Category Archives: Publication

Covid-19: Emotional and Mental Wellbeing of Essential and Frontline Workers

The article earlier published in New Spotlight; May 23, 2021

“Organizations could start by establishing that their essential and frontline workers’ emotional and mental wellbeing sits at the top of their corporate business criteria.”

Essential and frontline workers are those who provide essential services or key public services including healthcare, social service, journalism, justice system, government services, food production, distribution supply chain, public safety, national security, transport systems, utilities, communication, key financial services, etc. During these challenging times of Covid-19 pandemic, they are suffering various kinds of anxieties, stress, depression, sleep disorders, uncertainties, prolonged separation from their loved ones, etc.

As time passes by, these traumatic experiences are most likely to reflect on their psychological state, probably in more ways than one. Exposure to prolonged excessive stress can also cause harmful effects on emotional, physical as well as social well-being of the frontline workers who are going through unprecedented level of work pressure during this pandemic.

The immensity of stress is such that it can easily lead to exhaustion, burnout, mental disorder, substance use disorder, post-traumatic stress disorder (PTSD), and even suicidal thought or attempt.

Eventually this may translate into reduced quality of service, low productivity, non-compliance with required guidelines, increased risk of infection, mistakes, accidents, and compromised emergency response capacity, etc. in the healthcare as well as other essential public service sectors.

The situation is dire out there and we are certainly living through vulnerable time. Recent studies conducted among health care workers showed that 74% suffered stress, 41% reported anxiety, 34% had symptoms of insomnia, and 24% felt depressed.

Another survey carried out among nurses revealed that a whopping 38% were working with high level of stress. It is likely that a big chunk of the sufferers may develop PTSD resulting in long-term impact on their mental health, emotional wellbeing, career decisions, personal relationships, social skills, etc.    

Acknowledging the emotional part of dealing with this pandemic is a huge stepping stone towards managing work stress of the frontline workers. It is important to formalize the fact that we are all experiencing some level of anxiety, loneliness and isolation at our workplaces.

Therefore, the first logical step is to face the tragedy head-on and bring the topics directly on the work floor of the healthcare and essential service providing institutions. Normalizing these feelings and experiences within the organization helps employees feel comfortable in sharing their feelings.

Moreover, if the top leadership is open and supportive as well, it helps create a culture that can address mental health issues of essential and frontline workers more favorably.

Work-related stress originates when workers are presented with work overload, demands and pressures that are beyond their capacity and which challenge their ability to cope with the situation.

Stress occurs in a variety of work circumstances but is often made worse when employees feel they have limited resources, little control over work processes and even less support from supervisors and colleagues they work with.

All concerned parties must sincerely acknowledge the fact that the work-related stress due to Covid-19 is for real and it is severely affecting mental health of our frontline workers.

The demanding work environment is putting their physical as well as psychological health at risk every day. Under the circumstances, relevant authorities, governing bodies and the responsible management teams must put extra efforts to provide these tireless angels a work environment that should feel safe and free from negativities, such as violence, discrimination, insecurities, harassment, isolation, etc. at the least.

The management team may ask the frontline workers to take appropriate actions to deal with the risk of infection, at the same time cope with the work-related stress. It may also advise them to offer each other personal and professional support which in turn improves their collective performance, personal relations and job satisfaction.

Workers may be urged to keep calm and stay mentally or emotionally strong. These behaviors are necessary but, let’s be honest, are they helpful enough to maintain emotional and mental wellbeing of the essential workers? It would be really unfortunate if the organizations limited themselves to such simplistic solution which is easier said than done.

During difficult times like these, employees’ change in attitude (helpful behaviors as mentioned earlier) may come rather naturally, at least initially; however, it may gradually fade away and the employees may not behave the same over the time.

Therefore, this behavioral change needs to be reinforced and most importantly integrated into the culture of the organization itself. Such efforts to change or tweak the organizational culture will be successful and sustainable only when employers, top level management and responsible health administrators take the initiative seriously.

A positive health and safety culture cannot be achieved overnight, but it is clear that the change starts at the top and then follows a top-down approach. Organizations could start by establishing that their essential and frontline workers’ emotional and mental wellbeing sits at the top of their corporate business criteria.

People at the leadership positions must be sensitive enough to understand and feel the emotional challenges, psychological pain, and physical/mental exertion arising from the work that the frontline workers do so relentlessly.

Employers must be aware of the immediate needs (problems, priorities, work overload stress and even personal issues if any) of their staff and must provide with proper care, safety and support.

All the staff should be highly encouraged and arranged to have conversations and consultations in a one-on-one settings because empathy and assurance from the authority/manager can go a long way.

These leaders, managers, administrators and supervisors of relevant organizations must also understand that their frontline workers’ emotional and mental wellbeing will have direct impact on the valuable services they provide so selflessly and which the entire country depends on so desperately.

Our hearts go out to all the frontliners who are putting their lives on the line and battling this pandemic on our behalf. These are tough times and the least we can do is support and motivate our heroes to fight this nightmare; we fight, we endure and yes, collectively we shall overcome this.

The article earlier published in New Spotlight; May 23, 2021

COVID-19 Outbreak: Face Coverings Vs Surgical Masks Vs N95 Respirators

The Article also published in New Spotlight Nepal; July 13, 2020

“Coronavirus is smaller than the filtering pores on the N95 respirator, so you may wonder that the N95 respirator doesn’t work (can’t sieve out coronaviruses), right? Not exactly!”

Cloth Face Coverings

Cloth face coverings or masks are not manufactured to a recognized standard and they are not same as the surgical masks or respirators.

According to a research conducted in Nepal last year, the majority of locally available cloth face masks (having pore size 80 – 500 microns) may not be effective to avoid small particles (less than 10 microns). The study also revealed that repeated washing and drying of cloth mask deteriorates its efficiency.

Nonetheless, people who want to wear a face covering in public, workplaces and offices should be well encouraged to do so for the benefit of everybody. Several studies now indicate that wearing a mask, even a cloth face covering in the time of wide community spreads when physical distancing is tough to maintain, can create a physical barrier to the coronavirus.

A face covering can be very simple and may be worn in enclosed spaces as well as in crowded places where social distancing isn’t possible. While covering your mouth and nose, make sure you can talk with your face covering on and that it doesn’t irritate you. Otherwise you may be tempted to pull it out of place or touch your face and limit its effectiveness altogether.

face-covering

World Health Organization supports the use of cloth masks or face coverings to prevent the spread of coronavirus.

However, the benefit of using a cloth mask is limited and cannot be a substitute for other ways of managing risks in your homes and offices such as social distancing, reducing the number of people in the work area, minimizing time spent in contact, job rotations, increasing hand hygiene, and surface disinfection, etc.

Johns Hopkins Medicine also claims that wearing cloth masks or face coverings in public, when physical distancing can’t be maintained effectively, does offer protection against the spread of COVID-19.

The evidence suggests that wearing a face covering may not necessarily protect you, but it may protect others if you are infected and have not developed symptoms yet. On the other hand if you are healthy, a cloth face covering may as well protect you from larger infectious droplets from people around you.

Centers for Disease Control and Prevention reckons that a cloth covering may not protect the wearer, but it may keep the wearer from spreading the virus to others. That means “YOUR cloth face covering may protect THEM and THEIR cloth face covering may protect YOU”.

Let’s not forget that wearing a cloth face covering will especially help protect people who are at higher risk of severe illness from COVID-19 and workers who frequently come in close contact with other people (in shops, crowds, restaurants, etc.). Cloth face coverings will only prove to be effective in reducing the spread of COVID-19 when they are widely understood, accepted and practiced by all people in communities. 

Surgical Face Masks

Unlike face coverings, surgical face masks are manufactured to a recognized standard and can be effective in blocking splashes and large-particle droplets. Moreover, both face coverings and surgical masks do not provide complete protection from germs (viruses and bacteria) and other small contaminants in the immediate environment because of the loose fit between the surface of the mask or covering and your face.

You may notice that the edges of surgical masks are not designed to form a seal around the nose and mouth. 

surgical face mask

Surgical face masks are not to be shared and are normally designed to be worn in medical settings to limit the spread of infection. If worn properly, a surgical face mask is meant to help block large-particle droplets, splashes, sprays or splatter from reaching your mouth and nose. They also protect patients from the wearer’s respiratory emissions.

If your mask is damaged or soiled, or if breathing through the mask becomes difficult, you should discard it safely and replace it with a new one. Do not forget to wash your hands after handling the used mask.

Surgical-Mask-Effectiveness

The particle capturing capacity of the filter (nonwoven mats of fine fibers) used in modern surgical masks largely depends on its fiber diameter, porosity, thickness, etc. Due to the same characteristics, the performance of surgical face mask is superior to that of a cloth face covering. Nevertheless, the filtration mechanism of a surgical mask does not provide the wearer with a reliable level of protection from inhaling smaller airborne particles (less than 2.5 microns). Therefore the surgical face mask should not be considered a respiratory protection device.

N95 Respirators

A respirator, such as an N95 respirator, is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of small airborne particles. N95 respirators are capable of filtering out all types of small and large particles protecting you from exposure to biological aerosols including viruses and bacteria.

On the other hand, Surgical N95 respirators are commonly used in healthcare settings and are a subset of N95 respirators. A Surgical N95 respirator (also referred as a medical respirator) is recommended only for use by healthcare personnel who need protection from both airborne and fluid hazards such as splashes, sprays, etc.

female-nurse-wearing-green-n95-mask

The N95 designation means that when subjected to careful testing, the respirator blocks at least 95% of very small (up to 0.3 micron) particles. However, coronaviruses are even smaller in size (0.065–0.125 micron in diameter) and contain a single-stranded RNA as a nucleic material.

Therefore, the virus is smaller than the filtering pores on the N95 respirator, so you may wonder that the N95 respirator doesn’t work (can’t sieve out coronaviruses), right? Not exactly! 

To understand this concept first we need to know few basic principles pertaining to the behavior of viruses. “There is never a naked virus floating in the air or released by people”. The COVID-19 particle is indeed around 0.1 micron in size, but it is always enveloped by something larger. For example when a COVID infected person breaths, talks, coughs, etc., the exhaled viruses tend to attach to small droplets or aerosols (consisting of water, mucus protein and other biological materials from inside the infected person) which are all larger than 1 micron. Therefore, activities such as breathing, talking and sneezing generate particles around 1 micron in size, which can be efficiently collected by N95 respirator filters.

Although N95 respirator filter is 0.3 micron size, it works even better for particles smaller than the 0.3 micron threshold. This is because the N95 respirator filter does not only work by sieving out larger particles but also employ other mechanisms.

However counterintuitive it may sound, scientists have valid explanations for this. Firstly according to the principle of “Brownian Motion”, particles smaller than 0.3 microns move in an erratic or zig-zag kind of motion increasing the possibility of them getting trapped by the filtering fibers. Secondly due to the electrostatic attraction generated by the N95 respirator itself, particles smaller than 0.3 microns are drawn to the charged fiber and get stuck there, instead of just passing through the filtering pores. When the electrostatic charges are dissipated during extended usage and storage, the capability of stopping virus-sized particles (around 0.1 micron) diminishes. This is why repeated use of N95 respirator is not recommended.

The Article also published in New Spotlight Nepal; July 13, 2020

Also Read:

COVID-19: Know Your Risk Level

Covid-19 Pandemic: Safe Return to Work and Business Continuity

COVID-19: Disinfecting Your Homes and Offices

Ensuring Occupational Health & Safety by Managing Risk

The Article Earlier Published in https://www.spotlightnepal.com/2019/09/30/ensuring-occupational-health-and-safety-managing-risk/

1

A construction project, or any other for that matter, is termed a success when a given job is completed in time, within budget and with adequate quality.

Every organization essentially strives for reduced cost, minimum lead time, enhanced quality and sustainable growth. In this regard the booming infrastructure and construction sector of Nepal is no exception.

However, managers at various construction projects as well as in industrial plants or factories often worry about increased number of accidents, illnesses and environmental/safety compliance issues which eventually affect productivity, thereby obstructing her/his brand to remain competitive in the market. The solution lies in effective implementation and management of Health, Safety & Environment (HSE).

HSE, if not managed properly, can adversely affect any project or organization resulting in loss, delay and reduced quality of the work.

To put it simply, HSE works towards creating a work environment and procedures which protect us from injury, illness, damage, danger, loss and environmental impact. Call it safety if you will.

But no one can possibly guarantee hundred percent safety at your worksite. According to Murphy’s Law “Anything that can go wrong, will go wrong”. The law implies that there is always some possibility of something going wrong, especially when workers, equipment and complex procedures come together. Appropriate HSE control programs should, therefore, be implemented to reduce this ‘Possibility of Wrong’ to ensure overall safety and sustainability of not only the employees and the project but also the organization and the environment as a whole.

2

Accidents and Hazards

Accidents are one of the biggest concerns in any worksite, be it a construction site or general industry sector. More often than not they bring about injury and illness to the workers as well as loss and delay to the project. This clearly justifies why the goal of any organizational HSE policy is to reduce the number of workplace accidents, injuries and illnesses. If we dig deep enough we find that every accident is rooted in issues related to untrained EMPLOYEE, faulty EQUIPMENT, inappropriate METHOD, poor MANAGEMENT or hazardous work ENVIRONMENT.

An effective workplace accident prevention program has two fundamental aspects, namely identifying hazards and controlling the risks posed by those hazards. We will discuss both in this article.

3

A hazard can simply be defined as anything which has potential to cause harm to workers or the work itself. Earthquake, landslide, flammable substance, smoke & fume, low visibility, working underground, working at height, entering confined space, etc. have the potential to cause harm one way or another thus should be considered as hazards.

The immediate cause of every accident is either some kind of Behavioral Hazard or Conditional Hazard present at the worksite. Behavioral Hazards are unsafe human actions, such as inadequate body posture, unsafe equipment use, negligent housekeeping, etc. whereas Conditional Hazards are found in work environment, such as chemical, fire, electricity, pressure, noise, faulty equipment, vibration, fume or even external weather events and disasters.

4

A construction worksite is ridden with all kinds of hazards, such as slip, trip, falling objects, electrocution, falling from height, confined space, chemical spill, caught in machine, stored energy, etc. Moreover, Electrical, Fall, Struck-By and Caught-In or –Between hazards are known as the fearsome four of construction safety.

Nevertheless, it is imperative to understand that every hazard has a potential to translate into a risk and then followed by a full-blown accident. When we fail to timely eliminate the source of hazards or mitigate the risks posed by them, we are left to deal with severe consequences of the accident.

5

From the accident occurrence stand point, hazards can be differentiated into three categories, namely (i) The hazard that has not yet caused any accident or loss, (ii) The hazard that nearly caused accident but without injury or loss and (iii) The hazard that caused accident resulting in injury, illness, fatality or loss. The objective of reducing the number of accidents, in other words reducing the risks of their occurrence, is possible only when we are able to identify the hazards which cause the accidents in the first place. Below we discuss some more details on hazard identification process.

Proactive and Reactive Safety

A proactive safety is the key to success of any HSE program in any organization or construction site. A proactive safety approach is the one where we are able to identify the hazards and control their risks before they turn into accidents and impact workers’ health and safety as well as overall project and the environment. Various factors should be considered while designing and implementing a robust hazard recognition program. Some of them are listed below.

  • Take time and pay attention to details to recognize hazards at work
  • Recognize the type of hazards; Conditional or Behavioral
  • Focus on conditions which may result in serious injury or accident
  • Seek opinions from subject matter experts from other departments
  • Learn from previous accidents or loss incidents
  • Talk to workers and line supervisors about their past experiences

12 LPS Shaft_ HRT

In addition to the above mentioned criteria, utilizing safety related documents, such as work permit, site instruction, method statement, job hazard analysis, risk assessment, standard operating procedure, inspection checklists, etc. can greatly help to identify a wide range of workplace hazards or exposures.

6

Reactive approach, on the other hand, includes safety measures which are taken after an incident/accident has already occurred. Conventional it may sound, but if pursued sincerely a reactive safety approach could be a life saver. It could help us effectively identify the hazards from the past and mitigate the possibility of similar future accidents from happening. For example, making sure that your work area is free of any slip, trip or fall hazard is proactive safety, whereas fixing such hazards after someone slipped, fell and injured herself or himself is reactive safety.

As suggested by the Murphy’s Law, absolute safety is practically unattainable, however, we can always work towards reducing hazard exposures and mitigating risks in our workplaces.

Reduced risk is in fact safety. So it makes more sense to make use of both proactive and reactive approaches to implement appropriate HSE plans and procedures which in turn would help us achieve increased safety by guarding us against the risk of accidents, injuries and illnesses. So, the question is how we mitigate or control the risks prevalent in our construction sites, plants or factories.

7

Risk Control

Controlling the risk of exposure to occupational hazards is the fundamental way of preventing accidents, injuries and illnesses at your worksite.

Hierarchy of Controls suggests that there are mainly five ways to control the risks at workplaces, namely (i) Elimination, (ii) Substitution, (iii) Engineering Controls, (iv) Administrative Controls and (v) Personal Protective Equipment (PPE). The

Hierarchy of Controls ranks those five control options from highest level of protection and reliability to lowest. The idea is to help us determine economically feasible and effective risk control solutions suitable for our worksites.

8

Elimination and Substitution controls can be achieved through removing the hazards or selecting alternate products or equipment. Sometimes doing the same work in a less hazardous way is possible. For example, a hazardous chemical can be replaced by a less hazardous one.

Despite being the most effective control measures, Elimination and Substitution often tend to be difficult to implement in an existing process; major changes in equipment and procedures may be required to eliminate or substitute for an existing hazard.

If a hazard cannot be eliminated or replaced, it can sometimes be isolated, contained or kept away from workers. Thus Engineering Controls help modify existing machinery or suggest purchasing new machinery to provide applicable solution. The idea is to remove the hazard at the source, before it even comes in contact with the workers. Guarding moving parts of a machine or equipment and providing good ventilation system at worksite are some of the examples of Engineering Controls. The initial cost of implementation can be higher but over the time operating costs are frequently lower, and often can provide cost savings in other areas of the process, such as productivity and quality.

Administrative Controls develop new work rules or procedures to reduce the risk of hazard exposure. Both Administrative and PPE Controls are frequently used with existing processes where hazards have not yet been controlled completely by other means. They may be relatively inexpensive to establish but, over the long run, can be very costly to sustain.

9

Hazard Elimination and Substitution, of all, are the most effective way of controlling workplace hazards. For instance, getting rid of a hazardous job, tool, process, machine or substance is perhaps the best way of protecting workers. However, Elimination and Substitution controls fail to provide practical and economical solutions most of the times. Therefore, we need to look for other options in Engineering, Administrative and PPE Control measures.

13 Penstock Pipe - Bifurcation Tunnel

Let us consider an example of welding & fire safety at a construction site. Completely eliminating the possibility of welding, cutting or grinding to mitigate the risk of catching fire and exposure to welding fume does not sound practical at all. But we can apply Engineering Controls (such as barricading such hazardous working area, utilizing welding fume extractor, installing proper ventilation system, etc.) and Administrative Controls (such as removing flammable substances from the area, keeping applicable fire extinguishers nearby, etc.) to mitigate the risk. Besides, training your workers on the use of fire extinguisher, enforcing standard welding procedure, organizing job rotation, and assigning fire watch personnel are also some of the effective Administrative Controls to mitigate the risk of fire and exposure to toxic welding fumes.

10

PPE should be considered the last resort and the least effective way of mitigating the risk of accident, illness and injury at worksites.

It offers the lowest level of protection and should only be used when the hazard exposure cannot be removed or reduced by any other means. PPE Controls (such as steel toe boots, welding apron, leather gloves, safety goggles, respiratory masks, etc.) do not directly control the exposure of the welding, cutting or grinding hazards, however, can protect workers from their negative impact and consequences to certain extent.

The Article Earlier Published in https://www.spotlightnepal.com/2019/09/30/ensuring-occupational-health-and-safety-managing-risk/

 

Also Read:

COVID-19: Know Your Risk Level

(22 August 2018) When A Fire Broke Out at the 12th Floor of a 16 Story Residential Building in Mumbai

COVID-19: Disinfecting Your Homes and Offices

Covid-19 Pandemic: Safe Return to Work and Business Continuity

Construction Industry: Fatal (Focus-Four) Hazards

A Business Case for Health & Safety….

Fire Prevention and Fire Protection – Air Pollution in Kathmandu – Construction PPE – Carbon Monoxide poisoning – Electrical Safety – Fall Protection in General Industry– Fearsome 4 of Construction Safety – Fall Restrain System Vs. Fall Arrest System – Respiratory Protection – Portable Ladder Safety – Confined Space Entry – Initiating First Aid/CPR – Are you too busy… – If you have $86,400 in your account…