Anticipate, recognize, evaluate, control, and confirm

Last updated October 22, 2024

Anticipate, recognize, evaluate, control, and confirm (ARECC) is a decision-making framework and process used in the field of industrial hygiene (IH) to anticipate and recognize hazards, evaluate exposures, and control and confirm protection from risks (Figure 1). ARECC supports exposure- and population-informed hazard assessment, hazard- and population-informed exposure assessment, hazard- and exposure-informed population assessment, and risk-informed decision making in any endeavor.^[1]^[2]^[3]^[4]^[5]^[6]

History

The anticipate, recognize, evaluate, control, and confirm (ARECC) decision-making framework began as recognize, evaluate, and control. In 1994 then-president of the American Industrial Hygiene Association (AIHA) Harry Ettinger added the anticipate step to formally convey the duty and opportunity of the worker protection community to proactively apply its growing body of knowledge and experience to assessing and managing hazards, exposures, and resulting risks in existing and emerging situations.

The confirm step was added in 2011 to clarify the necessity of confirming that all steps in the decision-making framework were being effectively applied and that the desired outcomes were being achieved.^[2] Overall confirmation of the adequacy of decision making for risk management includes measurements of the effectiveness of controls in the workplace and evaluation of results from occupational epidemiological studies. Confirmation of training, documentation, and continuous improvement of the entire decision-making process must be carried out to ensure that all steps are scientifically grounded and appropriately applied.^[2]

The ARECC process

The implementation of ARECC (Figure 1) involves conducting risk assessment and applying risk management. The ARECC graphic appears as the first illustration in the authoritative industrial hygiene reference book A Strategy for Assessing and Managing Occupational Exposures.^[4] The Occupational Exposure Assessment Body of Knowledge (BoK) documents developed by the American Industrial Hygiene Association^[5]^[6] provide an organized summary of the collective knowledge and skills necessary for persons to use the ARECC process in conducting occupational exposure assessments. AIHA has also developed a Technical Framework on Susceptible Worker Protection^[7] which includes the application of ARECC to foster awareness, understanding, and the ability to apply knowledge about the protection of susceptible workers. AIHA is using the BoKs to establish a framework for the development of education programs and knowledge/skill assessment tools, and for the improvement of the state of professional IH knowledge.

Risk assessment

During the risk assessment phase, the details of existing or potential hazards and exposures to populations of workers and members of their communities are assessed to characterize risks. The hazard identification/dose-response/exposure assessment/risk assessment approach mirrors the process that was formulated by the National Academy of Sciences / National Research Council.^[8]^[9] Schulte et al. noted the interrelated criteria of hazard identification/exposure assessment/risk assessment/risk management/fostering of benefits for responsible development of nanotechnology.^[10] Schulte et al. also noted significant examples of progress in the fields of toxicology, metrology, exposure assessment, engineering controls and personal protective equipment (PPE), risk assessment, risk management, medical surveillance, and epidemiology for protection of nanotechnology workers.^[11]

As emphasized in Figure 1, strong interactions are needed between the hazard assessment, exposure assessment, and population assessment activities.^[12] Exposure- and population-informed hazard assessment ensures that realistic information about actual workplace exposure compositions, concentrations, and conditions are factored into any laboratory-based studies of health effects that are conducted. Hazard- and population-informed exposure assessment ensures that the relevant exposures are assessed in the appropriate locations and at the appropriate times. Hazard- and exposure-informed population assessment ensures that relevant and reliable susceptibility information for the exposed population is collected for assessment against, and refinement of, the hazard criteria. Identifying and defining dose-response relationships for exposures to hazards allows for the establishment of occupational exposure limits, hazard criteria for concerns such as exposures to skin, and the grouping of materials into hazard bands that can be similarly controlled.

Risk management

The risk management portion of the ARECC framework and process emphasizes leadership commitment to the safety and health mission and application of the hierarchy of controls. Commitment includes confirming that all ARECC process steps are being followed and that protection of safety, health, well-being, and productivity is being achieved.

The hierarchy of hazard controls is an integral component of the application of ARECC. The hierarchy is traditionally depicted as a vertical listing of hazard control and exposure control options in descending order of priority, beginning at the top with elimination of the hazard as the most effective control, followed by substitution of a less hazardous option, followed by engineering controls to prevent exposures, followed by administrative and work practice controls, and concluding with use of personal protective equipment as the least effective control at the bottom.

Figure 2 depicts an alternative depiction of the hierarchy as a pyramid of interactive control elements.^[13] The components of hazard and exposure control depicted in the pyramid formulation of the hierarchy of control are

Elimination of the presence or magnitude of the hazard (not always possible if the material or condition is essential to the activity objectives but sometimes possible in the case of objectives that can be achieved by methods such as computer simulation),
Substitution of a less hazardous material or procedure (sometimes possible, such as through the use of materially similar surrogates or the use of less dispersible materials or less energetic processes. A "regrettable substitution" may result if assumptions about the risk-reduction advantages of the substitution turned out to be wrong. Recent examples of regrettable substitution are the substitution of bisphenol S for bisphenol A in plastics, and the substitution of alpha-diketone for diacetyl in butter flavorings.^[14]
Modification of the material or procedure to reduce hazards or exposures (sometimes considered a subset of the substitution option but explicitly considered here to mean that the efficacy of the modification for the situation at hand must be confirmed by the user),
Engineering controls to prevent exposures (includes a variety of physical containment and ventilation strategies),
Warnings to indicate the need for and status of control (explicitly considered in the pyramid formulation to be a distinct hierarchy option to clarity the details of any warnings being used and to emphasize the growing capabilities and availability of real time sensors and monitors; whereas in other systems, warnings are sometimes considered part of engineered controls and sometimes part of administrative controls),
Administrative and work procedures to prevent exposures and confirm protection (an approach that relies highly on training and compliance), and finally, as the last barrier to exposure,
Personal protective equipment (including respiratory protection).

Figure 3 illustrates how the pyramid formulation of the interrelated elements of the hierarchy of control can be used to provide retrospective, contemporaneous, or prospective insights about the sustainability and levels of risks associated with work activities that involve different combinations of hazards, exposures, controls, and resulting risks. For example, elimination of a hazard is considered to be a highly sustainable strategy, and if a hazard was or is thought to have been eliminated from a process, then initial evaluations can focus on confirmation of material inventories and process knowledge. Similarly, control situations that rely heavily on engineered controls, warnings, work practices, or use of PPE are less sustainable and involve greater risks, and risk management evaluations can focus on confirmation of whether those controls were actually in place and properly applied.

In addition, other hazards may also be present such as heat stress, slips trips and falls, struck-by injuries, toxic metals, toxic gases, electrical shock, lasers, shift work and fatigue. If multiple hazards are present in a work activity, the status of the hierarchy of controls can be assessed for each hazard, and a worst-first, all-hazards approach can be used to prioritize actions to ensure protection from risks. Ideally, as recommended in the American National Standard for Prevention through Design ^[15] the hierarchy will be used to guide the design of work in a manner that will prevent the presence of hazards, exposures, and resulting risks.

ARECC leaders, cultures, and systems

The ARECC framework recognizes the essential contributions of leaders, cultures, and systems to achieving success (Figure 4).^[13] When failures to protect people and the environment from risks have occurred, root causes of those failures can be traced to shortcomings or breakdowns in one or more aspects of the prevailing leaders, cultures, and systems. Aspects of the decision-making framework and process related to building and sustaining relevant and reliable leaders, cultures, and systems can be particularly important when disparate technologies or activities are converging.

As illustrated in Figure 4, the components of a leaders, cultures, and systems approach in any setting can enable ARECC to:

make it easier for everyone to get the right things done right for protection from risks
by helping to build and sustain connected, protected, and respected communities
with leaders, cultures, and systems that have all the tools, training, and experience needed
to anticipate and recognize hazards, evaluate exposures, and control and confirm protection from risks to safety, health, well-being, and productivity
in all the places we live, learn, work, and play.

Figure 4 includes a "score card" that can be used to assess the adequacy of each element of the Connected/Protected/Respected, Leaders/Cultures/Systems, Tools/Training/Experience environment. This enables effective focus on areas that must be sustained and areas that require improvement.

Related Research Articles

Risk assessment determines possible mishaps, their likelihood and consequences, and the tolerances for such events. The results of this process may be expressed in a quantitative or qualitative fashion. Risk assessment is an inherent part of a broader risk management strategy to help reduce any potential risk-related consequences.

The American Conference of Governmental Industrial Hygienists (ACGIH) is a professional association of industrial hygienists and practitioners of related professions, with headquarters in Cincinnati, Ohio. One of its goals is to advance worker protection by providing timely, objective, scientific information to occupational and environmental health professionals.

Occupational hygiene or industrial hygiene (IH) is the anticipation, recognition, evaluation, control, and confirmation (ARECC) of protection from risks associated with exposures to hazards in, or arising from, the workplace that may result in injury, illness, impairment, or affect the well-being of workers and members of the community. These hazards or stressors are typically divided into the categories biological, chemical, physical, ergonomic and psychosocial. The risk of a health effect from a given stressor is a function of the hazard multiplied by the exposure to the individual or group. For chemicals, the hazard can be understood by the dose response profile most often based on toxicological studies or models. Occupational hygienists work closely with toxicologists (see Toxicology) for understanding chemical hazards, physicists (see Physics) for physical hazards, and physicians and microbiologists for biological hazards (see Microbiology, Tropical medicine, Infection). Environmental and occupational hygienists are considered experts in exposure science and exposure risk management. Depending on an individual's type of job, a hygienist will apply their exposure science expertise for the protection of workers, consumers and/or communities.

The threshold limit value (TLV) is a level of occupational exposure to a hazardous substance where it is believed that nearly all healthy workers can repeatedly experience at or below this level of exposure without adverse effects. Strictly speaking, TLV is a reserved term of the American Conference of Governmental Industrial Hygienists (ACGIH), who determines and publishes TLVs annually. TLVs issued by the ACGIH are the most widely accepted occupational exposure limits both in the United States and most other countries. However, it is sometimes loosely used to refer to other similar concepts used in occupational health and toxicology, such as acceptable daily intake (ADI) and tolerable daily intake (TDI). Concepts such as TLV, ADI, and TDI can be compared to the no-observed-adverse-effect level (NOAEL) in animal testing, but whereas a NOAEL can be established experimentally during a short period, TLV, ADI, and TDI apply to human beings over a lifetime and thus are harder to test empirically and are usually set at lower levels. TLVs, along with biological exposure indices (BEIs), are published annually by the ACGIH.

Exposure assessment is a branch of environmental science and occupational hygiene that focuses on the processes that take place at the interface between the environment containing the contaminant of interest and the organism being considered. These are the final steps in the path to release an environmental contaminant, through transport to its effect in a biological system. It tries to measure how much of a contaminant can be absorbed by an exposed target organism, in what form, at what rate and how much of the absorbed amount is actually available to produce a biological effect. Although the same general concepts apply to other organisms, the overwhelming majority of applications of exposure assessment are concerned with human health, making it an important tool in public health.

Control banding is a qualitative or semi-quantitative risk assessment and management approach to promoting occupational health and safety. It is intended to minimize worker exposures to hazardous chemicals and other risk factors in the workplace and to help small businesses by providing an easy-to-understand, practical approach to controlling hazardous exposures at work.

An occupational exposure limit is an upper limit on the acceptable concentration of a hazardous substance in workplace air for a particular material or class of materials. It is typically set by competent national authorities and enforced by legislation to protect occupational safety and health. It is an important tool in risk assessment and in the management of activities involving handling of dangerous substances. There are many dangerous substances for which there are no formal occupational exposure limits. In these cases, hazard banding or control banding strategies can be used to ensure safe handling.

Bioenvironmental Engineers (BEEs) within the United States Air Force (USAF) blend the understanding of fundamental engineering principles with a broad preventive medicine mission to identify, evaluate and recommend controls for hazards that could harm USAF Airmen, employees, and their families. The information from these evaluations help BEEs design control measures and make recommendations that prevent illness and injury across multiple specialty areas, to include: Occupational Health, Environmental Health, Radiation Safety, and Emergency Response. BEEs are provided both initial and advanced instruction at the United States Air Force School of Aerospace Medicine at Wright-Patterson Air Force Base in Dayton, Ohio.

Workplace health surveillance or occupational health surveillance (U.S.) is the ongoing systematic collection, analysis, and dissemination of exposure and health data on groups of workers. The Joint ILO/WHO Committee on Occupational Health at its 12th Session in 1995 defined an occupational health surveillance system as "a system which includes a functional capacity for data collection, analysis and dissemination linked to occupational health programmes".

The Institute of Occupational Medicine (IOM) was founded in 1969 by the National Coal Board (NCB) as an independent charity in Edinburgh, UK and retains its charitable purpose and status today. The "Institute" has a subsidiary, IOM Consulting Limited, which became fully independent in 1990 and now celebrates its 25th year within the IOM Group as an independent consultancy and also the commercial part of the IOM organization. It specializes in asbestos surveys and services, occupational hygiene services, nanotechnology safety, laboratory analysis and expert witness consulting services. IOM is therefore one of the UK's major independent "not for profit" centres of science in the fields of environmental health, occupational hygiene and occupational safety.

The substitution of dangerous chemicals in the workplace is the process of replacing or eliminating the use chemicals that have significant chemical hazards. The goal of the substitution process is to improve occupational health and safety and minimize harmful environmental impacts. The process can be time-consuming; assessments of dangers, costs, and practicality may be necessary. Substituting hazardous chemicals follows the principles of green chemistry and can result in clean technology.

Hierarchy of hazard control is a system used in industry to prioritize possible interventions to minimize or eliminate exposure to hazards. It is a widely accepted system promoted by numerous safety organizations. This concept is taught to managers in industry, to be promoted as standard practice in the workplace. It has also been used to inform public policy, in fields such as road safety. Various illustrations are used to depict this system, most commonly a triangle.

Engineering controls are strategies designed to protect workers from hazardous conditions by placing a barrier between the worker and the hazard or by removing a hazardous substance through air ventilation. Engineering controls involve a physical change to the workplace itself, rather than relying on workers' behavior or requiring workers to wear protective clothing.

<span class="mw-page-title-main">Toxicology of carbon nanomaterials</span> Overview of toxicology of carbon nanomaterials

Toxicology of carbon nanomaterials is the study of toxicity in carbon nanomaterials like fullerenes and carbon nanotubes.

Alternatives assessment or alternatives analysis is a problem-solving approach used in environmental design, technology, and policy. It aims to minimize environmental harm by comparing multiple potential solutions in the context of a specific problem, design goal, or policy objective. It is intended to inform decision-making in situations with many possible courses of action, a wide range of variables to consider, and significant degrees of uncertainty. Alternatives assessment was originally developed as a robust way to guide precautionary action and avoid paralysis by analysis; authors such as O'Brien have presented alternatives assessment as an approach that is complementary to risk assessment, the dominant decision-making approach in environmental policy. Likewise, Ashford has described the similar concept of technology options analysis as a way to generate innovative solutions to the problems of industrial pollution more effectively than through risk-based regulation.

The health and safety hazards of nanomaterials include the potential toxicity of various types of nanomaterials, as well as fire and dust explosion hazards. Because nanotechnology is a recent development, the health and safety effects of exposures to nanomaterials, and what levels of exposure may be acceptable, are subjects of ongoing research. Of the possible hazards, inhalation exposure appears to present the most concern, with animal studies showing pulmonary effects such as inflammation, fibrosis, and carcinogenicity for some nanomaterials. Skin contact and ingestion exposure, and dust explosion hazards, are also a concern.

Hazard substitution is a hazard control strategy in which a material or process is replaced with another that is less hazardous. Substitution is the second most effective of the five members of the hierarchy of hazard controls in protecting workers, after elimination. Substitution and elimination are most effective early in the design process, when they may be inexpensive and simple to implement, while for an existing process they may require major changes in equipment and procedures. The concept of prevention through design emphasizes integrating the more effective control methods such as elimination and substitution early in the design phase.

<span class="mw-page-title-main">Occupational exposure banding</span> Process to assign chemicals into categories corresponding to permissible exposure concentrations

Occupational exposure banding, also known as hazard banding, is a process intended to quickly and accurately assign chemicals into specific categories (bands), each corresponding to a range of exposure concentrations designed to protect worker health. These bands are assigned based on a chemical’s toxicological potency and the adverse health effects associated with exposure to the chemical. The output of this process is an occupational exposure band (OEB). Occupational exposure banding has been used by the pharmaceutical sector and by some major chemical companies over the past several decades to establish exposure control limits or ranges for new or existing chemicals that do not have formal OELs. Furthermore, occupational exposure banding has become an important component of the Hierarchy of Occupational Exposure Limits (OELs).

Engineering controls for nanomaterials are a set of hazard control methods and equipment for workers who interact with nanomaterials. Engineering controls are physical changes to the workplace that isolate workers from hazards, and are considered the most important set of methods for controlling the health and safety hazards of nanomaterials after systems and facilities have been designed.

A radioactive nanoparticle is a nanoparticle that contains radioactive materials. Radioactive nanoparticles have applications in medical diagnostics, medical imaging, toxicokinetics, and environmental health, and are being investigated for applications in nuclear nanomedicine. Radioactive nanoparticles present special challenges in operational health physics and internal dosimetry that are not present for other substances, although existing radiation protection measures and hazard controls for nanoparticles generally apply.

References

↑ Brandt, Michael T. (2010). "Industrial hygiene in the 21st century". The Synergist. 21 (8): 8.
1 2 3 Hoover, M.D.; Armstrong, T.; Blodgett, T.; Fleeger, A.K.; Logan, P.W.; McArthur, B.; Middendorf, P.J. (2011). "Confirming our industrial hygiene decision-making framework". The Synergist. 22 (1): 10.
↑ Laszcz-Davis, C.A.; Maier, A.; Perkins, J. (2014). "The Hierarchy of OELs: A new organizing principle for occupational risk assessment". The Synergist. 25 (3): 27–30.
1 2 Jahn, S.D.; Bullock, W.H.; Ignacio, J.S., eds. (2015). A strategy for assessing and managing occupational exposures. Falls Church, VA: American Industrial Hygiene Association. ISBN 978-1935082460.
1 2 Occupational Exposure Assessment Body of Knowledge (OEA BoK). Falls Church, VA: American Industrial Hygiene Association. 2015.
1 2 Competency Framework: Understanding and Applying ARECC to Occupational and Environmental Health and Safety. Falls Church, VA: American Industrial Hygiene Association. 2022.
↑ Technical Framework: Susceptible Worker Protection. Falls Church, VA: American Industrial Hygiene Association. 2023.
↑ National Research Council (US) Committee on the Institutional Means for Assessment of Risks to Public Health (1983). Risk Assessment in the Federal Government: Managing the Process . National Research Council. doi:10.17226/366. ISBN 9780309033497. PMID 25032414.
↑ National Research Council (US) Committee on Improving Risk Analysis Approaches Used by the U.S. EPA (2008-12-03). Science and Decisions: Advancing Risk Assessment. National Research Council. doi:10.17226/12209. ISBN 9780309120463. PMID 25009905.
↑ Schulte, P.A.; Geraci, C.L.; Murashov, V.; Kuempel, E.D.; Zumwalde, R.D.; Castranova, V.; Hoover, M.D.; Hodson, L.; Martinez, K. (2014-01-01). "Occupational safety and health criteria for responsible development of nanotechnology". Journal of Nanoparticle Research. 16 (1): 2153. Bibcode:2014JNR....16.2153S. doi:10.1007/s11051-013-2153-9. ISSN 1572-896X. PMC 3890581 . PMID 24482607.
↑ Howard, J.; Castranova, V.; Stefaniak, A. B.; Geraci, C. L.; Kuempel, E. D.; Zumwalde, R.; Hoover, M. D.; Murashov, V.; Hodson, L. L. (2016-06-01). "Taking stock of the occupational safety and health challenges of nanotechnology: 2000–2015". Journal of Nanoparticle Research. 18 (6): 159. Bibcode:2016JNR....18..159S. doi:10.1007/s11051-016-3459-1. ISSN 1572-896X. PMC 5007006 . PMID 27594804.
↑ Erdely, Aaron; Dahm, Matthew M.; Schubauer-Berigan, Mary K.; Chen, Bean T.; Antonini, James M.; Hoover, Mark D. (2016-09-01). "Bridging the gap between exposure assessment and inhalation toxicology: Some insights from the carbon nanotube experience". Journal of Aerosol Science. 99: 157–162. Bibcode:2016JAerS..99..157E. doi:10.1016/j.jaerosci.2016.03.005. ISSN 0021-8502. PMC 4990210 . PMID 27546900.
1 2 3 4 Hoover, M.D.; Cash, L.J.; Feitshans, I.L.; Oglevie Hendren, C.; Harper, S.L. (2018). "A Nanoinformatics Approach to Safety, Health, Well-being, and Productivity". In Hull, M.S.; Bowman, D.M. (eds.). Nanotechnology Environmental Health and Safety: Risks, Regulation, and Management (3rd ed.). Oxford: Elsevier. pp. 83–117. doi:10.1016/B978-0-12-813588-4.00005-1. ISBN 9780128135884.
↑ Anastas, Paul T.; Zimmerman, Julie B. (2015-03-13). "Toward substitution with no regrets". Science. 347 (6227): 1198–1199. Bibcode:2015Sci...347.1198Z. doi:10.1126/science.aaa0812. ISSN 1095-9203. PMID 25766217. S2CID 2825669.
↑ American National Standards Institute/American Society of Safety Engineers (ANSI/ASSE). 2011. PtD Standard Z590.3.2011, Prevention through Design: Guidelines for addressing occupational risks in design and redesign processes. American National Standards Institute/American Society of Safety Engineers, Des Plains, IL.