KOC.he.004 - Occupational Health and Hygiene - First Aid

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OCCUPATIONAL HEALTH AND HYGIENE - FIRST AID Document Number: KOC.HE.004 Approver : (Technical) Approver: (Administrative) Scope: Issue Date: Revision/Review Date:

Manager HSE

Author:

Team Leader H&E

Manager HSE All KOC Directorates

Document Coordinator: Control Tier:

Team Leader Standards 3

December 01, 2008

Issuing Group:

HSE Group

January 28, 2010

Next Review Date:

January 27, 2011

1.0 PURPOSE / SCOPE To provide practical guidance to implement a process that will ensure proper health & hygiene practice at work place, provide timely access to first aid for activities undertaken during the course of work. 2.0 DEFINITIONS First Aid First aid in the workforce is the provision of emergency, initial treatment and life support for people suffering from injury or illness at work until definitive treatment from an approved medical practitioner can be accessed. First Aider A person who has undertaken a certificate First Aid training course to provide initial first aid care to the ill or injured. Occupational Health function Function that has essentially preventive role and is responsible for: (a) advising on the requirements for establishing and maintaining a safe and healthy working environment which will facilitate optimal physical and mental health in relation to work; (b) promoting the adaptation of work to the capabilities of workers in the light of their physical and mental health; (c) providing vocational rehabilitation, health surveillance and first aid or emergency treatment. 3.0 General Requirement KOC HSEMS Element HSE-01, expectation 02

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4.0 Key Responsibilities TL Production Operations, TL Water Handling, TL Gas Operations • • •

Ensuring that all appropriate safety & health issues will be addressed during all phases of operational activities. Ensuring that adequate number of suitable staff are properly trained for first aid Each operation facility should have at least one first aider for the running shift.

Team Leader HSE Assets •

• •

Ensuring the adequate number of First aid kits are available at designated and easily accessible locations and all such locations are clearly displayed with FIRST AID signs at the site. Ensure the number of First Aid kits are adequate to the number of employees working in that particular department Ensure the contents of the First Aid kits are periodically monitored and replenished as and when required

Operations Supervisors • • •

Ensuring that First aid kits are properly maintained and regularly refilled as required. Ensure that First aid register of qualified first aider is maintained and updated. Ensuring the workers complying with all Health/ Hygiene issues as mentioned in the procedure.

Assets HSE Personnel • •

As per this procedure to provide advice to all concerned teams for proper implementation of Health/Hygiene practices at work premises as per this procedure. To seek necessary assistance from Industrial hygiene personnel as and when necessary for investigating certain Occupational Diseases.

Contractor’s representative • •

Ensuring proper cleaning/housekeeping will be maintained at the premises during execution of each of the company’s contracts Ensuring all the cleaning agents /practices should be non hazardous.

Manager Ahmadi Hospital • •

Ensure the availability of adequate no. of first aid kits at concerned locations. Provide appropriate first aid training to the related staff at desired intervals.

Head Preventive Medical Services (PMS - Medical Group) • • •

Provide appropriate training for first aider Provide necessary first kits & contents as requested Ensure advanced treatment (after first ) provided to the concerned staff.

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First Aiders • • • •

The provision of a service for emergency treatment, of injury or illness within their competencies. Arranging prompt and appropriate referral for patients who require further treatment. The maintenance of first aid equipment register, checking and restocking first aid kits. The recognition and reporting of deficiencies in the first aid to the HSE personnel of the area.

5.0 PROCEDURE 5.1 Health & Hygiene 5.1.1 General The employees are required to observe all general Health & Hygiene requirements laid down by the company. Each employee while at work has to take reasonable care to ensure the safety, health and welfare of him self and other persons who may be affected by his acts or omissions. No persons shall intentionally or recklessly interfere with or misuse anything provided by the Company in the interests of health, safety and welfare. The following health & hygiene practices must be kept in view while working inside company premises. •

Where work procedures require the use of protective clothing, etc., respiratory protection or other protective gear, these are to be maintained in a clean and hygienic condition.

•

All persons working inside the company premises are required to maintain a clean and tidy status at their place of work, including for personal lockers, wash rooms, laboratories & rest rooms, etc.

•

Persons handling or carrying out any work with chemicals, paint, toxic or other harmful substances, or any work involving dust or fumes, must thoroughly wash their hands before taking meals and before leaving worksite.

•

Where persons are required to lift or move heavy objects by hand, they should be trained in the correct methods of lifting and/or moving such objects as per manual handling procedure of the company.

•

Barrier creams approved by Medical Group are available at the location where its use is envisaged however it is to be used as instructed.

•

Hand cleaning solvents approved by Medical Group are provided in all washrooms and are to be used as directed. The use of non-approved solvents (gas oil, kerosene etc.) is forbidden.

•

Employees to report any injury or illness during their period of employment to the concerned authorities for evaluation of occupational diseases.

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5.1.2 Occupational Skin Disorders Occupational skin diseases can occur in workers of all ages and in any work setting, and cause a great deal of illness, personal misery, and reduced productivity. Although the frequency of occupational skin disease often parallels the level of hygiene practiced by employers, occupational skin diseases are largely preventable. Many consider this type of disease trivial and insignificant, but occupational skin disorders can result in complex impairment. Because large surface areas of skin are often directly exposed to the environment, the skin is particularly vulnerable to occupational exposure. Prevention & Control Dermatitis caused by substances or conditions present in the work environment are largely preventable, but only through the combined effort of management and workers. There are two major approaches to the prevention and control of occupational diseases in general and dermatitis in particular: environmental control measures and personal hygiene methods. In both cases, the key is cleanliness, both environmental and personal. Personal Hygiene Poor personal hygiene is believed to be a major factor causing occupational skin disorders. Unwashed skin covered with unwashed and unchanged clothes may be in prolonged contact with chemicals. Responsibility for maintaining clean skin is shared by employer and employee. Thus, adequate facilities for maintaining personal cleanliness should be provided in every place of employment. Educating workers in the preventive aspects of personal hygiene is essential. On the other hand, excessive skin cleansing with harsh agents can produce an irritant contact dermatitis or aggravate pre-existing dermatitis. Good Housekeeping Environmental cleanliness is nothing more than good housekeeping and it is maintained by frequently cleaning floors, walls, ceilings, windows, and machinery. Good housekeeping work is usually performed by cleaning contractors that is given direct responsibility for maintenance cleaning. In order to be effective, cleaning should be part of a plan and should be performed on schedule. Environmental cleanliness is important to maintain good morale, reduce contact dermatitis, and set an example for workers. Floors, walls, ceilings, and light fixtures should be cleaned regularly in order to maintain the best possible conditions in the facility. All facilities like washrooms, showers, toilets, and locker rooms should be kept clean and sanitary.

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Personal Cleanliness The importance of personal cleanliness in the prevention and control of occupational dermatitis is well established. When investigating contact dermatitis, one should also consider the possibility of irritants contacted at home or work. Personal hygiene plays a major role to contain many epidemic diseases, as the employees are likely to work in teams. Prevention of contact When facility and process design cannot eliminate all contact with irritants, personal protective equipment must be used. Included are gloves, aprons, and boots made of a material that is impervious to the particular substance. These, along with goggles, afford sufficient protection in most cases. All personal protective equipment required for a job should be carefully maintained and replaced when it becomes worn out, contaminated or unserviceable. In order to minimize contact with harmful agents, workers must have access to facilities for washing hands and be furnished with other means of keeping clean. The company should provide adequate washing facilities, good cleansing materials, and education on the need for good hygiene practices. Washbasins must be well-designed for the purpose, conveniently located, and kept clean to avoid undesirable practices as washing with more easily available solvents, mineral oils, or industrial detergents, none of which is intended for skin cleansing. For workers to keep their skin reasonably free of injurious agents, they must use washing facilities at least four times a day: during work (before eating, drinking, smoking, or using the restroom), before lunch, after lunch, and before leaving the facility. In case any occupational skin disease is found it should be reported to Industrial Hygienist for investigation. Those who work with toxic chemicals and radioactive substances must receive specific approved trainings, safe handling instructions and should take a shower after their work shift and change their clothing. Workers should be instructed in specific procedures for cleanliness. They should be aware of how, and when to wash and should be given sufficient time to wash. For many exposures, frequent washing alone is a successful preventive measure. In all cases, however, the use of large quantities of water on the skin following exposure to irritants is necessary. Safety showers and eyewash fountains should be available, and flushing should continue for at least 15 minutes. The choice of a good soap may in some cases involve technical considerations, which are better left to the medical group. The basic requirements of industrial skin cleansers are as follows: • It should remove industrial soil quickly and efficiently. • It should not harmfully dehydrate, abrade, or irritate the skin by normal application. • It should flow easily through dispensers. • It should be adequately preserved against microbial contamination. Control Tier 3

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The installation in work-area washing places of soap dispensing units containing properly selected cleansing agents has proved to be a valuable measure. Such units should be placed in convenient locations, and enough of them should be provided to accommodate all employees who are exposed to skin irritants. Where soap-dispensing units are furnished, workers should be required to use them. Barrier creams Barrier creams and lotions should be used to supplement, but not to replace, personal protective equipment. Protective barrier agents should be applied to clean skin. When skin becomes soiled, both the barrier and any soil should be washed off and the cream reapplied. Three main types of barrier creams and lotions are available. • • •

Vanishing cream Water-repellent cream Solvent-repellent

5.1.3 The Eyes The eye may be the organ most vulnerable to occupational injuries. Although the eye has some natural defenses, they do not compare with the healing properties of the skin, the automatic cleansing abilities of the lungs, or the recuperative powers of the ear. Consequently, the eye is at greater risk and eye and face protection is a major occupational health issue. There should not be any compromise in protecting the eyes. So it is mandatory to use eye protecting PPEs at all times as reasonably possible. Physical Hazards The eye is subject to many kinds of physical injury—blows from blunt objects, cuts from sharp objects, and damage from foreign bodies. Chemical Hazards The effects of accidental contamination of the eye with chemicals vary from minor irritation to complete loss of vision. In addition to accidental splashing, some mists, vapors, and gases produce eye irritation, either acute or chronic. In some instances, a chemical that does no damage to the eye can be sufficiently absorbed to cause systemic poisoning. Chemical Burns Because caustics are much more injurious to the eyes than acids, the medical prognosis of caustic burns is always guarded. An eye might not look too bad on the first day after exposure to a caustic, but later it may deteriorate markedly. This is in contrast to acid burns, in which the initial appearance is a good indication of the ultimate Control Tier 3

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damage. The ultimate result of a chemical burn may be a scar on the cornea. If this is not in front of the window in the iris, vision may not be greatly hampered. 5.2 First Aid Medical group is responsible to provide first aid to all staff & required first kits to relevant places until definitive medical treatment can be accessed. The following consideration should be taken: • • •

Identify relevant staff for First Aid training & train them accordingly. Ensure adequate no. of first aid kits (one First Aid Kit for every 100 workersKuwait private sector labor law No.38 of 1964,chapter 9,Article44) are provided at designated locations and maintained Provide employees with practical instructions of the procedures to be followed when first aid is required.

5.2.1 First Aid Assessments First Aid assessments must be undertaken in each area / department to determine the appropriate first aid facilities and suitably trained people. The assessment should be documented in consultation with the first aider and HSE assets of the area with consideration to • • • •

The number and distribution of employees including arrangements such as shift work, after hours and field trips. The nature of hazards and the severity of the risk The location of the workplace Known occurrences of accidents or illness.

The first aid assessment process can be organized through HSE assets & Medical group. 5.2.2 First Aiders Each operation facility should have sufficient number of certified first aider. It is desirable that first aiders be selected from those staff members whose duties normally do not take them away from the workplace. Prospective first aiders should be, Staff who show evidence of enthusiasm and a capacity to deal with injury and illness; Able to relate well to other staff. In reasonable health: Able to exercise sound judgment especially in relation to the need to involve other support services. Able to be called away from their ordinary work at short notice. Control Tier 3

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5.2.3 First Aid Training and Certification First aiders undertake the initial treatment of people suffering injury and illness. The treatment provided by first aiders should be consistent with their training and competency. When in doubt a first aider should recommend that an employee seek medical advice. A first aider should not be responsible for ongoing care. First Aid training must be undertaken by an Certified Training. First aid in the workplace training must cover the following Principles of First Aid, Aims of first aid and priorities of care, Expired Air Resuscitation EAR, Cardio Pulmonary resuscitation CPR, Hygiene, infection control and medical waste removal. Reports and legalities First Aid kits. Practical decision making. Function of respiratory and circulatory systems Cardiac emergencies. Secondary assessment & altered conscious state Burns Fractures, theory and practical Soft Tissue Injury, theory and practical Head Injuries, Spinal Injuries Eye Injuries, Respiratory emergencies, Asthma, hyperventilation Diabetes, Stroke, Epilepsy Allergic reactions Poisoning moving a patient Material Safety Data Sheets and how to read them. A First Aid in the Workplace certificate will last three years if an annual Cardio Pulmonary Resuscitation (CPR) training session is undertaken. 5.2.4 The First Aid Register. Area supervisors are required to maintain a register of qualified first aiders in their area. The register shall be displayed in a central area and contain first aider names, first aider locations, contact numbers, qualifications, first aider providers, dates of certification and dates of expiry. (Format is as shown in- Appendix-1). 5.2.5 First Aid Kits. The nominated first aider shall be responsible for maintaining the first aid kit provided by medical group & suitable for the type of first aid required.

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5.2.6 The Container. The first aid container should be prominently displayed easily recognized with a white crescent on a green background, accessible and the contents protected against dust and damage. The first aid kits should not be locked 5.2.7 Signage The location of each kit shall be signposted. 5.2.8 The Contents. Contents shall be supplied in quantities appropriate to the work area and be reviewed and maintained on a regular basis by the first aiders. As a guide each First aid kits should include the following items but not be limited to, (a) Two (2) packets of 100 gm absorbent cotton wool (b) Four (4) small plain wound dressings. (c) Two (2) medium plain wound dressings. (d) One ( 1 ) large plain wound dressing. (e) One (1) roll of absorbent ribbon gauze, 25mm x 5000 mm. (f) Eight (8) triangular bandages approx. 900 mm sides x 1270 mm base. (g) One (1) resuscitator (mouth-to-mouth) Brook airway type. (h) Six (6) rust free 50 mm safety pins, on a card. (i) One (1 ) pair 180 mm scissors, one blade sharp pointed, the other round made of rust free and stainless steel. (j) One (1) set inflatable arm splints. (k) One (1) set inflatable leg splints. (l) Two (2) creams to treat burns. (m) Two (2) eye cleaners for general use. (n) Two (2) packets salt tablets for hot and humid weather conditions. (o) Two (2) packets 'Panadol' Advise on the purchase of first aid equipment may be gained through the Medical group. 5.2.9 First Aid Equipment register. First aider should maintain First Equipment Register” to ensure & verify the availability and validity of the kit/contents as well as restocking.

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5.2.10 Additional modules Following additional modules (in addition to content mentioned above) may be required in KOC operational facilities. First aiders must be trained in the use of these additional modules. Eye module This module should be included in the basic first aid kit where, • Chemical liquids or powders are handled in open containers. • Spraying, hosing, compressed air or abrasive blasting operations is carried out. • There is any possibility of flying particles. • Welding, cutting or machining operations are conducted and • Where wearing of eye protection is recommended. Contents Guidance notes Eye wash (once only use container) Sterile eye pads Adhesive tape Note: The eye module does not replace the need for general eye wash facilities. Burns Module This module should be included where there is a possibility of a person sustaining a serious burn. Such places may include, • Places where heat is used in the process • Flammable liquids are used • Chemical acids or alkaline are used • Other corrosive chemicals are used Contents Guidance notes Burns dressings of assorted sizes Size of the dressings should be determined having regard to the nature of the hazard in the workplace. Field Trips All vehicles used on field trips, must travel with a standard first aid kit. The following items should be considered for inclusion in field trip first aid kits. Emergency reference manual Broad crepe bandages (for snake bites) Cervical collar (for spinal / neck injuries) Large clean sheeting (for covering burns)

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Thermal blanket (for treatment of shock) Basic splints. Single use cold packs Eye wash Analgesics. (First aiders must be trained on the use) Communication link. Whistle (for attracting attention), phone, V sheet, Eperb distress signal Torch / flashlight Pair of scissors Thermometer Small note book and pencil 5.2.11 Recording Reporting and Confidentiality. First aiders must record all first aid treatments on the First Aid record. A supply of these forms are to be kept with the first aid box. The original copy of the first aid record must be forwarded to the HSE dept. If first aiders have been advised that persons in their workplace have medical conditions they are required to treat such information in the utmost confidence. Such information may only be revealed to the appropriate personnel, should a medical emergency occur. 5.2.12 Employee Awareness The names of first aiders and their contact numbers should be displayed near all first aid boxes and in a central location in each area. All new employees must be informed of who the area first aider is and how first aiders can be contacted. 5.3 Eye Baths & Wash Solution Eye wash solution and equipment for immediate washing of eye is provided with all Medical First Aid Boxes and additionally in all places where hazardous materials are being handled and eye contamination may occur. Workers in such areas should be familiar with the location of such eye washing facilities and its use in emergency. It is recommended to seek medical advice immediately after eye washing in case of contamination with hazardous material. Eye wash bottles once opened should be disposed and replenished with sealed bottles. 5.4 Emergency Showers In all work places where acids, corrosives or other such hazardous materials are used or handled, emergency water shower facilities have been provided and which shall be used immediately in the case of body contamination. It is the responsibility of local Area Supervisors to ensure that these facilities are functional and kept ready for immediate use.

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6.0 Key Documents/Tools/References DOC. No. KOC-L-009 – Standard for Fire Protection & Safety Equipment Section No.7.11 “First Aid Kits /Stretchers” 7.0 Abbreviations HSE – Health, Safety & Environment HSEMS – HSE Management System KOC – Kuwait Oil Company 8.0 HSE Records (Retention period) o First Aid Register (5 Yrs)

Review & Revision Log Revision/ Review Date

Document Approver

Document Author

29 Oct. 2008

Manager-HSE

TL–H&E

Draft circulated for comments.

01 Dec. 2008 Manager-HSE

TL–H&E

Approved by HSEMS implementation committee & Issued for Implementation

28 Jan. 2010

TL–H&E

Annual Update with minor revisions.

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Manager-HSE

Revision/Review Details

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Appendix-1

Format for First Aid Register Faculty / area Name

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Location

No Contact

Annual CPR date

Certificate Expiry

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First Aid Trainer

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