Lesson 3 – Medical Surveillance – Occupational Diseases

MEDICAL EXAMINATION FOR THE ASSESSMENT OF FITNESS  TO WORK

CATEGORIES OF MEDICAL EXAMINATION

• This COP has  been  drafted  to assist  the  OMP  and  other  health  workers  in  determining   fitness  to perform   specific   work   at   Barberton   Mines   and  assessing  the  worker’s   ability   to  continue   the performance of such work at scheduled intervals thereafter.
• The fitness to perform work at the mine shall be evaluated at a series of standard examinations. These examinations will consist  of:  an  Initial  examination,  Periodic  examinations and  when  the  worker leaves  the  employment  or  the  mine,  an  Exit  examination.   The  purpose  of  the  examinations  is to ensure   that  there  is  no  disease   or  condition   present  or  developing in  the  worker  that  could  be aggravated by working on the mine.
• The presence of any such a condition  should  not pose  an unacceptable  health  or safety  risk to any individual  employee  or any other person on the mine.  The health status of any individual worker should not place the health of that worker at increased  risk in a particular environment nor place co workers  or the public at increased  risk.
• Any medical condition  found  at  any  examination   should  be  evaluated   in  terms  of  the  particular requirements for  that  specific  job  utilizing  the  person/job   specification  and  job  description.    Some irregularities found  at examination  might  be irrelevant  to the performance of a specific  job and may pose no risk to the worker or fellow workers.
• No person shall be allowed to perform any risk work at any of the operations of Barberton Mine unless he has  been  certified fit by  the  OMP  after  examination.   (In  possession of a “valid certificate of fitness”).

 

Initial Examination

• The initial examination  is used  to establish  a baseline against  which  subsequent changes  in health  status can be evaluated at subsequent  examinations.  Prospective  and new workers  must undergo  an initial examination with baseline  tests by the OMP.
• New and prospective  employees who  have  previously  been  employed  in the  Mining  Industry must  produce  an exit certificate  or a copy thereof  from their previous  employer.   A certificate  of Medical Fitness provided from other industrial sectors will also be accepted where applicable.
• All prospective employees who have  been  previously  employed  in the  mining  industry  will be considered to be “employees”  (as per Sect 20(6)  of the MHSA)  and will therefore  be entitled to appeal to the Medical Inspector  against any finding of unfitness to perform  any category of work.
• The Initial Examination will be relevant to the health hazards  and exposures of the envisaged occupation and to the results of relevant  risk assessments.
• All prospective employees will undergo  an initial examination and baseline  tests, as considered by the OMP to be appropriate  to the health hazards  and exposures of the envisaged occupation as identified in existing and ongoing risk assessments for the relevant job.

 

The Initial Examination will consist of:

• A questionnaire regarding the previous medical  and employment history of the prospective employee.
• A full physical examination with emphasis on the aspects of importance to the requirements of the envisaged occupation as identified in the person/job specification.
• A lung function test by means of spirometry. A full size chest X-ray.
• A screening audiogram – SABS 083 Code of Practice revised.
• A visual acuity test- a Snellen chart or any standard method to be used. Any other examinations at the discretion of the OMP.

 

Periodic Examination

• The frequency of any periodicor special  examination  shall be determined by the OMP.   At the periodic  examination,  the OMP should  be able to evaluate any subsequent disease  or condition, which may have an influence on the ability of the worker  to continue in his specific work.   The early detection of any  illness at these periodic examinations is or the utmost importance to maintain the health of an employee.
• The factors influencing this decision include :

–the specific hazards to which the worker is exposed,

–the nature and requirements of the work to be performed.   Any previous  medical,  surgical or occupational  history  should  also be considered before  a decision  regarding fitness  to work will  be  made.  The OMP may modify the frequency of such examinations based on examination results.

–The results of relevant risk assessments on the specific job category.

• If any occupational disease is identified during a periodic medical examination, appropriate management of such disease is to be instituted.
• All regulatory requirements, such as notifications to the DME, Department of Health or the MBOD
• are to be complied with.
• The standards of fitness requirements at the periodic examination  should generally  be the same as the initial standard of fitness requirements and be determined by hazards of the occupation.
• Any illness or impairment found at the examination should be considered in the light of the likely ability that the worker can continue working  without endangering  the health and safety of himself or any other worker.

 

The  OMP  should  use his professional  discretion  in applying  the standards  of fitness  during the periodic  examination.   The final conclusion  on the standard of fitness of the employee  will rely on:

 

The period of further exposure

• Some occupational diseases  take  a  long  time  to develop  and further  deterioration  of  an employee’s  health may continue even after the discontinued exposure  to the hazard.
• Where serious permanent  disablement could  occur,  further  exposure  to the hazard  will be deemed unacceptable.

 

The experience of the worker

• A more knowledgeable and skilled worker,  will generally  be able to perform  his job without significant  risk to himself  or to his fellow workers;  health and safety.   The  skill of the worker may balance with the impairment in such way that the worker  be deemed  fit to carry on with his duties as required of him.

 

Protection of the worker

• The employee may be protected against further deterioration in his health and thus also reduce the risk to his fellow employees. This will include :

–Supervised  work  may  ensure  that  an  employee with  an  occupational disease  that can cause   harm to fellow workers and himself will be able to receive medical attention immediately.

–Supervised medication may eliminate or reduce risk to the health or the safety of employees,  for example,  a controlled  responsible diabetic,  without creating  unacceptable risk.

 

The use of PPE.

• A serving driver for passengers and goods conveyance is no longer fit to work as a driver if there is more than 40 dB average pure tone (0.5, 1,2 and 3 kHz) hearing loss due to unacceptable risk to fellow employees.
• Where no supervision is possible or where there is a documented reluctance of the employee to comply with such measures,  the OMP should consider these factors before declaring such employee fit for duty.

 

The  periodic examination will consist of:

• A questionnaire regarding any significant medical, surgical of accident occurrences during the intervening time since previous examination.
• A full physical examination to determine  the ongoing health status of  employees  with emphasis on the aspects  of importance to the requirements of the employee’s occupation.
• Examinations are to be conducted in accordance with the medical surveillance plan requirements for that particular occupation and may include:

–A lung function test by means of spirometry.

–A full size chest  X-ray subject  to results of lung function test and hazardous chemical exposure.

–A screening audiogram  – SABS 083 Code of Practice  as revised

–A visual acuity test- a Snellen chart or any other standard  method  to be used.

–Any other examinations will be performed at the discretion  of the OMP.

• The periodic examinations are integrated into the occupational health  surveillance program and any biological  monitoring of the employee that has to be performed to comply with any legal requirement.

 

These may include the surveillance of:

• TB;
• Silicosis;
• Noise induced hearing loss;
• Workers exposed to ionising radiation;
• Workers exposed to other specific hazardous substances for which regulations exist, such as lead and asbestos;
• Workers exposed to other potentially hazardous substances and conditions as determined in risk   assessment and in accordance with the established medical surveillance plan.

 

Exit Examination

• The exit examination is used to establish the health status of the employee leaving the employment or the mine or works. An exit certificate must be provided to the employee by the OMP.
• If an occupational disease is  identified, appropriate management of such disease is to be instituted.   All regulatory requirements, such as notifications to the DME, Department of Health or the MBOD are to be complied with.
• An exit certificate shall be produced by the OMP after the examination. This certificate will provide a summary  of all occupational medical  surveillance conducted  during  the employment of the  employee by  Barberton Mines Limited.   The presence or absence of any occupational disease will be reflected  on the certificate.
• A copy of this certificate will be provided to the employee and a copy will be entered into the employee’s record of medical surveillance.

• The exit examination and tests will be appropriate to:

–the health hazards that the employee  were exposed to; the inherent requirements of the specific occupation; the results of all relevant risk assessments.

–All records  of any examination  will be kept under  the control of Barberton  Mines  Limited  for the period   as  specified  by  the  MHSA  (for  a  period  of  40  years  after  the  last  date  of  medical surveillance of the worker).   These may be made available only in accordance with the ethics of the  medical  practice,  or  if required  by  law  or  court  order,  or if the employee has,  in writing, consented  to the release of the information.

• The following examinations will be performed at no charge to the employees of Barberton Mines by the Occupational Health Department of the mine:

–to prospective employees of Barberton Mines Limited an initial examination;

–to current employees a periodical  medical examination;

–all other examinations as determined by the OMP and

–exit medicals to employees leaving the employment of Barberton Mines Limited.

 

 

CATEGORISATION OF FITNESS TO WORK

There  are only  two  findings that  may be made  by the  OMP:

• The standard has been met: an employee is fit for a particular category of work.
• The standard has not been met : an employee is unfit for a particular category of work.

The decision  on fitness in accordance with this COP lies with the OMP.   The fitness  to work  status of any employee will be cancelled  by the OMP  when  there  is reason  to suspect  that  the health of the worker  is such that the performance by him of risk work is likely to endanger his own health or safety, or the health or safety of other workers.

The  grounds   of  such  a  finding  and  the  effective  date  thereof  will  be  recorded  on  the  employee’s medical   surveillance  record.     If  the  employee   has  been  found  unfit  for  work   as  a  result  of  an occupational disease,  the OMP shall institute  appropriate  procedures in terms of the COlD  Act or the ODIMWA   In this instance,  (an occupational disease  causing  unfitness  to work),  the employer  must conduct an investigation in terms of Section 11 (5) of the MHSA

An employee can direct an appeal to the Principal  Medical  Inspector  of Mines within  90  days after a decision of unfitness by the OMP (MHSA Section 20).

Periodic  examinations should  be  risk  specific,  taking  into  account  the physical  requirements of the worker’s   occupation  and  the  hazard  and  risk  assessment of  the  workplace.    Some  disabilities  or impairments may  be  irrelevant  to  performing a  particular  job  category  and  the  employee  may  be declared  fit without posing a health or safety risk.

 

The interval  between examinations will be determined by the OMP with regard to:

• the specific health hazards present,
• the requirements of the worker’s occupation, and the results of any relevant risk assessment.

The interval between  examinations may only be extended under specific  and reasonable conditions  (to a maximum of 3 months)  in liaison with and at the discretion  of the OMP.

Periodic  examinations may be modified by the OMP according to a worker’s  health risks.

 

 

MINIMUM STANDARDS OF FITNESS TO PERFORM WORK AT A MINE ON INITIAL EXAMINATION

• The OMP should be governed  by the principle  that “The health  of the employee should  be. such,  that in the performance of his work  he should  not  endanger  his own  health  or safety or the health or safety  of other employees”.
• Each employee will be evaluated  individually taking  into  account  his  specific  occupation  and  the  state  of fitness/health required  for this occupation,  considering health hazards to which the employee  will be exposed to.  Consistency is important  and the OMP will follow the guidelines provided.
• Mining and the  processing of rock  is a potentially  hazardous occupation  and  calls  for a high  standard  of health and fitness  in those entering or re-entering the industry.
• The OMP may apply more or less stringent standards after taking into account  the job requirements as well as the worker’s experience and individual circumstances.
• Prospective employees who at examination are found  to be  suffering  from  serious  infectious  diseases  or other  conditions  which  preclude  him  from  working  on the mine  and works  will be referred  to his previous employer.
• The aim of  pre-employment  screening  is  to  ensure  that  a  healthy  work  force  is  employed   as  well  as preventing  the introduction of infectious  diseases.   This  will include  the workers  of contractors working  at Barberton  Mines Limited.
• Withholding information on any previous medical conditions at pre-employment screening  will be deemed  as fraudulent  and a person  will be discharged on establishing dishonesty.
• At initial examination  every  prospective   employee will  be  made  aware   of  this  fact.  The prospective employee will sign his medical  questionnaire, confirming that the information given  by  him  is true and complete.
• Criteria for exclusion of prospective employees are based  on clinical  findings  and on the history  from  the questionnaire.  The OMP will determine  and apply the standards  taking into account  the risk assessments and inherent  requirements of the job category.

 

THE MANAGEMENT OF SPECIFIC DISEASES OR CONDITIONS

• It is impractical to cover all possible medical problems that an employee may develop  after employment and therefore  the OMP should use his professional discretion.

 

INFECTIOUS DISEASES

a.  Gastro-Intestinal Infectious Diseases

• Persons with any infectious gastro-intestinal disease are to be certified unfit to prepare  or handle foodstuffs until  the  OMP  re-examines the  employee and  certifies  the  employee fit  to  resume such duties.

b.  Active Infectious Pulmonary Tuberculosis

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• All prospective employees are required  to have  a chest  X-ray  as part of their pre-employment examination.  Should tuberculosis be diagnosed  in a prospective employee, the person  will not be employed.
• If a prospective employee had been employed on a mine or works within the last twelve months, he will be referred  back  to the previous  employer  and that previous mine  will be responsible for further investigation,  treatment and submission to the MBOD for compensation purposes.
• If tuberculosis is found in a prospective employee, he has not passed the standard  of fitness and will be sent back to TEBA or to his nearest medical facility with a referral letter in order to receive treatment  for the disease.

 

 

INFECTIOUS DISEASES

AT PERIODIC  EXAMINATION (CURRENT EMPLOYEES)

• Current workers found  to  have  tuberculosis   will  be  managed according to  the  Tuberculosis Control Protocol of the specific  operation  and will only be declared  fit for work by the OMP.   The degree  of impairment caused  by the disease will determine the further fitness to work.
• A re-evaluation to  establish  fitness  to  work  will  be  carried  out  by  the  OMP  after  a  suitable interval.   The  employee  will  be found  Not  Fit  to work  where  there  is a continuing  infectivity  or serious impairment.
• To assess the degree  of damage  by previous  PTB,  chest  X-ray  and  lung  functions  should  be assessed.  There should be no more than 40% damage  on chest X-ray and the lung function test should  be  no  more  than  mild  disease  in the  rating  of  respiratory  impairment as  per  MOHAC guidelines.
• Whether one or both lungs  have  been  seriously  infected  by TB,  the employee  should  not  be exposed to dusty environments.

 

c.  Septic Lesions

• Persons suffering from chronic septic lesions should  not participate  in handling food.

 

ENDOCRINE AND METABOLIC DISEASES

Diabetes Mellitis

The  finding  that a worker  suffers  from  diabetes  should  be regarded  as a prospective  disability due to:

• The progress’1ve nature of the disease.
• The development of complications (poor vision, impaired renal function, etc.)
• Potential side effects (blackouts, impaired heat tolerance, etc.)

 

AT INITIAL  EXAMINATION (PROSPECTIVE EMPLOYEES)

• Non-insulin dependent diabetics (NIDDM)  may  be considered for safe surface  jobs only should the blood  glucose level be below 11g.dl.

 

AT PERIODIC  EXAMINATIONS (CURRENT  EMPLOYEES)

• Only NIDDM patients  who  are well controlled  will  be allowed  to work.   IDDM  persons  may  be allowed  but  only in special  circumstances and  with  restrictions  placed  on  the  type of work.   A NIDDM patient may be allowed to perform Category A, risk work but each case shall be judged individually  by the OMP.   No diabetic will be allowed  to perform  any Category  B risk work on the mine or works.
• Following any hypoglycaemic episode in a worker  the worker  will be re-educated and improved control must be established and a re-evaluation for fitness to work  will be performed after a suitable interval.

 

d.  Obesity

• Obesity adversely affects  heat  tolerance  or  the  ability  to exercise,  mobility,  general  health  or possible   medical  evacuation   (the  removal  of  a  sick  or  injured  obese  person  from  accident location at workplace)  may render a person unfit for a particular category of work.
• Workers with a mass of >1OOKg or <50Kg may be declared fit for work at the OMP’s discretion. The BMI chart can be used as a guideline.

 

THE MANAGEMENT OF SPECIFIC DISEASES OR CONDITIONS

DISEASES OF THE BLOOD AND BLOOD FORMING  ORGANS

• Any significant disease of the haemopoietic system may preciude employment in certain categories of work.
• Specific attention should be given to labourers in strenuous work categories. a. Haemophilia
• When inhibitors (antibodies)  are present  in large amounts  in the patient’s  blood,  the employee may  require  very high and expensive  quantities  of transfused  clotting factors  to stem bleeding. Life threatening haemorrhage is a constant risk.
• Traditional treatments involve  mostly  ‘on demand’  treatment,  i.e. patients  are treated  only after bleeding  symptoms  are recognized.   These bleeds  ultimately result in severely impaired joints.  It is known  that crippling joint involvement  can be avoided through periodic and regular transfusion.
• The haemophilia patient/employee needs to wear a medical identification  band, clearly indicating the employee’s  blood group and type of blood disease.

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• Haemophilia patients may be considered, but it is imperative that the patient discloses the matter as the implications for the employee and his colleagues are quite severe.

 

AT PERIODIC  EXAMINATIONS (CURRENT EMPLOYEES)

• These workers may be temporarily unfit for work pending treatment. Each case shall be judged individually by the OMP.

 

MENTAL DISORDERS

a.  Acute and Chronic Psychosis

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• Any new worker with an acute or chronic psychosis is unfit for risk work.

 

PERIODIC  EXAMINATION (CURRENT  EMPLOYEES)

• These workers may be temporarily unfit for work pending  treatment  and rehabilitation.  A re-evaluation  for fitness to work will be performed after a suitable interval.

 

b.  Severe Anxiety or Depressive Illness

• Persons suffering from  severe  anxiety  or depressive illness  complicated by significant  loss of memory  or concentration, agitation, behavioural disturbance  or suicidal thoughts should not be fit to work in categories  of risk work.

 

c.  Chronic Schizophrenia/Dementia

• Any organic brain syndrome should not be employed to work in risk categories.

 

d.  Alcohol or Substance Abuse/Dependency

• Alcohol and drug screening should be performed  on all risk category A and B workers.

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• Unfit for any risk work.

 

PERIODIC  EXAMINATION (CURRENT  EMPLOYEES)

• Unfit for risk category A or B workers. These workers may be temporarily  unfit for work pending treatment  and rehabilitation.
• A re-evaluation for  fitness  to work  will be performed after  a suitable  interval.   An  alcohol  and substance  abuse policy to be compiled.

 

DISEASES OF THE NERVOUS  SYSTEM  AND SENSORY ORGANS

a.  Epilepsy and other Conditions of Altered or Impaired Consciousness

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• Any medical condition which may result in an altered or impaired level of consciousness, including epilepsy renders  a person  unsuitable  for employment in certain areas or occupations on a mine,  such as underground, or operation  of moving  machinery or in dangerous  situations such as working at heights,   near  water, high voltage electricity or any other potentially dangerous situations.

 

AT PERIODICAL  EXAMINATIONS (CURRENT EMPLOYEES)

• Notwithstanding the above, an epileptic under medical  treatment  and without any events within a preceding period of two years may be considered for certain  categories  of work underground or on the surface.   The worker  will be re-educated and improved control established and a re­ evaluation for fitness to work will be performed  after suitable intervals.

 

EAR, NOSE AND THROAT

• An ear, nose  and throat  examination  is required  (which  includes  intact tympanic  membranes and functioning Eustachian  tubes)  and the minimum  standards  set below must be met  for occupations involving changes in barometric pressure and/or exposure to noise.
• However, the OMP will decide each case on the risk versus the skill and experience of the worker concerned.

 

a.  Audiometric Standards

 

AT INITIAL  EXAMINATION (PROSPECTIVE EMPLOYEES)

• All prospective employees will undergo a hearing test on pre-employment examination. No person with impaired  hearing will be placed  in a job where the possibility  exist that he will be in danger because of poor hearing or where his hearing may be further damaged.

 

PERIODIC EXAMINATIONS (CURRENT  EMPLOYEES)

• If a loss of hearing is discovered with a current employee,  the employee’s hearing will be followed-up by additional examinations with specific regard to the risk assessment.
• If a worker is found to have significant hearing loss, he will be referred to a registered audiologist for diagnostic audiograms  and the procedure of the hearing conservation program  will  be followed.
• Depending on the degree of hearing loss, removal  from the  source  could  be  considered, however,  a degree of flexibility should be exercised when deciding to take an employee  from his work.   The criteria to be used in determining  whether the employee  may continue  in their present occupation should be based on whether  the employee  may endanger  themselves  or others due to hearing  impairment.  The absolute minimum  for continued work in a noisy environment  should be a binaural hearing loss average of 60 dB(A).
• If any degree of heating  loss  is detected  the worker  will be  re-educated  and  advised  to use personal, of other suitable protective hearing devices.
• Workers may have to be withdrawn form their work in the following circumstances : Binaural hearing loss average> 60dB(A) in certain occupations.
• Binaural hearing loss average of> 45dB(A). Unilateral deafness of 100% in either ear.

 

VISION

• Binocular vision is necessary for all categories  of risk work.   A normal  visual field 50 degrees  nasal and 70 degrees temporal vision is required.

 

VISUAL ACUITY

• should be tested using Snellen charts in normal illumination. VISUAL FIELDS can be tested by the confrontation method.

 

COLOUR  VISION 

• should be tested using Ishihara charts. Normal  colour  vision and normal visual fields are required for passenger, and drivers as well as for certain other occupations, such as electricians.

 

CARDIOVASCULAR SYSTEM

 

a.  Cardiovascular Disease

• The worker must be free from  acute  or chronic  heart  disease,  which may  impair  his ability to undertake  the required physical exertion for a particular category of work.

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• Any applicant with uncontrolled hypertension >160/100 or complications from hypertension is unfit for employment.

 

AT PERIODIC  EXAMINATION (CURRENT  EMPLOYEES)

• A well-controlled hypertensive worker may work. Uncontrolled hypertensives or those with complications should be excluded from a got environment  and strenuous work.
• Hypertension is viewed as uncontrolled at a systolic value of 180 or higher and a diastolic value of 110 or higher.  There should be no loss of consciousness due to cardiac reasons.

 

RESPIRATORY SYSTEM

• The respiratory system  should  be free of acute or chronic  disease,  which may  impair  the ability to meet the required physical performance of a particular category of work.
• In individuals where there are mild  abnormalities of lung function  this  test should  not be the sole criterion  on which an individual is precluded  from mine work.   If the individual otherwise  appears  to have a normal  cardiorespiratory  system and is able to meet  the physical performance requirements of the specified  occupation  then he may be found fit for a particular  category of work.   Refer to the MOHAC Guidance  Note for OMP’s on lung function testing.
• For screening purposes a lung function test is normal  if FVC and FEV1 is greater  than 80% of the predicted or the (FEV1/FVC)  ratio is equal to or greater than 70%.

 

a.  Silicosis

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• All new workers with silicosis will be judged on an individual  basis.   The degree  of impairment caused  by the disease and the risk inherent  in the particular  category of work will be taken into account  in deciding on fitness to work.
• For screening purposes, a lung function  test is considered normal  if the FEV1  is greater  than
• 80% of predicted or the (FEV1/FVC) ratio is greater than 70% of predicted.
• A new worker will not be considered fit for work if the chest X-ray is classified as worse than ILO
• 1/1, regardless of size of the silicosis nodules.

 

b.  Occupational Asthma

• In addition to those employees who develop  occupational asthma  as a result  of the workplace exposure  to sensitizers, or irritants,  many employees  are unaware  that pre-existing  asthma may
• be worsened by the working environment.

 

Morbidity from occupational asthma is preventable.  Early diagnosis holds substantial promise for effective intervention.

 

AT INITIAL EXAMINATION (PROSPECTIVE EMPLOYEES)

• A controlled asthmatic person may be considered. The  importance of the correct use and availability of the medication needs to be stressed.

 

AT PERIODIC  EXAMINATIONS (CURRENT  EMPLOYEES)

• Only asthmatic patients who are well controlled will be allowed to work.   An asthmatic patient may be allowed to perform  risk work but each case shall be judged individually  by the OMP.
• Following any asthmatic attack episode in an worker the worker will be re-educated and improved control must be established and a re-evaluation for fitness to work will be performed after a suitable interval.

 

DISEASES OF THE DIGESTIVE SYSTEM

• There should not be any significant disease of the digestive system, which may impair an employee’s ability to perform a certain category of work.

 

GENITO-URINARY SYSTEM

• There should be no cases of unexplained proteinuria, glycosuria, haematuria of any other urinary abnormalities, which may render the worker unfit to perform his particular work.

 

SKIN

• Occupational skin diseases mostly  in the  form  of  allergic  and  irritant  (contact  dermatitis)  are  the second most common type of occupational disease.
• A history or the presence of any septic or chronic  skin condition  which is likely to be aggravated  by the worker’s  working conditions, may render him unfit for his particular  job category.  Such conditions include  psoriasis  and all chronic  forms of dermatitis.

 

Irritant  Contact Dermatitis

• Irritant contact dermatitis is the most common  occupational skin disease,  usually resulting from toxic reactions  to chemical irritants  such as solvents and cutting fluids.
• As the prognosis  of  occupational irritant  and  allergic  dermatitis  is poor,  prevention  is imperative. Occupation contact dermatitis  is likely to develop into chronic  skin disease.

 

MUSCULO SKELETAL SYSTEM

• Musculo skeletal disorders affect -the  soft  tissues  of the  neck,   shoulder,   elbow,  hand,  wrist- and fingers.     These   include  the  nerves  (e.g.  carpal  tunnel  syndrome),  tendons  (e.g.  tenosynovitis, peritendonitis, epicondylitis)   and  the  muscles   (e.g.  tension  neck  syndrome).   The  fitness  of  the worker   and  his  musculo-skeletal  development  and  integrity   should  be  such  that  he  is  able  to undertake the required physical  exertion to perform  his particular  job.

 

HEAT TOLERANCE

Where   the  wet  bulb  temperature   exceeds   27.5°  Celsius   or  the  dry  bulb  temperature   exceeds

• 37.0°C., the mandatory COP on Heat Stress Management shall apply. Employees  who need to work in such environments, must meet  all the physical  requirements and pass  the necessary  screening test prescribed in the COP before they will be found fit to work.
• Heat stroke and  heat  exhaustion  rendering  an  employee  unfit  for normal  work  for more  than  48 hours are reportable to the DME.

 

AGE

• No person under the age of 18 will be allowed to work on the Mine or Works.

 

OCCUPATIONAL DISEASES IN THE SECOND DEGREE

• If an employee is found by the MBOD to be suffering an occupational disease in the second degree, he is found unfit to perform  risk work of any nature on surface.

 

THE MANAGEMENT OF Ex-BARBERTON MINES  LIMITED  EMPLOYEES WITH  AN OCCUPATIONAL DISEASE

• If an ex-employee suspects that he has an occupational disease, a benefit examination will be done at the MBOD.
• The employee will have a benefit examination performed  and the relevant documentation will be forwarded to the  MBOD  or  RMA  for any possible  compensation.   If applicable, treatment  will be  started  and  the person will receive  a referral letter to his nearest appropriate  facility for continued management.

 

RADIATION

• Barberton Mines is committed, to manage potential  radiation,  hazards  and ensure  that employees’  health will not be adversely affected by accidental exposure  to such sources.

 

HANDLERS OF TOXIC SUBSTANCES

• Workers exposed to hazardous chemical substances as identified and evaluated by the company appointed Occupational Hygienist should have normal renal, hepatic and haemopoetic function.   Biological monitoring  will be done on these workers  at the discretion  of the OMP and also in accordance  with the relevant regulations.