OCCUPATIONAL

SAFETY & HEALTH

MANAGEMENT SYSTEM
HANDBOOK
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OSHMS Handbook
 INDEX
Sl No Contents Page No
1 Introduction to OSHMS 01
2 OSH Policy 03
3 Elements of OSHMS 04
4 Fire & Safety / CODE RED 14
5 HAZMAT Management / CODE BROWN 16
6 Infection Control 20
7 Personal Protective Equipment 22
8 Radiation safety 23
9 Manual Handling 28
10 Ergonomics 30
11 Ladder Safety 31
12 Safety Signage’s 32
13 Definitions 33
14 OSHAD Code of Practices 37
 1
1. OCCUPATIONAL SAFETY & HEALTH MANAGEMENT SYSTEM
Q: What is OSHMS?
Occupational, Safety and Health Management System (OSHMS) is a
management system that takes into consideration of all aspects relat-
ed to workplace safety and the health and safety of the workers.

Q: What is OSHAD?

Abu Dhabi Occupational Safety and Health

Center (OSHAD) is the regulatory body which
monitors the implementation of OSHMS
standards and it’s legal requirement with in
Abu Dhabi emirate only.

Q: What is the aim of OSHAD?

Pro

Red

uc To provide a Safe work place for

de
vi

standards eH
azards staff and to reduce work related
Objectives injuries and illness.
of OSHAD
Healthy &

Continuou

Sa si
ce

nt

a mproveme
fe workpl
 2

Q: What is the Administration Hierarchy of OSHAD?

Competent Authority
Abu Dhabi OSH Center (OSHAD)

Government Entities Delegated by

Government
OSHAD to follow up implementation in
Entities
sectors (Sector Regulatory Authorities)

Energy Transport Tourism & Construction Industry

Culture
(ADWEA) DOT TCA-AD DMA IDB

Health Waste Food Eduction Commercial

HAAD CWD-AD ADFCA ADEC DMA

NMC ROYAL HOSPITAL

Q: To which Sector Regulatory Authority (SRA), we are reporting to?

• DOH (Department of Health, Abu Dhabi)

• Note: DOH is the Sector Regulatory Authority
(SRA) for all Healthcare facilities

* HAAD has been renamed into

DOH (Department of Health, Abu Dhabi) ! Important
 3
2. OSH POLICY
Q: OSH policy statement of NMCRH is approved and authorized by?
• Hospital General Manager

OCCUPATIONAL SAFETY AND HEALTH POLICY

OSH VISION
All employees, patients, families, visitors and contractors of NMC Royal Hospital are working,
providing or receiving medical services in safe and healthy environment.

OSH MISSION
To prevent and control occupational health, safety, and infection-control related incidents.

MANAGEMENT COMMITMENT
The Management of NMC Royal Hospital, Khalifa city, is strongly committed to achieving and
maintaining a safe healthcare environment, preventing injuries and illness, preserving and
enhancing the health and wellbeing of its employee, patients, visitors and contractors by
implementing an Occupational Safety and Health Management System (OSHMS).

We shall achieve the same through identification and management of Occupational Safety and
Health risk, adopting and adhering to inflection control and patient safety principles and by
promoting a culture of safety.

! Important
We shall comply with the Abu Dhabi Occupational Safety and Health System Framework
(OSHAD-SF) and Health Authority of Abu Dhabi (HAAD) standards, all Occupational Safety and
Health legislation relevant to the Health sector of Abu Dhabi and any other standards the NMC
Royal Hospital subscribes to.

This policy provides the framework for setting, monitoring and reviewing occupational safety
and health objectives and targets consistent with the commitment to continually improve the
hospital's OSH performance.

We will ensure to provide appropriate OSH resources to effectively develop, implement and
monitor implementation of OSHMS as per the OSHAD-SF and health sector requirements.

This policy will be displayed in all public areas in the hospital, Intranet portal and
communicated to all employees, patients, contractors working for or on behalf of NMC Royal
Hospital, visitors and public.

This policy will be reviewed annually and upon the changes of any work flow, processes in the
hospital and new regulations, laws that are related to the OSH.

‫ ﺑﻴﺘﺮ ﺳﻼﺑﻴﺮﺗﺲ‬:‫اﻟﺴﻴﺪ‬
‫ﻣﺪﻳﺮ ﻋﺎم اﻟﻤﺴﺘﺸﻔﻰ‬
‫ﻣﺴﺘﺸﻔﻰ ان ام ﺳﻲ روﻳﺎل ﻓﻲ ﻣﺪﻳﻨﺔ ﺧﻠﻴﻔﺔ أﺑﻮ ﻇﺒﻲ‬
Date: 15/04/2017
Ver-002 Mr. Pieter Slabberts,
HOSPITAL GENERAL MANAGER: NMCRH: KC

* Make sure that OSH Policy is Displayed in your department

* All staff has to be aware of OSH Policy
* Make sure that you know the exact location of OSH
policy in Intranet portal
 4
3. Elements of OSHMS

Q: What all are the different elements of OSHMS?
• Element 01 - Roles, Responsibilities and Self-Regulation
• Element 02 - Risk Management
• Element 03 - Management of Contractors
• Element 04 - Communication & Consultation
• Element 05 - Training & Competency
• Element 06 - Emergency Management
• Element 07 - Monitoring, Investigation & Reporting
• Element 08 - Audit & Inspection
• Element 09 - Compliance & Management Review
Element 1 - Roles, Responsibilities and Self-Regulation
Q: What is your OSH Roles & Responsibility as a staff?
• Comply with reasonable OSH Instructions and safe working
procedures.
• Use of appropriate Personal protective equipment
and safety systems.
! Important

• Be familiar with Emergency and Evacuation procedures.

• Not willfully or recklessly endanger anyone’s health & safety.
• Assist with the preparation of risk assessments.
• Report OSH Hazards, incidents, Near misses and issues.
• Attend all applicable OSH Trainings, awareness programs
and mock drills.
Q: Who is responsible for our workplace Health & Safety?
• EVERYONE
Element 2 - Risk Management:
Q: What is the meaning of the term Hazard?
• A hazard is anything (any equipment, activity or process) that can
cause a potential harm.
Q: What is the meaning of the term Hazard?
• A hazard is anything (any equipment, activity or process) that can
cause a potential harm. Eg:
 5
Type of Hazard Example
Physical Noise, Vibration, Heat etc.
Chemical Dusts, fibers, fumes, gases etc.

Biological hazard Bacteria, viruses, fungus etc.

Psycho-Social hazard Stress, Violence at work, Substance misuse etc

Ergonomic hazard Posture, workplace layout etc
Q: What is the meaning of the term Risk?
• Risk is the probability of a hazardous event occurring, and severity of the event.
• Risk = Probability * Severity (P * S)
Q: What are the five steps of Risk Assessment?
• Identify the hazard (for Each activities).
• Identify the people who might be harmed and how.
• Evaluate the risk and decide on control measurer.
• Record the Significant findings and Implement them.
• Review and Update as Necessary.
Q: Which risk matrix is used for risk assessment as per OSHAD standard?
• Risk Assessment Matrix (5X5)

Consequence
Probability Insignificant Minor Moderate Major Catastrophic
(1) (2) (3) (4) (5)

Rare (1) 1 2 3 4 5
Possible (2) 2 4 6 8 10
Likely (3) 3 6 9 12 15
Often (4) 4 8 12 16 20
Frequently (5) 5 10 15 20 25

Risk Rating Risk Category Risk Rating Risk Category

15 - 25 Extreme Risk 4-6 Moderate Risk

8 - 12 High Risk 1-3 Low Risk
 6
Q: Hierarchy of control measures that we have

to adopt in order to reduce the risk?

Most
effective Hierarchy of Controls
! Important
Elimination Physically remove
The hazard

Sustitution Replace the hazard

Engineering
Isolate people from
Controls
the hazard
Administrative
Change the way
Controls
people work
PPE Protect the worker
with personal
Least protective
effective Equipment

How to access and control the risk?

Activity Hazard Risk Control Measures
Medication Sharps, Improper handling Sharp box availability,
adminis- Needles leads to cut injury, training and policy on
tration, IV infection, diseases safe handling of sharps
cannulation

Handling of Electricity Risk of electrocu- Proper usage of elec-

Electrical tion, fire trical equipment, safety
Equipment’s inspection & PPM

Q: When you have to review your Risk register?

• After an accident, incident or near miss

• when introducing new equipment, materials, substances,
machinery or plants into the workplace;
• When legislative obligations change (including regulations and
DOH policies and standards);
• On third party suggestions (e.g. DOH, FANR, HAAD OSHMS,
Contractors etc.)
• Otherwise Annually
 7
Hazard Identification and Risk Assessment - Sample
Activity Hazards
Handling of chemicals • Release of Hazardous material, Chemical spill.
at workplace • Accidental Contact to skin / Eye.
• Exposure to Dust from Powder form of
chemicals.
• Exposure to Fumes from Evaporation of
chemicals.
• Exposure to Mist in air by spraying chemicals.
• Exposure to Vapour / Gases from Liquid forms
of chemicals.
• Exposure to Flammable / Volatile substances
 8

Hazard Identification and Risk Assessment - Sample
Risks Control measures
Physicochemical Elimination
Effects • Eliminate the Chemical where reasonably practicable.
Explosives Substitution
Flammable & Com- • Substitution of the Chemicals with the less hazardous
bustible Substances (e.g. Highly Hazardous to Less hazardous
• Aerosols chemicals)
• Gasses Under Engineering control
Pressures • Enclosing the process where possible.
Health Effects • Provision of Flammable Storage cabinets for flammability
• Acute Toxicity and volatility.
• Skin Corrosion / • Use of general dilution ventilation and Local Exhaust
Irritant Ventilation to control airborne concentrations.
• Serious Eye damage
• Periodical Maintenance of Ventilation systems.
/ eye Irritant
• Respiratory or Skin • Restricted Access to Storage area/ Authorised person
Sensitising only, non-essential personnel excluded.
• Mutagenicity • Provision of Eyewash Station and Shower station.
• Carcinogenicity Administrative control
• Reproductive toxicity • Reducing numbers of people exposed and their level/
• Specific target duration of exposure to a minimum.
organ toxicity • Minimise inventory of Chemicals held at the workplace.
• Asthmagen • Prohibiting eating/drinking/smoking in contaminated areas.
• Aspiration hazard • Medical surveillance for employees.
Environmental Effects • Providing Employees with information, instruction and
• Toxic to the Aquatic training on the risks associated with the Chemical Handling.
Environment • Emergency procedures to be followed in-case of spillage
• Air pollution / Air (CODE BROWN).
Contamination • Providing appropriate warning signs.
affects the air we • Maintaining of all chemicals Material Safety Data Sheet
breathe. (MSDS) at workplace.
• Land Contamination • All Primary / Secondary chemicals would have to be
in case of large spill correctly labelled (NFPA)
• Hazardous to the • Carrying out regular atmospheric monitoring (e.g. Air
ozone layer Quality)
Personal Protective Equipments-
• The provision and use of respiratory protective equipment
/face-fit testing where necessary.
• The provision of Chemical resistant gloves, goggles and
face shields as a protection against Chemical splashes
 9
Element 3 - Management of Contractors:
Q: Name out some of the contractors for NMCRH?
• Housekeeping
• Security
• Chemical waste Collection
Note:
For any major modification works in your department, make sure
that they are having a valid work permit.
Element 4 - Communication & Consultation:
Q: How is OSHMS information’s communicated to staff?
• Through E Mails/ Circulars
• Signages/Posters/Display Screens
• Training
• Intranet portal
• Notice boards etc
Q: How OSH consultation takes place in our facility?
• Through OSH Committee
• Through departmental in charges/ Safety facilitators
• Direct consultation with staff (during risk assessment, incident
investigation etc)
Q: Meeting frequency of OSH Committee?
• Quarterly
Element 5 - Training & Competency:
Q: Have you attended the following mandatory trainings and
how frequently?
• Fire & Safety Training (Half Yearly)
• Hazmat Management (Yearly)
• Emergency Management (Yearly)
• OSHMS awareness (Yearly)
• Emergency drills
 10
Element 6 - Emergency Management:

Q: What all are the different Emergency codes used in our facility?
• There are total of 12 emergency codes as mentioned below:

Emergency code:

Red: Fire/Smoke
Green: Evacuation
Blue: Medical Emergency
Yellow: Missing Patient

Amber: Missing Child ! Important

Orange: Mass Casualty incident
Brown: Hazardous Material Release
White: Violence/ Aggressive Behavior

Gold: Utility Failure

Grey: Adverse Weather Condition
Silver: Weapon / Hostage

Black: Bomb Threat

Dial 14111 & Inform

Incident & location: Room/ Department/ Floor

Q: What is the Emergency contact no in NMCRH?

• 14111 (Internal call center)

 11
Q: Different Emergency Contact no in Abu Dhabi?

Abu Dhabi Authorities Emergency Contact

Abu Dhabi Police (Help desk) 999
Ambulance 998 or 999
Fire 997
Emergency and Disaster Management 02 419 3666 or
Operations Centre – HAAD 02 419 3660
Water and Electricity 991 or 992
Abu Dhabi OSH Centre 02 693 4747
Department of Health, Abu Dhabi (DOH) 02 419 3666

Element 7 - Monitoring, Investigation & Reporting:

Q: What all are the OSH KPIs that we are monitoring and
reporting to DOH through electronic - system?

• Total no of OSH Incidents and near misses

• Average no of OSH Training hours per Employee
• OSH departmental resources
• Amount of Non- Hazardous waste generated
• Amount of Hazardous waste generated ! Important
• No of Environmental monitoring activities
• Total no of Healthcare Associated Infections etc

Q: What is meant by an incident?

• Incident (OSH) is an event or chain of events which has caused

or could have caused fatality, injury, illness and/or damage to
assets, entity reputation or third parties.
 12

Q: What all are the different types of OSH incidents?
• Lost Time Injury; (Need to report to DOH within 3 days)
- Fatality; (Need to report to DOH within 24 Hrs)
- Permanent Total Disability;
- Permanent Partial Disability; and
- Lost Workday Case;
• Serious Injury; (Need to report to DOH within 3 days)
• Serious Occupational Illness / Disease; (Need to report to
DOH within 3 days)
• Serious Dangerous Occurrence; (Need to report to DOH
within 3 days)
• Restricted Work Case;
• Medical Treatment Case;
• First Aid Injury;
• Equipment / Property Damage; and
• Near Miss
Q: What is meant by near miss?
• A near miss is an unplanned, undesired event that did not result
in injury, illness, or damage – but had the potential to do so. All
the near misses are to be reported through Sapphire.

! Important
 13
Element 8 - Audit & Inspection:
Q: How often an OSH Audit has been carried out?

• Internal Audit – 3 Times a year

• External Audit – Once in a year by a Third party
• DOH Audit (As notified by DOH)

Q: How often an OSHMS Inspection has been carried out?

• Internal Inspection – By departmental safety facilitators and

safety officers on monthly basis
• DOH Inspections (As notified by DOH-anytime)
Element 9 - Compliance & Management Review:

Q: What all are the different Legal requirement that we need to

have compliance?

• Decree No (42) of 2009 concerning AD-EHSMS

• OSHAD manual – Ver 3.1 March 2017
• Health Sector EHSMS Requirements – Ver 2.1 , June 2015
• Federal Environmental Law (24) of 1999
• FANR Regulation No (24) Radiation safety
• Federal Law (21) of 2005 for waste management
• UAE Fire & Safety Code of practices
Q: What all are the points to be discussed in management
Review meeting?

• Review of OSHMS by EHS staff;

• Status of action on previous OSH Management system review
results;
• The adequacy of resources for maintaining an effective EHS
Management system;
• The results of internal OSHMS audits and external audits and
action on audit findings;
 14
• Risk management program;

• OSH performance against targets and objectives;
• Changes to legal and other requirements and evaluation
of compliance;
• Other changes that impact the organization;
• Relevant communications and complaints from and to external
interested parties
• OSH incidents, investigations, non-conformances and
corrective and preventative actions; and
• Recommendations for continual improvement
• Miscellaneous items

Q: How often an OSHMS Management review has been carried out?

• Yearly once

4. FIRE & SAFETY / CODE RED

Q: What is Fire?
• It’s a chemical reaction comprising of 3 elements resulting in
emission of Heat, light & smoke.

Q: What is Fire Triangle?

• The fire is illustrated as fire triangle

EN

HE
YG

which represents each side as follows:

AT
OX

a. Heat,
FUEL
b. Fuel &
c. Oxygen

Q: What are the different classes & their preventive measures?

If any of the three elements are removed, the fire is extinguished.
 15
Classes Prevention & Precaution
of Fire

Class A (Ordinary • Good Housekeeping.

combustible materials • No Smoking
like paper, wood etc)
• No open flames

Class B (Flammable • Proper Storage in Hazmat Cupboard

liquids like kerosene, • Use flammable liquids only in wel
acetone etc) ventilated areas.

Class C (Electrical fire) • Check any electrical equipment that

smells strange.

! Important • Prevent Overheating/overloading of

Electrical Equipment
• Proper maintenance of equipment’s
Class K (Kitchen fire) • Prevent overheating and spilling of the
cooking oils
• Safe storage away from heat source

Q: What are the different alarming systems available in case

of fire incident?

• MCP Manual Call point - Break the glass with thumb

• Call 14111 – Public Address System
• Shout CODE RED

Q: What to do in case of FIRE?

! Important
• Follow ‘RACE’
• Rescue anyone in the immediate area of the fire
• Alarm by calling 14111 and break manual call point
• Contain the fire- close doors and windows in the immediate fire
area but do not lock them. This will help to confine the smoke and
fire to one area. Oxygen line shut down…
• Extinguish the fire with the proper fire extinguisher/
Evacuate (CODE GREEN)
 16
Q: How many types of fire extinguishers are there in our facility?

• Carbon Dioxide (CO2) – Recommended for electrical fires
• Dry Chemical Powder (DCP) – For all kinds of fire
Q: How to operate fire extinguisher?
Remember the acronym PASS

Q: How will you evacuate in case of an emergency? – CODE GREEN

- Always evacuate through the nearest emergency exit. We follow 3
types of emergency evacuation.
- Horizontal evacuation (Evacuate within the same floor affected
zone to safer zone up on instruction)
- Vertical evacuation (Evacuate one or two floor(s) down from
affected floor to safer floor up on Announcement)
- Total evacuation (Evacuate form Building up on Announcement)
Evacuate through nearest Available EXIT & Proceed to Designated
ASSEMBLY POINT
5. HAZMAT MANAGEMENT / CODE BROWN
Q: What is meant by Hazmat?
• Any solid, liquid or gaseous materials having
properties that are harmful to human health or
severely affecting the environment, such as
materials that are toxic, explosive, flammable or
emitting ionizing radiation.
Any solid, liquid
or gaseous materials
having properties that are
harmful to human health or
severely affecting the
environment, such as
materials that are toxic,
explosive, flammable or
emitting ionizing radiation.

Any solid, liquid

or gaseous materials

• Eg: Chemicals, Products containing chemicals,

having properties that are
harmful to human health or
severely affecting the
environment, such as
materials that are toxic,
explosive, flammable or
emitting ionizing radiation.

Cleaning agents, Infectious wastes etc.

 17
Q: What all are the Hazards/risks related to Hazmat?
• Health hazards: The health effects can be acute or chronic:
- Acute Effects: it can immediately harm a person’s health upon
single contact with a chemical / Infectious waste
Eg:- headaches, nausea or vomiting and skin corrosion
- Chronic Effects: adverse effect develops on repeated/long term
exposure with a chemical / Infectious waste.
Eg:- asthma, dermatitis, nerve damage or cancer
• Physical hazards: can often result in injury to people and/or damage
to property as a result of the intrinsic physical properties.
• Environmental risks: On release to environment, may damage
environment
Q: How to recognize a hazardous chemical?
• Read labels on containers
• Pay attention to posted warning signs (eg. Radiation warning,
Bio Hazard, Pressure Vessel signages etc.)
• Read Material Safety Data Sheet (MSDS)

Q: What is MSDS? ! Important

• Material Safety Data Sheet

Q: What all information we can find in MSDS?

• All the following information we can get from MSDS:

Section 1 - Chemical Product and Company Identification
Section 2 - Composition/Information on Ingredients
Section 3 - Hazards Identification
Section 4 - First Aid Measures
Section 5 - Fire Fighting Measures
Section 6 - Accidental Release Measures
Section 7 - Handling and Storage
Section 8 - Exposure Control/Personal Protection
 18
Section 9 - Physical and Chemical Properties

Section 10 - Stability and Reactivity
Section 11 - Toxicological Information
Section 12 - Ecological Information
Section 13 - Disposal Considerations
Section 14 - Transport Information
Section 15 - Regulatory Information
Section 16 - Other Information

Q: What system we are following for labelling of Hazardous

chemicals?

• NFPA labeling system

• NFPA – National Fire Protection Association (NFPA 704 Standard)

Health Hazard Fire Hazard

Hazard Rating Flash points:
4 Deadly 4 Below 73° F
3 Extreme Danger 3 Below 100° F
2 Hazardous 2 Below 200° F
1 Slightly Hazardous 1 Above 200° F
0 Will not burn
0 Normal Material

Specific Hazard
OX Oxidizer Instability
ALX Alkaline 4 May Detonate
W Use no water 3 Shock+Heat may
SA Simple Asphydant Detonate
ACID Acid 2 Violent chemical
COR Corrosive change
Radioactive 1 Unstable if heated
0 Stable
 19
Q: What all are the different pictograms/symbols used for
identification of chemicals?

Exploding bomb Flame Flame over circle

(for explosion or (for fire (for oxidizing
reactivity hazards) hazards) hazards)

Gas cylinder Crossion Skull and

(for gasses under (for corrosive Crossbones
pressure) damage to metals, (Can cause death
as well as skin, or toxically with
eyes) short exposure to
small amounts)

Health Hazard Exclamation mark Environment*

(May cause or (May cause less (May cause damage
suspected of serious health to the aquatic
causing serious effects or damage environment)
health effects) the ozone layer*)

Biohazardous infectious Materials

(For organisms or tozins that can cause diseases in people or animals)

Q: What to do in case of Chemical spills?

If Spill is more than 1 Liter:

• Call 14111 and activate Code Brown
• Mark the area with Danger No Entry sign/seal the area
! Important
• Contain the area with large sponges
• Check MSDS of the chemical and type hazard
• Safety Officers to rush with HAZMAT team
• Neutralizing with neutralizer
• Cleaning up process by HK team
• Mark the waste as “Chemical
Hazard waste” put in the Yellow bag
• Proper disposal
• Incident Report
 20
6. INFECTION CONTROL

Hand hygiene

Q: What is meant by Hand hygiene?

• Hand hygiene is intended to decrease colonization with transient flora.
This aim can be achieved through hand washing or hand disinfection.
Q: The five moments for hand hygiene are as follows:
• Before patient contact
• Before aseptic task
• After body fluid exposure risk
• After patient contact
• After contact with patient surroundings
Q: Hand washing Technique?

0 1 2

Wet hands with water; Apply enough soap to cover Rub hands palm to palm;
all hand surfaces;

3 4 5

Right palm over left dorsum with Palm to palm with fingers interlaced; Backs of fingers to opposing palms
interlaced fingers and vice versa; with fingers interlocked;

6 7 8

Rotational rubbing of left thumb Rotational rubbing, backwards and Rinse hands with water;
clasped in right palm and vice versa; forwards with clasped fingers of right
hand in left palm and vice versa;

9 10 11

Dry hands thoroughly Use towel to turn off faucet; Your hands are now safe.
with a single use towel;
 21
Q: Duration of Hand rubbing technique?
• 20-30 Sec

Q: Duration of Hand Washing technique?

• 40-60 Sec
Waste Management

Q: What all are the different types of waste generated in our facility?
Class Color Code for Disposal
(Disposed through licensed contractor)

General Waste Black

Medical Waste Yellow (marked as Biohazard Infectious waste)

Histopathological waste RED (marked as Biohazard Infectious waste)

Chemical Waste Handover to HK

Pharmaceutical waste Handover to the IP Pharmacy

Handling of Sharps
Q: What all are the precautions to be taken while handling the Sharps?
• Needles and syringes shall be discarded as a single unit.
• Needles should NOT be purposely recapped by
hand, bent, disassembled or cut before use or disposal.
• Used disposable needles and syringes shall be
placed in the Puncture resistant, waterproof and
leak-proof sharps boxes designated for this purpose.
• Sharp containers must never be filled above the
Maximum Fill line, three-quarters full.
• Recapping of needles should be avoided where
at all possible; when it is ABSOLUTELY
NECESSARY (e.g. because there is no sharps’
container available for disposal, etc.) needles shall
be recapped using the “scoop method”
 22
Needle Stick Injuries

Q: What to do in case of Needle Stick Injury?

• Wash the area under running water with soap.

• Inform the Supervisor and ICN immediately.
• Consult the doctor and do the blood tests (HIV, ! Important

Hepatitis B & C).

• If you are aware of the patient/source of needle, then do the same
tests for patient also.
• If patient is refused to do the test, take the refusal consent.
• Report the incident in Sapphire.
• Needle stick injury / Blood & body fluid exposure form has to be filled
and sent to the Infection control nurse.
• Do the follow-up as needed.

7. PERSONAL PROTECTIVE EQUIPMENT (PPE)

Q: What all are the different types of PPEs used in our hospital?

PPE Uses
Masks Surgical masks provide barrier protection
against droplets including large respiratory
particles.

N95 Filters of airborne particles (Eg: TB)

Mask

Protective Eye When there is a possibility of being splashed /

wear (Goggles) contacted with blood, body fluids, secretions or
excretions.

Gloves Contact with blood, body fluids, secretions,

excretions, mucous membranes, non-intact skin or
surfaces soiled with visible blood or body fluids and
contaminated equipment and articles.
 23
Apron/Gown Any time that clothing is likely to be soiled by
splattering of blood, body fluids, secretion and
excretions.

PPEs Used for Engineering related activities

SAFETY HELMET

EYE PROTECTION EAR PROTECTION

PROTECTIVE HIGH VISIBILITY

OVERALLS CLOTHING

Full body harness

with tag line
should be used for
SAFETY PROTECTIVE works at a height
FOOTWEAR GLOVES
of 2 - 4 mtrs

8. Radiation Safety
Q: What all are the different types of radiations?

• Ionizing radiation – It is a type of radiation that

is able to disrupt atoms and molecules on
which they pass through, giving rise to ions and free
radicals. Eg: X-rays, alpha particles, beta particles etc.
• Non-ionizing radiation - They are electromagnetic waves incapable of
producing ions while passing through matter, due to their lower energy.
Eg for sources: Lasers, UV rays, Microwaves, Visible light etc
 24

Q: What is the basic radiation protection principle followed?

TIME DISTANCE SHIELDING

Less time spent near Great distance from Behind shielding from
source - less radiation source - less radiation source - less radiation
received received received

X -Ray

Q: Main departments dealing with X-rays in our hospital?

• Radiology Dept
• Dental
• Cath lab
• Urology
• Operation Theatre

Q: What all are the health effects & risks associated with X- rays?

• Acute effects (Deterministic effects) – are predictable and

will not occur below a threshold level. e.g. include:
- Nausea & vomiting
- Hair loss
- skin burns
- Central nervous system impairment
- Cataract etc.

• Chronic (Stochastic effects) – the exact outcome is not predictable,

but the risk is greater at high dose. E.g. include:
- Cancer
- DNA damage and mutation
- Hereditary effects etc
 25
Q: How can we measure the radiation exposure?

• Employees has to wear TLD dosimeter for the

measurement of radiation which has to be monitored
on monthly basis. !
Important

• If the Dosimeter dose results of a worker is above

0.25mSv (milliSievert)/month, Radiation safety officer has to
investigate the circumstances and determine the measures to be
taken to avoid a recurrence.
Q: What are the control measures for the safe handling of X – Rays?

• Engineering Control:
- Proper shielding of the control panel areas with lead glass and
lead lined doors.

• Administrative Control:
- Following the appropriate technical parameters for all
radiography procedures so as to ensure maximum safety for the
workers by ALARP principles.
- Radiation safety programs are conducted for all radiographers
and staff involving in the Radiation unit for awareness.
- Provides Instadose radiation badges to all staff for monitoring the
radiation exposure. Also report the damage of DIS badge or loss
of badge to the radiation protection officer for appropriate actions.
- Proper signage in the radiation areas and unauthorized entry restricted.

• Use of PPEs:
- Provision of Lead
aprons and required PPE’s.
 26
Laser

Q: Main departments dealing with Laser?
• Dermatology (class IV)
• Ophthalmology (class IV)
• Dental
• Physiotherapy
• Operation Theatre (class IV)
Q: What all are the health effects & hazards associated with X- rays?
• The hazards of health effects and hazards associated with laser
depends on different laser classes and is as follows:

Laser Class Associated hazards

Class 1 & 1M Safe, due to very low radiation emission

Class 2 & 2M Possible eye damage

Class 3b Eye hazard if magnifying viewing instruments are

used to view them

Class 3R Hazard to the unaided eye

Class 4 Eye and skin hazards. Possible fire and fume

hazard by interaction with target material

Q: What are the control measures for the safe handling of laser?
• Engineering Control:
- Screening/ enclosure to prevent the escape of hazardous beams.
- Non – reflective surfaces
• Administrative Control:
- Proper warning signage and unauthorized
entry restricted.
- Standard operating procedure for safe
handling of lasers.
- Training for the staff dealing with laser.
- Follow manufacture instructions.
• Use of PPEs:
- Safety eyewear labeled with the appropriate wavelength and optical
density has to be used
- Skin protection required for high power lasers
 27
UV Radiation
Q: Main departments using UV radiation?

• Dermatology (Phototherapy)
• Operation Theatre
• Laboratory
• Housekeeping
Q: What all are the health effects & risks associated with UV rays?
- Acute effects of exposure to radiation include:
- Skin: reddening of skin or erythema
- Eye: arc eye or the inflammation and temporary blindness

• Chronic effects include:

- Premature aging of the skin
- Skin Cancer
- Cataracts

Q: What all are the control measures for safe working with UV rays?
• Eliminate as far as possible
• Engineering Control:
- Screening/ enclosure to prevent the contact of person.
- Non – reflective surfaces
• Administrative Control:
- Proper warning signage and unauthorized entry restricted.
- Training for the staff dealing with UV.
- Follow manufacture instructions.
• Use of PPEs:
- Safety eyewear
- Skin protection as needed
 28
9. Manual Handling

Q: What is meant by Manual Handling?
• The term manual handling covers any workplace activity requiring the
use of force by a person to grasp, manipulate, strike, throw, carry,
move (lift, lower, push, pull), hold or restrain an object, load or body part
Q What all are the risks related to Manual Handling?
• Serious back injuries
• Musculoskeletal Disorders (MSD) - Musculoskeletal Disorders or
MSDs are injuries and disorders that affect the human body’s
movement or musculoskeletal system (i.e. muscles, tendons,
ligaments, nerves, discs, blood vessels, etc.)

Q: What all are the different steps in safe lifting/moving of weight?

Ist Line Therapy IInd Line Therapy/ Or Comments
In Allergy

Analyze the task:

• The load is too heavy?
• You need someone else
Step 1: Stop & to help?
Think • Can handling aids be
used?
• Where is the load going
to be placed?
Adopt a stable position:
• The feet should be
apart with one leg slightly
forward to maintain
balance.
Step 2: Position • Be prepared to move
the feet your feet during the lift to
Position the feet maintain your stability.
• Avoid tight clothing or
unsuitable footwear, which
may make this difficult.
 29
Ist Line Therapy IInd Line Therapy/ Or Comments
In Allergy

Adopt a good posture:

• When lifting from a low
level, bend the knees.
Step 3: Adopt a good
posture
• Keep the back straight,
maintaining its natural
curve.
• Keep the shoulders
level.

Get a good hold:

• Where possible, the
load should be hugged
Step 4: Get a firm as close as possible to
grip the body.
• Look ahead, not down
at the load, once it has
been held securely.

Move the Feet:

• Move smoothly.
• The load should not
be jerked or snatched
Step 5 : Move the feet as this can make it
harder to keep control
and can increase the
risk of injury.

Put down, then adjust:

• If precise positioning
of the load is neces-
Step 6 : Put down, sary, put it down first,
then adjust then slide it into the
desired position
 30
10. ERGONOMICS

Q: What is Ergonomics?
• Ergonomics is the science of designing the workplace, keeping in
mind the capabilities and limitations of the worker.
• The Goal of ergonomics is to ‘fit the job to the person,’ rather than
making the person fit the job.”
Q: What are the risks due to usage of DSE (Display Screen Equipment)?
• Musculoskeletal Disorders
• Visual fatigue, and
• Stress
Q: What all are the common Ergonomical problems/hazards
found in the offices?
• The screen is poorly positioned;
• Mouse is placed too far away;
• Chairs are not adjusted properly to fit the person working;
• Glare on the screen;
• Improper body posture;
• Not enough break during the activity;

Shoulders relaxed

45-70 cm (18-28 in.)

Top of screen at or Forearms and hands in a
slightly below eye straight line
level. (You may
need to adjust the Lower back supported
height of your mon-
itor.)

Forearms level or tilted

down slightly
Screen positioned
to avoid reflected
glare

Thighs tilted slightly

Clearance under
work surface

Feet flat on the floor

 31

11. LADDER SAFETY

Q: What are the safe practices while working on ladder?
• Always inspect the ladder before its use for any damage
• Shall have at least three points of contact (Both hands and one
foot or One hand and both Feet)
• Shall not carry materials or tools in hand (use tool belt or pouch)
• Don’t overreach to either sides, except to hold a stable
supporting structure.
• Only one person at a time has to use ladder
• Don’t move the ladder with a person on ladder
• Shall not climb beyond the third highest step
• Metal ladders should not be used on or near electrical conductors
 32
12. SAFETY SIGNAGES

Q: What all are the different colors used in signages and its meaning?
Color Used Signage Class Meaning Example

• Fire Fighting Stop ,

RED Equipment Dangerous
• Prohibition sign Behavior
& Danger

• Warning sign Be careful

YELLOW take
precautions;

• Mandatory sign Follow the

BLUE Instruction
strictly

• Emergency Exits escape

GREEN escape routes; Safe
• Safe Act Sign condition
 33
13. DEFINITIONS
Term Definitions

Abu Dhabi Occupational Safety Abu Dhabi Centre for Occupational

& Health Centre Safety and Health (OSHAD) is a
competent authority for managing
aspects of occupational safety
and health in the workplace, and
supervision of all aspects of occu-
pational safety and health at the
emirate level.
Acute Effect An adverse effect on any living
organism which results in severe
symptoms that develop rapidly
upon single exposure; symptoms
often subside after the exposure
stops.
Al ADAA OSH Electronic Application
maintained by OSHAD for reporting
and database management
functionalities required by OSHAD
for monitoring the implementation
of OSHAD-SF.
Audit: A systematic, independent and
documented process for obtaining
audit evidence and evaluating it
objectively to determine the extent
to which audit criteria are fulfilled.
Competence The ability to perform a particular
job in compliance
standards; in possession of
required skill, knowledge,
qualification, and/or capacity.
Compressed Gasses: Any gas that is under high
pressure.
 34
Term
Definitions

Confined Space: An enclosed or partially enclosed

space which:
• Is at atmospheric pressure
during occupancy; and / or
• Is not intended or designed
primarily as a place of work; and
• May have restricted means for
entry and exit;
Confined spaces include but are
not limited to:
• Storage tanks, tank cars,
process vessels, boilers, pressure
vessels, silos and other tank-like
compartments;
• Pipes, sewers, shafts, ducts and
similar structures;
Consequence: The outcome of an incident. A
single incident can generate
multiple consequences, and the
initial consequence of an incident
can escalate.
Contractor A person, organization, their
employees or a nominated
representative engaged to carry
out work for the nominated
entity in a contract for service
arrangement.
Control Measure: Actions and activities taken to
prevent or eliminate a hazard and/
or risk or reduce it to an as low as
reasonable practicable level
Correction action Correction is like first-aid, its
the instant action that is taken to
correct the nonconformity or to
reduce the impact nonconformity
that has occurred.
Corrective actions Corrective actions are steps that
are taken to remove the causes of
an existing nonconformity
or undesirable situation
 35
Term Definitions

Element (OSHAD - SF): A fundamental component of the

OSHAD-SF defining
requirements of an entity OSH
Management System.
Emergency: The outcome of an incident. A
single incident can generate
multiple consequences, and the
initial consequence of an incident
can escalate.
A sudden, urgent, usually
unexpected occurrence or
occasion requiring immediate
action.
First Aid Injury: Is a minor work-related injury or
illness that calls for only simple
“First Aid” treatment and does not
call for follow-up treatment by a
health-care professional. First aid
injuries do not result in lost time
from work or work restrictions.
Hazard: Any substance, physical effect, or
condition with potential to harm
people or property.
Hazard Analysis: The systematic process of
developing an understanding of
hazards. The process consists of
hazard identification, assessment
and risk determination.
Hazardous material Hazardous Material: Solid, liquid
(Hazmat) or gaseous materials having
properties that are harmful
to human health or severely
affecting the environment, such as
materials that are toxic, explosive,
or flammable.
 36
Term
Definitions

Hierarchy of control Try to control the hazards by

measure: implementing control measures in
following order:
• Elimination (Try to eliminate the
hazard)
• Substitute
• Engineering Control
• Administrative control (Policy &
Procedure)
• PPE (Personal protective equipment)

Inspection: Physical on-site verification that work is

performed and equipment is maintained in
accordance with applicable OSH standards
and procedures.
OSH Incident Any event which has caused any injuries,
illness, damage or loss of property.
Lost Time Injury (LTI): Any absence from work resulting from
work-related Fatalities, Permanent
Total Disabilities, Permanent Partial
Disabilities and Lost Workday Cases.
Manual Handling: Is any activity requiring the use of force
exerted by a person to lift, push, pull,
carry or otherwise move, hold or restrain
any person, animal or thing.
Medical The process of evaluating the health of
Surveillance: employees as it relates to their potential
occupational exposures to hazardous
agents.
Medical Treatment Medical Treatment Case (MTC) is a
Case (MTC): work-related injury or illness that calls
for medication, treatment, or medical
check that is administered by a health-
care professional and that goes beyond
first aid case. Medical treatment case
does not result in lost time from work
beyond the date of the injury.
 37
4. OSHAD Code of Practice (COP)
A code of practice (CoP) provides minimum mandatory OSH technical
requirements on a specific subject (e.g. Personal Protective Equipment).
Each entity must ensure they are aware of the subject matter covered
by the codes of practices and where this is part of their undertakings
ensure that the minimum requirements are complied with.

OSHAD Code of Practice

CoP 1.0 OSHAD SF- Hazardous Materials

CoP 1.10 OSHAD SF- Management of Asbestos Containing Materials
CoP 1.20 OSHAD SF- Lead Exposure Management
CoP 2.0 OSHAD SF- Personal Protective Equipment
CoP 3.0 OSHAD SF- Occupational Noise
CoP 3.1 OSHAD SF- Vibration
CoP 4.0 OSHAD SF- First Aid and Medical Emergency Treatment
CoP 8.0 OSHAD SF- General Workplace Amenities
CoP 9.0 OSHAD SF- Workplace Wellness
CoP 9.1 OSHAD SF- New and Expectant Mothers
CoP 9.2 OSHAD SF- Managing Work-Related Stress
CoP 10.0 OSHAD SF- Rehabilitation and Return to Work
CoP 11.0 OSHAD SF- Safety in the Heat
CoP 12.0 OSHAD SF- Prevention and Control of Legionnaires
Disease
CoP 13.0 OSHAD SF- Violence in the Workplace
CoP 14.0 OSHAD SF- Manual Handling and Ergonomics
CoP 14.1 OSHAD SF- Manual Tasks Involving the Handling of
People
CoP 15.0 OSHAD SF- Electrical Safety
 38

OSHAD Code of Practice

CoP 16.0 OSHAD SF- OSH Requirements for People with
Special Needs
CoP 17.0 OSHAD SF- Safety Signage and Signals
CoP 18.0 OSHAD SF- Employer Supplied Accommodation
CoP 18.1 OSHAD SF- Temporary Employer Supplied
Accommodation
CoP 19.0 OSHAD SF- Occupational Food Handling and Food
Preparation Areas
CoP 20.0 OSHAD SF- Safety in Design (Construction)
CoP 21.0 OSHAD SF- Permit to Work Systems
CoP 22.0 OSHAD SF- Barricading of Hazards
CoP 23.0 OSHAD SF- Working at Heights
CoP 24.0 OSHAD SF- Lock-out - Tag out (Isolation)
CoP 25.0 OSHAD SF- Driver Fatigue Prevention
CoP 26.0 OSHAD SF- Scaffolding
CoP 27.0 OSHAD SF- Confined Spaces
CoP 28.0 OSHAD SF- Hot Work Operations (eg Welding and
Cutting)
CoP 29.0 OSHAD SF- Excavation Work
CoP 30.0 OSHAD SF- Lone Working and or in Remote Loca-
tions
CoP 30.1 OSHAD SF- Working in International Locations
CoP 31.0 OSHAD SF- Working on, Over or Adjacent to Water
CoP 33.0 OSHAD SF- Working on of Adjacent to a Road
CoP 34.0 OSHAD SF- Safe Use of Lifting Equipment
and Lifting Accessories
 39
OSHAD Code of Practice

CoP 35.0 OSHAD SF- Portable Power Tools

CoP 36.0 OSHAD SF- Plant and Equipment
CoP 37.0 OSHAD SF- Ladders
CoP 38.0 OSHAD SF- Concrete Placing Equipment
CoP 39.0 OSHAD SF- Overhead and Underground Services
CoP 40.0 OSHAD SF- False Work (Formwork)
CoP 41.0 OSHAD SF- Steel Erection
CoP 42.0 OSHAD SF- Pre-Cast Construction
CoP 43.0 OSHAD SF- Temporary Structures
CoP 44.0 OSHAD SF- Traffic Management and Logistics
CoP 45.0 OSHAD SF- Underwater Activities
CoP 46.0 OSHAD SF- Underground Construction
CoP 46.1 OSHAD SF- Construction of Water Wells
CoP 47.0 OSHAD SF- Machine Guarding
CoP 48.0 OSHAD SF- Spray Finishing
CoP 49.0 OSHAD SF- Compressed Gases and Air
CoP 50.0 OSHAD SF- Abrasive Blasting and associated Protec-
tive Coating Work
CoP 51.0 OSHAD SF- Powered Lift Trucks
CoP 52.0 OSHAD SF- Local Exhaust Ventilation
CoP 53.0 OSHAD SF- OSH Management During Construction
Work
CoP 53.1 OSHAD SF- OSH Construction Management Plan
CoP 54.0 OSHAD SF- Waste Management