Injuries, accidental

The Precautions section contains information necessary for the user to avoid injury, accidental chemical releases, and equipment damage- This section includes information on hazardous materials or unusual environmental hazards that may be present during the operation. Level of detail should be based on training and user knowledge. Within the Precautions section you should consider what can happen, why, and the consequences of ignoring the precaution. Beware of overusing precautions. The precautions should add to the procedure and address only important safety issues. The use of irrelevant or self-evident precautions will dimmish the impact of the genuine safety concerns. 

This is optional depending on the potential hazards that may be involved in the performance of a procedme. If a step is critical, such as one step that could cause injury, accidental chemical release, degraded product, or equipment damage if performed incorrectly or omitted, a signoff line provides assurance that the step has been completed. Refer to Figure 5-11. 

For many decades, people called injury, illness, and death statistics resulting from adverse events accident statistics. There were accidental injuries, accidental illnesses, and accidental deaths. 

Ha2ard is the likelihood that the known toxicity of a material will be exhibited under specific conditions of use. It follows that the toxicity of a material, ie, its potential to produce injury, is but one of many considerations to be taken into account in assessment procedures with respect to defining ha2ard. The following are equally important factors that need to be considered physicochemical properties of the material use pattern of the material and characteristics of the environment where the material is handled source of exposure, normal and accidental control measures used to regulate exposure the duration, magnitude, and frequency of exposure route of exposure and physical nature of exposure conditions, eg, gas, aerosol, or Hquid population exposed and variabiUty in exposure conditions and experience with exposed human populations. 

Heavy metals on or in vegetation and water have been and continue to be toxic to animals and fish. Arsenic and lead from smelters, molybdenum from steel plants, and mercury from chlorine-caustic plants are major offenders. Poisoning of aquatic life by mercury is relatively new, whereas the toxic effects of the other metals have been largely eliminated by proper control of industrial emissions. Gaseous (and particulate) fluorides have caused injury and damage to a wide variety of animals—domestic and wild—as well as to fish. Accidental effects resulting from insecticides and nerve gas have been reported. 

Tlie remainder of tliis cliapter provides information on relative physical properties of materials (flash points, upper and lower explosive limits, tlireshold limit values, etc.) and metliods to calculate tlie conditions tliat approach or are conducive to liazardous levels. Fire liazards in industrial plants are covered in Sections 7.2 and 7.3, and Sections 7.4 and 7.5 focus on accidental explosions. Sections 7.6 and 7.7 address toxic emissions and liazardous spills respectively. tliese latter types of accident frequently result in fires and explosions tliey can cause deatlis, serious injuries and financial losses. 

An accidental release of liazardous materials sometimes necessitates evacuation of people from certain areas to prevent injury or deadi. Should it become necessary that an area be evacuated, die evacuation must be conducted in a well-coordinated, diorough, and safe manner. 

Administration of tiiese drugs may result in varying degrees of drowsiness. To prevent accidental falls and other injuries, die nurse assists the patient who is allowed out of bed with ambulatory activities. If extreme drowsiness is noted, the nurse instructs the patient to remain in bed and provides a call light for assistance... 

Dyspepsia, nausea, headache, pain, abdominal pain, asthenia, myalgia, accidental injury, ALT elevation... 

One of the major concerns for law-enforcement agencies in using less-lethal ammunition projectiles is the delicate balance between their effectiveness and their lethality. Impact biomechanics studies of a human body, including the use of less-lethal projectiles, are critically important when considering the protection of military personnel and civilians from accidental injury. 

Short-term exposure limit (STEL) TLV — the concentration to which workers can be exposed continuously for short periods of time without suffering from irritation, chronic or irreversible tissue damage, or narcosis of sufficient degree to increase the likelihood of accidental injury, impair self-rescue or materially reduce work efficiency, and provided that the daily TWA limit is not exceeded. A STEL is a 15 min TWA exposure which should not be exceeded at any time during the work day even if the TWA is within the TLV. It should not occur more than four times per day or without at least one hour between successive exposures. 

Compressed gases, therefore, present a unique hazard from their potential physical and chemical dangers. Unless cylinders are secured they may topple over, cause injury to operators, become damaged themselves and cause contents to leak. If the regulator shears off, the cylinder may rocket like a projectile or torpedo dangerously around the workplace. Other physical hazards stem from the high pressure of a cylinder s contents, e.g. accidental application of a compressed gas/air hose or jet onto an open cut or wound, whereby the gas can enter the tissue or bloodstream, is particularly dangerous. 

Hepatic Effects. Hepatic failure was reported in the case of an accidental ingestion of trichloroethylene that led to an acute overdose (Kleinfeld and Tabershaw 1954). In other case studies, blood analyses revealed no hepatic injury in a man who drank several tablespoons of trichloroethylene (Todd 1954) or in women who drank about 20 mL (Morreale 1976) or an unknown quantity (Perbellini et al. 1991). Self-reported liver problems were not increased among persons in the trichloroethylene subregistry who were exposed to trichloroethylene in their drinking water (ATSDR 1994 Burg et al. 1995). 

These process safety management systems help ensure that facilities are designed, constructed, operated, and maintained with appropriate controls in place to prevent serious accidents. However, despite these precautions, buildings close to hazardous process plants have presented serious risks to the people who work in them. This observation is prompted by the fact that some buildings, because of their design and construction, have collapsed when subjected to comparatively moderate accidental explosions, with serious injury or fatality to the occupants. Conversely, experience indicates that personnel located outdoors and away from such buildings, if subjected to the same blast, may have a lower likelihood of serious injury or fatality. 

Accidental slow addition of water to a mixture of the anhydride and acetic acid (85 15) led to a violent, large scale explosion. This was simulated closely in the laboratory, again in the absence of mineral-acid catalyst [1]. If unmoderated, the rate of acid-catalysed hydrolysis of (water insoluble) acetic anhydride can accelerate to explosive boiling [2], Essentially the same accident, fortunately with no injuries or fatalities this time, was repeated in 1990. 

In humans, one study of a worker accidentally sprayed with acrylonitrile indicated that transient injury to liver and muscle may have occurred, but the data are too limited to draw any firm conclusions (Vogel and Kirkendall 1984). 

Some liver damage has been reported in humans after acute exposure to high doses. In workers exposed to high levels of acrylonitrile vapors, mild jaundice was diagnosed (Wilson 1944). In a case of an accidental dermal exposure of a man, enzyme levels in the blood suggestive of liver injury were reported for several days (Vogel and Kirkendall 1984). These effects appeared to be fully reversible. 

Healthcare workers have a small risk of occupationally acquiring HIV, mostly through accidental injury, most often, percutaneous needlestick injury. 

It is also important to recognize the causes of accidental deaths, as shown in Table 1-5. Because most, if not all, company safety programs are directed toward preventing injuries to employees, the programs should include off-the-job safety, especially training to prevent accidents with motor vehicles. 

A massive explosion in Pasadena, Texas, on October 23,1989, resulted in 23 fatalities, 314 injuries, and capital losses of over 715 million. This explosion occurred in a high-density polyethylene plant after the accidental release of 85,000 pounds of a flammable mixture containing ethylene, isobutane, hexane, and hydrogen. The release formed a large gas cloud instantaneously because the system was under high pressure and temperature. The cloud was ignited about 2 minutes after the release by an unidentified ignition source. 

Lechin et al. 1996, Gray et al. 1999), but also increases the risk of falls and hip fractures (Passaro et al. 2000, Ray et al. 2000, Wang et al. 2001). Daily dose and longer duration of benzodiazepine use is associated with higher risk of fracture (van der Hooft et al. 2008). These fractures lead to great hospitalisation costs. In a European study it was estimated that costs of accidental injuries related to benzodiazepine use in the EU are between Euro 1.5 and Euro 2.2 billion each year. More than 90% of these costs were in the elderly with fractures as the major contributor (Panneman et al. 2003). 

Another type of activated double bond is found in isocyanates and isothiocyanates. Methylisocyanate was responsible for a disaster in Bhopal, India, in 1984 when approximately 40 tons of the gas were accidentally released leading to the death of thousands of people and injury to many more. Some have called this the worst industrial accident in history. Methylisocyanate reacts with nucleophiles as shown in Figure 8.18—in this case with a thiol. This reaction is reversible, and therefore a glutathione conjugate can act to... 

Whenever the accidental ignition in the open air of hydrogen gas-air mixture might be likely to cause personal injury or property damage, precautions shall be taken. For example ... 

Both Article 6(1) and Annex VII require notifiers to provide information concerning recommended methods and precautions for safe handling, storage, use, and transport of their substances. Annex VII also specifies that notifications must include emergency measures in the case of "accidental spillage" or "injury to persons (e.g. poisoning). ... 

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