Falls prevention through community intervention – A Swedish example

In order to control and reduce fall-related injuries, particularly among women over the age of 55, a safety management and falls prevention campaign was structured and implemented during 2006–2007 in the small industrial town of Södertälje, Sweden. A local campaign was launched to recruit falls prevention agents, to inform key target groups in the local community, and to educate older people about fall risks. A survey showed that the campaign had a greater impact among professionals with a special relation to fall risk than among the general population. Medical records were used in the evaluation of the outcomes. The results show that between 2005 and 2007 there was a drop of fractures related to falls in the council: an overall drop of 16.7% in the population; among men 55 or older a drop of 12%, among women 55 or older a drop of 15%, among home-dwelling women 55 or older a drop of 5.7% and among women in special accommodation a drop of 44.4%. Expressed in terms of years lost to disability (YLD), the overall drop in hip fractures treated at the local hospital between 2005 and 2007 was 48%. A comparison with National medical records for the same period shows the drop for the intervention area to be much larger than that for Sweden as a whole, although the effect was not statistically significant. The study demonstrates the advantages of a broad, community-based approach to injury prevention.     

Evaluating safety management and culture interventions to improve safety: Effective intervention strategies

The Dutch Ministry of Social Affairs and Employment provided subsidy over the period 2004–2008 to a number of companies to introduce changes aimed at reducing accidents by changing their safety culture and aspects of their safety management. As part of the programme a scientific evaluation was set up to assess the effectiveness of the interventions in 17 of the projects, covering 29 companies. Before and after studies were made of the companies, documenting the state of their safety management and risk control efforts and their accident rates before the intervention, the changes made over the study period and the resulting changes in a range of measures aimed at assessing the success of the changes. The analysis led to a categorisation of the projects according to their degree of success.This paper describes the patterns of interventions distinguishing between successful and not successful projects and discusses the mechanisms lying behind them. Interventions bringing about constructive dialogue between shop-floor and line management, providing motivation to line managers and strengthening the monitoring and learning loops in the safety management system (SM) appeared more successful. The amount of energy and creativity injected by top managers and, above all, by the coordinator (safety professional) appeared also to be a distinguishing factor.     

Inherent occupational health assessment during basic engineering stage

Each year more people die from work-related diseases than are killed in industrial accidents. Therefore it is essential to evaluate occupational health aspect during the process design. Early evaluation of safety, health, and environmental (SHE) performance is advantageous, since the opportunities to make the process inherently benign are greater and the cost therefore lower. The methods for occupational health assessments need to be tailored to specific design stages, since the data availability is changing as the design proceeds. In this paper, an index-based method called the Occupational Health Index (OHI) is presented for the basic engineering stage. The OHI is the final of the three methods in series proposed for health assessment in development and design stages. The OHI is based on the information available in piping and instrumentation diagrams (PIDs) and the plot plan. Four health aspects are considered; chronic inhalation risks to noncarcinogens and carcinogens, acute inhalation risk, and dermal/eye risk. The index is demonstrated on separation system of a toluene hydrodealkylation process. The assessment results allow the level of occupational health risks to be evaluated, the sources of exposures be detected, and corrective actions taken in a focused way.     

Inherent occupational health assessment during preliminary design stage

Chemical process routes can already be assessed as early as in the development and design phases. Process screening should not look at economic and technical aspects only, but also the safety, health, and environmental performances. In this paper, a method called the Health Quotient Index (HQI) is presented for the preliminary process design phase. The HQI provides a simple approach to quantify workers' health risk from exposure to fugitive emissions e.g. in petrochemical plants. The method utilizes process data from flow sheet diagram, which is already available at the preliminary design stage. Since the mechanical details of the process are still unknown, a database of the precalculated fugitive emissions for typical operations in chemical plants was created to simplify the assessment. The HQI can be used to rank alternative process concepts or to quantify the risk level of processes. As a case study, six process routes for producing methyl methacrylate are discussed. Three health indexes are compared in the case study. The HQI is able to highlight the difference of hazard levels between the routes better as a result of more detailed assessment of the exposures.     

Safety challenges in view of the upcoming hydrogen economy: An overview

If produced and arranged in the right way with carbon dioxide as a possible but permanently removed by-product, hydrogen as a new, large scale, applicable energy carrier promises significant reductions of carbon dioxide emissions. It is light, non-toxic, and clean burning. In different parts of the world, viz. United States, Japan, and Europe, programs have started some years ago to investigate hazardous properties of hydrogen in more detail and to develop special safety measures where necessary. Recently, in September 2009, the third International Conference on Hydrogen Safety (3rd ICHS) was held at Corsica, France. CFD tools have been adapted to describe hydrogen dispersion and explosion. Field tests have been carried out, an incident databank has been founded, knowledge gaps were defined, and risk analysis methods reviewed. The latter are required for drafting installation guidelines and measures for safe distances in land-use planning and licensing of hydrogen storage locations, pipelines, and re-fuelling stations. Yet some challenges remain. The paper will summarize present results and will address hydrogen related issues where more knowledge is needed to reduce uncertainty and improve the quality of risk control.     

Anhydrous ethanol production by extractive distillation: A solvent case study

Production of anhydrous ethanol in large scale has been made by extractive distillation using conventional solvents like ethylene-glycol. In the present paper, extractive distillation process is studied to obtain pure ethanol using ethylene-glycol and tetraethylene-glycol as solvents. Residue curve maps are used to analyse the proposed distillation processes in interpreting mixture behaviours and feasibility of distillation columns. The industrial process is simulated at steady state from residue curve map analysis. Simulation results for the ethanol/water mixture using ethylene-glycol, the conventional solvent, and tetraethylene-glycol, an alternative solvent, are presented. These results showed that the process using tetraethylene-glycol is reliable, although it requires more energy than the process with ethylene-glycol. However, ethylene-glycol has a considerable toxicity level while tetraethylene-glycol is non-toxic.     

Estimation of chemical concentration due to fugitive emissions during chemical process design

Fugitive emissions are not an environmental concern alone, but are also a health concern. From occupational health standpoint, fugitive emissions are the main sources of origin of the continuous exposure to workers. Operating plants regularly measure release and concentration levels through a plant-monitoring program. However, for processes which are still ‘on paper’, predictive estimation methods are required. Therefore, three methods for estimating concentration of the fugitive emissions are presented for the process development and design phases of petrochemical processes. The methods estimate the fugitive emission rates and plant plot dimensions resulting to fugitive emission concentrations. The methods were developed for the type and amount of information available in three process design stages; conceptual design, preliminary process design, and detailed process design. The methods are applied on a real benzene plant; the estimated benzene concentrations are compared to the actual concentration measured at the plant. The results show that as the information mounts up during design, the concentration estimate becomes more accurate. The results indicate that the methods presented provide simple estimates of fugitive emission-based concentrations during the design stages.     

Occupational chemical exposure and risk estimation in process development and design

Each year more people die from diseases caused by work than are killed in industrial accidents. Therefore, methods are needed to evaluate occupational health hazards as early as possible when the process is still under development. A method for estimating inhalative exposures and risks in petrochemical and related plants is presented. The method is simple and suffices with the limited data availability during the early design stages.The steps of the method, which utilizes preliminary process flow diagrams are as follows: first the fugitive emissions and process plot areas are estimated based on precalculated process modules representing the typical process sections (such as a distillation unit). Chemical concentration in the air is then calculated based on the wind velocity probability and the estimated process cross-sectional area. For this purpose a typical wind velocity distribution in the area is used. The worker risk of exposure to chemicals is evaluated either based on the concentration in air by using the hazard quotient method or calculating the carcinogenic chemicals intake and the resulting risk of cancer. The values are compared to the benchmarks.As a result the process route health characteristics such as fugitive emissions rate, critical wind speed, chemical concentration in air and intake amount as well as the corresponding risk of exposure are produced. By using statistical meteorological data, health risks of occupational exposure can be estimated more realistically as probabilities. The approach is capable of comparing alternative processes to select the concept which is inherently occupationally healthier. Using this method, the exposure problems of a process can be identified earlier and proper decisions can be made early in process development or predesign stage.The concentration-based method is demonstrated by a case study of six competing manufacturing routes for methyl methacrylate (MMA). The C3 is found to be the most harmful alternative to health. Both concentration-based and intake-based methods are applied. The study indicates that the intake-based risk estimation benchmark is stricter than the exposure limit-based benchmark for carcinogens.     

First-trimester maternal factors and biomarker screening for preeclampsia

Preeclampsia (PE), which affects about 2% of pregnancies, is a major cause of maternal and perinatal morbidity and mortality. PE can be subdivided into early onset PE with delivery <34 weeks' gestation and late onset PE with delivery ≥34 weeks. Early onset PE is associated with a higher incidence of adverse outcome. This review illustrates that effective screening for the development of early onset PE can be provided in the first-trimester of pregnancy. Screening by a combination of maternal risk factors, mean arterial pressure, uterine artery Doppler, maternal serum pregnancy-associated plasma protein-A and placental growth factor can identify about 95% of cases of early onset PE for a false-positive rate of 10%. © 2014 John Wiley & Sons, Ltd.