review of australian and new zealand workplace exposure surveillance systems · 2016. 6. 1. · •...

N O H S A C T E C H N I C A L R E P O R T 6

T I M D R I S C O L L

NO

HS

AC

TE

CH

NIC

AL

RE

PO

RT

6R

EV

IEW

OF

AU

ST

RA

LIA

N A

ND

NE

W Z

EA

LA

ND

WO

RK

PL

AC

E E

XP

OS

UR

E S

UR

VE

ILL

AN

CE

SY

ST

EM

S

REVIEW OF AUSTRALIAN AND NEW ZEALAND

WORKPLACEEXPOSURESURVEILLANCESYSTEMS

AUTHOR

Tim DriscollElmatom Pty Ltd

NOHSAC MEMBERS

Neil Pearce (Chair)CentreforPublicHealthResearch,MasseyUniversity

Evan DrysonOccupationalMedicalSpecialistsLtd,AucklandCentreforPublicHealthResearch,MasseyUniversity

Anne-Marie FeyerDirector,HealthAdvisoryPracticePricewaterhouseCoopers,SydneyAdjunctProfessorialResearchFellow,DepartmentofPreventiveandSocialMedicine,UniversityofOtago

Philippa GanderSleep/WakeResearchCentre,MasseyUniversity

Selwyn McCrackenInjuryPreventionResearchUnit,UniversityofOtago

NOHSAC SECRETARIAT

Mark Wagstaffe (Project Manager)Stephanie Kerruish (Administrative Support Officer)

ACKNOWLEDGEMENTS

ThisworkwasfundedbytheOfficeoftheAustralianSafetyandCompensationCouncil.

Theauthorwouldliketothankallthepersonsandauthoritiesthatcontributedtothisproject,withparticularmentionto:

• MsSuMonKyaw-Myint,DrPetaMiller,DrAnthonyHoganandMsJaniceBattoftheOfficeoftheAustralianSafetyandCompensationCouncil

• MarkWagstaffeoftheNationalOccupationalHealthandSafetyAdvisoryCommittee

• DrTonyLaMontagneoftheUniversityofMelbourne.

NOHSAC

Telephone:(04)9154463Fax:(04)9154329Email:[email protected]:www.nohsac.govt.nzPostaladdress:POBox3705,Wellington

ISSN0-478-28036-X

ISBN0-478-28058-0

ThisdocumentisavailableonNOHSAC’swebsitewww.nohsac.govt.nz.Itcanbefreelyquoted,copiedandcirculatedwithappropriateacknowledgement.Thesuggestedcitationis:Driscoll,T.Review of Australian and New Zealand workplace exposuresurveillance systems: NOHSAC Technical Report 6 :Wellington,2006.

R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

�

Table of Contents

List of Tables iv

List of Figures iv

Abbreviations v

Executive Summary vi

1. Introduction 1

1.1 Background 2 1.2 Definitions 3 Exposuresurveillance 4 Exposurecontrolsystemsurveillance 4 1.3 Reportaims 4 1.4 Outlineofthestructureofthisreport 42. Methods 5

2.1 Literaturereview 6 2.2 Surveyofcurrentorrecentapproaches 63. Literature Review 7

3.1 Approachusedtoidentifyrelevantliterature 8 3.2 Outcomeofthesearchandabstractreview 8 3.3 Paperswithoccupationalexposuresorcontrolmeasuresastheprimaryobjective 9 Australianstudies 9 NewZealandstudies 12 3.4 Papersprovidinginformationonoccupationalexposureorcontrolmeasuresaspartof

astudywithadifferentmainobjective 13 Australianstudies 13 NewZealandstudies 14 3.5 Discussion 154. Overview of Approaches to Exposure Surveillance 17

4.1 Thecontributionofexposuresurveillancetooccupationalhealthandsafety 18 4.2 Typesofexposuresurveillanceschemesorinformationsources 21 Routinelycollectedoccupationalexposuredata 21 Comprehensivesurveillancesystems 21 Job-exposurematrix 21 Specificexposuredatabases 21 Workforcesystems 22 Registersofsubstances 22 Industrysurveillancesystems 22 Population-basedexposuredata 23 4.3 Approachestodatacollection 23 Workplaceandworkforcesurveys 23 Routineorad-hocmonitoring 24 Continuousareamonitoring 24 Routineorad-hocpersonalmonitoring 24 Continuouspersonalmonitoring 24 Biologicalmonitoring 25

� � R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

5. Survey of Current Exposure Surveillance Systems in Australia and New Zealand 27

5.1 Introduction 28 5.2 Surveymethodology 28 Selectionoforganisations/companiestoincludeinthesurvey 28 Datacollectionapproach 28 Thesurveyquestionnaire 29 Distributionofthequestionnaire 29 5.3 Results 30 Overviewofresponses 30 OHSdepartments 31 Industrypeakbodies 32 Industryskillscouncils 33 Majorcompanies 33 Employeebodies 34 Researchbodies 34 Governmentdepartmentsandpublicauthorities 35 Other 36 NewZealandsurvey 37 5.4 Discussion 37 Summaryoffindingsfromthesurvey 37 Organisationsincludedinthesurvey 38 Representativenessofthefindings 38 Problemswiththesurvey 39 5.5 Conclusions 396. Issues and Actions Relevant to Effective Exposure Surveillance 41

6.1 Introduction 42 6.2 Dataissues 42 Definitionissues 42 Collectionandmeasurementissues 42 Codingissues 43 Recordingissues 43 Overallapproachtodataissues 43 6.3 Trainingissues 44 6.4 Samplingissues 44 6.5 Resourceissues 44 6.6 Prioritisationissues 45 6.7 Commitmentissues 46 6.8 Legislativeissues 46 6.9 Requiredresources 47 6.10 Casestudy–ARPANSA 47 Asingleagency 47 Ahighprofileexposure 47 Aprovenformofmonitoring 47 Personalexposureprofile 48 Regulatoryrequirements 48 Commitment 48 Nationalcoverage 48 Summary 48


� � �

6.11 Approachtodatacollection 49 6.12 Typesofsurveillancesystems 50 6.13 Likelyand/orfeasibledevelopmentsinexposuresurveillance 537. Summary and Conclusions 55

8. References 57

9. Appendices 63

Appendix1: Surveyquestionnaire 64 Appendix2: Coveringletterforsurveyquestionnaire 68 Appendix3: Listoforganisationsincludedinthesurvey 69 Appendix4: Exampleofprioritisingexposuresurveillanceofcarcinogens 77 Appendix5: ProposedexposuresurveillancematrixfromBrookeetal,2005 80

� v R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

List of Tables

Table1 ExposuresandsettingscoveredinAustralian-basedstudies 11

Table2 ExposuresandsettingscoveredinNewZealand-basedstudies 13

Table3 Generalsummaryofsurvey–questionnairessentandresponsesreceived–byrespondertype 30

Table4 Summaryofresponsesreceived–respondertypeforeachtypeofresponse–percentageofeachtypeofresponse 31

Table5 Summaryofresponsesreceived–typeofresponseforrespondertype–percentageofeachrespondertype 31

Table6 Criteriatousewhenprioritisingwhichexposuresshouldbethefocusofexposuresurveillance 46

Table7 Recommendationsregardingexposuresurveillancesystemsanddatacollectionapproachesforvariousgeneralexposuresandtheirassociatedoutcomes–selectedpriorityoutcomes 52

List of Figures

Figure1 Relationshipofexposureandoutcomeinformationtooccupationalhealthandsafetypreventionactivities 19

Figure2 Relationshipbetweenpotentialsourcesofinformationonoccupationalexposure 20


v

Abbreviations

ARPANSA TheAustralianRadiationProtectionandNuclearSafetyAuthority

ASCC AustralianSafetyandCompensationCouncil

CO Carbonmonoxide

HIV HumanImmunodeficiencyVirus

NOHSAC NationalOccupationalHealthandSafetyAdvisoryCommittee

NIOSH NationalInstituteofOccupationalSafetyandHealth

PPE Personalprotectiveequipment

PRMS PersonalRadiationMonitoringService


v

v � R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

Executive Summary

BAC KgROUND

TheOfficeoftheAustralianSafetyandCompensationCouncil(OASCC)oftheAustralianGovernmentDepartment

ofEmploymentandWorkplaceRelations(DEWR)andtheNewZealand-basedNationalOccupationalHealthand

SafetyAdvisoryCommittee(NOHSAC)haveidentifiedthepreventionofoccupationaldiseasesasaprioritytarget

area.Existingnationaldatasourceshavebeenreviewedandfoundtobeinadequateforthistask,sincetheyare

oftenbasedonworkers’compensationdataandreports.Programmesofexposuresurveillancecancompliment

disease and injury surveillance (that is, outcome surveillance) and can be used to strengthen and inform

occupationaldiseaseandinjurypolicyandpreventionprogrammes.Totheseends,informationisrequiredonthe

nature,extent,qualityandpotentialreplicationofexistingoccupationalexposuresurveillanceprojectsinAustralia

andNewZealand,andinternationally.

ThisprojectwascommissionedbytheOASCCtoaddressissuesraisedbytheInternational review of surveillance

and control of workplace exposures,whichwasconductedfortheOASCCandNOHSACbytheVictorianInstitute

of Occupational Safety and Health (VIOSH). Specifically, the VIOSH report found that there were no national

exposuresurveillancesystemsinAustraliaandNewZealandthatmettheircriteria.Asaresult,theyonlyreported

onexposuresurveillancesystemsoverseas.TheOfficesawtheneedtovalidateVIOSH’sfindingsforAustraliaand

NewZealand,sincelocaldatasetsofsomerelevancewereknowntoexist.However,itneededtobeestablishedif

such datasets were nationally representative or significant. In developing a workplace exposure surveillance

strategyofnationalsignificance,itwasimportantto:

• be aware of any national or nationally representative systems already in place that could be utilised as a

frameworkfordevelopinganAustraliansystem

• seek to engage stakeholders (including the occupational health and safety and workers’ compensation

jurisdictions) in thedevelopmentprocess to identifypotentialdataownersordatasources thatmaybeof

strategicusefortheproject,andtocommencetheprocessofidentifyingwhichofthesedataownersmaybe

willingtocontributetheirdatatoanationalexposuresurveillancerepository

• avoidanywasteofresourcesifaspecificentitywasalreadyfoundtobeworkingtowardsthedevelopmentof

anationalornationallyrepresentativesystem

• havearealisticassessmentoftherisksandpossiblepointsofresistancethatthedevelopmentofastrategy

mayface.

Theprojectaimedtoexamineoccupationalhealthandsafetyexposuresurveillanceandcontrolsystemsthatare

currentlyinuseinAustraliaand/orNewZealand,andtoproduceacriticalreviewofAustralianandNewZealand

approachestoexposuresurveillancerelevanttooccupationalhealthandsafety.Itfocusesonsurveillancesystems

thatprovideinformationonphysical,chemical,biological,psychosocialorotherhazardsthatcanbepresentinan

occupationalcontextandthatincreasetheriskofdevelopingawork-relateddisorder.Theultimateaimwastolead

toimprovementininformationsourcesthatwillunderpinapproachestothepreventionofwork-relatedinjuryand

diseaseinAustraliaandNewZealand.

For this project, exposure surveillance was defined as “the on-going and systematic collection, analysis and

interpretationofdatarelatedtooccupationalexposures,andtheuseofthisinformationforpreventionandcontrol

purposes”.Exposurecontrolsystemsurveillancewasdefinedas“theon-goingandsystematiccollection,analysis

andinterpretationofdatarelatedtooccupationalexposurecontrolsystems,andtheuseofthisinformationfor

preventionandcontrolpurposes”.


v � �

L I TERATURE REVIEW

AreviewwasconductedofpublishedAustralianandNewZealandliteraturerelevanttooccupationalexposureor

controlsystemsurveillance.Thisreviewrevealedthatneitherappearstohaveaprominentroleinoccupational

healthandsafetyatanationalorregionallevel.Exposureswerethemainfocusofanumberofstudies,covering

arangeofphysical,chemical,biologicalandpsychosocialexposures,andavarietyofoccupations,industriesand

exposurecircumstances.Afewstudiesreportedondetailedexposuresystemsbasedonaparticularcompanyor,

forpetroleumproductionandaluminiumproduction,onaparticularindustrysector.Insomecases,theexposure

measurementsprompted,orwerelikelytoprompt,aspecificresponsetocontroltheexposuresinsomeway,but

thisdidnotappeartobepartofaformalexposuresurveillancesystem.

Quantitative information on exposures is also available from many studies that focused on examining the

relationshipbetweenexposureandaparticularoutcomeandthatcollectedexposureinformationaspartofthe

investigation,butthesestudieswerealsonotconductedaspartofexposuresurveillance,noraroseasaresultof

exposuresurveillance.

OVERVIEW OF APPROAC HES TO EXPOSURE SURVEILL AN CE

Exposuresurveillancecancontribute to improvements inoccupationalhealthandsafety inanumberofways.

Mostimportantly,monitoringofexposuresallowspreventionactiontobeinstitutedearlierthanisusuallypossible

whenmonitoringoutcomes,particularlywhenthereisalonglatencybetweenexposureandtheoccurrenceofthe

resultingdisorder,asisthecasewithmanywork-relateddiseases.Thisallowsgreaterpotentialtopreventmore

cases developing. Options for feasible exposure surveillance systems depend primarily on the exposure of

interest.Theoutcomesofinterestarestillrelevant,butprimarilyintermsofinfluencingtheneedforanexposure

surveillance system. The over-riding aim of any comprehensive occupational health and safety system is the

preventionofthework-relatedinjuryandillness.Therearemanyinputsintosuchasystemleadingtothisultimate

goal(withexposuresurveillancepotentiallybeingoneofthem),anumberofdifferentdesignsthatcanbeusedfor

exposuresurveillancesystems,andavarietyofappropriateapproachestothecollectionofdatatosupportthem.

SURVEY OF CURRENT EXPOSURE SURVEILL AN CE S YS TEMS IN AUS TRALIA AND NEW ZEAL AND

The main part of the project was designed to provide an understanding of the way occupational exposure

surveillancewasused inAustraliaandNewZealand.The focuswasonnationalsystems,ornationally-relevant

systems.The required informationwascollected throughasurvey. Informationwascollectedviaanelectronic

questionnaire.ThisquestionnairewasdistributedinearlyFebruary2006,withinformationcollectedupuntilmid

April2006.InNewZealand,organisationsweresurveyedthroughdirectinterviewbyMrMarkWagstaffe.

Thesurveywassentviaemailto240separateorganisationsandinterestedindividuals.Responseswerereceived

from 63 organisations. The main finding of the survey was that exposure surveillance is not widely used in

Australia.Theonlyfunctioningnationalexposuresurveillancesystemistheionisingradiationmonitoringsystem

runbyARPANSA.Thishasbeeninexistenceformanyyearsandappearstobefunctioningeffectively.Themining

industry,throughtheMineralsCouncilofAustralia,isintheearlystagesofthedevelopmentofanationalexposure

surveillancesystemthatcurrentlyfocusesonnoisebutthatisexpectedtosoonbeexpandedtocoversomedusts

and radiation.The survey (anddirect consultationwithorganisations inNewZealand) suggests that exposure

surveillancedoesnothaveahighprofileinoccupationalhealthandsafetyinAustraliaandNewZealand.Several

multinational companies have comprehensive exposure surveillance systems incorporated into their risk

managementsystems,butthesesystemsarespecifictotheindividualcompanies.

v � � � R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

ISSUES AND ACTIONS RELEVANT TO EFFECT IVE EXPOSURE SURVEILL AN CE

Therearemanyissuesthatpresentpotentialbarriersandchallengestotheestablishmentofexposuresurveillance

systems,andnospecificguidelinesforthedevelopmentofoccupationalexposuresurveillance,althoughseveral

referencesprovideinsightintothekeyfeaturessuchsystemsshouldhave.Themostimportantpotentialbarriers

and challenges relate to data (definition, collection andmeasurement, coding, recording), training, sampling,

resources, prioritisation, commitment and legislation. Detailed recommendations regarding exactly which

exposuresshouldbethesubjectofexposuresurveillanceinAustraliaandNewZealand,andhowthoseexposure

surveillance systems should function, are beyond the scope of the current report. The development of such

recommendationsshouldbemadethroughconsultationwithkeystakeholders.However,somegeneralguidance

isprovided.

Differentexposureswillhavedifferentrequirementsregardingthedesignandfunctionofanexposuresurveillance

system.Someexposureswithinasinglegeneralclassofhazard(physical,chemical,biologicalandpsychosocial)

willtendtohavesimilarexposurecharacteristicsandsohavesimilarrequirementsofanexposuresurveillance

system,butmanywillnot.

For most exposures that are likely candidates for exposure surveillance, collection of exposure information

through recurrent survey seems likely tobe themost cost-effectiveapproach.These surveys can takevarious

forms,dependingontheexposureofinterest.Exposuredataalreadybeingcollectedmaybeabletobeutilisedfor

a limitednumberofexposures.This isapotentiallycheaperapproachthancollectingnewdataspecifically for

surveillancepurposes,butsuchinformationislikelytoonlybeavailablefromjurisdictionsorformediumtolarge

organisations,andsignificantworkwouldprobablyberequiredtostandardisethedatacollectionandreporting

approaches. Other routinely collected information, such as that collected by occupational safety and health

authorities for regulation or registration purposes, may be of use, but it is likely that the variations in the

approachescurrentlyusedbetweenandwithinjurisdictionswilllimittheextenttowhichtheinformationcouldbe

viewedasrepresentative.Forasmallnumberofexposures,otherdatacollectionapproacheswillbewarranted.

Themaincandidatesintermsofthetypesofexposuresurveillancesystemsforuseatanationalorjurisdictional

levelandonanon-goingbasisseemtobespecificexposuredatabasesutilisingdatacollectedbyareamonitoring,

personalmonitoring,orsurveys;andjob-exposurematrices.Giventhelargecostintermsofresourcesandtime

requiredtoestablishandrunanexposuresurveillancesystem,itislikelythatinthemediumtermonlyalimited

number of exposures could be the subject of detailed exposure surveillance. For most of these, recurrent

workplace surveys are likely to be the most cost-effective method of obtaining the necessary information.

On-going, comprehensive surveillance incorporating a wide range of exposures (i.e. the direct monitoring of

potentiallythousandsofhazardoussubstances),basedonrecurrentworkplacesurveys,isnotlikelytobeviable

in themedium term ineitherAustraliaorNewZealand.Apotentiallyviablealternative is theconstructionand

maintenanceofanationaljob-exposurematrix(ortherelatedtask-exposurematrix).Thiscouldprovidedetailed

exposure information on a large number of exposures and exposure tasks. Alternatively, specific exposure

databasesusinginformationfromsurveys(oftheworkplaceandof individuals),andspecificareaor individual

measurementsforaverylimitednumberofexposures,areviable.Biologicalmonitoringmightalsobeappropriate

incertaincircumstances. Job-exposurematricesareappropriate formanyphysicalandchemicalexposures,as

wellassomebiologicalexposures.

There are no obvious pending technological changes in exposure monitoring that are likely to affect the

development and use of occupational exposure surveillance. However, there are a number of potential

developmentsinexposuresurveillanceinthemediumterm.Therearealsoanumberofstrategicdevelopments

that should increase the likelihood that occupational exposure surveillance can be significantly improved in

AustraliaandNewZealand


� x

SUMMARY AND C ON CLUSIONS

Thisprimaryaimofthisprojectwastoexamineoccupationalhealthandsafetyexposuresurveillanceandcontrol

systemsurveillancecurrentlyinuseinAustraliaand/orNewZealand,andtoproduceacriticalreviewofAustralian

andNewZealandapproaches toexposureandcontrolsystemsurveillance relevant tooccupationalhealthand

safety.Thesurveyrevealedthatexposureandcontrolsystemsurveillancedoesnotappeartoplayamajorrolein

occupational health and safety in eitherAustralia orNewZealand, particularly at the jurisdictional or national

level.Thiswasconfirmedbytheliteraturereview,whichidentifiedaconsiderableamountof informationabout

work-relatedexposures,butvery little related toproperexposureorcontrolsystemsurveillanceatanational,

jurisdictionalor regional level.Thereareasmallnumberofexposuredatabases thatmightbeappropriate for

inclusion inexposuresurveillancesystemsat this level.There isalsoa fully functioningexposuresurveillance

systemforionisingradiationinAustraliaandNewZealand.

There are many important issues that need to be considered in developing exposure and control system

surveillanceinAustraliaandNewZealand.Significantresourceswillberequiredtoadequatelyexploretheseissues

andultimatelyresolvethem,buttherearemajoradvantagestoinvestingsuchresources.Therearemanypotential

hazardsthatarecandidatesforexposuresurveillance,asmallnumberofappropriatesurveillancesystemdesigns,

andarangeofpotentialapproachestodatacollectionavailabletosupportwhateversystemsaredeveloped.

x R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6


�

SECT ION ONE

INTRODUCTION

1

� R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

�.� BAC KgROUND

TheOfficeoftheAustralianSafetyandCompensationCouncil(OASCC)oftheAustralianGovernmentDepartment

ofEmploymentandWorkplaceRelations(DEWR)andtheNewZealand-basedNationalOccupationalHealthand

SafetyAdvisoryCommittee(NOHSAC)haveidentifiedthepreventionofoccupationaldiseasesasaprioritytarget

area.Existingnationaldatasourceshavebeenreviewedandfoundtobeinadequateforthistask,sincetheyare

oftenbasedonworkers’compensationdataandreports.Programmesofexposuresurveillancecancompliment

disease and injury surveillance (that is, outcome surveillance) and can be used to strengthen and inform

occupationaldiseaseandinjurypolicyandpreventionprogrammes.Totheseends,informationisrequiredonthe

nature,extent,qualityandpotentialreplicationofexistingoccupationalexposuresurveillanceprojectsinAustralia

andNewZealand,andinternationally.

ThisprojectwascommissionedbytheOASCCtoaddressissuesraisedbytheInternational review of surveillance

and control of workplace exposures,whichwasconductedfortheOASCCandNOHSACbytheVictorianInstitute

of Occupational Safety and Health (VIOSH). Specifically, the VIOSH report found that there were no national

exposuresurveillancesystemsinAustraliaandNewZealandthatmettheircriteria.Asaresult,theyonlyreported

on exposure surveillance systems overseas. The resultant report identified 24 working exposure surveillance

systems invariouscountries,primarily theScandinaviancountries, theUnitedStatesandtheUnitedKingdom.

However, the report identifiedmanyproblemswith the systems currently inplaceand found thatnoneof the

systemswasdirectlyapplicabletoAustraliaandNewZealand.Itwasconcludedthatworkplacesurveyswerelikely

tobethemosteffectivedatacollectionapproachforexposuresurveillanceinAustraliaandNewZealand1.

TheOfficesawtheneedtovalidateVIOSH’sfindingsforAustraliaandNewZealand,sincelocaldatasetsofsome

relevancewereknowntoexist.However,itneededtobeestablishedifsuchdatasetswerenationallyrepresentative

orsignificant.Indevelopingaworkplaceexposuresurveillancestrategyofnationalsignificance,itwasimportantto:

• be aware of any national or nationally representative systems already in place that could be utilised as a

frameworkfordevelopinganAustraliansystem

• seek to engage stakeholders (including the occupational health and safety and workers’ compensation

jurisdictions) in thedevelopmentprocess to identifypotentialdataownersordatasources thatmaybeof

strategicusefortheproject,andtocommencetheprocessofidentifyingwhichofthesedataownersmaybe

willingtocontributetheirdatatoanationalexposuresurveillancerepository

• avoidanywasteofresourcesifaspecificentitywasalreadyfoundtobeworkingtowardsthedevelopmentof

anationalornationallyrepresentativesystem

• havearealisticassessmentoftherisksandpossiblepointsofresistancethatthedevelopmentofastrategy

mayface.



approachestoexposuresurveillancerelevanttooccupationalhealthandsafety.Itfocusesonsurveillancesystems

thatprovideinformationonphysical,chemical,biological,psychosocialorotherhazardsthatcanbepresentinan

occupationalcontextandthatincreasetheriskofdevelopingawork-relateddisorder.Theultimateaimwastolead

toimprovementininformationsourcesthatwillunderpinapproachestothepreventionofwork-relatedinjuryand

diseaseinAustraliaandNewZealand.

The formalaimof theproject,aspresented in the relevantRequest forQuote (RFQ) releasedon14thOctober,

2005,was to“provideDEWR [whichcontains theOASCC]andNOHSACwitha critical reviewofAustralianand

NewZealandworkplaceexposuresurveillancesystemswhichwillbeusedwithother informationto informthe

developmentofaproposedAustraliannationalhazardexposuresurveillancesystem”.


�

Theprojectwastoproduceamatrixofexposuresurveillancesystemswhichtakeintoaccount:

• thedifferingcategoriesofexposures

• thepossibletypesofsurveillancemethodsavailable

• thediseaseandinjurygroupsofinterest.

All relevantexposures,surveillancemethodsanddisordersweretobeconsidered.Nospecificexposureswere

nominatedintheRFQ,butphysical,chemical,biologicalandpsychologicalhazardswereidentifiedasrelevant.

All relevant surveillancemethodswere tobe included,but specific surveillancemethods tobe considered, as

documentedintheRFQ,included:

• routinesurveillancesystems

• comprehensivesurveillancesystems

• workforcesystems(labourforcesurveys)

• exposuredatabases

• registersofsubstances

• industrysurveillancesystems

• relevantpopulationsurveillancesystems

• otherrelevantsystems.

Similarly,allrelevantdisordersweretobeincluded,with,asstipulatedbytheRFQ,priorityattentiontobegivento:

• respiratorydiseases

• occupationalcancers

• contactdermatitis

• infectiousandparasiticdiseases

• cardiovasculardiseases

• musculoskeletaldisorders

• mentalorneuropsychiatricdisorders

• noise-inducedhearingloss.

In addition, injuries and any relevant disorder not included in the above list were included. The project also

consideredsurveillancesystemsthatprovideinformationonexposurecontrolmeasuresoronmeasuresdesigned

topreventorminimisetheeffectsofexposure(suchastheprevalenceofsmokedetectors,useofappropriate

guardsorwearingofseatbelts).

�.� DEF INIT IONS

This project is focusedon exposure surveillance, but also takes into account surveillanceof exposure control

systems.Althoughexposuresurveillanceissometimesseenasasubsetofhazardsurveillance2,inthisprojectthe

terms “exposure surveillance” and “hazard surveillance” are considered synonymous. For ease of reading,

“exposure surveillance” is used throughout this report. Exposure surveillance is taken to cover all forms of

occupationalhazard,includingphysical,chemical,biologicalandpsychosocialhazards.


EXPOSURE SURVEILL AN CE

Ingeneralterms,publichealthsurveillancehasbeendefinedbytheUnitedStatesCentresofDiseaseControland

Prevention(CDC)as“...theon-goingsystematiccollection,analysis,andinterpretationofhealthdataessentialto

the planning, implementation, and evaluation of public health practices, closely integrated with the timely

disseminationofthesedatatothosewhoneedtoknow.Thefinallinkinthesurveillancechainistheapplicationof

these data to prevention and control. A surveillance system includes a functional capacity for data collection,

analysis, and dissemination linked to public health programs.”3. The International Labour Organisation uses

different wording, but has a similar intent, defining exposure surveillance as “the process of assessing the

distributionof,andtheseculartrendsin,useandexposurelevelsofhazardsresponsiblefordiseaseandinjury”4.

For this project, the CDC definition was adapted to an occupational context, and specifically for exposure

surveillance.Thedefinitionusedforexposuresurveillancewas“theon-goingandsystematiccollection,analysis

andinterpretationofdatarelatedtooccupationalexposures,andtheuseofthisinformationforpreventionand

controlpurposes”.

EXPOSURE C ONTROL S YS TEM SURVEILL AN CE

Examplesofexposurecontrolsystems(orhazardcontrolsystems)asdefinedforthisprojectarethepresenceof

potentially protective agents such as seat belts, smoke alarms, roll-over protection on tractors and forklifts,

bicyclehelmetsandresidualcurrentdevices.Othercontrolsystemsofinteresttotheprojectrelatetobehavioural

attributessuchasbasicresuscitationskillsanddefensivedrivingcourses.Exposurecontrolsystemsurveillance

isthereforetheapplicationoftheaboveapproachtoexposuresurveillancetothecollectionofdataonexposure

control systems.Thedefinitionused for theprojectwas“theon-goingandsystematic collection,analysisand

interpretation of data related to occupational exposure control systems, and the use of this information for

preventionandcontrolpurposes”.

�.� REPOR T AIMS



approachestoexposuresurveillancerelevanttooccupationalhealthandsafety.

�.� OUTL INE OF THE S TRUCTURE OF THIS REPOR T

Thisreporthasninemainchapters.Chapter1providesbackgroundregardingtheproject.Theapproachtakenin

conductingtheprojectisdescribedinChapter2.Chapter3providesaliteraturereviewofoccupationalexposure

andcontrolsurveillanceinAustraliaandNewZealand,andChapter4isanoverviewofpotentialapproachesto

exposure surveillance. The survey of current exposure surveillance systems in Australia and NewZealand is

described in Chapter 5, followed by a consideration of issues relevant to effective exposure surveillance in

Chapter 6. Chapter 7 presents brief summary conclusions, and the references are provided in Chapter 8.

Chapter9containstheappendices.


�

SECT ION T WO

METHODS

2

6 R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

� .� L ITERATURE REVIEW

AreviewwasconductedofpublishedAustralianandNewZealandliteraturerelevanttooccupationalexposureor

controlsystemsurveillance.ThisisdescribedindetailinChapter3.

�.� SURVEY OF CURRENT OR RECENT APPROAC HES

Itwasexpectedthatmanyoftheexposuresurveillancesystemscurrentlyorrecentlyinexistencewouldhavebeen

runbypublicoccupationalhealthandsafetyauthorities(ortheirequivalent)orotherpublicinstitutions.Theinitial

intention was therefore to search the web sites of each of these authorities for relevant information on the

authority’sapproachtoexposuresurveillance,includingpast,presentandplannedsystems.Authoritieswerethen

tobecontacteddirectlytoobtainfurtherinformation.However,oncetheprojectcommenced,itwasdecidedto

formally survey a wide range of public, and some private, organisations regarding their use of exposure

surveillancesystemsandexposurecontrolsystems,asitwasthoughtthiswouldprovidemorecomprehensiveand

usefulinformation.ThemethodologyusedforthissurveyisdescribedindetailinChapter5.


�

SECT ION THREE

LITERATURE REVIEW

3


� .� APPROAC H USED TO IDENTIFY RELEVANT L ITERATURE

ThepublishedliteraturewassearchedfororiginalandreviewarticlesrelatedtoexposuresurveillanceinAustralia

orNewZealand.Englishlanguageliteraturepublishedfrom1986uptoearly2006inclusivewasused.Keywords

usedinitiallywere:

• “work”,“work-related”,“occupation”,or“occupational”

AND“surveillance”,“hazard”

ANDAustraliaORNewZealand

ANDoneormoreof:

• “falls”,“motorvehicle”,“tractor”,“electricity”,“accident”

• “exposure”, “arsenic”, “asbestos”, “beryllium”, “cadmium”, “chromium”, “diesel” “exhaust”, “nickel”,

“silica”, “tobacco”, “smoke”, “environmental tobacco smoke”, “benzene”, “ethylene oxide”, “ionising

radiation”,“noise”,“jobstrain”,“jobcontrol”,“shiftwork”

• “personalprotectiveequipment”,“PPE”,“respirator”,“harness”.

Thislistwasthenrefinedasaresultoftheinitialresultsofthesearch.Somesecondaryfollow-upofsourcescited

inreferencelistswasalsoundertaken,butthiswasnotconductedonacomprehensivebasis.

InitialsearcheswereconductedthroughMedline,OSH-ROMandNIOSHTIC.

Abstractswere read and assessed for relevance against the objectives of the project, taking into account the

appropriatenessofthestudymethodology.

�.� OUTC OME OF THE SEARC H AND ABS TRACT REVIEW

Theinitialsearchidentified533referencespublishedbetween1986andearly2006inclusive.Mostofthesewere

excludedbecausetheywere:

• entirelyorprimarilyfocusedoncountriesotherthanAustraliaorNewZealand(64)

• notfocusedonoccupationalhealthandsafety(124),or

• focusedonoccupationalhealthandsafety,butnotrelevanttoexposureorcontrolsurveillance(251).

Thisleft94references.Ofthese,occupationalexposuresorcontrolmeasuresweretheprimaryobjectiveof48,

and the remaining 46 provided some information on exposures or controlmeasures as part of paperswith a

differentmainobjective.

Therewould be other published articles that provide information on exposure in Australian andNewZealand

workplacesbutthatwillnothavebeenidentifiedintheliteraturesearchbecauseofthefocusoftheoriginalsearch

onexposuresurveillanceratherthanexposure itself.However, thefocus justonexposureswasnotpartofthe

projectasoriginallyenvisaged,andidentificationanddescriptionofallrelevantpublishedpapersisamajortask.

Therefore, the analysis presented is intended to provide reasonable understanding of the type and extent of

informationthatisavailableinAustraliaonoccupationalexposures,withoutattemptingtobeall-encompassing.


�

� .� PAPERS WITH OCCUPATION AL EXPOSURES OR C ONTROL MEASURES AS THE PRIMARY OBJECT IVE

TherewerenopapersthatdescribedexistingorplannedexposuresurveillanceineitherAustraliaorNewZealand.

However, 48 papers were primarily focused onmeasuring occupational exposures. These covered a range of

exposuresinavarietyofoccupationalsettings.

AUS TRALIAN S TUDIES

Noise levels were studied on farms (by visiting a sample of farms and taking measurements at the ears of

machineryoperatorsandbystanderswhiletheywereengagedintheirusualfarmtasks5)andintheheadphones

ofradioannouncers6.

Radiation exposures of technologists operating positron emission technologywas reported in one study.This

concludedthatexposureswerewithinoccupationalhealthandsafetylimits,butcouldbeloweredbyusingbetter

shielding7.

ExposureofQueenslandfarmerstoUV-Bonthefaceinthesummerwasestimatedusingtheprobabilityofoutdoor

activity,thedistributionofsolarradiationonthefaceandtheambientUV-Bforthegeographicarea8.

Theincidenceandcharacteristicsofhypoxicepisodesinmilitaryaircraftwasstudiedthroughareviewofreported

incidents9.

Exposuretopotentialviolencewasstudiedinvarioussettingsinthehealthsector.Themethodologyincludeda

prospectivestudyofsecuritycallsforunarmedviolentthreatsinanemergencydepartment10,asurveyofnursing

staff in emergencydepartments11, surveysof general practitioners12, 13, a surveyof healthcareworkers14, anda

review of violent incidents reported to the Australian Incident Monitoring System15. (The Australian Incident

Monitoring Systemi was established by the Australian Patient Safety Foundation, and collects information on

thingsthatgowronginhealthcare.Thefocusisonpatientsafety,butthecollectedinformationcoversaspectsof

exposurestohealthcareworkers,suchasviolenceandfatigue16).

BenzeneexposuresinthepetroleumindustrywerestudiedinseveralpapersaspartoftheHealthWatchproject.

(TheHealthWatchprojectisahealthsurveillanceprogrammeratherthananexposuresurveillancesystem,but

has collected or estimated hydrocarbon exposure, particularly to benzene, in Australian petroleum industry

workers17.) These addressed various aspects of the absolute exposures and the methodology used to best

estimate these exposures. Exposures were estimated using a combination of worker interview, inspection of

companyrecords,sitevisits,telephoneinterviewsandexposuremonitoringdata18–21. Inanotherstudy,artificial

neural networkswere used to study benzene exposures in tanker operators, and proved useful in decreasing

the required input of expert occupational hygienists without losing much in terms of accuracy of exposure

predictions22.

Thevalidityandusefulnessofusingurinelevelsasameasureofoccupationalexposureto4,4’-methylene-bis-

(2-chloroaniline)(MBOCA)wasexaminedinastudyofworkersinsevenfactorieswithexposedworkers23.

Absolute dust exposures were studied in coal miners using thousands of routine personal respirable dust

measurements24.

Informationonenvironmentaltobaccosmokeexposure intheworkplacewascollectedviatelephonesurveyof

members of a relevant union25. Another study examined the prevalence ofworkplace bans on smoking, using

workers’reportsaboutrestrictionofsmokingattheirworkplaces26.

i FormoreinformationonAIMS,seehttp://www.patientsafetyint.com/aims.aspx

�0 R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

The validity of using expert panels to estimate chemical exposures on the basis of job classification was

investigatedinastudyofbraintumours,withtheexpertpanels’assessmentcomparedwithquantitativeexposure

estimatesavailablefortheincludedjobs.Thestudyshowedthattherewasconsiderablepotentialforexposure

misclassification27.

Exposuretosharpsinjuriesinthehealthsectorwasthesubjectofseveralstudies.Fouranalysedsharpsinjuries

reportedbystaffatlargehospitals28–31.Twoexaminedtheincidenceofneedlestickinjuriesandtheprevalenceof

hepatitisBvaccinationthroughsurveys–oneusingtenyearsof recurrentsurveysofnurses32,andanotheran

anonymoussurveyoffinalyearmedicalstudents,dentistrystudentsandstaffatalargeteachinghospital33.The

useofuniversalprecautionswasstudiedinanaesthetists,includingtheprevalenceofalwayswearinggloves,the

re-sheathingofneedlesandneedlestickinjuries34.AquestionnairesurveyofAustralianteachinghospitalsin1992

showed that all had “...an established procedure for documenting occupational exposure to blood and body

fluids”.Mostofthehospitalsreportedbeingwillingtocontributeinformationtoanationalsurveillanceproject,

butthestudyfoundconsiderablevariationbetweenhospitalsintermsofthewaytheymonitoredandrecorded

relevantexposures.Theauthorsrecommendedthatanationalsurveillancesystembeestablished35.

Potential exposures to blood-borne infection were studied in the beauty therapy industry by sending a self-

administeredquestionnairetotherapistsidentifiedthroughtheYellow Pages36.

Exposures to wood dust and endotoxins were studied at a variety of woodworking sites by taking personal

inhalableexposuremeasurementsandenvironmentalsamplesattheworksites37,38.

Exposurestoaspergillusduringconstructionworkatahospitalwasstudiedusingrecurrentairsampling39.

Theprevalenceofoccupationalexposuretobatlyssaviruswasstudiedusingreportsofexposuretoapublichealth

unitoverthreeyears40.

The prevalence and nature of exposure to traumatic events has been studied in a survey of “peri-operative”

nurses41.

Fatigue in the transport industry was the focus of two studies. Long-distance truck drivers were studied by

interviewingdriversaboutexposuressuchasthenumberofhoursofdriving,andthenumberofhoursofsleep,in

a24-hourperiod42,andtaxidriverswerestudiedoveratwo-yearperiod,withdataonthenumberandlengthof

shifts,numberandlengthofbreaks,andfatigue-relatedsymptomsandincidentscollectedfromcompanyrecords

andthroughdriverinterviews43.

Exposures in thealuminium industrywere studiedaspartof a cohort studyof industryworkers.Botha task-

exposurematrixandajob-exposurematrixweredevelopedusingthousandsofpersonalsamplescollectedover

manyyearsandcoveringarangeofairbornecontaminants, includingfluorides,coaltarpitchvolatiles,sulphur

dioxide,inspirabledust,aluminadust,bauxitedustandoilmist44,45.

Exposuresintheseafoodindustrywerestudiedusingacross-sectionalsurveyofemployers.Thisstudyexamined

bothexposuresandtheuseofcontrolmeasures46.

Exposures in veterinary nurses were studied through a self-administered questionnaire. This identified high

prevalencesofexposuretox-rayradiation,anaesthetics,formaldehyde,pesticidesandvaccines47.Asimilarstudy

of veterinarians, also via self-administered questionnaire, identified themain reported exposures as being to

chemicals (such as “flea rinses, formalin, glutaraldehyde, x-ray developers and gaseous anaesthetics”) and

potentially to x-rays. The study also provided information on controlmeasures (extractor fans for scavenging

wasteanaestheticgases)48.

TheexposuresandsettingsoftheAustralianstudiesaresummarisedinTable1.


��

T A B L E � Exposures and settings covered in Australian-based studies

E X P O S U R E S E T T I N g R E F E R E N C E

Physical

Noise Farming,radioannouncing Williams,20036 Depczynski,20055

Radiation Positronemissiontechnologyoperation Roberts,20057

UV-Bradiation Farming Airey,19978

Hypoxicatmosphere Airforce Cable,20039

Threatsofviolence Healthsector Benveniste,200515 Knott,200510 Lyneham,200011 Magin,200512 Mayhew,200314 Tolhurst,200313

Chemical

Benzene Petroleumindustry Black,200422 Glass,2000,2001,2001,200518–21

MOCA Manufacturingindustry Wan,198923

Dust Coalmining Kizil,200224

Environmentaltobaccosmoke Various Borland,199726 Cameron,200325

Other Useofexpertpanels Benke,199727

Biological

Sharpsexposures Healthsector Bowden,199329 Charles,200331 deVries,199433 MacDonald,199535 Mallon,199230 Richards,199734 Smith,200528 Whitby,200232

Blood-borneinfection Beautytherapists Murtagh,200436

Wooddustandendotoxins Woodworking Alwis,199938 Mandryl,200037

Aspergillus Constructionwork Cooper,200339

Batlyssavirus Variousoccupations McCall,200040

Pyschosocial

Traumaticevents Peri-operativenurses Michael,200141

Fatigue Transportindustry Arnold,199642 Dalziel,199743

Other

Various Aluminiumindustry Benke,2000,200144,45

Various Seafoodindustry Lopata,200446

Various Veterinarynurses VanSoest,200447

Various Veterinarians Jeyaretnam,200048

�� R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

NEW ZEAL AND S TUDIES

Ataskandsafetyanalysiswasconductedofphysicalhazardsinchainsawfelling49.

NoiselevelswerealsostudiedonfarmsinNewZealandbytakingmeasurementsonarandomsampleoffarms,

withnoiselevelsfoundtoaveragearound85dB(A)50.

Cosmicrayexposureinflightcrewwasthesubjectofonestudy51.

Environmentaltobaccosmokeexposureintheworkplacewasstudiedusingface-to-faceinterviewsofworkers52.

Bloodleadlevelsandexposuretoleadwerestudiedinlead-exposedworkersbytakingregularbloodsamplesand

checkingontheresponsesmadeforworkerswithelevatedreadings53.

AstudyofNewZealandweldersassessedtheresponsetoarespiratoryhealthsurveybyinspectingtheworkplaces

atalatertimeandidentifyingwhetherlocalexhaustventilationandrespiratoryprotectionwerebeingused54.

Exposuretosharpsinjuriesinthehealthsectorwasstudiedinapostalsurveyofgeneralpractitionersandpractice

nurses,withan82%responserate55.

Forestryworkerswerealsothebasisofastudyoftheprevalenceoffatigueandassociatedexposuressuchaslong

workinghours,reducedrecovertime,fast-pacedworkandreducedsleep56.

Adetailedstudyofplywoodmillworkersexaminedexposures topersonal inhalabledust,bacterialendotoxin,

terpene,abieticacidandformaldehyde57.

Exposures in the boat-building industry were studied using a questionnaire administered by an occupational

health nurse and occupational health and safety inspector. Subjects were workers in randomly selected

workplaces.Thisprovidedqualitativeinformationonthemainexposures58.

Ageneralapproachtoexposuresurveillanceandcontrolsurveillancewasinvestigatedusingaself-administered

questionnairethatwasregularlycompletedbymanagersandsupervisorsandthenusedasabasisforadviceon

howtoimprove.Theapproachwastrialledintwoworkplacesand,basedonthisverylimitedtrial,appearedtobe

ausefulmeansofbothmonitoringexposuresandimprovingoccupationalhealthandsafety59.

TheexposuresandsettingsoftheNewZealandstudiesaresummarisedinTable2.


��

T A B L E � Exposures and settings covered in New Zealand-based studies

E X P O S U R E S E T T I N g R E F E R E N C E

Physical

Physicalhazards Chainsawfelling Bentley,200549

Noise Farming McBride,200350

Cosmicrays Flightcrew Taylor,200451

Chemical

Environmentaltobaccosmoke Variousworkplaces Jones,200152

Bloodlead Leadworkers Grant,199253

Biological

Sharpsexposures Healthsector Lum,199755

Pyschosocial

Fatigue Forestryworkers Lilley,200256

Other

Various Plywoodmillworkers Fransman,200357

Various Boatbuilding Ruttenburg,200158

Respiratorycontrols Welders Slater,200054

General Various Haque,200059

�.� PAPERS PROVIDIN g INFORMATION ON OCCUPATION AL EXPOSURE OR C ONTROL MEASURES AS PAR T OF A S TUDY WITH A DIFFERENT MAIN OBJECT IVE

Forty-sixstudiesprovidedsomequantitativeinformationonexposuresorcontrolmeasuresaspartofpaperswith

adifferentmainobjective.Thesepapers cover a rangeof topics,which are listed separately forAustralia and

NewZealand.

AUS TRALIAN S TUDIES

Physical:

• noiseinvariousworkers60

• sunexposureinoutdoorworkers61andgeneralworkers62,63

• radiationexposureinreactorworkers64

• radongasexposureinuraniumminers65

• artificialultravioletradiationinvariousworkers66

• occupationallightvehicleuseinvariousworkers67

• physicalhazardstothefootinvariousworkers68

• physicalfactorsinsurflifesavers69

Chemical:

• asbestosexposureinminers70,71

• silicaexposureinvariousworkers72


• benzeneandotherchemicalexposureinpetroleumworkers73,74

• passivesmokinginvariousworkers75–77

• pesticidesinvariousworkers78

• solvents,metals,organicdustsandPCBsinvariousworkers79

• chemicalexposuresinfarmers80

Biological:

• Q-feverexposureinabattoirworkers81

• wooddustexposuresinfurnituremanufacturingworkers82

Psychosocial:

• stressinruralnurses83

• workstressinpublicservants84

• jobstraininprofessionalworkers85

• workorganisationinvariousworkers86

• psychologicaltraumainnurses87

Other:

• variousexposuresinphysiotherapists88,89

• chemicalandbiologicalexposuresinmeatworkers90

• dusts,chemicalsandradiationintextileworkers91,92

• variousexposuresinaluminiumsmelterworkers93

NEW ZEAL AND S TUDIES

Physical:

• fallshazardsindairyfarming94

Chemical:

• dustexposureinsaw-millers95

• variousexposuresinfoundryworkers96

• chemicalexposuresinwelders97,98

Biological:

• hepatitisBexposureinpoliceandcustomspersonnel99

• condomuseinsexworkers100

Psychosocial:

• fatigueinpilots101

Other:

• physicalandbiologicalexposuresinpoultryworkers102

• chemicalandbiologicalexposuresinmeatworkers103

• respiratoryexposuresinfarmers104


��

� .� D ISCUSSION

The review of published literature on Australian and NewZealand exposure surveillance and control system

surveillancerevealedthatneitherappearstohaveaprominentroleinoccupationalhealthandsafetyatanational

orregionallevel.Exposureswerethemainfocusofanumberofstudies,coveringarangeofphysical,chemical,

biological and psychosocial exposures, and a variety of occupations, industries and exposure circumstances.

Afewstudiesreportedondetailedexposuresystemsbasedonaparticularcompanyor,forpetroleumproduction

andaluminiumproduction,onaparticularindustrysector.Insomecases,theexposuremeasurementsprompted,

orwerelikelytoprompt,aspecificresponsetocontroltheexposuresinsomeway,butthisdidnotappeartobe

partofaformalexposuresurveillancesystem.

Quantitative information on exposures is also available from many studies that focused on examining the

relationshipbetweenexposureandaparticularoutcomeandthatcollectedexposureinformationaspartofthe

investigation,butthesestudieswerealsonotconductedaspartofexposuresurveillance,noraroseasaresultof


Insummary,apartfromtwosystemsbasedonanindustrysector,thereisnopublishedinformationondetailed

exposuresurveillance,eitherofasingleexposureorarangeofexposures,atanationalorregionallevelineither

AustraliaorNewZealand.What information is available appears tobe fragmented,under-resourcedand lacks

strategicco-ordinationanddirection.

�6 R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6


��

SECT ION FOUR

4EXPOSURE SURVEILLANCE

OVERVIEW OF APPROAC HES TO


� .� THE C ONTRIBUTION OF EXPOSURE SURVEILL AN CE TO OCCUPATION AL HEALTH AND SAFET Y

Exposuresurveillancecancontribute to improvements inoccupationalhealthandsafety inanumberofways.

Mostimportantly,monitoringofexposuresallowspreventionactiontobeinstitutedearlierthanisusuallypossible

whenmonitoringoutcomes,particularlywhenthereisalonglatencybetweenexposureandtheoccurrenceofthe

resultingdisorder,asisthecasewithmanywork-relateddiseases.Thisallowsgreaterpotentialtopreventmore

casesdeveloping.Otherpotentialadvantagesinclude:

• thereareusuallymanymorepotential“occurrences”ofexposurethanthereareoccurrencesofoutcomes2,4

• theapproachhighlightsthecausativeexposureandtheneedtoproperlycontrolit2,4

• monitoring exposures provides the most appropriate and direct measure of the success or otherwise of

programmesdesignedtodecreaseexposure2,4

• tomonitorprogressandidentifyareasneedingadditionalfocus

• toevaluatemeasuresalreadyinplace

• todemonstratecompliancewithlegislative/regulatoryrequirements

• todemonstratecompliancewithinternalreportingrequirements

• toassessorimprovecosteffectivenessandproductivity

• toprovideevidenceofmanagerialconcernforthehealthofworkers.

Optionsforfeasibleexposuresurveillancesystemsdependprimarilyontheexposureofinterest.Theoutcomesof

interest are still relevant, but primarily in terms of influencing the need for an exposure surveillance system.

Disorders which have a long latency between exposure and the occurrence of the disorder are appropriate

candidatesforanexposuresurveillancesystembecausemonitoringoftheoutcomereflectsexposuresmanyyears

beforehandratherthanrecentexposures.Usingoutcomeinformationtoplanpreventionmeasuresinlong-latency

conditionsmeans that theprevention initiativesarebasedonhistoricalexposures thatmaynot reflectcurrent

occupationalexposures. Insuchsituations,monitoringofcurrentexposuresseemsmorelogical,morelikelyto

leadtofasterimprovementsinoccupationalhealthandsafety,arguablymoreethicalandpotentiallymorecost

effective.Thatisnottosaythatmonitoringoftheoutcomeisunimportant.Itwillalwaysbeimportanttomonitor

outcomes, because injury and illness are the absolute and unarguable measures of occupational health and

safety. Monitoring outcomes therefore provides the best measure of the success or otherwise of prevention

initiatives, andprovides evidence to support or refute understanding of the relationship between a particular

exposureandtheoutcometowhich ithasbeen linked.However, in long latencydiseases,onlymonitoringthe

outcomemeansmanyworkersmaybeexposedincircumstancesthatcouldbeavoided.

Theover-ridingaimofanycomprehensiveoccupationalhealthandsafetysystemisthepreventionofthework-

relatedinjuryandillness.Therearemanyinputsintosuchasystemleadingtothisultimategoal,withexposure

surveillance potentially being one of them. Figure 1 presents one way of representing such a comprehensive

system,showingtheplaceofexposuresurveillance.(Otherrepresentationscouldalsobeused.)

Thetwokeyinputsintotheoverallsystemareinformationonthelevelofoutcomeandinformationonthelevelof

exposure.Where there is good knowledge about the relationship between exposure and outcome, and good

knowledge about effective prevention approaches, information on exposure can lead directly to effective

preventionactivity.Similarly,informationonoutcomescanpromptanincreaseinpreventionactivity.Forconditions

of short latency (e.g. injury from exposure to electricity), and where there is a clear connection between

occupationalexposureandtheoutcomeinallormostindividualwork-relatedcases,monitoringoutcomescanbe

aneffectivewayofmonitoringtherelevantareaofoccupationalhealthandsafety.Exposuresurveillancemaystill

beuseful,butinmanyinstancesitwillprovemoredifficultorcostly,atleastintheshortterm,thanusingoutcome

information, although ethically itmay be better tomonitor exposure. For conditions of long latency (such as


��

Goodunderstandingofexposure-outcomerelationship

Poororincompleteunderstandingofexposure-outcomerelationship

Potentiallyeffectivepreventionmeasures

Knowneffectivepreventionmeasures

ImprovedlevelofOHS

Outcomeinformation

Exposureinformation

Evaluationofpreventionmeasures

occupational lung cancer), or where the connection between work and the outcome is difficult to identify in

individualcases,theexposurearmofthemodelbecomesmoreimportant.Thisisanimportantpotentialuseof


Wherethereisnotagoodunderstandingoftherelationshipbetweenexposureandoutcome,exposureinformation

canbelinkedwithoutcomeinformationtoprovideabetterunderstandingoftheexposure-outcomerelationship

(e.g.useofpesticidesandhaematologicalmalignanciessuchaslymphoma).Thisisthesecondpotentialuseof

exposuresurveillanceinformation.Thelinkageofexposureinformationwithoutcomedata(whichiscommonly

collectedthroughspecificepidemiologicalstudies)hasimportantimplicationsforthewayexposuredatamightbe

collected and coded. Once there is good knowledge of the relationship between exposure and outcome, this

informationcanbeusedtohelpdesignpotentiallyeffectivepreventioninitiativesfortrial.

ThemiddlesectionofFigure1representsthesituationwherepreventioninitiativeshavebeendesigned,buttheir

effectivenessisnotyetknown.Theseinitiativesmustbetrialledinordertoidentifytheinitiativesthataremost

effective. Exposure informationmayproveuseful to such trials,but it is likely that suchexposure information

wouldbecollectedinspecificallydesignedstudiesratherthanitcomingfrommoregeneralsurveillancesystems.

F I g U R E � Relationship of exposure and outcome information to occupational health and safety prevention activities

� 0 R E V I E W O F AU S T R A L I A N A N D N E W Z E A L A N D WO R K P L AC E E X P O S U R E S U RV E I L L A N C E S YS T E M S : N O H SAC T E C H N I C A L R E P O R T 6

Exposuresurveillancesystems

Exposureinformation

Job-exposurematrix

Exposurecontrolsystems

Ad-hocexposureinformation

Workplacesurveys

Exposureregisters

Workforcesurveys

Figure 2 illustrates how the potential sources of exposure information might interact or combine to provide

informationonexposurethatcanthenbeusedforpreventionpurposes(thesesourcesareconsideredlaterinthis

chapter). Aswith Figure 1, this interaction could be drawn in several differentways.There are currently three

existingsourcesofinformationthatcouldpotentiallybeusedtoprovideexposureinformation.Thesearead-hoc

sources(themostcommon),exposuresurveillancesystems(rare)andexposurecontrolsystems(rare).Information

for exposure surveillance systems can potentially come from several sources, either singly or in combination.

Themostimportantoftheseisprobablythejob-exposurematrix,orworkplace-exposurematrix.

F I g U R E � Relationship between potential sources of information on occupational exposure


��

� .� T YPES OF EXPOSURE SURVEILL AN CE SC HEMES OR INFORMATION SOURCES

This section provides a brief overview of themain approaches to exposure surveillance. It is not intended to

provideacomprehensivedescriptionofthetopic.Amoredetailed literature-basedconsiderationofthearea is

providedintherecentlycompletedInternational review of exposure surveillance and control systems1.

ROUTINELY C OLLECTED OCCUPATION AL EXPOSURE DATA

Exposuredataissometimescollectedaspartofroutineworkbyanoccupationalhealthandsafetyauthorityor

privateorganisation.Thedatausuallycoverasingleexposure,oraverylimitednumberofexposures.Suchdata

collections are not usually considered by exposure surveillance systems, as there is no clear connection to

preventionorrelatedactivity,butinsomecircumstancestheexposuredatamaybesuitableforuseinaproper

surveillancesystem.

C OMPREHENSIVE SURVEILL AN CE S YS TEMS

Comprehensiveexposuresurveillancesystemsaresystemsdesignedtocoverawidevarietyofhazards.Several

large companies in Australia and NewZealand appear to have such systems in place (although there is no

publishedliteraturedescribingthem),buttherearenosuchsystemsrunorusedbypublicagencies.

JOB -EXPOSURE MATRIX

A job-exposure matrix is a database that cross-classifies exposures with job tasks or job titles. The major

advantageofajob-exposurematrixisthatitallowsexposurestobepredictedforapersonwithaparticularjob

task (or occupation) in a particular industry without having to separately measure the exposures for every

individual. Themain disadvantages are that a huge amount of data and associated resources are required to

obtainthenecessaryinformationtoconstructthematrixandthat,unlessthematrixisupdatedonaregularbasis,

itsoonbecomesoutofdate.Thebestexamplesofjob-exposurematricesatanationalorinternationallevelare

theNationalOccupationalHazardSurveyandNationalOccupationalExposureSurveyconductedbytheNational

InstituteofOccupationalSafetyandHealthintheUnitedStates,andtheCarcinogenicExposure(CAREX)database

developed by the Finnish Institute of Occupational Health. Job-exposure matrices are based on measured or

estimatedexposuresinawiderangeofjobtasks.Sincetheexposureswillvaryasthetasksvary,job-exposure

matricesshouldideallybedevelopeddenovoineachcountry.Inpractice,sincethedatacollectionrequiredisso

massive, and the same task performed in different settings can often be expected to have similar types and

intensitiesofexposures,job-exposurematricesoftencombinedatacollectedspecificallyforthematrixwithdata

collectedelsewhereforadifferentmatrixorfordifferentpurposes.

SPECIF IC -EXPOSURE DATABASES

Specific-exposure databases are information systems that collect data on specific exposures. A variety of

informationmaybecollected. Itmightbebasedonpersonalexposureoronenvironmental levelsofexposure.

A typical example of an exposure database based on personal exposure is one used tomonitor exposure to

ionising radiation. Typical examples of exposures based on environmental levels of exposure are those


commonlyusedtomonitorambientnoiselevelsinindustrialworksites.Exposuredatabasescanbeexpectedto

formthefundamentalpartofanyexposuresurveillancesystem.

WORKFORCE S YS TEMS

Labour force surveys are population surveys that provide information on the number of people employed in

varioussectionsofthelabourforce.Informationisstratifiedbyoccupationandindustry,eitherseparatelyorcross-

classified.Inaddition,alabourforcesurveycommonlyprovidesdemographicinformationontheworkforce,such

asageandgender.Informationonaspectsofwork,suchashoursofwork,shiftwork,full-time/part-time/casual,

isalsosometimesavailable.

Labourforcesurveydataarepotentiallyusefultoexposuresurveillanceintworelatedways.Firstly,theyprovide

informationonthenumberofpeopleatriskinapopulation.Combinedwithexposureinformation,thisallowsthe

rate(inthiscase,theprevalence)ofexposuretobecalculated.Theseratescanbecomparedovertimetoprovide

ameasureof the trend in termsofexposure in thepopulation.Thesecond, relateduseofsuch information in

exposuresurveillanceistoprovideameasureofhowmanypeopleareineachoccupation-industrygroup.Usedin

conjunctionwitha job-exposurematrix, or relatedexposure information system, this information canbeused

whenestimatingthenumberofpeoplelikelytobeexposedtoaparticularhazard,eitheroverallorstratifiedby

differingexposurelevels.

LabourforcesurveyinformationinAustraliaandNewZealandisprovidedbytheAustralianBureauofStatistics

(ABS)andStatisticsNewZealandrespectively.Detaileddescriptionsoftheinformationavailablefromlabourforce

surveyscanbefoundatthewebsitesofbothorganisationsii.

RE gIS TERS OF SUBS TAN CES

Registersofsubstancesaredatabasesthatprovideinformationonwhichworkplacesareinvolvedinthestorage

and/oruseofparticularhazardoussubstances.Theythereforeprovideinformationonpotentialexposure.Inthe

absenceofinformationofenvironmentalorpersonalexposuretospecifichazardoussubstances,registersprovide

guidanceasto the likelyprevalenceofexposure.However, theydonotprovide informationonthe intensityor

frequencyofexposure.

INDUS TRY SURVEILL AN CE S YS TEMS

Industrysurveillancesystemstypicallyinvolvemorethanonespecifictypeofsurveillancesystem.Industry-based

systems can, in theory, incorporate one or more components of the workforce, exposure or register systems

already described. There are no established industry-based systems in Australia or NewZealand. The Health

Watchsystemrunbythepetroleumindustrycollectssomeinformationonexposures,butonlyaspartofahealth

surveillance project18–21. Similarly, theHealthwise project collects some information on exposure of aluminium

workersaspartofadetailedhealthsurveillanceproject44,45.TheminingindustryinAustralia,throughtheMinerals

Council of Australia, is in the process of trialling an industry-based surveillance system focused on noise

(seedetailedinformationaboutthisinSection5.3).TheQ-feverRegisterprovidesarecordoftheimmunestatus

ofworkerspotentiallyexposedtoQ-fever,butnotontheprevalenceofexposuretoQ-feveriii.

ii Seehttp://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4A5D8F4E8F9C9DBBCA256F7200832FECforAustralia,and

http://www.stats.govt.nz/datasets/work-income/household-labour-force-survey.htmforNewZealand.

iii Seehttp://www.qfever.org/


� �

POPUL ATION -BASED EXPOSURE DATA

Thereislikelytobelimitedcollectionofexposuredataatapopulationlevel,andwhatiscollectedislikelytohave

limiteddirectusefulnessinoccupationalexposuresurveillancesystems.Populationexposuredatacollectionis

notundertakeninanysystematicfashionandsodoesn’treallyconstituteaformalsurveillancesystem.Probably

themostpotentiallyuseful informationisthatcollectedoncontrolsystems(e.g.prevalenceofresidualcurrent

devicesorsmokedetectors inhouses),whichcouldbeused tocompare tosimilar informationcollected inan

occupational context. Both the National Health Surveyiv and the Household, Income and Labour Dynamics in

Australia(HILDA)surveyvmayproviderelevant informationifpurpose-specificmodulesareaddedtothem,but

suchmodulesareunlikelytobeusedonanon-goingbasis.Similarly,thepoisonsinformationcentresthatexist

in most jurisdictions provide a little information on poisoning related to workplace exposures, but such

exposuresonlymakeupa small proportionof the total reports to the centres, e.g. 1% (106 cases) inVictoria

in 2005105 and 2% (645 cases) inWestern Australia in 2002106, the available information (at least the publicly

available information) is not detailed, and the data provide only a very broad, general indication of possible

occupationalexposures.

�.� APPROAC HES TO DATA C OLLECT ION

Thissectionprovidesabriefoverviewof themainapproaches todatacollection thatcanbeused inexposure

surveillance.

WORKPL ACE AND WORKFORCE SURVEYS

Workplaces can be surveyed to provide information on exposures of interest. These surveys can involve

observationsoftheworkplaceandtheworkforce,takemeasurementsofpersonalorareaexposures,ortakethe

formofquestionnairesdirectlygiventoworkersormanagers,orpostedtothem.Thesurveyscanalsoinvolvean

auditofthepresenceofparticularexposuresorcontrolmeasures.Theresultinginformationmaybequalitativeor

quantitative.Anexampleof theseapproaches isasurveyofsolventuseconducted ina light industrialarea in

Sydney in the 1990s, which initially sent a questionnaire to businesses and then validated the responses by

visitingasampleofthebusinessesincludedinthesurvey107.

Asimilarsurveyapproachcanbeusedwherethefocusistheworkerorthemanagerratherthantheworkplace.

Usually the information iscollectedviaaquestionnaire thatcanbemailedtoworkersorgivento them,either

directly or over the phone. Alternatively, the subjects can be interviewed. For example, information on the

prevalence of exposure to environmental tobacco smoke, and on the presence of workplace smoking bans

(acontrolmeasure)hasbeencollectedinthismanner25,26,52.

ThemostextensiveapproachesusingsurveysforexposuresurveillancewereconductedintheUnitedStatesby

theNationalInstituteofOccupationalSafetyandHealth(NIOSH)inthe1970sandthe1980s,andathirdmajor

surveyhasbeenproposed108.Thegoalsofthesurveyprovideanindicationofthetypeandextentofinformation

thatcanbecollected.Thesurveysetsoutto:

• estimatethetotalnumberofworkersexposedtoawiderangeofspecifichazardsandthenumberexposedat

varyingqualitativelevelsofexposure

• describethedistributionofhazardswithregardtooccupation,industry,geographyandworkerdemographics

iv Seehttp://www.abs.gov.au/Ausstats/[email protected]/0/cac1a34167e36be3ca2568a900139364?OpenDocument

v Seehttp://melbourneinstitute.com/hilda/


• describethenatureandextentofhazardcontrolsforreducingworkerexposures

• describethenatureandextentofspecificoccupationalsafetyandhealthprogrammecomponents

• identifypreviouslyunrecognisedgroupsatriskfromknownhazards

• identifynewandemerginghazards(bycomparingdatafromprevioussurveysandfuturesurveys)108.

ROUTINE OR AD-HOC MONITORIN g

Routineandad-hocmonitoringofexposuresatanarea level isoneof themostcommonapproaches taken to

exposuremonitoringforvirtuallyallhazards.Theexposuremeasurementsareusuallyorganisedbythemanagers

oftheworkplace,orbyconsultantsengagedbytheworkplacetomakesuchmeasurements.Themeasurements

may be taken for many reasons, including to compare to worksite requirements (e.g. internal auditing), for

externalcompliancepurposes,tocheckplantfunctioning,ortomonitortheeffectofnewproceduresorequipment.

Suchmonitoringmay be done through directmeasurement of the intensity of the exposure (e.g. to physical

exposuressuchasnoise,heat,light;andtoavastarrayofhazardoussubstances),orthroughsurveysproviding

aqualitativeassessmentofexposures.

C ONTINUOUS AREA MONITORIN g

Continuousmonitoringofmanyphysicalandchemicalhazardsatanarealevelistechnicallypossibleandoften

not prohibitively expensive. Such monitoring is common in many large workplaces and provides very useful

informationforexposuresurveillance,allowingimmediateidentificationofanincreaseinexposureandtherefore

thepotentialforpromptpreventativeactioninresponse.

ROUTINE OR AD-HOC PERSON AL MONITORIN g

Routineandad-hocmonitoringofexposuresisnotundertakenascommonlyasareamonitoring,butnevertheless

isareasonablycommonapproachtoobtaininginformationaboutpersonalexposuretophysical,andparticularly

chemical, hazards. Depending on the frequency of sampling and the standardisation of the approach used,

exposure data obtained through routine and ad-hoc personalmonitoring can be used as part of an exposure

surveillancesystem.

C ONTINUOUS PERSON AL MONITORIN g

Formanyexposures,theriskofoccurrenceoftheoutcome,ortheseverityoftheoutcome,isdirectlyrelatedto

thetotalexposuredose,eitheroveralifetimeoroveradefinedperiodoftime.Forsuchexposures,anon-going

assessmentofthetotalexposuredosecanmakeausefulcontributiontoexposuresurveillance.Unfortunately,for

mostexposures,particularlyphysicalandchemicalexposures,continuousmonitoringof individualexposureis

practically difficult and resource intensive, and so is not feasible. A prominent exception to this is ionising

radiation, forwhich a continuousmonitoring system has been in place in Australia for a number of decades.

Monitoringoflong-distancetruckdrivers’timewhilstdriving,ortimewithoutaproperrestbreak,usinglogbooks

ormoresophisticatedelectronicmethods,isanexampleofsuchmonitoringappliedtoergonomicexposures.


� �

B IOLOgIC AL MONITORIN g

Theplaceofbiologicalmonitoringinexposuresurveillanceisuncertain.Strictlyspeaking,itmeetsthedefinition

ofexposuresurveillance,sinceitrelatesdirectlytooccupationalexposures.Biologicalmonitoring(e.g.ofblood

lead)canprovideveryusefulinformationintermsofthequalitativeaspectsofexposure,butitusuallydoesnot

providequantitative informationon the exposures in theworkplaceor of theworker.However, these external

exposuremeasurementsthattypicallyformthebasisofexposuresurveillancearereallyonlyusedinanattempt

to understand the likely internal dose theworker gets ofwhatever exposure is being considered. In essence,

externalexposuremeasures,whetherenvironmentalorpersonal,arereallyusedassurrogatemeasuresof the

internal exposure of the worker. So, it can be argued that biological monitoring provides a better exposure

estimate,asitisbasedonthepresenceofthesubstanceinbodyfluidortissue.

Biologicaleffectmonitoring(e.g.monitoringredcellcholinesteraseinpesticide-exposedworkers) issomewhat

different,inthatitmeasuresnottheamountabsorbedbutthebiologicalconsequencesofthatabsorption.Ifthe

measured consequences are not themselves important, and precede the development of more serious

consequences, then it might be reasonable to use biological effect monitoring in an exposure surveillance

programme.However,thephilosophyofexposuresurveillanceistoidentifyproblemexposuresbeforetheyoccur,

sobiologicaleffectmonitoringsitsuneasilywithit.

Forthevastmajorityofexposures,therearenorecognisedbiologicalmonitoringapproaches.Fortheseexposures,

externalexposuremeasurementremainstheonlypracticalmethodofdatacollectiononwhichtobaseexposure

monitoring.Forthoseexposuresforwhichvalidandinterpretablebiologicalmeasuresareavailable,theyshould

beconsideredaspartofexposuresurveillance.Biologicalmonitoringisvirtuallyalwaysroutineorad-hoc,rather

thancontinuous.


� �

SECT ION F IVE

5EXPOSURE SURVEILLANCE SYSTEMS

SURVEY OF CURRENT

IN AUS TRALIA AND NEW ZEAL AND


� .� INTRODUCTION

The main part of the project was designed to provide an understanding of the way occupational exposure

surveillancewasused inAustraliaandNewZealand.Thefocuswasonnationalsystems,ornationally relevant

systems.Therequiredinformationwascollectedthroughasurvey.Thischapterdescribesthemethodsandresults

of the survey,and implications thishas for futurework inoccupationalexposuresurveillance inAustraliaand

NewZealand. The information provided about the relevant exposure surveillance schemes differs from the

structurelistedintheprojectcontract,butallareaslistedinthecontractareincludedinthereport.Theoriginal

plannedstructurewasmodifiedtomoreefficientlypresenttheinformationobtainedduringtheproject.

�.� SURVEY METHODOLO gY

SELECT ION OF ORgANISATIONS /C OMPANIES TO IN CLUDE IN THE SURVEY

Thefocusoftheprojectwasnationalexposuresurveillancesystems,ornationallyapplicablesystems.Therefore,

inAustralia,theoriginalintentionofthesurveywastotargetthemainoccupationalhealthandsafetyagenciesin

each of the Australian States and Territories and in NewZealand. In addition, relevant union and industry

surveillanceschemesweretobetargetedforinclusion.Followingdiscussionwiththesteeringcommittee,itwas

decided to expand the survey to includemost universities and to also include a convenience sample of large

Australian-based companies. An opportunistic, key informantmethodologywas used for recruitment, with an

attempttousekeynetworksthatwerebelievedmighthaveexperiencewithexposuresurveillanceorbeawareof

organisationsthatdid.Thismeantthatorganisationsorpersonsnotinitiallytargeted,butwhofoundoutabout

thestudyandcontactedoneoftheprojectmembers,wereincluded.Inaddition,professionalOHSgroupssuchas

theAustralasianFacultyofOccupationalMedicineandtheAustralian InstituteofOccupationalHygienistswere

contactedinthehopethattheirmembersmighthaverelevantinformationthemselvesorwouldnominaterelevant

organisations. The justification for including universities was that universities may be conducting research

relevanttoexposuresurveillance,ormighthaveexposuresurveillancesystemsinplace.Thejustificationforthe

inclusionofaselectedgroupoflargecompanieswasthatanyexposuresurveillancesystemsbeingusedinthe

privatesectorwerelikelytobeusedbylargecompanies,andthatonlysystemsusedbynationalormulti-national

companies would be likely to be applicable at a national level. The project was not designed to provide a

comprehensivesurveyofalllargecompaniesanddidnotattempttoproducesuchacomprehensivesurvey.

AsimilarapproachwasusedinNewZealand,exceptthatonlypublicorganisations,aswellasunionandindustry

bodies,wereincluded.

Inaddition,ageneralcallforresponseswassenttooccupationalmedicinespecialistsinAustraliaandNewZealand

viatheAustralasianFacultyofOccupationalMedicine(AFOM).TheAFOMsent informationabouttheprojectto

occupationalmedicinespecialistsviathegeneralFacultyemaillist.

DATA C OLLECT ION APPROAC H

Thesurveywasdesignedtoallowthecollectionofinformationonsurveillancesystemsandactivitiesrelevantto

the project. Information was collected via an electronic questionnaire developed by the project leader, in

consultationwiththesteeringcommittee.Participantswereaskedtoprovidewhatinformationtheycouldforeach


� �

oftheareaslistedinthequestionnaire.Theywereencouragedtoprovideanswerselectronicallyandtoreturnthe

completedquestionnaireasanelectronicfile,althoughresponsesonpaper,orviatelephone,werealsoaccepted.

Answerstomostquestionsrequiredtextinformation.Participantswereencouragedtoprovidefurtherinformation

onaseparatesheetofpaperifthiswasnecessary.

THE SURVEY qUES TIONN AIRE

Thesurveyquestionnairewasbasedonaprevioussimilarquestionnaireusedbytheprojectleader,butadapted

tocoverallrelevantareasforthecurrentproject.Thequestionnairebeganwithabriefdescriptionoftheproject

andtheworkingdefinitionofexposuresurveillancesystemsandexposurecontrolsystems,whichwasfollowed

byquestionscoveringallrelevantaspectsofthesesystems.Themainareascoveredinthequestionnairewere:

• Section1.Basicinformationandcontentsofthesystem:

-Name,ownerandbasicdocumentsofthesurveillancesystem

-Focus

-Typeofinformation

-Datacollection

-Datarecordingandstorage

-Reliabilityandvalidity

-Linkages

• Section2.Theinternalandexternalusesandaimsofthesystem

-Datause

-Frequencyandcontentofreportsissuedfromthesurveillancesystem

-Ethicalandprivacyissues

-Conditionsforaccessandusebyexternalusers

• Section3.Backgroundandfuture

The full questionnaire is shown in Appendix 1, and the covering letter that accompanied the questionnaire is

showninAppendix2.

DIS TRIBUTION OF THE qUES TIONN AIRE

InAustralia,thequestionnairewasdistributedinearlyFebruary2006,withaninitialduedateof6thMarch2006.

Somesurveysdidnot reach the intendedpersons initiallybecauseof incorrect contactdetails, andadditional

organisations were identified after the questionnaires were distributed. Therefore, some participants did not

receivethequestionnaireuntillateFebruary.Theseparticipantswerethengivenseveralmoreweekstocomplete

thequestionnaire.Forvariousreasons,certainorganisationswereunabletocompletethequestionnairebythe

initialduedate.Theseorganisationswereencouragedtosubmitthequestionnaireassoonastheywereable,even

if thismeant theywouldbesubmitting it severalweeks“late”.Organisations thatdidnothavea surveillance

systemwereencouragedtosendabriefemailtotheprojectleadertothateffect.

InNewZealand,organisationsweresurveyedthroughdirectinterviewbyMrMarkWagstaffe.


� .� RESULT S

TheAustralianandNewZealandaspectsofthesurveywereconductedseparately.TheAustraliancomponentof

thesurveywasmoreextensivethantheNewZealandcomponent,andisdescribedindetailfirst.TheNewZealand

componentisthensummarised.

OVERVIEW OF RESPONSES

Thesurveywassentviaemailto240separateorganisationsandinterestedindividuals(eightofthesesurveys

wereunabletobeproperlydeliveredduetowrongemailaddresses).Mostoftheseweresentdirectly,butsome

weresentfollowingenquiryfromanindividualorreferralfromanotherindividualororganisation.Thesurveyed

organisations included industry peak bodies, industry skills councils, employee organisations, government

departments, research bodies and selected major companies. The list of included organisations is shown in

Appendix3.

Responseswerereceivedfrom63organisations.Anorganisationwasdeemedtohaverespondediftheysenta

completedquestionnaireorcontactedtheprojectleader(byemailorphone)tosaythattheyeitherdidnothave

any relevant systems, or that the questionnairewas not relevant to them. Some of the industry peak bodies

referred the questionnaire to specific companieswhom they represented, and someof these companies then

respondeddirectly.Otherpeakbodiesresponded,butonlytoindicatethatthequestionnairewasnotrelevantto

theirwork.ThelevelandtypeofresponsesreceivedaresummarisedinTables3,4and5.

T A B L E � General summary of survey – questionnaires sent and responses received – by responder type

R E S P O N D E R T Y P E N U M B E R S E N T R E S P O N S E S R E C E I V E D %

OHSdept 8 4 50.0

Industrypeaks 106 18 17.0

Industryskillscouncils 6 2 33.3

Majorcompanies 15 10 66.7

Employeebodies 11 1 9.1

Research 50 11 22.0

Departments 28 12 42.9

Other 8 5 62.5

Total 232 63 27.2


��

T A B L E � Summary of responses received – responder type for each type of response – percentage of each type of responsevi

R E S P O N D E R T Y P E C O M P L E T E D S U RV E Y N O S YS T E M N O T R E L E VA N T

( % ) N = � � ( % ) N = �� ( % ) N = ��

OHSdepartments 8.0 15.4 0.0

Industrypeakbodies 4.0 30.8 50.0

Industryskillscouncils 0.0 15.4 0.0

Majorcompanies 24.0 15.4 9.1

Employeebodies 0.0 0.0 4.5

Researchbodies 28.0 7.7 13.6

Departments 24.0 7.7 18.2

Other 12.0 7.7 4.5

Total 100.0 100.0 100.0

T A B L E � Summary of responses received – type of response for responder type – percentage of each responder typevi

R E S P O N D E R T Y P E N U M B E R O F C O M P L E T E D N O S YS T E M ( % ) N O T R E L E VA N T ( % ) T O TA L ( % )

R E S P O N S E S S U RV E Y ( % )

OHSdepartments 4 50.0 50.0 0.0 100.0

Industrypeakbodies 18 5.6 22.2 61.1 100.0

Industryskillscouncils 2 0.0 100.0 0.0 100.0

Majorcompanies 10 60.0 20.0 20.0 100.0

Employeebodies 1 0.0 0.0 100.0 100.0

Researchbodies 11 63.6 9.1 27.3 100.0

Departments 12 50.0 8.3 33.3 100.0

Other 5 60.0 20.0 20.0 100.0

Total 62 40.3 21.0 33.9 100.0

OHS DEPAR TMENT S

ThemainOHSagency ineach jurisdiction (exceptTasmania),plusComcare,were included in the survey. Four

responded–twowithcompletedsurveysandtwotosaytheydidnothaveanyexposuresurveillancesystems.The

twoagenciesthatdidresponddidnotreallyhaveanexposuresurveillancesystemasitisus

review of australian and new zealand workplace exposure surveillance systems · 2016. 6. 1. · •...

Documents