Element 5: Physical and psychological health

5.1 Noise

Noise can cause temporary or permanent hearing loss, ringing in the ears (tinnitus) and, indirectly, stress, poor communication and accidents. Hearing damage is gradual and painless, so workers often do not notice it until it is permanent.

Useful terms: sound pressure (the pressure variation of the sound wave), intensity (the energy flow), frequency (pitch, measured in hertz), the decibel scale (logarithmic, so a small rise in dB is a large rise in energy), dB(A) (weighted to match the human ear, used for most workplace measurement) and dB(C) (used for peak or very loud sounds).

A common rough prompt for noise problems is whether people have to raise their voices to hold a normal conversation when about two metres apart. This is only a prompt to investigate and is not a measurement.

Whether exposure must be assessed, and the exposure limits, come from recognised standards that apply where you work; measurements are compared with those limits. Exposure is judged over a working day or week, not by one reading at one machine.

Basic controls follow the hierarchy: eliminate or reduce noise at source; then isolation (enclosures), absorption, insulation, damping and silencing. Hearing protection is the last resort.

Types are earplugs and earmuffs; they must be chosen for the noise level (attenuation), fitted properly, worn all the time, kept clean and replaced when worn. Their limits include discomfort, poor fit, and difficulty hearing warnings. Health surveillance (hearing tests) detects early damage.

Key terms

• dB(A): Decibel level weighted to the sensitivity of the human ear.
• Attenuation: The reduction in noise level provided by hearing protection.

Study tip: Hearing protection is never the first answer to a noise problem.

Practice questions for 5.1

5.2 Vibration

Hand-arm vibration (from tools such as drills, grinders and breakers) can cause hand-arm vibration syndrome, which includes damage to blood vessels, nerves and joints in the hands (for example white finger). Whole-body vibration (from vehicles and machines) is linked to back pain.

Exposure should be assessed when vibrating tools are used regularly or for long periods. Measurements are compared with limits set by recognised standards.

Controls include: using different working methods (mechanisation where possible); low-vibration tools; choosing suitable equipment for the job; maintenance programmes so that tools stay in good condition; limiting exposure time with rotas and planning to avoid long periods of use; and suitable PPE such as gloves that keep hands warm. Health surveillance has a role.

Study tip: Time limits and rotas are a control, not a replacement for better tools.

Practice questions for 5.2

5.3 Radiation

Non-ionising radiation has less energy and does not break up atoms. It includes ultraviolet light (burns, skin cancer), infrared (heat burns), visible light and lasers (eye damage), microwaves and radio waves (heating of tissue). Sources include welding arcs, lasers, furnaces and sunlight for outdoor workers.

Ionising radiation has enough energy to break up atoms and damage cells. It includes alpha, beta, gamma rays, X-rays and neutrons, and radon gas, which comes from the ground and can build up in buildings. It can cause radiation burns, cancer and genetic damage. Sources include X-ray machines, industrial gauges and radioactive materials.

Basic controls: eliminate or reduce use; time (limit time exposed), distance (stay as far away as possible) and shielding (put a barrier between the person and the source); keep radioactive sources locked and labelled; restrict access to controlled areas.

A competent person (such as a radiation protection adviser or supervisor) advises and oversees the strategy. Monitoring (dose badges and area monitors) and health surveillance are used for classified workers.

Key terms

• Ionising radiation: Radiation with enough energy to damage atoms and cells, such as X-rays and gamma rays.

Study tip: Remember time, distance and shielding.

Practice questions for 5.3

5.4 Mental ill-health

Mental ill-health is common and costs organisations through absence and reduced performance. Common conditions include stress, depression, anxiety and panic attacks, and post-traumatic stress disorder (PTSD). Signs can include changes in behaviour, mood, attendance, quality of work, and relationships with colleagues.

The HSE Management Standards describe six areas that cause work-related stress when they are poorly managed:

• Demands (workload and work patterns).
• Control (how much say people have).
• Support (from managers and colleagues).
• Relationships (including bullying).
• Role (do people understand their role?).
• Change (how it is managed and communicated).

Controls address these six areas, for example by matching workloads to abilities and giving workers a say in how they work.

The home-work interface also matters: commuting, childcare, relocation and caring for vulnerable relatives can add pressure. Most people with mental ill-health can continue to work effectively with appropriate support.

Key terms

• Management Standards: The six areas of work design that affect stress: demands, control, support, relationships, role and change.

Study tip: Learn the six standards in order. They give you a ready checklist.

Practice questions for 5.4

5.5 Violence at work

Violence at work includes physical violence, psychological abuse, verbal abuse and bullying. It harms workers' physical and mental health and can lead to absence, staff turnover and damage to the organisation's reputation.

Higher risk jobs include police, fire and medical staff, social workers, customer service workers, lone workers, people dealing with others under the influence of drugs or alcohol, and those who handle money or valuables.

Controls include: a clear policy and zero tolerance message; risk assessment of tasks and places; physical design (counters, barriers, lighting, alarms, CCTV); safe systems of work (not working alone, meeting arrangements, cashless methods); training in conflict management; reporting and support after incidents.

Study tip: Violence includes verbal abuse and bullying, not just physical attacks.

Practice questions for 5.5

5.6 Substance abuse at work

Alcohol, legal and illegal drugs and solvents can affect judgement, coordination and reaction time. They increase the risk of incidents, absence and poor performance, and they put colleagues and others at risk. Legal medicines can also affect safety, for example if they cause drowsiness.

Controls include:

• A clear policy that covers what is prohibited and what help is available
• Information and training for managers and workers
• Checks and testing where they are justified, for example for safety critical roles and following incidents
• Support and confidential help for people with a problem, with disciplinary action as a last resort

Study tip: A policy that includes support gets more cooperation than one that only threatens discipline.

Practice questions for 5.6