Management fatality prevention

Medical [Centers for Disease Control and Prevention (CDC), case definition, differential diagnosis, signs and symptoms, mass-casualty triage recommendations, casualty management, fatality management]... 

This chapter proposes that major and somewhat shocking innovations in the content and focus of occupational risk management systems will be necessary to achieve additional progress in serious injury and fatality prevention. Comments are made in this chapter on ... 

Results achieved in recent years from attempts to reduce serious injuries and fatalities cannot be considered stellar. In 2007, a national forum on Fatality Prevention in the Workplace was sponsored by Indiana University of Pennsylvania in cooperation with the Alcoa Foundation. Attendance was great and the speakers provided good information, a large part of which suggested tweaking elements in existing occupational risk management systems. 

Getting Management Interest in Fatality Prevention For this discussion, the manufacturing industry was selected to illustrate the narrow range within which its fatality rates fall, the probability that an organization may or may not have a fatality, and an approach to be taken to achieve an interest in the subject. 

Importantly, a culture change will also be needed to add a focus on serious injury and fatality prevention within the safety management system while not diminishing efforts to reduce not-so-serious injuries. 

In Chapter 8, Improving Serious Injury and Fatality Prevention, this author wrote that risk assessments should be established as the core of an occupational risk management system. So, also, should risk assessment be a major element in a systemic causation model. 

A few prominent writers would have you believe that behavior modification, training, and leadership (consisting largely of what is referred to in OSHA literature as administrative controls) are almost the entirety of the practice of safety. But, events of the recent past indicate that several of the big hitters in behavior-based safety have revised their positions and now talk and write about taking a systems approach to safety management (see Chapter 8, Improving Serious Injury and Fatality Prevention ). 

A Systemic Sociotechnical Model for an Operational Risk Management System is provided in the chapter on Improving Serious Injury and Fatality Prevention. Some will consider it radical. 

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. 

Carbamazepine toxicity is manifested by drowsiness, nausea and vomiting, gait disturbance, nystagmus, confusion, neuromuscular excitability, and seizures (Menkes, 1999). Overdose with CBZ can be lethal (Arana et ah, 1986). In a retrospective study of 307 intoxicated patients, 41 (13%) had a fatal outcome (Schmidt and Schmitz-Buhl, 1995). Doses exceeding 24 g were important indicators of fatality. The management of CBZ overdose is primarily supportive, to prevent potential atrioventricular (AV) block (Arana et ah, 1986), possible respiratory depression (Schmidt and Schmitz-Buhl, 1995), stupor, and coma. 

Acute medical emergencies are a feature of this substance abuse with sometimes fatal results, and a wide variety of solvent-based products can be used. Management of these acute stages may include neuroleptics to control the agitation and toxic state which will settle over a few hours. No specific medical management is necessary after this, and a full network of support systems needs to be established. Education of the medical complications is crucial in any preventative programme and there needs to be community involvement in its management (Barnes 1979 Sourindhrin and Baird 1984). 

Poor water system designs, installations, maintenance, and management are typically associated with illness and fatalities, and therefore usually preventable. 

The importance of safety and its practice is related to the risk and hazards involved in a particular operation. Corrosion personnel, in common with other engineers, are faced with hazards and the extent of hazards, and the severity is the decisive factor in determining the fatality rates. Thus in any industrial operation it is necessary to (i) identify the hazard and (ii) take necessary action to prevent the occurrence of the hazard. The identification and remedial steps taken to prevent the occurrence of the hazard is of paramount importance in loss prevention. Along with increased advances in technology, the identification of hazards has also become increasingly difficult. Loss prevention depends upon the management system. The physical hazards also may not be on the surface and thus inaccessible to a simple visual inspection. 

With respect to guidehnes and standards that include provisions applicable to the prevention of accidents resulting in severe injuries or fatalities, it is my view that the Europeans are the world s leaders. Very little safety literature applies specifically to preventing serious injuries. But, at http //mahbsrv.jrc.it/NewProducts-SafetyManagementSystems.html, you will find Guidelines on a Major Accident Prevention Policy and Safety Management System as Required by Council Directive 96/82/EC (Seveso II). This document was issued by the European Commission—Joint Research Centre, Institute for Systems Information and Safety, Major Accident Hazards Bureau in Luxemburg. 

To conclude on the case of team-safety representatives, this practice has been initiated by the labor union and supported by plant management. For the plant management and the union this practice is initiated as to increase the individual responsibility of performing safe collective operation of the metal plant. This bipartite solution is at present taking form, and the ultimate aim is to prevent a fatal accident. AU our interview respondents argued that one more fatal accident would cause a final plant close down. In this sense the team-safety representative is a vehicle for increasing the collectivity s responsibility for safe work performance. 

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