ICMM Health and Safety Performance Indicator Definitions

Health and Safety
Performance Indicator Definitions

Health and Safety Performance Indicator Definitions
Health and Safety
Performance
Indicator Definitions

4

Contents
Purpose 6
General Definitions 7
Safety Indicators 9
Injury Numbers 9
Calculated Indicators 12
Health Indicators 14
Definitions of Health Indicators Used in Data Entry and Reporting 14
Health Metric Definitions 16
Appendix: Further Information 18

A Definitions 18
B Health indicator criteria 20
C Health Risk Assessment 28
D Ergonomics Assessment 31

Purpose
This document contains the definitions used by ICMM for lagging (outcome) safety
and health metrics. These metrics are captured in the ICMM Benchmarking
database (http://www.shecbenchmarking.com). Indicators are separated into those
collected (and reported) and those not collected, but calculated.
The document also contains, as appendices, additional information on metrics,

which may be used as a basis for improvements to benchmarking in the future. In
particular, the appendices include information on possible leading (system/process
implementation/leadership) indicators, and improved health metric indicators which
provides information to member companies for determining future direction for
health management and health research.
The document has been prepared based on input from ICMM member companies
and from the International Aluminium Institute (IAI).
The intent is:

• To define a core group of metrics to be used by all ICMM member companies;
• To ensure that the metrics are simple to apply and are relatively general in scope;
• To provide clear definition of key terms;
• To provide additional metrics which may be used on a voluntary basis by
individual companies.
1 If you wish to register to use the ICMM Benchmarking Database, please contact the ICMM secretariat (info@icmm.com)

General Definitions
Employee
Individual employed directly by the company. The preference in the database is to

count directly supervised contractors as contractors, however where companies do
not separate this information from employee information, it is acceptable to count
them and their associated injuries under employee data.
Contractor
Any individual, company or other legal entity that carries out work, work-related
activities, or performs services pursuant to a contract for service. This includes
sub-contractors, and personnel working both full time and part time.
Occupational Illness
An occupational illness is any abnormal condition or disorder, other than one

resulting from an occupational injury, caused by exposures to factors associated
with employment. It includes acute or chronic illnesses or diseases, which may be
caused by inhalation, absorption, ingestion or direct contact.
Illnesses are distinguished from injuries in that the latter occur at “an instant in
time”. For injury, the gap between exposure and the onset of signs or symptoms is
short (minutes to hours, but less than one shift) whereas the gap for illness is
longer (days, weeks or years). If there is a known latency period for the
development of illness following an acute exposure, then the condition is to be
considered an illness. This will also apply to injuries that eventually result in
occupational diseases e.g. asthma resulting from acute high level exposure to an
irritant gas.
Work-related Activities
Work-related activities are those where the employer can set safety, health and
environmental standards, and can supervise and enforce their application.
If an event or exposure in the work environment either caused or significantly

contributed to an injury, or significantly aggravated a pre-existing condition, then
the case is considered work-related. Work-relatedness is presumed for injuries
resulting from events or exposures occurring at the employer’s work
establishment unless an exception specifically applies.
Injuries and illnesses occurring away from the work establishment are considered
work-related only if the worker is engaged in a work activity or is present as a
condition of his or her employment or contract.
Work performed as a part of haulage of product between operated sites, whether

by directly employed or contract operators, would normally be included as work-
related. Work performed at a contractor’s home base is not included as work-
related unless it is clearly under the supervision and standards of the company.

8
Injuries and illnesses that occur while the employee is travelling are work-related
if at the time of the injury or illness the employee/contractor was engaged in
work-related activities “in the interests of the employer”. Examples of these
activities include:
• Driving or being driven in a vehicle for work-related purposes, irrespective of

the cause of any incident involving the vehicle.
• Flying to visit another site or customer/supplier contact.
• Being transported to and from customer contacts after lodging has been
established and as part of work-related activity.
• Entertaining, or being entertained to transact, discuss or promote business,
provided the entertainment is at the direction of the employer.
However when travelling employees check into a hotel, motel or other lodging,
they establish a “home away from home”. Thereafter, their activities are evaluated
in the same manner as for non-travelling employees. For example, injuries
sustained when commuting from a hotel to a temporary work site are not work-
related, just as injuries sustained during an employee’s normal commute from a
permanent residence to an office are not considered work-related.
Work Environment
The work environment is defined as the establishment and other locations where
one or more employees are working or are present as a condition of their
employment.
Pre-existing Conditions
Pre-existing conditions are those which an individual brings with them to the
current employer, either caused by exposure at another workplace or by non-
occupational factors.
Significant Aggravation
A significant aggravation is defined as occurring when an incident occurring at

work results in tangible consequences that go beyond those the worker would
have experienced as a result of the pre-existing illness/disease alone, absent the
aggravating effects of the workplace.
Routine Functions
Routine Functions are work activities/assigned duties that the employee regularly
performs at least once per week or as part of the roster cycle.

Safety Indicators
Injury Numbers
Fatalities
Work-related injury resulting in death of employee or contractor. Fatalities are

categorised according to the following types:
• Electrical
• Explosions and Fires
• Falls from Heights
• Geotechnical
• Hazardous Substances
• Machinery, Equipment and Hand Tools
• Mobile Equipment
• Slips, Trips and Falls
• Other
Lost Time Injuries
A Lost Time Injury (LTI) is a work-related injury resulting in the

employee/contractor being unable to attend work on the next calendar day after
the day of the injury. If a suitably qualified medical professional advises that the
injured person is unable to attend work on the next calendar day after the injury,
regardless of the injured person’s next rostered shift, a lost time injury is deemed
to have occurred.
Restricted Work Injuries
A Restricted Work Injury (RWI) is a work-related injury which results in the

employee/contractor being unable to perform one or more of their routine
functions for a full working day, from the day after the injury occurred. An RWI
should be certified by advice from a suitably qualified health care provider.
Lost Time + Restricted Work Injuries
Some companies do not differentiate between Lost Time and Restricted Work
Injuries. For such companies, counts of LTIs reported to the ICMM database
include RWIs, and are marked as such in the database. As a result, the main
benchmarking injury statistic that should be used is the ‘Lost Time + Restricted
Work Injury’ count (and associated frequency rate). However, the preference is that
the ICMM database LTI count excludes RWIs and that RWIs are counted separately.
Medical Treatment Injuries
A Medical Treatment Injury (MTI) is a work-related injury resulting in the

management and care of a patient to combat disease or disorder, including any
loss of consciousness, which does not result in lost time or restricted work.
MTIs include (for example) suturing of any wound, treatment of fractures,

treatment of bruises by drainage of blood, treatment of second and third degree
burns.

10
MTIs do not include:

• Visits to physicians or other licensed health care professional solely for
observation or counselling.
• The conduct of diagnostic procedures, such as X-rays and blood tests, including
the administration of prescription medications used solely for diagnostic
purposes (e.g. eye drops to dilate pupils etc.).
• Visits to physicians or other licensed health care professionals solely for
therapy as a preventative measure (e.g. physiotherapy or massage as
preventative therapy, tetanus or flu shots).
• First Aid Injuries (FAIs) as listed in the Appendix.
First Aid + Medical Treatment Injuries
Some companies do not differentiate between Medical Treatment and First Aid
Injuries. For such companies, counts of MTIs reported to the ICMM database
include FAIs, and are marked as such in the database. The preference is that the
ICMM database MTI count excludes FAIs.
Days Lost Reporting
“Days lost” are counted as the number of calendar days2 after the day of the
incident, during which the employee or contractor is unable to perform all of their
routine functions or is temporarily assigned to a different job. This includes full
days lost, as for a Lost Time Injury. Days lost counting ceases if the person ceases
employment with the company, or the person is permanently reassigned to a new
job.3
Days lost are counted during the month in which the days lost occurred. Some
companies credit days lost in the month in which the injury or illness occurred
rather than the month in which the days lost are incurred. While this is not
preferred for the ICMM database, it is an option as it makes very little difference to
injury rates over time.
Time spent travelling, or waiting for diagnosis following an incident is not included
in days lost, unless the injury becomes classified as a Lost Time Injury or a
Restricted Work Injury.
No lost days are recorded for fatalities.
Days lost to Lost Time Injuries
The number of calendar days during which an employee or contractor is unable to

attend work during the month in which the lost days occurred.
2 Some companies count scheduled work days instead of calendar days. Where this is done it is clearly marked as such
in the database. Companies using this practice should also indicate whether lost time/ restricted work injuries are
counted as such if the injured party is unable to attend work on the next calendar day rather than the next scheduled
work day.
3 Some companies cease counting lost days after 180 lost calendar days have elapsed. The preference for the ICMM
database is that the full number of lost days is supplied, in other words that a 180 day limit is not applied.

11
Days lost to Restricted Work Injuries
The number of calendar days during which an employee or contractor is able to

attend work but is unable to perform one or more of his / her routine functions,
during the month in which the lost days occurred.
Days lost to Lost Time & Restricted Work Injuries
Total of calendar days lost (both restricted work and lost days) during the month in
which the days lost occurred.
Days lost to Work-related Diseases
The number of calendar days during which an employee or contractor is either

able to attend work but is unable to perform all his / her routine functions, or is
unable to attend work, due to occupational illness which is work-related.
Days lost to Non Work-related Illnesses and Injuries
The number of calendar days during which an employee or contractor was unable
to attend work due to non work-related illness or injury.4
Exposure Hours
The “exposure hours” used in injury performance calculations are the total
number of hours worked by employees or contractors carrying out work-related
activities. This includes hours worked onsite, offsite and travelling on behalf of
work, but excludes hours spent travelling as part of normal commuting to and
from a person's place of residence.
Exposure hours reported should reflect actual hours worked, not planned hours.
4 Not all companies will be able to supply this statistic at this stage, and companies will not be monitored against the
supply of this statistic yet.

12
Calculated indicators
Total Recordable Injuries (TRIs)
TRI = Number of (Fatalities + Lost Time Injuries

+ Restricted Work Injuries + Medical Treatment Injuries)
Frequency Rate (FR)
Injury frequency rates are normally expressed as the number of injuries per
million hours worked.
FR = Number of injuries * 1,000,000 / hours worked
In some jurisdictions, such rates are expressed per 200,000 hours worked. The
ICMM database defaults to calculating frequency rates based on million hours
worked, but can also be set to calculate rates per 200,000 hours. Where rates are
described in text, the denominator used should be mentioned to avoid confusion.
Fatality Frequency Rate (FFR)
FFR = Fatalities * 1,000,000 / hours worked
Lost Time Injury Frequency Rate (LTIFR)
LTIFR = LTIs * 1,000,000 / hours worked
Total Recordable Injury Frequency Rate (TRIFR)
TRIFR = (Fatalities + LTIs + RWIs + MTIs) * 1,000,000 / hours worked

13
Severity Rate (SR)
SR = (Days lost to LTIs and RWIs) * 1,000,000 / hours worked
Duration Rate (DR)
DR = (Days lost to LTIs and RWIs) / Number of (Fatalities + LTIs + RWIs)
Absentee Rate (AR)
AR = Total days lost * 1,000,000 / hours worked
Total days lost = days lost to LTIs and RWIs plus days lost to work-related diseases
plus days lost to non work-related illnesses and injuries.
Number of Personnel
Total personnel = hours worked per year / 20005
5 2000 hours per year = 50 weeks x 40 hours and is an approximation of an average number of hours per year per person
exposed

Health Indicators
14
Definitions of Health Indicators Used in Data Entry and Reporting

New Cases (per disease):
Only new cases are counted for lagging indicators.
New cases are counted when all of the following criteria are met:
• There is a known association between the exposure(s) and the occupational
illness or disease.
• There is evidence of current or previous exposure to the agent of concern
during employment with the current member company.
• A dose sufficient (with respect to concentration and duration of exposure) to
cause the illness/disease has been documented through an appropriate
professional assessment (e.g. industrial hygiene reports) or a professional
opinion that the exposure is consistent with the condition.
• There is evidence of the illness/disease as diagnosed by a medical practitioner.
• The necessary (minimum) latency period exists to establish the probability of
association.
• There has been no previous recorded illness of same type involving the same
body part, or the individual has had a previous recorded illness of same type
affecting the same body part but had recovered completely (all signs and
symptoms had disappeared) from the previous illness and an event or exposure
in the work environment caused the signs or symptoms to reappear (NOTE: for
illnesses where the signs or symptoms may recur or continue in the absence of
an exposure in the workplace, the case must only be recorded once. Examples
include occupational cancer and pneumoconioses).
Significant aggravation of a pre-existing condition shall also be counted as a new

case when all of the above criteria are met.
New cases are counted separately for employees and contractors.
New cases are counted as of the date the illness/disease is diagnosed and are
reported on a calendar year basis.
To ensure usability of benchmarking data, definitions of cases are provided. These

case definitions are not necessarily consistent across all national regulatory
frameworks, but do conform to international conventions (e.g., WHO, ISO, ILO,
CDC, ATS/ERS, etc.) where possible.

15
Fatalities (per disease):
Number of deaths resulting from an occupational disease within the reporting

year, counted according to the date of death.
Disease Rates:
Disease rates are expressed per 1000 persons at work. The number of personnel
at work is calculated as noted on the previous page based on hours worked.
Note: the calculation of meaningful statistics for diseases involving a long lag
period prior to the development of the disease poses a definitional challenge. No
method is ideal. However, for comparative purposes, and to provide a standard
baseline, a disease rate is applied, even for diseases with a long lag period prior to
their manifestation. It is recognized that this rate is not a true reflection of risk to
the current working population.

16
Health Metric Definitions
Health metric definitions with their associated World Health Organization

International Classification of Diseases (ICD-10) identifier.
Work Related Asthma [ICD-10: J45, J45.1,

J45.9]
Asthma is “work related” when there is an association over time between
symptoms and work. A criteria for inclusion of work-related asthma can be found
in the appendix.
Work Related Chronic Obstructive Pulmonary Disease (COPD)6 [ICD-10: J42, J43,
J44]
Cases of COPD should be reported if they meet the following criteria:
• Recognized by a Workers’ Compensation Authority or equivalent
• Recognized as an occupational disease by the physician responsible for the site
For a more detailed criteria, see appendix.
Pneumoconioses [ICD-10: J61, J62,

J63, J63.0, J63.1,
A medical diagnosis of parenchymal lung disease with compatible radiological
J63.2, J63.8 ]
findings related to exposures to a range of substances (see appendix).
Work Related Cancers [ICD-10: C67 (C67.0-

C67.9), C34 (C34.0-
A medical diagnosis of cancer related to exposures to a range of agents (see
C34.9), C45 (C45.0-
appendix for list). Specific guidelines (based on the scientific literature) on work
C45.9)]
relatedness for bladder and lung cancer in the primary aluminium industry are
provided as appendices.
Infectious Diseases [ICD-10: B50-54,

A90-99, and potentially
Vector-borne diseases (e.g. malaria) in persons not originally from, or living
others in the “A” and
permanently in, relevant disease endemic areas.
“B” categories]
Deep Vein Thrombosis (DVT) [ICD-10: I80]

A medical diagnosis of DVT that has occurred as a result of work-related travel.
6 Sources used to develop these criteria: Quebec compensation guidelines; review of aluminium industry epidemiology
studies (e.g., Moira Chan-Yeung, Norwegian studies and Richard Martin's unpublished study)

17
Silicotuberculosis [ICD-10: J65]

An X-Ray consistent with silicosis (see Pneumoconioses above) as well as positive
sputa microscopy or culture for Mycobacterium tuberculosis.
Beryllium Related [ICD-10: J63.2,

T56.7]
Beryllium sensitization and chronic beryllium disease (CBD). See appendix for
further details.
Hearing Loss7 [ICD-10: H83.3]

OSHA Recordable Hearing Shift (Incidence): An age-corrected average hearing
shift in either ear of greater than or equal to 10 dB at 2000, 3000 and 4000 Hz
when compared to baseline, coupled with a greater than or equal to 25 dB average
hearing level in the same ear at 2000, 3000 and 4000 Hz. See:
www.osha.gov/recordkeeping/hearinglossflowchart.pdf
Hand-Arm Vibration Syndrome [ICD-10: J45, J45.1,

J45.9]
Vibration White Finger (VWF) equal to or greater than the Stockholm grading of 2.
Musculo-Skeletal Syndrome [ICD-10: M62.6,

G56.0, G57.5, M65,
A medical diagnosis of disorders and diseases of the musculoskeletal system
M65.4, M70, M71,
having a proven causal relationship with work and associated with repetitive
W43, etc.]
motion and/or stress. Disorders arising out of single events are specifically
excluded and are regarded as injuries.
Occupational Dermatitis [ICD-10: L23 and

L23.X, L24 and L24.X,
Non-infectious inflammation of the skin provoked by contact with an external
L25 and L25.X]
chemical or substance, accompanied by itching, cracking, blistering & ulcerations
Platinosis (Platinum Salt Sensitivity) [ICD-10: T56.9]

Allergy to complex halogenated salts of platinum is an acquired hyper-sensitivity
to the complex salts of platinum which becomes manifest after a variable period of
symptomless exposure. The clinical characteristics include one or more symptoms
and signs of dermal, ocular and nasal allergy and/or asthma.
7 Other definitions of hearing loss (Prevalence and Standard Threshold Shift) are in the Appendix and should be used
where applicable.

Appendix: Further Information
18
This appendix contains additional definitions and examples to provide further

understanding of the definitions above. These definitions are not currently directly
used in ICMM benchmarking.
A Definitions
A1 First Aid Injury
A First Aid Injury is recorded when first aid treatment is required as a result of a
work-related injury. OSHA determines First Aid to mean the following treatments:
• Visit(s) to a health care provider for the sole purpose of observation

• Diagnostic procedures, including the use of prescription medications solely for
diagnostic purposes
• Use of non prescription medications including antiseptics
• Simple administration of oxygen
• Administration of tetanus/diphtheria shot(s) or booster(s)
• Cleaning, flushing or soaking wounds on skin surface
• Use of wound coverings such as bandages, gauze pads etc.
• Use of hot and cold therapy e.g. compresses, soaking, whirlpools, non
prescription creams/lotions for local relief except for musculoskeletal
disorders.
• Use of any totally non-rigid, non-immobilizing means of support e.g. elastic
bandages
• Drilling of a nail to relieve pressure for subungal haematoma
• Use of eye patches
• Removal of foreign bodies embedded in the eye if only irrigation or removal
with cotton swab is required
• Removal of splinters or foreign material from areas other than the eyes by
irrigation, tweezers, cotton swabs or other simple means.
All of the above are regarded as First Aid Injuries, regardless of the health care
provider, who may be a physician, nurse or other health care provider.
A2 Sickness
The role negotiated with society. Sickness is the external and public mode of being
“unhealthy”. Sickness is the social role, a status, a negotiated position in the
world, a bargain struck between the person, henceforward called "sick", and a
society which is prepared to recognise and sustain the person.
A3 Lagging and Leading Indicators
Lagging indicators, also sometimes called trailing, downstream or ‘after-the-fact’

indicators, provide historical information about health and safety performance.
With lagging indicators, nothing can be changed to alter the measure of health and
safety performance, as it is history. Any changes made may influence future
performance but cannot alter the past performance. Classic injury statistics (i.e.,

19
injury frequency rate, lost workday rate, etc.) are examples of lagging indicators.
Leading indicators, also sometimes called ‘upstream’ indicators, are used as

predictors of health and safety performance. The advantage of using leading
indicators of performance is that actions can be taken to alter the course of health
and safety performance. If an indicator predicts poor performance, it is not
necessary to wait to see if the prediction is correct. Changes can be implemented
to increase the probability of improved performance. Thus, leading indicators can
provide guidance whereby there is greater assurance of achieving good health and
safety performance.
A4 Leading Indicators for Occupational Health
Measurement of leading indicators is considered to add value to the understanding

of organizational efforts to improve the management of Occupational Health in the
workplace.
Reporting of leading indicators also encourages organizations to adopt recognized

occupational and environmental health management practices and is important to
the sustainability of the organization and its employees.
The following indicators are considered relevant to the above objectives:
Description Measure
Management Number of plants with recognized health Number of

System and safety management systems (e.g. plants certified
Certification OHSAS 18001 or equivalent). compared with
total number of
IAI Objective: Implementation of plants asked.
Management Systems for Health and Safety
in 95% of Member Company plants by 2010.
Employee Exposure Health risk management is essential for Percentage of

Assessment the well-being of employees. This process plants with a
involves HIRARC (Hazard Identification, formal process
Risk Assessment, Risk Control). in place that
fulfil the defined
IAI Objective: Implementation of an criteria as
Employee Exposure Assessment 95% of specified in the
Member Company plants by 2010. attached criteria
document.
Ergonomics – Is there a formal process in place to Percentage of

Process identify AND control specific ergonomic sites with
risks? process in place

20
B Health indicator criteria
B1 Asthma
All Asthma
Non-Work-Related Asthma
No association between
symptoms and work. Work-related Asthma
Asthma is ‘work-related’ when
there is an association over time
between symptoms and work.
Work-aggravated Work-caused (true OA)

Work-aggravated asthma is pre- Occupational asthma (OA) is
existing or coincidental new onset asthma caused by workplace
asthma which is made worse by exposure and not by factors outside
exposures in the workplace. of the workplace. OA can occur in
workers with or without prior
asthma.
Allergic/Immunolgic* Irritant/Non-Immunologic*
Allergic OA is characterized by a Irritant-induced OA may occur
latency period between first within a few hours of a high
exposure to a respiratory sensitizer concentration exposure to an
at work and the development of irritant, gas, fume or vapour at
symptoms; the sensitizer may be work (e.g. classic acute RADS), or
an agent of high (lgE-mediated) or in response to chronic low-level
low molecular weight; latency can irritant exposures which may
range from weeks to years. For manifest after an extended period
some agents causing this type of of time (days to years). Most
OA, evidence for an immunologic Asthma in the Primary Aluminium
mechanism is still lacking (or may Industry is generally viewed to
not exist). belong in this latter category.

21
CRITERIA FOR WORK-RELATED ASTHMA

COMMENTS
Compatible exposure history
AND Compatible a) One or more of the following: Cough (with exertion

symptoms (subjective or at rest), sputum, wheeze, chest tightness,
evidence of airflow difficulty in breathing, breathlessness
limitation) b) Symptoms are typically episodic, and often worse
when sleeping following a work shift.
c) May occur immediately or delayed (after several
hours or during sleep) following exposure
AND Objective evidence a) Spirometry showing reduced FEV1 or FEV1/FVC

of airflow limitation values relative to personal baseline or appropriate
population predicted values, which is at least
partially reversible either spontaneously or in
response to treatment
• Bronchodilator response must demonstrate an
increase in FEV1 of >12% and >200 ml from the
baseline value during a single testing session; or
b) non-specific bronchial hyper-responsiveness as
demonstrated by histamine or methacholine
inhalation challenge (i.e., PC20 < 8mg/ml or
equivalent)
AND Temporal a) Symptoms improve on days away from work, such as

relationship to the work days off, weekends, holidays; or
environment/exposure b) Symptoms worsen during or after the work day (less
sensitive than ‘a’); or
c) Serial pulmonary function measurements:
• PEFR: at least 4 readings per day for a sufficient
period of time to quantify readings during several
continuous days at work as well as several
continuous days away from work, and showing a
circadian variation of at least 20% on days at
work and showing a pattern of improvement on
days away from work
• Spirometry
• Histamine or methacholine challenge testing; or
d) Cross-shift spirometry showing a fall in FEV1 of at
least 10%
Supporting Information • Daily diary: symptoms, medication use, etc.

• Diffusing capacity; detailed respiratory function tests
• Exclusion of alternative diagnoses

22
B2 Work Related Chronic Obstructive Pulmonary Disease (COPD)
8
Definition of COPD (ATS/ERS)
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable

disease state characterised by airflow limitation that is not fully reversible. The
airflow limitation is usually progressive and is associated with an abnormal
inflammatory response of the lungs to noxious particles or gases, primarily caused
by cigarette smoking. Although COPD affects the lungs, it also produces significant
systemic consequences.
8
Diagnosis of COPD (ATS/ERS)
The diagnosis of COPD should be considered in any patient who has the following:
symptoms of cough; sputum production; or dyspnoea; or history of exposure to
risk factors for the disease.
The diagnosis requires spirometry; a post-bronchodilator forced expiratory volume

in one second (FEV1)/forced vital capacity (FVC) <70% confirms the presence of
airflow limitation that is not fully reversible.
Spirometry should be obtained in all persons with the following history: exposure
to cigarettes; and/or environmental or occupational pollutants; and/or presence of
cough, sputum production or dyspnoea.
Spirometric classification has proved useful in predicting health status, utilisation
of healthcare resources, development of exacerbations and mortality in COPD.
COPD: Diagnosis and classification of severity – World Health Organization
A simple classification of disease severity into four stages is presented below. The
management of COPD is largely symptom-driven, and there is only an imperfect
relationship between the degree of airflow limitation and the presence of
symptoms. The staging, therefore, is a pragmatic approach aimed at practical
implementation and should only be regarded as an educational tool, and a very
general indication of the approach to management. FEV1 refers to forced
expiratory volume in one second and values refer to measures of FEV1 taken after
use of a bronchodilator. FVC refers to forced vital capacity.
Poorly reversible airflow limitation associated with other diseases such as

bronchiectasis, cystic fibrosis, tuberculosis, or asthma is not included except
insofar as these conditions overlap with COPD. In many developing countries both
pulmonary tuberculosis and COPD are common. Therefore, in all subjects with
symptoms of COPD, a possible diagnosis of tuberculosis should be considered,
especially in areas where this disease is known to be prevalent. In countries in
which the prevalence of tuberculosis is greatly diminished, the possible diagnosis
of this disease is sometimes overlooked.
8 *Excerpted from: Eur Respir Jrn 2004: 23; 932-946. ATS/ERS TASK FORCE. Standards for the Diagnosis and Treatment
of Patients with COPD: a summary of the ATS/ERS position paper.

23
Stage Severity Criteria

Stage 0 AT RISK Characterized by chronic cough and sputum
production. Lung function, as measured by
spirometry, is still normal.
Stage I MILD COPD Characterized by mild airflow limitation (FEV1/FVC
< 70% but FEV1 > 80% predicted values) and usually,
but not always, by chronic cough and sputum
production. At this stage, the individual may not even
be aware that his or her lung function is abnormal.
Stage II MODERATE Characterized by worsening airflow limitation

COPD (FEV1/FVC < 70%; 50% < FEV1 < 80% predicted) and
usually the progression of symptoms, with shortness
of breath typically developing on exertion. This is the
stage at which patients typically seek medical
attention because of dyspnea or an exacerbation of
their disease. The presence of repeated exacerbations
has an impact on the quality of life of patients and
requires appropriate management.
Stage III SEVERE Characterized by severe airflow limitation (FEV1/FVC

COPD < 70%; 30% < FEV1 < 50% predicted) or the presence
of respiratory failure or clinical signs of right heart
failure. Patients may have severe (Stage III) COPD
even if the FEV1 is > 30% predicted, whenever these
complications are present. At this stage, quality of life
is appreciably impaired and exacerbations may be
life-threatening.
Guidelines for recognition as an occupational disease (Aluminium Industry):

The epidemiological literature pertaining to COPD in the primary aluminium
industry suggests that COPD is associated with pot-room work exposure. There is
insufficient evidence to link COPD with exposures in other areas like casting,
carbon-plant operations and alumina refining.
If occupational COPD is defined as COPD that would not have arisen without work
exposure, some threshold of exposure needs to be agreed upon. The literature
does not yield a consistent threshold. It is proposed that for the sake of simplicity
in reporting, the following arbitrary criteria be used for physician-designation of
occupational COPD:
• Non-smokers: 10 years or more of pot-room work

• Ex-smokers and smokers: 20 years or more of pot-room work
• All COPD cases with a prior diagnosis of pot-room asthma
These criteria should not be used to second-guess Workers’ Compensation

Authority recognized cases, all of which should be reported.

24
B3 Beryllium
Beryllium sensitization* is an “allergic” condition to beryllium that can develop

after a person breathes beryllium dust or fumes. Some researchers think it might
also occur if beryllium penetrates the skin through an open cut or from a
beryllium splinter.
Diagnostic Criteria:
• Sensitization requires at least 2 positive BeLPTs, performed as separate tests
(2 tests on blood, or one blood and one BAL)
• No evidence of abnormal physiological, anatomical or pathological changes
consistent with CBD
• No symptoms
Chronic beryllium disease9 (CBD) is a lung condition that can develop after a
person breathes beryllium dust or fumes. The immune system sees beryllium as a
“foreign invader,” and builds an “army” of cells in the bloodstream that are
prepared to react to beryllium wherever they see it in the body. In CBD, the
reaction of the immune system against inhaled beryllium particles has resulted in
scarring (called granulomas) in the lungs.
Diagnostic Criteria:
• Confirmed sensitization
• Plus compatible pathologic, physiologic, functional or radiographic
abnormalities
• Symptoms may or may not be present
B4 Pneumoconioses – list of substances
• Asbestos
• Cobalt
• Refractor Ceramic Fibres
• Silica
• Cristobalite
• Coal Workers Pneumoconiosis
• Other substances known to cause pneumoconiosis.
9 Source: National Jewish Medical Centre, Denver, Co.

25
B5 Cancers
B5.1 Cancer agents list:
• Asbestos
• Benzidine and salts
• Bichloromethyl ether (BCME)
• Chromium and chromium compounds
• Coal tars and coal tar pitches, soot
• Beta-naphthylamine
• Vinyl chloride
• Benzene or its toxic homologues
• Toxic nitro- and amino-derivatives of benzene or its homologues
• Ionizing radiation
• Pitch, bitumen, mineral oil, anthracene, or the compounds, products or
residues of these substances
• Coke oven emissions
• Compounds of nickel
• Dust from wood
• Cancer caused by any other agents not mentioned in the preceding items where
a direct link between the exposure of a worker to this agent and the cancer
suffered is established.
B5.2 Bladder Cancer
The following criteria should be used to determine if a case of bladder cancer in

an individual working in the primary production of aluminium is ‘work-related’:
• Pathology confirmed diagnosis of bladder cancer

• Individual is currently or has previously worked in a coal tar pitch (CTP) job
• CTP exposure at the industrial level is documented
• Latency from first exposure to CTP until onset of symptoms or date of diagnosis
of at least 10 years
• Calculated attributable risk (i.e., probability of causation) >50%, independent of
smoking.
• AR% = [(RR exposed – RR unexposed)/RR exposed] X 100
• AR of 50% corresponds to a relative risk (RR) of 2.0, and also to
a cumulative exposure to BaP = 19µg/m3 years *
RR = Relative Risk
AR = Attributable Risk
*Armstrong B, et al. Compensating Bladder Cancer Victims Employed in

Aluminium Reduction Plants. Journal of Occupational Medicine 1988: 30; 10. 771-
775

26
B5.3 Lung Cancer
The following criteria should be used to determine if a case of lung cancer in an

individual working in the primary production of aluminium is ‘work-related’:
• Pathology confirmed diagnosis of lung cancer

• Individual is currently or has previously worked in a coal tar pitch (CTP) job
• CTP exposure at the individual level is documented
• Latency from the first exposure to CTP until onset of symptoms or date of
diagnosis of at least 10 years
• Calculated “P” (i.e., probability of causation) >50%, taking into account the
smoking history of the individual.*
(0.0476)(B[a]P) x 100%
P = 1 + (0.33)(p - y) + (0.0476)(B[a]P)
P = Probability that the cancer is of occupational origin (upper 95% confidence

limit)
B[a]P = ug/m3-year B[a]P total career dose
P – y = Cumulative tobacco exposure in pack-years
* Armstrong B, Theriault G. Compensating Lung Cancer Patients Occupationally

Exposed to Coal Tar Pitch Volatiles. Occupational and Environmental
Medicine.1996: 53: 160-167.
B6. Additional Hearing Loss Metrics
ICMM and IAI member companies are moving towards using the following hearing
loss definitions. Once a reasonable number of companies have data in these
formats, the Benchmarking database will be modified to include capture of cases
according to these definitions.
Hearing Impairment (Prevalence): As per ISO criteria and at:

www.who.int/pbd/deafness/hearing_impairment_grades/en/index.html (see
opposite page)
It is recognized that organizations will require time to implement this metric. The
IAI/ICMM committee felt that if the 1000, 2000 and either 3000 or 4000 Hz data
were available, then this metric should be reported by the organization.
OSHA Standard Threshold Shift (Incidence – Early Loss Indicator): Individual sites
and organizations are encouraged to collect data on this metric. A standard
threshold shift (STS) is an age-corrected change in hearing threshold relative to
the baseline audiogram of an average of 10 dB or more at 2000, 3000, and 4000 Hz
in either ear. (as per OSHA Regulations: UU1910.95(g)(10)(i)UU).

27
Corresponding
Grade of
audiometric Performance Recommendations
Impairment
ISO value
No or very slight
0 – No 25 dB or better hearing
impairment (better ear) problems. Able to
hear whispers
Able to hear and
1 – Slight 26-40 dB repeat words Counseling. Hearing aids
impairment (better ear) spoken in normal may be needed.
voice at 1 metre
Able to hear and
2 – Moderate 41-60 dB repeat words Hearing aids usually
impairment (better ear) spoken in araised recommended.
voice at 1 metre
Able to hear Hearing aids needed. If no
3 – Severe 61-80 dB some words hearing aids available, lip-
impairment (better ear) when shouted reading and signing should
into better ear. be taught.
Hearing aids may help

4 – Profound Unable to hear
understanding words.
impairment 81 dB or greater and understand
Additional rehabilitation
including (better ear) even a shouted
needed. Lip-reading and
deafness voice.
sometimes signing essential.
Grades 2, 3 & 4 are classified as disabling hearing impairment
The audiometric ISO values are averages of values at 500, 1000, 2000, 4000 Hz
B7 Musculoskeletal
These may include but are not limited to:

• Carpal tunnel syndrome
• Rotator cuff syndrome
• De Quervain's disorder
• Trigger finger
• Tarsal tunnel syndrome
• Sciatica
• Epicondylitis
• Tendonitis
• Raynaud's phenomenon
• Whole body vibration syndrome
• Herniated spinal disc
• Whole Body Vibration Syndrome.

28
C Health Risk Assessment
Name 3.5 Health Risk Management

a. Hazard Identification, Risk Assessment,
Risk Control (HIRARC)
b. Employee Health Assessment
Definition Health risk management is essential for the well-being

of employees. This process involves HIRARC and
Employee Health Assessment.
Unit of measurement Percent of plants with a formal process in place that

fulfil the defined criteria as specified under Target
Condition.
Measurement methods Record the number of plants with a formal HIRARC

program that meets the defined criteria as specified
under Target Condition.
Purpose To indicate to what degree the industry has a formal

health risk management process in place that meets the
criteria for HIRARC and Employee Health Assessment
processes.•
Aggregation method Add up company data
Target Condition Each site should have implemented and update at least
annually:
A) HIRARC process that includes ALL of the following

elements:
• Identification/classification of all health hazards
(e.g. acceptable – significant or insignificant,
uncertain health hazards
• Quantitative assessment of risk for all uncertain
health hazards
• Control of unacceptable health risks via appropriate
counter measures (e.g. personal protective
equipment, engineering controls, product
substitution etc.)
• Annual reviews of effectiveness of the process.
1. Occupational Hygiene (OH) Qualitative Exposure

Assessments
This refers to assessing all chemical and physical
agents by Similar Exposure Group (SEG) at a location
and deciding whether the SEG should be classified as
insignificant, significant, unacceptable, or uncertain.
Significant risks are those which exceed 50% of the
Occupational Exposure Limit (OEL). By definition,
insignificant risk would be less than 50% of the OEL.
Unacceptable SEGs would be those exceeding an

29
Target Condition OEL. Uncertain SEGs would be those for which a

decision as to exposure level is unknown. Agents
assessed also include process intermediates and
byproducts produced in the manufacturing process.
In order to state that an OH qualitative exposure

assessment is in place, at least 95% of identified
agents need to be assessed and categorized.
2. OH Quantitative Assessments
Uncertain SEGs, identified in (1) above, need to be
categorized as either insignificant, significant, or
unacceptable through quantitative analysis. The
number/percentage of uncertain SEGs should be
tracked. The ultimate goal is 100% assessments
completed (e.g. no uncertain SEGs)
In order to state that an OH quantitative exposure

assessment process is in place, 95% and above of the
uncertain SEGs must be quantitatively assessed via
OH sampling techniques.
3. Number of Unacceptable SEGs identified by agent

and number of impacted employees
Unacceptable SEGs are those which exceed an OEL.
Agent includes a description of chemical (e.g. CTP,
asbestos, silica, etc.) or physical (e.g. noise, heat,
radiation, etc.) agents.
4. Percentage compliance with personal protective

equipment requirements (PPE)
How many of the affected employees in unacceptable
SEGs defined above are wearing required PPE (e.g.
respirators, hearing protection, protective clothing,
etc.)?
5. Percentage of unacceptable EGSs that have been

reduced to acceptable status via engineering,
administrative, and/or substitution controls.
Acceptable means the exposure is less than the OEL
B) Employee Health Assessment based on ALL of the

following elements:
• Pre-placement physical exams covering critical
elements:
• Relevant periodic health assessments for ALL
identified health risks include fitness for duty
issues as well as exposure to chemicals,
physical, or biological agents.
• Fitness for duty evaluations include mobile
equipment operators, respirator users and heat-
exposed individuals.

30
Target Condition • For chemical exposures, surveillance should be

initiated for employees exposed to >50% of the
OEL.
• For noise, surveillance should be initiated for
noise exposures at 80 dbA and above (8-hour
TWA)
• The above exams should be carried out on a
frequency that meets accepted health surveillance
practices
• The percentage of required exams completed
should be tracked. The ultimate goal should be
100% completion rate for required surveillance
exams
• A system to communicate results to employees
• An annual site summary of results (without
individual attribution) and appropriate follow-up
process
Examples of health assessments for relevant

exposures:
• Hearing tests for noise exposure
• Spirometry for exposures to respiratory irritants
• Appropriate surveillance measures for exposure to
carcinogens
• General health and medication review for exposure
to heat
• General health and medication review and vision
tests for vehicle operators.
Data available? NO. Needs to be included in an annual survey on SD

indicators.

31
D Ergonomics Assessment
Name Ergonomic Process
Definition Plants with a formal ergonomic process in place to

identify AND control specific ergonomic risks which
fulfils the defined criteria as specific under Target
Condition.
Unit of measurement Percentage of plants with processes in place.
Measurement methods Record the number of plants with a formal ergonomic

process that meets the defined criteria as specified
under Target Condition.
Purpose To measure the implementation of company-specific

ergonomic processes to favourably impact on
ergonomic-related injury and illness.
Aggregation method At the company level, add up the data, determine the
percentage of plants that meet the criteria.
At the IAI level, determine the overall industry

number/percentage from reported company data.
Target condition Each site should have implemented all of the following
items:
• Written ergonomics policies and procedure
• Employee training
• An effective medical management program
And at least one of the following:

• Ergonomic risk factor determination (qualitative) on
relevant job tasks has been completed
• Ergonomic hazard analyses (quantitative) are
performed for tasks where ergonomic risk factors
have been identified
• Significant ergonomic risks have been prioritized
for control
When a plant has not satisfied the above target

conditions, the plant is considered not to have met the
requirements and would not be included in the final tally.

32
This publication contains general guidance only and should not be

relied upon as a substitute for appropriate technical expertise.
Whilst reasonable precautions have been taken to verify the
information contained in this publication as at the date of
publication, it is being distributed without warranty of any kind,
either express or implied.
In no event shall the International Council on Mining and Metals

("ICMM") be liable for damages or losses of any kind, however
arising, from the use of, or reliance on this document. The
responsibility for the interpretation and use of this publication lies
with the user (who should not assume that it is error-free or that it
will be suitable for the user's purpose) and ICMM assumes no
responsibility whatsoever for errors or omissions in this publication
or in other source materials which are referenced by this
publication.
The views expressed do not necessarily represent the decisions or

the stated policy of ICMM. This publication has been developed to
support implementation of ICMM commitments, however the user
should note that this publication does not constitute a Position
Statement or other mandatory commitment which members of
ICMM are obliged to adopt under the ICMM Sustainable
Development Framework.
The designations employed and the presentation of the material in

this publication do not imply the expression of any opinion
whatsoever on the part of ICMM concerning the legal status of any
country, territory, city or area or of its authorities, or concerning
delimitation of its frontiers or boundaries. In addition, the mention
of specific entities, individuals, source materials, trade names or
commercial processes in this publication does not constitute
endorsement by ICMM.
This disclaimer shall be construed in accordance with the laws of

England.
Published by International Council on Mining and Metals (ICMM),

London, UK
© 2009 International Council on Mining and Metals 2009. The ICMM

logo is a trade mark of the International Council on Mining and
Metals. Registered in the United Kingdom, Australia and Japan.
Reproduction of this publication for educational or other non-

commercial purposes is authorized without prior written
permission from the copyright holders provided the source is fully
acknowledged. Reproduction of this publication for resale or other
commercial purposes is prohibited without prior written
permission of the copyright holders.
Design: magenta7
Print: Pennington Fine Colour
Available from: ICMM, www.icmm.com, info@icmm.com
This book is printed on Challenger Offset 120gsm and 250gsm

paper. A great proportion of the raw material used is the by-
product from other processes i.e. saw mill waste and waste which
results from
forest thinning. The mill holds not only ISO 2002 but also ISO 14001
accreditation for their environmental management systems, which
include an active policy on sustainable forestry management.

ICMM – International Council on Mining and Metals
The International Council on Mining and Metals (ICMM) is a CEO-led industry

group that addresses key priorities and emerging issues within the industry. It
seeks to play a leading role within the industry in promoting good practice and
improved performance, and encourages greater consistency of approach
nationally and across different commodities through its association members
and member companies.
ICMM’s vision is for a respected mining and metals industry that is widely
recognized as essential for society and as a key contributor to sustainable
development.
www.icmm.com
ICMM
35/38 Portman Square
London W1H 6LR
United Kingdom
Telephone: +44 (0) 20 7467 5070

Fax: +44 (0) 20 7467 5071
Email: info@icmm.com

ICMM Health and Safety Performance Indicator Definitions

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

ICMM Health and Safety Performance Indicator Definitions

Uploaded by

Copyright:

Available Formats

Health and Safety

Performance Indicator Definitions

Health and Safety Performance Indicator Definitions

Health and Safety Performance Indicator Definitions

Appendix: Further Information 18

Health and Safety Performance Indicator Definitions

The document also contains, as appendices, additional information on metrics,

The intent is:

Health and Safety Performance Indicator Definitions

Individual employed directly by the company. The preference in the database is to

An occupational illness is any abnormal condition or disorder, other than one

If an event or exposure in the work environment either caused or significantly

Work performed as a part of haulage of product between operated sites, whether

Health and Safety Performance Indicator Definitions

• Driving or being driven in a vehicle for work-related purposes, irrespective of

A significant aggravation is defined as occurring when an incident occurring at

Health and Safety Performance Indicator Definitions

Work-related injury resulting in death of employee or contractor. Fatalities are

Lost Time Injuries

A Lost Time Injury (LTI) is a work-related injury resulting in the

Restricted Work Injuries

A Restricted Work Injury (RWI) is a work-related injury which results in the

Lost Time + Restricted Work Injuries

Medical Treatment Injuries

A Medical Treatment Injury (MTI) is a work-related injury resulting in the

MTIs include (for example) suturing of any wound, treatment of fractures,

Health and Safety Performance Indicator Definitions

MTIs do not include:

First Aid + Medical Treatment Injuries

Days Lost Reporting

No lost days are recorded for fatalities.

Days lost to Lost Time Injuries

The number of calendar days during which an employee or contractor is unable to

Health and Safety Performance Indicator Definitions

Days lost to Restricted Work Injuries

The number of calendar days during which an employee or contractor is able to

Days lost to Lost Time & Restricted Work Injuries

Days lost to Work-related Diseases

The number of calendar days during which an employee or contractor is either

Days lost to Non Work-related Illnesses and Injuries

Health and Safety Performance Indicator Definitions

Total Recordable Injuries (TRIs)

TRI = Number of (Fatalities + Lost Time Injuries

Frequency Rate (FR)

Fatality Frequency Rate (FFR)

FFR = Fatalities * 1,000,000 / hours worked

Lost Time Injury Frequency Rate (LTIFR)

LTIFR = LTIs * 1,000,000 / hours worked

Total Recordable Injury Frequency Rate (TRIFR)

TRIFR = (Fatalities + LTIs + RWIs + MTIs) * 1,000,000 / hours worked

Health and Safety Performance Indicator Definitions

Severity Rate (SR)

SR = (Days lost to LTIs and RWIs) * 1,000,000 / hours worked

Duration Rate (DR)

DR = (Days lost to LTIs and RWIs) / Number of (Fatalities + LTIs + RWIs)

Absentee Rate (AR)

AR = Total days lost * 1,000,000 / hours worked

Total personnel = hours worked per year / 20005

Health and Safety Performance Indicator Definitions

Definitions of Health Indicators Used in Data Entry and Reporting

Only new cases are counted for lagging indicators.

Significant aggravation of a pre-existing condition shall also be counted as a new

New cases are counted separately for employees and contractors.