For many years, hydraulic fracturing was an important element of oil and gas drilling operations. With the rapid advancement of new technologies, the quality and efficacy of fracking considerably improved. Unfortunately, until the present, the benefits and costs of hydraulic fracturing have been considered mainly in terms of their environmental risks (Wilkinson, 2012). As a result, the health consequences of workers exposure to silica during fracking have been persistently overlooked. Today, workers exposure to silica during hydraulic fracturing is one of the biggest occupational health concerns. Last year, the National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) issued an official note to confirm the dangers of workers exposure to respirable crystalline silica. In light of these issues, every employer should reduce the risks of health complications that result from workers continuous participation in fracking procedures.
Hydraulic Fracturing: The Basics
To understand how crystalline silica impacts workers health, the basics of the hydraulic fracturing process should be explained. According to Esswein, Kiefer, Snawder, and Breitenstein (2012), hydraulic fracturing is the process of injecting large volumes of water, sand, and chemicals into the ground at high pressure to break up shale formation allowing more efficient recovery of oil and gas. In other words, hydraulic fracturing (or fracking) is one of the most important procedures in good stimulation, which is used to facilitate gas and oil recovery. Fracking had been used in oil and gas drilling since the 1940s, but the emergence of new horizontal drilling technologies led to a substantial increase in fracking procedures (Esswein et al., 2012). Unfortunately, it is not until very recently that the health impacts of hydraulic fracturing became a matter of occupational health concern.
Hydraulic fracturing by itself is not very dangerous. Rather, it is the use of crystalline silica that makes fracking so problematic. Many hydraulic fracturing processes are impossible without silica. At each stage of the fracking process, workers are exposed to hundreds of thousands of sand particles (Esswein et al., 2012). During fracking, large volumes of water are pumped into a well, to fracture the tight and shale formations that prevent the smooth flow of oil and gas (OSHA, 2012). As a result, all workers engaged in the process face equally high risks of exposure and related health complications.
Why Is Fracturing So Dangerous to Workers Health?
As stated earlier, it is not fracturing but the use of silica that raises the biggest occupational health concerns. Fracking involves large amounts of silica. At least four million pounds of sand are used to frack one well (Sturgis, 2012). Transporting, refilling, moving, and replacing silica create dangerous dust that is released into the air (OSHA, 2012). During hydraulic fracturing, workers can be exposed to one or more sources of silica. It can be the dust ejected from access ports and sand movers or the dust released along the sand transfer belt (OSHA, 2012). Whatever the source of silica dust, the risks of developing health complications are always high.
It is not a secret that continuous exposure to silica dust can lead to the development of silicosis. Silicosis is a lung disease that develops when workers inhale respirable crystalline silica and its dust (Esswein et al., 2012). Silicosis is both treatable and preventable. It develops only after prolonged exposure to silica dust, and its progress is quite slow (Esswein et al., 2012). Still, employers working in the oil and gas industry have few chances to avoid silicosis dangers. The rates of mortality of acute silicosis are quite high. Due to extensive silica dust exposures, workers can develop the symptoms of silicosis very quickly (Esswein et al., 2012). In these situations, chances to save the worker from death will be meager.
The most vulnerable to silicosis are the workers, who are directly exposed to silica dust due to their workplace obligations, such as tunnelers, sandblasters, and miners (Esswein et al., 2012). Silica is usually categorized as a lung carcinogen, which also means that it can lead to the development of chronic obstructive lung disease (COPD) (Esswein et al., 2012). Even renal disease and autoimmune diagnoses may have their roots in continuous exposure to silica dust (Esswein et al., 2012). Workers, who constantly deal with silica dust, also face higher risks of respiratory infections and tuberculosis (Esswein et al., 2012).
Fracturing and Silica Dust Dangers: Statistics and Research
The current statistics of silica dust exposure and related health complications are very unsatisfactory. According to Esswein et al. (2012) and OSHA (2012), 435,000 employees currently work in the U.S. oil and gas industry. Almost half of them can be exposed to excessive levels of silica dust (Actio, 2012). Between 2003 and 2009, the prevalence of occupational deaths in the oil and gas industry was 27.5 per 100,000 (Sturgis, 2012). This is seven times higher than the overall rates of fatality among all U.S. workers (Sturgis, 2012). Between 2003 and 2005, the rates of fatality among oil and gas workers increased 15 percent (Sturgis, 2012). Most probably, it is due to the lack of effective health protection measures that oil and gas industry workers face high risks of fatality and disease. 100 percent of the fracking sites tested during 2012 had their workers exposed to excessive concentrations of respirable crystalline silica (Sturgis, 2012). These data suggest that the oil and gas industry needs a profound change in its occupational health philosophy. The risks of health problems for the workers operating directly at the well are particularly high. The oil and gas industry should become more concerned about the health and future wellbeing of its workers. Today, numerous methods and models are available to employers, as they are striving to protect their workers from the most common health hazards.
Protecting Works from Occupational Hazards
The magnitude of the occupational health problems impacting workers in the oil and gas industry is difficult to overestimate. However, most employers have everything needed to protect their employees from the most common health hazards. Industrial enterprises in the oil and gas industry can switch to less hazardous substances, which do not contain silica (Esswein et al., 2012). In addition, passive enclosures can and must be used at all points, where dust is generated (Esswein et al., 2012). Employers can also use screw augers instead of traditional transfer belts on sand movers when it is possible and cost-effective. According to Esswein et al. (2012), it is a relevant prevention-through-design consideration, and it does have the potential to reduce the scope of health complications in workers, who are exposed to silica dust.
In addition, employers working in the oil and gas industry must constantly monitor the quality of air in the workplace and reduce workers exposure to silica dust with the help of safe work practices (OSHA, 2012). To monitor and control the quality of air, employers can collect dust samples at the site. The results will show whether any of the current workers are exposed to the levels of respirable silica dust above the limits of exposure (OSHA, 2012). Yet, at all times, it is through education and training that the most prevalent occupational hazards can be successfully addressed. OSHA (2012) recommends implementing an education and communication program for workers. The importance of such programs is justified by the fact that workers have the right to know what substances they are being exposed to, how these substances impact their health, and how to avoid these damaging impacts.
Conclusion
Workers exposure to silica dust is one of the most prevalent occupational health concerns facing the oil and gas industry. Thousands of workers in the oil and gas industry are subjected to unreasonably high concentrations of silica dust. The problem is particularly complicated for the employees, who participate in hydraulic fracturing. Silica dust increases employees vulnerability to lung and autoimmune diseases. Still, most employers in the oil and gas industry have everything needed to deal with these challenges. Air monitoring, prevention through design, education, and training can alleviate the burden of silicosis and other lung diseases in workers. All employees should have access to occupational training and safety information because they have the right to know what substances they are exposed to and how to prevent the most common occupational health risks.
Esswein, E., Kiefer, M., Snawder, J. & Breitenstein, M. (2012). Worker exposure too crystalline silica during hydraulic fracturing. Centers for Disease Control and Prevention. Web.
The United Arab Emirates is a fast-growing and diversified economy in the Gulf region. Its population is composed of different ethnic groups and nationalities coming from Southeast Asia, the Middle East, and Europe. International firms or multinationals help boost the economy. As a result, it has complicated health problems due to occupational hazards.
This is not the case if we look at the history of the UAE as a growing Muslim nation. Emiratis have the belief of environmental stewardship as ingrained in their Muslim culture. The Holy Quran teaches believers to care for animals and plants and tell Muslims to have great concern for the environment (Aspinall, 2006 as cited in Gibson et al., 2013).
Environmentalism is deeply seated in the peoples culture. His Excellency Sheikh Zayed, the UAEs founder, has been internationally recognized for his conservation efforts, having received no less than the Gold Panda Award from the international body, the World Wildlife Foundation (2000 as cited in Gibson et al., 2013). Sheikh Zayed also received posthumously the Champion of the Earth Award from the UN Environment Programme (Gibson et al., 2013). Despite their love for nature, Emiratis also want economic growth. There lies a complication because of the threat of the environment on peoples health.
This paper will discuss the UAEs environmental risks that have caused occupational health problems. The problem stems from the continuous economic growth which has triggered the influx of tourists and migrant workers in the country. First, there was the problem of infectious diseases, but due to the governments enhanced health programs, the problem has shifted to non-infectious diseases, such as cardiovascular disease, occupational injury, cancer, and respiratory illness.
This paper will first delve into the background of the country UAE, from its roots: seven hereditary monarchies that decided to form the UAE. Major economic activities began when it struck oil, and from this, the problem of health evolved. Discussion of the literature will focus on health issues and their causes. Some case studies on tumor and brain cancer suffered by workers in a chemical and manufacturing plant are also included in the final analysis of the literature. The conclusion and recommendations will discuss the governments strategic health plan. Future research should deal with longitudinal data that should be available for UAE strategic planning in health and safety programs. There is a lack of empirical research on this aspect.
Literature Review
The United Arab Emirates
The UAE is a country comprised of seven hereditary monarchies called emirates, established in the early part of the seventies. The country is blessed with so-called black gold, oil, but has successfully diversified its economy by attracting large multinationals to invest in its land. It has enhanced infrastructures, built skyscrapers, and diversified its manufacturing base of aluminum, steel, iron, and other metals, for local use and exports (Loney et al., 2013).
The UAE population is a combination of natural birth and migration of workers who are attracted to the countrys high wages and benefits and the quality of life afforded by foreign and local firms. This makes the countrys population structure unique. Foreign workers fill in the lack of skills of local workers. Abu Dhabi is the largest area and has a population of 2.3 million, but half of this is composed of migrant workers. In other words, the UAE population is composed of different nationalities of varying backgrounds, ethnicities, demographics, and cultural eccentricities (Loney et al., 2013).
With an annual growth of 6.5% of GDP from 2000 to 2005, the UAE is one of the most successful economies in the region of the Gulf Cooperation Council (UAE Bureau of Statistics as cited in Al-Kaabi, 2006). Construction had attributed 12% of the non-oil percentage of GDP in 2003. The construction labor force increases yearly; in 2003 the labor force had a yearly increase of 24% (UAE Bureau of Statistics as cited in Al-Kaabi, 2006).
Oil became a primary source of economic progress but the country was quick and the rulers wise enough to diversify. In the 1960s the UAE invested in various sectors to reduce economic dependence on oil. These sectors are global and required infrastructure development. Dubai and Abu Dhabi are the two Emirates which have experienced continuous construction projects (Najem, 2015). As billions of dollars are being infused into the economy, the construction workers are the main driving force in infrastructural development and the entire growth. According to Najem (2015), there is a sense of unfairness in how construction workers are being treated.
Before the UAE was formed, the Trucial States relied on trading, pearling, fishing, agriculture, and animal husbandry. The discovery of oil led to radical changes to the peoples daily activities and the growth course of the country. But before it struck oil, it has been a destination for migrant workers. The immigration of workers dates back to the pearling era in the 1800s.
The present migration rates of the UAE are among the highest in the world, i.e. 13.5 migrant workers per 1,000 people (CIA World Factbook as cited in Najem, 2015). In this country, the population boom is parallel with infrastructural development. The countrys population is approximately nine million, a steady growth obtained because of workers migration (World Bank as cited in Najem, 2015).
The fear of life without oil had set in the countrys policy-making body. In the 1990s, the country began to realize that investing foreign assets abroad was just a few of the things it could do, and so it invested in agriculture and real estate to increase its foreign direct investment (FDI) and enhance domestic economic productivity across different sectors. Currently, the government has been investing in several new infrastructural projects to pursue economic diversity. The country has been most successful in such areas as tourism, financial services, trade, agriculture, real estate, and construction. But as a whole, investing in infrastructure has considerably increased FDI rates over time. It also has to increase its labor force continuously.
Historical Background
The literature provides vast evidence on the relationship between environmental sustainability and human health. Even medical artifacts dating back to the Assyrian and pre-historic times provide concepts of environmental conditions that cause diseases. Valleys and rivers were classified by ancient texts according to the health status of those areas and were analyzed as to whether they were safe or not for human habitation (Gibson et al., 2013).
Looking at the effects of health caused by the environment should stimulate research on several significant factors, such as analyzing the probability theory and connect this with the problem at hand, discussion on the instruments to quantify the presence of pollutants in the environment, mathematical calculations on epidemiologic research linking the quantified presence of pollutants to certain health problems, public health records, and instruments or computer software that provide a simulation of environment pollution and community. These data and instruments were not available during the Renaissance period but techniques then were already formulated and applied today, though the present time has the knowledge and technology to measure and simulate to assess the environment.
The Renaissance era provided the present time with facts on the probability theory. Before this time, policymakers used very risky and uncertain methods, in consultation with the clergy and religious people, instead of using reliable tools of probability (Gibson et al., 2013).
Aside from theory, decision-makers can also use quantitative methods in assessing health risk data, and mathematical relationships relating to contact with the identified contaminants to certain health causes as a result of toxicologic and epidemiologic research. This scarcity of tools and instrumentation and the lack of appropriate public data recording were major barriers to assessing the relationship between environmental hazards and human health (Covello & Mumpower as cited in Gibson et al., 2013, p. 3).
Measuring or quantifying the link between the amount of contaminant in contact with the human body and the resultant disease is a current technique but the science of toxicology dates back to the time of historic physician Paracelsus who formulated the basic principle of toxicology which states that the amount of dose determines the poison caused on the human body (Graham as cited in Gibson et al., 2013). Covello and Mumpower (as cited in Gibson et al., 2013) added that the nineteenth-century scientist Pasteur understood and clearly explained the idea of infection or the link between the environment that carries contaminants and poisonous agents and the infected human body.
Health Priority Issues in the UAE
The study of Loney et al. (2013) focused on major public health issues affected by the current economic boom and other major activities. The researchers used secondary data or peer-reviewed journals and articles from different databases and government publications and websites which publish articles focusing on this particular issue. The researchers were looking for public health priority problems, such as cardiovascular disease, injury caused by occupational factors, cancer, and other diseases including respiratory illness.
According to the study, fertility rates have significantly declined in the UAE caused by rapid urbanization, changing beliefs about family growth, and enhanced education and employment for women leading to reduced marriages. On the other hand, life expectancy has also improved since men and women are now reaching the ages of 77 to 79 years old, respectively.
Infectious diseases, once a major concern of the governments health department, is caused by the migration of foreign labor and the temporary influx of people from the different parts of the world. Nevertheless, the standard of living has improved even to the lowly Emirati, so that infectious diseases are no longer a problem as this is being effectively addressed by the governments health care services. In the past few years, attention has shifted to non-infectious diseases which have rapidly increased (Gibson & Farah, 2012).
The UAEs fast economic advancement has enhanced public health but brought some problems, in particular an increase in non-infectious diseases such as heart problems, cancer, type II diabetes, and respiratory diseases. Environmental risk is number one, which has brought national attention as constantly reported in the media.
The Environmental Agency-Abu Dhabi (EAD) made immediate moves in 2007 to address the issue, particularly by measuring the environmental burden on public health. EAD asked for a strategic plan, which was then awarded to a consortium composed of two universities: one from North Carolina the Norwegian Institute for Air Quality Research and the UAE University (Gibson & Farah, 2012). This was an ambitious project and a model for the Middle East. The World Health Organization hailed this project and also provided help through oversight and some methods to be used. The study focused on occupational risk factors, particularly on exposure to harmful chemical and other biological agents, and exposures in the industrial and agricultural sectors.
The study found that a perfect environmental health plan could not be attained, but it recommended some possible effective methods in dealing with non-infectious diseases. The group developed a five-step strategy that measures the weight of the disease pointing to every risk factor and asked the stakeholders to focus on those risk factors and define the possible solutions. These steps are explained in the following paragraphs.
Measure the risks. Gibson and Farah (2012) and the researchers measured the risks related to the identified 14 risk factors. The estimates of deaths and diseases possibly caused by occupational factors were based on methods used by the WHO and normally practiced in quantification cases for public health. The researchers used the Analytica software in encoding the risk mathematical solutions. They arrived at a simulation model titled the UAE Environmental Burden of Disease Model which could enable future works to quantify the results of interventions that can minimize pollutant intervention (Gibson & Farah, 2012, p. 683).
The researchers used the deliberative technique in prioritizing risks, the one proposed by the U.S. Office of Science and Technology Policy. This technique integrates both quantitative risk data and stakeholders thoughts systematically.
Define effective initiatives for minimizing risks and quantifying development. The plan had to provide recommendations using the initiatives or steps that could be implemented shortly (possibly 4 to 20 years) to lessen risks. The process had to identify key performance indicators (KPI) to measure improvement. The identification of KPIs was provided by scientists.
Ask for members feedback and suggestions. This was possible by conducting workshops and consultations with stakeholders to study, debate, and revise the recommended initiatives and KPIs.
Prepare the discussed plan and put the plan into action. The risk ranking and planning activity was put into a formal document.
Cardiovascular Disease
One of the major causes of mortality is cardiovascular disease, which accounts for 30% of all deaths in the UAE. The Emirati diet has been much influenced by western culture as Western tourists and workers enter the country. Musaiger (2010) has noted that the consumption of fresh vegetables and fruits has been reduced and substituted with pork, chicken meat, sugar, and fat. Adult men are into smoking, with 25% perceived smokers, and only 1.6% of Emirati women. Risk factors for CVD are prevalent among Emiratis. Changes in lifestyle, particularly diet, have contributed to the prevalence of CVD.
Similarly, in health studies in Korea, cardiovascular disease due to overwork was found to be the primary cause of death and disability among Koreans; thus costs for compensation for this disease have increased significantly (Won, Hong, & Hwang, 2013).
WHO (1990 as cited in Musaiger, 2010) reports that among the different nationalities in the UAE, there are sharp contrasts between ethnic groups which could exacerbate the risk factors for CVD.
Factors Linked to CVD
Nutritional Factors
Studies about UAE nutrition are scarce. The Preventive Medicine Department (1995 as cited in Musaiger, 2010) reported that the UAE food consumption has been affected by western food patterns. Traditional food has not been largely patronized and there has been a steep decline in consumption of this type of food. This lifestyle contributes to chronic diseases. A study in Bahrain states that patients with myocardial infarction were not consumers of fresh vegetables and fruits. The study of Musaiger and Abuirmeileh (1998 as cited in Musaiger, 2010) found that Emiratis had a slow intake of fresh fruits and vegetables. Daily intake of fruits and vegetables can prevent or reduce the prevalence of CVD because dietary fiber present in such foods can lower serum cholesterol (Sharpnel et al., 1992 as cited in Musaiger, 2010).
Smoking
Smoking is the most common cause of CVD morbidity and mortality. Smoking causes four times increased risk of heart disease and a high risk of death (Lakier, 1992 as cited in Musiager, 2010). Again, there is less research being conducted on the prevalence of smoking in the UAE. The study of Musaiger reported that 25% of UAE men aged 20-80 years were smokers, but there were only about 1.6% of women smokers of the same age. Second-hand smoking is also a threat to ones health. Leone (1993 as cited in Musaiger, 2010) indicated that active and passive smokers had low concern for the effects of smoking, such as atherosclerotic coronary alterations, focal myocardial lesions, and arrhythmias. Bender et al.s (1993 as cited in Musaiger, 2010) study found that most UAE physicians were smokers, but the physicians agreed that smoking was dangerous to their health. The study focused on 275 physicians, where 36% were found to be current smokers, and 12.7% were former smokers.
Hypercholesterolemia
A study in the UAE about the relationship of serum cholesterol and CVD showed that the prevalence was found between 47 to 53% among Arab nationals and from 22.7 to 44.5% among non-Arabs (Musaiger, 2010). Hypercholesterolemia was prevalent among the different nationalities in the UAE. Twenty percent of Emirati nationals were found to have high cholesterol, 34% were within the borderline, while 46% had desirable blood cholesterol, and about 50% overall were affected.
Overweight and Obesity
Across the population, there has been a stable growth in food energy consumption, yet physical exercise is found to be uncommon among Emiratis (Musaiger, 2010). Overweight and obesity are also contributors to CVD among Emiratis. In a study in early 2000, 33% of married women were overweight and 38% were obese. Obesity among women increased with age, reaching its height at age 30-39 years, but fell slightly when they reached 40 years and above. Married men were less prone to obesity compared to women. Moussa et al. (1994 as cited in Musaiger, 2010) researched the effect of body fat and fat localization on blood pressure levels in school children of Al-Ain, UAE. The study recorded that there was a significant difference in systolic and diastolic blood pressure means between obese and non-obese children.
Occupational Injury
Injury is one of the causes of death and disability in the UAE. It can be accident-related, like falls or drowning. Children under 15 years old account for about 9% of injury-related deaths between 2000 and 2008, with about 104 children dying annually because of it (Loney et al., 2013). Traffic injury is mostly the case, next is drowning and then falls. Males are mostly the victim of injury than females (Loney et al., 2013).
Occupational factors include exposures, indoor air pollution, unclean water condition, seafood factors, and ambient air pollution, among others. Outdoor air pollution is considered the highest risk, with studies indicating a mean rank of 1.4. Indoor air pollution is next with a mean rank of 3.3. Gibson and Farahs (2012) study pinpointed 216 possible interventions in mitigating environmental risks to diseases in the UAE.
Toxicants
There are several occupational injuries since the UAE is into manufacturing, using various metals and chemicals. A chemical that is harmful to human health is known as formaldehyde, or formalin (O3). This is used in medical laboratories and mortuaries, but is also present in other products or chemicals; it can be used as a cleaning agent or disinfectant, or in paper products and even plywood (Ahmed, 2011). Severe and long-lasting exposure to this chemical by inhalation can cause respiratory illness. If it hits the eye, it can cause blindness. Over-exposure is indeed discouraged as it can lead to lung cancer. Laboratory technicians, including students and professors in universities using the chemical, are at greater risk.
A study on exposure to the chemical was conducted in the laboratories of Sharjah University. Different concentrations of formaldehyde were measured in the different laboratories of the university. It was noted that the chemical had been constantly used in the laboratories for the preservation of animals and other specimens for study. In medical schools, formalin was also used to preserve or embalm cadavers used by students in medical research. In the process of preservation, it was possible that the students could inhale the chemical vapors. The study found that the measured concentration of the chemical was higher in the anatomy laboratory, or higher than the ceiling standard imposed by the USA-NIOSH, which was just 0.1ppm. The researchers recorded that about 94% of the students and instructors were exposed to the chemical, who then displayed symptoms of eye irritation and other symptoms in the primary organs of sensation (Ahmed, 2011).
Other toxicants include carbon monoxide, a highly lethal pollutant which connects with the bodys hemoglobin, and the association results in carboxyhemoglobin that affects the vital organs of the body. Carbon dioxide (CO2) also has harmful effects on the human body and particularly injurious to children in school. Another deadly pollutant is a classification of volatile organic compounds (VOC) which comes from biogenic chemicals or car exhaust and is dangerous for respiratory diseases. A large amount of VOC can cause cancer. Methane is also produced in manufacturing plants in Dubai and can cause respiratory disease for workers if a large amount is inhaled (Behzadi & Fadeyi, 2012).
Indoor Air Pollutants
Indoor air pollutants in the UAE work environment include carbon monoxide, a large amount of hydrogen sulfide, nitrogen, and sulfur. One of the leading causes of respiratory diseases is indoor air pollution. Contaminants are gases, combustion chemicals to organic chemicals. They come from outdoor pollutants and penetrate in residences (Funk et al., 2014).
The governments of Dubai and Abu Dhabi, particularly the Environmental Agency-Abu Dhabi (EAD), have continuously conducted studies on the effects of chemical and indoor pollutants on human health. One of these studies includes indoor quality research (IAQ) in schools in Dubai whose aim was to formulate a program to protect children from indoor pollutants in schools (Behzadi & Fadeyi, 2012). Various schools were the subject of the study in which the amounts of IAQ were measured. The results yielded positive for indoor pollutants, but immediately after the study the researchers and school authorities conducted cleaning of the school atmosphere and the appliances, including the air conditioning units which were to be cleaned every 3 months (Behzadi & Fadeyi, 2012).
Occupational Safety
Work in a construction project is a dangerous occupation, particularly in the Middle East, where projects are accomplished for a short period. The construction work in the UAE are mostly performed by foreign workers, many of them are not trained for construction work (Al-Kaabi, 2006).
Accidents in the Workplace
The UAE construction sites are unsafe to work with (Al-Kaabi, 2006). In Dubai, construction accidents increased by 70% in 2004, accounting for 105 injuries. Several accidents in the different sectors in agriculture, mining, industry, construction, transportation, has not been regularly reported. More than 77 construction companies have reported zero accidents, per a report from the UAE Ministry of Labor and Social Affairs (2000 as cited in Al-Kaabi, 2006), which seems unbelievable considering that these construction companies have various violations in employing foreign workers. The law requires that companies provide an accident report to the Ministry of Labor and Social Affairs. The Bureau of Statistics (2000 as cited in Al-Kaabi, 2006) reported occupational accidents that seemed incomplete, as shown in the table below.
Type of Accident No.
Car accidents 346 (56.7%)
Others 95 (15.6%)
Run over 52 (8.5%)
Broken elevators 40 (6.6%)
Fainting 22 (3.6%)
Falls 15 (2.5%)
Trapped children 15 (2.5%)
Building collapse 11 (1.8%)
Suicide 9 (1.5%)
Asphyxiation 4 (0.6%)
Sand failure 1 (0.2%)
Total 610
Table 1. Number of accidents in 1999 (Bureau of Statistics, 2000 as cited in Al-Kaabi, 2006).
The table above does not conform to international standards of reporting of accidents because of its lack of details, such as classification per industry category and there is no further information whether those accidents occurred during construction operations.
Some cases of construction accidents can be stated here. One case involved a worker who was hit by a falling piece of scaffolding that resulted in the instant death of the victim (Hadad, 2005 as cited in Al-Kaabi, 2006). Carelessness indeed can lead to accidents. The collapse of a crane led to severe injuries for two workers, one had injured head and the other broken bones. When the roof of a building collapsed, six died and six were injured (Abdullah, 2004 as cited in Al-Kaabi, 2006). Two other accidents happened in Sharjah in 2002 and the other one in Dubai, costing nine workers lives (Al-Kaabi, 2006, p. 18). Many cases were considered near misses, but they occurred because of violation of rules and standard procedures by the company concerned.
Al-Kaabi (2006) surveyed to analyze basic safety aspects, for example, accident types, workers safety training, safety monitoring, and other safety measures instituted by the construction companies. The author had vast experience in construction in the UAE which allowed him to have a deep grasp of safety measures and programs in the country. The survey method was by way of questionnaires, focusing on safety measures, precautions, programs, and outcomes. The questionnaires were sent to construction contractors in Abu Dhabi and Dubai. Most of the companies involved in the study were relatively large and had vast experience in construction. The companies were involved in various construction projects that included residential buildings, commercial buildings, highways, bridges, and other steel construction.
Almost all (96%) of construction companies provided workers with certain types of insurance, but five small companies (4%) did not provide insurance to their workers. Insurance coverage included compensation in case of an accident, life insurance, government care, all-risks insurance, and health insurance, etc. Orientation, education, and training were provided to newly accepted workers. Workers were also provided with personal protective equipment (PPE), such as helmet, gloves, boots, and eye/face goggles. A UAE law prescribes issuance of PPE for workers in workplaces, such as construction sites.
Al-Kaabis (2006) study found that approximately 30% of the companies did not provide PPE to their workers. But 91 contractors (75%) complied with the law and strictly implemented the use of PPE. Companies that did not provide PPE reasoned out that PPE was too expensive and that its use was against cultural practices.
Contractors were also asked to provide data regarding on-site safety measures, for example, guardrails, signs, fences, shelters, and other safety measures. The questions regarding equipment and tools focused on the maintenance and handling of heavy equipment. Al-Kaabis (2006) survey also focused on health and hygiene. Construction sites had lavatories, safe drinking water, and lunch and rest areas. All companies maintained regular site cleanliness.
Cancer
Cancer is something that the UAE people must be serious about because the majority of Emiratis do not attend cancer screening. The UAE Cancer Registry (2006 as cited in Gulf News, 2015) indicated that the five cancers that Emiratis should be aware of are breast, colorectal, gastric, thyroid and lung (Gulf News, 2015). Early detection is the key to the successful treatment of cancer.
Mesothelioma is an occupation cancer as it is the result of inhalation of the building material asbestos that causes cancer in the lungs. The use of asbestos has been banned in many countries, but this material is very useful in manufacturing. Despite the danger, some countries still use asbestos because it is cheap. In Dubai, citizens still adhere to the use of asbestos because of the lack of knowledge about the danger of asbestos, particularly that it causes Mesothelioma cancer. Patients who have contracted Mesothelioma display symptoms of shortness of breath, chest pains, and gradual or sudden weight drop. Symptoms of the disease may usually take 20 to 50 years to be detected.
The most common cancer for UAE men is colorectal, lung, leukemia, prostate, and others; whereas women are prone to breast, thyroid, colorectal, and cervical. Leukemia and lung cancers are common for both gender, and the most ranking for males are prostate and lung cancer (Glob Health Action, 2013 as cited in Loney et al., 2013).
Respiratory Illness
A recent virus outbreak has occurred in the UAE and also in the Middle East region. This is known as the MERS-Cov (Middle East Respiratory Syndrome Coronavirus). People who get infected with this virus develop serious respiratory illness accompanied by fever, cough, and difficulty in breathing (Sasendran, 2014).
Respiratory illness for Emiratis is mostly caused by inhalation of chemicals and gases, dust and other undesirable vapors, or poor air quality. Exposures to fumes can cause asthma, bronchitis, and various diseases of the lungs or possibly cancer. The study of Loney et al. (2013) found that Emiratis and migrant workers are at high risk of exposures to gases and fumes because of heightened economic development, dependence on motorized transport and traffic bottlenecks, unfavorable weather patterns as the atmosphere is mixed with dust and fumes, and the vast economic and manufacturing activities that emit different kinds of air pollutants.
Entry and exit points in Abu Dhabi, Dubai, and Sharjah receive and send off visitors traveling from the different countries of the world. This scenario poses the increased threat of the spread of diseases and the UAE is at a possible risk from respiratory diseases because of airborne viruses that carry SARS or Mers-COV. Traditional respiratory disease like tuberculosis can also be transmitted here. New viruses roam around the earths atmosphere. The UAE and every airport, entry or exit points, must be constantly guarded.
In addition to the above health problems suffered by migrant workers and the UAE population in general, there are also psychiatric problems that have to be dealt with. One is the so-called Dubai Syndrome (Al-Maskari et al., 2011), which refers to stress and a feeling of deprivation suffered by spouses and families of migrant workers. Aside from the debts incurred by applicants before they are accepted for work in the UAE, there are other reasons the applicants feel, such as the guilt for leaving . The Philippine ambassador to the UAE explained that the migrants families back home think the migrants are earning thousands of dollars, and the poor migrant goes deeper into debt & (Najem, 2015, p. 30).
Poor working conditions in construction sites exacerbate the migrant workers emotional state. There are suicide cases, albeit this news lacks epidemiological data, caused probably by the low priority of psychiatric health research in the UAE (Statistical Yearbook of Abu Dhabi, 2006 as cited in Al-Maskari et al., 2011).
Psychiatric problems are societal, which have to be given much concern because it involves migrant workers. Health problems such as this can lead to functional injury in a sense, reduced quality of life, low performance at work, lost productivity, and so on. Globally, suicide cases account for about 1.5% of the worldwide burden of diseases.
Case Study
Refining and Petrochemical Production
In a cohort study of 1,205 respondents working in a Canadian oil refinery for more than five years, the researchers recorded three deaths due to brain cancer (Theriault & Goulet, 1979 as cited in Thomas, 1986). This was non-significant as the work histories of the three brain cancer cases were ambiguous about occupational exposures. A proportionate mortality ratio study of deceased, active and retired members of the Oil, Chemical, and Atomic Workers International Union (OCAW) in Texas indicated an increased frequency of deaths due to brain cancer among white male hourly workers employed in petroleum refining and petrochemical plants (Thomas et al., 1980 as cited in Thomas, 1986).
The increased relative frequency of brain tumor deaths occurred primarily among active employees in three oil refineries in the Beaumont-Port Arthur area of the Texas Gulf Coast. A nested case-control study comparing work histories of the brain tumor cases with those of persons who died from other causes indicated an elevated brain tumor mortality risk among OCAW members whose jobs involved the intraplate pumping and transporting of bulk liquids (crude oil and products) and the manufacture of lubricating oil, but the odds ratios were not statistically significant (Thomas et al., 1980 as cited in Thomas, 1986).
In a mortality study of oil refinery workers employed by 19 U.S. companies, 8 deaths due to brain cancer were observed and 4.9 were expected (Schottenfeld et al., 1981 as cited in Thomas, 1986). The investigators indicated that there may have been underreporting of deaths because of the short study period (2 years) and the lag time between the date of death and receipt of a death certificate.
Cancer incidents among actively employed refinery workers during the study period were compared with that for the U.S. using cancer registry incidence data. Nine incident cases of brain cancer were reported and about seven were expected. No analyses by the duration of employment or occupation were shown.
Brain cancer mortality was not excessive among 35,000 employees of eight British oil refineries between January 1950 and December 1975 (Rushton & Alderson, 1981 as cited in Thomas, 1986). However, approximately 20 percent of the study subjects had scientific, technical, administrative, clerical, or engineering jobs, most of which are presumably low-exposure occupations. This same difficulty occurred in a cohort of workers at oil distribution centers in England (Rushton & Alderson, 1981 as cited in Thomas, 1986), where supervisors, managers, administrators, and clerical workers were included in the analyses. In one study of refinery workers, investigators found no association between brain cancer risk and oil refinery employment (Hanis et al., 1982), and two other groups of investigators did not report observed and expected numbers for brain cancer (Hanis et al., 1982; Tabershaw as cited in Thomas, 1986). The follow-up period for several studies was very short (less than 10 years), and risks of fatal disease with long latent periods may have been underestimated.
A group of primary brain cancer deaths among workers at a Union Carbide petrochemical plant in Texas City, Texas was reported in 1980 (Alexander et al., 1980 as cited In Thomas, 1986). All of the decedents were less than age 66 at death and the best medical information available indicated that 15 of 18 tumors were glioblastoma multiforme. A cohort mortality study of workers at this plant showed a significant elevated SMR for brain tumors among white male hourly workers. A similar analysis by the company of the same data also indicated a significantly increased brain cancer mortality risk among workers who held hourly positions, but nested case-control analyses indicated no significantly elevated odds associated with exposure to any specific chemicals (Austin & Schnatter, 1983; Leffingwell et al., 1983 as cited in Thomas, 1986).
Operating engineers employed in the petrochemical industry in Texas and Louisiana had an elevated frequency of brain tumor deaths. This excess is primarily due to a significantly elevated PMR for brain tumors among persons employed as operators in oil refineries and petrochemical plants (Thomas, 1986).
A study of workers in a rubber plant in Ohio indicated an elevated brain cancer mortality risk among employees in the curing and tire-building department. Later studies in the same plant population also suggested that men employed in tire assembly and tire building had an increased brain cancer mortality risk, but brain cancer mortality was less than expected in the entire plant population (Monson & Fine, 1980 as cited in Thomas, 1986).
A cohort study from 34 plants examined the relationship between polyvinyl chloride exposure and the risk of cancer. Among persons who had worked for at least one year in a job involving exposure to vinyl chloride, the total number of brain cancers deaths observed was significantly greater than expected. Twelve brain cancer deaths observed during the study period included glioblastomas, two astrocytomas, one ependymoma, and five unspecified types (Thomas, 1986).
Conclusion
Through the different studies discussed above and upon initiatives of the UAE government and the general public, many areas and issues have been addressed and to provide the strategic plan necessary to deal with all the safety and health problems of the UAE population and the migrant workers. Full coordination and cooperation between the different sectors must be attained so that specific diseases and new viruses threatening the country now and shortly can be properly addressed. Loney et al. (2013) recommend effective surveillance and monitoring.
Health and safety issues are not only the concern of the internal government but a global concern because the spread of diseases and viruses can have rapid consequences if not dealt with quickly and effectively. The coverage in dealing with SARS and the MERS-Cov outbreak is an example of international cooperation and coordination.
The UAE issue has become an international issue because tourists and migrant workers are going there to visit or work. It is an attraction to the world, thanks in part to the government and the Emiratis themselves for making their country a model for economic diversification and development. The problem that this economic progress has brought up should be the concern of all. Even if the government and the UAE people are addressing it, there is not enough action and much has to be done.
Recommendations
It is recommended that consistent and effective longitudinal data be available for UAE strategic planning in health and safety programs. A portion of this has been achieved but there are still many things to be done.
The UAE government can use technology for safety in construction. An expert system is known as How safe was first developed by Levitt (as cited in Al-Kaabi, 2006), and could determine the strength and weakness of a construction firms organization and procedures. The system starts with a hypothesis and a series of fundamental goals helps to prove the hypothesis.
The technique in knowledge extraction in How safe is structured like an inverted tree where the top-level diagnosis is helped by three to four lower-level inferences or deductions which can be analyzed by the use at the end of each branch. Each leaf of the trees branches corresponds to a question to which the user chooses the degree of belief. The conclusion is reached with the inferred degree of belief in the top-level hypothesis in addition to the reliability of the conclusion given as a percentage (Al-Kaabi, 2006).
Furthermore, the UK Health and Safety Executive (HSE) developed the computerized expert system known as Estimation and Assessment of Substance Exposure (EASE), which simplifies dangerous substances exposure assessments. This system utilizes some rules to forecast a series of probable exposures or an end-point for a certain work situation (Cherie & Hughson as cited in Al-Kaabi, 2006). The safety regulations in the UK require that the maker of a new substance should notify the appropriate authority about it, and the authority will have to carry out a risk assessment. A computer-based system that addresses exposure to a substance in the workplace is effective.
Al-Kaabi, N. (2006). A fuzzy-based construction safety advisor (CSA) for construction safety in the United Arab Emirates (Doctoral thesis, The Ohio State University). Web.
Al-Maskari, F., Shah, S., Al-Sharhan, R., Al-Haj, E., Al-Kaabi, K., Khonji, D.,&Bernsen, R. (2011). Prevalence of depression and suicidal behaviors among male migrant workers in the United Arab Emirates. Journal of Immigrant Minority Health, 13(1), 1027-1032. Web.
Behzadi, N., & Fadeyi, O. (2012). A preliminary study of indoor air quality conditions in Dubai public elementary schools. Architectural Engineering and Design Management, 8(1), 192-213. Web.
Gibson, J., Brammer, A., Davidson, C., Folley, T., Launay, F., & Thomsen, J. (2013). Environmental burden of disease assessment: A case study in the United Arab Emirates. New York: Springer.
Gibson, J., & Farah, Z. (2012). Environmental risks to public health in the United Arab Emirates: A quantitative assessment and strategic plan. Environmental Health Perspectives, 10(5), 681-686. Web.
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Loney, T., Aw, T., Handysides, D., Ali, R., Blair, I., Grivna, M.,&El-Obaid, Y. (2013). An analysis of the health status of the United Arab Emirates: The Big 4 public health issues. Web.
Musaiger, M. (2010). Risk factors for cardiovascular disease in the United Arab Emirates. International Journal of Food Sciences and Nutrition, 49(1), S65-S70. Web.
Najem, P. (2015). The dark side of growth (Masters thesis in Global & International Studies, University of California, Santa Barbara). Web.
Saseendran, S. (2014). UAE tightens scrutiny of camel shipments from GCC. Web.
Thomas, T. (1986). A retrospective study of brain tumors and occupational risk factors (Doctoral thesis, John Hopkins University, Baltimore, Maryland). Web.
For many years, hydraulic fracturing was an important element of oil and gas drilling operations. With the rapid advancement of new technologies, the quality and efficacy of fracking considerably improved. Unfortunately, until the present, the benefits and costs of hydraulic fracturing have been considered mainly in terms of their environmental risks (Wilkinson, 2012). As a result, the health consequences of workers’ exposure to silica during fracking have been persistently overlooked. Today, workers’ exposure to silica during hydraulic fracturing is one of the biggest occupational health concerns. Last year, the National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) issued an official note to confirm the dangers of workers’ exposure to respirable crystalline silica. In light of these issues, every employer should reduce the risks of health complications that result from workers’ continuous participation in fracking procedures.
Hydraulic Fracturing: The Basics
To understand how crystalline silica impacts workers’ health, the basics of the hydraulic fracturing process should be explained. According to Esswein, Kiefer, Snawder, and Breitenstein (2012), “hydraulic fracturing is the process of injecting large volumes of water, sand, and chemicals into the ground at high pressure to break up shale formation allowing more efficient recovery of oil and gas.” In other words, hydraulic fracturing (or fracking) is one of the most important procedures in good stimulation, which is used to facilitate gas and oil recovery. Fracking had been used in oil and gas drilling since the 1940s, but the emergence of new horizontal drilling technologies led to a substantial increase in fracking procedures (Esswein et al., 2012). Unfortunately, it is not until very recently that the health impacts of hydraulic fracturing became a matter of occupational health concern.
Hydraulic fracturing by itself is not very dangerous. Rather, it is the use of crystalline silica that makes fracking so problematic. Many hydraulic fracturing processes are impossible without silica. At each stage of the fracking process, workers are exposed to hundreds of thousands of sand particles (Esswein et al., 2012). During fracking, large volumes of water are pumped into a well, to fracture the tight and shale formations that prevent the smooth flow of oil and gas (OSHA, 2012). As a result, all workers engaged in the process face equally high risks of exposure and related health complications.
Why Is Fracturing So Dangerous to Workers’ Health?
As stated earlier, it is not fracturing but the use of silica that raises the biggest occupational health concerns. Fracking involves large amounts of silica. At least four million pounds of sand are used to frack one well (Sturgis, 2012). Transporting, refilling, moving, and replacing silica create dangerous dust that is released into the air (OSHA, 2012). During hydraulic fracturing, workers can be exposed to one or more sources of silica. It can be the dust ejected from access ports and sand movers or the dust released along the sand transfer belt (OSHA, 2012). Whatever the source of silica dust, the risks of developing health complications are always high.
It is not a secret that continuous exposure to silica dust can lead to the development of silicosis. Silicosis is a lung disease that develops when workers inhale respirable crystalline silica and its dust (Esswein et al., 2012). Silicosis is both treatable and preventable. It develops only after prolonged exposure to silica dust, and its progress is quite slow (Esswein et al., 2012). Still, employers working in the oil and gas industry have few chances to avoid silicosis dangers. The rates of mortality of acute silicosis are quite high. Due to extensive silica dust exposures, workers can develop the symptoms of silicosis very quickly (Esswein et al., 2012). In these situations, chances to save the worker from death will be meager.
The most vulnerable to silicosis are the workers, who are directly exposed to silica dust due to their workplace obligations, such as tunnelers, sandblasters, and miners (Esswein et al., 2012). Silica is usually categorized as a lung carcinogen, which also means that it can lead to the development of chronic obstructive lung disease (COPD) (Esswein et al., 2012). Even renal disease and autoimmune diagnoses may have their roots in continuous exposure to silica dust (Esswein et al., 2012). Workers, who constantly deal with silica dust, also face higher risks of respiratory infections and tuberculosis (Esswein et al., 2012).
Fracturing and Silica Dust Dangers: Statistics and Research
The current statistics of silica dust exposure and related health complications are very unsatisfactory. According to Esswein et al. (2012) and OSHA (2012), 435,000 employees currently work in the U.S. oil and gas industry. Almost half of them can be exposed to excessive levels of silica dust (Actio, 2012). Between 2003 and 2009, the prevalence of occupational deaths in the oil and gas industry was 27.5 per 100,000 (Sturgis, 2012). This is seven times higher than the overall rates of fatality among all U.S. workers (Sturgis, 2012). Between 2003 and 2005, the rates of fatality among oil and gas workers increased 15 percent (Sturgis, 2012). Most probably, it is due to the lack of effective health protection measures that oil and gas industry workers face high risks of fatality and disease. 100 percent of the fracking sites tested during 2012 had their workers exposed to excessive concentrations of respirable crystalline silica (Sturgis, 2012). These data suggest that the oil and gas industry needs a profound change in its occupational health philosophy. The risks of health problems for the workers operating directly at the well are particularly high. The oil and gas industry should become more concerned about the health and future wellbeing of its workers. Today, numerous methods and models are available to employers, as they are striving to protect their workers from the most common health hazards.
Protecting Works from Occupational Hazards
The magnitude of the occupational health problems impacting workers in the oil and gas industry is difficult to overestimate. However, most employers have everything needed to protect their employees from the most common health hazards. Industrial enterprises in the oil and gas industry can switch to less hazardous substances, which do not contain silica (Esswein et al., 2012). In addition, passive enclosures can and must be used at all points, where dust is generated (Esswein et al., 2012). Employers can also use screw augers instead of traditional transfer belts on sand movers when it is possible and cost-effective. According to Esswein et al. (2012), it is a relevant prevention-through-design consideration, and it does have the potential to reduce the scope of health complications in workers, who are exposed to silica dust.
In addition, employers working in the oil and gas industry must constantly monitor the quality of air in the workplace and reduce workers’ exposure to silica dust with the help of safe work practices (OSHA, 2012). To monitor and control the quality of air, employers can collect dust samples at the site. The results will show whether any of the current workers are exposed to the levels of respirable silica dust above the limits of exposure (OSHA, 2012). Yet, at all times, it is through education and training that the most prevalent occupational hazards can be successfully addressed. OSHA (2012) recommends implementing an education and communication program for workers. The importance of such programs is justified by the fact that workers have the right to know what substances they are being exposed to, how these substances impact their health, and how to avoid these damaging impacts.
Conclusion
Workers’ exposure to silica dust is one of the most prevalent occupational health concerns facing the oil and gas industry. Thousands of workers in the oil and gas industry are subjected to unreasonably high concentrations of silica dust. The problem is particularly complicated for the employees, who participate in hydraulic fracturing. Silica dust increases employees’ vulnerability to lung and autoimmune diseases. Still, most employers in the oil and gas industry have everything needed to deal with these challenges. Air monitoring, prevention through design, education, and training can alleviate the burden of silicosis and other lung diseases in workers. All employees should have access to occupational training and safety information because they have the right to know what substances they are exposed to and how to prevent the most common occupational health risks.
Esswein, E., Kiefer, M., Snawder, J. & Breitenstein, M. (2012). Worker exposure too crystalline silica during hydraulic fracturing. Centers for Disease Control and Prevention. Web.
The United Arab Emirates is a fast-growing and diversified economy in the Gulf region. Its population is composed of different ethnic groups and nationalities coming from Southeast Asia, the Middle East, and Europe. International firms or multinationals help boost the economy. As a result, it has complicated health problems due to occupational hazards.
This is not the case if we look at the history of the UAE as a growing Muslim nation. Emiratis have the belief of environmental stewardship as ingrained in their Muslim culture. The Holy Qur’an teaches believers to care for animals and plants and tell Muslims to have great concern for the environment (Aspinall, 2006 as cited in Gibson et al., 2013).
Environmentalism is deeply seated in the people’s culture. His Excellency Sheikh Zayed, the UAE’s founder, has been internationally recognized for his conservation efforts, having received no less than the Gold Panda Award from the international body, the World Wildlife Foundation (2000 as cited in Gibson et al., 2013). Sheikh Zayed also received posthumously the “Champion of the Earth Award” from the UN Environment Programme (Gibson et al., 2013). Despite their love for nature, Emiratis also want economic growth. There lies a complication because of the threat of the environment on people’s health.
This paper will discuss the UAE’s environmental risks that have caused occupational health problems. The problem stems from the continuous economic growth which has triggered the influx of tourists and migrant workers in the country. First, there was the problem of infectious diseases, but due to the government’s enhanced health programs, the problem has shifted to non-infectious diseases, such as cardiovascular disease, occupational injury, cancer, and respiratory illness.
This paper will first delve into the background of the country UAE, from its roots: seven hereditary monarchies that decided to form the UAE. Major economic activities began when it struck oil, and from this, the problem of health evolved. Discussion of the literature will focus on health issues and their causes. Some case studies on tumor and brain cancer suffered by workers in a chemical and manufacturing plant are also included in the final analysis of the literature. The conclusion and recommendations will discuss the government’s strategic health plan. Future research should deal with longitudinal data that should be available for UAE strategic planning in health and safety programs. There is a lack of empirical research on this aspect.
Literature Review
The United Arab Emirates
The UAE is a country comprised of seven hereditary monarchies called emirates, established in the early part of the seventies. The country is blessed with so-called black gold, oil, but has successfully diversified its economy by attracting large multinationals to invest in its land. It has enhanced infrastructures, built skyscrapers, and diversified its manufacturing base of aluminum, steel, iron, and other metals, for local use and exports (Loney et al., 2013).
The UAE population is a combination of natural birth and migration of workers who are attracted to the country’s high wages and benefits and the quality of life afforded by foreign and local firms. This makes the country’s population structure unique. Foreign workers fill in the lack of skills of local workers. Abu Dhabi is the largest area and has a population of 2.3 million, but half of this is composed of migrant workers. In other words, the UAE population is composed of different nationalities of varying backgrounds, ethnicities, demographics, and cultural eccentricities (Loney et al., 2013).
With an annual growth of 6.5% of GDP from 2000 to 2005, the UAE is one of the most successful economies in the region of the Gulf Cooperation Council (UAE Bureau of Statistics as cited in Al-Kaabi, 2006). Construction had attributed 12% of the non-oil percentage of GDP in 2003. The construction labor force increases yearly; in 2003 the labor force had a yearly increase of 24% (UAE Bureau of Statistics as cited in Al-Kaabi, 2006).
Oil became a primary source of economic progress but the country was quick and the rulers wise enough to diversify. In the 1960s the UAE invested in various sectors to reduce economic dependence on oil. These sectors are global and required infrastructure development. Dubai and Abu Dhabi are the two Emirates which have experienced continuous construction projects (Najem, 2015). As billions of dollars are being infused into the economy, the construction workers are the main driving force in infrastructural development and the entire growth. According to Najem (2015), there is a sense of unfairness in how construction workers are being treated.
Before the UAE was formed, the Trucial States relied on trading, pearling, fishing, agriculture, and animal husbandry. The discovery of oil led to radical changes to the people’s daily activities and the growth course of the country. But before it struck oil, it has been a destination for migrant workers. The immigration of workers dates back to the pearling era in the 1800s.
The present migration rates of the UAE are among the highest in the world, i.e. 13.5 migrant workers per 1,000 people (CIA World Factbook as cited in Najem, 2015). In this country, the population boom is parallel with infrastructural development. The country’s population is approximately nine million, a steady growth obtained because of workers’ migration (World Bank as cited in Najem, 2015).
The fear of life without oil had set in the country’s policy-making body. In the 1990s, the country began to realize that investing foreign assets abroad was just a few of the things it could do, and so it invested in agriculture and real estate to increase its foreign direct investment (FDI) and enhance domestic economic productivity across different sectors. Currently, the government has been investing in several new infrastructural projects to pursue economic diversity. The country has been most successful in such areas as tourism, financial services, trade, agriculture, real estate, and construction. But as a whole, investing in infrastructure has considerably increased FDI rates over time. It also has to increase its labor force continuously.
Historical Background
The literature provides vast evidence on the relationship between environmental sustainability and human health. Even medical artifacts dating back to the Assyrian and pre-historic times provide concepts of environmental conditions that cause diseases. Valleys and rivers were classified by ancient texts according to the health status of those areas and were analyzed as to whether they were safe or not for human habitation (Gibson et al., 2013).
Looking at the effects of health caused by the environment should stimulate research on several significant factors, such as analyzing the probability theory and connect this with the problem at hand, discussion on the instruments to quantify the presence of pollutants in the environment, mathematical calculations on epidemiologic research linking the quantified presence of pollutants to certain health problems, public health records, and instruments or computer software that provide a simulation of environment pollution and community. These data and instruments were not available during the Renaissance period but techniques then were already formulated and applied today, though the present time has the knowledge and technology to measure and simulate to assess the environment.
The Renaissance era provided the present time with facts on the probability theory. Before this time, policymakers used very risky and uncertain methods, in consultation with the clergy and religious people, instead of using reliable tools of probability (Gibson et al., 2013).
Aside from theory, decision-makers can also use quantitative methods in assessing health risk data, and mathematical relationships relating to contact with the identified contaminants to certain health causes as a result of toxicologic and epidemiologic research. This scarcity of tools and instrumentation and the lack of appropriate public data recording were major barriers to assessing the relationship between environmental hazards and human health (Covello & Mumpower as cited in Gibson et al., 2013, p. 3).
Measuring or quantifying the link between the amount of contaminant in contact with the human body and the resultant disease is a current technique but the science of toxicology dates back to the time of historic physician Paracelsus who formulated the basic principle of toxicology which states that the amount of dose determines the poison caused on the human body (Graham as cited in Gibson et al., 2013). Covello and Mumpower (as cited in Gibson et al., 2013) added that the nineteenth-century scientist Pasteur understood and clearly explained the idea of infection or the link between the environment that carries contaminants and poisonous agents and the infected human body.
Health Priority Issues in the UAE
The study of Loney et al. (2013) focused on major public health issues affected by the current economic boom and other major activities. The researchers used secondary data or peer-reviewed journals and articles from different databases and government publications and websites which publish articles focusing on this particular issue. The researchers were looking for public health priority problems, such as cardiovascular disease, injury caused by occupational factors, cancer, and other diseases including respiratory illness.
According to the study, fertility rates have significantly declined in the UAE caused by rapid urbanization, changing beliefs about family growth, and enhanced education and employment for women leading to reduced marriages. On the other hand, life expectancy has also improved since men and women are now reaching the ages of 77 to 79 years old, respectively.
Infectious diseases, once a major concern of the government’s health department, is caused by the migration of foreign labor and the temporary influx of people from the different parts of the world. Nevertheless, the standard of living has improved even to the lowly Emirati, so that infectious diseases are no longer a problem as this is being effectively addressed by the government’s health care services. In the past few years, attention has shifted to non-infectious diseases which have rapidly increased (Gibson & Farah, 2012).
The UAE’s fast economic advancement has enhanced public health but brought some problems, in particular an increase in non-infectious diseases such as heart problems, cancer, type II diabetes, and respiratory diseases. Environmental risk is number one, which has brought national attention as constantly reported in the media.
The Environmental Agency-Abu Dhabi (EAD) made immediate moves in 2007 to address the issue, particularly by measuring the environmental burden on public health. EAD asked for a strategic plan, which was then awarded to a consortium composed of two universities: one from North Carolina – the Norwegian Institute for Air Quality Research – and the UAE University (Gibson & Farah, 2012). This was an ambitious project and a model for the Middle East. The World Health Organization hailed this project and also provided help through oversight and some methods to be used. The study focused on occupational risk factors, particularly on exposure to harmful chemical and other biological agents, and exposures in the industrial and agricultural sectors.
The study found that a perfect environmental health plan could not be attained, but it recommended some possible effective methods in dealing with non-infectious diseases. The group developed a five-step strategy that measures the weight of the disease pointing to every risk factor and asked the stakeholders to focus on those risk factors and define the possible solutions. These steps are explained in the following paragraphs.
Measure the risks. Gibson and Farah (2012) and the researchers measured the risks related to the identified 14 risk factors. The estimates of deaths and diseases possibly caused by occupational factors were based on methods used by the WHO and normally practiced in quantification cases for public health. The researchers used the “Analytica” software in encoding the risk mathematical solutions. They arrived at a simulation model titled the “UAE Environmental Burden of Disease Model” which could enable future works to quantify the results of interventions that can minimize pollutant intervention (Gibson & Farah, 2012, p. 683).
The researchers used the deliberative technique in prioritizing risks, the one proposed by the U.S. Office of Science and Technology Policy. This technique integrates both quantitative risk data and stakeholders’ thoughts systematically.
Define effective initiatives for minimizing risks and quantifying development. The plan had to provide recommendations using the initiatives or steps that could be implemented shortly (possibly 4 to 20 years) to lessen risks. The process had to identify key performance indicators (KPI) to measure improvement. The identification of KPIs was provided by scientists.
Ask for members’ feedback and suggestions. This was possible by conducting workshops and consultations with stakeholders to study, debate, and revise the recommended initiatives and KPIs.
Prepare the discussed plan and put the plan into action. The risk ranking and planning activity was put into a formal document.
Cardiovascular Disease
One of the major causes of mortality is cardiovascular disease, which accounts for 30% of all deaths in the UAE. The Emirati diet has been much influenced by western culture as Western tourists and workers enter the country. Musaiger (2010) has noted that the consumption of fresh vegetables and fruits has been reduced and substituted with pork, chicken meat, sugar, and fat. Adult men are into smoking, with 25% perceived smokers, and only 1.6% of Emirati women. Risk factors for CVD are prevalent among Emiratis. Changes in lifestyle, particularly diet, have contributed to the prevalence of CVD.
Similarly, in health studies in Korea, cardiovascular disease due to overwork was found to be the primary cause of death and disability among Koreans; thus costs for compensation for this disease have increased significantly (Won, Hong, & Hwang, 2013).
WHO (1990 as cited in Musaiger, 2010) reports that among the different nationalities in the UAE, there are sharp contrasts between ethnic groups which could exacerbate the risk factors for CVD.
Factors Linked to CVD
Nutritional Factors
Studies about UAE nutrition are scarce. The Preventive Medicine Department (1995 as cited in Musaiger, 2010) reported that the UAE food consumption has been affected by western food patterns. Traditional food has not been largely patronized and there has been a steep decline in consumption of this type of food. This lifestyle contributes to chronic diseases. A study in Bahrain states that patients with myocardial infarction were not consumers of fresh vegetables and fruits. The study of Musaiger and Abuirmeileh (1998 as cited in Musaiger, 2010) found that Emiratis had a slow intake of fresh fruits and vegetables. Daily intake of fruits and vegetables can prevent or reduce the prevalence of CVD because dietary fiber present in such foods can lower serum cholesterol (Sharpnel et al., 1992 as cited in Musaiger, 2010).
Smoking
Smoking is the most common cause of CVD morbidity and mortality. Smoking causes four times increased risk of heart disease and a high risk of death (Lakier, 1992 as cited in Musiager, 2010). Again, there is less research being conducted on the prevalence of smoking in the UAE. The study of Musaiger reported that 25% of UAE men aged 20-80 years were smokers, but there were only about 1.6% of women smokers of the same age. Second-hand smoking is also a threat to one’s health. Leone (1993 as cited in Musaiger, 2010) indicated that active and passive smokers had low concern for the effects of smoking, such as atherosclerotic coronary alterations, focal myocardial lesions, and arrhythmias. Bender et al.’s (1993 as cited in Musaiger, 2010) study found that most UAE physicians were smokers, but the physicians agreed that smoking was dangerous to their health. The study focused on 275 physicians, where 36% were found to be current smokers, and 12.7% were former smokers.
Hypercholesterolemia
A study in the UAE about the relationship of serum cholesterol and CVD showed that the prevalence was found between 47 to 53% among Arab nationals and from 22.7 to 44.5% among non-Arabs (Musaiger, 2010). Hypercholesterolemia was prevalent among the different nationalities in the UAE. Twenty percent of Emirati nationals were found to have high cholesterol, 34% were within the borderline, while 46% had desirable blood cholesterol, and about 50% overall were affected.
Overweight and Obesity
Across the population, there has been a stable growth in food energy consumption, yet physical exercise is found to be uncommon among Emiratis (Musaiger, 2010). Overweight and obesity are also contributors to CVD among Emiratis. In a study in early 2000, 33% of married women were overweight and 38% were obese. Obesity among women increased with age, reaching its height at age 30-39 years, but fell slightly when they reached 40 years and above. Married men were less prone to obesity compared to women. Moussa et al. (1994 as cited in Musaiger, 2010) researched the effect of body fat and fat localization on blood pressure levels in school children of Al-Ain, UAE. The study recorded that there was a significant difference in systolic and diastolic blood pressure means between obese and non-obese children.
Occupational Injury
Injury is one of the causes of death and disability in the UAE. It can be accident-related, like falls or drowning. Children under 15 years old account for about 9% of injury-related deaths between 2000 and 2008, with about 104 children dying annually because of it (Loney et al., 2013). Traffic injury is mostly the case, next is drowning and then falls. Males are mostly the victim of injury than females (Loney et al., 2013).
Occupational factors include exposures, indoor air pollution, unclean water condition, seafood factors, and ambient air pollution, among others. Outdoor air pollution is considered the highest risk, with studies indicating a mean rank of 1.4. Indoor air pollution is next with a mean rank of 3.3. Gibson and Farah’s (2012) study pinpointed 216 possible interventions in mitigating environmental risks to diseases in the UAE.
Toxicants
There are several occupational injuries since the UAE is into manufacturing, using various metals and chemicals. A chemical that is harmful to human health is known as formaldehyde, or formalin (O3). This is used in medical laboratories and mortuaries, but is also present in other products or chemicals; it can be used as a cleaning agent or disinfectant, or in paper products and even plywood (Ahmed, 2011). Severe and long-lasting exposure to this chemical by inhalation can cause respiratory illness. If it hits the eye, it can cause blindness. Over-exposure is indeed discouraged as it can lead to lung cancer. Laboratory technicians, including students and professors in universities using the chemical, are at greater risk.
A study on exposure to the chemical was conducted in the laboratories of Sharjah University. Different concentrations of formaldehyde were measured in the different laboratories of the university. It was noted that the chemical had been constantly used in the laboratories for the preservation of animals and other specimens for study. In medical schools, formalin was also used to preserve or embalm cadavers used by students in medical research. In the process of preservation, it was possible that the students could inhale the chemical vapors. The study found that the measured concentration of the chemical was higher in the anatomy laboratory, or higher than the ceiling standard imposed by the USA-NIOSH, which was just 0.1ppm. The researchers recorded that about 94% of the students and instructors were exposed to the chemical, who then displayed symptoms of eye irritation and other symptoms in the primary organs of sensation (Ahmed, 2011).
Other toxicants include carbon monoxide, a highly lethal pollutant which connects with the body’s hemoglobin, and the association results in carboxyhemoglobin that affects the vital organs of the body. Carbon dioxide (CO2) also has harmful effects on the human body and particularly injurious to children in school. Another deadly pollutant is a classification of volatile organic compounds (VOC) which comes from biogenic chemicals or car exhaust and is dangerous for respiratory diseases. A large amount of VOC can cause cancer. Methane is also produced in manufacturing plants in Dubai and can cause respiratory disease for workers if a large amount is inhaled (Behzadi & Fadeyi, 2012).
Indoor Air Pollutants
Indoor air pollutants in the UAE work environment include carbon monoxide, a large amount of hydrogen sulfide, nitrogen, and sulfur. One of the leading causes of respiratory diseases is indoor air pollution. Contaminants are gases, combustion chemicals to organic chemicals. They come from outdoor pollutants and penetrate in residences (Funk et al., 2014).
The governments of Dubai and Abu Dhabi, particularly the Environmental Agency-Abu Dhabi (EAD), have continuously conducted studies on the effects of chemical and indoor pollutants on human health. One of these studies includes indoor quality research (IAQ) in schools in Dubai whose aim was to formulate a program to protect children from indoor pollutants in schools (Behzadi & Fadeyi, 2012). Various schools were the subject of the study in which the amounts of IAQ were measured. The results yielded positive for indoor pollutants, but immediately after the study the researchers and school authorities conducted cleaning of the school atmosphere and the appliances, including the air conditioning units which were to be cleaned every 3 months (Behzadi & Fadeyi, 2012).
Occupational Safety
Work in a construction project is a dangerous occupation, particularly in the Middle East, where projects are accomplished for a short period. The construction work in the UAE are mostly performed by foreign workers, many of them are not trained for construction work (Al-Kaabi, 2006).
Accidents in the Workplace
The UAE construction sites are unsafe to work with (Al-Kaabi, 2006). In Dubai, construction accidents increased by 70% in 2004, accounting for 105 injuries. Several accidents in the different sectors in agriculture, mining, industry, construction, transportation, has not been regularly reported. More than 77 construction companies have reported zero accidents, per a report from the UAE Ministry of Labor and Social Affairs (2000 as cited in Al-Kaabi, 2006), which seems unbelievable considering that these construction companies have various violations in employing foreign workers. The law requires that companies provide an accident report to the Ministry of Labor and Social Affairs. The Bureau of Statistics (2000 as cited in Al-Kaabi, 2006) reported occupational accidents that seemed incomplete, as shown in the table below.
Type of Accident No.
Car accidents 346 (56.7%)
Others 95 (15.6%)
Run over 52 (8.5%)
Broken elevators 40 (6.6%)
Fainting 22 (3.6%)
Falls 15 (2.5%)
Trapped children 15 (2.5%)
Building collapse 11 (1.8%)
Suicide 9 (1.5%)
Asphyxiation 4 (0.6%)
Sand failure 1 (0.2%)
Total 610
Table 1. Number of accidents in 1999 (Bureau of Statistics, 2000 as cited in Al-Kaabi, 2006).
The table above does not conform to international standards of reporting of accidents because of its lack of details, such as classification per industry category and there is no further information whether those accidents occurred during construction operations.
Some cases of construction accidents can be stated here. One case involved a worker who was hit by a falling piece of scaffolding that resulted in the instant death of the victim (Hadad, 2005 as cited in Al-Kaabi, 2006). Carelessness indeed can lead to accidents. The collapse of a crane led to severe injuries for two workers, one had injured head and the other broken bones. When the roof of a building collapsed, six died and six were injured (Abdullah, 2004 as cited in Al-Kaabi, 2006). Two other accidents happened in Sharjah in 2002 and the other one in Dubai, costing nine workers’ lives (Al-Kaabi, 2006, p. 18). Many cases were considered “near misses,” but they occurred because of violation of rules and standard procedures by the company concerned.
Al-Kaabi (2006) surveyed to analyze basic safety aspects, for example, accident types, workers’ safety training, safety monitoring, and other safety measures instituted by the construction companies. The author had vast experience in construction in the UAE which allowed him to have a deep grasp of safety measures and programs in the country. The survey method was by way of questionnaires, focusing on safety measures, precautions, programs, and outcomes. The questionnaires were sent to construction contractors in Abu Dhabi and Dubai. Most of the companies involved in the study were relatively large and had vast experience in construction. The companies were involved in various construction projects that included residential buildings, commercial buildings, highways, bridges, and other steel construction.
Almost all (96%) of construction companies provided workers with certain types of insurance, but five small companies (4%) did not provide insurance to their workers. Insurance coverage included compensation in case of an accident, life insurance, government care, all-risks insurance, and health insurance, etc. Orientation, education, and training were provided to newly accepted workers. Workers were also provided with personal protective equipment (PPE), such as helmet, gloves, boots, and eye/face goggles. A UAE law prescribes issuance of PPE for workers in workplaces, such as construction sites.
Al-Kaabi’s (2006) study found that approximately 30% of the companies did not provide PPE to their workers. But 91 contractors (75%) complied with the law and strictly implemented the use of PPE. Companies that did not provide PPE reasoned out that PPE was too expensive and that its use was against cultural practices.
Contractors were also asked to provide data regarding on-site safety measures, for example, guardrails, signs, fences, shelters, and other safety measures. The questions regarding equipment and tools focused on the maintenance and handling of heavy equipment. Al-Kaabi’s (2006) survey also focused on health and hygiene. Construction sites had lavatories, safe drinking water, and lunch and rest areas. All companies maintained regular site cleanliness.
Cancer
Cancer is something that the UAE people must be serious about because the majority of Emiratis do not attend cancer screening. The UAE Cancer Registry (2006 as cited in Gulf News, 2015) indicated that the five cancers that Emiratis should be aware of are “breast, colorectal, gastric, thyroid and lung” (Gulf News, 2015). Early detection is the key to the successful treatment of cancer.
Mesothelioma is an occupation cancer as it is the result of inhalation of the building material asbestos that causes cancer in the lungs. The use of asbestos has been banned in many countries, but this material is very useful in manufacturing. Despite the danger, some countries still use asbestos because it is cheap. In Dubai, citizens still adhere to the use of asbestos because of the lack of knowledge about the danger of asbestos, particularly that it causes Mesothelioma cancer. Patients who have contracted Mesothelioma display symptoms of shortness of breath, chest pains, and gradual or sudden weight drop. Symptoms of the disease may usually take 20 to 50 years to be detected.
The most common cancer for UAE men is colorectal, lung, leukemia, prostate, and others; whereas women are prone to breast, thyroid, colorectal, and cervical. Leukemia and lung cancers are common for both gender, and the most ranking for males are prostate and lung cancer (Glob Health Action, 2013 as cited in Loney et al., 2013).
Respiratory Illness
A recent virus outbreak has occurred in the UAE and also in the Middle East region. This is known as the MERS-Cov (Middle East Respiratory Syndrome Coronavirus). People who get infected with this virus develop serious respiratory illness accompanied by fever, cough, and difficulty in breathing (Sasendran, 2014).
Respiratory illness for Emiratis is mostly caused by inhalation of chemicals and gases, dust and other undesirable vapors, or poor air quality. Exposures to fumes can cause asthma, bronchitis, and various diseases of the lungs or possibly cancer. The study of Loney et al. (2013) found that Emiratis and migrant workers are at high risk of exposures to gases and fumes because of heightened economic development, dependence on motorized transport and traffic bottlenecks, unfavorable weather patterns as the atmosphere is mixed with dust and fumes, and the vast economic and manufacturing activities that emit different kinds of air pollutants.
Entry and exit points in Abu Dhabi, Dubai, and Sharjah receive and send off visitors traveling from the different countries of the world. This scenario poses the increased threat of the spread of diseases and the UAE is at a possible risk from respiratory diseases because of airborne viruses that carry SARS or Mers-COV. Traditional respiratory disease like tuberculosis can also be transmitted here. New viruses roam around the earth’s atmosphere. The UAE and every airport, entry or exit points, must be constantly guarded.
In addition to the above health problems suffered by migrant workers and the UAE population in general, there are also psychiatric problems that have to be dealt with. One is the so-called “Dubai Syndrome” (Al-Maskari et al., 2011), which refers to stress and a feeling of deprivation suffered by spouses and families of migrant workers. Aside from the debts incurred by applicants before they are accepted for work in the UAE, there are other reasons the applicants feel, such as the “guilt for leaving”. The Philippine ambassador to the UAE explained that the migrants’ families back home think the migrants are earning thousands of dollars, and “the poor migrant goes deeper into debt …” (Najem, 2015, p. 30).
Poor working conditions in construction sites exacerbate the migrant workers’ emotional state. There are suicide cases, albeit this “news” lacks epidemiological data, caused probably by the low priority of psychiatric health research in the UAE (Statistical Yearbook of Abu Dhabi, 2006 as cited in Al-Maskari et al., 2011).
Psychiatric problems are societal, which have to be given much concern because it involves migrant workers. Health problems such as this can lead to functional injury in a sense, reduced quality of life, low performance at work, lost productivity, and so on. Globally, suicide cases account for about 1.5% of the worldwide burden of diseases.
Case Study
Refining and Petrochemical Production
In a cohort study of 1,205 respondents working in a Canadian oil refinery for more than five years, the researchers recorded three deaths due to brain cancer (Theriault & Goulet, 1979 as cited in Thomas, 1986). This was non-significant as the work histories of the three brain cancer cases were ambiguous about occupational exposures. A proportionate mortality ratio study of deceased, active and retired members of the Oil, Chemical, and Atomic Workers International Union (OCAW) in Texas indicated an increased frequency of deaths due to brain cancer among white male hourly workers employed in petroleum refining and petrochemical plants (Thomas et al., 1980 as cited in Thomas, 1986).
The increased relative frequency of brain tumor deaths occurred primarily among active employees in three oil refineries in the Beaumont-Port Arthur area of the Texas Gulf Coast. A nested case-control study comparing work histories of the brain tumor cases with those of persons who died from other causes indicated an elevated brain tumor mortality risk among OCAW members whose jobs involved the intraplate pumping and transporting of bulk liquids (crude oil and products) and the manufacture of lubricating oil, but the odds ratios were not statistically significant (Thomas et al., 1980 as cited in Thomas, 1986).
In a mortality study of oil refinery workers employed by 19 U.S. companies, 8 deaths due to brain cancer were observed and 4.9 were expected (Schottenfeld et al., 1981 as cited in Thomas, 1986). The investigators indicated that there may have been underreporting of deaths because of the short study period (2 years) and the lag time between the date of death and receipt of a death certificate.
Cancer incidents among actively employed refinery workers during the study period were compared with that for the U.S. using cancer registry incidence data. Nine incident cases of brain cancer were reported and about seven were expected. No analyses by the duration of employment or occupation were shown.
Brain cancer mortality was not excessive among 35,000 employees of eight British oil refineries between January 1950 and December 1975 (Rushton & Alderson, 1981 as cited in Thomas, 1986). However, approximately 20 percent of the study subjects had scientific, technical, administrative, clerical, or engineering jobs, most of which are presumably low-exposure occupations. This same difficulty occurred in a cohort of workers at oil distribution centers in England (Rushton & Alderson, 1981 as cited in Thomas, 1986), where supervisors, managers, administrators, and clerical workers were included in the analyses. In one study of refinery workers, investigators found no association between brain cancer risk and oil refinery employment (Hanis et al., 1982), and two other groups of investigators did not report observed and expected numbers for brain cancer (Hanis et al., 1982; Tabershaw as cited in Thomas, 1986). The follow-up period for several studies was very short (less than 10 years), and risks of fatal disease with long latent periods may have been underestimated.
A group of primary brain cancer deaths among workers at a Union Carbide petrochemical plant in Texas City, Texas was reported in 1980 (Alexander et al., 1980 as cited In Thomas, 1986). All of the decedents were less than age 66 at death and the best medical information available indicated that 15 of 18 tumors were glioblastoma multiforme. A cohort mortality study of workers at this plant showed a significant elevated SMR for brain tumors among white male hourly workers. A similar analysis by the company of the same data also indicated a significantly increased brain cancer mortality risk among workers who held hourly positions, but nested case-control analyses indicated no significantly elevated odds associated with exposure to any specific chemicals (Austin & Schnatter, 1983; Leffingwell et al., 1983 as cited in Thomas, 1986).
Operating engineers employed in the petrochemical industry in Texas and Louisiana had an elevated frequency of brain tumor deaths. This excess is primarily due to a significantly elevated PMR for brain tumors among persons employed as operators in oil refineries and petrochemical plants (Thomas, 1986).
A study of workers in a rubber plant in Ohio indicated an elevated brain cancer mortality risk among employees in the curing and tire-building department. Later studies in the same plant population also suggested that men employed in tire assembly and tire building had an increased brain cancer mortality risk, but brain cancer mortality was less than expected in the entire plant population (Monson & Fine, 1980 as cited in Thomas, 1986).
A cohort study from 34 plants examined the relationship between polyvinyl chloride exposure and the risk of cancer. Among persons who had worked for at least one year in a job involving exposure to vinyl chloride, the total number of brain cancers deaths observed was significantly greater than expected. Twelve brain cancer deaths observed during the study period included glioblastomas, two astrocytomas, one ependymoma, and five unspecified types (Thomas, 1986).
Conclusion
Through the different studies discussed above and upon initiatives of the UAE government and the general public, many areas and issues have been addressed and to provide the strategic plan necessary to deal with all the safety and health problems of the UAE population and the migrant workers. Full coordination and cooperation between the different sectors must be attained so that specific diseases and “new” viruses threatening the country now and shortly can be properly addressed. Loney et al. (2013) recommend effective surveillance and monitoring.
Health and safety issues are not only the concern of the internal government but a global concern because the spread of diseases and viruses can have rapid consequences if not dealt with quickly and effectively. The coverage in dealing with SARS and the MERS-Cov outbreak is an example of international cooperation and coordination.
The UAE issue has become an international issue because tourists and migrant workers are going there to visit or work. It is an attraction to the world, thanks in part to the government and the Emiratis themselves for making their country a model for economic diversification and development. The problem that this economic progress has brought up should be the concern of all. Even if the government and the UAE people are addressing it, there is not enough action and much has to be done.
Recommendations
It is recommended that consistent and effective longitudinal data be available for UAE strategic planning in health and safety programs. A portion of this has been achieved but there are still many things to be done.
The UAE government can use technology for safety in construction. An expert system is known as “How safe” was first developed by Levitt (as cited in Al-Kaabi, 2006), and could determine the strength and weakness of a construction firm’s organization and procedures. The system starts with a hypothesis and a series of fundamental goals helps to prove the hypothesis.
The technique in knowledge extraction in How safe is structured like an inverted tree where the top-level diagnosis is helped by three to four lower-level inferences or deductions which can be analyzed by the use at the end of each branch. Each leaf of the tree’s branches corresponds to a question to which the user chooses the degree of belief. The conclusion is reached with the inferred degree of belief in the top-level hypothesis in addition to the reliability of the conclusion given as a percentage (Al-Kaabi, 2006).
Furthermore, the UK Health and Safety Executive (HSE) developed the computerized expert system known as “Estimation and Assessment of Substance Exposure” (EASE), which simplifies dangerous substances exposure assessments. This system utilizes some rules to forecast a series of probable exposures or an end-point for a certain work situation (Cherie & Hughson as cited in Al-Kaabi, 2006). The safety regulations in the UK require that the maker of a new substance should notify the appropriate authority about it, and the authority will have to carry out a risk assessment. A computer-based system that addresses exposure to a substance in the workplace is effective.
Al-Kaabi, N. (2006). A fuzzy-based construction safety advisor (CSA) for construction safety in the United Arab Emirates (Doctoral thesis, The Ohio State University). Web.
Al-Maskari, F., Shah, S., Al-Sharhan, R., Al-Haj, E., Al-Kaabi, K., Khonji, D.,…Bernsen, R. (2011). Prevalence of depression and suicidal behaviors among male migrant workers in the United Arab Emirates. Journal of Immigrant Minority Health, 13(1), 1027-1032. Web.
Behzadi, N., & Fadeyi, O. (2012). A preliminary study of indoor air quality conditions in Dubai public elementary schools. Architectural Engineering and Design Management, 8(1), 192-213. Web.
Gibson, J., Brammer, A., Davidson, C., Folley, T., Launay, F., & Thomsen, J. (2013). Environmental burden of disease assessment: A case study in the United Arab Emirates. New York: Springer.
Gibson, J., & Farah, Z. (2012). Environmental risks to public health in the United Arab Emirates: A quantitative assessment and strategic plan. Environmental Health Perspectives, 10(5), 681-686. Web.
Gulf News: 88% of UAE people don’t go for cancer screening. (2015). Web.
Loney, T., Aw, T., Handysides, D., Ali, R., Blair, I., Grivna, M.,…El-Obaid, Y. (2013). An analysis of the health status of the United Arab Emirates: The ‘Big 4’ public health issues. Web.
Musaiger, M. (2010). Risk factors for cardiovascular disease in the United Arab Emirates. International Journal of Food Sciences and Nutrition, 49(1), S65-S70. Web.
Najem, P. (2015). The dark side of growth (Master’s thesis in Global & International Studies, University of California, Santa Barbara). Web.
Saseendran, S. (2014). UAE tightens scrutiny of camel shipments from GCC. Web.
Thomas, T. (1986). A retrospective study of brain tumors and occupational risk factors (Doctoral thesis, John Hopkins University, Baltimore, Maryland). Web.
The purpose of this paper is to analyze and discuss the impact of mercury poisoning on the occupational health of workers and its toxicology. As a result, the paper first elaborates the scientific details of the nature and effects of mercury, outlines the historical background of the problem in the workplace, identifies the sources of the problem, and assesses the gravity of the situation using a case study to see how mercury poisoning affects people at work. Also, this research examines the current status of mercury poisoning in workplaces, evaluates the impact of this toxic metal on the biosphere, conducts a succinct data analysis, endorses plans for the future along with proper suggestions, and draws a pertinent conclusion. The research primarily focuses on occupational health and attempts to identify and address the dangers associated with the physical exposure to mercury in some specific workplaces, while evaluating the possible solutions to the problem through the maintenance of a protected and healthy working atmosphere.
Scientific Details of the Nature and Effects of Mercury
Mercury, a heavy metal that is liquid in room temperature, is toxic in all its available forms – according to Olson (2016), even the slightest contamination from this element can cause gastrointestinal complications, neurological disorders, and fatal bilateral kidney malfunctioning. Olson (2016) further suggested that humans can get in touch with the metal in various ways, but the most common modes include breathing its vapor, absorbing it through the skin, or swallowing or infusing it by some means. The metal is available in nature as elemental mercury, inorganic salts, and some organic compounds; however, methyl mercury is frequently suggested to have the most dangerous impact on human health in the long run, as its absorption into the bloodstream can be fatal. Mercury is one of the constituent metals of the planet and is hardly found in nature in its elemental state; as a result, it appears as compounds or bivalent atoms, although the pure metal is conventionally used in manufacturing industries (for example, in certain types of electrical applications, fluorescent lamps, thermometers, barometers, and sphygmomanometers), exposing the workers to its toxicity.
Even more dangerously, at normal temperatures, unwrapped mercury usually evaporates into extremely toxic odorless vapors causing grievous harm to the respiratory tract – as the temperature continues to increase; higher amounts of vapors are discharged, and this inflicts incurable sicknesses over the factory workers. Mercury is extracted from the ores of mercury sulfide, and traditionally, this is the key source for the commercial extraction of the metal through the treatment of the compound above 540º Celsius – consequently, laborers are exposed to pollution in two stages, firstly, by direct contact during extraction, and secondly, by inhalation of the metal during vaporization. World Health Organization (2017) reported that depending on the nature of the source, mercury poisoning could lead to a wide range of health issues, starting from metal disturbances to physical mutations. Workers exposed to the metal for longer-term can suffer from irreversible disorders. The following table briefly shows the health impact of various forms of metal:
Forms of mercury
Effects on human health
Elemental or metallic mercury
Mercury in this form is usually absorbed via the lungs, and chronic exposures can cause irritability, nervousness, emotional changes, excessive shyness, tremors, instability in sensations, insomnia, poor nerve responses, twitching, muscle atrophy, Minamata disease, and numbness
Permanent impairment of central and peripheral nervous systems, injury to digestive and immune systems, high blood pressure, low cardiac rate variability, cerebral palsy, delayed development, seizures, mental retardation, and liver damage
Acute exposure to metallic mercury can create hyperactive ligament reflexes, sensory mutilation, sluggish sensory or motor nerve transmission rate, as well as paresthesia
Organic mercury (for example, methyl mercury)
Industrial workers habitually exposed to the metal can suffer from hallucinations, paralysis, incoherent speech, Minamata disease, and brain damage
It can also cause loss of peripheral vision, impairment thyroid gland, loss of hearing, ‘pins and needles’ sensation in arms, legs, and face, and lack of coordination of movements, and poor balance
In younger workers, it can hamper brain growth, and damage to neurons, attention, cognitive thought, memory, and spatial skills
Inorganic salts of mercury or other mercury compounds
Exposure for a prolonged period can cause harm to the gastrointestinal tract, the nervous system, and renal failure
Inhalation can cause neuromuscular effects, tremors, insomnia, headaches, behavioral and neurological chaos, and cognitive and motor dysfunction
Inorganic salts are accumulated in kidneys and can corrode human skin, eyes, and respiratory tract
Table 1: The health impact of various forms of mercury. Source: Generated from the World Health Organization (2017).
Historical Background and Sources of the Problem
Spiegel (2009) noted that historically mercury was used in gold mining and extraction of some other forms of metals, which increased the occupational health risks of the workers. However, there existed occupations in which poor people were compelled to use mercury as a catalyst in the production of other commercial items. Traditionally, workers who were directly engaged in the mining of mercury from its ore (mercury sulfide ores), or processed the compound by heating it to obtain pure elemental mercury, remained exposed to the toxicity throughout the day not just by physical contact, but also by inhalation of the vapor. Old-fashioned industries that dealt with the making of electrical switches, fluorescent lights, thermometers, barometers, or sphygmomanometers also required workers to come into touch with the toxicity since there were no environmental, employment, or health and safety regulations to address the issue in the past. Lack of scientific evidence and knowledge of the direct causal link between mercury and physical illness was also an unfavorable factor. According to Spiegel (2009), historically, poverty-stricken laborers in above fifty nations extracted gold with the assistance of mercury without any precautionary measures, and only recently, the United Nations has come forward with the roadmap for handling the issues of occupational health and environmental justice.
Case Study
In the 1950s, a chemical company located near Minamata Bay in Japan utilized mercury in making acetaldehyde, while the improper handling of methyl mercury without sufficient precautionary measures caused mental disturbances (later termed as Minamata disease) not just to the workers of the factory, but also to the local people of the entire vicinity. The poisoning spread rather quickly in the area, affecting the food chain, and investigations revealed that more than 2,200 adults were suffering from Minamata disease, whilst children started to show symptoms of an extremely agonizing syndrome similar to cerebral palsy, and pregnant women who were exposed to the pollution had newborns with poor brain development. Perhaps one of the most notorious cases of occupational toxicity from mercury poisoning is the Kodaikanal thermometer factory incident, where Unilever, the renowned global giant in consumer products, was held liable for inflicting injury on the workers during the manufacturing procedure due to poor work environment and unplanned waste disposal behind the factory. Kodaikanal tragedy remains to be one of the worst events of mercury pollution in the workplace, and the case has been elaborated comprehensibly in the table below:
1983
Due to stricter ecological laws in the United States preventing the use of mercury in production plants, Chesebrough Ponds relocated its mercury thermometer plant to southern India
1986
The plant was permitted to be located at a residential vicinity surrounded by a lush woodland
At this stage, Unilever’s subsidiary company Hindustan Lever purchased this factory as a part of Unilever’s takeover of Chesebrough
Until 2001
Pereira (2016) noted that until February 2001, over 163 million thermometers were manufactured in the plant using more than 900 kilograms of mercury per year and were exported in the United States and European countries
The poisonous wastes were allowed to remain in Kodaikanal
While carrying out its business, the corporation failed to pay even slightest attention to occupational safety issues and did not follow the guidelines for handling risky substances like mercury
Above one thousand employees were exposed to mercury poisoning
Numerous laborers died early and they claimed the deaths were due to occupational exposure to mercury
Other laborers and their families were fighting to survive with the health hazards and the resultant economic adversity
Many children of laborers were born with congenital complicacies, while some children died
March 2001
Employees revealed a huge deposit of mercury waste in a crowded part of the city
Unilever also threw mercury in the woodland near the factory
Local pollution control board closed the factory, but still, now, tons of mercury wastes are present in the adjacent lands and surrounding atmosphere
The company continued its efforts to avoid corporate liability and negligence
Early 2003
India was able to compel Unilever to take back 289 tons of mercury wastes to recycle factory in the US
The laborers and their families continued their fight for sufficient reparation and the cleaning of the remaining mercury
2006
Ex-workers of the factory sued the company in the Madras High Court
They had suffered from miscarriages, renal and nervous system disorders, and disabilities
2011
The Indian Ministry of Labor came up with the findings that there was proof of mercury poisoning in amongst the workers
The committee stated that about 45 workers had died from the poisoning and over six hundred of them suffered from grievous injuries
2015
Finally, the company came to a financial settlement and offered damages to the affected workers, but their physical injuries were irreversible
Table 2: Kodaikanal case study. Source: Generated from Pereira (2016).
Current Status
Spiegel (2009) stated that in recent years, the developed countries have formulated laws and regulations regarding employees’ health and safety rights, protected workplace environment, fairness in employment terms, and guidelines for factories and industries regarding precautionary measures and safe limits of toxic materials in the atmosphere. Presently, the United Nations has put forward numerous agendas to ensure the occupational health of workers to assure their basic human rights and ascertain that employers do not exploit them by unfairly forcing them to perform hazardous jobs. The UN has also drafted many soft laws and course of action for the member states requiring them to ensure surveillance over the local industries and to create domestic laws to oversee the matter. Regional alliances like the European Union came up with strong rules imposing a regulatory burden over the member states and multinational corporations to comply with the occupational health and safety measures and public health policies.
At present, there are many technical analyses and well-funded researches regarding the ecological and health risks related to heavy metals like mercury and improper labor practices that address the necessity for punitive public policies to meet the requirements of the susceptible community and propose environmental justice models to broaden the traditionally restricted focus on poisonous working conditions. However, even after the introduction of so many legal sanctions, state authorities are failing to oversee the smaller industries or factories located in the rural or remote areas.
Spiegel (2009) suggested that the underdeveloped gold extraction industries in rural areas of Tanzania, for example, attracts poverty-stricken workers for whom mining is the mere source of income; therefore, irrespective of the fact that this industry offers the globe’s most alarming source of mercury contamination, there is nothing much the workers can do. The author further added that around a hundred million workers rely on these extraction industries to earn their living, whereas about thirteen to fifteen million miners globally generate approximately eight hundred to one thousand tons of mercury annually; consequently, it cannot be argued that the situation has significantly improved due to the regulatory policies in the recent years.
The Impact on Biosphere
Notably, mercury can have an irreparable impact on the biosphere, and the most crucial feature of the effect is in the capacity of the metal to accumulate in living beings and to move around the food chain; moreover, the bio-magnification of methyl mercury has the most extensive consequences over the animal kingdom. Even though each form of the metal can gather inside the bodies of the animals to some extent, methyl mercury is easily broken down than any other forms; in fact, almost hundred percent of the metal bio-accumulating in predator fishes consist of methyl mercury because fishes process this chemical quite quickly and vigorously. It is suggested that birds and mammals that consume fish possess greater methyl mercury content within themselves as compared to other creatures in the aquatic ecology, whereas predators that feed on the birds or mammals are also found to be sufferers since traces of the chemical has been detected in eagles, bears, and some rare tiger species.
Mercury assists methylation of bacteria, so when methyl mercury-carrying bacteria freely travels along the food chain or excrete the chemical in the pond or lakes, the pollution further aggravates and an increasing number of ecosystems are endangered. Mercury diminishes the essential microbiological activity in the soil and the Arctic zone is the most vulnerable location due to the long haul transportation of the metal, although the adverse effects are not limited to that area only and the wildlife is seriously threatened in the US as well.
Data Analysis
It is essential to evaluate the data on the quantity of mercury released by each industry to comprehend the most vulnerable workplace. US Environmental Protection Agency (2017) suggested that the data illustrating the annual emission levels of the metal is quite frightening since worldwide, around five to eight thousand metric tons of mercury are produced each year. According to these statistics, the biggest emitter of the pollutant is the gold mining industry, releasing about thirty-seven percent of mercury each year, whereas around twenty-four percent of the metal is released by the coal combustion industry, as demonstrated in the figure below:
Figure 1: Mercury discharge based on industry. Source: US Environmental Protection Agency (2017).
Suggestions and Plans for the Future
To significantly reduce the use of mercury in the industries, and make sure that strict measures for occupational safety are ensured in the factories where treatment with mercury is unavoidable, certain corporations and state authorities have undertaken several strategic plans for the future. Also, experts have suggested several possible solutions to shrink the health hazards caused by the metal during work. While most of the action plans focus on imposing regulatory and managerial burdens upon the employers themselves, certain policies require actions from the other stakeholders as well. Some recommendations and futuristic plans to reduce or eliminate the impact of mercury exposure amongst workers are outlined below:
Steps
Implementation methods
Employers’ dedication
Employers must see deterrence of workplace injury as a key objective and conform to domestic and international laws and regulations
Managers must take the responsibility to protect occupational health with adequate authority and proficiency and employ privately hired consultants
Allocate enough budgets to establish an eco-friendly working environment
Training and education
The companies must arrange regular training sessions to educate workers about safe practices
The edification process must include enlightening the workers about the techniques by which exposures can be prevented
A list of workers missing the training sessions or not participating there should be maintained
Worker participation
Workers must start collaboration to form and manage health and safety committee
Take part in training and education organized by the management of the company
Demand access to safety data from the employers about the working environment regularly
Detection of risk
Authorities should investigate accidents and closely observe any incidents of mercury spillage
Supervisors of the company should maintain records and investigation results of accidents
The reports should be communicated to experts, consultants, and trainers regularly to get their opinion on how to avoid any such future incidences
The reports must be shared with the employees compulsorily to enlighten them about how accidents can be avoided and identify working practices by which exposures to mercury can be reduced
Implementing controls
Companies must come forward with short and long-term strategies
They should regularly publish health and safety guidebooks containing the fair policies of employment and safe procedures to conduct daily operations at factories
The government must enforce policies and procedures to oversee the issue
Governmental efforts
Collect data regarding the works that involve mercury and other associated practices
Create an inventory of all the industrial locations where mercury is used
Create an inventory on the number of employees working with mercury on each shift
Consider workers indirectly exposed to the toxicity as well as those standing nearby
Prepare an authentic categorization of all workers near the factory (for example, permanent or temporary workers, storekeepers, interns and students, housekeeping, truck drivers, supervisors and managers, visitors, contractors, as well as official, administrative, and clerical staff)
Increase investment in research and development to discover the scientific solution to the problem
Supervisors’ duties
Record the job title and duties of each employee
Scrutinize the responsibilities by calculating how often and how long they perform a task
Create a comprehensive list of divisions, procedures, floors, or work stations where mercury is used
Other actions
Record the normal, irregular, overtime, and urgent work shifts
Record the changes in the number of productions, administer trial runs, and test batches
Regulate the temperature of the factories, as greater temperatures can boost vaporization of the metal
Limiting elemental mercury exposure
Observe and conduct interviews to find out how employees might be exposed
Avoid direct contact with mercury or splashing or spilling over the skin
Collect industrial wastes and safely transport them to recycling plants rather than disposing of them here and there
Improve the design of the workplace so that it is well-ventilated and easy to clean
Avoid handling of objects that contacted mercury
Use gloves, special clothing, repellent shoes, and eyeglasses
Thoroughly wash skin, nails, face, and hair at end of work shift
Discard or sterilize the clothing or gloves used in each session
Sterilize workstations and other areas outside the factory
Always close container in which mercury is kept as it can easily vaporize
Avoid smoking in the site
Prevent the admission of any kind of beverages, food, or utensils in or near the site
Always wearing respirators
Throw out used respirators at a proper location
Additional safety measures
Observe workers at production facilities and carry out their interviews to find out what controls are implemented across the plant
Isolate or regulate vulnerable areas by closing doors, restricting entry of superfluous workers, limiting time in the area, controlling the movement of air in the area
Consult professional industrial hygienist or engineer for the purpose
Introduce innovative technologies that can better regulate the pollution
Store and transfer mercury-containing items in impermeable bags
Set up monitors that can give an alarm when the acceptable airborne concentration of the metal exceeds
Working surfaces should be made with stainless steel and must have proper drainage systems
The surface should be sloped to a compilation arena
Avoiding wood or carpeted flooring in the factory building
Using dark color in floors so that mercury spillage can be easily noticed
Proscribing the use of vacuum pumps for cleaning purposes
Preventing dry sweeping or wiping
Clearing spills quickly
Regularly checking the efficiency of the supervision systems
Discussing with occupational health and safety professionals or other industry experts for essential directions
Carrying out medical checkup of the workers every week
Table 3: Recommendations and futuristic plans. Source: Self-generated.
Conclusion
Exposure to mercury at occupation can cause irreversible and deadly physical and mental illnesses to workers in the long run. However, historically the trend amongst employers was to ignore precautionary measures and to focus rather on profit generation. Along with scientific advancement, people turned out to be more conscious and state authorities and the United Nations updated their laws to include occupational health and safety measures as the central focus. Still in remote areas, appropriate compliance to these regulations cannot be ensured. As a result, the government, corporate organizations, employees, local communities, and other stakeholders should jointly undertake some futuristic strategies to uphold occupational safety measures in all spheres of production.
Spiegel, S. (2009). Occupational health, mercury exposure, and environmental justice: learning from experiences in Tanzania. American Journal of Public Health, 99(3), 550-558.
Health assessment is one of the most sensitive phases of the nursing process. It lays the foundation upon which subsequent procedures can be conducted successfully. Every individual is entitled to the highest possible quality of health and nothing should be allowed to compromise this right (Jarvis, 2008). However, the day-to-day encounters of life may pose a great challenge to the maintenance of good health. Medical professionals usually take this fact into consideration during health assessment procedures. The essay discusses occupational health assessment and how it can be used to enhance the quality of health.
Occupational health refers to a specialty in the field of medicine which is concerned with understanding the interaction of individuals’ health with their respective work (Acutt & Hattingh, 2008). It seeks to explain how work can affect people’s health and also how ill health can affect the effective execution of their responsibilities. Doctors usually handle a number of people who have health concerns related to their work. They may either be sent by their employer or bring health complaints on their own which are work-related. The physician will therefore be forced to conduct a thorough assessment of the situation. This is what is referred to as occupational health assessment.
Occupational health assessment involves the examination and evaluation of an individual by a medical professional with an aim of establishing the relationship between the worker and the nature of work performed by the person (Harrington, 2002). The doctor examines the role of the individual in the place of work as well as their historical background as far as their work is concerned. Cases of prolonged illness and hence the absence from work have prompted employers to seek occupational health assessments for their employees. Most employers seek occupational health reports before employing an individual while others require that their workers go for occupational health check-ups on a regular basis. There is also the need to know the main reason(s) for seeking medical attention particularly with regard to the nature of health complaints (Jarvis, 2008). This process takes place long before any physical examination is recommended or conducted. These assessments are generally geared towards determining the fitness of an individual to perform a given job.
Apart from examining a person’s fitness and suitability for a given task, an occupational health physician may recommend specific improvements to the working conditions for the sake of workers’ safety and effectiveness. Doctors can even make visits to the workplace to ascertain the conditions and to judge whether they are fit for the employees (Harrington, 2002). Some working environments may pose health hazards to the workers who may end up falling seek due to exposure to these hazards.
Occupational health assessment has proved very useful in ensuring that employees are protected from potential health hazards in their places of work. It helps in detecting health threats in advance to prevent any further health risks (Oakley, 2008). Furthermore, this assessment assures the employers that their workforce is in good health and can therefore work optimally. The findings by occupational health doctors can be very useful in determining the potential of an individual in relation to the nature of work to be done. The physician can assess a person for the ability to lift weights, visual acuity, and so forth. The doctor can then advise the client accordingly or when necessary, write a report to the employer detailing the fitness and the nature of treatment which the employee needs to be accorded (Acutt & Hattingh, 2008). The doctor, at his/her discretion, may conduct a physical examination on the client. It is, however, important to note that occupational health assessment reports should not be used by employers as a basis for firing their employees. This is a legal issue in most countries of the world.
References
Acutt, J. & Hattingh, S. (2008). Occupational health assessment: management and practice for health professionals (3rd ed). Juta & Company Ltd.
Harrington, J. M. (2002). The essence of occupational health (5th ed). Wiley-Blackwell
Jarvis, C. (2008). Physical examination and health assessment (5th ed). St. Louis: W.B.
Oakley, K. (2008). Occupational health assessment (3rd ed). John Wiley & Sons Saunders Co.
Hazards at workplaces emerge when the surroundings can lead to illness, injury, or even death during work. Equipment, toxic materials, unsafe working methods, and human behavior are just a few of the many facets of the workplace that may pose hazards. Identifying the hazards in one’s workplace is the first step in any occupational risk assessment. Therefore, some of the occupational health hazards such as confined space entry and noise dangers are critical risks that should be recognized, evaluated and controlled in any firm through different ways.
Confined Space Entry Health Hazards Plan
Confined Space Entry Health Hazards Identification
The occurrence of particular health hazards in a confined space entry can be identified by a range of signs and symptoms that may be present in a person. These may include but are not limited to feeling lightheaded or dizzy, nausea, having difficulty in breathing, being disoriented or confused, and fatigue (Rikhotso et al., 2021). If any of these symptoms occur, it is important to exit the confined space immediately and seek medical attention. Additionally, some of the hazards in a confined space may include toxic gases, low oxygen levels, or fire risks.
Level of Risk Evaluation
There are some methods used to evaluate the level of risk for each hazard identified in a confined space entry. One approach is to use a qualitative risk assessment tool, such as the Hazard Identification and Risk Assessment (HIRA) tool (Rikhotso et al., 2021). A HIRA is an evaluation tool that can be used to determine which hazards provide the highest risk in terms of their likelihood of occurring and the possible severity of their effects.
Control Measures Recommendations
Numerous actions can be taken to lessen the risks associated with operating in confined spaces and some can include:
Air Supply – If the confined space has a constrained air supply, make sure that a secure supply is brought in.
Monitor for Gases – The air in the confined space should be continuously checked for any hazards that could result from exposure to hazardous gasses.
Noise Health Hazards Plan
Noise Health Hazards Identification
The most likely causes of hazardous noise at the workplace are equipment and machinery. Therefore, the first step in recognizing the hazard is to identify the sources of noise in the Factory. That can be done by conducting a noise survey and, once the sources of noise have been identified, their noise levels can be measured (Rikhotso et al., 2021). If the noise levels exceed the exposure limit, then the presence of specific noise health hazards is likely.
Risk Evaluation
To evaluate the level of risk for each noise health hazard in the factory, one would need to look at the noise levels in the factory and compare them to the OSHA (Occupational Safety and Health Administration) noise exposure limits. Furthermore, the level of risk for each noise health hazard can be evaluated by looking at the type of work that is done in the factory (Rikhotso et al., 2021). That is done in relation to the number of employees who are exposed to the noise.
Control Measures Recommendations
Some of the control measures recommended for eliminating identified hazards or reducing the risk of exposure to the noise hazards in the factory include:
Create and maintain an efficient program for protecting hearing that typically includes noise intensity and staff exposure surveillance, as well as training on the dangers of noise exposure.
Implement engineering controls to reduce noise exposure, such as enclosing noisy machinery or installing sound-absorbing materials in the work environment.
Conclusion
Workers must be protected from occupational safety and health threats to which they may be subjected at work. Effective risk control activities and risk analysis, assessment, and management procedures can help achieve that. Understanding the legal background, ideas, risk analysis, health and safety risk assessment technique, control methods, and the roles performed by everybody concerned is essential to carrying out an efficient risk management process.