ARTICLE | Jayandran Mohan, HSE Consultant and NEBOSH IGC Tutor

FIT FOR WORK

Improve health to reduce height risks

ayandran Mohan The main hazards associated with work at protection, fall protection and protection

J considers the health

assessments and
physical training that
minimise the risks when working
height are falls and falling objects resulting
in death, neck and spinal injuries leading
to permanent paralysis or multiple broken
bones. Falling objects can also cause
from falling objects by ensuring the
following barriers to prevent items from
slipping or being knocked off the edge
of a structure: objects/tools secured
severe injuries that may result in death, onto the structure (e.g. scaffolding)
at height.
brain damage, paralysis or multiple broken when not in use; or an exclusion zone
bones. By doing a risk assessment and
Introduction applying the risk prevention hierarchy,
created beneath the area where the
work is taking place.
the proper control measures will be
Work at height is work in any place,
implemented by the employer to control The employer will follow the risk
including a place at, above or below
the above hazards. Along with the prevention hierarchy and the control
ground level, where a person could
control measures, the primary proactive measures to control the hazards, by:
be injured if they fell from that place.
measure in work at height safety is
Access and egress to a place of work 1. Modifying the work process, e.g.
doing effective health assessment, along
can also be work at height. Examples work from ground level and design
with maintaining employees’ fitness by
of work activities that are classified as modifications such as changing the
providing efficient ergonomic training.
working at height include: working on structure’s build process so that steel
trestles, flat and fragile roofs, ladders,
fragile materials on ground level Employer is erected at ground level and craned
into place.
adjacent to an excavation, formwork
within an excavation, erecting false work
responsibility 2. Providing a safe working platform,
or formwork, elevated platforms, and It is the responsibility of the employer to e.g. scaffold with guardrails and
climbing on poles, chimney stacks carry out work at height risk assessment properly installing safety equipment
and scaffolding. and consider the aspects such as edge such as rope access equipment.4

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ARTICLE | Height Safey

3. Minimising the distance of falls

by providing fall arrest equipment,
e.g. harness and lanyard.
4. Minimising consequences of falls by
providing a soft landing, e.g. safety
nets, air bags, etc.
5. Provide effective training and
supervision and deploying
competent workers.
6. Implementing preventive active
monitoring, inspection and
maintenance of access equipment
like ladders and MEWPs.

Health
assessments
The specific health conditions which
may preclude the individual from
working safely at height are recurring
dizziness/altered balance, epilepsy,
diabetes, psychiatric conditions
(including a fear of heights), heart
disease, severe lung conditions, alcohol
and drug abuse, significant impaired
joint function/mobility issues, cognitive
disorders (e.g. dementia/brain damage),
assessments could be determined
reduced communication skills (deafness,
by age as follows:
visual impairment). ILO Occupational
Health service 1985 R171 Section B • Younger than 40 years old – five yearly
11 (1a) says that the employer has to
carry out a health assessment for the • 40 to 52 years – three yearly
worker before deploying them into high • 53 and older – two yearly
risk activities. The following medical Health factors versus fitness criteria for work at height
assessments are carried out to ensure Locomotion
an individual is fit to work in a specific There should be a full range and power Health Factors Fitness Criteria
environment. People who are involved in of movement in all four limbs. An
Weight With a full body harness, the physical weight of
work at height activities such as amputation will normally be a user including tools must be < 280 lbs, with a
industrial abseiling, rigging, contraindication to this work. There body mass index of < 35
telecommunications engineering and should be full recovery of muscle bulk
many more may require a medical and power after a fracture. There should Back, knee, foot, neck and bone Full normal range of movement, no chronic
joints discomfort, lower and upper limb strength,
review to check their fitness for a also be full mobility of the spine. Good adequate body flexibility, adequate balance
specific work role. movement of the cervical spine is
particularly important. Blood pressure (BP) Controlled hypertension: BP < 150/100
Medical examinations
The working at height medical Obesity Eyesight 6/36 or better in both eyes and not corrected
by glasses
examination involves a general health Excess body fat is a weight penalty
screen including vision and body mass during climbing and also indicative of Hearing Capable of hearing emergency commands
index (BMI), a grip strength test, a low level of habitual activity. Obesity ‘Whisper Test’. Able to hear the speech
urinalysis to check for diabetes, a fitness should be judged clinically and by use bandwidth (defined as 300-3,400 Hz)
test (chester step) and a consultation of appropriate height/weight tables. Epilepsy No seizures for two years
with an occupational health professional. Individuals weighing more than 15 - 20
As the likelihood of health (and thereby per cent more than their ideal weight Mental illness, including No untreated or unresolved depression,
fitness for work) issues generally are unlikely to be acceptable for work depression any psychotic illness means individual is
considered completely unfit for work
increase with age, the recurrence of at height.

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 Height Safey | ARTICLE

Cardiovascular system Hearing and vision

A detailed examination of the existence A good level of hearing is required in
of any heart disorders such as Ischaemic the speech bandwidth (defined as 300-
heart disease, Vasovagal attacks or 3,400 Hz). Visual acuity uncorrected
Vertebrobasilar insufficiency. Individuals should be a minimum of 6/36 in each
fitted with permanent cardiac pacemakers eye. Visual acuity corrected should be
will require careful assessment of their 6/12 in each eye. This means that the
underlying conditions. person with impaired vision can see at
six meters what a person with normal
Respiratory system vision can see at 12 metres. Where
Any lung disease, either obstructive or correction, either by spectacles or
fibrotic, which significantly impairs lung contact lenses, is required, a spare pair
function is likely to be a contraindication. of spectacles should be carried. Visual
In case of doubt, lung function should fields should be full in both eyes.
be measured by peak flow reading. Monocular vision is not acceptable in
Neoplastic disease of the lung is an any applications, but may be accepted
absolute contraindication. in an experienced rigger after a suitable
period of adaptation has elapsed.
Diabetes “workers involved in work at height
Diabetes controlled by diet alone will Physical stamina and strength
be acceptable, but insulin dependent The history of the habitual level of
activities such as industrial abseiling,
diabetes will not. Diabetes treated by exercise undertaken at work and during rigging, and telecommunications
diets and oral hypoglycemic agents may
be acceptable if there is no history of
leisure time will provide some insight
into the likely level of an individual's
engineering may require a medical review”
hypoglycaemic episodes or other fitness. The best test is the ability to
complications of the disease. undertake the work required, but it is
desirable that a check of physical
Nervous system stamina is made before this is
A history of any seizure is a undertaken. For use in the consulting
contraindication. There should be no room a step test is most convenient,
history of unexplained episodes of loss with pulse rate returning to near-resting
of consciousness. There should be no levels within two minutes.
history of episodes of vertigo or
giddiness or of conditions affecting
balance, such as Meniere's disease or
Ergonomic
chronic middle ear disease. Balance training
should be tested clinically. Migraines, Ergonomic training combines three
particularly if they result in visual forms of exercise: body weight
symptoms, are likely to be unacceptable. exercises, flexibility exercises and “ergonomic training combines three
Consideration should be given to the
possible CNS side effects of prescribed
yoga postures. forms of exercise: body weight
medication. Alcohol or drug As is the case with any form of exercise, exercises, flexibility exercises and
incorrect posture and poor form can
dependence will be a contraindication.
Severe anxiety, neurosis, a history of a cause injury. The guidance of a competent
yoga postures”
psychotic illness, or acrophobia (fear of fitness trainer or occupational yoga
heights) will be a contraindication. therapist should be sought if in any4

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ARTICLE | Height Safey

doubt regarding the correct form for 20-30 pull-ups without stopping. Train Flexibility exercises include:
any of the exercises mentioned in the workers to do 50 pull-ups in less
this article. than seven minutes in any combination • Extending the arms straight up
of sets. An adequate level of strength- overhead while standing on toes
By completing ergonomic workouts the to-weight for most people who wear • Bending over and touching the toes
physical and mental stamina of workers a harness and work at height is
heavily involved in work at height is with straight legs
between three and five pull-ups.
maintained, which directly reduces the • Touching the middle of the back with
incidence rate of unsafe acts of Push-ups either hand by reaching over the
individual behaviour. This results in an Push-ups require core strength, neck shoulders.
optimistic and proactive safety culture strength and arm strength. A healthy
in an organisation. As with the strength exercises, flexibility
and fit person should be able to do 100 exercises will improve the chances of
The following body weight exercises are push-ups in less than 10 minutes in any being able to evacuate, self-rescue and
workouts workers can undertake to combination of sets that works for the rescue someone else.
increase the likelihood of surviving a fall, individual. A worker involved in height
to assist in being rescued or to enable activities must be able to complete 10 Yoga for workplace safety
self-rescue. push-ups without stopping. The yoga mode of ergonomic training
Squats is composed of postures that improve
Hang from a bar both physical and mental wellbeing,
Climbers and people who work from Squats require strength, flexibility and which concretely provide fitness for
ropes have incredibly strong hands and balance. In an evacuation or during an work at height. To maintain medical
shoulders. They know that their lives emergency rescue there is a need to fitness the following yoga workouts can
depend on being able to hold on. A climb stairs, ladders or over obstacles. be done under the supervision of
good exercise of hand and shoulder These manoeuvres require leg strength. competent yoga professional.
strength is to hang from a bar for one Performing a self-rescue after a fall
minute. An individual who can manage nearly always requires being able to do Pranayama is the formal practice of
this has the ability to save to himself. a one-leg squat. While it may seem an controlling the breath, which yogic
After completing this challenge with absurdly high number, a healthy and fit philosophy believes to be the source of
two hands, the worker should then try person should be able to do half as our prana, or vital life. Ustrasana (Camel)
hanging from just one hand. many squats as his weight, so 100 is an intermediate level back-bending
squats for a worker weighing 200 lbs yoga posture that adds flexibility and
Pull-ups etc. If a worker can not do even 20% strength to the body, while also helping
A pull-up requires core strength, hand of this, then the worker’s ability to to improve digestion. Virabhadrasana
strength and arm strength and is the evacuate, rescue and self-rescue will (Warrior) strengthens and tones the
best exercise to maintain a good be greatly reduced. arms, legs and lower back, improves
strength to weight ratio. Rescuing balance in the body and helps to
another person or doing a self-rescue Flexibility increase stamina. Shashankasana (Hare)
after a fall will nearly always require the Flexibility exercises are very important is so called as it resembles a hare in the
ability to pull up. People with an as evacuation and rescue require a final position. Benefits of Shashankasana
excellent strength-to-weight ratio can certain amount of flexibility to reach, include relaxation, relieving depression
do 10 pull-ups. Elite climbers can do contort and climb over obstacles. and cardiac ailments, and a good upper

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 Height Safey | ARTICLE

Work at Height - Fitness Factors Ergonomic Yoga Training Postures “along with the implementation of risk
Healthy respiratory system Pranayama (Rejuvenating respiratory energy) assessment, risk prevention hierarchy
Acrophobia (fear of height) and Ustrasana (Camel)
and control measures, the requirement
anxiety control of fitness and health assessment is
Absence of Musculoskeletal Virabhadrasana (Warrior) equally important”
Disorder (MSD)

Good cardiovascular system Shashankasana (Hare)

Good hearing Tadasana (Mountain)

body stretch. Tadasana (Mountain) is References
Good vision Bhramari Pranayama (Bee breath) highly helpful for active hearing.
1. Art of Living.org, Yoga Postures.
Bhramari pranayama (Bee breath) is
No obesity Surya Mudra (Rejunvating digestive energy)
a very effective breathing exercise to 2. International Labor Office Geneva,
Absence of nervous system Adho Mukha Svanasana (Downward release the mind of agitation, frustration The ILO at a Glance.
disorders facing dog) or anxiety and get rid of anger. It helps 3. Total Access (UK) Ltd, Work at
to improve focus and coordination Height & Confined Space
Absence of mental illness, Gyan Mudra (Psychic gesture of knowledge)
including depression between both eyes. Surya Mudra helps Medical Assessment.
to heat the body and raises the
Presence of physical stamina Urdhvamukha svanasana (Upward metabolism. It is also an excellent 4. Dominic Cooper C, 2002. Revitalising
facing dog) posture to aid weight loss. Adho Mukha Health & Safety – Achieving the Hard
Svanasana (downward dog) releases Target, Coal Pro Seminar.
Table 1.2 Work at height - Fitness factors versus Yoga postures
tension from your spine while 5. National Examination Board in
strengthening arms, shoulders and Occupational Safety and Health, Unit
Industry Fall from Height - Fatal Injuries back. It is a mild inversion that calms GC2 – Control of International Work
the nervous system and helps relieve Place Risks.
Agriculture, forestry and fishing 2 stress. Gyan Mudra is highly helpful to 6. National Examination Board in
Mining and quarrying 1 control and dispel excessive anger, Occupational Safety and Health, Unit
emotional instability, anxiety, short GC1 – Management of International
Manufacturing 4 temper, irregular or disturbed sleep, Health and Safety.
Gas, electricity and water supply, 1
laziness, lethargy, depression and
insanity. Urdhvamukha svanasana 7. DEUS Rescue, Physical Fitness for
sewerage, waste and recycling
(Upward facing dog) strengthens the Work at Height.
Construction 14 back, thus relieving the body of lower 8. Health and Safety Executive blog,
Service oriented 7 back ache. Most of the body weight is RIDDOR reporting.
borne by the arms and wrists, thus
Total 29 strengthening them.
Author
Source: www.hse.gov.uk/statistics/riddor-notification.htm
Conclusion Jayandran
Mohan is a
The Report of Injuries, Diseases and
Petrochemical
Dangerous Occurrences Regulation
Engineer and
(RIDDOR) has reported the injuries of
Safety
employees in Great Britain by falls from
Professional
height in the year 2014/15 to the
with Executive
Health & Safety Executive. The updated Management experience. He holds a
statistics are as follows: degree in Safety Engineering, a Bachelor
RIDDOR has reported that 2,950 Degree in Chemical Engineering, an
specified injuries and 3,117 over seven Honours Diploma in Petroleum
day injuries occurred in Great Britain Engineering and Industrial Safety and is
related to falls from height in 2014/15. NEBOSH IGC, IOSH and CIEH certified.
He has 12 years of assorted health and
Along with the implementation of
safety experience in petrochemical plant
advanced risk assessment, risk
EHS software testing, FMCG Chemicals
prevention hierarchy and control
Consulting and HSE Training. Jayandran
measures, the requirement of fitness
is currently working as a NEBOSH IGC
and health assessment is equally
Tutor for the Indian region in Greenworld
important as it improves behaviour,
Group LLC, Dubai.
attitudes and competence when
working at height. < [email protected]

May 2016 | hsme 51