PRESCRIPTION MEDICATIONS on first visit for minor injury or discomfort. SOAKING THERAPY on initial visit to medical personnel or removal of bandages by SOAKING. Application of hot or cold COMPRESS(ES) DURING 1ST VISIT to medical personnel. Application of OINTMENTS to abrasions to prevent drying & cracking.

The following procedures, by itself, is not considered medical treatment:

Administration of TETANUS SHOT(S) or BOOSTER(S). However, these shots are often given in conjunction with more serious injuries. Injuries requires these shots may be recordable for other reasons.

MEDICAL TREATMENT

The following are generally considered medical treatment. Work-related injuries for which this type of treatment was provided or should have been provided are almost always recordable:

Treatment of INFECTION. Application of ANTICEPTICS during 2nd or subsequent visit of medical personnel. Treatment of 2ND OR 3RD DEGREE BURN(S) Application of SUTURES (stitches) Application of Butterfly Adhesive Dressing in lieu of stitches. Removal of Foreign Bodies Embedded in Eye

Removal of Foreign Bodies from wound if procedure is complicated because of depth of embedment. Use of Prescription Medication (except a single dose administration on 1st visit for minor injury) Use of hot or cold Soaking therapy during 2nd or subsequent visit of medical personnel. Application of hot or cold compresses during 2nd or subsequent visit of medical personnel. Cutting away Dead Skin (surgical debridement)

Application of Heat Therapy during 2nd or subsequent visit of medical personnel. Positive X-RAY diagnosis (fracture, broken bones etc.) Admission to a Hospital or equivalent facility for treatment.

CLASSIFICATION OF INJURY AND INCIDENT

Definition of an INCIDENT

An incident is an unexpected/unplanned occurrence that interferes with the orderly progress of work and that caused or might have caused one or more of the following:

A serious injury or adverse effect on the health of one or more employees. Actual or potential significant loss of physical facilities even though potential for injury was small. An environmental problem. A situation that could have as unfavorable impact on the public.

Incidents have been classified into eight categories, which are:

Injuries Occupational illness Process Safety Incidents Violations of safety Procedures/practices Vehicle Incidents Equipment Failure Environment Incident Others

INJURIES

Death and /or injury or occupational disease suffered by a person which arises out of and in the course of his employment, on or off the employees premises, i.e. resulting from work activity or environment of employment. Injuries have been classified into 5 categories:

FATILITY: Death resulting from work injury or occupational illness. LOST WORKDAY INJURY (LWI): Any injury or illness which prevents the employee from performing all the duties of his regularly assigned job on any workday following the incident on which the employee has been scheduled to work.

LOST WORKDAYS: All days (whether consecutive or not) on which an employee is scheduled to work, but is either absent on restricted duty or unable to perform all the duties of his job because of injury or illness. Days away from work should include only those full days or shifts that are missed by the employee/ contractor. No lost workdays are charged for fatalities.

Restricted Work Case (RWC): Any work related injury that results in restricting the employee to perform all or any part of his normal assignment during all or any part of the work day or shift. Recordability of restricted duty at times will be dependent upon the nature of the work performed by the employees. e.g. a sprained ankle may not be lost workday for an office assistant working at a desk since he can perform all his duties but it probably would be for an operator or a mechanic.

MEDICAL TREATMENT CASE (MTC)

Any work related injury in which treatment (other than 1st aid) is administered by a physician or by registered professional personnel under the standing orders of a physician. Medical treatment does not include 1st aid treatment, even though provided by a physician or registered professional personnel.

Examples of MTC :
Abrasions: Treatment of abrasions that occur to deeper than full skin depth. Bruises: Treatment of bruise by drainage of blood. Burn: The treatment of 2nd & 3rd degree burn. Fractures: Treatment of fractures Infections: Treatment of infection arising out of an injury. Prescriptions: Administration of prescriptions medicine. Sutures: The suturing of any wound.

First Aid Case (FAC)

First aid is limited to any one-time treatment and any follow up visit for the purpose of observation of minor scratches, cuts ,burns which do not ordinarily require prescription medication/medical care. First aid can be provided by a physician or nurse.

Reportable Injuries
All the following injuries to ECPL or Contractor employees will be reportable: 1: Fatality 2: Lost Workday Injury (LWI) 3: Restricted a Workday Case (RWC) 4: Medical Treatment Case (MTC) 5 First Aid Case. (FAC)

Occupational Illness
Occupational illness can be defined as any disorder not resulting from an injury that is caused by environmental factors associated with employment. The basic difference b/w an injury or illness is the single incident concept. If the condition resulted from prolonged or multiple exposure to a hazardous substance or environmental factor, it is an illness.

A few example of occupational illnesses are as under:

1)

2) 3)

4)

un-authorized operation of radioactive source resulting in exposure of personnel to radiation with adverse effects. Drinking water tests for bacteria or other pollutants outside of specified limits. Heat stress signs or symptoms of heat stroke or heat exhaustion. Storage of PPE that could result in chemical exposure (e.g., coat over contaminated pants).

PROCESS SAFETY INCIDENTS:

Defined as an incident that directly involves or could involve, process equipment and materials, including on-side storage and handling of process materials. It requires completion of process incident Classification and scoring sheet. Additionally, incidents that result in any off-side impacts are also classified as process safety incidents: evacuation, shelter-in-place, injury/illness.

Classification
Process incidents having scores of equal to or more than 75 points (>=75) are classified as process safety incidents and require reporting and formal incident report. process incidents having scores equal to or more than 130 points are classified as serious process safety incidents and to be investigating by a designated team. Categories of process safety incidents are as under:

Process Release
Any release of process materials in significant amount to the environment from manufacturing facilities (leaks, relief valves). Process vent gases released at safe locations will also be reported. Some examples are:

Significant release of flammable material such as synthesis gas, hydrogen, methane, hot oil, etc. Creation of a gas mixture or vapor clouds in the flammability limits in which ignition did not occur but could possibly have occurred. Toxic gas or liquid release (ammonia & chlorine) such as from valve gland, transmitters etc. which require full face mask for isolation.

Problems Of Heat Balance In Hot Weather

Human being maintain body temperature with in a very narrow range under varying environmental temperature. That is why like birds and other mammals, man is also called homoeotherm. The human body , like the internal combustion engine produces heat in the process of converting food into energy. 80-85% of the energy liberated as a result of metabolism is in the form of heat. Body gets rid of excess heat produced to prevent over heating.

Human body must maintain heat balance not only under normal, comfortable conditions but also under adverse condition of hot weather. Heat exchange b/w body & environment or to be more exact heat loss during hot weather takes place by four types of physical processes.

Conduction: When there is surface to surface contact heat is transferred from hotter objects to the other one.

Convection: Heat is lost from the body to low temperature moving wind. Loss is increased by movement of the body or increase in speed of wind.

Radiation: The human body receives heat by radiation from the hotter objects e.g. sun. Body losses heat by radiation to environment when later is cooler.

Evaporation: This is most important during hot weather. Evaporation of water from the body surface results in heat loss and cooling of the body. It is interesting to note that the process requires 580cal (2.3BTU) of heat to change 1gm of water to its vapor state at body temperature.

Sweating begins at a temperature of 33C and increases in proportion to heat load. Relative humidity plays important role in the process off heat loss through evaporation. Less humidity more evaporation.
Physiological effects of heat load are: 1)Increase blood flow to the skin. 2)Cardiac output increased, may be doubled or tripled. 3)Up to 4 quarts of fluid loss in sweat depending upon temperatures and duration of exposure.

Heat stress results in : -Adverse effect on vital body functions -Impairment of mental efficiency.

Increase Body Temperature Results In: (impaired mental efficiency) -Decreased work done -increased error

Adverse effect on vital body functions: -Excessive heat load may result in failure of temperature regulating system and overheating.

Muscle Cramps: -Lowering of blood pressure -Fainting

Heat Stroke: Delirium, coma, brain damage, death.

Industrial Operations
To understand specific heat balance problems in industrial operations it is important to look into the sources of heat. -Climate or weather -Protective equipment which reduces heat loss

Precautions
Acclimatization: Major changes that occur within a week.

How To Acclimatize: -Have short period of moderate exercise -Avoid spending too much time in air conditioned areas -avoid excessive exertion

Advantages Of Acclimatization -Greater efficiency -Personal comfort Other Precautions: -Avoid working in direct sun -Protect skin from sun burn -Wear light colored and light weight clothing -Use little additional saltexcessive intake by tablets is harmful -Avoid dehydration

First Aid Treatments

Heat Collapse or Heat Exhaustion: (there is normal body temperature, pale skin, sweating, weakness) -Move victim to a cool ,shaded place. -Lay him/her down & give sips of cold water if conscious. -If unconscious check/maintain ABC (airway, breathing , circulation (heart beat). -Get medical help.

Heat Stroke: (there is very high body temperature, hot & red skin, rapid & strong pulse) -move victim to a cool , shaded place -remove clothing -cool him/her by wrapping in a cold & wet sheet. Keep sheet cook & wet by pouring cold water on it. -Do not over chill him/her. -place in recovery position if unconscious and check & maintain ABC. -get medical help.