Health Case Studies
People are essential to the success of our business. Understanding and mitigating the impact of occupational exposures on our workforce is integral to our journey towards Zero Harm. Within our Aluminium CSG, it is recognised that there are a number of health risks associated with the aluminium industry that must be controlled in order to ensure the health and safety of our employees and contractors. To improve the identification and management of these risks in a comprehensive and systematic manner, an occupational health management strategy is being implemented across our Aluminium assets.
Context
The key factor in our strategy is that we must promote an environment that contributes to our employees and contractors being fit for work and fit for life. In line with this, our health management program identifies and builds on best practice that exists within the Aluminium CSG.
Our aim is to ensure the sustainability of the program through an ongoing risk assessment and management process, occupational health professional networking, and the commitment of our asset and CSG leaders to manage and resource the tasks within the program.
Objectives
The objectives of the program are to:
- adopt common standards and methodologies for exposure assessment and medical evaluation
- establish a baseline health risk profile through systematic assessment of exposures and evaluation of employee health
- implement internationally referenced standards and methodologies, consistent with industry best practice and aligned with the Company's requirements
- implement a strategy to minimise health and business risk
- establish a review process to ensure continuous improvement.
This approach ensures that our health program is comprehensive, is based on international best practice and is sustainable.
Respiratory Health Focus
- Respirator kit testing at Bayside
As respiratory health issues are known to be associated with exposure to irritants in aluminium smelting, particular focus was given to this aspect during the initial phase of the program. Progress to date includes:
- increased awareness of respiratory health responsibilities through regular feedback to management and employee and contractor work groups, individual interviews with employees and managers, and training initiatives
- the development of a standard medical protocol for respiratory health management and its implementation across our aluminium smelters
- a peer review of program protocol by international experts in occupational asthma in the aluminium industry (medical tests of respiratory health, diagnostic criteria and respiratory protection programs are referenced to international standards)
- an independent audit of the quality of spirometry (measurement of lung capacity) practices
- a review of the respiratory protection program to allow improvement plans to be developed, which are currently being implemented through the introduction of improved respirator filters, fit testing, respirator servicing and training.
At the conclusion of the first year of development and implementation of the respiratory program, our aluminium smelters in southern Africa — Mozal, Hillside and Bayside — hosted an International Respiratory Health Management Conference. International researchers and practitioners in the management of respiratory health in the aluminium industry participated in the conference, reviewing local practices and sharing their international experience and expertise.
- Respirator servicing at Mozal
Professor Tom O'Donnell is Emeritus Professor, University of Otago, New Zealand, and former Chairman of the Health Committee of the International Aluminium Institute. Professor O'Donnell participated in the conference workshop and was involved in reviewing the respiratory program. He provided the following assessment.
'The process of developing successfully this program for implementation among the diverse workforce populations at BHP Billiton aluminium industry plants has been impressive. Specific objective criteria have been assembled consistent with best practice guidelines of the American and European Respiratory Societies. These are for use, firstly to minimise the incidence of occupational asthma among the workforce through careful pre-employment exclusion of applicants in whom characteristics statistically more commonly associated with occupational asthma and secondly, to facilitate the prompt early diagnosis and management of incipient occupational asthma through regular workforce respiratory screening.
'The successful introduction of this program was due significantly to the involvement of the various "grass roots" plant physicians in developing the protocols rather than an imposition of some external document. Their enthusiastic acceptance of responsibility under the convener Linda Kissane ensured "buy in". A smooth introduction was achieved for the management and the overall workforce of various cultures in KwaZulu-Natal and Mozambique.
'Those involved assessed relevant publications through scientific journals and communicated with international authorities in this field. The protocols and criteria (particularly the objective ones) are expressed in a specific, straightforward manner so that they are readily transparent to potential employees and their families, those already in employment, management and administrative staff, contractors and health professionals. They provide a clear basis for legally sound decision-making.
'I attended a health workshop at Richards Bay in November 2004. I was impressed by the enthusiasm and confidence in the project among the health professional and representatives from various sections of the plants. I was struck by the confidence for success in meeting the challenge summed up as "Can we lick this Occupational Asthma? Yes we can!"
'I consider that this project development has been of very high quality and provides striking evidence of the strategy towards health issues so strongly expressed by BHP Billiton among its workforce. It will be received with commendation and followed with interest throughout the Industry.'
Dr Clifford Smith is a consultant pulmonologist responsible for the review and final diagnosis of respiratory cases from our three aluminium smelters in southern Africa. Dr Smith also participated in the conference workshop and reviewed the program. He provided the following testimonial.
'I have been involved with BHP Billiton for approximately 18 months in the capacity of consultant pulmonologist.
- Special respirator for people
with beards
'Patients referred for opinions have complex issues relating to diagnoses, the role of occupational dust exposure and smoking. The smelters in southern Africa have not always used standard and similar methods of pre-employment screening and monitoring of patients. Diagnostic and therapeutic interventions likewise may differ in each smelter depending on individual experience and preference.
'I would strongly commend the efforts of Linda Kissane to standardise the respiratory health programs at the smelters. It allows for good medical practice with easy application by medical and associated personnel at all the plants.
'Careful peer (both industrial and medical) review approaches apply to numerous medical issues. These include pre-employment screening of employees, monitoring programs, practical issues as to placement of patients, and associated medical management issues. Doctors would have an easy reference for diagnostic and management problems. This would promote consistency and excellence in respiratory health management in an industrial setting'.
Next Challenges
The next steps in our strategy are to:
- develop standard protocols for key health processes
- progress implementation of the respiratory health program with particular emphasis on case management and exposure prevention
- develop pitch exposure risk profiles, implement control strategies and investigate medical surveillance requirements
- implement a medical screening process for contractors and develop contractor exposure profiles
- continue to focus on the prevention of hearing loss by limiting noise exposure
- implement a strategy for injury case management and rehabilitation.
