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IE 8570 Health, Safety, and the Environment
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What are some of the “Task, equipment, environment, selection, and training” interventions that could prevent or mitigate hearing loss?Propose a specific example of when someone might be exposed to hearing-loss related noise exposure and how these different strategies might work in that situation (examples may be workers in a manufacturing, truck drivers, construction workers etc.) 
Consider prevention strategies for the control of risk factors for musculoskeletal disorders in the textbook.If we classify these according to the interventions at the task, equipment, environment, selection, and training levels, what types of interventions are underrepresented in the list in the textbook?Why is that?What other interventions could we implement to prevent/mitigate these exposures?Based on the examples, what might work best?  
the pdf is the lecture notes you can refer incase of anytihngLecture 4 Industrial Safety
Dr. Neyens
IE 8570
Module 4
1
Safety and Accident Prevention
• Health: disease-causing
situations, prolonged
conditions
• Safety: injury-causing
situations, acute or eventbased conditions
• Safety legislations designed to
increase health and safety of
people
http://www.damncoolpictures.com/2009/02/most-dangerous-jobs-in-world.html
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What is an accident?
• It has been defined as:
– “Without apparent cause”, “Unexpected”
– “Unintentional acts”, “Mishaps”, “Chance”
– “Act of Gods”
– Meister (1987) defines accident as “an unanticipated event which
damages the system and/or an individual or affects the accomplishment of
the system mission or the individual’s task”
• But we know that there are system designs that can be used as a
‘barrier’ for accidents
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Accidents
• In a typical year
– 47,000 people die in motor
vehicle crashes
– 13,000 die in falls
– 7,000 die from poisoning
• Most common workplace deaths and
injuries
– Overexertion
– Impacts
– Falls
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NIOSH estimates that over 10 million people
are exposed to hazardous substances.
Cost of deaths and injury: $50 billion a year
Each workplace fatality costs U.S. society
$780,000 per victim.
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4
“Swiss Cheese Model”
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http://csel.eng.ohio-state.edu/productions/pexis/conceptualize/view.html
5
Coal Mine Disaster (Dec 6, 1907)
• Monongah, West Virginia
• Killed 362 coal miners
– Men and boys
• Earth shook as far as 8 miles
• Every local mine official was
missing
http://www.msha.gov/DISASTER/MONONGAH/MONON1.asp
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Textile factory fire (Mar 25, 1911)
• Fire in NY’s garment district
Triangle Shirtwaist factory
– Within 18 minutes, 146
people were dead
• Almost all were young women (16 to
23-yrs-old)
– Fire exits were all blocked
– The one fire escape collapsed
– Most doors were locked;
those that were unlock,
opened inward
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http://www.ilr.cornell.edu/trianglefire/
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7
History of Safety Legislations
Workers’ Compensation
• Congress passed the Employers’ Liability Acts of 1906 (Supreme court said
unconstitutional) then a softened law was passed in 1908.
• Attempts to pass comprehensive workers’ compensation acts in NY (1898), MD (1902),
MA (1908), and MT (1909) failed
• 1st comprehensive workers’ compensation law in WI (1911)
• These early laws provided compensation to workers regardless of who was at fault
Goals
• Provide sure, prompt, and reasonable income and medical benefits to work-accident
victims regardless of fault.
• Also helps promote the study of accident causation.
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Safety Administrations in US
In the US, OSHA and NIOSH was set up from the 1970 Occupational Safety and
Health Act
Occupational Safety & Health Administration (OSHA)







Implement safety programs
Set and revoke health and safety standards
Conduct inspections
Investigate problems
Monitor illnesses and injuries
Issue citations
Assesses penalties
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Safety Administrations in US
National Institute for Occupational Health (NIOSH)
• Conduct research and make recommendations for the prevention
of work-related injury and illness
• Gather information, conduct scientific research, and translate the
knowledge gained into products and services.
• Background of researchers
– Human factors, epidemiology, medicine, industrial hygiene, safety,
psychology, engineering, chemistry, and statistics
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Mine Safety and Health Administration
• Set up in 1978
– based on Federal Mine Safety and Health Act
• To enforce compliance with mandatory safety and health standards in the
nation’s mines to:
− eliminate fatal accidents
− reduce the frequency and severity of nonfatal accidents
− minimize health hazards
− promote improved safety and health conditions
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http://www.msha.gov/
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11
Coal Mine Disaster (2010)
• April 5, 2010, West Virginia
• 29 miners died, 2 injured by explosion
• Miner owners had dismal safety record
– 2009: 458 citations
– In 2 months prior: miners evacuated 3X because of dangerously high
methane levels
– Cited 3X for ventilation problems
– 2008: pleaded guilty to safety violations: paid $20M in fines
• $209M settlement (including $1.5M for each family)
• Mine superintendent—guilty of conspiring to impede MSHA—
21 months in prison
• Security Director—36 months in jail for false statements and
obstruction
• Co. President—conspiracy to willfully violate health can safety
standards – up to 1 year in prison (as of Dec 2015)

http://www.cnn.com/2010/US/04/13/west.virginia.mine/index.html
http://www.cnn.com/2013/07/13/us/u-s-mine-disasters-fast-facts/
12
http://www.cdc.gov/niosh/mining/UserFiles/statistics/15g05aaa.svg
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Textile factory fire (Feb 23, 2006)
• 65 workers killed, 100 seriously
injured in Bangladesh
• Girls as young as 12 yrs old
• Prevented from escaping
– Factory guards had locked the main
entrance and other gates to prevent
theft and monitor
– Tiny stairwell was jammed with people
• No fire safety equipment, no fire
drills
http://www.wsws.org/articles/2006/mar2006/bang-m02.shtml
http://www.chinadaily.com.cn/english/doc/2006-02/24/content_523768.htm
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Rana Plaza Complex Bangladesh
• “One of the worst industrial accidents
ever” Al-Mahmoud, WSJ 2013
• Collapse of an 8-story textile factory
• Mixed use building: bank, apartments,
shops, clothing factories.
• 1,129 people were killed, 2,515 were
injured.
http://en.wikipedia.org/wiki/File:Dhaka_Savar_Building_Collapse.jpg
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http://money.cnn.com/2008/08/20/news/fewer_workers_die_on_job/
16
Product Liability
• Allege that product is defective and that the defect cause
injury or death.
• Three types of defects:
– Design defect
– Manufacturing defect
– Warning defect
** There is a difference between a defective product or an
inherently “dangerous” product (e.g., carving knife,
chainsaw)
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Product Liability
• A product is defective if:
– It fails to perform safely when used in a reasonably foreseeable
manner
– The risk inherent in the design outweighed the benefit of the design
• Examples?
– Juggling chainsaws?
– Using a lawnmower as a hedge trimmer?
– Get cut with a kitchen knife while chopping onions (design defect)?
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What do we have to do with product
liability?
• Human Factors and Ergonomics contributions:
– Address the moral and economic concerns of occupational safety
– Defines reasonably foreseeable
– Trade off between risk and benefit
– Help manufacturers design safer products
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Warning label design
• Challenges to warning design
– Notice, Perceive, Comprehend, Comply
– Proliferation can reduce salience and
compliance
– Social and cultural factors are critical
“smoking causes cancer…”
• Warnings should contain:
– Signal word (Danger, Caution, Warning)
– Description of hazard
– Consequences
– Behavior needed to avoid hazard
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Warning Labels
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http://www.experienceproject.com/uw.php?e=67892
http://www.seton.com/seton/catalog/browseSpaceCode.do?spaceCode=D08
http://www.rsingh.net/gender/images/surgeon1.jpg Module 4
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Product Warnings – a bit much?
A label on a toilet?
Recycled flush water unsafe for drinking.
A butane lighter warns:
“Do not use near flame.”
Nikon warns when operating its cameras:
“Care should be taken not to put your finger in your eye
accidentally.”
An Ultradisc-2000 CD player’s warning says:
“Do not use the product as a projectile in a catapult. This could
cause personal injury and will void the warranty.”
Examples of other warning labels: www.crazywarnings.com
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www.dumbwarnings.com/warnings.php?site=warnings
22
And Now, a Warning About Labels
By DEBORAH FRANKLIN
The New York Times October 25, 2005
The “FOR EXTERNAL USE ONLY” sticker stumped 25 % of
even those who could read every word, and misled 90 % of the adults in the
IE
lowest
8570
literacy group.
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Current medicine labels
• These are the labels that I had to interpret
when I was helping to take care of my
grandma.
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Work related musculoskeletal disorders
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Work-Related musculoskeletal
disorders (MSDs):
The adverse health effects that arise from repeated
exposure to micro-trauma in an occupational setting.
– Multi-factorial
– Slow onset
– Recovery time
Also known as:
• Occupational MSDs
• Repetitive Strain Injuries
• Repetitive Motion Disorders
• Cumulative Trauma Disorders
•IE 8570
Overuse Syndromes Module 4
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Work-Related MSDs:
Theories
(there are many, but here are a few)
• Multivariate Interaction Theory
– Genetic
– Morphological
– Psychosocial
– Biomechanical
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Kumar, Ergonomics. 2001.
27
Kumar, Ergonomics. 2001.
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Work-Related MSDs: Theories
• Overexertion Theory
– Tolerance exceeded with overexertion
– Interaction
• Force
• Exposure time (duration)
• Posture
• Motion
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Kumar, Ergonomics. 2001.
29
Major Risk factors for Work-Related MSD
• Repetitive Motion
• Static Postures
• Awkward Postures
• Contact Pressure
• Forceful Exertions
• Task duration
• Environmental stressors
30
Movement types
• Flexion or Extension
• Adduction or Abduction
• Median (or medial) or Lateral
• Pronation or Supination
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Wrist movements
http://o.quizlet.com/uDf07L6r7LRa.H4VxXXziQ.jpg
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http://tt.tennis-warehouse.com/showthread.php?t=440080
32
Types of MSDs
• Tendonitis
– Rotator cuff tendonitis
– Epicondylitis
– De Quervain’s Syndrome
• Nerve compression syndromes
– Carpal tunnel syndrome
• Low back disorders
– Lumbar disc syndrome
• Vibration white finger
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http://www.whitefinger.co.uk/
33
Rotator Cuff Tendonitis
• Inflammation of rotator cuff tendons
at the shoulder
• AKA
–Impingement syndrome
–Swimmer’s shoulder
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Rotator cuff tendinitis
Supraspinatus
tendon
Bursa
Irritation of the
rotator cuff
tendons at the
shoulder
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Rotator Cuff Tendonitis
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Rotator Cuff Tendonitis:
Etiology
• Laboratory induced tendonitis
• Hagberg et al. Ergonomics. 1981.
• Frequency of arm elevation > 60°
• Bjelle et al. Br J Ind Med. 1981.
• Time spent with arm elevation > 90°
– Bagging pears (75%) vs. bagging apples (41%)
• Sakakibara et al. Ergonomics. 1995.
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Rotator cuff Etiology
• High force and/or repetition in
– Chicken wing posture (right-angle)
Signs and symptoms
• Pain with motion in
the pinch zone
• Weakness of shoulder
abduction
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Rotator Cuff Tendonitis:
Pathophysiology
• Intrinsic impingement
– Overuse, tension overload, trauma leads to degeneration
• Extrinsic impingement
– Mechanical compression
• Neer. J Bone Jt Surg. 1972.
• Michener et al. Clin Biomech. 2003.
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Rotator Cuff Tendonitis:
Pathophysiology
• Pinch zone 60 ° – 120°
• Levitz & Ianotti, in Gordon et al, eds. Repetitive Motion Disorders of the
Upper Extremity. 1995.
• Reduced inferior translation of humeral head
• Ischemia
• Inflammation
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Rotator Cuff Tendonitis:
Pathophysiology
• 30° abduction (no load)
– Upper trap 15 mmHg
– Supraspinatus 80 mmHg
– Blood flow impeded at 40 mmHg
• Järvholm et al. Eur J Appl Physiol. 1988.
• Decrease in circulation in tendon
• Fatigue & inflammation
– Muscle fatigue as low as 5% MVC
• Sjøgaard et al. Eur J Appl Physiol. 1988.
• Degeneration
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Epicondylitis: Anatomy
• Lateral epicondyle
– Tendinous origin of extensor forearm muscles
• Extends wrist & fingers
• Medial epicondyle
– Tendinous origin of flexor forearm muscles
• Flexes wrist & fingers
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Lateral Epicondylitis
• Inflammation of the lateral epicondyle
• AKA – Tennis elbow
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Medial Epicondylitis
Small tears of the muscle / tendon
unit on the inside of the elbow
AKA Golfer’s Elbow
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Epicondylitis:
Pathophysiology
• Microtears in tendon (origin)
• Scar tissue formation
• Reinjury
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Symptoms
Lateral Epicondylitis:
• Pain with lifting palm down
• Pain with forceful gripping or twisting
• Extensor weakness
Medial Epicondylitis:
• Pain with forceful gripping or twisting
• Flexor weakness
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Carpal Tunnel Syndrome
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Compression of
the median
nerve within
the carpal
tunnel
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Carpal Tunnel Syndrome
• Compression of median
nerve within the carpal
tunnel
• Tingling, numbness, pain
• Symptoms often
nocturnal
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Carpal Tunnel Syndrome:
Etiology
• Repetition
– High force-high rep vs. low force-low rep
– OR 15.5 (95% CI 1.7-142)
• Silverstein et al. AJIM. 1987.
• Forceful gripping
– Force more important
• Chiang et al. Scand J Work Environ Health. 1993.
• Forceful gripping
– Carpal tunnel pressure increases with increase force of
pressing & pinching
• Keir et al. J Orthop Res. 1998.
• Awkward posture
– Wrist flexion or extension
• Werner et al. Clin Biomech. 1997.
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Carpal Tunnel Syndrome:
Etiology
• Awkward postures
– Finger flexion
• Ham et al. J Hand Surg. 1996.
– Wrist extension with MCP extension
• Keir et al. J Hand Surg [Am]. 1998.
• Vibration
– Duration of exposure
• Nilsson et al. Scand J Work Environ Health.
1994.
– Difficult to separate from force
• An increase in carpal tunnel pressure
lead to ischemia
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Carpal Tunnel Syndrome:
Models of Pathogenesis
• Contact stresses
– Intraneural edema
• Reaction force on tendon increases
with greater flexion or extension
• Armstrong & Chaffin. J Biomech. 1979.
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Thoracic
Outlet Syndrome
Compression of
the nerves and
arteries in the
thoracic outlet
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54
Thoracic Outlet
Syndrome
Extra
rib
Compression:
muscle tension
scar tissue
extra rib
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deQuervain’s
Tenosynovitis
Inflammation of
tendons and
synovium
Abductor
Pollicis Longus
Extensor
Pollicis Longus
Extensor
Pollicis
Brevis
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Trigger Finger

Formation of nodule in
tendon from repeated
trauma
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Prevents full
extension of
finger
57
Low Back Disorders
• 80% of population
• 85% non-specific
– Dillane et al, 1966
• 16-19% of all worker compensation
claims
• 33-41% cost
• Webster & Snook. Spine. 1994
• Ages 33-55 years old
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Low Back Disorders:
Anatomy
• Muscles
• Facet joints
• Intervertebral
discs
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Posture & Intradiscal Pressure
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Nachemson & Morris. J
Bone Jt Surg [Am]. 1964.
60
Posture & Intradiscal Pressure
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Wilke et al.
Spine. 1999.
61
Lumbar Disc Syndrome:
Pathophysiology
• in vitro volume (H2O content) loss of 19%
– 13 – 36% decrease in nucleus hydrostatic pressure
• Adams et al. Spine. 1996
• in vivo decreases by 20% during a day
• Botsford et al. Spine. 1994
• Transfer of load from nucleus to annulus (posterior)
• Nociceptors in external annulus
• Bogduck & Twomey. Clin Anat of Lumbar Spine. 1991.
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Lumbar Disc Syndrome:
Signs & Symptoms
• Pain or numbness in the back, buttock, leg
• Worse with moving out of prolonged postures
– Sitting
• Better with walking
• Worse with forward bending
• Worse in the morning
• Positive neurological tests
Bernard BP, ed. Musculoskeletal Disorders and Workplace Factors. DHHS (NIOSH) Publication # 97-141, 1997.
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Vibration
• Two major type of vibration exposure:
– Whole body vibration
– Hand-arm vibration
– Which is worse for your body, high frequencies or low
frequencies?
• Hand-Arm Vibration Syndrome (HAVS)
(AKA Raynaud’s phenomenon and vibration white
finger)
• No current government regulation, but there are
recommendations
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Vibration (HAVS)
• Exact pathology has not been determined, but probably involves damage
to the nerves and smooth muscles of the blood vessels in the hand
http://drugster.info/medic/term/vibration-white-finger/
– Primary, reduction in blood flow to the fingers and hand: Results in
nerve, blood vessel, and tendon damage
– Feeling of ‘pins-and-needles’, numbness or cold
– Reduced skin temperature, decreased sensitivity and dexterity
– Vascular attacks- hand or fingers blanch (turn white), similar effects
to frostbite: flesh dies.
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