The first thing before conducting the investigation is defining the problem. A proper definition of the problem is critical when trying to understand how to conduct the inquiry. The first action I would take would be the separation of the four ladies in the break room so as to prevent them from discussing and comparing their symptoms. The next step would be an interview with the remaining fourteen employees assigned to this part of the warehouse to find out if they have ever experienced similar symptoms. After identifying the commonalities in the complaints, the problem, and its likely sources, it will be easy to find a solution. The reports of dizziness and lightheadedness come from an area of the warehouse where workers blister pack on a line and the temperature is at around 40 degrees F.
Investigation of the Problem and Its Likely Source
I would first consider the likelihood that the employees are suffering from illnesses related to cold such as frostbite or hypothermia. When individuals suffer from hypothermia, their body temperature decreases to around 95 degrees F. Hypothermia sets in because the rate at which the body loses heat is greater than the metabolic rate of heat production. Hypothermia can be mild, moderate or severe. Some symptoms of hypothermia become evident when the body gets exposed to temperatures between 30 and 50 degrees F. Shivers, goose bumps and numbness are some of the symptoms of mild hypothermia. Moderate and severe hypothermia cause a cessation in shivering, lack of coordination, slow speech, poor decisions like removing warm clothes in the cold and drowsiness (Zafren & Danzl, 2013).
On the other hand, frostbite symptoms include cold skin with a prickling feeling, numbness, the skin color changes to red, bluish-white, white or grayish, hard or waxy skin. Clumsiness sets in due to a stiffness of the muscles. In severe cases, frostbite causes blistering after rewarming. Based on severity, frostbite occurs as frostnip, superficial frostbite, and deep frostbite. During frostnip, the skin either pales or turns red and further exposure causes a prickling or numbing feeling (Danzi, 2012).
Conventionally, frostnip has no peramanent effect on th skin. In superficial frostbite, the red skin turns pale or white. While the skin may remain soft, the individual begins to feel warm. When one rewarms at this stage, the skin appears blue or purple. Besides, one may experience swelling, burning or stinging. Severe frostbite affects all the layers of the skin as well as other tissues found underneath. The individual becomes numb, loses all sensations of cold and pain meaning that the muscles and joints may stop working. Large blisters form after one to two days after rewarming and the parts change to black due to the death of the tissues (Zafren et al., 2013).
However, none of the workers complain about the symptoms of cold that would suggest either hypothermia, frostbite or other cold-related illnesses. The main complaint is dizziness and lightheadedness. The next step would be to investigate other characteristics of this part of the warehouse. The store contains twenty loading docks, more than a dozen gas-powered forklifts and special seals on the loading doors to maintain the cold interior temperature while keeping out the heat.
Moreover, the only noticeable odors in this part of the warehouse are the exhausts from the forklifts as they move around. Since the warehouse does not have environmental monitors and sensors except for the refrigeration temperature, it suggests that the employees in this part of the store suffer from carbon monoxide poisoning. The individual seals meant to keep heat out, and cold in also restrict the circulation of air. Apart from the constant utilization of forklifts, the warehouse is very likely exposing employees in this sector to poisoning from carbon monoxide (Scott & Foster, 2013).
The signs of poisoning as a result of carbon monoxide are similar to other conditions such as heart attack, flu, and muscular sclerosis. Carbon monoxide poisoning causes death by replacing oxygen in the blood so that one suffocates. While high concentrations kill quickly, moderate levels accumulate and can get misdiagnosed leading to death. Low levels over an extended period can lead to health problems particularly for patients at risk. Besides, long-term exposure can cause brain damage. Removing the victims from the area of exposure is not adequate in itself. The most effective treatment involves using a hyperbaric chamber, which helps replace carbon monoxide with oxygen under pressure (Berlin, Yodaiken & Hanman, 2012).
Therefore, this part of the warehouse needs several modifications so as to eliminate the threat of carbon monoxide poisoning. First, the warehouse manager should consider replacing the internal combustion engines on the forklifts with either hydraulic jacks or electric forklifts. If the store should continue using gas-powered forklifts, then the management should ensure that the carbon monoxide emitted fall within the manufacturer’s ideal standard for the forklift. Also, carbon monoxide monitors should be placed throughout the working area and adjacent parts of the warehouse. The warehouse manager can have a mechanical ventilation system designed and installed so as to control contaminants in the workplace. Above all, the workers need education on the signs of poisoning due to carbon monoxide and its dangers (Scott et al., 2013).
The US Department of Labor Occupational Safety and Health Administration (OSHA) recognize that carbon monoxide is a typical manufacturing danger caused by the partial burning of materials comprising of carbon. It notes that the most common source of carbon monoxide poisoning in the workplace is the internal combustion engine. With regards to carbon monoxide, OSHA has standard 1917.24 under part number 1917 subpart B. Standard 1917.24 (a) stipulates that the content of carbon monoxide in a vehicle or chamber should remain at 50 parts per million on an average of eight hours. If the carbon monoxide concentration exceeds 100 parts per million, then employees should get evacuated from the room. Therefore, it is vital to conduct tests so that exposure does not exceed the limits according to standard 1917.24 (b) (Henn, Bell, Sussell & Konda, 2013).
Standard 1917.24 (c) requires that the tests on the concentration of carbon monoxide be carried out by qualified personnel through the use of gas sensor tube units. These appliances should receive verification from The National Institute for Occupational Safety and Health (NIOSH) under 30 CFR Part 11 or similar assessing tools with similar or greater accuracy. Finally, Standard 1917.24 (d) requires that records of the date, time, location and results for at least thirty days shall be made available (Henn et al., 2013).
If the warehouse manager implements the above recommendations and adheres to the OSHA standards under Part Number 1917, then the risk of carbon monoxide contamination will be reduced to a great extent. The management of the warehouse should meet all the above recommendations by a certain deadline. Otherwise, they risk serious legal repercussions. Employees need to receive training on how to identify carbon monoxide poisoning and what to do when one of their colleagues becomes poisoned.
Berlin, A., Yodaiken, R. E., & Hanman, W. A. (Eds.). (2012). Assessment of toxic agents at the workplace: roles of ambient and biological monitoring. Springer Science & Business Media.
Danzi, D. F. (2012). Hypothermia and frostbite. Prehospital Care Pearls and Pitfalls, 316.
Henn, S. A., Bell, J. L., Sussell, A. L., & Konda, S. (2013). Occupational carbon monoxide fatalities in the US from unintentional non‐fire related exposures, 1992–2008. American journal of industrial medicine, 56 (11), 1280-1289.
Scott, T., & Foster, T. (2013). Assessing carbon monoxide poisoning: Tricia Scott and Theresa Foster explain how emergency care practitioners can test whether patients have been exposed to this common but highly toxic gas. Emergency Nurse, 20(10), 14-19.
Zafren, K., & Danzl, D. F. (2013). Hypothermia and frostbite. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa: Mosby Elsevier.