to gather data for the identification and rec- ognition of the specific hazards (Agency for Toxic Substances and Disease Registry, 2018; Lyon & Hollcroft, 2016). Moreover, in the identification and rec- ognition step, we conducted walk-through audits in combination with extensive reviews of the literature to understand the basic operations of workplace facilities (Ameri- can Industrial Hygiene Association [AIHA], 2020). We recognize that one of the limita- tions of walk-through audits is the primary reliance on previous experience, and for this reason, persons conducting audits must be given components of education and train- ing in specific industries to accomplish these tasks (Arnold et al., 2016). The lack of suf- ficient tools to assess hazards and the extent of the exposure can lead to underestimated or overestimated exposure scenarios and mis- characterized risks to human health, safety, and the environment (Arnold et al., 2016). Some tools for improving professional judgments are available for exposure assess- ments of multiple hazards. These tools include exposure banding or the Exposure Control Category and Exposure Control Banding schemes of the American Industrial Hygiene Association (AIHA; Anna, 2011) and National Institute for Occupational Safety and Health (NIOSH, 2019), which can be used to help make professional judgments under conditions of uncertainty, particularly in environments of multiple hazards. These tools are particularly useful for interpreting exposure scenarios when there are limited sampling data for the hazard relative to OELs. Limited exposure data for single hazards can easily be analyzed and interpreted by using statistical tools such as the Bayesian decision analysis or IHSTAT frameworks. In these circumstances, the analysis can be accompanied by a tiered criterion to make it easy to interpret the results as a risk cat- egory, which are adequate for prioritization and characterization relative to OELs (Table 1). This approach is being used to optimize resources and inform management options (Mulhausen & Damiano, 2011). Surveys and informal or formalized inter- views are qualitative assessment strategies that rely on interacting with people who are being exposed to the hazards, usually work- ers and people in the community. These approaches usually are subjective—regard-
less of if they are structured, nonstructured, standardized, or nonstandardized—and can be prone to selection or recall biases (Bogner & Landrock, 2016; Salazar, 1990). One way to avoid this shortcoming is to increase the knowledge of the assessor through training and education to identify, anticipate, recog- nize, evaluate, and control individual hazards that are crucial to human safety, health, and the environment (Vadali et al., 2012). For this approach to be e£ective, it is also essential to create and ask relevant questions that collect the opinions of workers and people in the community about the hazards (Table 2). A checklist of risks from the hazards—whether perceived or real—should help with the met- rics for assessing the hazards and the risks to human health, safety, and the environment (AIHA, 2020; Campbell Institute, 2019). Another method relates to the complexity of the work environment and possibly the varying work hours of personnel, along with the confinements of the hazards. For this reason, it is necessary to create and admin- ister electronic and paper questionnaires. As appropriate, questionnaires should be validated and approved by an institutional review board and consent forms should be provided to respondents (U.S. Department of Health and Human Services, 1998). The validity of the questionnaires is as impor- tant as the structure and the reliability of the questionnaires. This questionnaire approach is helpful in capturing as many opinions as possible from workers exposed to multiple hazards via dif- ferent tasks and jobs. As the rationale for selecting questionnaire respondents relies on the people in charge of the design and implementation of exposure assessment or management who are in charge of health, safety, and the environment at a workplace, it is equally important to select people from the community to be respondents for a wider range of answers. In other instances, an occu- pational physician who frequently interacts with workers when injuries and illnesses are reported can be a good resource for inter- views and questionnaires (Plog & Quinlan, 2012; Tendai, 2021). The opinions of workers or people in the community about hazards—whether per- ceived or real—and their qualitative views can be used to assess multiple hazards to jus- tify the risk characterization that was previ-
In North America, there are at least 1,859 metal and metallurgical industrial facilities, including heavy and energy-intensive oper- ations such as blast furnaces, steel works, and rolling and finishing mills. These facili- ties are classified by the North American Industry Classification System (NAICS) or Standard Industrial Classification (SIC) as code 3315. Other classifications for metal and metallurgical industries include: elec- trometallurgical ferroalloys (NAICS or SIC 3313); steel wire drawing, steel nails, and spikes (SIC 3315); cold-soled steel sheets, strips, and bars (SIC 3316); foundries (SIC 3325); and primary smelting and refining of nonferrous metals (SIC 33339). The economic impact of the industries under these classifications is profound. This industry has a productive capacity of >90% in iron and steel products, a total annual rev- enue of $90 billion, approximately 150,000 direct employees, and a yearly payroll of $7 billion (American Iron and Steel Institute, 2018). While there are substantial economic benefits to this industry, measures are neces- sary—including conducting comprehensive exposure assessments—to protect the safety and health of workers in this industry. Methods A literature review was conducted to under- stand the intersection of workplace hazards and the risks to workers and the community. Recognizing the connection, we further eval- uated the complexity and nature of the heavy industrial operations of metal and metallur- gical facilities as a case study to show how a comprehensive framework can be crafted to assess exposures to multiple hazards. The risk assessor must characterize the risks to support the goals of the company and to pro- tect the health and safety of both workers and the community (Lyon & Hollcroft, 2016). A comprehensive framework of assess- ment was used for this study. This framework is based on the tenets and steps of indus- trial hygiene: identification and recognition, evaluation and analysis, and control or man- agement of multiple hazards. Although such frameworks target workplace facilities, our results can be generalized across many indus- tries and the general environment. Further, steps that are embedded in the fundamentals of risk assessment of initial scoping, plan- ning, and information gathering were utilized
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December 2023 • Journal of Environmental Health
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