健康管理手册_解决水泥行业的职业暴露（英文版）_18页_2mb

报告摘要

Summary of the Cement Sustainability Initiative (CSI) Health Management Handbook

Core Content

This document, titled Addressing occupational exposures in the cement industry, outlines good practices for managing health risks related to dust, respirable crystalline silica (RCS), and noise in the cement sector. It is designed to support CSI member companies in creating a proactive approach to occupational health, beyond legal compliance, to enhance worker safety and well-being.

The handbook emphasizes the importance of identifying high-risk areas, assessing personal exposure, implementing control measures, and conducting health surveillance. It also provides guidance on the use of personal protective equipment (PPE) and key performance indicators (KPIs) to monitor and improve health management practices.

Main Objectives

Protect employees by promoting appropriate health management practices.
Foster a common approach to managing occupational exposure risks, particularly dust and noise.
Implement good practices across all activities under CSI member control, ideally within five years.
Promote the extension of these practices to contractors, as allowed by local legislation.

Key Principles

The document is compliant with all applicable legal requirements.
It is open, transparent, and non-discriminatory in its development.
Health management practices are built on two pillars:
1. Proactive risk assessment and mitigation.
2. Correct implementation of health surveillance protocols.
Only trained professionals should conduct exposure measurements and medical surveillance.
Line management is responsible for ensuring the risk assessment is carried out properly.

Scope of Application

Applies to all business sectors related to building materials within CSI member companies.
Reporting responsibilities depend on the level of management control:
- Companies with >50% shareholding must report 100% of the data.
- In 50/50 joint ventures, only the company with health and safety management responsibility should report.
- If the controlling shareholder is not a CSI member, then minority members are not obliged to report.

Understanding Hazards and Management Tools

Common hazards in the cement industry include dust, respirable crystalline silica, and noise.
Dust can lead to COPD, while RCS can cause pneumoconiosis and silicosis.
Noise can result in progressive hearing loss, especially with high-intensity or prolonged exposure.
The basic pillars of health management include:
1. Identification of high-risk areas.
2. Assessment of personal exposure.
3. Selection of control techniques.
4. Design of medical surveillance protocols.

Dust, Respirable Crystalline Silica, and Noise Management

4.1. Identification of Critical Areas

High-risk areas for dust or noise should be marked with signage.
Dust identification includes visible airborne or settled dust, spills, and open stockpiles.
Noise identification includes high-noise equipment and communication difficulties.
Quantitative measurements are necessary, not just non-quantitative observations.
Settled dust analysis can serve as a cross-check for airborne dust data.

4.2. Assessment of Personal Exposure

Personal exposure assessments should be conducted for occupations with significant exposure to dust, RCS, and noise.
Homogeneous exposure groups (HEGs) are recommended to reduce the need for individual assessments.
Sampling duration should cover a full shift, adjusted for job variability.
Exposure time evaluation is essential before any measurement, preferably in consultation with an occupational physician.

4.3. Good Prevention Practices

Hierarchy of controls should be applied to reduce exposure:
1. At source: using low-dust materials, de-dusting systems, and enclosed machinery.
2. At the workplace: reducing dust and noise through technical measures.
If exposure cannot be reduced below reference levels, PPE and organizational measures (e.g., limiting exposure time) should be used.
PPE standards must be met by national or international regulations.
Respiratory masks should be at least FFP2 category.
Hearing protection should provide minimum 25 dB SNR attenuation.
Face fit tests and comfort checks are strongly recommended.
PPE storage should be in clean, dry, and closed compartments.

Health Surveillance Protocols

5.1. General Considerations

Health surveillance is a preventive element of the health management system.
It should be based on scientific knowledge and established medical methods.
It must be conducted at appropriate intervals and take risks into account.
Occupational health services are responsible for advising on health screening, work adaptation, and reassignment.

5.2. Protocol for Workers Exposed to Dust and RCS

Frequency of controls:
- Employees with no symptoms: every three years.
- High exposure or other lung-straining factors: more frequent check-ups.
Medical history collection includes:
- Occupational history and symptoms.
- Pulmonary diseases, atopy, smoking habits, and family history.
Specific medical exams include:
- Spirometry (FVC, FEV1, FEV%).
- Thorax percussion, lung auscultation.
- X-ray should be restricted to cases of medical necessity.
Actions following results:
- Employees with COPD or silicosis should undergo further examination or treatment.
- Silicosis may require checking for joint or kidney damage.
- Employees with pre-existing lung conditions should be informed and possibly reassigned.

5.3. Protocol for Workers Exposed to Noise

Frequency of controls:
- First inspection within six months of employment.
- Follow-up inspections after one year, then at intervals adapted to risk, but not exceeding three years.
Medical history collection includes:
- Noise exposure data, ear conditions, previous hearing loss, noise exposure outside work, and ototoxic chemical exposure.
Specific medical exams include:
- Audiometry (performed in accordance with ISO standards).
- Otoscopy to check for earwax, fluid, or perforation.
Actions following results:
- Check if noise levels are higher than assumed.
- Ensure risk assessments are accurate.
- Confirm PPE adequacy and use compliance.
- Verify noise zone labeling and maximum stay times.

Key Performance Indicators (KPIs)

Percentage of employees working in sites where recommendations are implemented (includes:
- Identification of critical areas.
- Assessment of personal exposure.
- Implementation of prevention measures and PPE.
- Health surveillance protocols.
Occupational Illness Frequency Rate (OIFR):
- Defined as the number of recognized occupational illnesses per million worked hours.
- Includes confirmed cases related to dust, RCS, and noise.

Glossary

Lung cancer: While silicosis is linked to lung cancer, cement dust is not considered a risk.
Medical practitioner: A licensed professional who diagnoses and treats illnesses.
Occupational health service: A service focused on prevention, adjustment, and well-being of workers.
Occupational hygienist: An expert in assessing and controlling workplace exposure risks.
Occupational physician: A specialist in occupational medicine, focusing on prevention, management, and rehabilitation.
Personal exposure to inhalable dust: Measured in mg/m³, representing a full shift. Sampling instruments are based on a 50% statistical cut at 100 μm aerodynamic diameter.

This document serves as a comprehensive guide for CSI member companies to ensure health and safety in the cement industry, with a focus on dust, RCS, and noise. It encourages a proactive and preventive approach, aligning with international standards and local legislation, while promoting shared best practices across the sector.

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