( ..

2554)


( .. 2554)

..

. 02-5918172, 02-5904514, 02-5918381

02-5904388, 02-5918381
E-MAIL : OCC_SERVICE@HOTMAIL.COM

MEDIA.ENVOCC@GMAIL.COM
:
3 : ( 2554)

: 1,500
ISBN
: 978-616-11-0566-2

2550

(Hospital accreditation)




1
2

-

-

-
3

-

-

-

-

-

-

-

-

-
4

-

-

-

-
5

-

-

-

-

1
5
5
6
7
9
9
15
16
23
29
32
33
34
36
43
44
44
44
45
57
57
57
61
63

 ()

6

-

-

-
7

- ( 7.1)

- ( 7.2)

- ( 7.3)

-

-

-

-

-

-

-

-

-
8

-

-

-

-

-

-

-

1
2
3 (Job Safety Analysis)
4 Orthrorator
5
6

67
67
67
68
71
71
74
80
83
83
84
85
90
90
91
93
94
97
97
98
99
104
106
109
111
113
115
129
133
141
145
157

 ()

3.1
19
3.2 SBS BRI
38
3.3
39

3.4 //
41
4.1
46
4.2
48
4.3
48
4.4
50
4.5 A
50
4.6 B
51
4.7
52
4.8
53
4.9
54
4.10
56
5.1
61
5.2
64

(Pre Exposure Prophylaxis)
5.3
65

(Post Exposure Prophylaxis)
7.1
71
7.2
74
7.3
80

7.4
83
7.5
84
7.6
85
7.7
87
7.8 88
7.9 CIE
89
7.10
90
7.11
91

ASHRAE Standard 62-1989
7.12 92

2




3

1 2

6



7

Gun 1983
(National Institute for Occupational Safety and Health: NIOSH) 1988
(Acute conditions)

1.5

(low-back injury)
(Relative Risk) 166



International Commission on Occupational Health (ICOH) International Social Security
Association (ISSA)

(QA HA)

(National Institute for Occupational
Safety and Health: NIOSH)

1958 (American Medical Association)

(American Hospital Association)

(National Institute
for Occupational Safety and Health: NIOSH)


1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

(Health Hazards)
n

(Physical health hazards)

1. (Heat)

1) (Heat Stroke)

2) (Heat Exhaustion)

 3) (Heat Cramp)

4) (Heat Rash)

1)

-
-
-
-
-
-
-

10

(Acclimatized)

2)

(WBGT index)

2. (Noise)

(Decibel)

(Temporary hearing loss)

1 2

(Permanent hearing loss) Hair Cell

Cardiovascular Endocrine Neurological

11


1)

1
2)

-
-

3. (Ionizing radiation)

12


100 Roentgens

2 14

3 epilation

24

fibrosis Aplastic

1)

13


2)
-

3)

Complete Blood Count

4. (Non-ionizing radiation)

Incubator UV

1) ( UV)

2)

3) (IR)

4) 10 KHz

Tinitus
5)

6)

14

1)
2) UV, IR,
3)
4)

(Biological health hazards)

HIV AIDs

1. HIV AIDs

3 8

2 3

1) body fluids HIV

body fluids

body fluids

2)

(Disposable)

3)

body fluids

body fluids

Sodium hypochlorite 0.5 %

15

 4)

body fluids

body

fluids Sanitary landfill

or pit latrine
5) HIV

AIDs

2. Mycobacterium tuberculosis

Tuberculosis

3


1)

2)

3)

4) Tuberculin test X-ray

n

(Chemical health hazards)

Anesthetic gas ()

16

1)

2)

3)

4)

5) (Talc)

6)

7)

17

3.1

18

 3.1

Ethylene oxide

Quaternary ammonia


compounds
(Central Supply) Mercury

, Miller-Abbot Sphygmomanometer
Formaldehyde

Ammonia

(Food Service) Chlorine

Acetone

Iodophors

Methyl Ethyl Ketone


Phenol
,

(House Keeping)
Quaternary ammonia

compounds
Sodium hypochlorite

(Chlorine)
(Laundry) Sodium hypochlorite

Asbestos

(Maintenance
Carbon monoxide

Engineering)
Methyl Ethyl Ketone

Ethylene oxide

Mercury

Miller-Abbot Sphygmomanometer
(Patient Care Areas) Methanol (Methyl Alcohol)
(Nursing Service) Quaternary ammonium

compounds
Acetone

Acrolein
(Laboratory Reagent)
Acrylamide
(Laboratory Reagent)

(Laboratories)
Ammonium persulfate
(Laboratory Oxidizing Agent)
Azides
(Laboratory Reagent)
Benzene

Carbon tetrachloride

19

Acetone
Acrolein
Acrylamide
Ammonium persulfate
Azides
Benzene
Carbon tetrachloride
Chloroform
Chromic acid
Diaminobenzidine
Diethylether
Dioxane
Ether
Ethidium bromide

Ethoxyethanol
Formaldehyde
Glycerol
Glutaraldehyde
Hydroxylamine
Lead acetate
Methanol (Methyl Alcohol)
Nitrocellulose

Osmiumtetraoxide
Perchloric acid
Phenol
Picric acid
Potassium permanganate
Propylene oxide
Pyridine
Silver nitrate
Potassium dichromate
Stoddard solvent

20

(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Oxidizing Agent)
(Laboratory Reagent)



(Laboratory Reagent)
(Laboratory Reagent)

(Laboratory Reagent)
(Laboratory Reagent)
DNA
Gel Electrophoresis DNA
(Laboratory Reagent)

(Laboratory Reagent)
( formaldehyde)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)


(Embedded Tissues)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)

Tetrahydrofuran
Trichloroethylene
Toluene
Uranyl acetate
Xylenes
Vanadium
Vanadyl sulfate
Nitrous oxide

(Surgical Services) Diethylether
Cyclopropane
Enflurane
Halothane
Isoflurane
Methyl merthacrylate
Ethylene oxide

Mercury
Lead Metal

Formaldehyde

(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)

(Laboratory Reagent)
(Laboratory Reagent)
(Laboratory Reagent)
(Anesthetic gas)
(Anesthetic gas)
(Anesthetic gas)
(Anesthetic gas)
(Anesthetic gas)
(Anesthetic gas)

Material Safety Data Sheet (MSDS)

/

Internet /

21

1)

2)

3)

/

4) Hood

5)

6)

1)
2)
3)

1)

2)

3)

4)

5)

1)

2)

22

(Ergonomics)

(Musculoskeletal disorders: MSDs)

(Low back pain) (Tendinitis) (Tenosynovitis)

(Carpal Tunnel Syndrome: CTS)

1. (Risk identification)

2. (Risk evaluation)

23

3. (Risk control)

1.

24

Odd Ratio 16.7 MSDs
(66%) (61%) (60.7%)

(76.8%) /

20

25

1)
-
-
-

-
-

2)
-
- 2
- ( 50-75

)
-
-
-
-

3)
-

26

2.

Ryan (Cashier)
90%

1)

()

90

2)

3)

5-10 ..

4)

61-66 ..

5)

6)

27

3.

30
(workstation)

1)

4.5 )

2) 4
/
2.1.

28




90 120

2.2.

15 - 20

50 100 (

(Psychosocial health hazards)

(
)

(Work performance) (Job satistaction)

29

(Stress)

1)
2)
3)
4)
5)
6)

(Violence)

-
-
-

30

 -

-

1.

2.

3.

4.

5.

6.

7.

1)

2)

31

(Fire and Disasters)

1.

2.

3.

4.

1)

2)

1)

32

2)

(Compressed gas)

Nitrous Oxide Enflurane Halothane Isoflurane Sevoflurane Desflurane

33

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

1) /

2)

3)

1250 F

(Electrical equipments)

(Centrifuge)

34

1)
2)
3)
4)
5)

150

1)

Ground Fault

Circuit Interupter GFI

breaker fuse breaker

switch -

35

 Cut out

0.25

2)




n

(Indoor Air Quality)

90%

(Discomfort)

(Environmental Protection Agency: EPA)

36

2 5

1,000

100

1. Sick Building Syndrome (SBS)

5

I. (Eye Irritation)

II. (Nasal Manifestation)

III. (Throat and Respiratory tract symptom)

IV. (Skin problems)

V. (Headaches Dizziness Fatigue)

37

2. Building Related Illness (BRI)

TB
(Legionnaire Disease) (Legionella Pneumophila)
3.2 SBS
BRI

3.2 SBS BRI

SBS
BRI

3.3

38

 3.3

, Legionella
Pontiac fever (Case report)
(, , , pneumophila

)

,



(Cross-sectional study)




Mycobacterium


tuberculosis

(Cross-sectional study)





(Case report)

,
Aspergillus,
(Cross-


sectional study


,

, ,

(Case report)
,

,





(Cross-sectional study

,

Alkylphenol

(Case report)

novolac resin

,

,
,
(Case report)
,


(

, -

)

39

SBS BRI

SBS

SBS BRI

(Discomfort)

BRI


SBS BRI

3.4

(80% )

20%

40

 3.4 /
/

- /

10

- (Asbestos)

0.01 ppm
2-10 ppm

(VOCS)






(CO) , ,








(CO2) ,



,

(Ozone)

( -
)
Legionnaire




-




-

41

-
-
- 20 .
- 1,000 ppm (ASHRAE 62-1989)
-

- ASHRAE standard

62-1989 ( 7)

-
-

/ /
-

-
-
-
-

42

1
2
3
4

43


/

1

(Hazard)

(Risk)

I.
II.
III.

1.

2.

3.

4.

44


5.

45

/:

Sick Building Syndrome

(Subjective
Judgment)

(1) /
(2)

46


(Steps in Conducting Risk Assessment and Risk Management)

//

47

4.2

4.2

(1)
/
(2)
/
(3)

(Near miss)

3 4.3

48

 4.3

(1)

,
( , , ,
)

(
)
, (

(2)

(3)

3
/
4.4

4.4

A B

3 A B 4.5 4.6

A B

A B

49

 4.4

=
x


(1)
/
(2)
/ (3)

(2)
(3)
2
3
1

4
6
2


6
9
3




(1)

4.5 A

()

50

 4.6 B

()

51

 4.7

(1)
(3)
(2)









(2)
(6)
(4)












(3)
(9)
(6)

A B

A

B

/

52





4.8 4.10

4.8

-
-

1.

2.


3.

/
4.

1.

2.

-
-

-

1.

2.

1.
2.

53

 4.9

-
-

1.

2.







1.
-

-

/

-
2.

3.

-

-

-

-




-
-

54

1.

2.

3.








1.

2.

3.






1.

2. Universal precaution

3.

1.

 4.9 ()


-
/
-

-

- /

- /

1.
2. //

1.

2.

55

 4.10

-

-

1.

2.
3. /

4.

5.

1.
2.
3.

4.

5.

-
-

1.

2.

-
-

1.

2.
3.

1.

-

-
-
2. /

3.

56

1.

2.

3.

4.

57


1.

1)

2)

3)

4)

2. 1

(

)



3.

4.

58


5.

6.

7.

1.

59

2.

3.

Spirometer () Audiometer (
) Orthorator ()

(Methylhippuric acid) (End of

shift)



:
:

60

-
-
-
-
- nasal swab C/S MRSA
- rectal swab C/S
-
-

()

5.1

5.1

1.

2.
3.
4.
-
5. /
-
-
-

-

- CBC
-
-

-
-
-
-
- CXR
- Stool Exam For Parasite
-
-

- CBC
-
-

-
- CXR
- Stool Exam For Parasite
-

-

61

-
-
-

-
-

-

-
-

-

-
-
-

-


-

-
-



-

-
-
-

-


-

-




-

(CBC / Urine exam / C.X.R
FBS, BUN, Creatinine, L.F.T 35 Cholesterol, Triglyceride LDL/HDL Uric acid
pap smear 1 40
40 EKG

1.

2. 1

3. 1

4. X-ray 1

5.
- 40 g/100 ml 6

62

1.

2.

3.

5.2 5.3

63

 5.2
(Pre Exposure Prophylaxis)

(Meningococcal
polysaccharide vaccine)

Polio vaccine

3 (intramuscular
injection)
0, 1 6
1

2 (subcutaneous
injection) 0 1
1

1

2 4- 8
( 13
1 )
2
6
1

IPV 3

0, 1 2
3 6-12
3 (1ml.) 0,
7, 21 28

4 (intradermal
injection) 1ml. 0, 7, 21
28
1 0.1 ml.
3
0, 1 3
6-12 10

64

Typhoid vaccines: IM,

SC, and oral





Smallpox (Vaccinia vaccine)

1 0.5 ml.
2 0.5 ml.
2 0.5 ml.
4
3
0.5 ml. 0.1 ml.


1 10

5.3
(Post Exposure Prophylaxis)

(Meningococcal disease)

Benzathine penicillin, 1.2 mU

1
Erythromycin (1gm/) 7
Immunoglobulin 1
(0.02 ml/.) 2

HBIG 0.06 ml/.
7
3

0,1 6
HBIG 2 1
1
Rifampicin, 600 mg 12
2 Ceftriaxone
250 mg 1
ciprofloxacin 500 mg 1
Erythromycin 500 mg
4 trimethoprim
sulfamethoxazole 2
14

PPE

PPE

65

 5.3

(Post Exposure Prophylaxis) ()

HRIG 20 IU/.
1 ml.
0, 3, 7,14, 28
Varicella Immunoglobulin
< 50 .: 125 U/10 .
>50 .: 625 U

1. Pre Exposure Prophylaxis
2. Post Exposure Prophylaxis
3. /

66

1.
2.
3.
4.
5.

1
2
3

(Preliminary Walkthrough Survey)

67

( 1)

1.

2. 6

3.

4.

68

1.
2.
3.
4.
5.
6.

69

7.1

7.1

TLV (Threshold Limit Value)

ACGIH
PEL

PEL (Permissible Exposure Limit)

OSHA

PEL-C, TLV-C

PEL-STEL, TLV-STEL

(Short
term Exposure Limit) 15

TWA 4
1

71

PEL-TWA, TLV-TWA

IDLH (Immediately Dangerous to

Life or Health)

/ IDIH

mg/1

mg/m3

1
(
)

BEIs (Biological Exposure Indices)

ppm (Parts Per Million Parts of Air)

(1 ppm = 1.68 mg/ m3 (25 degC,760 mmHg))
UN Number


(The United Nation)
NFPA (National Fire Protection)
(National Fire Protection Association)

OSHA (Occupational Safety and
(Department of Labor)
Health Administration)


.. 1970 (Occupational

Safety and Health Act 1970;OSHAct)


ACGIH (American Conference of

Governmental Industrial Hygienists)

ACGIH

(Threshold limit value; TLV) Biological Exposure Indices; BEIs




NIOSH (National Institute for

Occupational Safety and Health)


OSHA

72



A-Z

7.2

A-Z 7.3

73

74

TWA

STEL Ceiling TWA

ACGIH 2006
STEL Ceiling IDLH

TWA

STEL Ceiling 2520

OSHA 2005

Acetone (67-64-1)
500 ppm 750 ppm - 250 ppm -
- 2500 ppm 750 ppm 1000 ppm -
-

Acrolein (107-02-8)
-
- 0.1 ppm 0.1 ppm 0.3 ppm
-
2 ppm 0.1 ppm -
-
-

-
-
-
Acrylamide (79-06-1)
0.03
-
-
0.3
-
- 60 mg/m3 0.3
3
3
3
mg/m
mg/m


mg/m

Ammonia (7664-41-7) 25 ppm 35 ppm
-
25 ppm 35 ppm
- 300 ppm 50 ppm
-
-
50 ppm

-
- 0.1 f/cc(1) -
-
5 f/cc(1)
Asbestos (1332-21-4) 0.1 f/cc -
- 0.1 f/cc(1) -
> 5 m

(fiber)
> 5 m

Azides (26628-22-8)
-
-
-
-
-
0.1 ppm
-
-
-
-
-

(as HN3)
0.3 mg/m3
(as NaN3)

Benzene (71-43-2)
0.5 ppm 2.5 ppm -
0.1 ppm 1 ppm
- 500 ppm 1 ppm 5 ppm
-
10 ppm

(Substance)

NIOSH 2005

A1

(Asbestosis) A1

A3

A4

A4

7.2

75

TWA

STEL Ceiling TWA

ACGIH 2006
STEL Ceiling IDLH

TWA

STEL Ceiling 2520

OSHA 2005

Carbon tetrachloride 5 ppm 10 ppm

-
-
2
- 200 ppm 10 ppm 200 ppm 25 ppm 10 ppm
(56-23-5) (60 min.)
(5 min.
Maximum

Peak in
Any 4 hrs.)

Chlorine (7782-50-5) 0.5 ppm 1 ppm
-
-
-
0.5 ppm 10 ppm
-
-
1 ppm 1 ppm

(15 min.)

Chloroform (67-66-3) 10 ppm -
-
- 2 ppm
- 500 ppm -
-
50 ppm 50 ppm


(60 min.)




- 250 Mg/3 1 mg/m3 -
- 1 mg/m3
Chromium (7440-47-3) 0.5 mg/m3 -
And inorganic
Compounds as Cr 0.5 mg/m3
Metal and Cr III
0.5 mg/m3 -
- 0.5 mg/m3
25 mg/m3
-
-
-
Compounds

(Substance)

NIOSH 2005

-
A4

A3

A4

A2

7.2 ()

76

TWA

STEL Ceiling TWA

ACGIH 2006
STEL Ceiling IDLH

TWA

STEL Ceiling 2520

OSHA 2005

Water soluble Cr VI 0.5 mg/m3 -

-
-
-
-
-
-
-
-
-
compounds

Insoluble Cr VI
0.01
-
-
-
-
-
-
-
-
-
-
3
compounds
mg/m

Dioxane (123-91-1)
20 ppm -
-
- 1 ppm 1 ppm 500 ppm 100 ppm -
-
-



(30 min.)


Enflurane (13838-16-9) 75 ppm -
-
-
-
2 ppm
-
-
-
-
-

(60 min.)


-
- 1900 ppm 400 ppm -
-
-
Ether Ethyl ether 400 ppm 500 ppm -
-
(60-29-7)

Ethylene oxide
1 ppm
-
-
0.1 ppm -
5 ppm 800 ppm 1 ppm 5 ppm
-
-
(75-21-8)

Formaldehyde (50-00-0) -
- 0.3 ppm 0.016 ppm -
0.1 ppm 20 ppm 0.75 ppm 2 ppm
-
3 ppm

(15 min.)

(Substance)

NIOSH 2005

A2

A2

A4

A3

A1

A1

7.2 ()

77

TWA

STEL Ceiling TWA

ACGIH 2006
STEL Ceiling IDLH

TWA

STEL Ceiling 2520

OSHA 2005

Glutaraldehyde
-
- 0.05 ppm -
-
0.2 ppm
-
-
-
-
-
(111-30-8)

-
-
-
-
- 15 mg/m3 -
-
-
Glycerol (Glycerinmist) 10 mg/m3 -


(Total)
(56-81-5)
15 mg/m3

(resp.)

Halothane (151-67-7) 50 ppm -
-
-
-
2 ppm
-
-
-
-
-

(60 min.)


Lead (7439-92-1)
0.05
-
-
0.05
-
-
- 0.5 mg/m -
-
0.2
3
mg/m
mg/m3
Inorganic compounds. mg/m
As Pb

-
0.1 10 mg/m3 -
- 0.1 mg/m3 -
Mercury (7439-97-6)
0.01
0.03
-
0.05
mg/m3
mg/m3

mg/m3 mg/m3

Methanol (67-56-1)
20 ppm 250 ppm - 200 ppm 250 ppm - 6000 ppm 200 ppm -
- 200 ppm

(Substance)

NIOSH 2005

A3

A4

7.2 ()

78

TWA

STEL Ceiling TWA

ACGIH 2006
STEL Ceiling IDLH

TWA

STEL Ceiling 2520

OSHA 2005

Methyl Ethyl Ketone 200 ppm 300 ppm - 200 ppm 300 ppm - 300 ppm 200 ppm -
-
-
(MEK) (78-93-3)


-
-
-
Osmium Tetroxide
0.0002 0.0006
-
0.0002 0.0006
- 1 mg/m3 0.002




3
ppm
ppm
ppm
mg/m
(20816-12-0)
ppm

Phenol (108-95-2)
5 ppm
-
-
5 ppm
- 15.6 ppm 250 ppm 5 ppm
-
-
5 ppm

(15 min.)



-
-
Picric acid (88-89-1)
0.1
-
-
0.1
0.3
- 75 mg/m3 0.1 mg/m3 -
3
3
3
3
mg/m mg/m
mg/m

mg/m


-
- 400 ppm 100 ppm -
-
-
Propylene oxide
2 ppm
-
-
-
(75-56-9)

Pyrdine (110-86-1)
1 ppm
-
-
5 ppm
-
-
10000 5 ppm
-
-
-

ppm

(Substance)

NIOSH 2005

A3

A3

(Dermatitis) /

A4

7.2 ()

79

TWA
STEL Ceiling IDLH

200 ppm 250 ppm

- 2000 ppm 200 ppm -

-
-

1800 20000 500 ppm -

-
-
3
3
mg/m
mg/m
(15 min.)

A3

Argyria (skin, eyes,

mucosa)

0.05 35 mg/m3 -
-
mg/m3
(15 min)

0.5
-
(resp)
Mg/m3

A4

Xylene (1330-20-7)
100 ppm 150 ppm - 100 ppm 150 ppm - 900 ppm 100 pmm -
- 100 ppm
(o, m, p isomers)
A4
(95-47-6: 108-38-3;
106-42-3)

Vanadium (1314-62-1) 0.05

-
-
-
-

mg/m3

Trichoroethylene
50 ppm 100 ppm -
-
-
- 1000 ppm 100 ppm 300 ppm 200 ppm 100 ppm
(79-01-6)
(5 min
A5
Maximum

Peak in
any 2 hrs)

Toluene (108-88-3)
50 ppm -
- 100 ppm 150 ppm - 500 ppm 200 ppm 500 ppm 300 ppm 200 ppm

(10 min

Maximum
A4

peak)

50 ppm 100 ppm

Stoddard solvent
100 ppm -
-
350
-

3
(8052-41-3)
mg/m

Tetrahydrofuran
(109-99-9)

TWA

STEL Ceiling 2520

OSHA 2005

0.01 300 ppm - 10 mg/m3 0.01

-
-
-
3
3
mg/m
mg/m
-
-
-
-
-
-
-
-

STEL Ceiling TWA

ACGIH 2006

Silver (7440-22-4) Metal 0.1 mg/m3 -

-
Soluble compounds
0.01
as Ag
mg/m3
-
-

(Substance)

NIOSH 2005

7.2 ()

80

S-Phenylmercapturic Acid

t,t-Muconic acid

Phenol

Benzene

1.4 mg/g creatinine

500 g/g creatinine -

Ethylene oxide

During exposure

0.8 g/100 ml

< 2 ppm

12 ppm

* BEIs1 Biological Exposure Indices ACGIH

** BEIs2 Biological Exposure Indices Lauwerys RR, Industrial Chemicals Exposure - Guidelines for Biological Monitoring, 2nd ed.,
Lewis Publishers, Florida, 1993

Blood

0.5 mg/m3

Expired air

During exposure

Ethylene oxide

Ethylene oxide

20 ppm

3.5% of hemoglobin < 1% of hemoglobin 3.5% of hemoblobin

Increase during shift 10 g/L

Urine

50 mg/g creatinine < 20 mg/g creatinine 45 mg/g creatinine

Total chromium

End of shift

< 2 mg/g creatinine 3 mg/g creatinine

BEI s2*

25 g/g creatinine -

50 mg/L

End-exhaled air

End of shift

End of shift

End of shift

End of shift

End of shift

BEI s1*

End of shift at End 25 g/L

Of work week

Carbon monoxide

Blood

Urine

Urine

Urine

Urine

Chromium
Total chromium
Urine

Carboxyhemoglobin

Carbon monoxide

Acetone

Acetone

7.3

81

Lead

Total inorganic mercury

Lead

Mercury

Urine

Blood
Prior to shift

Not critical

Expired air

35 g/g creatinine < 5 g/g creatinine < 50 g/g creatinine

30 g/100ml

0.5 ppm

Urine

Nitrous oxide

Total phenol

Tetrahydrofuran

Nitrous oxide

Phenol

Tetrahydrofuran

2 mg/L

End of shift

End of shift

8 mg/L

250 mg/g creatinine < 20 mg/g

250 mg/g

60 g/g creatinine

< 2.5 g/g creatinine 2.5 g/g creatinine

End of shift

End of shift

15 mg/L

* BEIs1 Biological Exposure Indices ACGIH

** BEIs2 Biological Exposure Indices Lauwerys RR, Industrial Chemicals Exposure - Guidelines for Biological Monitoring, 2nd ed.,
Lewis Publishers, Florida, 1993

Urine

Urine

Urine

Urine

Methyl Ethyl Ketone Methyl Ethyl Ketone

Methanol

End of shift

halothane

Urine

After 5-d exposure 0.25 mg/100 ml

Methanol

Halothane

Blood

After 5-d exposure 10 mg/g creatinine

BEI s1*

BEI s2*

End of shift at End End of shift at End < 1 g/g creatinine < 2 g/g creatinine

Of work week

Trifluoacetic acid

Urine

Total inorganic mercury
Blood

Trifluoacetic acid

Halothane

7.3 ()

82

Methylhippuric acid

Xylenes

urine

urine

0.05 mg/L

End of shift

1.5 g/g creatinine

1.5 g/g creatinine

0.1 <mg/1

1.6 mg/g creatinine 1.5 g/g creatinine 2.5 g/g creatinine

End of shift at end < 50 g/g creatinine

Blood

75 mg/g creatinine

<0.3 mg/g creatinine 1 mg/g creatinine

BEI s2*

* BEIs1 Biological Exposure Indices ACGIH

** BEIs2 Biological Exposure Indices Lauwerys RR, Industrial Chemicals Exposure - Guidelines for Biological Monitoring, 2nd ed.,
Lewis Publishers, Florida, 1993

Vanadium

Vanadyl sulfate

Vanadium Pentoxide Vanadium

Toluene

Urine

End of shift

Hippuric Acid

0.5 mg/L

End of shift

o-Cresol

Toluene

Urine

End of shift at end 4 mg/L

of work week

End of shift at end 300 mg/g creatinine

of work week

End of work week 100 mg/g creatinine

BEI s1*

Free trichloroethanol
Blood

Trifluoacetic acid and

Urine
Trichloroetylene

Urine

Trifluoacetic acid

Trichloroethylene

7.3 ()

WBGT (Wet Bulb Globe Temperature)

7.4

34

32

, ,

30

.. 2549

200

200 350


350



(Wet Bulb Globe Temperature: WBGT)

0.7

0.3
0.7
0.2 0.1

83

7.5 (
)

7.5
()

12

8

7

6

5

4

3

2

1 30

1

30

15

(TWA) dB (A)
87
90
91
92
93
95
97
100
102
105
110
115

.. 2549

1. (TWA)

T
=

8
2(L-90)5

T ()

L ()
(TWA)

2. (TWA)
(Peak) 140

84

7.6 7.6 7.7

7.6

()

-
-
-
-
-
/ ()
-
-
-

-

-


-

-

-

-
-

-
-

(Boiler)
-

200
400
100
100
400
20
50
50
300
400
300
300
200
100
200
300
50
400
100
200

85

()

/ ()
- ()
- ()
-

400
800
600
600
400

.. 2549

7.7

2,400
- ()

1,600
-

( 25 )

-

-

1,222
-

-

-

-


800
-

-

-

86

 7.7 ()

()
800
- (

25 ) (

)

600
-

-

-

-


400
- (

125 )

-

- (

-

-

-

-


300

-
-
-
-
-
-
-

200
- (

750 )

.. 2549

87

 7.8

Scanners
/







ICU

EMLux
200
200
50
200
500
300
100
300
300
1000
5
200
500
1000
500
50
500
500
300
500
300
300
500
1000
100
300
1000
20
500
1000
5000
5000
1000
300
300
750
5000

: EMLux : ()

88

 7.9 CIE (International

Commission on Illumination)

(Lux)

100
300
200
5

500
1000

50
750
300

750
30000

750
10000

500
750

500
750

89

20 5
50

( )

7.10

7.10







(PM10)

90

20-26 C

30-60%

1,000 ppm

800 ppm

25 ppm
8
0.26 mg/m3
24
0.15 mg/m3
24
4 /
1
0.04-0.4 ppm

0.05 ppm
8
0.08 ppm
8
0.1 fiber/cc
8
0.05 fiber/cc
0.1 fiber/cc
< 500 CFU/m3

< 500 CFU/m3

< 0.1 ppm

< 0.4 ppm

ASHRAE Standard
ASHRAE Standard
ASHRAE Standard
OSHA
ACGIH (2003)
EPA
ASHRAE Standard
EPA
WHO (1984)
ACGIH (2002)
EPA
ACGIH (2006)
OSHA
NIOSH
WHO
WHO
ASHRAE Standard
ASHRAE Standard

55
62
62

62

62
62



American Society of Heating, Refrigeration, and Air Conditioning Engineers (ASHRAE)
ASHRAE Standard
62-1989 7.11

7.12

7.11


ASHRAE Standard 62-1989



1,000




ICU

10
20
20
20
20

// (cfm/person)
25
15
30
15
15

91

 7.12

1
1

25

25

Nursery

12

(ICU)

12

12

12

10 (Protective
Environment)

12

11 (Laboratory)

12

12

92





( )
(
/ )

1.

2. 2

3.

24

4.

..

5.

Benzene Phenol

6.

7.

93


8.

(Cooling Tower)

100,000 (103) CFU/L

v
ACGIH (American Conference of Governmental Industrial Hygienists)
http://www.acgih.org
v
NIOSH (National Institute for Occupational Safety and Health)

http://www.cdc.gov/niosh
v OSHA (Occupational Safety and Health Administration)

http://www.osha.gov
v WHO (World Health Organization)

http://www.who.int

v
http://occ..ddc.moph.go.th
-
http://www.referencetoxiclab.com
-

http://anamai.moph.go.th/chemnet
v

http://www.dmsc.moph.go.th
v

http://msds.pcd.go.th

94


v

http://www.nice.dipw.go.th
v

http://www.chemtrak.org
http://www.chemtrack.trf.or.th
v

http://www.doa.go.th

v (MSDS)
http://www.merck.co.th

95

1.
2.
3.
4.
5.
6.
7.

1.

2.

3.

4.

5.

6.

7.

1.

2.

3.

97

1.

1.1 A

2,200

1.2 B

20,000

1.3 C

1.

98

B A C


2.



3.

4.

(.), American National Standard

Institute (ANSI), European Standard (EN), Australian/New Zealand Standard (AS/NZS)

2.

99



1. (Safety spectacles)

2. (Safety Goggles)

3. (Face shields)


(Welding
shields)

1.

ANSI, EN, International Standard Organization (ISO)

2.

100

3.
4.
5.
6.

-


-

1.

2.


3.


4.

(Contact lenses)

Optical density

101

3.

1.

( )

2.

(Breathing zone)

Air-lined respirator
Self-contained breathing apparatus (SCBA)

1. (Exposure limit)

10

50

2.


., ANSI, EN, AS/NZS Japanese Industrial Standard (JIS)

102


3.
(Fit)


4.

5.

-

-

-

1.

World Health Organization

(WHO), Centers for Disease Control and Prevention (CDC)

2.

3.

(User seal check)

(Fit test) 1

4. (Fluid resistance)

ASTM F 1862-00 American
Society for Testing and Materials

5.

-

-

Software

-

103


6. (Surgical mask, gauze mask, )


-

50-100

- 10

4.

1.

2.

104



1.

Noise Reduction Rating (NRR),
Single Number Rating (SNR)


2.

3.

-

-

105

5.

1.

ASTM

F 739 (Degradation)
(Permeation) (Permeation
rate) (Breakthrough time)

-

106

 -
-

2.

- (Kevlar)
- (Metal mesh)

3.

-
-
- (Aluminized gloves)

4.

107

1.

ANSI, EN, International Standard
Organization (ISO)

2.
1


3. ( )



4. ( )


5.

6.

-

-

Disposable gloves

(Natural rubber latex) (

)

108

6.

6.1

1. (Gas-Tight Encapsulating Suit)

SCBA

2. (Liquid
Splash-Protective Suits)

3.
(Non-hazardous Chemical Protective
Clothing)

109

1.


NFPA, NIOSH

2.

3.

-

-

6.2

1.

2.

3.

4.

110

WHO, CDC

7.

1.

(Toe box)

111


2. (Electrically conductive shoes)

3. (Electrical hazard, safety-toe shoes)

600

1.

., ANSI, EN

2.

3.
4.
5.

112


.


; 2550
.


; 2551
.

; 2545

113

1. /
2.
3.
4.
5.
6.
6.1
6.2
6.3
7.
....................................................................................................
8.
....................................................................................................

117

()
()

1.

2.

3.

4.

5.

6.

118

119

/
(A)

( 3 4)

( 6 9)

* (C) =
(6
(3
(2)
(3) (1

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

.........................................

()

1
(A)x(B)
9)
4)
2)

120

/
(A)

( 3 4)

( 6 9)

* (C) =
(6
(3
(2)
(3) (1

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

1.
2.
3.
4.
5.

()

2
(A)x(B)
9)
4)
2)

121

/
(A)

( 3 4)

( 6 9)

* (C) =
(6
(3
(2)
(3) (1

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

()

3
(A)x(B)
9)
4)
2)

122

* (C) = (A)x(B)
(6 9)
(3 4)
(2)
(3) (1 2)

(B)

/
(1) (2) (3)
(1)
()
()

/
(A)

.................................................
* ( 1 2) ( 3 4) ( 6 9)

()

123

/
(A)

( 3 4)

( 6 9)

* (C) = (A)x(B)
(6 9)
(3 4)
(2)
(3) (1 2)

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

/


/
.................................................

()

124

/
(A)

( 3 4)

( 6 9)

* (C) = (A)x(B)
(6 9)
(3 4)
(2)
(3) (1 2)

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

.................................................
1.
2.
3.

()

125

/
(A)

( 3 4)

( 6 9)

* (C) = (A)x(B)
(6 9)
(3 4)
(2)
(3) (1 2)

(B)

/
(1) (2) (3)
(1)
()
()

* ( 1 2)

.......................................

()

126

(A)x(B)

(6

9)

(B)
(A)
(3 4)
(1 2)

.......................................................................................................................................................................












/

127

=
x

(1)

(1)

(2)

(3)

(2)

(3)

128


***

***

1.

2.

3.

4. (1a-1c.)
4.1
4.2
4.3

4.4

5. ( 2a-2e.)
5.1

5.2

5.3
5.4

5.5

6.
6.1

6.2

131

132

1b.

1c.

2a.

1a.

1.

2c.

2d.

2e.

3a.

3b.

3.

()

2b.

2.

 3

(Job Safety Analysis)

 (Job Safety Analysis)

(Job Safety Analysis, JSA)

JSA
JSA

JSA

-
-
-

4 JSA

1. (Select)
2. (Step)
3. (Identify)
4. (Develop)

135

1.

( )
(

)
(

2.

2.1

7 - 10




2.2 ()

-
-
-
-
JSA

)
(

136

3.

4.

JSA

137

(Source)

-
-
-
-
-
(Path)

-
-
-

(Receiver)
-
-
-
-

(Safety Standard Operation

Procedure SSOP)

138

 (Job Safety Analysis : JSA)

1.


2.

1.1

SSOP

1.1

1.

2.1 2.1
2.



2.2
2.2 /
3.


/
2.3
4.

5.

139

SSOP

3.1
3.1 6.

3.2

7.
3.2



4.1
4.1
4.

8.




5.1
5. 5.1
9.
5.2

6. 6.1 6.1
10.






7.1
7.1
7.
11.
8.1
8.1
8.






12.

13.


14.



3.

140

 4

Orthrorator

 Orthrorator

1.

2.

3.

8 12

1.

2.

1. 8

2.


3.


4.

143

1.

TWA 8 85

2.


3.

4.

. .. 2541 107

.. 2546








1.

ANSI S3.1-1991

OSHA- 1983 ( 1)

147

 1 Occupational Safety and Health

Administration; OSHA 1983

(Hertz)
500
1000
2000
4000
8000
(dB)
40
40
47
57
62
: Noise and Hearing Conservation Manual, 1986 American Industrial Hygiene Association.


2. (Audiometer)










1 (Audiometer)

(ANSI 3.6 1969 R-1989 )
ISI 6189-1983 (E) Listening check
(Basic Calibration) 2

2.1 Listening check Function check
Listening check Function

1000 Hz. Hearing
threshold level (HTL) 70

-
2000 3000 4000 6000 8000

500 Hz. 1000 Hz.

70 dB(HTL)

148

 2.2 Subjective test biological test Subjective

test 25

10

2.3 Acoustic calibration 1 2
Couper National Bureau of standard 9A
couper
acoustic calibration
500 6000

Hearing threshold level (HTL) 70

10 10
10 15

exchaustive calibration



3.
(Audiologist)




4.
4.1
4.2 12
(TTS)
4.3
< 85
4
4.4 15
5

149












2


5.

(pure tone air - conduction threshold)

5.1 3
5.1.1 (Baseline audiogram)

85

30
5.1.2 (Annual audiogram)

(Baseline audiogram)

15 500 1000 2000

3000 4000 6000 Hz.

15
Confirmation audiogram 30 annual audiogram

Baseline
audiogram (TTS)

150

 annual audiogram Baseline audiogram

New baseline audiogram
5.1.3 (Exit audiogram)

85

6.
(Pure tone) 500 1000 2000 3000
4000 6000 Hz.
6.1

( 1 )
6.2 Otoscope

6.3
-

6.4

6.5
-

151

6.6
6.6.1
6.6.2 1,000 Hz. 40
1 3
6.6.3 10
5
6.6.4 4 2 3

1) 1,000 Hz. 40

20 ( 60 )

2) 10

6.6.3 6.6.5
6.6.5 2000 3000 4000 6000 HZ. 1000
500 Hz. 1000 Hz.
6.6.6


7.


O ()
X ()



O
X




x


8.

500- 6000 Hz.
Baseline Audiogram

152





9.
1.
500 8000 25

2.

500 8000 25

500 8000
3.

500 1000 2000 3000 25

4000 6000 45

1. Otoscope

2. (Baseline Audiogram)
2.1 500 1000 2000 3000 25
2.2 4000 6000 45
2.3. 500 1000 2000 2 15
2.4. 3000 4000 6000 2 30

3. / (Annual Audiogram)
3.1 500 1000 2000 baseline Audiogram 15
3.2 3000 4000 6000 baseline Audiogram 20

1.

2. 3

3.






153

154

155

1.

2.

3.

4.

1. 30
2.
3.
4.
5.

1.
2.
3. 3
4.

1. 15

159

2.


Nose Clip

Mouthpiece

( TLC)

( RV)

3 8

Acceptibility & Reproducibility

spirometer


3. Acceptibility criteria & Reproducibility criteria
3.1 Acceptibility criteria
1.

- extrapolated volume 5 % FVC 0.5

2. -
6 / plateau 1

mouthpiece
3.2 Reproducibility criteria
Acceptibility criteria 3 Reproducibility
FVC FEV1 FVC FEV1 150

160


4. Reproducibility 3

1. FVC FVC
2. FEV1 FEV1
3. FVC FEV1 FVC FEV1

FVC FEV1












Spirograme















Spirograme

161

1.

FEV1 /FVC % 75
FVC 80
FEV1 80

2. 2
2.1 (Restriction pattern)

FVC 80
2.2 (Obstruction pattern) FEV1/FVC %
75 FEV1 80

1.


2.

3.

4. 5

162


.....................................

............
k
1. / /... .
......
2. m 1 m 2
k
3. ( ).... .
4. .
..
m m .
5.
m ( 6)
m .....
6. /
m ( 7)
m




()

7.
m ...
( 8)

m ( / )


/

8 . 46 . 24 .
2 .

m ...................

m ............

m /

163

8.
m 1. ( 9 )
m 2. .
9. ()


/




1.






2.






3.





4.






5.






6. /






7.






8.






9.






10.





11.






12.






13.






14.







9.1 m
m
9.2




( ) /
1.

2.

3.

164

k 10.

( 3 )
10.1
m ( 10.2)
m
4 6 4
m
m

m
m
3
m
m

m
m

m 1
m 2.
m 3.
m 4.
10.2 (Wheeze)

m ( 10.3)
m
()

o /
o
o
o

10.3
m
m
()
o /
o
o

165























()

%
Predicted


Predicted



FVC % (L.)
o
FEV1 % (L.)

FEV1 / FVC %

FET100%()

Peak-flow (L/min)

166

o
o

.

.

.

3M ()

167