NEBOSH International General Certificate

in Occupational Safety and Health

Unit IG2

Element 5: Physical and Psychological Health

Learning Objectives

• Describe the health effects associated with exposure to noise and

appropriate control measures.
• Describe the health effects associated with exposure to vibration
and appropriate control measures.
• Describe the health effects associated with ionising and non-
ionising radiation and appropriate control measures.
• Describe the causes of work-related mental ill-health and how the
condition can be managed.
• Describe the risk factors and appropriate controls for violence at
work.
• Describe the effects of substance abuse on health and safety at
work and control measures to reduce such risks.
5.1 Noise

3
Jobs Effected by Exposure to Noise
• Construction workers:
 Plant, machinery, e.g. concrete breakers.
• Uniformed services:
 Small arms and artillery.
• Entertainment sector workers:
 Loud music.
• Manufacturing sector workers:
 Industrial machinery.
• Call centre staff:
 Acoustic shock from headsets.
The Effects of Exposure to Noise
Physical effects: Psychological effects:
• Temporary: • Stress.
 Reduction in hearing (temporary • Concentration problems.
threshold shift).
 Ringing in ears (temporary tinnitus).
• Permanent:
 Tinnitus.
 Noise-induced hearing loss
(permanent threshold shift).
 Inability to hear vehicles, warnings,
conversations.
The Human Ear

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The Human Ear

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Terminology
• Sound pressure: • A-weighting:
 The air pressure of sound  Sound pressure level

waves moving through the corrected to match human

air. Expressed in decibels hearing sensitivity.
(dB). • C-weighting:
• Decibel (dB):  Sound pressure level

 The unit of sound pressure corrected for impulse noise.

level; subjectively the
‘loudness’.
• Frequency:
 The number of pressure
waves per second
Decibel Levels

Measurement
Sound
in dB(A)
0 Faintest audible sounds
20-30 Quiet library
50-60 Conversation
65-75 Loud radio
90-100 Power drill
140 Jet aircraft taking off 25m away
Noise Exposure Standards

• The two factors which determine the degree of harm are:

 Noise level.
 Duration of exposure.
• A noise assessment is undertaken to measure noise
levels and durations of exposure.
• This is then used to make an estimate of workers’
personal exposure to noise.
• Personal exposure is then compared to the legal
standards.
• Measurements and assessment must be undertaken by a
competent person.
Noise Exposure Standards

Personal noise exposure:

• The daily personal noise
exposure (LEP,d) is a worker’s
calculated 8-hour noise exposure.
• Worker’s exposure to single peaks
of exposure (impulse noise) is
also measured - this is the peak
sound pressure.
Noise Exposure Standards

• Subject to national laws

around the world.
• No harmonised standards.
• In the UK, these are laid out
in the Control of Noise at
Work Regulations 2005.
• Follow EU directive.
Noise Exposure Standards
• Lower exposure action values:
 a daily or weekly personal noise exposure of 80 dB(A); and
 a peak sound pressure of 135 dB (C) for impulse noise.
• Upper exposure action values:
 a daily or weekly personal noise exposure of 85 dB(A); and
 a peak sound pressure of 137 dB(C) for impulse noise.
• Limit values:
 a daily or weekly personal noise exposure of 87 dB(A); and
 a peak sound pressure of 140 dB(C) for impulse noise.
(Where employees’ exposure varies markedly from day to day, the
weekly personal noise exposure can be used in place of the daily
personal exposure standards).
Noise Exposure Standards: Actions Triggered

Lower Exposure Action Value: 80

dB(A) LEP,d
• Carry out noise assessment.
• Provide information, instruction and
training.
• Make hearing protection available.
Noise Exposure Standards: Actions Triggered

Upper Exposure Action Value: 85dB(A)

LEP,d
• Carry out a noise assessment.
• Reduce noise exposure by engineering
means, ALARP.
If noise is still above 85dB(A):
• Mandatory hearing-protection zone.
• Information, instruction and training.
• Provide hearing protection and enforce
use.
• Health surveillance.
Noise Exposure Standards: Actions Triggered

Exposure Limit Value: 87 dB(A)

LEP,d
• Immediately prevent exposure
and reduce below the limit
value.
The ELV is an absolute ceiling
above which exposure must not go.
Group Exercise

A noise survey has been carried out

and there are two work areas of
concern:
• Machine shop - noise levels 83
dB(A) throughout the shift.
• Wood-working area - noise levels
90 dB(A) throughout the shift.
Discuss the actions that would need
to be taken in each area.
Basic Noise Control Measures

How Noise Travels from Source to Receiver

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Basic Noise Control Measures
Reduce noise at source Protect the receiver
• Eliminate. • Acoustic haven.
• Substitute. • Hearing protection.
• Modify the process.
• Maintenance.
• Damping.
• Silencing.
Interrupting the pathway
• Insulation.
• Isolation.
• Absorption.
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Hearing Protection

Ear defenders (muffs):

• Encase the ear and bones
surrounding the ear.
Ear plugs:
• Fit into the ear canal.
Hearing Protection
Ear defenders or muffs:

Advantages of Ear Defenders Limitations

Easy to supervise and enforce use Uncomfortable when worn for
as they are visible long time
Must be routinely inspected,
Less chance of ear infections
cleaned and maintained
Higher level of protection
possible through all sound Efficiency may be reduced by
frequencies; bone transmission is long hair, spectacles or earrings
reduced
Can be integrated with other PPE, Incompatible with some other
e.g. Safety helmets items worn
Re-usable Need dedicated storage facility
Hearing Protection
Ear plugs:

Advantages of Ear Plugs Limitations

Difficult to see when fitted, so
Cheap supervision and enforcement
difficult
Risk of infection if dirty or if
Disposable
cross-contaminated when inserted
Often more comfortable to wear
Do not interfere with any other
items worn (e.g. PPE)
Hearing Protection

Whichever type of hearing protection

is chosen, arrangements should be
made for:
• Information, instruction, training.
• Safe storage.
• Cleaning.
• Maintenance.
• Replacement.
Hearing Protection

Attenuation:
Information is required on the:
• Noise in the workplace:
 From survey.
• Attenuation characteristics of the
hearing protection:
 From manufacturer.
• Ear defenders/muffs give higher
attenuation than ear plugs.
The Role of Health Surveillance

Audiometry allows:
• Identification of workers with:
 Pre-existing hearing damage.
 New hearing damage.
• Removal/exclusion of such workers
from high-noise areas.
• Investigation of noise controls to
rectify problems.
5.2: Vibration

26
Health Effects of Exposure to Vibration

Hand-Arm Vibration effects:

Hand-Arm Vibration Syndrome (HAVS)
• Vibration white finger (blanching).
• Nerve damage.
• Muscle weakening.
• Joint damage.
Carpal tunnel syndrome.
Typical vibration white finger
(Source: HSE Guidance L140)
(Reproduced under the terms of the Open Government Licence)
Health Effects of Exposure to Vibration

• Whole-body vibration effects:

 Back pain.
• Occupations:
 Drivers.
 E.g. dumper truck driving.
The Assessment of Vibration Exposure

Control of Vibration at Work Regulations

2005
• Vibration ‘dose’ determined by:
 Vibration magnitude.
 Duration of exposure.
• Personal exposure is estimated.
• Called ‘eight-hour energy equivalent
vibration magnitude’ or ‘A(8)’.
• This is compared to legal standards.
Vibration Exposure Standards

The daily exposure action value is:

• 2.5 m.s-2 A(8) for hand-arm
vibration.
• 0.5 m.s-2 A(8) for whole-body
vibration.
The daily exposure limit value is:
• 5.0 m.s-2 A(8) for hand-arm
vibration.
• 1.15 m.s-2 A(8) for whole-body
vibration.

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Vibration Exposure Standards

At or above the daily exposure At or above the daily

action value: exposure limit value:
• 2.5 m.s-2 for HAVS, • 5 m.s-2 for HAVS,
• 0.5 m.s-2 for WBV: • 1.15 m.s-2 for WBV:
 Vibration risk assessment.  Vibration risk
assessment.
 Reduce exposure level.
 Reduce exposure
 Training.
below the ELV.
 Health surveillance.
Basic Vibration Control Measures

• Reduce vibration at source:

 Eliminate.

 Substitute.

 Change work technique.

 Maintenance.

• Interrupt the pathway:

 Isolate.

• Duration:
 Limit time exposed.

 Job rotation.

• Person:
 PPE.

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Role of Health Surveillance

At or above the exposure action value.

Health surveillance allows:

• Identification of workers with:
 Pre-existing vibration damage.
 New vibration damage.
• Removal/exclusion of such workers from
vibration sources.
• Investigation of vibration sources to rectify
problems.
5.3: Radiation

34
The Types of Radiation and their Health Effects

Two types:
• Non-ionising:
 Does not cause ionisation in
the material that absorbs it.
 E.g. visible light.
• Ionising:
 Does cause ionisation in the
material that absorbs it.
 E.g. X-rays.
Health Effects
• Ultraviolet (UV):
 high-frequency, electromagnetic radiation (light) emitted by white-hot materials, such as the
arc produced during arc-welding.
• Visible light:
 electromagnetic radiation between the UV and IR frequencies and visible to the human eye.
• Infrared (IR):
 lower-frequency, electromagnetic radiation (light) emitted by red-hot materials, such as
molten metal being poured into castings.
• Microwaves:
 lower-frequency, electromagnetic radiation emitted by a microwave generator.
• Radiowaves:
 lower-frequency, electromagnetic radiation emitted by an antenna.
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Typical Occupational Sources of Non-Ionising Radiation

Types Sources Health Effects

Skin burns
Sunlight
Ultraviolet (UV) Arc eye (photokeratitis)
Arc welding
Skin cancer
Visible light Lasers Temporary blindness
Red-hot steel Redness and skin burns,
Infrared (IR)
Glass manufacture retinal burns, cataracts
Food preparation Internal heating
Microwaves
Telecommunications Organ damage
Radio, TV Internal heating
Radiowaves
Radar Organ damage

37
Controlling Exposure to Non-Ionising Radiation
Types Protection
• Cover exposed skin
Ultraviolet (UV)
• Protect eyes
• Low class: avoid shining in eyes
Visible light, lasers • High class: eye protection, shielding,
non-reflective surfaces
• Cover exposed skin
Infrared (IR)
• Protect eyes
• Safe distance
Microwaves
• Isolate and lock off
• Safe distance
Radiowaves
• Isolate and lock off
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Types of Ionising Radiation

• Alpha Particles
 Smoke detectors and science labs.

• Beta Particles
 Science labs and thickness gauges.

• X-rays
 Medical radiography and baggage security
scanners.
• Gamma-rays
 Industrial radiography for non-
destructive testing of metal and welds.
• Neutrons
 Nuclear power stations.
Health Effects

• Acute Health Effects

 Radiation sickness and diarrhoea.
 Hair loss.
 Anaemia (red blood cell damage).
 Reduced immune system (white
blood cell damage).
• Chronic Health Effects
 Cancer.
 Genetic mutations.
 Birth defects.
Basic Means of Controlling Exposure to Ionising Radiation
• Time
 Minimise exposure.
 Dose proportional to time.
• Distance
 Alpha and beta can’t travel long
distances through air.
 Other forms obey the inverse square
law:
double the distance = quarter the dose.
• Shielding
 Using material such as lead.
Basic Means of Controlling Exposure to Ionising Radiation

Ionising Radiations Regulations 2017

Dose limits on exposure:
• General public < 1mSv per year.
• Workers < 20mSv per year.
The Regulations require that a risk
assessment be carried out. This should be
done by a competent person.
A Radiation Protection Adviser and
Radiation Protection Supervisors may
need to be appointed.
Radon Gas

• Naturally occurring radioactive

gas.
• Emits alpha particle radiation
(ionising radiation).
Health effects:
 Outside body - not
particularly hazardous.
 Inside body (by inhalation)
- increased risk of lung
cancer.
Radon Gas
Where naturally occurring levels are
high:
• Outside - low concern.
• Inside - poorly ventilated workplaces,
e.g. basements, can be a significant risk.
Control of risk above the action level:
• Undertake a survey.
• Appoint a radiation protection
supervisor.
• Introduce engineering controls:
 Positive pressure air fans.

 Radon sumps and extraction systems.

Basic Radiation Protection Strategies

Basic protection strategies that apply in

all cases:
• Eliminate exposure so far as is
reasonably practicable.
• Reduce exposure to the lowest level
reasonably practicable.
• Do not exceed the relevant radiation
dose limits.
• Risk-assessed by a competent person.
• Training and information.
• Health surveillance.
Role of Monitoring and Health Surveillance

Types of examination include:

• Skin checks.
• Respiratory checks.
• Exposure records.
• Sickness records.
5.4: Mental Ill Health

47
The Prevalence of Mental Ill Health Within the Workplace

• 440,000 cases of work-related

stress, depression or anxiety
in 2017/18 (prevalence rate of
1,800 per 100,000).
• 239,000 new cases (incidence rate
of 720 per 100,000).
• 15.4 million days lost (average 25.8
days per case).
• Account for 44% of all work-
related ill health cases and 57% of
all working days lost due to ill
health.
Anxiety
“A feeling of unease, such as worry or fear, that
can be mild or severe.” (NHS)
Anxiety can have both psychological and
physical symptoms.
Long-term anxiety can lead to serious ill-health
conditions, such as hypertension and heart
disease.
Anxiety is sometimes linked to:
• Panic disorder (having panic attacks).
• PTSD caused by exposure to a
traumatic event.
• Depression.
Depression

“Feelings of extreme sadness, despair or

inadequacy that last for a long time.”
(NHS)
The severity of the symptoms of
depression can vary.
At its mildest, depression involves being
persistently low in spirit (low mood)
while, at its most severe, depression
makes sufferers feel suicidal and that
life is no longer worth living.
Work-Related Stress

Stress is:
The adverse reaction that people have to
excessive pressure of other demands placed
upon them.
Health effects:
 Psychological.
 Physical.
 Behavioural.
Can lead to serious ill health if prolonged.
Work-Related Stress

Psychological: Physical: Behavioural:

• Anxiety. • Sweating. • Sleeplessness.
• Low self-esteem. • Fast heartbeat. • Poor
concentration.
• Depression. • High blood
pressure. • Poor decision-
making.
• Skin rashes. • Mood swings.
• Muscle tension. • Irritability.
• Headache. • Alcohol
• Dizziness. consumption.
• Drug misuse.
• Absence from
work.

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Causes of Work-Related Mental Ill Health

Causes of stress:
• Excessive demands.
• Lack of control over work.
• Lack of support.
• Poor workplace relationships.
• Lack of clarity about an individual's
role.
• Threat of change, and change itself.
Staying in Work
Research indicates that work is good for mental health, and
that prolonged absence from work is bad for mental health:
• The employer should adopt policies and procedures that
enable those suffering from mental ill health to remain in
work.
• Most people who mental health problems recover fully or are
able to manage the problem and continue to work effectively.
• Historically mental health has been stigmatised and sufferers
discriminated against and excluded from work.
• Work is often the best place for them to be.
• Equality legislation means it may be illegal to discriminate
against someone with a mental health problem.
Stress Control Measures

HSE ‘Management Standards’ approach:

User the six causes as a framework for risk
assessment:
• Demands.
• Control.
• Support.
• Relationships.
• Role.
• Change.
Stress Control Measures
Control Measures
• Demands
 reasonable demands, sufficient resources.

• Control
 given as much control as possible.

• Support
 information, instruction, training, additional support.

• Relationships
 clear anti-harassment and bullying policies.

• Role
 clear job descriptions, responsibilities and authority.

• Change
 planning and preparation for change, communication, timescales.

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5.5: Work-Related Violence

57
Risk Factors and Control Measures

Work-Related violence:
"Any incident in which a
person is abused, threatened
or assaulted in circumstances
relating to their work.”
Risk Factors for Violence

• Cash handling.
• Lone working.
• Representing authority.
• Wearing a uniform.
• Dealing with people under stress.
• Dealing with people under the
influence of drugs or alcohol.
• Censuring or saying "no".
Risk Factors for Violence

• Hospital accident and emergency

staff.
• Police.
• Social workers.
• Bus and taxi drivers.
• Fire-fighters and paramedics.
• Traffic wardens.
• Railway staff.
• Teachers.
Control Measures for Violence

Discover the extent of the

problem by:
• Collecting and analysing
incident reports.
• Interviewing staff
(formally or informally).
• Staff surveys.
Control Measures for Violence
At a central office:
• Zero-tolerance and prosecution.
• Security staff.
• CCTV.
• Security doors.
• Minimise queues and waiting times.
• Display waiting times.
• Training.
• Screens.
• Panic alarms.
• Pleasant environment.
Control Measures for Violence
Conducting home visits:
• No work in high-risk areas.
• Incident records.
• Vetting customers.
• Visit-logging.
• Pre- and post-visit communications.
• Training.
• Communication means/GPS.
• No visits after dark.
• Not carrying cash or valuables.
5.6: Substance Abuse at Work

64
Types of Substances Abused at Work

• Alcohol
 taken at lunch time, at work, or still in a
worker’s system from the night before.

• Legal drugs
 prescription or over-the-counter non-
prescription drugs.

• Illegal drugs (controlled)

 such as heroin, cannabis, cocaine.

• Solvents
 sniffing substances such as glue, solvent
cleaners and paint-spray cans.
Risks to Health & Safety from Substance Abuse at Work

General signs:
• Late attendance.
• Increased absenteeism.
• Poor work quality.
• Reduced output.
• Dishonesty.
• Theft, potentially to fund a habit.
• Irritability and mood swings.
• Deterioration in working relationships.
Risks to Health and Safety from Substance Abuse at Work

Effects on safety performance:

• Sensory impairment.
• Skewed perception.
• Impaired motor control.
• Fatigue and drowsiness.
Increased risk for:
• Driving.
• Operating machinery.
• Making decisions.
Control Measures to Reduce Risks from Substance Abuse at Work

Drugs and alcohol policy:

• No alcohol at work or during working hours.
• Statutory legal requirements, e.g. drink drive laws.
• Non-statutory requirements set by the employer.
• Access for workers to rehabilitation and treatment.
• Disciplinary procedures.
• Information, instruction and training of managers,
supervisors and workers.
• Random drugs and alcohol testing:
 Legal and ethical implications.
Summary
In this element, we have:
• Explained the effects of exposure to excessive noise, noise exposure standards and
basic principles of noise assessment.
• Outlined the different ways to control exposure to noise.
• Discussed the effects of exposure to excessive hand-arm and whole-body
vibration, the exposure standards and the basic principles of vibration assessment.
• Outlined the different ways to control exposure to vibration.
• Described the types of non-ionising and ionising radiation, their health effects, and
control of exposure (including radon).
• Outlined the effects of work-related mental ill health, the causes and preventive
measures.
• Discussed risk factors for work-related violence and control measures.
• Outlined types of substances abused at work, and risks to health and safety of
drugs and alcohol misuse and the control measures available.
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