Occupational health – simply injuries on a different timeline.
I recently watched a documentary about sulphur mining on an Indonesian island off East Java.
On this island, day after day locals enter the edge of an active volcano, Mount Ijen, to mine solidified sulphur.
There is a captive market, with the sulphur being sold and used in the manufacture of explosives, cosmetics, firelighters and bleaching activities. The sulphur is, therefore, a valuable resource to the people of the island.
The problem, however, lies in the extraction methods and working conditions; and, once again, through my health and safety lens, I found myself thinking about what it is that companies could and should be doing differently.
The conditions to which the so-called miners are exposed reminded me of similar conditions and risks in the article I wrote called “As sweet as honey” covering the honey harvesters in Nepal (which was published in SHEQ MANAGEMENT issue 6 of 2017), only this time the main risk to those entering the volcano is related to occupational health, although there are, without doubt, also certain safety risks.
The mining process
These miners wake up in the early hours of the morning to start mining the sulphur from the volcano, before the sun has risen and before the heat of the day beats down on them.
Day after day, they set about the long and tiring walk up the slopes of the mountain, over the lip of the volcano and down the inner slippery rock slopes and into the depths of the volcanic crater below. Here they extract the solidified sulphur masses.
Solid sulphur is formed when the toxic volcanic gasses cool down. To expedite this process and maximise product availability, the miners have developed a way of fast-tracking the hardening process. They’ve installed pipes connected to the openings in the walls of the volcano to capture the gases and funnel the condensate sulphur into large drums where it hardens.
Miners then break the solidified sulphur into blocks to be extracted from the volcano and sold to prospective buyers. The blocks are equally distributed in two baskets, connected by a long bamboo pole and spanning the miners’ shoulders as they negotiate their passage out of the volcano. The combined weight of the product in the two baskets is sometimes in excess of 90 kg.
The realities and the risks
There are definite safety risks associated with this mining technique. For starters, Mount Ijen is an active volcano! Beyond that, the risk of both minor and more serious injury remains high, with slipping, tripping and/or falling being a very real threat.
What struck me, however, was the far less obvious, but equally severe, occupational health risks to which the miners are exposed; with the toxic sulphur fumes and volcanic smoke burning their eyes and throats, and impacting their lung functionality.
In many instances, and despite the toxic gases and volcanic smoke present, the miners are provided with little or no personal protective clothing and equipment to protect them from injury or occupational illness or disease.
At best, they wrap rags around their faces to protect against gas inhalation. They’re also not issued with safety helmets, gloves or safety shoes, and don’t have suitable tools for breaking the solidified sulphur into more manageable blocks.
Despite these working conditions, the miners will accept the risks associated with this work in order to provide for the needs of their families. Even more concerning, is that each miner earns the equivalent of six US dollars (R74) per day.
The reality for these sulphur miners is dire: continuous exposure to toxic gases and volcanic smoke, all with long-term negative effect on their health; no consideration given to whether a miner is medically fit to perform the task; no monitoring of the real impact of the toxic gasses on their health; and no thought for how the overall ergonomics of the task is impacting their health (such as bending and climbing steps and slippery slopes while carrying heavy loads).
In contrast, companies have a responsibility to ensure a safe and healthy working environment for their employees, who need to be able to do their jobs with the comfort of knowing that all the necessary steps have been taken to mitigate the associated safety and health risks.
It is not uncommon for companies to place more focus on safety than on occupational health issues – primarily because key performance indicators are more often associated with lag and lead indicators related to the incident trends and the safety initiatives.
Typically, when an injury occurs, the consequences of the incident are immediately visible (for example, a cut or fracture and, in most instances, blood).
In the case of occupational diseases, on the other hand, the results of exposure to the source (such as noise, asbestos, chemicals and repetitive tasks) are only identified at a much later stage. These diseases typically don’t affect current injury numbers, such as total recordable case rates, or those for newly compensated occupational diseases.
Occupational disease needs to be considered an injury to a person, just on a different timeline. Occupational health should, therefore, be given the same level of attention as the safety of employees and contractors.
Asking the right questions
The question to companies is whether they have, in addition to their attention to safety, considered the various elements related to occupational health in their overall risk-management approach.
Let’s consider some of the aspects:
• Medical examinations
A comprehensive medical programme is an important component of a company’s risk-management programme. This could include pre-employment medical examinations as well as pre-placement medicals, all of which would help to ascertain whether the applicant is suited to the position and capable of conducting the tasks required without endangering their safety or overall health.
Pre-employment medicals also provide the company with a baseline of a person’s medical condition, so that they can monitor any deterioration while in their employment. In situations such as these, regular medicals are also helpful, so that both employee and employer can monitor their health and identify any trends of deterioration.
Accurate person-job specifications can, and should, be used to support all medical assessments.
In addition to medical testing before and during employment, companies may also require exit medical tests to confirm the employee’s condition of health at the time of leaving their employ. Should the person’s health deteriorate at his or her next place of employment, it can quickly be ascertained whether working at the former company contributed to the ill health.
When developing workstations and process equipment, a company should consider the ergonomic-related aspects of that job and/or task. Companies need to mitigate any negative impact that a particular job or task may have on an employee.
We only need think of the Indonesian miners carrying up to 90 kg of sulphur on their shoulders all day to appreciate the impact on their backs, necks, shoulders and knees.
It is important for industries to measure and monitor the levels to which employees are exposed to gasses, extreme temperatures and noise. All these elements have an industry limit, which needs to be monitored through personal or fixed monitors in high-risk areas of an operation.
Thinking back to the miners, there is definitely no monitoring of the volcanic gasses to which they are exposed, and from which may have lost their lives over the years.
• Personal protective clothing and equipment
Although typically the last resort in the hierarchy of controls, issuing employees with the correct protective equipment (in good working order) is very important. In the case of our sulphur miners, the rags tied across their faces should be replaced with suitable gas masks to protect them from exposure to the toxic volcanic gases.
It’s not enough for employers to just issue the correct equipment. They also need to ensure that it’s all in good working order and that employees have received appropriate training in terms of using the equipment.
Making the tough jobs a little less tough
Proactive occupational health initiatives and controls need to receive the same degree of scrutiny and attention as the safety initiatives and controls. The reality is that employees are sometimes forced to make a trade off – their health for employment retention – all in the noble pursuit of supporting their families.
Again, the Indonesian miners are a case in point: whether in their own private capacity or as company employees, they opt to engage day after day in a high-risk activity (with obvious and definite impacts on their health) to be able to support their families.
As companies, we do not have the luxury of ever assuming we’ve done all we can to ensure the health and safety of our employees! Safety and health need to always be on our agenda, and we need to constantly make safety the “easy” option for employees.
When considering the hierarchy of controls, it’s not always possible to eliminate or substitute a task or hazard. However, we can, and should, always consider engineering controls before implementing administrative controls, and issue personal protective equipment to address the residual risks.
Where instituting engineering controls is not possible, it is of utmost importance that other robust controls are implemented.
As leaders, we have a moral obligation and responsibility to our employees and their families to take occupational health matters seriously!