Injury Potential Matrix

Adhesion molecules such as LI, neural cell adhesion molecule (N-CAM) and N-cadherin promote axonal regeneration by homophilic interactions between axons and Schwann cell surfaces (see Ch. 7). The expression of p75 (low affinity NGF receptor, Ch. 27) is also increased at the Schwann cell surface after injury. Extracellular matrix molecules, such as tenascin and proteoglycans, increase the regenerative potential of damaged peripheral nerves by binding to integrins on the axonal surface. 

Fillers present a potential inhalation and dermal contact hazard. They can cause mechanical damage to the skin, which may aggravate the irritant effect of other chemicals and additives. When fillers are handled in a liquid epoxy matrix or in a cured epoxy, their inhalation hazard is low. However, inhalation exposure to fillers can occur when they are handled in the dry state or when one is machining or grinding cured epoxy products. Inhalation exposure to fillers such as crystalline silica or fiberglass may result in delayed lung injury. Asbestos fillers have long been abandoned from use for these reasons. 

The process of fibrogenesis results in an increase in the extracellular matrix, i. e. all insoluble organic constituents of the interstitial space. This represents an uniform, dynamic and potentially reversible reaction of the liver to chronic injury. Fibrosis is considered to be a possible forerunner of liver cirrhosis. 

The ulcer may be sterile. Stromal breakdown and progressive ulceration is largely driven by matrix metalloproteinases (MMPs) and serine proteases derived from local comeal cells and from leukocytes sequestered in the cornea in response to the initial injury (Fig. 13.1). Inoculation and replication of pathogenic bacteria at the site of minor epithelial injury releases exotoxins and microbial proteases that potentiate the initial processes of comeal breakdown and amplify endogenous stromal hydrolysis. However, once started, an ulcer can evolve its own biochemical momentum based... 

There is abundant evidence that a diverse array of pro-teinases, particularly those of macrophage or leucocyte origin, have a fundamental role in the injury processes associated with diseases such as ai-antitrypsin deficiency, smoking-related emphysema, cystic fibrosis, bronchiectasis, bronchitis and other respiratory syndromes (Karlinsky and Snider, 1978 Stockley, 1983 Senior and Campbell, 1983 Surer etal., 1984 Janoff, 1985 Snider etal., 1991). However, there has been little exploration of their potential involvement in other airway disorders that have an inflammatory cell aetiology, such as certain types of specialized fibrotic disorders including chronic severe asthma. This is particularly true for the matrix metalloproteinases (MMPs), despite the expectation from their individual substrate specificities (Emonard and... 

In general, these have not been widely applied. One example is synthetic protein membranes, the use of which i.s based on the fact that protein denaturation may be a mechanistic function in corneal eye injury with some materials. The reactive component is a synthetic protein-globulin matrix. In one series, the predictability of eye irritating potential was 89%, and in another it was 93% (Soto and Gordon, 1990). 

Hazard information is converted to risk information by evaluating the severity of potential accidents associated with the hazard and by evaluating the probability that the hazard could produce an accident. It is done by developing a matrix with severity on one axis and probability on the other, with a numeric code used to represent the risk associated with each hazard. This risk assessment code (RAC) is used to prioritize hazards and determine their acceptability. Hazard severity may be expressed quantitatively (for example, dollar loss or number of injuries), qualitatively (verbal descriptions), or as a combination (Table 11-1). 

The company Near Miss Accident Investigation Form (NMAIF) is to be used for the investigation of aU high-potential (use risk matrix on form) near misses, property damage, and injury producing accidents. 

Not all near miss incidents have high potential to cause injury and loss, yet some do. The only way to prioritize the reported occurrences is to risk-rank th by means of a risk assessment. The best tool for this is the risk matrix. Rananber, it s not what happened, it s what could have happened. The risk matrix is a crystal ball to predict the future or possible outcome of an event. Use it to forecast the probability of the next loss. Near miss incidents that fall into the high-high areas on the risk matrix should receive priority for investigation and rectification. 

ANSI ZlO-2012 (Occupational health and safety Systems, 2012) defines risk as an estimate of the combination the likelihood of occurrence of a hazardous event or exposure(s), and the severity of injury or illness that may be caused by the event or exposures . In ANSI ZIO, a risk matrix is used to develop an estimate of the specific risk and is based on a combinafion of experience, industry history, science, and understanding of hazards. The risk matrix provides on what the potential severity may be in a worst case scenario based on the type of exposure. 

Although not mandatory in the HAZOP method, this study comprised a risk assessment to all deviations detected. Risk assessment was performed through the use of a risk matrix already used in similar industries which included the combination of probability (possibility that the event occurs) and severity (as a consequence of the event). For the risk assessment criteria, four levels of probability were defined very unlikely/remote, likely/possible, probable and frequent. For severity were defined also four levels reduced, moderate, high, very high/catastrophic. The designation of risk parameters took into account the probability of occurrence, the measures implemented, historical events, potential injury to persons, to materials, to the environment. The combination between the four levels lead to four types of risk, grouped in two levels, acceptable/not significant, which even... 

---