1. Occupational Safety and Health a Priority for Management System of SC LEIPA PACK SRL Ion Necula, General Manager Liliana Rapas, M.D.Dr.D.

3. The Buildings  Extrudare : 673,89 mp,  Printing building: 608,79 mp,  Utilities building: 127,10 mp,  Gate building: 9 mp,  Plumbing, fire fighting installation: 110 mp,  Local water source:70 m,  Septic waste,  Offices: 175,84 mp.

4. Products (1)

5. Products (2)

6. Products (3)

7. Products (4)

8. Products (5)

9. Products (6)

10. Technology  Extruder  Printing

13. Raw Materials and Waste Quantities  Main raw materials: 250 t/month * paper and cardboard * polyethylene * ink  Waste: paper, cardboard, polyethylene 2 t/month movement: mechanical manual

19. Quality, Safety and Health Management  ISO 9001:2000  Risk Assessment Risk indices/occupation 3,11 – 3,61  Occupational Health Surveillance 45 workers

20. Management of MSD  Consultation: *with workers *with safety specialists and occupational medicine physician  Risk Identification: *team: safety specialist, occupational medicine physician, human resources manager *information sources: occupational diseases statistics, work injury statistic, workers complaints, first aid reports, workplace’s ergonomics  Risk Assessment: *risk assessment specialists  Risk Control: * engineering control (work environment, equipment, materials) * administrative control (work organization, human resources and materials)  Education and Training of Workers (risk identification, first signs and symptoms, potential health effects, measures and work procedures for prevention, mechanical aids and protective equipment, risk control)  Assessment  Policy and Procedure (general/high risk, a structure for responsibilities and policy implementation)

21. EDUCATION TRAINING

23. RISK FACTORS OF MSD a) the physical demands of work activities, including: force required repetition duration work postures local contact stresses b) aspects of the layout and condition of the workplace: working reaches working heights seating floor surfaces c) the characteristics of objects handled size and shape load condition and weight distribution container, tool and equipment handles d) environmental conditions, including cool temperature e) the characteristics of the organization of work: work – recovery cycles task variability work rate

24. Law(1) GD 355/2007 Occupational Health Surveillance Sheet no. 127 and Sheet no.125 Pre placement medical assessment Fitness for work Periodical medical exams Major diseases for work

25. Law(2) GD 1425/2006 Methodological Norms for Implementing the Law for Safety and Health at Work no. 319/2006  Table 22 – occupational diseases DiseaseRisk Factor BursitisLoad movement EpicondylalgiaRepetitive movement Synovitis TendinosisExtreme postures, bad and Tenosynovitisprolonged Joints inflammationstrauma of joints Disorders of back spine Disc protrusion Fracture of the bones

26. MSD  neck pain  lumbar back pain  joints pain * elbow * ankle * knees

27. Lumbar Back Spine  Identification of risk factors  Risk assessment and control  Workers training on MSD risk  Advices: * lifting the loads * good posture * technical equipment * protective equipment  Occupational medicine surveillance  Management of the diseases (diagnostic – treatment – prophylaxis)

28. Elbow Joint  Identification of risk factors (repetitive movement, contact pressure)  Recognizes of risk for MSD (risk assessment and control)  Education and training for workers  Occupational Health Surveillance (algorithm) *exclusion of red flags for potentially serious elbow conditions: fracture, dislocation, infection, tumor, inflammation, progressive neurological deficit, vascular compromise; *contusion/epicondylalgie/epicondylitis/ tendinosis/radial tunnel syndrome/ ulnar tunnel syndrome/olecranon bursitis, infectious or noninfectious/biceps tendinosis/ pronator syndrome/nonspecific elbow pain

29. Work and medical history, focused physical examination N Potentially red flags Y Discuss, educate, reassure, manage pain, precribe activity Red flags for neurovascul ar compromise, hematoma, effusion, septic joint Red flags for tumor, dislocation, fracture, inflammation Return to usual activities Modify activities and work Emergency studies Imaging, lab studies INITIAL VISIT

30. If condition unresolved, reases with interval history and focuses physical exam 7 DAYS information specialist OM Reassure, discuss, educate, precribe condition-specific treatment and modify workas needed 3 – 4 weeks If condition unresolved, reassess with interval history and brief, physical exam Special studiesPain assessment if indicated abnormalY NO Specialist consultation (alg.3 si 4) Psychological consultation If condition unresolved, evaluation by specialist for conservative care 6 – 8 weeks

31. CONCLUSIONS  PARTENERSHIP  PRIORITY  INTEREST

32. THANK YOU!