Occupational Environmental Health Workshop Brantford John Oudyk - - PowerPoint PPT Presentation

▶
occupational environmental health workshop
SMART_READER_LITE
LIVE PREVIEW

Occupational Environmental Health Workshop Brantford John Oudyk - - PowerPoint PPT Presentation

Dec 26, 2023 138 likes •768 views

Occupational Health Clinics for Ontario Workers I nc. Occupational Environmental Health Workshop Brantford John Oudyk MSc CIH ROH Occupational Hygienist November 18, 2009 Occupational Health Clinics for Ontario Workers (OHCOW) an

slide-1
SLIDE 1

Occupational Environmental Health Workshop

John Oudyk MSc CIH ROH Occupational Hygienist November 18, 2009

Occupational Health Clinics for Ontario Workers I nc.

Brantford

slide-2
SLIDE 2

Occupational Health Clinics for Ontario Workers (OHCOW)

  • an inter-disciplinary occupational

health team:

  • occupational physicians
  • occupational health nurses
  • ergonomists
  • occupational hygienists
  • funded by WSIB Prevention Services
slide-3
SLIDE 3

OHCOW Clinic Services:

1.

individual client (clinical)

2. answer questions (work/health related) 3.

informational presentations

4. workplace visits

  • requested by co-chairs of JH&SC

5. exposure/health investigations

  • medical/hygiene/ergonomic combined
slide-4
SLIDE 4

What OHCOW does:

Medical Medical

  • symptoms

symptoms

  • tests results

tests results

  • physical exam

physical exam

  • diagnosis

diagnosis

Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology

Work Relatedness Work Relatedness

  • epidemiological review

epidemiological review

  • strength of association

strength of association

Prevention Prevention

slide-5
SLIDE 5

Options:

1) look at the exposures – working from the exposure to the disease

Medical Medical

  • diagnosis

diagnosis

  • tests results

tests results

  • physical exam

physical exam

  • treatments

treatments Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology Work Relatedness Work Relatedness

  • is the exposure linked?

is the exposure linked?

  • how strong is the link?

how strong is the link?

2. 1.

slide-6
SLIDE 6

Options:

2) look at the disease – working from the disease backwards to the exposures

Medical Medical

  • diagnosis

diagnosis

  • tests results

tests results

  • physical exam

physical exam

  • treatments

treatments Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology Work Relatedness Work Relatedness

  • is the exposure linked?

is the exposure linked?

  • how strong is the link?

how strong is the link?

2. 1.

slide-7
SLIDE 7
slide-8
SLIDE 8

if the scientists are arguing, what can a lay person do?

  • there are organizations which gather

evidence and decide what causes cancer and what doesn’t

  • different organizations have different

criteria

– International Agency for Research on Cancer (IARC) – National Toxicology Program (NTP)

slide-9
SLIDE 9

I ARC* classification of carcinogens

Group 1 – Confirmed carcinogen Group 2 2A – Probable carcinogen 2B – Possible carcinogen Group 3 – Not classifiable Group 4 – Probably not carcinogenic

*International Agency for Research on Cancer

slide-10
SLIDE 10

I ARC on the Web:

  • List of all agents evaluated to date (listed by CAS numbers)
  • List of all agents evaluated to date (listed by alphabetical order)
  • List of all agents evaluated to date (listed by Group)

Group 1: The agent is carcinogenic to humans. Group 2A: The agent is probably carcinogenic to humans. Group 2B: The agent is possibly carcinogenic to humans. Group 3: The agent is not classifiable as to its carcinogenicity in to humans. Group 4: The agent is probably not carcinogenic to humans.

http://monographs.iarc.fr/ENG/Classification/index.php http://www.inchem.org/pages/iarc.html

slide-11
SLIDE 11

Scenario:

  • mechanic using parts cleaner with

Varsol for many years has skin cancer

  • n his hand and face
slide-12
SLIDE 12

aspects of determining work-relatedness

Medical Medical

  • diagnosis

diagnosis

  • tests results

tests results

  • physical exam

physical exam

  • treatments

treatments

Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology

Work Relatedness Work Relatedness

  • is the exposure linked?

is the exposure linked?

  • how strong is the link?

how strong is the link?

slide-13
SLIDE 13

Options:

1) look at the exposures – working from the exposure to the disease

Medical Medical

  • diagnosis

diagnosis

  • tests results

tests results

  • physical exam

physical exam

  • treatments

treatments Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology Work Relatedness Work Relatedness

  • is the exposure linked?

is the exposure linked?

  • how strong is the link?

how strong is the link?

2. 1.

slide-14
SLIDE 14

VARSOL 3139 SOLVENT – MSDS

http://www.msds.exxonmobil.com/psims/AlternateFormat.aspx?Brand= iol&DocumentID= 183640&DocumentFormat= RTF

Reportable Hazardous Substance(s) or Complex Substance(s): Name CAS# Concentration Stoddard solvent 8052-41-3 100% Hazardous Constituent(s) Contained in Complex Substance(s): Name CAS# Concentration Ethyl Benzene 100-41-4 0.1-0.5% Naphthalene 91-20-3 0.1-0.5% Nonane 111-84-2 1-5% Pseudocumene (1,2,4-Trimethylbenzene) 95-63-6 1-5% Xylenes 1330-20-7 0.1-0.9%

slide-15
SLIDE 15

search I ARC database

http://www.inchem.org/pages/iarc.html

slide-16
SLIDE 16

I ARC database results:

stoddard solvent (100%) I ARC Group 3 ethylbenzene (0.1-0.5%%) I ARC Group 2B naphthalene (0.1-0.5%%) I ARC Group 2B xylenes (0.1-0.9%%) I ARC Group 3

slide-17
SLIDE 17

check Haz-Map by agent

http://hazmap.nlm.nih.gov/

slide-18
SLIDE 18

Haz-Map results for Stoddard Solvent

Adverse Effects

  • Neurotoxin

CNS Solvent Syndrome

  • Hepatotoxin

Hepatotoxin, Secondary

  • Nephrotoxin

Yes

Diseases

Diseases associated with exposure to this agent:

  • Encephalopathy, chronic solvent
  • Solvents, acute toxic effect
slide-19
SLIDE 19

does Varsol cause skin cancer?

  • as a mixture: IARC category 3 carcinogen
  • has minor IARC category 2B ingredients:

– naphthalene associated with lung cancer in animals – ethylbenzene caused lung and kidney cancers in animals

  • is this relevant to human skin cancer?
  • what about the dirt that is removed from

cleaning parts and dissolved into the Varsol?

slide-20
SLIDE 20

let’s look from the other side:

  • start with disease – skin cancer
  • use National Library of Medicine

Haz-Map database:

http://hazmap.nlm.nih.gov/

slide-21
SLIDE 21

Options:

2) look at the disease – working from the disease backwards to the exposures

Medical Medical

  • diagnosis

diagnosis

  • tests results

tests results

  • physical exam

physical exam

  • treatments

treatments Exposure Exposure

  • to what

to what

  • how much

how much

  • how long

how long

  • toxicology

toxicology Work Relatedness Work Relatedness

  • is the exposure linked?

is the exposure linked?

  • how strong is the link?

how strong is the link?

2. 1.

slide-22
SLIDE 22

check Haz-Map by disease

http://hazmap.nlm.nih.gov/

slide-23
SLIDE 23

Disease/Syndrome

Skin cancer

Comments

The major risk for outdoor workers is exposure to ultraviolet light. Other agents carcinogenic to the skin include: PAHs (coal tar, shale oil, or mineral oils); arsenic (pesticide manufacturing; sheep dip; copper, lead or zinc smelting); and ionizing radiation (radiologists); [LaDou, p. 254-7]

Latency/Incubation Years Related Information in Haz-Map Agents Hazardous agents that cause this disease:

Arsenic and compounds Coal tar Coal tar pitch volatiles Oil mist, mineral Radiation, ionizing Radiation, solar Shale oils Soots

http://hazmap.nlm.nih.gov/cgi-bin/hazmap_generic?tbl= TblDiseases&id= 32

slide-24
SLIDE 24

CHE Toxicant and Disease Database

  • The CHE Toxicant and Disease

Database is a searchable database that summarizes links between chemical contaminants and approximately 180 human diseases or conditions.

  • put on the web by the Collaborative on

Health and the Environment (CHE)

http://database.healthandenvironment.org/index.cfm

slide-25
SLIDE 25
slide-26
SLIDE 26

CHE database results for skin cancer

slide-27
SLIDE 27

Skin cancer (non-melanoma) Causes [strength of evidence]:

arsenic+ [Strong] coal tars+ [Strong] ionizing radiation+ [Strong] mineral oils+ [Strong] shale oils+ [Strong] UV radiation+ [Strong] aromatic amines [Good] arsenical pesticides [Good] benz(a)anthracene# [Good] benzo(a)pyrene# [Good] creosotes# [Good] dibenz(a,h)anthracene [Good] dimethyl benzanthracene [Good] ethylene oxide [Good] methylcholanthrene [Good] PAHs [Good] pesticides [Good] acrylamide# [Limited] vinyl chloride [Limited]

Notes: + - Group 1 human carcinogen, # - Group 2A human carcinogen (IARC), Skin cancer caused by

chemical exposure can take 20-50 years to manifest.

References:

Baker SR and Wilkinson CF, ed. The Effects of Pesticides on Human Health. Workshop Proceedings, Advances in Modern Environmental Toxicology XVIII. May 9-11, 1998. Princeton Science Publishing, Princeton. Spiewak, R. Pesticides as a Cause of Occupational Skin Diseases in Farmers. Ann Agric Environ Med 2001;8:1-5. http://database.healthandenvironment.org/index.cfm

slide-28
SLIDE 28

I s skin cancer related to a mechanic’s exposure to Varsol?

  • probably not to clean Varsol, but, …
  • Varsol with soot and dirt from dirty

engine parts could contain PAH’s which can cause lung cancer, …

  • next step – review exposure in greater

detail

slide-29
SLIDE 29

exposure review

  • take a history of all jobs going way back (latency)
  • ask worker to describe use of Varsol (get the whole

story – ask co-workers also)

  • find any old MSDS’s, hygiene reports, pictures, floor

plans, etc.

  • find out how much was used?
  • length of exposure?
  • any skin exposure? how long? how much of the body

covered?

  • any symptoms (defatting of the skin, dermatitis)?
slide-30
SLIDE 30

Workplace conditions:

  • draw a layout of the worksite (for fixed work

stations)

  • indicate size of room and height of walls
  • identify fans, ventilation if any
  • describe conditions, accumulated dust,
  • dours, visibility, traffic
  • describe “exposure symptoms”, blowing dust
  • ut of nose, junk in eyes, odours affecting

nose/eyes, etc.

slide-31
SLIDE 31

Materials, usage, consumption:

  • list materials used to do work
  • describe state of material (solid, liquid, gas, powder,

fume, etc.)

  • describe equipment used (compressed air, thermal

degradation products, etc.)

  • indicate range of consumption (minimum, maximum,

average)

  • describe emissions and % capture of ventilation (if

any)

  • present information in table format if possible
  • PPE
slide-32
SLIDE 32

Clean-up procedures, hygiene facilities:

  • describe the clean-up routine
  • indicate where lunches, breaks were

taken

  • describe facilities available for personal

hygiene

slide-33
SLIDE 33

Documentation:

  • MSDS’s
  • Hygiene measurements
  • Shipping & Receiving records
  • Drawings of workplace, photographs,

newspaper clippings

  • Seniority lists, pay stubs, employment records

Make sure you don’t dump or overload – prioritize and put archives in appendix

slide-34
SLIDE 34

making the link …

  • given that:

– worker has many years (20+ ) of skin exposure to Varsol of on average 2-3 hours per day of “wet” skin on the hands (latency & significant exposure) – Varsol used to clean engine parts which have soot (PAH’s) on them (presence/exposure to carcinogens) – skin cancer being related to PAH’s and soot (exposure-disease link)

… therefore, on the balance of probabilities there is evidence to suggest an occupational contribution to the skin cancer

slide-35
SLIDE 35

Body mapping:

http://www.hazards.org/diyresearch/gallery9.htm

slide-36
SLIDE 36

Types of I nformation used in Mapping

  • Symptoms/conditions (where does it hurt?)

– First aid reports – Health Information – Workers who have left the job – Absenteeism

  • Hazard information

– Accidents – Chemicals, physical hazards, biological – Psycho-social hazards

slide-37
SLIDE 37

Body mapping:

http://www.hazards.org/diyresearch/images.htm

slide-38
SLIDE 38

Body mapping:

http://www.hazards.org/diyresearch/images.htm

slide-39
SLIDE 39

Body mapping:

http://www.hazards.org/diyresearch/images.htm

slide-40
SLIDE 40

www.geog.psu.edu/people/tschakert/

I am committed to participatory research (PR) as an epistemological framework that promotes critical engagement with marginalized communities (of space and practice) in order to open up alternative routes for 'doing' geography. PR methods allow involving local stakeholders from the initial research design to data collection, interpretation, and final recommendations. Over the years, I have used change matrices, village and resource flow mapping, Venn diagrams, focus groups, group drawings, agricultural calendars, ranking, piling, and scoring, visual household budgets, participatory GIS, conceptual mapping (mental models), hazard mapping, vision mapping, body health mapping, environmental theatre, and, most recently, participatory video. Try it!

slide-41
SLIDE 41
  • R. shoulder
  • R. leg

ankle wrist back

  • L. foot

neck

  • R. elbow
  • L. knee
slide-42
SLIDE 42

Discomfort scales:

A/0 = never B/1 = rarely (few times/month) C/2 = frequently (few times/week) D/3 = constantly (nearly every day) 0 no discomfort 1 2 fairly comfortable 3 4 5 moderate discomfort 6 7 8 very uncomfortable 9 10 extreme discomfort

neck

slide-43
SLIDE 43

Likelihood of seeking treatment:

freq discmfrt

B/ 1 = rarely C/ 2 = frequently D/ 3 = constantly

1 2 3 4 5 6 7 8 9 10

not likely to seek treatment somewhat likely to seek treatment very likely to seek treatment

legend

slide-44
SLIDE 44

Your results:

somewhat & very likely to seek treatment

slide-45
SLIDE 45

Google maps:

slide-46
SLIDE 46

What is geomatics?

Geomatics is the discipline of gathering,

storing, processing, and delivering geographic information, or spatially referenced information.

http://en.wikipedia.org/wiki/Geomatics

slide-47
SLIDE 47

Google Earth:

slide-48
SLIDE 48

NPRI data:

slide-49
SLIDE 49

Local NPRI reporting sites:

slide-50
SLIDE 50

Local NPRI reporting sites:

slide-51
SLIDE 51

Local NPRI reporting sites:

slide-52
SLIDE 52
slide-53
SLIDE 53

Close-up:

slide-54
SLIDE 54

Scientific reports:

slide-55
SLIDE 55
slide-56
SLIDE 56
slide-57
SLIDE 57

Cancer Care Ontario

  • “The Ontario Health and Environment Integrated Surveillance

(OHEIS) Project aims to improve our understanding of the links between environmental hazards/exposures, health outcomes and risk.

  • This will be achieved through the development of a

comprehensive, standardized geographic information system (GIS) for the rapid assessment of these relationships at large and small scales of geography.

  • If successful, it will enable fast and accurate mapping and risk

assessment of cancer in Ontario, resulting in CCO being better able to communicate to other public sector agencies and the public at large the nature of spatial variations in cancer rates and the contributions of environmental and modifiable risk factors.”

slide-58
SLIDE 58
slide-59
SLIDE 59
slide-60
SLIDE 60
slide-61
SLIDE 61

How much information do you need?

  • What is the purpose for collecting the

info?

  • Who are you trying to influence to do

something?

  • How much science is needed?
  • How do you think they will respond?