Chapter 2 : Physical Hazards
A physical hazard is an agent or factor that can cause harm with contact. Physical hazards include noise, radiation, heat and cold stress, ergonomic, and vibration hazards.
Noise
Basic information
Hazardous noise is one of the most common occupational hazards as millions of workers are exposed to hazardous noise on a regular basis. Exposure to high levels of noise may cause hearing loss, create physical and psychological stress, reduce productivity, interfere with communication, and contribute to accidents and injuries (OSHA, d). In addition, over 1 billion people aged 12–35 years risk losing their hearing due to prolonged and excessive exposure to loud music and other recreational sounds (World Health Organization, 2022). The chart below shows different types of noise that are associated with different decibel levels. Decibels are used to measure the intensity of noise.
Hearing loss, create physical and psychological stress, reduce productivity, interfere with communication, and contribute to accidents and injuries.
Hearing conditions
There are several terms that refer to different hearing conditions. Sometimes the terms stand alone, while others are subparts of another term and some can apply under multiple categories. For example, Presbycusis is defined as age induced hearing loss, however it can be a type of sensorineural, or permanent hearing loss.
Short-Term Hearing Loss
Short-term exposure to loud noise can cause a temporary change in hearing. An example is when you go to a loud concert, and afterward you have difficulty hearing for a short time.
Permanent Hearing Loss
Exposure to high levels of noise for a prolonged time can cause permanent hearing loss. Neither surgery nor a hearing aid can help correct this type of hearing loss (OSHA, d). An example is years of working at a factory around high noise levels, or long-term drivers exposed to traffic noise leading to a permanent loss of hearing.
Conductive Hearing Loss
Conductive hearing loss occurs from any condition in the outer or middle ear that interferes with sound passing to the inner ear (CDC, 2022b). Examples include ear wax or foreign objects in the ear canal of the outer ear, fluids or infection in the middle ear, damage to the eardrum or the bones in your middle ear, or exposure to ototoxic chemicals in the workplace. This type of hearing loss can often be treated with medicine or surgery (CDC, 2022b). Amplification aids such as hearing aids can also help this type of hearing loss.
Sensorineural Hearing Loss
Sensorineural hearing loss occurs when there is a problem in the way the inner ear or hearing nerve works (CDC, 2022b). This is the most common type of permanent hearing loss. Most of the time medicine or surgery cannot fix it, although hearing aids may help you hear (American Speech-Language-Hearing Association, ).
Tinnitus
Tinnitus is basically ringing in your ears; however, it can be any sound such as whistling, buzzing, chirping, hissing, humming, roaring, or even shrieking. It can be in one or both ears and either temporary or permanent. Almost everyone has had tinnitus for a short time after being exposed to extremely loud noise. While there's no cure for chronic tinnitus, it often becomes less noticeable and more manageable over time (Harvard, 2022).
Presbycusis
Presbycusis is a gradual sensorineural hearing loss associated with aging (age-induced hearing loss). The onset and the degree of hearing loss can vary considerably and is related to genetics or other impacts such as an accumulation of diseases, medications, and the cumulative effect of noise in the modern environment (OSHA, 2022).
Short-term hearing loss, permanent hearing loss, conductive hearing loss, sensorineural hearing loss, tinnitus, presbycusis.
Controls
Engineering Controls
These controls can include: eliminating or minimizing noise exposure by installing equipment that produces less noise, installing equipment that prevents or contains the escape of noise at its source, using dampening materials or baffles, or using worker enclosures or vibration isolation devices (OSHA, 2022).
Administrative Controls
Administrative controls involve changing work schedules to reduce the amount of time any one worker spends in the high noise area, changing practices such as distancing from noise-producing equipment, limiting the amount of time listening to loud music, and teaching people about the effects of noise exposure (OSHA, 2022).
Personal Protective Equipment
Hearing protection devices (HPDs) are a form of PPE and are the last line of defense for protecting workers from noise exposures. They may also be used in combination with engineering and administrative controls, HPD’s include earplugs, earmuffs and hearing bands (OSHA, 2022).
Radiation - Radon
Basic Information
Radon is a radioactive gas that has no smell, color or taste. Radon is produced from the natural radioactive decay of uranium, which is found in all rocks and soils. Radon tends to concentrate in enclosed spaces such as buildings, basements, and underground mines. It can also be present in water and in some building materials (World Health Organization, 2021b).
Health Effects
Globally, in 2019, residential radon exposure alone was estimated to have caused 84,000 deaths by lung cancer; in some countries, it is among the leading causes of lung cancer (World Health Organization, 2021a). It is estimated that radon causes between 3–14% of all lung cancers in a country, depending on the national average radon level and the smoking prevalence (World Health Organization, 2021b). A combination of smoking and indoor radon gas further increases the cancer risk. The chart below shows that smokers have a significantly higher chance of getting lung cancer when exposed to the same amount of radon as a non-smoker.
Controls
One of the ways to control radon exposure is to establish national regulations, building codes and/or guidelines for radon prevention and mitigation. Where possible test radon levels and implements radon mitigation renovations and ventilation systems. Some common ways of reducing radon levels in existing buildings include increasing under-floor ventilation, installing a radon sump system in the basement or under a solid floor and sealing floors and walls (World Health Organization, 2021b).
Radiation – UV Rays
Basic Information
More than 60,000 skin melanoma-related deaths worldwide were estimated to be caused by solar UV radiation in the year 2000 (World Health Organization, 2006). Natural UV radiation levels depend on sun elevation, latitude and altitude, cloud cover, and ground reflection. Exposures can also occur using sunbeds and other artificial tanning devices. While all populations are potentially at risk, specific subpopulations such as children, outdoor workers, and fair-skinned people are at particular risk of skin cancer (World Health Organization, 2006).
Children, outdoor workers, and fair-skinned people.
Health Effects
The main three cancers with UV exposure are cutaneous malignant melanomas, squamous cell carcinomas and basal cell carcinomas. In addition, UV exposure causes sunburn, skin photoaging, and cataracts (World Health Organization, 2006).
Controls
Providing shaded areas in the workplace, schools, playgrounds, parks, and swimming pools are all ways to protect from UV exposure. Other suggestions include restricting the use of sunbeds and other artificial tanning devices and using welding goggles and barrier screens during welding operations. When you must be outside, use sunglasses and sunscreen with the proper UV protection factor. The picture below shows how sunscreen can protect from the exposure of UV photons.
Radiation – X-rays
Basic Information
Worldwide, an estimated 3.6 billion diagnostic medical examinations, such as X-rays, are performed every year. This number continues to grow as more people access medical care. About 350 million X-rays are performed on children under 15 years of age. Using radiation in medical imaging can save lives and prevent the need for more invasive procedures, but inappropriate use may lead to unnecessary and unintended radiation doses for patients. Because children are smaller and have a longer lifespan than adults their risk of developing radiation-induced effects is greater (World Health Organization, 2006).
Health Effects
Radiation damage to tissue and/or organs depends on the dose of radiation received, or the absorbed dose. Radiation can impair the functioning of tissues and/or organs and can produce acute effects such as skin redness, hair loss, radiation burns, or acute radiation syndrome. These effects are more severe at higher doses and higher dose rates (World Health Organization, 2016).
Controls
There are three basic strategies to control exposure to X-rays, they are: limit the time of exposure to radiation sources, increase the distance from the sources and to shield the person from the source. Use of radiation dosimeters and monitors on people working near radiation sources can monitor their exposures to help to know how long they are exposed to X-rays and to restrict their time if they are becoming overexposed. For example, often X-ray technicians will wear radiation monitoring badges. When they get to a certain level of exposure they are no longer allowed to conduct X-rays. Second, moving an X-ray technician further away from the X-ray machine lowers their potential of exposure. Sometimes this is done by locating the operating switch far from the machine. Third, the use of lead shielding or lead aprons to protect those performing and receiving x-rays. Patients and their families should also be educated about the risks and benefits of imaging procedures.
Use of radiation dosimeters and monitors on people working near radiation sources to monitor their exposure. Increase the distance people are from radiation exposure. Use lead shielding or lead aprons to protect those performing and receiving x-rays.
Heat
Basic Information
Millions of workers are exposed to heat in their workplaces. Although illness from exposure to heat is preventable, every year thousands become sick from occupational heat exposure, and some cases are fatal. Hazardous heat exposure can occur indoors or outdoors and can occur during any season if the conditions are right, not only during heat waves (OSHA, b).
Health Effects
Heat Stroke
Heat stroke is the most serious heat-related disorder and occurs when the body’s temperature regulation fails, and body temperature rises to critical levels. Heat stroke is a medical emergency that may result in death. The primary signs and symptoms of heat stroke are confusion, irrational behavior; loss of consciousness; convulsions; a lack of sweating; “hot and dry” skin; and an abnormally high body temperature (CDC, 2022a).
Heat Exhaustion
Heat exhaustion is the body’s response to an excessive loss of water and salt, usually through excessive sweating (CDC, 2022a). Signs and symptoms are excessive sweating, headache, nausea, vertigo, weakness, thirst, and giddiness. Heat exhaustion should not be dismissed lightly. Fainting or heat collapse is often associated with heat exhaustion (OSHA, c).
Heat Cramps
Heat Cramps are usually caused by performing hard physical labor in a hot environment. These cramps have been attributed to an electrolyte imbalance caused by sweating. Cramps also appear to be caused by the lack of water replenishment (OSHA, c).
Heat Rashes
Heat rashes are the most common problem in environments where the skin is persistently wetted by unevaporated sweat. Heat rash is sometimes called Prickly heat and is manifested as red papules and usually appears in areas where the clothing is restrictive. As sweating increases, these papules give rise to a prickling sensation. Heat rash papules may become infected if they are not treated. In most cases, heat rashes will disappear when the affected individual returns to a cool environment (OSHA, c).
Controls
Engineering
General ventilation dilutes hot air with cooler air or the use of air conditioning. Build cool rooms, break areas, or shaded areas. Shields can be used to reduce radiant heat. Insulate hot surfaces (OSHA, c).
Administrative
Administrative controls include acclimatizing workers by exposing them to work in a hot environment for progressively longer periods, replacing fluids by providing cool water or liquids and drinking commercially available carbohydrate-electrolyte replacement liquids is also effective. Other examples are reducing the physical demands of a job, providing recovery breaks and rest periods and rescheduling hot jobs for the cooler part of the day (OSHA, c).
Acclimatize workers by exposing them to work in a hot environment for progressively longer periods. Replace fluids by providing cool water or liquids, drinking commercially available carbohydrate-electrolyte replacement liquids is also effective. Reduce the physical demands of a job. Provide recovery breaks and rest periods. Reschedule hot jobs for the cooler part of the day.
Personal Protective Equipment (PPE)
PPE could include the use of reflective clothing, cooling ice vests, wetted clothing and wearing hats (OSHA, b).
Cold
Basic Information
In a cold environment, most of the body’s energy is used to keep the internal core
temperature warm. Over time, the body will begin to shift blood flow from the extremities (hands, feet, arms, and legs) and outer skin to the core (chest and abdomen). This shift allows the exposed skin and the extremities to cool rapidly and increases the risk of frostbite and hypothermia. When the body can no longer maintain core temperature by constricting blood vessels, it shivers to increase heat production. Maximum severe shivering develops when the body temperature has fallen to 95oF. Hypothermia becomes an issue at this point (Princeton, ).
The body's energy is used to keep the internal core temperature warm. Blood flow will shift from the extremities and outer skin to the core. This shift allows exposed skin and extremities to cool rapidly and increases the risk of frostbite and hypothermia.
Health Effects
Hypothermia
Hypothermia occurs when the normal body temperature (98.6°F) drops to less than 95°F. Exposure to cold temperatures causes the body to lose heat faster than it can be produced. Prolonged exposure to cold will eventually use up the body’s stored energy. The result is hypothermia, or abnormally low body temperature. Hypothermia is most likely at very cold temperatures, but it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or immersion in cold water. An important mild symptom of hypothermia is uncontrollable shivering, which should not be ignored. Although shivering indicates that the body is losing heat, it also helps the body to rewarm itself. Moderate to severe symptoms of hypothermia are loss of coordination, confusion, slurred speech, heart rate and breathing slow, unconsciousness and possibly death. Body temperature that is too low affects the brain, making the victim unable to think clearly or move well. This makes hypothermia particularly dangerous because a person may not know what is happening and won’t be able to do anything about it (OSHA, e).
Frostbite
Frostbite is caused by the freezing of the skin and tissues. Frostbite can cause permanent damage to the body, and in severe cases can lead to amputation. The risk of frostbite is increased in people with reduced blood circulation and among people who are not dressed properly for extremely cold temperatures. Reddened skin develops gray and white patches in the fingers, toes, nose, or ear lobes; tingling, aching, a loss of feeling, firm/hard, and blisters may occur in the affected areas (OSHA, e).
Controls
Engineering controls
Radiant heaters may be used to warm people. If possible, shield work areas from
drafts or wind to reduce wind chill (OSHA, a).
Administrative controls
Train workers on how to recognize cold stress illnesses and injuries. Work at
warmer parts of the day and use a buddy system. Encourage good hydration but avoid drinking alcoholic beverages (OSHA, e).
PPE
Wear layers of loose-fitting clothing for better insulation. Do not wear tight fitting clothing. Wear hats or hoods, gloves, boots, and other warm clothing. Avoid the use of cotton (OSHA, b).
Layers of loose-fitting clothing. Do not wear tight-fitting clothing. Hats, hoods, gloves, boots, and other warm clothing. Avoid cotton.
References
American Speech-Language-Hearing Association. Sensorineural Hearing Loss. Retrieved Nov 16, 2022, from https://books.byui.edu/-bgo
CDC. (2022a). Heat Stress – Heat Related Illness. Retrieved Nov 16, 2022, from https://books.byui.edu/-HQk
CDC. (2022b). Types of Hearing Loss. Retrieved Nov 16, 2022, from https://books.byui.edu/-Imej
Harvard. (2022). Tinnitus: Ringing in the ears and what to do about it . Retrieved Nov 16, 2022, from https://books.byui.edu/-dmM
OSHA. (a). Cold Stress Guide. Retrieved Nov 17, 2022, from https://books.byui.edu/-pzZF
OSHA. (b). Heat. Retrieved Nov 16, 2022, from https://books.byui.edu/-vuIb
OSHA. (c). Heat Stress Guide. Retrieved Nov 16, 2022, from https://books.byui.edu/-BVPN
OSHA. (d). Occupational Noise Exposure . Retrieved Nov 8, 2022, from https://books.byui.edu/-MUhSt
OSHA. (e). Winter Weather. Retrieved Nov 17, 2022, from https://books.byui.edu/-ooN
OSHA. (2022). OSHA Technical Manual (OTM). Retrieved Nov 16, 2022, from https://books.byui.edu/-ZBaT
Princeton.Cold Stress Facts. Retrieved Nov 17, 2022, from https://books.byui.edu/-fXIG
World Health Organization.Guidance on radiation and health. Retrieved Nov 16, 2022, from https://books.byui.edu/-hprN
World Health Organization. (2006). Health consequences of excessive solar UV radiation. Retrieved Nov 16, 2022, from https://books.byui.edu/-wdia
World Health Organization. (2016). Fact Sheet-Ionizing radiation, health effects and protective measures. Retrieved Nov 16, 2022, from https://books.byui.edu/-DVm
World Health Organization. (2021a). More countries act against exposure to radon and associated cancer risks. Retrieved Nov 16, 2022, from https://books.byui.edu/-PnIp
World Health Organization. (2021b). Radon and health. https://books.byui.edu/-PZRV Retrieved Nov 16, 2022, from
World Health Organization. (2022). WHO releases new standard to tackle rising threat of hearing loss. Retrieved Nov 8, 2022, from https://books.byui.edu/-jnCL
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