A 10-Step approach to the Occupational Health Programme (Continued):

Step 6: Occupational Hygiene Programme

This step is conducted by an approved inspection authority and includes measurement of environmental exposures. This includes exposures to hazards such as noise, dust, illumination and air-borne contaminants (organic compounds, vapours, fumes, etc). The hazards identified in the HRA (Step 1) are now formally evaluated by means of measurements A report is submitted to the company including suggestions for controlling the hazards that pose significant health risks to employees. This information is channelled to Step 9, at which corrective measures are contemplated.

Step 7: Safety Management Programme

This component includes a wide variety of safety interventions, including safe working procedures, safety controls (such as permits to work etc), and safety mechanisms on equipment, (such as guards, railings, lockout procedures etc). These processes are largely the responsibility of line management and, possibly, the Risk Officer. Other components include incident investigation, housekeeping and the general organisation of the Safety Programme (such as the functioning of the Health and Safety Committee and the Health and Safety Representatives etc.). Periodic inspections and audits (internal and external) are used to measure progress and these reports are fed into Step 9, at which corrective measures are contemplated.

Step 8: Medical Screening and Surveillance Programme:

Medical screening and surveillance (see Section 3) means a planned programme of periodic examination (which may include clinical examinations, biological monitoring or medical tests) of employees by an Occupational Health Practitioner or in prescribed cases by an Occupational Medicine practitioner. Biological monitoring simply measures the levels of the toxic substance in the body (thereby providing a more accurate indication of absorption or target organ exposure than simple air-borne exposure monitoring). Biological effect monitoring comprises medical examination and testing, which seeks to identify early typically subclinical adverse health effects of exposure to the hazard. These tests might include x-ray changes, audiometric changes, lung function changes or other subclinical and clinical findings. The key elements of this step include test selection, setting required test standards, and determining test frequency. These are described in detail in the reference on Worker-Allocated Surveillance Programmes  (WASPs). Other important objectives of Medical Screening and Surveillance include suitability or fitness assessment, ensuring that employees meet the inherent requirements of their occupations; progress evaluation; rehabilitating of employees; and assistance in their return to suitable work. Health outcomes resulting from such interventions  are fed into Step 9 (see below).

Step 9: Data Analysis and Reporting:

(See the Health Information Guidelines document)
This step brings together the outcomes of Steps 6, 7 and 8. The objective is to identify critical findings in the Occupation Health Programme as a whole, relating to the "3 P's" (Progress, Problem, Performance):

• Progress of the programme.
• Problem (high risk) areas.
• Effectiveness of intervention measures, ie. Performance.

These three components should be highlighted and appropriate recommendations issued in a composite report.

Step 10: Corrective Measures

The recommendations drawn from the report should be listed in an Action Plan with appropriate time deadlines and accountabilities. Overall responsibility for this should be at the highest level in the company in order to drive the implementation of the recommendations effectively. As these corrective measures are instituted and completed they actually change the health risk profile of the company, which ultimately requires a re-visitation of the Health Risk Assessment (Step 1).

This risk management cycle should occur at least every two years as prescribed by the Occupational Health and Safety Act.