Putting the “H” back into Occupational Health and Safety means working systematically towards the prevention of foreseeable harm arising from identified health hazards, writes Norman Jennings.
The New South Wales Mine Safety Advisory Council (MSAC) is the principal OHS body in the NSW mining and extractives industry that provides advice to the Minister. Part of the world-leading vision of MSAC is to put the “H” back into Occupational Health and Safety. This tripartite vision is shared by the NSW key stakeholders – employers, employee representatives and the regulator.
MSAC has a systematic approach to health management, consulting extensively with industry. Firstly, it sought to identify the health and safety priorities of those working in the industry. Secondly, it provided guidance on how those priorities could best be managed or progressed. Thirdly, it provided the means for the industry to obtain targeted assistance. Lastly, MSAC is providing the mechanisms to monitor and evaluate the effectiveness of measures taken to tackle those priorities.
MSAC has been actively promoting the systematic management of priority health issues in NSW mining. The Council has also been developing targeted health education and assistance programs for the industry and promoting their delivery throughout NSW.
Recently, MSAC established the Health Management Advisory Committee (HMAC). Comprising of representatives with extensive and specialist health knowledge of different industry sectors, HMAC is well placed to provide advice on the coordination of the regulation of health issues in the NSW mining and extractives industry. Its role is to identify and monitor emerging health issues in the industry and propose collaborative approaches to addressing them. The aim is to assist sites in developing and implementing systematic health management plans which integrate into their overall management systems.
The MSAC approach to health management
Before establishing the HMAC, MSAC undertook extensive consultation with industry and research on priority health issues. MSAC also identified a need to improve the coordination of health management and implement collaborative strategies to raise awareness of issues and promote the use of tools to assist the industry. Moreover, MSAC recognised the need to collect and analyse data on action on-site and evaluate progress in five priority areas:
- Health management
- Fatigue
- Dust and diesel particulate
- Noise
- Musculoskeletal disorders
A breakdown of the high priority exposures and related disorders (apart from health management) is:
- Noise causing noise-induced hearing loss
- Vibration causing musculoskeletal disorders
- Diesel exhaust fumes leading to respiratory disease
- Hazardous substance exposure causing dermatitis
- Ergonomic stressors causing musculoskeletal conditions
- Ergonomic stressors causing back disorders
- Ergonomic stressors causing fatigue and related disorders
- Psychosocial hazards causing mental disorders
- Ultraviolet radiation and skin disease
- Dust exposure leading to respiratory disease
MSAC recognises that the disease effects of these health hazards are not always apparent until much later after exposure has occurred. Also, while some exposures are readily measurable or have exposure standards (such as noise and dust) they may not be the only cause of the onset of a disease. The lack of a clear work/play divide may then lead to an under-reporting of the issue.
Industry too, has acted in concert with the other stakeholders to great effect, with ongoing vigilance, cooperation and a genuine willingness to improve the health outcome of its workers. Industry has systematically tackled the major health issue of pneumoconiosis in the underground coal sector. This collaborative effort by government, industry and unions to develop and use desirable work practices, technology and surveillance to reduce exposure to coal dust has led to the eradication of “Black Lung” in the NSW coal mining industry. This is in contrast to other mining countries where Black Lung is still a major issue.
After widespread industry consultation, the next step for MSAC has been the development and rollout of an integrated approach to addressing priority areas through the development of practical guidance to industry. Risk management guides were developed for health, fatigue and musculoskeletal disorders. These resources were promoted and supported through a series of workshops aimed at assisting implementation at sites.
MSAC help so far – Industry Health Guides and Education
Health Management
The MSAC guide Health Management Plan1 covers:
- Policy development
- Consultation
- Risk management
- Exposure monitoring
- Training and information
- Supervision
- Health surveillance
- Illness management and rehabilitation
- Health and wellbeing
- Records management and reporting
- Evaluation and performance measures
The purpose of the guide is to enable mine operators to systematically manage health risks in the workplace so that they comply with the legislative framework. Ultimately, the aim is to ensure that there are no negative impacts to the health of workers.
Desirable approaches to the development of a health management plan are suggested but not prescribed. This means that individual operators can develop a plan that is specific to their needs, commensurate with their level of management maturity and reflective of their resources, while addressing the key components of a health management plan.
Fatigue
The 2005 Wran Mine Safety Review2 highlighted hours of work and fatigue as one of the single most important issues facing the mining and extractives industry in NSW. In 2007, MSAC Digging Deeper project3 showed clearly that hours of work in the NSW mining and extractives industry are long, and that fatigue issues needed to be addressed.
Following an extensive review of available information on fatigue management and lengthy, constructive negotiations between stakeholders, MSAC produced the Guide to the development and implementation a Fatigue Management Plan.4 Agreement on this document was a significant milestone and provides an opportunity for the industry to move further towards world-leading OHS. The guide:
- Identifies who needs a fatigue management plan
- Explains how to develop a site-specific fatigue management plan
- Identifies the need for a policy commitment to manage fatigue effectively
- Explains early and ongoing consultation roles for all relevant groups
- Identifies everyone’s role
- Is risk management based, requiring: hazard identification; risk assessment; control of the risks; and evaluation of the effectiveness of the risk control process
- Requires risk assessment advice with triggers and action points
- Requires all mines with fatigue risks to have a documented fatigue management plan that is part of its OHS management system or plan
- Applies to all employees and contractors working on sites
- Explains the training, documentation, and record keeping required
The guide provides practical advice on how mines should consult to develop and implement, a fatigue management plan. The Department has also carried out an education and assistance program throughout NSW to support its implementation by industry.
Musculoskeletal Disorders
Musculoskeletal disorders (MSD) are the main cause of workers’ compensation in the NSW mining and extractives industry, accounting for approximately half of all claims. MSD is an umbrella term for injuries and disorders that include:
- Sprains and strains of muscles, ligaments and tendons (e.g. shoulder muscle strain leading to rotator cuff tear)
- Back injuries, including damage to the muscles, tendons, ligaments, spinal discs (e.g. ruptured discs), nerves (e.g. sciatica), joints and bones
- Joint injuries or degeneration, including injuries to the shoulder, elbow, wrist, hip, knee, ankle, hands and feet
- Bone injuries (e.g. fractures)
- Nerve injuries (e.g. carpal tunnel syndrome)
- Soft tissue hernias (e.g. abdominal hernias)
- Muscular and vascular disorders as a result of whole body and hand-arm vibration
The MSAC Guide to the Management of Musculoskeletal Disorders in the Mining and Extractives Industry5 is designed to help sites take planned preventative measures to deal with risks associated with musculoskeletal injuries. It includes practical examples, case studies, resources and easy-to-use tools. A major benefit of the guide is that it provides information and management processes that are consistent with regulatory requirements and with world-leading practice. Moreover, it utilises capacities that already exist on-site to control musculoskeletal risk.
Health Indices – Lead and Lag Indicators MSAC believes that performance monitoring forms part of a good practice approach to managing health and safety. Use of performance lead and lag indicators can and should play an important role in the minimisation of adverse health and safety consequences.
Sometimes referred to as positive performance indicators, lead indicators aim to help organisations adopt proactive or “upstream” management of their hazards before an incident or exposure occurs. On the other hand, lag indicators provide”after the fact” or “downstream” data, showing the extent of the damage already done.
Using lead indicators in conjunction with traditional lag indicators can provide a higher level of assurance that the risks are being adequately controlled and can give organisations an early warning of any weaknesses in their control systems, and thereby assist in better protection of workers’ health and safety.
There were five priority health hazard areas identified as benefitting from this health indices approach: Noise-induced hearing loss; Musculoskeletal disorders; Lung disease from diesel particulate; Lung disease from dust; and Fatigue.
Noise
Hazardous noise poses a serious and ongoing risk to the health of those who are exposed to it throughout their working life. The World Health Organisation considers noise-induced hearing loss the greatest preventable occupational disease today.
The measurement of hearing loss claims data (lag indicator) is still somewhat problematic due to differences in sites, equipment and individual factors. The development of new guidance material (e.g. the SWA Code of Practice – Managing noise and preventing hearing loss at work6) and lead indicator fact sheets aims to reduce, eliminate or control hazardous noise before hazardous exposure occurs.
Lung Disease – Diesel Particulate and Dust
Diesel particulate poses a risk to the health of those exposed to it. Classified as a potential cancer causing agent (lung and bladder cancer mainly), it can also cause chronic respiratory inflammation and irritation to the throat and eyes.
The developed guidance material and lead indicator fact sheets indentify a range of means to reduce worker exposure to hazardous levels of diesel particulate matter. Eliminating diesel exhaust by the use of electrically powered vehicles is achievable but not always practicable. Better control of diesel exhaust fumes can be achieved, for example, through the selection of equipment which minimises exhaust output. Ventilation is another factor, as are maintenance of equipment, correct selection of fuels, and (as for dust) the proper and regular maintenance of haulage roads in and around a mine.
The Future – Health and Safety Cultural Maturity
MSAC recognises that a mature health management system depends on a mature OHS culture which is built through consultation, commitment of resources, communicating responsibilities, promoting participation and by following through with meaningful actions.
A mature and resilient culture requires a progressive approach to health management by the development of systems which anticipate risks and seek to eliminate or control exposures at their source.
Health indices are but one step in the journey towards this end. If correctly adopted and implemented they can be used to drive OHS culture maturity in a continuous improvement process.
MSAC has begun this journey by identifying industry priority health indices which will enable evidence-based decision making for the implementation of further targeted health education and assistance programs. The new Health Management Advisory Committee (HMAC) will be evaluating the impact of these projects between now and 2014, and will oversee the roll-out of new projects designed to help reduce issues that adversely affect the health of those working in the mining and extractives industry.
HMAC has already developed a set of factsheets on each of the five health issue areas above in the lead and lag indicators matrix, including how and what companies could be measuring or monitoring to improve their outcomes.
MSAC has worked hard to raise general awareness of health and safety issues that affect large and small mine sites. It has highlighted issues that impact on vulnerable workers – contractors and young workers.
The Council has funded research, developed practical guidance material and endorsed the delivery of education programs that raise the awareness of workers and management on the issues and the most desirable means to manage them. MSAC is focused on obtaining solid, relevant information about contemporary health issues so that further improvements towards achieving a more mature health and safety culture in the NSW mining and extractives industry can be made.
Putting the “H” back into Occupational Health and Safety means working systematically towards the prevention of foreseeable harm arising from identified health hazards. If eliminated, and further improvements to the health and safety of mine workers are achieved, the NSW Mine Safety Advisory Council is further along its path towards having the NSW industry not just leading OHS in Australia, but becoming a world-leader in health and safety culture and practice.
Norman Jennings was appointed Chairman of the NSW Mine Safety Advisory Council in March 2006 and was reappointed in 2009.
Norman spent 19 years as the mining and metals specialist and a Deputy Departmental Director at the ILO in Geneva. He was deeply involved in promoting the ratification and implementation of ILO Convention No. 176 on Safety and Health in Mines. He was particularly concerned with the employment, training and working-time and OHS effects on workers and employers arising from the restructuring of the mining and metals industries.
Prior to joining ILO, Norman, an engineer and economist, was a senior official in the Department of Resources and Energy in Canberra.
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