Chemical Safety In The Workplace - Labour
Chemical Safety in the WorkplaceGuidance Notes onSafe Use of Chemical DisinfectantsOccupational Safety and Health BranchLabour Department
These Guidance Notes are prepared by theOccupational Safety and Health Branch ofthe Labour DepartmentFirst edition January 2007These Guidance Notes are issued free of charge and can be obtained from the offices of the OccupationalSafety and Health Branch or downloaded from the Labour Department’s website at http://www.labour.gov.hk/eng/public/content2 8c.htm . For enquiries about addresses and telephone numbers of the offices,please call 2559 2297.These Guidance Notes may be freely reproduced except for advertising, endorsement or commercialpurposes. Please acknowledge the source as “Chemical Safety in the Workplace - Guidance Notes onSafe Use of Chemical Disinfectants”, published by the Labour Department.
Contents1PREFACE12INTRODUCTION23CHEMICAL DISINFECTANTS CLASSES33.1Alcohols33.2Aldehydes33.3Chlorine Compounds33.4Iodine Compounds33.5Phenolics43.6Quaternary Ammonium Compounds43.7Oxidizing Agents43.8Others5HAZARDS64.1Overview64.2Chemical hazards64.3Health hazards74567CHEMICAL SAFETY PROGRAMME85.1Overview85.2Major elements9RISK ASSESSMENT106.1Overview106.2Factors for consideration in the risk assessment10SAFETY MEASURES127.1Strategy in establishing safety measures127.2Substitution/ Elimination137.3Engineering control measures137.4Administrative control measures147.5Personal protective equipment (PPE)147.6Precautions during handling and storage167.7Health surveillance18
Contents8910EMERGENCY PREPAREDNESS198.1Overview198.2Emergency response plan198.3Emergency equipment20HAZARD COMMUNICATION219.1Overview219.2Sources of hazard information219.3Means of hazard communication21INFORMATION, INSTRUCTION AND TRAINING2410.1 Overview2410.2 Information and instruction2410.3 Employee training25APPENDIX ISome Common Chemical DisinfectantsAPPENDIX IIPotential Hazards of Some Chemical INTS34
1PrefaceChemical disinfectants are chemical substances used to control, prevent, or destroy harmful microbes.Workers in hospitals, health care facilities, poultry facilities, abattoirs, food products manufacturingplants, sanitary and similar services, etc. frequently use chemical disinfectants to eradicate thediseases causing microbes.Chemical disinfectants could be hazardous to workers if they are not properly handled. Some of thechemical disinfectants are flammable and explosive. They may react with incompatible chemicalsviolently and generate toxic gases. All chemical disinfectants are, by their very nature, potentiallyharmful or toxic to living organisms. Like other toxic substances, the chemical disinfectants couldbe harmful to humans upon entering the body.However, the chemical disinfectants would be effective and safe tools when handled properly withthe safety measures in place. If misused, they can be hazardous and harmful to workers.This set of Guidance Notes would serve as a reference to facilitate users in identifying the hazardsarising from the use of chemical disinfectants and taking effective safety measures. Users areencouraged to refer to the information provided in these Notes for establishing a chemical safetyprogramme suitable for their working environment. 1
2IntroductionDisinfection is a process in which chemical or physical means is used to control or destroy themicroorganisms that are capable of causing diseases. There are three levels of disinfection1 (i.e.high, intermediate and low level) with respect to the effectiveness of the disinfection.Disinfecting agents are substances used to control or destroy harmful microorganisms such asbacteria, viruses, or fungi. Many disinfectants are non-specific in their action and will act against aspectrum of microorganisms. Chemical disinfectants can be grouped in accordance with theirchemical properties. They work on various modes of action to destroy the microorganisms such asby rupturing the cell wall, denaturing proteins or lipids, oxidation, alkylation, etc. The efficacy of adisinfectant hinges on various factors including concentration, contact duration, temperature, pH,the presence of organic matters and metal ions.Choice of the disinfectant to be used depends on the particular situations. Some of the disinfectantsare adopted because of the wide spectrum of destroying microorganisms in order to achieve effectivedisinfections. Others destroy a smaller range of disease-causing organisms but are preferred becausethe chemical disinfectants are less or non-toxic to human and the level of disinfections required islow. There are disinfectants which possess surfactant effect and are used to clean and disinfect in“one-step” process.Workers in hospitals, health care facilities, poultry facilities, abattoirs, food products manufacturingplants, sanitary and similar services, etc. frequently use chemical disinfectants to destroy diseasescausing microorganisms. Some of the chemical disinfectants are flammable and explosive. Thereare disinfectants that would react with incompatible chemicals violently and generate toxic gasesposing hazards to workers. All chemical disinfectants are, by their very nature, potentially harmful ortoxic to living organisms. Like other toxic substances, the chemical disinfectants can enter the bodythrough several routes, including absorption through skin or mucous membrane, inhalation andingestion. Sometimes a chemical substance can enter through more than one of the routes. However,chemical disinfectants would be effective and safe tools when handled properly with the safetymeasures in place. If misused, they can be hazardous and harmful to workers and the environment.1High-level disinfection destroys all microorganisms, with the exception of high numbers of bacterial spores.Intermediate-level disinfection controls Mycobacterium tuberculosis, vegetative bacteria, most viruses, and most fungi,but does not necessarily destroy bacterial spores.Low-level disinfection destroys most bacteria, some viruses, and some fungi, but it cannot be relied on to destroyresistant microorganisms such as Mycobacterium tuberculosis or bacterial spores. 2
3Chemical Disinfectants ClassesDisinfectants can be divided into classes on the basis of their chemical compositions and eachclass has its characteristics, hazards, toxicities and efficacy against various microorganisms. Theclasses are as follows:3.1AlcoholsAlcohols, usually in the form of 70% isopropyl alcohol or 60 to 80% ethyl alcohol, arecommonly used topical disinfectants. They are effective against bacteria and envelopedviruses. Alcohols are not effective against bacterial spores and non-enveloped viruses.Alcohols are somewhat slow in their germicidal action.3.2AldehydesAldehydes are broad-spectrum disinfectants. The most commonly used agents areformaldehyde and gluteraldehyde. Aldehydes are very effective against bacteria, fungi,viruses, mycobacteria and bacterial spores.3.3Chlorine CompoundsChlorine compounds are considered broad spectrum, being effective against bacteria,enveloped and non-enveloped viruses, mycobacteria and fungi. At high concentrations,chlorine compounds can be sporicidal. The most commonly used agents are chlorinedioxide, sodium hypochlorite (Chlorine Bleach) and calcium hypochlorite.3.4Iodine CompoundsIodine compounds are broad spectrum and considered effective for a variety of bacteria,mycobacteria, fungi and viruses. Tincture of iodine could be used as an antiseptic for skincuts and scrapes. Iodine agents are inactivated by quaternary ammonium compounds andorganic debris. An iodophor is a combination of iodine and a solubilizing agent or carrier;the resulting complex provides a sustained-release reservoir of iodine and releases smallamounts of free iodine in aqueous solution to kill microbes. 3
Chemical Disinfectants Classes3.5PhenolicsThe disinfectants are phenol (carbolic acid) derivatives. They have a characteristic pine-tarodor and turn milky in water. Phenols at 5% concentration are considered bactericidal,tuberculocidal, fungicidal and virucidal for enveloped viruses. They retain more activity inthe presence of organic material than iodine or chlorine-containing disinfectants. Cresols,hexachlorophene, alkyl- and chloro- derivatives and diphenyls are more active than phenolitself.3.6Quaternary Ammonium CompoundsQuaternary ammonium compounds, such as benzalkonium chloride, are generally odourless,colourless, non-irritating, and deodorizing. The compounds have disinfectant effect andsome have detergent action. However, some quaternary ammonium compounds areinactivated in the presence of some soaps or soap residues. Their antibacterial activity isreduced in the presence of organic material. Quaternary ammonium compounds are effectiveagainst bacteria but only and somewhat effective against fungi and viruses.3.7Oxidizing AgentsCommon oxidizing agents are hydrogen peroxide, ozone, peracetic acid and potassiumpermanganate.The hydrogen peroxide used as an antiseptic, is also effective in disinfection of inanimateobjects. It could be sporicidal if operated at high temperatures. Peracetic acid is one of theeffective liquid sporicides and is used widely in disinfection of food processing equipmentand medical instruments because it does not leave toxic residues.Potassium permanganate has broad antimicrobial properties. It is an effective algicide(0.01%) and virucide (1%) for disinfection, but tends to irritate tissues at concentrations 1:10,000. 4
Chemical Disinfectants Classes3.8OthersEthylene oxide has wide use as an disinfecting agent with very broad biocide activity againstmicroorganisms including bacterial spores and viruses. It is a highly flammable chemical.It is toxic, mutagenic and carcinogenic. Chlorhexidine is a biguanide compound, one of thewidely used disinfectants. It is effective against most bacteria and is non-irritating to tissues.Biguanide has a broad antibacterial spectrum, however it is limited in its effectiveness againstviruses and is not sporicidal, mycobactericidal, or fungicidal. 5
4Hazards4.1Overview4.1.1Chemical disinfectants are effective and safe tools for eliminating viruses andmicrobes when used properly. If not, they can be hazardous. The disinfectantscould have dangerous properties that are potentially hazardous to workers, forexample, ethylene oxide is highly flammable and explosive. Chemical disinfectantssuch as the strong oxidizers would generate toxic gaseous products upon reactingwith other chemicals.4.1.2Many of the chemical disinfectants are harmful to workers if the disinfectants areunsafely handled. Some of the chemical disinfectants are irritating to the skin,eyes, and respiratory system. The highly corrosive disinfectants could inflict seriousdamage if they come into contact with the skin or eyes. The airborne disinfectantswould also cause respiratory problems if used in poorly ventilated areas.4.1.3When selecting a disinfectant for a particular use, user should take into considerationthe hazardous properties of the chemical disinfectant. Material Safety Data Sheet(MSDS) for all disinfectants used should be read and understood by all personnel,who will work with the chemicals.4.2Chemical hazards4.2.1Flammability is one of the potential dangers when chemical disinfectants are used.Alcohols are flammable liquids that could be ignited if used near a flame, spark orany ignition source particularly when the alcohols are applied by spraying as mist.Ethylene oxide is a highly flammable and explosive gas that has an explosiveconcentration range of 3% to 100% by volume. Formaldehyde gas, which is givenoff by either liquid formalin or paraformaldehyde powder, has a characteristicpungent odour and is highly flammable. It forms explosive mixtures with air andthe explosive concentrations range from 7% to 73% by volume. Hydrogen peroxidepossesses strong oxidizing properties and spilling high concentration peroxidesolutions on flammable substance can cause an immediate fire. Sodiumhypochlorite in aqueous solutions is not explosive but the anhydrous sodiumhypochlorite becomes an explosive substance. Calcium hypochlorite is notflammable. However, it acts as an oxidizer with combustible materials. 6
Hazards4.2.2Mixing chemical disinfectants with other chemical substances could be hazardous.Chlorine, which is a toxic gas, is rapidly released from sodium hypochlorite solutions(bleaching solutions) if mixed with acids for example, the acidic cleaning agents.In such circumstances, workers would be exposed to high concentrations of chlorinethat could be fatal. Calcium hypochlorite decomposes readily in water or whenheated, releasing oxygen and toxic chlorine. It may react explosively with ammonia,amines, or reducing agents. When formaldehyde is mixed with strong oxidizers,violent reactions could occur. Mixing formaldehyde solution (formalin) withpotassium permanganate could cause an explosion.4.3Health hazards4.3.1Formaldehyde is an effective disinfectant. It is a toxic and carcinogenic chemicaland can cause eye irritation, cough, shortness of breath, skin irritation, chronicbronchitis and exacerbation of asthma. It can also react with chlorine to formanother carcinogen. Ethylene oxide is toxic by inhalation. It is also an irritant tothe skin, eyes, and the respiratory tract. Ethylene oxide may damage the nervoussystem, and the chemical is also a carcinogen.4.3.2Glutaraldehyde is a strong irritant to the skin, eyes, and respiratory system. Contactwith the chemical can cause skin sensitisation, leading to allergic contact dermatitis.Exposure to the chemical may exacerbate asthma. High concentrations ofhypochlorite are irritating to the mucous membranes, eyes and skin. Concentratedhydrogen peroxide solution is corrosive and the domestic-strength peroxidesolutions could cause local burns, irritation of the mucous membranes, eyes andthe skin. Quaternary ammonium compounds might cause mild to severe irritationof the skin and mucous membranes depending on the chemical properties and theconcentration. Allergic reactions can occur to workers handling iodine solutionsand iodophors. Concentrated iodine compounds can be irritating to skin. Phenolsdisinfectants may cause irritation of the skin, local burns, headache, vomiting,diarrhoea, and damage to the kidneys in severe cases. Alcohol disinfectants canbe irritating to the injured skin. Inhalation of concentrated alcohol vapour maycause irritation of the respiratory tract and have effects on the central nervoussystem. 7
5Chemical Safety Programme5.1Overview5.1.1To ensure the safety and health of employees engaged in handling disinfectants, acarefully planned chemical safety programme is essential. The aim of a chemicalsafety programme is to systematically identify and investigate potential hazards inorder to minimize the risk of adverse health and safety effects due to exposure tochemicals in the workplace. In the programme, the chemical hazards of disinfectantsshould be firstly identified. The risks arising from these hazards are assessedtaking account of the work situations and personnel involved. Appropriatepreventive and/or control measures are then set up to eliminate or mitigate therisks, with their effectiveness being regularly monitored and reviewed. Theassociated hazard information and protective measures should be communicatedto all affected employees. The chemical safety programme should also includeother elements like planning of emergency responses and training of employees.5.1.2The chemical safety programme should be organized and integrated into the overallsafety management system of the workplace to facilitate its effectiveimplementation. Employers should deploy adequate manpower and resourcesfor the development, implementation and maintenance of the programme. 8
Chemical Safety Programme5.2Major elements5.2.1A chemical safety programme should include the following major elements:(a)risk assessment – to identify the potential hazards arising from the materialsand processes involving the use of disinfectants and to assess their associatedrisks taking into account the adequacy and effectiveness of existing controlmeasures;(b)safety measures – to adopt and maintain preventive and/or control measuresto eliminate the risks or minimize them to acceptable levels;(c)emergency preparedness – to establish plans and procedures for emergencyresponse;(d)hazard communication – to establish appropriate and effective means todisseminate the safety and health information on the materials and processesto employees via adequate instruction and training; and(e)monitoring and review – to monitor the effectiveness of the adopted safetymeasures with regular review and revision which may also be required forany new requirements or significant changes in the materials or processes.5.2.2Depending on individual situation of the workplace, employers may find it beneficialto include other elements such as inspection, accident investigation and healthsurveillance in the chemical safety programme. 9
6Risk Assessment6.1Overview6.1.1Risk assessment is a process to estimate the level of risk and decide whether therisk is tolerable or acceptable. Before risks can be assessed, the hazards relatedto the process and associated disinfectants have to be identified. The risks arethen estimated in terms of the people who might be involved and their exposure,the likelihood and potential consequences of the identified hazards. Suitable safetymeasures will then be developed and implemented with periodic monitoring andreviews.6.2Factors for consideration in the risk assessment6.2.1Many factors can influence the risk of hazards associated with chemical disinfectantsin the workplace. These include physical, chemical and toxic properties of thedisinfectants, work practices, the nature and duration of the exposure, the effectsof combined exposures, the routes of entry into the human body, and thesusceptibility of the worker.6.2.2It should be noted that many of the chemical disinfectants are proprietary preparedformulations and their chemical components may not be shown in detail on thecontainers. Employers who use the chemical disinfectants should obtain detailedhazard information and user safety precautions from the suppliers.6.2.3Reference should be made to relevant legislation, codes of practice, guidelinesand best trade practices in order to decide on the need and adequacy of safetymeasures. Employers should keep an inventory of all chemical substances in theworkplace, identify whether they are hazardous and ensure that they are handledand stored safely. It is also essential to obtain the Material Safety Data Sheet(MSDS) of the chemical disinfectants from the suppliers, as it contains a wealth ofinformation indispensable for risk assessment, stipulation of safety measures andemergency planning. 10
Risk Assessment6.2.4The risk assessment should be reviewed regularly and whenever there is anyindication to suspect that it is no longer valid or when there has been a significantchange in the circumstances to which the assessment relates. In particular, therisks associated with the processes and chemical disinfectants should be reviewedwhen:(a)there are changes to any of the processes or their scales;(b)there are changes in the materials used; or(c)safer procedures or improved preventive measures become available orreasonably practicable in light of recent technological advancement.6.2.5When assessing airborne exposure, the Code of Practice on Control of Air Impurities(Chemical Substances) in the Workplace issued by the Labour Department shouldbe followed.6.2.6Risk assessment should be performed by competent persons who are wellknowledgeable about the hazards associated with the chemical disinfectants andrelated processes including the physical and chemical changes at each stage ofthe processing work. Specialist or expert advice should be consulted wheneverneeded.6.2.7The Chemical Safety in the Workplace: Guidance Notes on Risk Assessment andFundamentals of Establishing Safety Measures published by the Labour Departmentprovides detailed information about the systematic approaches for conducting riskassessment related to chemical hazards. 11
7Safety Measures7.1Strategy in establishing safety measures7.1.1The primary consideration is to adopt appropriate preventive measures such as byelimination or substitution in order to directly remove the hazards at source. Onmany occasions, a chemical disinfectant or process can be replaced by a saferone that eliminates or minimizes the risks to acceptable level. If such measuresare not possible, segregation of the disinfectants or the processes or other controlmeasures should be taken. The use of personal protective equipment should onlybe considered a supplementary means or as the last resort to minimize workers’exposure to the hazards.7.1.2Safety measures can be realised by engineering and administrative controls.Engineering control measures such as installation of suitable types of ventilationcan eliminate or lower the level of disinfectant in the air at source. Administrativecontrol measures such as by implementation of safe work practices and schedulingof breaks or rotating shifts can limit worker's time spent near the hazard thusreducing their exposure. The adoption of good housekeeping practices could notbe more emphasized when disinfectants are concerned.7.1.3It is desirable to consider safety and health aspects of the materials, processesand equipment at the design or purchase stage. This will save additional expensesand often reduce practical difficulty in subsequent adjustments to accommodatethe safety features. Management should also keep abreast of the up-coming safetyalternatives or devices that are available on the market.7.1.4All safety measures should be documented, for example, in the standard operatingprocedures (SOP), and should be made known to the workers concerned. Theeffectiveness of such measures should be constantly monitored and reviewed toensure adequacy of the adopted safety measures. If any changes are made to theSOP in respect of the use of disinfectants, a fresh risk assessment should beconducted and any amended protective measures should be documented in theSOP accordingly. 12
Safety Measures7.2Substitution/ Elimination7.2.1There are occasions where a hazardous chemical disinfectant could be substitutedby using other less harmful disinfectants to minimize or eliminate risks, for example,ortho-phthalaldehyde (OPA) has been used as glutaraldehyde alternative.7.2.2In addition to chemical disinfectants, heat, radiation or other physical means mayalso be appropriately used to reduce or eliminate microbes. As such, hazardouschemical disinfections process could be replaced by physical methods whereapplicable. Objects could be disinfected effectively using steam under pressure(autoclave), dry heat (flame, baking) or gamma radiation.7.3Engineering control measures7.3.1The primary objective of adopting engineering control is to eliminate or lower therisks at source. Engineering controls include ventilation, enclosure and isolation.7.3.2Ventilation is one of the effective engineering means to prevent accumulation ofvapours of explosive/flammable mixtures or inhalation of toxic gases or vapours inthe workplace. There are two types of ventilation: general dilution ventilation andlocal exhaust ventilation. Whatever the type, ventilation should be used togetherwith other methods of control to strengthen the safety protection. Attention mustbe paid to the relevant environment protection requirements in the discharge ofexhaust air to prevent contamination of the outside environment. Enclosure is analternative means to contain hazardous substance or work process if the substanceand process cannot be eliminated or substituted. Highly toxic chemical could behandled in a closed glove box. Isolation is a safety measure to control exposure tohazards. Worker could be isolated from hazardous working environment byengineering control measures, for example using isolation booth etc. 13
Safety Measures7.4Administrative control measures7.4.1Administrative control measures include arrangement of work schedules andstipulation of safe work practices so that the risk of exposure of individual employeeto chemical disinfectants can be reduced. Employers should ensure that these areincorporated into the management system as far as practicable. Typical safe workprocedures that reduce the worker's exposure to chemical disinfectants shouldinclude the following:(a)ensuring the time spent near the hazard is kept to minimum. Workers shouldnot stay between the work piece and the extraction system during operation;(b)keeping pots or bottles of chemical disinfectants closed when not in use;(c)avoiding skin contact with chemical disinfectants;(d)keeping minimum amount of chemical disinfectants for use in the workplace,usually no more than a half-day’s or one shift’s supply; and(e)7.5adopting general practices of good housekeeping.Personal protective equipment (PPE)7.5.1The primary objective of using PPE is to supplement other control measures byminimizing worker’s risks of exposure to chemical disinfectants through inhalationor skin contact. Being only passive protective measures PPE should not replacepreventive measures and in general, it should be considered as the last resort inrespect of the safety measures outlined in this section.7.5.2Appropriate PPE should be chosen with regard to the hazards and physical natureof the chemical disinfectants and their routes of entry into the human body. TheMSDS information and risk assessment will help determine the PPE requirements.Before and after use, PPE should be inspected for any signs of damage. It shouldbe regularly cleaned and stored in good condition. Contaminated PPE should beproperly treated or disposed of as appropriate, and replacement sets kept readilyavailable. Moreover, as no PPE will give long-term protection, a programme shouldbe in place for its regular replacement.7.5.3Wrongly selected, improperly used or maintained PPE may do more harm thangood as the user may have a false sense of security. Readers should refer toChemical Safety in the Workplace: Guidance Notes on Personal ProtectiveEquipment for Use and Handling of Chemicals for details. 14
Safety MeasuresProtective clothing7.5.4Protective clothing protects the skin or personal clothing from contact with chemicaldisinfectants and prevents spread of contamination. When handling chemicaldisinfectants, such as dispensing and storage, or conducting work processesinvolving chemical disinfectants, employees should always wear suitable protectiveclothing. Protective clothing includes gloves, aprons, gowns and overalls. It isimportant to choose protective clothing made of materials that resist penetrationor damage by the chemical disinfectants involved.7.5.5It is prudent to always check with the suppliers and consult the MSDS of thechemical disinfectants involved.Face and eye protection7.5.6Where there is a reasonably foreseeable risk of eye injury, suitable goggles, eyecupor cover types eye protectors should be worn. Special-purpose goggles may berequired for irritating mist. If protection to the whole face including mouth, noseand eyes is required, face shield should be used.Respiratory protective equipment7.5.7Respiratory protective equipment (RPE) protects workers against exposure to dusts,gases, fumes and vapours, but exposure duration should be kept short.7.5.8RPE should be used to protect the workers where engineering control is notreasonably practicable such as during maintenance work, cleaning, or emergencieswhere hazardous vapour is generated from chemical spillages or inadvertent mixingof incompatible chemicals.7.5.9The choice of RPE depends on the air contaminants concentration, duration ofexposure and physical and chemical nature of the chemical disinfectants. 15
Safety Measures7.5.10The following RPE can protect against airborne chemical contaminants:(a)air purifying respirators – when fitted correctly, most half-face and full-facerespirators equipped with appropriate filters could reduce the exposure toair contaminants by 90% and 98% respectively; many powered air-purifyingrespirators that use battery-operated motor blower to draw air through filtershave similar efficiency.(b)airline respirators – airline respirators supply clean air to the mask, helmet orhood using an airline, and the device could reduce the exposure to aircontaminants by 96% to 99.9%, depending on the type of covering.7.6Precautions during handling and storage7.6.1When selecting a disinfectant, its health effects on human, the extent of exposure,and the appropriate health and safety precautions should be considered. Differentdisinfectants should not be mixed or used in combination without properassessment of the risks and potential hazardous reactions, and taking proper safetymeasures. It should be noted that chemical disinfectants must not mix withincompatible chemicals. For example, it should never mix bleach with ammonia orwith acidic products including drain, toilet bowl, and metal cleaners. Toxic fumes(strong enough to be fatal) will result. If necessary, use detergents first and rinsethoroughly with water before using bleach for disinfection. It is also known thatmixing peroxide disinfectants with cleaner agents containing acids or alkalis couldform hazardous explosive mixtures.7.6.2Full-strength concentrates are seldom used for disinfection purposes. Workingconcentrations should not exceed manufacturers’ specifications as overdosingincreases the risk to operators, in addition to being wasteful, and may damageplant and equipment.7.6.3Diluting disinfectant concentrates by manually tipping drums is a poor practice; itwill inevitably cause a spill risk and sh
5 CHEMICAL SAFETY PROGRAMME 8 5.1 Overview 8 5.2 Major elements 9 6 RISK ASSESSMENT 10 6.1 Overview 10 6.2 Factors for consideration in the risk assessment 10 7 SAFETY MEASURES 12 7.1 Strategy in establishing safety measures 12 7.2 Substitution/ Elimination 13 7.3 Engineering control measures 13 7.4 Administrative control measures 14
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Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. Crawford M., Marsh D. The driving force : food in human evolution and the future.
Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.
