Health risk assessment

and management

Health

Advancing environmental
and social performance
across the energy transition

www.ipieca.org
IOGP Report 384

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1.0 December 2006 First issue
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Health risk assessment
and management

The global oil and gas association for advancing environmental

and social performance across the energy transition

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Contents

1. Health risk assessment and management within the business model 9

1.1 Alignment with business objectives 9
1.1.1 Licence to operate 9
1.1.2 Business continuity 9
1.1.3 Emergency preparedness and response 9
1.1.4 Human performance 10
1.1.5 Regulatory compliance and responsible standards 10
1.2 HSE management system 10
1.3 Management communication and engagement 11
1.3.1 Annual health risk management plans 12
1.4 Metrics and performance indicators 12
1.4.1 Data quality metrics 13
1.4.2 Health risk assessment process/activity metrics 13
1.4.3 Programme effectiveness/outcome metrics 13
1.5 Communication tools 14
1.5.1 Communication and business partnering 15
1.5.2 Communicating success 16

2. The health risk assessment and management process 18

2.1 Organization and scope 18
2.1.1 Resources and organization 18
2.1.2 Scope of a health risk assessment 19
2.2 Hazard identification and hazard assessment 20
2.2.1 Hazard inventory 20
2.2.2 Risk rating schemes 21
2.3 Risk assessment process 23
2.3.1 Qualitative risk assessment methodology and tools 23
2.3.2 Quantitative exposure assessment – types, technologies, and new developments 25
2.4 Health risk management 26
2.4.1 Control and recovery measures 26
2.4.2 Maintenance of control and recovery measures 29
2.4.3 Communicating controls and recovery measures 29
2.4.4 Health surveillance and occupational epidemiology 29
2.4.5 Documenting and reviewing health risk assessments 30
2.4.6 Competence and training of assessors 31
Conclusion 31

References 32

4 — Health risk assessment and management

Scope

This Report presents the recommendations that the The Report is presented primarily from the perspective of
IOGP-Ipieca Health Committee and Occupational Hygiene field operations and projects in upstream activities; however,
Subcommittee consider essential for optimal health risk the underlying principles of health risk management are
assessment (HRA) and management within a health, safety, equally relevant to any operation type, such as midstream
and environment (HSE) management programme. It sets up and downstream activities, office locations, and contractor
an operational framework that expands upon, and refers to, activities that support these operations. There is an
other IOGP-Ipieca Health Committee Reports 1-9, 11-12 where accompanying Compendium containing useful tools and
appropriate. good practices.
This Report addresses the incorporation of health risk
management and its wider management in a company’s
business and HSE management system, as well as the
application of the HRA and management process for all
activities and health hazards within the oil and gas industry.

5 — Health risk assessment and management

Executive summary

The purpose of this Report is to expand on the health risk The first section of this Report deals with health risk
assessment (HRA) and management information presented assessment and management within the business model.
in IOGP-Ipieca Report 343 – Health management in the oil The focus in this section is to highlight how business
and gas industry. objectives align with health risk management. Key business
objectives that fully align with health risk management
It provides a framework for integrating HRA and HRA
include:
management into an organization’s health, safety, and
environment (HSE) management system and includes the • Licence to operate
identification, assessment, and control of potential health • Business continuity
hazards and risks, and the reduction of occupational illness
• Emergency response and preparedness
in employees and contractors through the HRA process. It
offers clear, practical guidance and good practice examples
• Workforce effectiveness

associated with the industry’s work. • Regulatory compliance and responsible standards
Integration of a health risk management programme into
The HRA and management processes described here are
health and safety management systems is critical for success.
designed to be sufficiently flexible for applicability across
This Report provides integration models and discussion of
all industry activities, including company and contractor
communication and engagement, particularly between field
activities, from exploration and production to complex
operations and site and senior management. These concepts
manufacturing operations or even a simple retail site.
are supported by visual examples to help business managers
The audience includes company and contractor business understand the business case for health risk management.
and line managers, HSE managers, health professionals,
A business planning cycle and approach are outlined for
occupational hygienists, and project managers working in
HRAs. Planning tools, including those to align plans with the
the oil and gas industry.
business’s financial planning and budget cycle, are provided,
The purpose of an HRA is to provide the necessary and advice on how to obtain front-end input from HSE
information and understanding of health risks and their counterparts and business contacts is provided.
controls to prevent workers from experiencing acute
The Report continues with a discussion regarding metrics
and chronic health effects. These assessments need to
and the communication of health risk management
be conducted throughout the life cycle (all phases) of
deliverables with visual examples that can be used to support
business operations, including reassessment as required by
a conclusion or case for action. Recommended metrics are
changes in the work environment or business operations.
shared with references to IOGP-Ipieca health indicators and
Individual health hazards should be identified, their risks to
other metrics.
health evaluated, and appropriate mitigations and recovery
measures determined.

6 — Health risk assessment and management

Executive summary

The final topic in this first section of the Report focuses

on tools for communicating basic HRA and management
messages and successes with an emphasis on keeping
communications simple and visual where possible. Steps to
facilitate a purposeful risk discussion are provided, and visual
examples of simple ‘before and after’ health risk reductions
are shared as effective communication tools.
The second section of this Report provides a framework for,
and details of, the HRA and management process, along
with references to practical examples and working tools,
which can be found in the accompanying Compendium.
An HRA process begins with hazard identification.
The identified hazards are evaluated qualitatively or
quantitatively, and the methodologies, technologies,
and tools used in these evaluations are presented and
discussed. Common hazards within oil and gas operations
are identified in simple tables and in editable risk assessment
tools for chemical, physical, biological, and ergonomic and
psychological risk management. These hazards and the
evaluation results can be plotted on a customizable risk
matrix for characterization and clearer understanding of the
risk. The Report then provides guidance related to control
and recovery tools with real-life examples that illustrate the
effective application of risk management approaches.

7 — Health risk assessment and management

 Section number 1

Health risk
assessment and
management within
the business model
A commitment to health risk management
is fundamental to oil and gas operations.
It is the role of the health risk assessor to
support this commitment through active
engagement with the company to anticipate,
assess, and understand health risks, to
effectively communicate these risks to the
company, and to identify risk management
approaches that incorporate health
considerations in business decision-making.

8 — Health risk assessment and management

Section 1

1. Health risk assessment and management within the

business model

1.1 ALIGNMENT WITH BUSINESS OBJECTIVES consider how their support role can contribute in emergency
scenarios and what issues they might be asked to support.
Health, safety, and environment (HSE) programmes are Examples of health-related support for business continuity
established to enable businesses to effectively and efficiently plans could include:
meet operational effectiveness goals. These operational
goals may be stated in different ways by an individual • Ensuring a safe food and water supply
organization but generally cover the following areas. • Monitoring mould and indoor air quality issues in the
event of a severe weather impact
1.1.1 Licence to operate • Overall pandemic response planning (when to
implement/relax safeguards, quarantine, testing, etc.)9
Licence to operate is the premise that a business should
meet and exceed expectations of all stakeholders to be • Responding to fire or chemical releases
successful as a long-term profitable business. In the context • Assessing when to shelter in place or evacuate
of health risk assessment (HRA), licence to operate includes • Monitoring for toxic materials and providing the
maintaining a safe and healthy workplace so that workers necessary controls
feel protected and are productive. As it relates to community,
it means that operations provide gainful employment to Health risk assessors can also support internal and external
community members and do not create disruption from communications regarding potential or perceived health risks
excessive noise, odours, environmental release, or adverse of workers and the community, and work with management
safety events. Customers expect that the business’ products in these events.
should create societal benefit, be safe for customers to use,
and create value for the customer. 1.1.3 Emergency preparedness and response

Health and safety team members support the licence to Emergency preparedness and response are critical for oil and
operate in many ways. HRAs play a key role in demonstrating gas operations. Risk management and health risk assessors
a healthy and safe work environment. A key benefit to play an indispensable support role in both planning and
the business is avoidance of disruption due to worker response aspects. Health support in an emergency could
health concerns. When HSE team members frequently include:
engage in field operational assessments, it demonstrates • Evacuation and transport
care and management commitment. HSE engagement • Public health authority engagement
in field operations is beneficial to HSE staff in that they
gain operational knowledge, which improves clarity
• HRA
of communication regarding health risks, establishes • Guidance on evacuation versus shelter in place
credibility with operational workers, and fosters worker and • Occupational hygiene monitoring
management buy-in to prevention and mitigation. • Mitigation and health recovery measures (e.g., site clean-
up procedures, training, decontamination measures)
1.1.2 Business continuity
Both medical and occupational hygiene resources should be
Business continuity is a planning process to identify engaged in emergency preparedness and response teams
scenarios that could disrupt or diminish a business’s and participate in team drills with the business. Emergency
ability to operate at optimum levels. There are numerous response drills should include health aspects and lasting
scenarios that can impact business continuity, ranging health effect considerations after initial incident containment
from raw material supply, weather events, pandemics, and (e.g., vapour release into a community) so that resources
cybersecurity events to industrial accidents. Some scenarios can be adequately anticipated and accessible if response is
may have a direct health impact and others may result in needed.
health issues that arise as the scenario evolves. It is the
Guidelines for occupational hygiene emergency preparedness
responsibility of those involved in HRA and management to
and response are included in the Compendium to this
provide input to business continuity plans so that health-
publication.
related scenarios can be addressed as well as the health
aspects of each scenario. Health risk assessors should also

9 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

1.1.4 Human performance The Compendium to this Report has examples of specific
risk guidance, including for benzene, vector-borne disease
Human performance is another core area in which health
control, hearing conservation, paints and coatings, and
resources can support the business in addressing health
welding, burning, and cutting.
risks in the workforce. The HRA process ensures workers
are protected from work-related health hazards. In addition, The business management and health risk assessors
health screening programmes and promotion of well-being should establish a system to monitor and assure base risk
activities can encourage employees to adopt or continue assessment and management standards. These standards
healthy lifestyle habits and exercise to improve workforce and practices should be supported by audits, technical
health. Health programmes such as health surveillance, reviews, and scientific evaluation as needed with assigned
workplace fitness-for-duty screening, medication disclosure, follow-up and closure to address gaps.
fatigue management, and employee well-being and
resiliency all support the business objective of having an
effective and productive workforce that is safe and healthy.
1.2 HSE MANAGEMENT SYSTEM
HSE professionals play a key role in establishing and As with safety and environmental risks, health risks should
maintaining these programmes. be managed systematically as part of an HSE management
system (HSE-MS)11. There are different models for HSE-
1.1.5 Regulatory compliance and responsible MS and health plays a role in each element regardless
standards of the model. A fundamental attribute is that business
Regulatory compliance is part of the licence to operate management owns the HSE-MS and is accountable for
concept and regulations for a particular jurisdiction should its successful implementation. Management leadership,
be followed as a minimum requirement. Regulatory commitment, and accountability are essential to drive the
jurisdictions vary globally and health regulations may system and its continuous improvement cycles. HRA and
or may not be founded on evidence-based science. It is other health programmes can be structured in business
recommended that businesses develop responsible internal management systems in different ways.
standards or adopt appropriate external standards to Figure 1 shows the four steps in an HRA management
apply when regulations do not adequately address known system: identification, assessment, control, and recovery. HRA
health risks based on current science. Examples of where is the practical application of the process and encompasses
health risk assessors can support the business in setting the HSE-MS elements of implementation, monitoring,
responsible standards includes but may not be limited to: and corrective action. The deliverables from the HRA will
• Proactive selection of science-based occupational therefore satisfy certain health requirements of the HSE-MS.
exposure limits (OELs) for use as core standards.
Regulatory OELs in different countries can vary from
no regulation to more stringent than current science Figure 1: Health risk assessment (HRA) management
would suggest. Maintaining a scientific position on OEL system
standards for your business enables consistency across
Leadership and
operations and establishes a position for regulatory commitment
advocacy.
Policy and strategic
• Development and adoption of base-level standards HRA objectives
within the company or the external development
Organization,
of standards. These are important for companies responsibility,
that operate across multiple regulatory jurisdictions. resources, standards,
and documentation
These standards will ensure a base level of hazard IDENTIFY ASSESS
identification, risk assessment and management, duty of Hazard and effects
management
care, and ethical health practice are applied regardless
CONTROL RECOVER
of the country, operation type, or regulatory jurisdiction. Planning and procedures Corrective action
External industry guidance including this Report
Implementation Monitoring
and other IOGP guidance1-9, or other hazard-specific
Corrective action
standards such as the internationally adopted hazard Audit and improvement

analysis critical control point standards for food safety10, Management review
Corrective action
and improvement
can assist in establishing science-based corporate
guidance. HRA Management System

10 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

Figure 2: Health risk assessment management system improvement cycle

Business management systems with integrated health processes

Management, leadership, commitment & accountability

Community
Risk Facilities Incident
Information & Personnel Operations & Management Third party awareness &
assessment & design & investigation
documentation & training maintenance of change services emergency
management construction & analysis
preparedness

Health in design Personnel health Health Health studies

and training management and metrics
• Exposure Controls
• Medical clinics, of change
• Health hazard training • Epidemiology studies
water systems, • Fitness for duty • New chemical review • Health metrics
food services • Medical •Health procedural • Job safety analysis
• Ergonomics evaluations changes for health
• Facility changes for
health
• Occupational exposure
limit changes

Health risk Health Health in site Third-party Health in

assessments documentation procedures health aspects emergency
• Medical resource • Product hazards • Health practices – • Health hazard preparedness
link to site procedures
assessment •Medical and disclosure and response
• Health risk exposure records • Benzene • Health requirements
• Blood-borne • Provision of
assessment in contracts emergency
• Exposure pathogens • Introduction of
• Gas testing medical services
assessment chemicals by third • Occupational
• Occupational • Work permit criteria parties
•Noise standards hygiene emergency
exposure limits response
• Respirator use
• Disease outbreak
response plans

Management system expert reviews improvement cycle

Figure 2 shows another management system framework, in it may be more difficult to gain management support. HRA
which health processes are integrated into elements of the should be a component within the corporate health or
business management system. HSE policy. Business management should understand the
breadth of the HRA management programme and how HRA
Each system has a purpose, scope of coverage, roles and
is a preventive measure that not only avoids lost productivity
responsibilities, procedures (e.g., integrated HSE business
but can enhance and motivate personnel, resulting in
operations), verification measures, and an ongoing
enhanced workforce productivity. Simple visual tools to
management review and improvement cycle to ensure
show and prioritize health risks include the risk matrices
objectives are met effectively. IOGP Report 510 – Operating
discussed in Section 2 and other visual diagrams that enable
Management System Framework11 provides more detail on
quick recognition of priority and/or impact. Examples of
management systems.
communication visuals are included in Section 1.5.
Another critical communication and engagement step
1.3 MANAGEMENT COMMUNICATION AND is daily visibility in field operations. Engaging at the field
ENGAGEMENT operational level will help health risk assessors learn the
operational details necessary to effectively communicate
Management communication, engagement, and support
at all levels in the business. Engaging with operations and
are essential components of a successful HRA management
maintenance workers is critical to enable detailed knowledge
system. Frequent and effective communication with
of health risks and controls. Operations will appreciate the
management will increase support for the system. Effective
access to, and visibility of, professionals that can help them
communication of health risks to business managers and
navigate safely in daily tasks. Engaging operations as part of
non-health professionals requires skilful articulation of the
the team can ensure that the health risk assessor is invited
risk proposition and the potential outcomes in a way that
to attend daily or weekly operations, project planning, and
describes a business case for action. Management has to
process safety meetings, etc. Management will recognize
prioritize investments and resources and, in many cases,
the level of operational knowledge and respect the effort to
make decisions regarding competing safety and health
support operations, which may increase future funding to
priorities. If the risks are not understood by the manager,
manage health risks.

11 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

Figure 3: Health risk assessment planning cycle

Communicate results, Understand business,

metrics, and learnings regulatory, and risk landscape

Downstream
End products
Anticipate occupational hygiene
Execute/adapt plans
Upstream resource and budget needs

Chemical End products

Gain plan endorsement

with business stakeholders

1.3.1 Annual health risk management plans • Piloting new engineering controls to replace reliance on
personal protective equipment (PPE)
Annual HRA management plans should be developed,
including HRA and monitoring priorities, inspections, and • Workforce training and information
engineering and operational control projects needed for • Professional and/or technical training for those involved
worker health protection, as well as the resources required in HRA and management
to accomplish the objectives. Annual plans should be • HSE-MS audits
developed considering previous plans, HRAs and monitoring
results, remaining recommendations (ongoing or not yet As plan accomplishments are delivered, they should be
completed), anticipated business objectives/projects, and documented to demonstrate their value to the business.
potential regulatory impacts that may be forthcoming in the Key deliverables should be communicated in a manner
next year. that leverages visualization of results and processes and
describes outcomes in simple terms but supported by
HRA management plans should be in alignment with the metrics. An example of an annual planning spreadsheet is
business financial planning and budget cycle and should included in the Compendium to this Report.
involve front-end input from health risk assessors, HSE
counterparts, and business contacts as depicted in Figure
3. Proposed deliverables should meet a business objective. 1.4 METRICS AND PERFORMANCE INDICATORS
Key business objectives may include but are not limited to:
Metrics and performance indicators for health risk
• Assessment of priority health risks to enable safe management are a key element to evaluate programme
operations effectiveness and value to the business. Metrics can be any
• Regulatory compliance or assessment data gathered from the HRA management process that
provides quantitative information about the process, such
• Changes to OELs or internal and external standards as data quality, rate/pace, plan completion, or risk reduction.
based on new science
IOGP-Ipieca-API Report 437 – Sustainability reporting
• Effectiveness/maintenance of existing risk prevention, guidance for the oil and gas industry12 summarizes key
mitigation, or recovery measures
indicators for workforce health.
• Critical HRAs tied to project or operation cycles Metrics can be used individually or together. Metrics can
(exposures in special projects)
be categorized several ways and it is most useful to use a
• Identification of more efficient risk management combination of 1) data quality metrics, 2) process/activity
strategies
metrics, and 3) effectiveness or outcome metrics.

12 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

1.4.1 Data quality metrics 1.4.3 Programme effectiveness/outcome metrics

Data quality metrics help ensure that data entered in a These metrics show the effectiveness and outcome of the
recording or reporting system is of sufficient quality that HRA management programme as well as opportunities
it can be used for decision-making. If data is entered for improvement. Examples of effectiveness and outcome
by multiple persons in multiple locations, it is critical to metrics include:
assign common database nomenclature and data entry
processes. Data quality metrics help ensure data entry rules
• Proportion of HRAs for normal operations that involve
the highest exposure risk. If the highest exposure risks are
are followed and can point out areas of inconsistency for within the organization’s risk tolerance, then the outcome
improvement. Examples include: is appropriate.
• Number of ‘key’ defined fields in the HRA template or • Trend of technical/engineering solution implementation
database not completed – these could include HRA and action closure. Implementation of a solution shows
conclusions, HRA approval fields, sample duration, alignment between HRA outcome and the operation’s
sampling pump flow rates, etc. risk tolerance.
• Percentage of HRAs not approved by occupational • Observed activities for which control measures could be
hygiene for quality control improved (e.g., not wearing hearing/respiratory protection
where needed). Non-utilization of a control measure is a
1.4.2 Health risk assessment process/activity metrics measure of poor acceptance of programme elements.
These metrics measure points along the HRA process in • Number of actions and status of the actions in progress,
order to determine its performance. Examples include: complete, or overdue. Monitoring the progress of
• Percentage of HRAs completed/reviewed versus plan recommended actions is another way to monitor
acceptance of the HRA. Consistent non-acceptance or
• Percentage of air/water/noise samples collected versus delay of actions or projects may indicate that either the
target for a period
risk assessors are too conservative or the risk tolerance
• Health surveillance completion rate versus target of operations management is too high. This enables the
The example in Figure 4 is intended to drive increased health risk assessor to adapt HRA actions or influence
quantitative data collection for the HRA of short-term management risk tolerance.
tasks. It places an emphasis on the need for either more • Tracking the number of occupational illnesses or
quantitative or qualitative assessments depending on exposure events with no consequence is termed the
management objectives and resources available. monitoring of lagging indicators, rather than the previous
bullet points in this list, which describe leading indicators.
Identifying and investigating lagging incidents will lead to
better control and prevention of further incidents.

Figure 4: Example company metric to drive an increase in exposure monitoring for short-term, higher-risk tasks to
better confirm exposure risk conclusions (HRA, health risk assessment)

Global high-risk task HRAs Global task samples collected

1400 7000
1200 6000
1000 5000
800 4000
600 3000
400 2000
200 1000
0 0
2016 2017 2018 2019 2020 2016 2017 2018 2019 2020
Quantitative Qualitative Task samples collected

13 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

Figure 5: Visual overview of a health risk management programme

Undetected
pathological Onset of Usual time of Employer
Exposure changes symptoms diagnosis/R X notification

Unmitigated
consequences
Vulnerable Subclinical Clinically apparent Recovery or progression
PROMOTE individual disease disease to disability or death
Health & safety
Mitigating
actions

Exposure control Surveillance Employer Early Health support,

PREVENT
• Elimination & early disagnosis notification treatment mortality studies
Illness & death
• Substitution e.g., hearing,
• Engineering benzene, asbestos
controls
• PPE
MITIGATE
Disease risks &
consequences Potential time frame for disease manifestation –up to 40 years

1.5 COMMUNICATION TOOLS illness prevention and mitigation result in the preservation
of business reputation, licence to operate, and avoidance of
Section 1.3, which discusses management communication impacts from occupational illnesses.
and engagement, highlighted key aspects of the HRA
management programme. In this section, we focus on tools The breadth of a health risk management programme and
for communicating basic messages, with an emphasis on its components can be shown in visual diagram formats that
keeping communications brief, straightforward, and visual include the health hazards present, the controls in place, and
where possible. Short communications are better, so long the mitigations in place to reduce the impact or avoid the
as they make their point clearly and produce the desired adverse health outcome. An example visual overview of a
response. health risk management programme is shown in a timeline
in Figure 5.
A fundamental premise is that business managers need to
understand the health risk management programme and
its importance, including that occupational disease and

Figure 6: Visual overview of health risk management and control over time

Non-science-based regulations or absence of standards

Exposure monitoring and assessment

Procedures and training

Exposure risk

PPE and work controls

Exposure asse
ssment strategy

Culture change
1980

1990

2000

2010

2021

Time

14 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

Figure 7: Example bow-tie diagram

Occupational health programme overview

Industrial hygiene Clinical services and health surveillance studies

Health
hazards
Hazard
identification
Health risk
assessment
Exposure
controls
Site
preparedness
Occupational Occupational Early detection
exam presymptomatic
Clinical
diagnosis &
Workforce
health
Health,
safety,
in the hazard technical exposure enrolment treatment studies operations,
workplace communication administrative
PPE
Drills
screening
in the Response
and recovery
epidemiology cost &
reputation
monitoring workplace measures

Hazards Prevention safeguards Workplace scenario Mitigation safeguards Consequences

Figure 6 provides an example of a health risk management 1.5.1 Communication and business partnering
programme maturity road map showing, through an
Effective communication and partnering with business
evolving health risk management strategy, the progression
managers and field operations personnel are critical to
of a programme from basic compliance to total worker
enable an understanding of why risk reduction is important
health protection.
when making proposals for change. The chances of success
Bow-tie diagrams are another type of visual, which can be are greatly improved when this sort of partnership is built into
used to identify weak or failed safeguards that contributed the health risk management programme, particularly when
to an event. An example is shown in Figure 7. seeking solutions that require investment or procedural
change. An example of steps for purposeful risk discussion
are highlighted in Table 1.

Table 1: Seven steps in a risk discussion

7 STEPS DETAIL

1. Have a case for action Case for action should be supported by comprehensive and coherent data

2. Build partnerships Network and get to know business partners

3. Know your audience Downward, upward, or lateral communication

4. Identify barriers and solutions Assumptions, emotions, language differences, distractions, timing, active
before communicating listening, and understanding

5. Speak a common language Hierarchy of controls – this is a universal concept but not always understood
by everyone

6. Timing Consider creative ways to fund within the budget cycle

7. Value to the client Know your audience, their motivation, and the value to the business

15 — Health risk assessment and management

Section 1
Health risk assessment and management within the business model

1.5.2 Communicating success

As control measures and solutions are implemented, it is
critical to communicate what success looks like. This can be
accomplished via ‘before and after’ examples and a visual
timeline. These ‘success stories’ can be used to share good
practice and encourage wider implementation across the
business. See Figure 8 for examples.

Figure 8: Examples of before and after implementation of control measures

a) Before and after photographs for exposure control improvement in tank gauging

Hermetic valve installed on the access point,

Tank gauging via open access point
containing the operations

b) Before and after visual example using photographs for a benzene exposure control improvement

Open spigot sampling of stream with >0.1% benzene Closed loop sample system installed
– 150 workers required to wear respirators (middle photograph) – no respirator required

c) Before and after visual example using noise plot plans

Noise levels from pumps requiring double hearing Enclosure over pumps for <US$3000 reduced peak
protection with some areas >95 decibels levels to 80 decibels – no hearing protection required

16 — Health risk assessment and management

 Section 2

The health risk

assessment and
management
process
The HRA and management process is
concerned with preventing negative impacts
on health from work activities and providing
a healthy workplace. The aim is to identify
workplace health hazards, evaluate their risks
to health, and determine appropriate control
and recovery measures.

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Given the multifaceted nature of health and the Those conducting an HRA should have the collective
responsibility of employers to provide a safe and healthy knowledge, skills, and experience to:
workplace, it is essential that a systematic approach is used
to evaluate the potential for harm and protect against any
• Know how to carry out HRAs
adverse exposure. Figure 9 is a flow chart of the HRA and • Understand the workplace operations being assessed
management process. • Gather information systematically and make judgements
on hazards, exposures, and potential risks to health

2.1 ORGANIZATION AND SCOPE • Understand the applicable standards and methods for
controlling exposures and reducing risks

2.1.1 Resources and organization • Apply existing knowledge available within the company
Typically, line managers are responsible for ensuring that
• Know the limit of their competence and where to get
further help
workplace health risks are assessed and managed for all
personnel under their control, including contractors. They The HRA team could include operations and maintenance
should be supported by competent personnel who can personnel, HSE professionals, occupational hygienists,
conduct HRAs, as well as operational and maintenance clinical health staff, and other specialists (e.g., toxicologists,
personnel who have knowledge of the activities performed. epidemiologists, ergonomists, human factor engineers,
It is the role of the business to provide the following occupational health physicians, and infectious disease
essential items for effective delivery of an HRA: specialists). The required competence of the HRA assessors
is dictated by the activities being assessed, the nature and
• Clear roles and responsibilities severity of the hazards and risks involved, as well as the
• Competent health risk assessors familiarity of the activities.
• A list of specialists for support The level of resource needed depends on the depth,
• Adequate time, equipment, information, training, and complexity, and scope of the HRA. Simple HRAs can be
support for the assessors completed by an individual or a small team of competent
• Resources to implement remedial action plans assessors. HRAs for complex activities and/or new projects

Figure 9: Flow chart of the typical health risk assessment process (HSE-MS, health, safety, and environment
management system)

Identify health hazards and their

Review when harmful effects (acute/chronic)
changes affect risk
and at designated
intervals Assess the potential risk for each
health hazard

Low risk High or medium risk Inconclusive

Manage for continuous improvement
Add control and recovery
via standard procedures and Obtain further
measures adequate to manage
competencies within HSE-MS information
health risks?
(check these are adequate)

Yes No
Document the assessment, controls, Develop remedial action plan to
recovery measure and remedial improve control and recovery
action plan measures

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should be led by a competent assessor who has undergone • Operational process unit, e.g., distribution terminal, lube
the requisite training to lead such HRAs, which in most cases oil blending plant, small gas production platform
are structured-scenario-based risk assessments. See Section
2.4.6 on HRA assessor competence and training for further
• Individual process units, e.g., catalytic cracker, olefins unit,
utilities
details.
• Similar groups based on roles, e.g., production operator,
maintenance technician, security
2.1.2 Scope of a health risk assessment
Taking an activity-based approach gives considerable scope
The HRA process is applicable to the life cycle of any
for grouping activities into broadly consistent categories. In
operation. All new and existing operational activities,
this way, assessment of similar types of work need not be
maintenance and turnaround activities, projects,
repeated in separate HRAs. For example, when a particular
acquisitions, closures, divestments, and abandonments
operation is conducted by a maintenance group at one site
should be included. HRAs should be performed at the
or location, it may be generalized to be similar at another
earliest stage of a project or operation, reviewed periodically,
location if the equipment, materials, and activities are
and revisited when there is a significant change or as
sufficiently similar. A good example might be changing filter
required by local legislation. Higher-risk activities should
cartridges in a fuel filter pot. These are commonly referred to
be identified and evaluated first, and implementation of
as similar exposure groups (SEGs).
controls should be prioritized; see Table 2 for further detail.
The scope of an HRA will depend upon the activity. What is
The approach to implementing the HRA process depends
included in any one HRA depends on what is manageable,
on the organizational structure and type of work activities
what is relevant to the exercise, the possibilities for exposure,
being conducted. The HRA scope should be activity based,
and the potential risk of the activity. For example, HRAs for
as appropriate, and could apply to the whole process,
complex activities with highly hazardous substances should
specific sections of a process, or specific routine and non-
contain more detail than those with lower-rated hazards.
routine tasks. Activities should be organized into pragmatic
For further information, see the American Industrial Hygiene
assessment units (AUs). Several AUs may be necessary to
Association’s (AIHA) A Strategy for Assessing and Managing
cover all the operations. Examples of an AU include:
Occupational Exposures13.

Table 2: Examples of activities and HRA scope

New activities and Implementation of HRAs at the conceptual and detailed design stages of new activities, projects,
developments and developments allows for the selection of control and recovery measures in the design
phase. Consider plans, process descriptions, etc. and their likely health hazards to select control
measures.

Existing Identify all routine and non-routine operational, maintenance, and turnaround activities.
operations These can be identified via workplace visits and talking with personnel, and reviewing working
procedures, work permits, and injury and illness data, etc. It is good practice to develop an activity
inventory and prioritize potentially higher-risk activities first.

Changes to Identify any change that could affect risk, triggering a review of the HRA. Ideally there should be a
existing activities formal ‘management of change’ procedure in place. Example changes include change to the work
or process (including organizational changes), occupational illness, new monitoring data, reduced
occupational exposure limit or hazard classification change, regulatory update, field observations,
or audit findings.

Post-operational Identify activities during shutdown, decommissioning, and abandonment activities as they may
activities entail specific hazards, e.g., naturally occurring radioactive materials, per- and polyfluoroalkyl
substances, polychlorinated biphenyls, and asbestos.

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2.2 HAZARD IDENTIFICATION AND HAZARD If the HRA is for a project that has not yet been built, reviews
ASSESSMENT of the project design information (including digital design
models if available) together with an HRA from a similar
A health hazard is something with the potential to adversely facility are key sources of information. Another valuable
affect the health of individuals or groups. The difference resource can be a template to follow either for new projects
between safety hazards and health hazards is that safety or new assessments.
hazards, such as a fall from height, have the potential to
HRAs conducted via a desktop exercise or through a design
cause immediate physical injury, whereas health hazards
model review have limitations. The HRA should be validated in
have the potential to cause occupational illness (which
the field when possible and the results adjusted accordingly.
may be acute, delayed, or chronic) with varying degrees of
disability or even death. Ultimately, an inventory of health hazards in the AU should
be identified and listed. For each health hazard, the following
2.2.1 Hazard inventory should be identified:
Health hazard identification is a process that considers all • Harmful effects and whether these are acute and/or chronic
facets of the work activity to • Quantity or size of the hazard, e.g., whether it is acting on
the whole or specific parts of the body
identify the presence of health hazards within the defined AU.
Hazards can be grouped into chemical, physical, biological, • Routes of entry, e.g., through skin or eye contact,
and ergonomic and psychological hazards (see Table 3). inhalation, ingestion, or hearing

Projects in remote areas will also require an assessment • Any hazard rating (e.g., health hazard rating scheme,
Globally Harmonized System of Classification and
of local health infrastructure, endemic disease risk, as well
Labelling of Chemicals (GHS) hazard code)
as health considerations for accommodation14, laundry
provisions, drinking water, and food services10. Local public Useful sources of information for HRAs include existing
health authorities can provide information on medical site occupational hygiene monitoring reports, workflow
infrastructure and public health considerations. charts, occupational illness and incident reports, trade
association material, such as IOGP-Ipieca Reports, and other
The health hazard identification process usually requires
literature reports. Safety data sheets are a valuable source of
the involvement of a person who has had training in health
information for chemical and biological hazards and should
hazard identification, together with individuals familiar with
be available for each agent present at a site.
the activity being assessed, such as operations personnel.
The starting point of the hazard identification process can Examples of common health hazards present at different
take place onsite as a walk-through survey, as a virtual site types of oil and gas and petrochemical operations are
tour (video), or by using digital design models of the Aus. It provided in the Compendium to this Report, with Table 4
should include a review of local procedures and discussions specifically listing example higher-risk health hazards found
with personnel conducting the activities. in the oil and gas industry.

Table 3: Health hazards

CHEMICAL* PHYSICAL BIOLOGICAL ERGONOMIC AND

PSYCHOLOGICAL
Solid Noise Legionella Manual handling operations
Liquid Vibration Bacteria Display screen equipment
Gas Heat Viruses Fatigue
Dust Cold Mites Psychological stressors
Mist Light Yeasts Excessive workload
Fibre, including asbestos Ionizing radiation Pathogens Time pressures
Vapour Non-ionizing radiation Insect sting Change in the workplace
* Including all raw, Resiliency issues
intermediate, final, and
waste chemicals

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Table 4: Example higher-risk hazards, potential health effects, and activities in the oil and gas industry

HAZARD POTENTIAL HEALTH EFFECT ACTIVITY

Benzene Leukaemia, bone marrow, blood, and Collecting samples from pipes or vessels
immune system containing benzene
Mercury Tremors, mental and memory effects, Breaking into pipes or vessels containing
speech disorders mercury; maintenance
Nickel, cobalt Lung cancer, sensitization Catalyst handling
Formaldehyde Cancer, skin sensitization Handling drilling fluid
Silica/quartz Silicosis, lung cancer Drilling, cementing, fracking
Hydrogen sulphide Respiratory arrest, unconsciousness Breaking containment, sampling
Lead Convulsions, nerve disease, anaemia Removing old paint
Chromium and other metals Cancer, metal fume fever, arc eye Welding
Asbestos Mesothelioma, lung cancer, asbestosis Maintenance, handling gaskets
Legionella Legionellosis Maintenance in cooling towers, use of
insufficiently clean shower facilities
Food and water safety Food poisoning Food provision on/offsite
Noise Noise-induced hearing loss, tinnitus Plant or helicopter operations, use of power
tools
Heat or cold Heat illness, such as fainting, stroke; Hot or cold seasons; hot plant work
hypothermia, frostbite
Hand-arm vibration Vibration white finger Use of power tools
Radiation from naturally Bone and other cancers Handling sludge and other waste from drilling
occurring radioactive materials
Ionizing radiation Cancer Use of level gauges for non-destructive testing
Manual loads / repetitive Musculoskeletal disorders and acute Maintenance, operations
movements strains
Psychological hazards Depression, stress, anxiety Turnarounds, projects, remote operations,
heavy workload

2.2.2 Risk rating schemes matrix, and the horizontal axis of the matrix describes the
probability that the event would occur.
Some organizations use defined risk rating schemes to help
prioritize potential health risks as high, medium, or low and The potential risk is described in roughly diagonal bands
determine the need for more detailed HRA. across the matrix, which are typically colour-coded. The
combination of consequence and likelihood identifies the
Two common risk rating schemes used for occupational
risk field and corresponding risk band; see Figure 10 for an
health risk rating include: 1) a scenario-based risk assessment
example. The scenario-based risk matrix is particularly suited
matrix and/or 2) an exposure-based risk assessment matrix.
to single events or acute exposure events.
These can be used together or independently.
Scenarios rated as medium or high will usually require a
In the scenario-based scheme, a particular scenario is
detailed HRA with mitigation strategies to lower the risk level
described in detail (for example, what would be the risk
to an acceptable level. Those with low-risk potential normally
of a malaria fatality if a person were assigned to a malaria
do not require further mitigation and are typically managed
location without taking malaria medication?). The health- or
by standard procedures and the competencies of supervisors
human-related outcome or consequence associated with
and workers.
the scenario is described on the vertical axis of the risk

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Figure 10: Scenario-based risk assessment matrix

Scale levels A B C D E
General Very Unlikely Unlikely Possible Likely Very likely
Has occurred in the Happens about yearly Happens about monthly
Never heard of in the Has occurred in
Historical organisation or similar in similar organizations in similar organizations
industry operations industry operations
operations worldwide worldwide
A freak combination A rare combination Could happen when Not certain to happen
of factors would be of factors would be additional factors are but an additional Almost inevitable that
Descriptive
required for an incident required for an incident present but otherwise factor may result in an an accident would result
to result to result unlikely to occur accident
People Severity A B C D E

No health
effect/injury/illness
0 Very low

Slight health
1
effect/injury/illness

Minor health
effect/injury/illness
2 Low

Major health
effect/injury/illness
3 Medium

Single fatality/
permanent total 4 High
disability

Multiple fatalities 5

A note of caution: experience has shown that health Table 5: Example health hazard classification table
hazards are not always assigned a rating that reflects the full
extent of their potential consequences. This is particularly HEALTH HAZARD CLASSIFICATION HEALTH
true when using scenario-based assessments where the SEVERITY RATING
outcome is from chronic exposure and the health effect Very toxic, carcinogenic, mutagenic,
4
may not appear until many years after exposure. To allow reprotoxic, respiratory sensitizer
for this, the estimate of ‘probability’ for chronic health risks Toxic, skin sensitizer 3
should be based on historical exposure evidence, and
Corrosive, burns 3
decisions on probability should favour the higher category.
Harmful, irritants 2
An alternate approach for health hazards with chronic
Minimal to no known hazard 1
effects is an exposure-based risk rating scheme, which
allows for assessment of longer-term exposures. In this
The probability (horizontal axis) is expressed as a percentage
risk matrix, the severity or consequence of the hazard is
of the adopted exposure limit of the substance being
expressed on the vertical axis in terms of a health severity
evaluated. The exposure rating is used as an estimate of
rating; these are standardized health hazard ratings
relative probability, as the probability of an adverse effect is
assigned to substances based on the severity of the health
generally assumed to increase as the exposure approaches
outcome that can be caused by exposure to the agent or
the reference value. This can be divided into exposure ranges
substance. This matrix typically uses four tiers of increasing
as a percentage of the OELs (e.g., A = <1%, B = <10%, C =
severity rating (i.e., rating 4 is the highest severity and rating
<50%, D = <100%, and E = ≥100% of the OEL).
1 is the lowest; see Table 5). These hazard categories can
be based on the GHS and the European Union regulation A health exposure risk assessment is completed for an
1272/2008 on the classification, labelling, and packaging of exposure profile by combining an exposure rating with a
substances and mixtures16. standardized health severity rating using the health/exposure
risk matrix.
The potential risk in the exposure-based matrix is also described
in roughly diagonal, colour-coded bands. The cell where the
severity rating consequence (vertical axis) and percentage
of OEL exposure (horizontal axis) intersect identifies the
corresponding risk band (see Figure 11 for an example).

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Figure 11: Exposure-based risk assessment matrix

Exposure Rating – Percentage of OEL

Health Severity Rating A (<1% occupational B (>1% occupational C (>10% occupational D (>50% occupational E (>100% occupational
exposure limit) exposure limit) exposure limit) exposure limit) exposure limit)

Minimal to no know
I Low
hazard nuisance

Harmful, irritant,
transient or reversible 2 Medium
effect
Toxic, Corrosive,
burning, skin sensitizing, 3 High
irreversible effect

Very toxic, CMR,

4
respiratory sensitizing

Low
Medium

High

The exposure-based risk matrix may be used for either drivers, laboratory technicians, and cleaning staff. It could
chronic or acute exposures that result in a health outcome. be of relevance to consider differences in exposure patterns
It can be applied to chemical, biological, or physical agents for the same SEG in different work shifts and whether other
with an OEL. groups, such as visitors, may be affected.
It should be noted that the health/exposure risk matrix 2.3.1.3 Health risk assessment information
assesses only risks associated with occupational exposure.
It should not be interpreted as cumulative health risk, which The information collated and included in the HRA should
can be influenced by non-occupational factors. The exposure include:
risk matrix is particularly useful when exposure monitoring • All health hazards and their health effects
results are known for the exposure being assessed. It is also
particularly useful in identifying exposure mitigations that will
• The operating conditions (temperature, humidity, etc.)
during which the HRA is performed (season, regular
move the exposure into the lower-risk area. operation, maintenance, shutdown)
• The level (dose), duration, and frequency of exposure
2.3 RISK ASSESSMENT PROCESS • For chemical and biological agents, a record of the
substance’s form (gas, dust), its approximate quantity,
2.3.1 Qualitative risk assessment methodology and and the routes of exposure (through inhalation, the skin,
tools ingestion, or injection)
The overall aim of a qualitative HRA is to estimate the risks • A description of the process or activity and the
to health and determine the most appropriate control equipment used, including consideration of:
measures to reduce risks. • Potential sources of exposure during the activity, e.g.,
fumes from welding, noise from compressors
2.3.1.2 Similar exposure groups
• Effort needed to do the work and how this could
For a particular hazard, it is necessary to identify the affect exposure
personnel and groups of personnel that would be affected. • Presence and effectiveness of existing control
This can be done by dividing the workforce into groups with measures, e.g., procedures, ventilation, noise damping,
similar exposure to health hazards. SEGs typically share a PPE
job/role, do the same tasks, and are exposed to the same
• PPE used during the activity assessed and any
hazardous agents. SEGs can also be referred to as worker protection factors
groups. Examples include plant operators, road tanker
• Any foreseeable accidents, emergencies, or spills

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• Relevant OELs or standards representing adequate If no standard has been set by the national authority or by
controls an operating company, a working limit should be sought
from the supplier and/or experts familiar with the hazard. If a
• Any existing personal exposure monitoring data,
national/country OEL or standard is less stringent than that
anonymous biomonitoring, health surveillance results,
and any direct-reading results from handheld devices recommended by an operating company, then the operator’s
OEL should be applied.
• Consideration of vulnerable groups that may be at
increased risk, such as inexperienced or untrained In some cases, the HRA assessor may not have enough
personnel information to fully estimate exposure. In these ‘inconclusive’
cases, further information should be collected to further
2.3.1.4 Observation of operations and controls define exposure and may include quantitative personal
Having collated the HRA information, it is important to exposure monitoring data. Advice from experts, such as an
observe, verify, and talk to those involved about operating occupational hygienist, should be sought (see Section 2.3.2 -
conditions, including the following: Quantitative exposure assessment).

• Views of those closest to the work on whether there Typically, exposure risk conclusions are either high, medium,
may be other personnel affected (such as visitors and low, or inconclusive (see, for example, Table 6).
cleaners)
Table 6: Example exposure risk conclusions (OEL,
• Working practices and housekeeping occupational exposure limit)
• Any operator shortcuts or ‘improvements’ to written
procedures EXPOSURE RISK RISK
• Working position relative to the source CONCLUSION
• Personnel use of PPE High Unacceptable risk: exposure
The level of exposure experienced by workers is influenced (≥100% OEL) exceeds OEL/standard. Not
by work practices and the effectiveness of existing adequately controlled. Further risk
control measures. For this reason, the effectiveness and reduction is required.
maintenance of controls should also be observed during Medium There is some degree of control.
task execution and compared with any defined standards, (50 to <100% OEL) Further risk mitigation may be
such as engineering design standards, procedures, and required to reduce the risk further
PPE specifications. The effectiveness and maintenance below the OEL/standard.
in the workplace should be reviewed. Ask, for example,
whether the local exhaust ventilation (LEV) captures the Low / very low Acceptable risk: risk is controlled
contaminant. Are respirators in good condition and do they (10 to 50% OEL / (exposure is below the OEL) but
have up-to-date filters? Are gauges regularly calibrated? <10% OEL) should be monitored for change.
These and other questions can provide valuable insight Inconclusive More information or quantitative
into worksite conditions and behaviours. Defined standards exposure monitoring data is needed
should be considered in the light of advances in technology to make a conclusion.
and information to encourage continuous improvement.
Look also for evidence of exposure, including, for example, Exposure to health hazards should be controlled to below
dust on surfaces, dust clouds, spills, and/or odours. the OEL using the hierarchy of controls (see Section 2.4.1 -
Personnel may also mention unusual exposures (e.g., high Control and recovery measures).
peak noise during certain tasks) or health effects they or
It is good practice to make two separate exposure risk
colleagues experience (e.g., sore back, headaches).
conclusions to understand the extent to which exposure is
2.3.1.5 Estimated exposure conclusion dependent on whether the worker group is wearing PPE or
not:
An estimate of personal exposure should be made and
compared with a standard representing adequate control, • Exposure conclusion if PPE is not worn
such as OELs or noise action limits. • Exposure conclusion if PPE, e.g., respirator, hearing
protection devices, is worn

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2.3.2 Quantitative exposure assessment – types, Personal exposure monitoring should only be conducted by,
technologies, and new developments or in consultation with, a professional occupational hygienist.
Background, area, or handheld direct-reading monitoring
Quantitative exposure assessment involves both personal and
may be undertaken by competent personnel, such as
background monitoring, including traditional occupational
laboratory technicians. Other monitoring techniques such as
hygiene methods such as personal sample pumps and filter
modelling (Section 2.3.2.3) and epidemiology (Section 2.4.4)
devices requiring laboratory analysis, as well as automated
should be conducted by specialists.
and direct-reading sensor methods, which can increase the
amount of samples/data and provide results faster. Only suitable and valid monitoring (including analytical)
techniques, usually defined at the international or national
Workplace monitoring is part of an HRA. It can further
level, should be used and referenced in the HRA. It is
support the HRA exposure risk conclusion and should be
recommended that analysis should be conducted by
conducted in the following circumstances:
accredited laboratories using suitable and validated methods.
• If an exposure risk conclusion is ‘inconclusive’ – to The results of exposure monitoring should be compared
further quantify and define exposure
with the OEL or a company acceptance level. To be cost-
• If failure or deterioration of control measures could result effective, the number of exposure samples performed, or the
in a serious health effect
extent of measurement, should be balanced with the need
• To confirm the effectiveness of control measures for confidence in the results, typically to ensure exposure is
• If local regulations require, even if the exposure risk limited to a certain level.
conclusion is low
For chemicals, guidance on how many measurements
Any exposure monitoring results should be recorded or should be taken before it can be confidently assumed that
referred to in the relevant HRA. the chance of exceeding the exposure limit is acceptably low
is provided in European Standard EN 689:2018 Workplace
Personal exposure monitoring should be used to estimate
exposure – Measurement of exposure by inhalation to
the personal exposure risk of a health hazard. Samples
chemical agents – Strategy for testing compliance with
intended to represent a worker’s exposure through inhalation
occupational exposure limit values15 as well as the AIHA’s
should be collected by attaching the sample medium or
A Strategy for Assessing and Managing Occupational
instrument sensor on or near the shoulder of the person
Exposures13.
monitored to capture a sample in the breathing zone.
For noise, quantitative exposure assessments can be done
Background, area, and direct-reading measurements
based on measurement with a noise-integrating dosimeter
can also be very useful to help manage risks but may not
or handheld sound-level meter. Stationary noise sensors can
adequately represent personal exposure in a worker’s
also be used when assessing noise exposure in a specific
breathing zone. These types of measurements are most
area. Similar assessments can be performed for other
useful for taking short-term measurements where estimates
physical hazards, such as vibration, lighting, and radiation.
of potential exposure are used for work permits, protective
equipment determination, or designating hazard zones, There are a number of freely available tools that assist in
such as high noise areas. Direct-reading instruments can exposure calculations and statistics, for example, noise and
also be used for surveillance by continuously monitoring the hand-arm vibration calculators, and the AIHA’s and Belgian
hazard of interest (e.g., hydrogen sulphide, noise) as input to Society for Occupational Hygiene’s statistics packages
risk management. known as IHSTAT and BWStat, respectively.
The measurement methods vary widely. For chemicals,
methods range from passive/active adsorption tubes and
badges to filters and direct-reading instruments and sensors;
for non-chemical hazards, other types of monitoring
equipment are used, including sound-level meters and
thermal environment, lighting, and vibration-sensing
instruments.

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Figure 12: Open (left) and closed (right) sampling devices

Closed loop sampling device replacing

Addition of gauges to limit sampling to a minimum
an open sampling point

2.3.2.1 Direct-reading and sensor technology exposures. Tools include the Advanced REACH Tool, the
COSHH Essentials e-tool, or the European Solvents Industry
Direct-reading methodologies and sensors are being used
Group’s Generic Exposure Scenario Risk and Exposure Tool
more frequently for health and safety risk assessments.
for workplace exposure assessments under the EU REACH
They can detect and monitor hazardous conditions faster,
regulations.
potentially in real time, allowing for quicker intervention
strategies, and they can trigger alarms in the event of
unsafe conditions. These technologies can provide timely 2.4 HEALTH RISK MANAGEMENT
information to users, and additional valuable data within
the monitoring session, compared with traditional time- 2.4.1 Control and recovery measures
delayed monitoring methods. Sensors can be small enough
that they are incorporated into wearable devices such as 2.4.1.1 Control
watches and clothing. Figure 12 provides examples of how
If the HRA identifies any activities with exposures that are
personal direct-reading sensor data was used to identify
too high or for which controls are insufficient or ineffective,
tasks where exposures potentially exceeded OELs, leading to
additional controls will be needed to reduce the exposures to
several control improvements, including adding gauges and
an acceptable level of risk.
replacing open sampling equipment with closed sampling
devices. The hierarchy of controls should be implemented in the
following order of preference:
2.3.2.2 Digitalization and big data
1. Elimination of the hazard (e.g., task ceased, chemical
Use of direct-reading instruments and sensor technology removed)
has made it possible to obtain a large volume of sampling 2. Substitution of the hazard (e.g., using less hazardous
data of relevance to exposure and to assess large worker chemical/process)
groups in real time. Data collection and analysis allows for
3. Technical or engineering control (e.g., enclosing the
performance analysis, identification of positive and negative
process, noise silencer)
trends, and can provide an early warning of emerging issues.
4. Administrative/management control (e.g., reducing
It is important that data is collected in a manner that will exposure times, developing procedures)
deliver quality and actionable output and include efficient
5. PPE
integration of occupational hygiene data with other HSE-
related data that can contribute to creating the ‘bigger In a bow-tie model, in which the exposure incident is placed
picture’ for decision makers. in the centre, the hierarchy of controls are the preventive
barriers to the left, whose aim is to prevent the exposure
2.3.2.3 Exposure modelling incidence from occurring (Figure 13).
Exposure modelling is most commonly used in work-related These controls are illustrated in more detail in Figure 14.
risk assessments of chemicals, as well as in the event of
unplanned releases, to estimate worker and community

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Figure 13: Bow-tie model

Exposure

ILLNESS
incident

PREVENTIVE BARRIERS CONSEQUENCE REDUCING BARRIERS

Figure 14: Hierarchy of controls

Medic
Elimination Technical barriers PPE Exposure r

Substitution Organizational
incident

PREVENTIVE BARRIERS

For risks assessed as high, serious consideration should be Following HRAs in a lube blending plant, a number of controls
given to eliminating, substituting, or finding alternative ways were recommended:
of carrying out the operation to avoid the risk. In the case
of hazards that have carcinogenic, mutagenic, reprotoxic
• Drums are now handled with a steering wheel (right)
(CMR), and/or allergic effects, these should be replaced, if • Groups of drums are moved with forklifts
possible, by a lower-risk hazard or process that does not • Oil mist is collected with local ventilation to reduce mist
contain the hazard. exposure and slip/fall risks

If it is not possible to eliminate or substitute, as is often • Windows were installed in the grease plant in addition to
air conditioning to reduce heat stress
the case, technical or engineering controls should be
implemented, if reasonably practicable, especially for routine, • Noise exposure was reduced by installing a sound barrier
frequent activities. For all high-risk activities, controls are in the blending area
needed to prevent exposure incidences and their adverse
health consequences. For risks assessed as acceptable or
low, controls can be established and maintained via standard
procedures, training, and personnel competencies and should
be managed for continuous improvement. See Figure 15 for
example recommended control measures from an HRA.

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Figure 15: Example health risk assessment (HRA) control recommendation: a drum with steering wheel

Following HRAs in a lube blending plant, a number of controls were

recommended:
• Drums are now handled with a steering wheel (right)
• Groups of drums are moved with forklifts
• Oil mist is collected with local ventilation to reduce mist exposure and
slip/fall risks
• Windows were installed in the grease plant in addition to air
conditioning to reduce heat stress
• Noise exposure was reduced by installing a sound barrier in the
blending area

2.4.1.2 Compliance and ALARP In both compliance and ALARP, the relevant supporting
information and evidence should be documented in the
The definition of ‘acceptable risk’ varies between different
HRA.
countries and organizations. The exposure risk should
always be reduced below any OEL or standard representing 2.4.1.3 Recovery measures
adequate control. Compliance will range from being just
below the OEL or other standard to being 50%, 20%, and Recovery (preparedness) measures are required to mitigate
10% of the OEL, depending on the applicable requirements. the potential effects should exposure control measures
fail and to prevent the potential escalation of health
Compliance should be established either via competent risks. Examples of mitigation measures (consequence-
judgement or quantitative monitoring, if required. reducing barriers as illustrated in Figure 16) include medical
European Standard EN 689:201815 provides guidance on emergency response arrangements, eyewash and shower
demonstrating chemical exposure compliance with OELs. stations, escape equipment such as rebreathers, personal
Some country regulations or companies require risk to alarms, signage and communication equipment, and post-
be compliant as well as reduced to as low as reasonably traumatic stress counselling. Some situations may require
practicable (ALARP), including consideration of control special measures such as the availability and use of calcium
measures in accordance with the hierarchy of controls. The gluconate on hydrofluoric acid burns. Measures to reduce
UK’s Health and Safety Executive defines ALARP and the the possible escalation of incidents when controls fail should
core concept of ‘reasonably practicable’ as weighing the risk be included in the medical emergency response plan.
against the trouble, time, and money needed to control it. Specifications for adequate recovery measures should be
It is considered good practice to reduce exposures to CMR identified, similarly to control measures. In addition, regular
hazards to ALARP, to include the hierarchy of controls with emergency exercises should be carried out to test the
an emphasis on closed systems and engineering control effectiveness of emergency arrangements and to help
where technically possible, and to limit the amount of the train staff.
hazard and the number of workers to the minimum required.

Figure 16: Example of consequence-reducing barriers

Medical emergency Health surveillance

Exposure
ILLNESS

PPE response

ional
incident
Clinical treatment

CONSEQUENCE REDUCING BARRIERS

28 — Health risk assessment and management

Section 2
The health risk assessment and management process

2.4.2 Maintenance of control and recovery measures In addition to prioritizing risk control actions, the matrix can
also be used to prioritize other activities, such as:
Control measures will only remain effective if they are
properly and regularly inspected and maintained, including: • Health risk communication
• Engineering controls: preventive maintenance, routine • Exposure monitoring plans
inspections, examinations, and tests to ensure plant and • Health surveillance
equipment continue to operate at design specifications.
This is particularly important for ventilation systems; it is 2.4.3.3 Health risk and control information and training
good practice to examine and test LEV every 12 to 18 Personnel should understand the risks to health from
months. health hazards and the precautions to be taken to protect
• Procedural controls: procedures that include instructions themselves during their work. It is good practice to
to ensure adequate maintenance of controls, e.g., work detail training and information methods via local hazard
instructions describing control measures, work permit communication policies and procedures.
systems, record systems, instruction and training records,
Relevant health risk and control training should be provided
supervision, safe systems of work, and emergency
within the induction period for new employees, via on-the-
arrangements.
job training and as refresher training at designated intervals,
• PPE: specific respiratory, hearing, and chemical such as every 3 years.
protective equipment, most of which requires routine
inspection and maintenance, training, and instruction. Information on health risks and controls should also be
provided via work permits, work instructions, summary worker
All plant and equipment needed for recovery should be information cards, worksheet reminders, toolbox talks, and shift
routinely inspected and maintained in good working order. handovers, and via posters, labels, and signage, as appropriate.

2.4.3 Communicating controls and recovery Personnel and their management should be informed
measures of the results of HRAs, monitoring results, and collective
anonymous health surveillance results. In addition, personnel
2.4.3.1 Actions should be informed individually of their:
In cases of unacceptable exposure, action should be taken • Personal workplace monitoring results
to inform any affected personnel and ensure they are • Health surveillance results, including information and
protected. A remedial action plan should be documented, advice regarding further medical assessment, if necessary
listing the additional control and recovery measures needed
both in the short and longer term. As with action plans 2.4.4 Health surveillance and occupational
arising from other aspects of the HSE-MS, implementation epidemiology
priorities, responsible persons, and target dates for actions
should all be clearly identified and the details entered into 2.4.4.1 Health surveillance
a tracking system to ensure remedial actions are tracked Health surveillance assesses the health of the individual in
to completion. Necessary resources will need to be made relation to the workplace hazards to which they are exposed
available to track actions and implement them. For further by all routes of exposure. Any health surveillance results
information on communication, engagement, and tools should be summarized and anonymized and the information
refer to Sections 1.3 and 1.5. linked back to the HRA, if legally possible.
2.4.3.2 Prioritizing actions Health surveillance should be conducted in the following
circumstances:
To assist in prioritizing actions, hazard and exposure ratings
can be combined via the exposure-based HRA matrix (see • When the exposure risk is unacceptable and there is:
Section 2.2.2, Figure 11). First priority actions are indicated • An identifiable disease or health effect related to the
by the high-risk portion of the matrix and could include, for exposure
example, stopping the activity and identifying immediate • A reasonable likelihood that the disease or health
controls, such as PPE, to control exposure in the short effect may occur
term. Second priority actions, indicated by the medium-risk • A valid technique for detecting indications of the
portion of the matrix, could include, for example, further disease or the effect
work practice improvements or engineering control, which
may take longer to implement. • When health surveillance is mandated by local authorities
or required for certain substances or processes, even if
the exposure risk conclusion is acceptable

29 — Health risk assessment and management

Section 2
The health risk assessment and management process

Health surveillance typically involves individual exposure HRA records should:

questionnaires, disease surveillance, and medical
surveillance, including biomonitoring. The content and
• Be readily accessible when needed, e.g., by employees,
for internal/external audits, for local or national
frequency of health surveillance should be determined by authorities, or for periodic review
the HRA or in accordance with regulatory requirements.
Biomonitoring can also be used as a verification of • Meet legal requirements
control measures, unlinked to health surveillance. Health • Be kept for a period as required by national laws and/or
surveillance conducted in the industry typically looks for practice.
benzene, lead, mercury, noise, and hand-arm vibration • Contain sufficient information to ensure an audit trail on
hazards, and other hazards as appropriate for the site and how conclusions/decisions were reached
activity. • Allow tracing of individuals from the job type, activities,
Employees should be encouraged to participate in health and thus health hazards, controls, monitoring records,
surveillance by, for example, discussing information about etc.
its benefits. Contractors should undergo health surveillance • Include personal exposure monitoring and anonymous
with their own employer, and the company typically asks health surveillance results
that contractors provide evidence of this health surveillance,
if required. 2.4.5.2 Reviewing health risk assessments

Health surveillance should be conducted by competent Regular reviews should include consideration of the extent
personnel and the results interpreted by, or under the to which the HRA expectations described in this Report
supervision of, suitably qualified occupational health are being met, including whether systems and procedures
professionals, such as an occupational physician or nurse. operate as documented. Additionally, individual HRAs should
Individual health surveillance records should be kept be fully reviewed periodically, for example every 5 years, and
confidential. If an employee is found to have an identifiable revised when necessary. Any significant change that may
disease or adverse health effects, an investigation into have an impact on health risks – for instance, changes in the
further measures to control exposure should be completed work processes, job patterns/activities, or specific hazards
and employees referred for medical evaluation and advice. and risks – should trigger a review of the HRA, in addition to
reviewing the effectiveness of designated actions following
2.4.4.2 Occupational epidemiology implementation.
Occupational epidemiology can be used to examine health 2.4.5.3 Record-keeping
outcomes among workers and their potential association
with hazards in the workplace, including noise, chemicals, Records will need to be kept in accordance with local
heat, and radiation. Using meta-analysis, many occupational regulatory requirements and local company record retention
epidemiology studies can be synthesized to help set OELs policies for, for example, 50 years, including the following:
and make other kinds of policy decisions. There are several • Occupational hygiene exposure monitoring results and
types of epidemiology studies, with cohort studies and case- reports
control studies being the most well-known.
• Personal exposure assessment records
2.4.5 Documenting and reviewing health risk • Health surveillance results, including biomonitoring
results
assessments
• A list of all personnel engaged in work with, or exposed to,
2.4.5.1 Documenting health risk assessments CMR chemicals and allergens
HRAs, associated exposure monitoring data, and actions The following records should also be kept but for a shorter
should be documented and kept. This may be part of a self- period, for example 5 years, depending on local regulatory
contained HRA report or included in an element thereof, requirements and company policies:
such as an HSE risk assessment, a hazards and effects • Health risk and control information, instruction, and
management process, or a safety case. Where chronic training
health risks are encountered, records should be kept for a
sufficiently long period to allow the evaluation of individual • Maintenance, examination, and test results of control
measures, e.g., LEV, PPE
health effects. It is also possible that they may act as
insurance against possible future liabilities. To achieve this,
arrangements should be made to place records that are no
longer current in an archive.

30 — Health risk assessment and management

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The health risk assessment and management process

2.4.6 Competence and training of assessors

Personnel involved in HRA and management should be
competent. For example, health risk assessors should
attend risk assessor training together with coaching from
a competent assessor. Assessors could be occupational
hygienists, HSE practitioners, production chemists, or other
personnel such as line managers. Line managers should be
provided with awareness training or information regarding
their health risk management responsibilities.
Personal exposure monitoring should be conducted by
an accredited professional occupational hygienist or in
consultation with one. If sourcing an occupational hygienist,
please refer to the International Occupational Hygiene
Association’s (IOHA) (www.ioha.net) National Accreditation
Recognition (NAR) occupational hygiene qualifications
and training across the world. The Occupational Hygiene
Training Association (www.ohtatraining.org) accredits
occupational health training providers around the world. The
British Occupational Hygiene Society provides guidance on
choosing occupational hygiene consultants in its Buyer’s
Guide for Obtaining Occupational Hygiene Services.

CONCLUSION
Risk assessment and control are at the foundation of a
well-functioning HRA management programme. The
guidance provided here is presented as a recommended
model for health risk management in the oil and gas
industry and was developed by a team of oil and gas
industry occupational hygiene and health experts. A quality
health risk management programme will embrace these
concepts, adapt the recommendations into location-specific
provisions, and enable continuous improvements that will
ensure even greater preservation of good health in the
generations of workers to come.
For further information on conducting HRA and management
see AIHA’s A Strategy for Assessing and Managing
Occupational Exposures13. Introductory training and free
training materials can be provided via the OHTA, including
the online or face-to-face course W201 Basic Principles in
Occupational Hygiene. In addition, the IOGP-Ipieca Health
Committee offers other guidance1-9 on the risk management
of various health aspects, such as thermal extremes, drilling
fluids, fatigue, mental health, and infectious disease.

31 — Health risk assessment and management

 References

32 — Health risk assessment and management

References

1. IOGP-Ipieca Report 343 – Health management in the oil and gas industry
2. IOGP-Ipieca Report 626 – Managing fatigue in the workplace
3. IOGP-Ipieca Report 378 – Managing workplace stress. A guide for oil industry managers & supervisors
4. IOGP-Ipieca Report 382 – A guide to malaria management programmes in the oil and gas industry
5. IOGP-Ipieca Report 398 – Health aspects of work in extreme climates
6. IOGP-Ipieca Report 394 – Managing tuberculosis
7. IOGP-Ipieca Report 481 – A guide to vector borne disease management programmes in the oil and gas industry
8. IOGP-Ipieca Report 605 – Pandemic management in the oil and gas industry
9. ISO 22000:2018 Food safety management systems – Requirements for any organization in the food chain
10. IOGP Report 510 – Operating Management System Framework for controlling risk and delivering high performance in
the oil and gas industry
11. IOGP-Ipieca-API Report 437 – Sustainability reporting guidance for the oil and gas industry
12. Jahn S, Bullock W, and Ignacio J. (eds) A Strategy for Assessing and Managing Occupational Exposures, 4th edition.
Falls Church: AIHA, 2015.
13. Building Responsibly Worker Welfare Principles, https://www.building-responsibly.org/worker-welfare-principles
14. European Standard EN 689:2018 Workplace exposure – Measurement of exposure by inhalation to chemical agents –
Strategy for testing compliance with occupational exposure limit values.
15. Regulation (EC) No 1272/2008 of the European Parliament and of the Council of 16 December 2008 on classification,
labelling and packaging of substances and mixtures, amending and repealing Directives 67/548/EEC and 1999/45/EC,
and amending Regulation (EC) No 1907/2006

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Ipieca is the global oil and gas association dedicated to advancing environmental and social
performance across the energy transition. It brings together members and stakeholders to
lead in mainstreaming sustainability by advancing climate action, environmental responsibility,
and social performance across oil, gas and renewables activities.

Ipieca was founded at the request of the United Nations Environment Programme in 1974.
Through its non-lobby and collaborative approach, Ipieca remains the industry’s principal
channel of engagement with the UN.

The International Association of Oil & Gas Producers (IOGP) is the global voice of our
industry, pioneering excellence in safe, efficient and sustainable energy supply – an
enabling partner for a low-carbon future. Our Members operate around the globe,
producing over 40% of the world’s oil and gas. Together, we identify and share knowledge
and good practices to improve the industry in areas such as health, safety, the environment
and efficiency.

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