The HSE Quarterly 31

Health, Safety and Environment

ISSUE 31 M A RC H

2016

31

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As I researched the theme for this issue I came across an interesting article in one of our daily newspapers. In the article a question was asked; “Is it really possible that energy from renewable sources can be inserted into the Caricom energy mix in such a way as to make the slightest noticeable difference in the years ahead?”. This was a question asked by the former manager of Caricom’s Energy Programme, Mr. Joseph Williams. That question should be taken seriously given the fact that the energy requirements of the world including the Caribbean are increasing at alarming rates.

More and more, the subject of renewable energy receives public attention.

The debate on renewable energy is fostered by the fact that fossil fuels are becoming scarce and that their combustion produces CO2 which contributes to climate change.

In this issue we look at the now critical matter of renewable energy in our region. There has been a lot of research and several countries have already made significant progress in exploring alternative sources of energy. One example is the Trafalgar Hydro Plant and the drilling works which started at three sites for the exploration of geothermal power in Dominica.

Our feature article written by Dr. Deryck Pattron, examines the downturn in global hydrocarbon prices and the necessary action on renewable energy sources, as alternatives to fossil fuels as sources of energy, in order to save our economy. Readers can also enjoy a piece by Dr. Abrahams Mwasha on Renewable Aggregates for use in the Construction Industry. Though our focus is on Renewable Resources readers can also find other interesting articles such as the very interesting research on TherapeuticYoga as a Tool for Proactive Safety Culture.

We are pleased to make Mark Corbin our featured HSE professional in this issue. Mr. Corbin has a passion for Road Safety with an ambition to make roads safer in the Caribbean. He is the author of the 2013 report ‘Improving Caribbean Road Safety: Towards a Framework for the Caribbean’ which was published in issues 28 and 29 of the HSE Quarterly.

As we keep focus on road safety we again urge you to be responsible road users. In 2015 some countries in the region saw reductions in their road fatalities. However others had record high numbers. We all need to do our part to ensure that the senseless loss of life is curtailed.

I thank you all for supporting the publication over the past seven years. I ask for your continued support as we navigate these uncertain economic times which have had their effects on the publication. We however give our commitment to maintain the quality you have come to expect.

Thank you.

Janice Smith Editor-in-Chief 4

P.9 March 2016

Contents

9. Global Drive for Renewable Energy in Light of Dwindling Hydrocarbon Reserves: Implications for Trinidad & Tobago & CARICOM

P. 26

15. Renewable Aggregates for Ready Mix Concrete

20. Too Sweet for Life: Diabetes Mellitus 23. Occupational Psychology and

Therapeutic Yoga -Tools for Proactive Safety Culture

P. 27

ISSUE 31

29. Time to Think Business Continuity Plans: Lessons from Tropical Storm Erika

34. Leg Ulceration: A Vast Problem 43. Renewable Energy and Economic Development in the Caribbean

P. 20 Health Corner

PUBLISHER Jaric Environment, Safety and Health Services Limited.

EDITOR IN CHIEF Janice Smith EDITOR Appleloniah Kipps EDITORIAL BOARD Dr. Anthony J. Joseph Kandiss Edwards Eric Kipps Devitra Maharaj-Dash Magdalene Robin WRITERS Dr. Abrahams Mwasha Dr. Deryck D. Pattron Leandra Belle-Charles Jayandran Mohan Allan Sandy Linda Sheridan Cherma St. Clair CREATIVE DIRECTOR Kenneth Henry GRAPHIC DESIGNER Stefan Francis PHOTOGRAPHY Shutterstock Graphicstock Fotolia BUSINESS ADDRESS The HSE Quarterly Lot 5B Trincity Industrial Estate, Trinicity Email: thehsequarterly@jaricesh.com Website: www.jaricesh.com The opinions expressed in the HSE Quarterly do not necessarily reect those of the editor, publishers or their agents.

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By Dr. Deryck D. Pattron, Ph.D. Public Health & Safety Consultant

Abstract Global oil production and its hydrocarbon products are now experiencing a massive downturn in financial profits, worldwide. As the world moves towards the 21st century, countries worldwide are beginning to experience the effects of global warning with concomitant climatic changes and health problems. Trinidad and Tobago (T&T) is not well-advanced in the preparation process, in looking for and making use of alternative sources of renewable energy. This may be due to fact that T&T is a hydrocarbon-based economy. This approach, if not changed, would lead to serious economic hardships, illhealth and decreased environmental quality. It would therefore be prudent for us to critically reflect and to take the necessary action on renewable energy sources as alternatives to fossil fuels as sources of energy in order to save our economy, health and the environment, not only for our generation, but for all future generations.

Key words: renewable energy, fossil fuel, environmental health, pollution, greenhouse gases 9

Introduction

in our present consumption of fossil fuels sooner rather than The big question of when global oil later (Sawin, 2003; EIA, 2008 production will reach its limit and and The Economist, 2008). It is how fast it will decline afterwards estimated that the global energy has marginalised energy experts consumption is to double by 2030. for quite some time. The latest It would therefore be unwise to record-low oil prices have rekindled continue our energy consumption the debate (Energy Information of fossil fuels as usual at the Administration–EIA, 2003). detriment of the environment, For years, both sides have held human health and safety (Wisner, their ground. Some believe that, Pickle and Eto, 1998). given our reliance on petroleum, dwindling oil reserves would at the The Problem very least send shocking ripples through the global economy. The awareness of the destructive Others believe it a bit further, effects of fossils fuels, and the predicting widespread economic economic hardships associated collapse and even the onset of ‘a with its use, is now becoming post-industrial stone age’. We are more and more prevalent yet to fully experience the truth of worldwide. The search for this predicament (EIA, 2003). alternatives sources of energy have already been initiated in In the reality of dwindling oil some developed and developing reserves, all-time low oil prices countries. Where do T&T and worldwide, threats of ozone the CARICOM region fit into the depletion and climatic changes, scheme of things with regards countries worldwide (including to adopting and using more countries in the Caribbean efficient and safer renewable Region or Caribbean Community sources of energy?

[CARICOM]) are forced to search for, develop and use alternative Renewable Energy Paradigm sources of energy, namely renewable energy. There is now a Renewable energy is defined as substantial body of evidence which energy that is replenished by suggests that with or without the nature at a rate faster than its peak oil there is need for change rate of consumption by human 10

activities. Renewable energy plays an important role in the supply of energy for domestic and industrial purposes. When renewable energy sources are used, the demand for fossil fuels is reduced. Unlike fossil fuels, non-biomass renewable sources of energy such as hydropower, geothermal energy, wind energy and solar energy do not directly emit greenhouse gases–the major causes of ozone depletion (Swain, 2003 and Beattie, 2005).

A transition to cleaner, more secure energy is necessary, but it will not happen overnight.

Currently, it is estimated by the International Energy Agency that 80% of the current global energy comes from finite fossil fuels (Deyette, Clemmer and Donovan,2003). Of this 80%, 35% comes from oil, 25% comes from coal and 20% comes from natural gas. It is only 11% that comes from renewable sources such as biomass waste, 6% from nuclear and 2% from hydropower. Solar, wind and geothermal power make up less than 1% of the global energy supply mix (EIA, 2003 and Sawin, 2003).

Our main concern as scientists and environmentalists is that if we know that we have finite reserves of fossil fuels and they have had a bad effect on the environment and our health and quality of life, why do we continue to use it so aggressively? This may be due to fact that fossil fuels may be more available and more economical in the final analysis Wisner, Pickle and Eto, 1998).

Renewable energy has generally been more expensive to use than fossil fuels. Renewable energy is often not available 24/7 in some instances and may be located in remote locations. The use of expensive infrastructure, equipment and human resources are required in order to make the use of renewable resources as a viable energy alternative to fossil fuels (Beattie, 2005).

United Kingdom Perspective on Renewable Energy Much support is being given to the use of renewable energy resources by governments worldwide (The Economist, 2008). In the United Kingdom (UK) support for the use and development of renewable energy is provided in the 2003 Energy White Paper.

It is prescribed in the 2003 Energy White Paper that 10% of electricity generation should come from renewable sources by 2010 and 20% by 2020. The UK government has set a goal that 5% of the total transport fuel must come from renewable sources by the year 2010. Additionally, renewable sources of energy have been exempted from Climate Change Levy (Wisner, Pickle and Eto, 1998).

Review of the data obtained from the UK renewable energy generation for 2004, revealed that the major renewable energy contributors in descending order are biomass (52%), hydropower (35%), landfill gas (28%), onshore wind (12%), municipal solid waste combustion (7%), cofiring of biomass with fossil fuel (7%), other biofuels (7%) sewage sludge digestion (3%), offshore wind (1%) and solar photovoltaics (0.03%) (Deyette, Clemmer and Donovan, 2003).

United States Perspective on Renewable Energy In the United States (US) renewable energy

accounts for approximately 2% of the total electricity produced. This is followed by 51% nuclear, 21%, natural gas, 17% hydropower, 6% and 3% other (EIA, 2003). There is now an increased number of State and Federal Energy Policy Acts (2002 and 2005) incentives that is expected to stimulate growth and use of renewable resources in the near future.

Arising out of these Policy Acts are three main categories of incentives to promote renewable energy technologies (EIA, 2008 and Database of State Incentives for Renewable Energy–DSIRE, 2003). There are financial incentives, volunteer and outreach programmes and rules and regulations (DSIRE, 2003).

The financial incentives include tax exemptions rebate programmes, grant programmes, loan programmes and production incentives. Currently, there are 200 financial incentives that promote renewable energy in the US (DSIRE, 2003).

Volunteer and outreach programmes include programmes that involve pricing, certification and outreach. Currently, there exists 201 volunteer and outreach programmes in the US (DSIRE, 2003).

Rules, regulations and policies include a wide range of public benefits.

There are 216 rules, regulations and policies in the US that deal with renewable portfolio standards, contractor licensing requirements, engineering standards, equipment certifications, solar access laws, metering rules and generation disclosure rules (DSIRE, 2003).

11

CARICOM Perspective on Renewable Energy

Brazil, like T&T, is a petroleum-based driven economy that has achieved success with the use The Caribbean Region is also following this trend of renewable energy. Brazil has developed its of renewable energy initiative and development. sugarcane, ethanol industry for production of CARICOM or the Caribbean Community in 1998 vehicle fuel, which now replaces 40% of Brazil’s established the Caribbean Renewable Energy gasoline imports (CARICOM, 2009).

Development Programme (CREDP). The main objective of CREDP is to increase the use renewable T&T Perspective on Renewable Energy energy in the Caribbean Region by removing barriers to its adoption. However, the removal of T&T’s vision of renewable energy resources is to these barriers has not been easy. Since it requires supplement renewable sources of energy with political will, financing, policy reform, information existing petroleum-based sources of energy in and human capacity. The use of renewable energy the promotion of sustainable development. This in the Caribbean Region is therefore met with objective is being achieved through partnerships varying degrees of success (CARICOM, 2009). with various stakeholders such as the Ministry of Energy and Energy Industries, the Tourism In January 2008, the Government of Dominica Development Company Ltd (TDC), British signed a transnational partnership agreement Petroleum Trinidad and Tobago (BPTT), and United with the Regional Council of Guadeloupe for the Nations Development Programme (UNDP). The development of Dominica’s geothermal energy. outcomes of this objective would serve to guide This agreement falls under the Geothermal Energy the development of a national, renewable, energy in the Caribbean Island Project (CARICOM, 2009). policy and programme.

Similarly, Costa Rica has achieved a high level of success in the use of renewable energy in the Additionally, the UNDP and its partnership with form of hydroelectricity or geothermal, wind and the Tobago Bed and Breakfast Association and the biomass energy (as alternative energy sources Trinidad Host Home Association engaged in a Small to fossil fuels). In 1994, two pieces of legislation Grants Programme Incentives to replace electric were introduced that provided the impetus water heaters with solar water heater systems. for the development of geothermal, wind and This and other projects have already started since biomass electricity production and the promotion 2007 and are presently ongoing (UNDP, 2009). of efficient energy utilisation throughout the At present there exists no published energy economy (CARICOM, 2009). policy regarding renewable energy in T&T. Yet, 12

it is hoped through the said initiatives that a national policy will soon be developed and be available. Incorporated in this policy would be the use of biofuels as alternative sources of energy from fossil fuels.

Ethanol production has already started at Point Lisas, Trinidad and exported to the US for purification. The sustained futuristic development of biofuels may be challenging in T&T, since falling oil prices together with the global financial meltdown and the scarce availability of arable lands may place further hardships upon the population.

New infrastructure in terms of factories and downstream industries would now have to be developed to sustain this new energy transition. Whether funding would be available in the near future would be somewhat doubtful and be highly competitive in light of other equally important issues such as health care, education and national security.

at all types of renewable energy such as wind energy, biological As a developing country, it energy, fuel cell energy, hydro is prudent that we utilise our energy, solar energy, and ocean resources in the wisest possible energy. The practicality of manner that would bring some these various renewable energy measure of hope and security to sources should be thoroughly the people, ensuring sustainable investigated and tested now to development, health and determine their suitability and wellbeing. In keeping with the applicability and to break the global drive for clean sustainably viscous cycle of dependence on renewable energy, T&T is moving dwindling hydrocarbon reserves (EIA, 2003). This would lead to a towards achieving this goal. safer, healthier environment for Reducing the dependency on all, including future generations. the use of fossil fuels such as oil, coal and natural gas can prevent References devastating effects on the environment. There in an urgent Beattie, K. 2005. Engineering & need not only for T&T to adopt Management. New York: Clarkson this new culture of renewable University. energy, but for CARICOM and the rest the world as well, in Caribbean Community order to protect ourselves and (CARICOM). 2009. Caribbean our future generations from the Renewable Energy Development ill effects of global warming, Programme–CREDP. http://www. climatic changes and threats to caricom.org. (accessed January 22, 2009). human, animal and plant life.

Conclusion

Trinidad and Tobago, like the Deyette, J., S. Clemmer, and rest of the Caribbean community D. Donovan. 2003. Plugging should seriously consider looking in Renewable Energy, Grading 13

the States. Massachusetts: Union of Concerned Scientists.

Database of State Incentives for Renewable Energy (DSIRE). 2003. http://www.dsireusa.org. (accessed January 22, 2009).

Energy Information Administration (EIA), 2003.

Annual Energy Review 2001: Energy Overview. http://www.eia.doe.gov/emeu/aer/overview.html. (accessed January 22, 2009).

Energy Information Administration (EIA). 2003.

Electricity Restructuring Fact Sheets. http://www. eia.doe.gov. (accessed January 22, 2009).

Energy Information Administration (EIA). 2008.

“How Much Renewable Energy Do We Use?” Energy in Brief–What everyone should know about energy. http://tonto.eia.doe.gov/energy_in_brief/ renewable_energy.cfm.

Sawin, J. 2003. Charting a new energy future. In State of the World, ed. Lester R. Brown, 85–109.

Boston: W.W. Norton & Company, Incorporated.

The Economist. 2008. The Future of Energy: The Power and the Glory. Special Report. Economist.

Com. http://www.economist.com/opinion/ displaystory.cfm?story_id=11565685.

United Nations Development Programme (UNDP). Energy and Environment. http://www. undp.org.tt. (accessed January 22, 2009).

Wisner, R., S. Pickle, and J. Eto. 1998. Details, Details… The Impact of Market Rules on Emerging “Green” Energy Markets. California: Lawrence Berkeley National Laboratory.

14

By Dr. Abrahams Mwasha Department of Civil and Environmental Engineering University of West Indies

Abstract For any country in the world, a natural resource can be interpreted as a source of wealth. A natural resource qualifies as a renewable resource if it is replenished by natural processes at a rate comparable or faster than its rate of consumption by humans or other users. Renewable resources may also mean commodities used to create infrastructure such as rocks, timber, plastics and ceramics glasses used in construction industry. Some natural renewable resources such as rock (aggregates), water, timber and biomass must be carefully managed to avoid exceeding the environment’s capacity to replenish them.

The construction industry arguably has a number of negative impacts on the environment, with construction materials forming a significant part of those impacts. Most of the modern materials used in construction industry (e.g. building materials such as concrete, fossil fuels [as source of energy], etc) are manufactured using a finite resource. Finite resources include current resources such as natural aggregates. Despite the vast supply and recent drop in demand, the amount of new supplies being found is decreasing. Renewable construction materials such as recycled aggregates from construction wastes, i.e. concrete have extremely high embedded energy. In this paper, recycled aggregates, for ready mix concrete is analysed.

15

Introduction The wealth of any country is measured by its gross national product and services (Arnold et al. 2008).

The services, such as construction works, daily consume tonnes of natural resources on a daily basis for providing different types of engineering structures such as building, roads, bridges, etc.

Concrete is a composite material made from the combination of three basic constituents viz. (1) cement (usually Portland cement), (2) coarse and fine aggregate (usually natural sand) and (3) water.

Extraction of these materials requires high quality raw material, equipment and fossil fuel. Concrete is the most commonly used construction material.

The several definitions of concrete today with regards to its specific application are: • Reinforced Concrete • Prestressed Concrete • Fiber Reinforced Concrete • Shotcrete • High Strength Concrete • High Performance Concrete • Self Compacting Concrete, etc.

and CO2 (Energy Information and Administration– EIA, 2006) and also indirectly through the use of energy sourced from fossil fuels.

The cement industry produces 5% of global manmade CO2 emissions, of which 50% is from the chemical process and 40% from burning fuel. The amount of CO2 emitted by the cement industry is nearly 900 kg of CO2 for every 1000 kg of cement produced (Mahasenan et al. 2003). A cement plant consumes 3 to 6 GJ of fuel per tonne of clinker produced, depending on the raw materials and the process used.

Aggregates which occupy at least three quarters of the volume of concrete play a major role in reducing shrinkage, bleeding and, of course, enhancing the strength for medium and high strength concretes.

Without proper alternative aggregates in the future, the concrete industry globally will consume 8-12 billion tonnes annually of natural aggregates after the year 2010. In this paper the properties of both fresh and hardened concretes using recycled quartzite aggregates from Trinidad and Tobago (T&T) has been investigated.

The cement industry may create employment and business opportunities for local people, particularly in the remote locations of developing countries where there are fewer opportunitiesforeconomicdevelopment.

However, the process of manufacturing cement causes environmental impacts at all stages of processing. These environmental impacts include the emissions of airborne pollution in the form of dust, gases, noise and vibration when operating machinery and during blasting in quarries, as well as the damage to the countryside from quarrying. Cement manufacture contributes to greenhouse gases both directly through the production of carbon dioxide (CO2) when calcium carbonate is heated, producing lime 16

Renewable Aggregates Construction, demolition, reconstruction and restoration of buildings result in high quantities of demolition and construction waste; in the next years, the volume of these waste materials are expected to rise considerably. Relevant amounts of mineral rubble are used as engineering material for roads, earth constructions and dikes.

Since construction materials are increasingly judged by their ecological characteristics, concrete recycling gains

importance because it protects natural resources and eliminates the need for disposal by using the readily available concrete as an aggregate source for new concrete. Recycled aggregate is the result of processing appropriate construction and demolition concrete wastes.

The processing leads to crushed sand and gravel, derived from concrete rubble. According to Justman 1998 the market, researchers found over 1000 concrete recycling plants in operation in the United States producing more than 100 million

tons of concrete aggregates per (PCA), the applications without year. any processing include Concrete recycling is a relatively simple process. It involves breaking, removing, and crushing existing concrete into a material with a specified size and quality. ACI 555 (2001) has documented methods of processing old concrete into recycled concrete aggregates.

The quality of the concrete with recycled concrete aggregates is very dependent on the quality of the recycled material used.

Reinforcing steel and other

1. Many types of general bulk fills; 2. Bank protection; 3. Base or fill for drainage structures; 4. Road construction; 5. Noise barriers and embankments.

embedded items, if any, must be removed and care must be taken to prevent contamination by other materials such as asphalt, soil and clay balls, chlorides, glass, gypsum board, sealants, paper, plaster, wood and roofing materials, which can be troublesome.

air separation and size reduction in a crusher to aggregate sizes, crushed concrete can be used’ (PCA). The PCA outlines that these contaminants can be used as:

Applications of Recycled Aggregates

2. structural grade concrete;

Most of the unprocessed, crushed concrete aggregate is sold as 37.5 mm (1½ inches) or 50 mm (2 inches) fraction for pavement sub-bases. After the removal of contaminants through selective demolition, screening, and/or

1. new concrete for pavements, shoulders, median barriers, sidewalks, curbs and gutters, and bridge foundations;

3. soil-cement pavement bases;

Recycled aggregates can be 4. lean-concrete or econo-crete used as both processed and bases; unprocessed. According to Portland Cement Association 5. bituminous concrete.

17

Testing of Recycled Aggregates in T&T

that the (w/c = 0.4) RA mix had significantly higher values of compressive strength than the other RA Two sets of testing were done using the recycled mixes, this being expected, as it is well known that aggregate (RA) in concrete production; both the higher the percentage of cement, the stronger examined different strength aspects associated the cement matrix, and the greater the strength of with concrete production. The first series of tests the concrete. examined the compressive strength of cubes using varying grades of RA. These grades include However, when comparing the (w/c = 0.5) RA mix low strength (LS), medium strength (MS) and and the (w/c = 0.55) RA mix, a discrepancy was high strength (HS). It was found that when using observed. The general compressive strength of the recycled aggregate as coarse aggregate in the (w/c = 0.5) RA mix was lower than those of the (w/c production of concrete, RA derived from medium = 0.55) RA mix. It raises the question of invariability or high strength concrete is a better choice of compressive strength when using recycled than natural aggregate (NA) when comparing aggregate. In addition, the 7-day compressive compressive strength. strength was greater than the 14-day compressive strength for both (w/c = 0.4 and w/c = 0.45) RA Results and Discussions mixes. The addition of the admixture was done so that the workability of the concrete mix would The mode of failure for the concrete using the increase, thus yield results without negatively recycled aggregate was relatively difficult in affecting the true result. This apparent need for ascertaining, as the general uniformity produced admixture is as a result of high water absorption by using recycled aggregate complicated the rates possessed by the recycled aggregate. specific mode of failure (Mark, 2007). The recycled aggregate itself is composed of coarse Conclusions and Recommendations aggregate and mortar. When mixed with the other components to obtain the new concrete mix, • When using recycled aggregate as coarse the transition between old and new mortar may aggregate in the production of concrete, it can be become less apparent. In this way, the meaning recommended that using RA derived from Medium of aggregate failure (the failure of the coarse or High strength concrete performed better than aggregate) or bond failure (failure due to the Natural aggregate when comparing compressive bonding between mortar and aggregate) changes strength. slightly, as aggregate failure would encompass the failure of the coarse aggregate within the recycled • RA derived from low strength concrete generally aggregate, the failure of the bond between coarse has a lower compressive strength than NA in aggregate and old mortar or the simultaneous concrete mix, but still can be used to some degree. failure of both coarse aggregate and mortar It may not be economically feasible. bond.

• The invariability of using a mixture of strengths The maximum compressive strength achieved of aggregate can lead to variance in compressive overall was the (Water (w)/Cement(c) (w/c) = strength as shown in the concrete mix containing 0.4) mix 28-day result of 58.9 MPa. Compressive different strengths of concrete. This invariability strength results for RA mix (w/c = 0.5) after a period may be accounted for with the analysis of the of 28 days showed a maximum of 53.2 MPa while specimens shown under the electron microscope NA (w/c = 0.5) strength results showed a maximum having lines of weaknesses. of 40.9 MPa. This is a 30% increase in compressive strength of the NA strength result. When the w/c • Concrete mixes containing RA with a w/c < 0.5 was compared between samples, it was observed would require the addition of admixture, as the 18

Mahasenan, N., S. Smith, K. Humphreys, and Y. Kaya. 2003. The Cement Industry and Global Climate Change: Current and Potential Future Cement Industry CO2 Emissions. Greenhouse Gas Control Technologies–6th International Conference. Oxford: Pergamon.

mix would become far unworkable for reliable results to be obtained. This inclusion of admixture, including analysis on cost to volume ratios involving admixture, should be done.

• What should be taken into consideration is the size of recycled aggregate used in the concrete mixes.

Normally, particle sizes should not be greater than 25mm so as to ease the action of compacting, nor smaller than 10mm. A stricter size distribution regime can be assessed where the size of recycled aggregate components can be tested for their compressive strength in concrete mixes.

Mark A. Justman. 1998. C&D Debris Recycling.William Turley. Private communication Mark, J., A. Mwasha, and C. Paul. 2007. “Potential for the Use of Recycled Aggregates in Trinidad and Tobago.” http://www.irbdirekt.de/daten/iconda/CIB8518.pdf

• It was observed in the electron beam microscope analysis that for a specific specimen, a fracture line Portland Cement Association (PCA) “Materials: was observed. A general aggregate test involving the Aggregates.” Concrete Technology. http://www. influence of the somewhat randomness of structure cement.org/tech/cct_aggregates_recycled.asp. of the recycled aggregate should be done.

Tony Arnold J.R., N.C. Stephen., and M.C. Lloyd. 2008.

Introduction to Material Management. USA: Pearson References International Edition.

American Concrete Institute (ACI) 555. 2001. ACI Committee 555 Report. Michigan: ACI. Energy Information and Administration (EIA). 2006.

Emissions of Greenhouse Gases in the United States (US). Washington, DC: EIA 19

N

Context

By Cherma St. Clair MSc, PGCE, BA (Hons), DipMid, RN Lead Nurse Practice Development, London, England Diabetes Mellitus is a condition in which the amount of glucose (sugar) in the blood is too high because the body cannot break it down or use it properly. Insulin is a hormone produced by the pancreas that helps the glucose to enter the cells where it is used as fuel for the body; it is vital for life. The main symptoms of untreated diabetes are increased thirst; passing urine frequently especially at night; extreme tiredness; weight loss; genital itching or regular episodes of thrush; blurred vision; and excessive sweating.

The main types of diabetes are Type 1, Type 2 and Gestational.

Type 1 Diabetes; also known as Insulin Dependent Diabetes, is an autoimmune disease which develops because the body is unable to produce insulin. It normally has an early onset appearing before the age 40 and is treated by insulin injections and diet. Regular 20

exercise is highly recommended.

Type 2 Diabetes; commonly known as Non-insulin Dependent Diabetes, develops when the body produces insufficient insulin and or uses the insulin produced ineffectively. It is a metabolic disorder, that usually appears in people over the age of 40, but can occur in the under 40 aged group. Treatment can include combinations of: • Diet and exercise • Diet, exercise and tablet (hypoglycaemic) • Diet, exercise, tablet and insulin injection • Diet, exercise and insulin injection

Gestational Diabetes Mellitus (GDM) only occurs during pregnancy. Women who develop GDM have an increased risk of developing Type 2 Diabetes in later life. This type is treated with prescribed diet and insulin injection; however for some women, hypoglycaemic tablets are additionally needed and prescribed.

Diabetes is a costly disease for those affected, their families and health care systems. For Type I and Type 2 diabetes, the disease process can lead to pain, anxiety, inconvenience, and impaired quality of life. It is the leading cause of blindness in adults in developed countries and the most common cause of amputation (World Health Organization, 2003).

Those with diabetes are two to four times more likely to develop cardiovascular disease and stroke due to the damage caused to the majorarteries.Othercomplications include erectile dysfunction in men, increased incidences of still birth as pregnancy outcome for women, kidney disease and nerve damage â&#x20AC;&#x201C; numbness in hands and

5) Take a careful look at what and how you eat. Switch from having The main aim of treatment is to high fat diet and sugary snacks achieve blood glucose levels as to having three well balanced near to normal as possible. There meals daily, inclusive of about is conclusive evidence that good five to seven portions of fruit and control of blood glucose levels can vegetables, and low to moderate substantially reduce the risk of protein as a high protein diet puts developing complications and slow a strain on the kidneys. their progression. This in addition to a healthy lifestyle will help 6) Ensure that you have an improve wellbeing, protect against adequate intake of fluid consisting long term damage and contribute of at least 1.5 litres of water per to a substantial improvement in day. quality of life.

7) Get adequate sleep of at least six In summary I will leave you with hours in addition to periods of rest some tips to succeed in the fight in twenty four hours. against diabetes mellitus: References: 1) Get rid of the sedentary lifestyle.

Remember Type 2 diabetes is a Diabetes UK. 2015. http://www. diabetes.co.uk/ (accessed July 31, lifestyle disease. fingers and feet.

2015).

2) Exercise â&#x20AC;&#x201C; At a minimum a 30 minute walk of other type of physical activity is needed daily.

World Health Organization.2014.

Diabetes. http://www.who.int/ diabetes/en/ (accessed July 31, 2015).

3) Reduce alcohol intake and stick The National Institute for Health within the recommended weekly and Care Excellence. 2013. Diabetes unit limit.

Guidelines. https://www.nice.org.uk/

guidance/diabetes. (accessed July 31, 2015).

4) Stop smoking 21

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Psychology and

Therapeutic Yoga Tools for Proactive Safety Culture

By Jayandran Mohan Training Department, Green World Training Institute, Chennai, India

Abstract Understanding the emotional needs of employees, proactively sensing the psychological distress factors of the employees and tuning them through counseling therapy will be challenging work in any organization. The human body is composed of Physical and Mental layers, Counseling Therapy deals with mental comfort while Therapeutic Yoga deals with occupational diseases like Musculoskeletal Disorders, Hearing and Vision issues, Stress Management and Concentration loss. Detailed analysis has done about all the above human discomforts involved in high risk activities like Work at Heights and Confined Spaced entry. This article explains how Occupational Psychology and Therapeutic Yoga can be applied in Industry for high risk activities.

Keywords: Occupational Psychology, Therapeutic Yoga, Confined Space, Work at Heights

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Introduction

Health Services” as safe and healthy working environments which will facilitate optimal physical Occupational Psychology is the science of measuring and mental health in relation to work and the psychological variables, such as knowledge, self adaptation of work to the capabilities of workers. esteem, skills and abilities of an employee, and understanding human behavior in the workplace Counseling Therapies with respect to the organisation’s principles and policies. A field that is concerned with the safety, Counseling aims to help employees to manage physical and mental well being of an employee is their accident prone psychological difficulties.

Therapeutic Yoga. Therapeutic Yoga is an initiative The Safety Occupational Psychologist has to which can be implemented by the employer or understand the types of psychological issues that appointed competent Occupational Yoga therapist exist in the workplace and has to decide on the and can be followed by the worker. It includes counseling method as follows: breath control, simple meditation, adoption of specific body postures practiced for health and Psychoanalytic Therapy relaxation so as to perform well in the assigned tasks especially in high risk activities.

Psychoanalytic therapy or talk therapy can be done by listening to Employees talk about their Therapeutic Yoga can be applied to maintain lives which will release their personal stress. worker fitness during high risk activities like Work at Heights and Confined Space Entry, and will help to remove their respective phobias i.e., Acrophobia Behavioral Therapy and Claustrophobia. The employee well being is a very important factor to control accidents in In Behavioral therapy employees are encouraged the workplace. Individual behavior like Attitude, to gradually face their fears e.g. their fear of heights Competence, Perception, plays a vital role in Work by explaining the safety precautions adapted in Place Safety. Individual behavior and the mental Work at Heights. well being can be improved if the employer applies the idea of Occupational Psychology and Therapeutic Yoga. The International Labour Office (ILO 161 and ILO 1959 R112) defines “Occupational 24

into high risk activities like Work at Heights and Confined Space entry. Areas considered in the Group therapy is a form of psychotherapy where fitness assessment forWork at Heights andConfined two or more employees will interact with their Space entry activities are Respiratory system, superiors to pave the way healthy dignified Cardiovascular system, Back/knee/foot/neck Joint or any Musculoskeletal Disorder, Hearing (with relationship. or without whispering sound),Nervous system, Art Therapy Obesity, Vision, Physical Stamina, Mental Stamina (Acrophobia - Fear of Height ,Claustrophobia -Fear Art therapy involves the use of artistic means to of Enclosed Spaces, other depressions). work through difficult emotions. It helps individuals

who are having trouble discussing their problems Therapeutic Yoga Postures verbally.

Group Therapy

Therapeutic Yoga blends postures, breath work, hands-on healing and meditation techniques High Risk Activities Health Assessment which will maintain the worker’s fitness level in par The International Labour Office, Occupational with High Risk activities and the below images will Health Service, 1985, R171, Section B11 (1a), explain in detail. states that the employer has to carry out a health assessment for the worker before deploying them Fig 1 – Therapeutic Yoga Postures

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Cooper, Dominic C. 2002. Revitalizing Health and Safety – Achieving the Hard Target.

Iyer, Geeta. 2009. Illuminating Lives with Yoga.

International Labor Office. 2007. The ILO at a Glance. Geneva.

Figure 2 – Workplace Incidents Caused by Human Error

National Examination Board in Occupational Safety and Health. n.d. Unit GC2 – Control of International Work Place Risks.

National Examination Board in Occupational Safety and Health. n.d. Unit GC1 – Management of International Health and Safety.

The above statistics clearly indicate that Human Error is also one of the prime factors for work place accidents. By implementing Occupational Total Access (UK) Ltd. 2015. Work at Height & Psychology and Therapeutic Yoga, workers Confined Space Medical Assessment. physical and mental well being will be sound which will result in a reduction of accidents due to Human Error.

References Cooper, Cary L and Robertson, Ivan T. 2004.

International Review of Industrial and Organizational Psychology. Vol 19.

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Mark Corbin Transport Planner and Project Manager Highways England, UK Mark Corbin is a transport planner and project manager currently working for one of the world’s leading road operators; Highways England. Mr. Corbin is originally from Barbados but has lived and worked in the UK for the past fifteen (15) years. He is a graduate of Oxford Brookes University where he pursued his Master’s Degree in Transport Planning. He also holds a Bachelor’s of Science Degree with Honours in Automotive Technology from the University of Huddersfield.

Prior to leaving Barbados he worked in the automotive industry and lectured at the Samuel Jackman Prescod Polytechnic on the City & Guilds Motor Vehicle Engineering certificate and diploma courses.

Throughout his career in England he has led the delivery of a number of highway, public transport and road safety improvements and numerous stakeholder management events.

The development of long term transport strategies has also formed a key part of his work.

As a qualified project manager with Highways England, Mr. Corbin is currently leading two significant strategic studies in the North of England; the Trans-Pennine Tunnel and Manchester Northwest Quadrant study. The tunnel study aims to examine feasible options for connecting two of England’s major cities; Sheffield and Manchester by what could potentially be the world’s longest road tunnel. The Manchester Northwest Quadrant study seeks to address longstanding connectivity problems on one of England’s busiest motorways the M60.

Mark has a passion for Road Safety with an ambition to make roads safer in the Caribbean. He was the author of the 2013 report Improving Caribbean Road Safety: Towards a Framework for the Caribbean.

Professionally he is a registered member of the Institute of the Motor Industry and the Chartered Institute for Highways and Transportation.

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4 8 11 12 15 16 18 19 20 21

A very large expanse of sea, in particular, each of the main areas into which the sea is divided geographically A systematically organized body of knowledge on a particular subject.

The presence in or introduction into the environment of a substance or thing that has harmful or poisonous effects.

Relating to the production of electric current at the junction of two substances exposed to light Increase in the overall temperature of the earth's atmosphere generally A colorless, transparent, odorless, tasteless liquid that forms the seas, lakes, rivers, and rain A colorless, odorless gas produced by burning carbon and organic compounds and by respiration To make or become acid; convert into an acid The strength and vitality required for sustained physical or mental activity.

The surroundings or conditions in which a person, animal, or plant lives or operates

1 Convert (waste) into reusable material 2 A synthetic material made from a wide range of organic polymers such as polyethylene, PVC, nylon, etc 3 The ability to continue a defined behavior indefinitely 5 The wealth and resources of a country or region, especially in terms of the production and consumption of goods and services.

6 A colorless, odorless flammable gas that is the main constituent of natural gas.

7 A thing used for transporting people or goods, especially on land, such as a car, truck, or cart 9 The action of conserving something, in particular.

10 Wild animals collectively; the native fauna (and sometimes flora) of a region 13 A viscous liquid derived from petroleum, especially for use as a fuel or lubricant 14 The planet on which we live; the world 17 The phenomena of the physical world collectively, including plants, animals, the landscape, and other features and products of the earth

By Leandra Belle-Charles Programme Manager, The OSH Institute of Dominica 29

Introduction A natural disaster like tropical storm Erika, although infrequent, may require institutions to implement their disaster recovery plans and to improvise creative solutions to address unforeseen difficulties quickly. There may be a great need for businesses to reassess how well they are prepared for foreseeable natural disasters at all levels of the organization, not just from the perspective of recovering and restoring information technology but also managing staff who may suffer loss in one way or the other and even unforeseen absenteeism.

Employee Absence Due to Natural Disasters When considering whether to grant employees annual leave it is good practice for employers to bear in mind the possibility of their absence due to the passage of a natural disaster . Employers should consider various alternatives to assist with productivity after a natural disaster. Could the stranded employee work from where they are, or from a nearby office? It may even be sensible to pay the employee for some or all of the missed time to maintain good relations and loyalty. It is very critical that employers demonstrate some level of sympathy/empathy in their approach to employees during these times. This brings across a critical aspect which every employer should consider, which is the idea of a Disaster Management Plan or Policy. Does your organization have one? If not, when negotiating collective bargaining

agreements, some reference should be made as to how the employer and employees treat in cases of natural disasters.

Operational Needs Having a sense of direction in regards to operational needs is very essential for post natural disaster business continuity. Employers must know what critical functions need to be restored immediately in order to provide confidence to their employees when responding to a disaster. Identifying potential threats, assessing their potential impact, assigning priorities, and developing planned responses are the basic principles of sound business continuity planning. Employers must therefore implement reasonable safeguards to mitigate the range of risks that realistically may confront their institution.

Developing, implementing, and regularly testing disaster recovery and business continuity plans to ensure their continued effectiveness for responding to changing business and operational needs takes time, resources, and money but is critical. Consideration must therefore be given to striking a balance between addressing the threats institutions face with cost-effective measures to mitigate those risks and recognizing areas where it may be either cost-prohibitive or impossible to alleviate the exposure.

Disaster drills should be relevant to specific locations and must consider worst-case scenarios.

You may want to reconsider the frequency and scope of future testing strategies to incorporate 30

more thorough functional and full-scale tests of all support operations and business lines.

These periodic tests are most effective when they simulate realistic disasters and require the processing of a sufficient volume of all types of transactions to ensure adequate capacity and capability at all recovery sites.

Facilities should be safe prior to allowing personnel to re-enter the premises. A professional inspection may be necessary or advisable as some types of structural problems are difficult to detect. An inspection of your sites/buildings may determine that the damage to these premises is so severe that it is not safe to resume business operations at those locations. Therefore, before reopening for Disaster recovery and business continuity plans business, a risk assessment and planning exercise should not assume that all key personnel will be should be undertaken to ensure that your facilities available at designated sites to assist in recovery are safe. efforts. Evacuation orders, safety and health hazards, or damaged infrastructure (e.g., washedout roads, collapsed bridges, and downed power Conclusion lines) may prevent employees from timely reporting to assigned locations, despite their best efforts. The effects of tropical storm Erika have provided Tropical storm Erika illustrated that a widespread everyone with an opportunity to assess or reassess disaster can leave employees stranded without their preparedness for natural disasters. Oneâ&#x20AC;&#x2122;s access to working land-line or cellular telephone reaction to the aftermath should provide a clear services. Employers may consider the development, indication as to whether from a personal or business testing and updating of a contact list for senior perspective there was some level of readiness and management, employees, customers, vendors, preparedness to deal with the worst case scenario and key government agencies. Maintaining copies of a disaster. The creation of a Business Continuity of this information at all sites, plus one or more off- Plan, for each business location is the advisable site locations, can be very helpful in the event of a counsel for sustained trading nowadays. disaster. Similarly, employers may want to develop alternate ways for locating and communicating The OSH Institute and the Dominica Employers with employees and customers. Less-traditional Federation takes this opportunity to express our communication methods might include two-way deepest sympathies to all those who lost loved radios, cellular telephones with text messaging ones during the passing of Tropical storm Erika and capability, satellite telephones, or personal data to all who in one way or the other were affected. assistant (PDAs). Employees could use these less- Keep the faith! traditional communication methods to report their location and obtain current information. In Reference addition, you may want to establish a central point of contact outside the potential disaster area and Federal Financial Institutions Examination make pre-established toll free telephone numbers Council, n.d. Lessons Learned from Hurricane available for employees and customers.

Katrina. https://www.ffiec.gov/katrina_lessons. htm (accessed September 1st, 2015).

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“To truly transform our economy, protect our security, and save our planet from the ravages of climate change, we need to ultimately make clean, renewable energy the profitable kind of energy.” ~ Barack Obama “Once the renewable infrastructure is built, the fuel is free forever. Unlike carbon-based fuels, the wind and the sun and the earth itself provide fuel that is free, in amounts that are effectively limitless.” ~ Al Gore “It is time for a sustainable energy policy which puts consumers, the environment, human health, and peace first.” ~ Dennis Kucinich “The sun provides more energy in one hour than all humanity uses, in all forms, in a single year. Sunlight can provide us with its own resolution to our energy problems. The only transformation required is for humanity to reduce, or end, consumption of stored solar (as fossil fuels) and, in its place, use freely available "fresh" solar.” ~ David S. Findley “Studies show that investments to spur renewable energy and boost energy efficiency generate far more jobs than oil and coal.” ~ Jeff Goodell “Clearly, we need more incentives to quickly increase the use of wind and solar power; they will cut costs, increase our energy independence and our national security and reduce the consequences of global warming.” ~ Hillary Rodham Clinton

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A Vast Problem

By Linda Sheridan. MSc, PG Cert, BSc, NDN, RN,T.V. Specialist Nurse England UK

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Leg Ulcers are a vast problem for both patients and health services resources (Moffatt, Franks, Oldroyd et al. 1992). Leg Ulcers are not merely uncomfortable, they are sometimes painful dependent on the cause, and are always annoying.

Often the affected individuals are prevented from leading their normal work and social lives.

Furthermore millions of people every year are affected by this condition, including the family, friends and caregivers. This article focuses on the main categories of leg ulcers, whilst other leg ulcer aetiologies will be summarised in Table 1.

Table 1: Other Aetiologies of Leg Ulceration.

Venous Insufficiency This refers to improper functioning of the one-way valves in the veins. Veins transport venous blood from the capillaries towards the heart against gravity. Two mechanisms assist this uphill flow, the calf muscle pump which pushes blood towards the heart during exercise, and the one-way valves which prevent the flow of blood back downhill.

There may be reflux through the valves, obstruction of the veins and/or impaired calf pumping action result in pooling of blood around the lower part of the leg to just below the ankle. The increased venous pressure causes fibrin deposits around the capillaries, which then act as a barrier to the flow of oxygen and nutrients to muscle and skin tissue.

The persistent high pressure in the veins of the legs precipitates tissue and cell death that leads to the ulceration (Tortora and Grabowski, 2003).

Arterial Insufficiency “A leg ulcer is a long-lasting chronic sore on your lower leg or foot, that takes more than four to six This refers to poor blood circulation to the lower leg weeks to heal” (Davies et al. 1983). and foot and is most often due to atherosclerosis.

In atherosclerosis the arteries become narrowed About 1% of the middle-aged and elderly from deposits of fatty substances in the arterial population are affected with chronic leg ulceration, vessel walls, often due to high levels of circulating which usually occurs secondary to a range of cholesterol and aggravated by smoking and high disease processes and or conditions. The most blood pressure (hypertension). In contrast to high common of these are blood circulation disorders. pressure that causes venous ulcers, it is the lack of Where the cause is due to ‘Circulatory Insufficiency’ arterial blood supply in the delivery of oxygen and leg ulceration aetiology can be sub-divided into other nutrients to the leg and foot that result in Venous (45-80%) and Arterial (5-20%). Diabetic tissue and cell death and subsequently ulceration. leg ulceration is another large supplementary Diabetic leg ulcers are associated with poorly group (15-25%). controlled diabetes mellitus and can be either venous or arterial. Diabetic patients have an Ulceration may be caused by minor injury increased risk for developing leg ulcers due to high resulting from a plaster cast or ill-fitting boots or blood sugars coupled with the interrelated nerve may be triggered by bacterial infection, especially damage. Diabetic patients may not be fully aware Impetigo, Erythema and Cellulitis and less often of the risks associated with wearing tight clothing Tropical Ulcer, Tuberculosis or Leprosy. It is such as socks or tights, and the patient may not be important to be able to differentiate between the aware of the need to check their skin for rubbing main types of leg ulcers which are subdivided into or areas of injury. In addition they may not be venous and arterial insufficiency. Ascertaining able to fully feel the effects of compression from the aetiology of the ulcer is paramount to ensure bandages, plaster cast or any other restrictors appropriate and safe management is provided. that may have been applied for other underlying conditions, due to primary nerve damage.

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The predisposing causes of venous and arterial ulcers differ as detailed in Table 2 below. It is crucial to address the underlying cause, together with the management of the ulcer itself. This measure is to reduce the high risk of a venous leg ulcer recurring after treatment. Particularly important to note is that if you have previously had a leg ulcer there is a significant chance of recurrent leg ulceration developing in the future months or years.

Table 2: Pre-disposing Causes of Venous and Arterial Ulcers

Confirming the aetiology of the leg ulceration and formulating an appropriate treatment regime is critical, as the management of Venous ulcers differs from Arterial ulcers. The Royal College of Nursing (RCN) Guidelines for practice outline that nurses conducting the assessment (and who are responsible for the care and treatment of the patient) must be appropriately trained and experienced in leg ulcer management and care (RCN 2000). According to Ray et al. (1994) unless the practitioner has undergone formal training in the Doppler Ultrasound Technique and the Ankle Brachial Pressure Index (ABPI) measurement can be unreliable.

A full holistic patient assessment is pivotal to confirming the aetiology of the leg ulceration,

which will facilitate the appropriate management.

This assessment should include, obtaining a comprehensive medical history, allergies, current medication and origin of the ulcer if known by the patient; followed by a physical review of the ulcer site and ulcer bed. Lastly an ABPI needs to be undertaken. This involves the use of a hand held Doppler and a Doppler probe to measure the pressure in the arm and the ankle. The calculation involves dividing the highest pedal pulses by the highest brachial pulse. The normal value is 0.90 to 1.3. If the ABPI is less than 0.9, there is likely to be arterial disease. Levels of less than 0.5 indicate severe arterial disease (RCN, 2006). This assessment is crucial for diagnosis (see Table 3 for interpretation of ABPI readings).

Table 3: Interpretation of ABPI

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The Characteristics of venous ulcers also differs Picture 2: Arterial Leg Ulceration from arterial ulcers. These are tabulated below (Table 4) and Figures 1 and 2 illustrate differences further.

Table 4: Characteristics of Venous Ulcers Compared to Arterial ulcers

The management of diagnosed leg ulcers must be timely and involve the mulit-professional team approach. Patients may be referred to a Vascular Consultant to determine if vascular ultrasound is required and whether surgery intervention needs to be carried out. In addition patients should be advised to wear at least Category 2 support stockings (compression hosiery). This is particularly important for post-thrombotic syndrome, leg swelling or discomfort, and for long-distance flights.

Picture 1: Venous Leg Ulceration

Treatment for venous leg ulceration is best keeping the primary dressing simple, applying moist wound healing principles (Cutting and Tong, 2003) which usually involves cleaning with saline and appropriate dressing for the wound bed indicators (Dowsett and Ayello, 2004). Multilayer compression bandages or Short Stretch bandaging systems should be used to retain the primary dressing as it protects the bony prominences, absorbs exudate and assists with the improving the blood flow in the legs. Antibiotics may also be used if the ulcer becomes infected, but they do not help uninfected ulcers to heal.

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Â

Arterial leg ulcers are notoriously hard to heal. • The aim of treatment is keep the arterial ulcer dry and protected from pressure. Arterial surgery to improve blood supply may be necessary (Vuolo, 2009). The destruction of any emboli in the • arteries or the opening of constricted arteries using balloon angioplasty or arterial stents or even bypass grafts should be considered which will increase the peripheral blood flow. Compression bandages should be used advisedly and under • close supervision and not be considered as a firstline treatment choice.

Check your feet and legs regularly. Look for cracks, sores or changes in colour. Moisturise after bathing.

Due to susceptibility of leg ulceration from primary • conditions and precipitating factors some leg ulcers cannot be prevented. However measures can be taken to promote healing and minimise the • risk of further recurrence. The simplest action is to be very careful not to injure your legs, particularly when pushing a supermarket trolley or push- • chairs. Do consider the following tips:

When sitting, wriggle your toes, move your feet up and down and take frequent walks.

•

Consider protective shin splints.

•

Walk and exercise for at least an hour a day to keep the calf muscle pump working properly.

•

Lose weight if you are overweight.

•

Stop smoking.

•

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Wear comfortable well-fitting shoes and socks.

Avoid socks with a tight garter or cuff. Check the inside of shoes for small stones or rough patches before you put them on.

If you have to stand for more than a few minutes, try to vary your stance as much as possible.

Avoid sitting with your legs crossed. Put your feet up on a padded stool to reduce swelling.

Avoid extremes of temperature such as hot baths or sitting close to a heater. Keep cold feet warm with socks and slippers.

Consult a Chiropodist or Podiatrist to remove callus or hard skin.

References

Conclusion

Cutting, K. and Tong, A. 2003. Wound Physiology and Moist Wound healing. Medical Communications Ltd, Holsworthy.

Most Venous leg ulcers will heal within three to four months with timely diagnosis and intervention.

However, some ulcers may take longer to heal, while a very small number may never heal. This said, if patients with leg ulcers are effectively investigated and promptly treated, the majority of venous ulcers should be permanently healed with on-going long term preventative measures.

Dowsett, C. and Ayello E. 2004. Tiime Principles of Chronic Wound Bed Preparation and Treatment. Br J Nurs 13(Suppl 15). S16â&#x20AC;&#x201C;S23.

Moffatt, C.J., Franks, P.J., Oldroyd, M.I., Bosanquet, N., Brown, P., Greenhalgh RM, and McCuollum, C.N. 1992. Community clinics for leg ulcers and impact on healing. BMJ 1992;305: 1389-92 Ray, S.A. Srodon, P.D. Taylor, R.S. & Dormandy, J.A. 1994.

Reliability of Ankle: Brachial Pressure Index Measurement by Junior Doctors. British Journal of Surgery. 81, (2), p188-190.

On the other hand Arterial leg ulcers remain a challenge to even the most experienced practitioner, patients and relatives as the large number will never heal. Patients who have an underlying diagnosis of Diabetes will need to be stabilized and manage their blood sugars, in addition to the leg ulcer management.

Royal College of Nursing. 2006. The nursing management of patients with venous leg ulcers. Recommendations. London, U.K. R.C.N. Royal College of Nursing. 2000. The management of patients with venous leg ulcers. Implementation guide. London, U.K. R.C.N.

Healthcare professionals should be competent to offer and deliver evidence based advice and practice for the desired outcome which is appropriate for every individual patient.

Tortora, G.J. and Gabowski, S.R. 2003. Principles of anatomy and physiology. NewYork, U.S.A. John Wiley & Sons.

Vuolo, J. 2009. Wound care made incredibly easy. London, UK Lippincott Williams & Wilkins.

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Wash clothes in cold water whenever possible. As much as 85 percent of the energy used to machine-wash clothes goes to heating the water.

Use a drying rack or clothesline to save the energy otherwise used during machine drying. If you must use a dryer, consider adding dryer balls to cut drying time.

Buy locally raised, humane, and organic meat, eggs, and dairy whenever you can. Purchasing from local farmers keeps money in the local economy.

Use a water filter to purify tap water instead of buying bottled water. Not only is bottled water expensive, but it generates large amounts of container waste.

Buy in bulk. Purchasing food from bulk bins can save money and packaging.

Unplug appliances when you're not using them. Or, use a "smart" power strip that senses when appliances are off and cuts "phantom" or "vampire" energy use.

The big secret: you can make very effective, non-toxic cleaning products whenever you need them. All you need are a few simple ingredients like baking soda, vinegar, lemon, and soap.

Donate or recycle your cell phones and computers responsibly when the time comes. E-waste contains mercury and other toxics and is a growing environmental problem.

Install compact fluorescent light bulbs (CFLs) when your older incandescent bulbs burn out.

Bring a reusable water bottle, preferably aluminum rather than plastic, with you when traveling or at work.

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42 52

By Allan Sandy Garifuna Energy Limited

Abstract It is clear that as a result of the current bidding war for finite fossil fuels, those societies with limited resources could find themselves outbid for the vital energy supplies and, as a result, precluded from increasing their energy use. In such an environment, cheaply produced renewable energy is an absolute necessity for economic development and sustainability.

We in the Caribbean, can derive these alternative energy sources from ocean and tidal currents since the region possesses a comparative advantage due to its geography and location. The energy derived from these processes would be used to extract hydrogen and chlorine from the marine environment as well as produce fresh water through desalination.

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Introduction All economic systems depend critically on energy resources for sustainability, continuous evolution and growth. Furthermore, the direct relationship between energy use and economic development is noted. One observes, in most economies, the interrelationships and dependencies between the various sectors: Agricultural, Industrial, Transportation, Finance, Distribution and Advertising. These sectors are all very energy intensive as they depend on water, energy, transportation and telecommunication infrastructure.

As concerns the Caribbean islands, the level of infrastructural development varies in quality from poor to satisfactory. The main influence is the lack of capital for infrastructural development that is due in part to the high energy costs for fossil fuels.

These high costs in turn lead to repeated balance payments problems. This chronic indebtedness leaves very little funding available for capitalintensive infrastructure projects financed from domestic sources. The infrastructural deficiencies are pervasive, long-term and have a severely negative impact on economic growth and development. This lack of economic growth subsequently inhibits any future domestic capital accumulation, thus leading to a vicious circle of low growth and underdevelopment. In our development of alternative energy, there are four basic considerations on which the developmental strategies rest: (1) Any development is sustainable over the longterm.

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(2) Environmental protection and climate change mitigation is an intrinsic part of the process.

(3) Local resources (technical, administrative, land, sea, air and mineral commodities) are fully utilized.

(4) Labour-force participation and income from employment must increase from current levels at a sustained rate.

The Impact of High Cost Energy on Caribbean Economies As an economy grows, it increases its utilisation of energy, which when combined with land, labour, capital and technology creates wealth. The role of technology is critical in the wealth production process. Energy provides the capacity for doing work. Work, when applied to oneâ&#x20AC;&#x2122;s technological capital stock, serves to amplify human labour to produce goods and services. It is not possible to achieve such growth without technology and technological systems do not work without energy inputs. This amplification in labour productivity is critical to economic development.

One now witnesses the worldâ&#x20AC;&#x2122;s major economies evolving into very complex systems as typified by phenomena such as globalisation and the establishment of multinational federations and consolidated trading blocks; these are all linked together through complex telecommunication networks. As a result of this increase in complexity and economic activity by the major world economies, one notices a constant increase in the demand for energy.

There has been a progression of energy sources used in the amplification of human labour, for example the advances from strictly human power, to domesticated animals and later wood, charcoal and coal (in that order). Strides made with respect to coal were followed by advances in the current regimen of oil and gas, and the future promise of hydrogen-fueled electricity. These developments were all made to facilitate this economic work of wealth creation.

The Caribbean economies because of their low levels of technological development and limited capital resources have had to resort to the production of goods and services with very little value added. Lacking the capital base and the technology to increase the value added to their products, these economies continue to produce lowmargin agricultural products, minerals and metals, which are sold mainly in the world’s commodity markets where the trade terms over time move against commodity suppliers to result in decreasing revenues.

The high energy costs combined with a reduction in revenues have served to seriously inhibit and constrain economic activity in the Caribbean to such an extent that some of the islands have experienced negative economic growth, with no prospect of an improvement in the situation as long as the cost of energy remains high. The president of the Inter-American Development Bank (IDB) in 2007, Luis Alberto Moreno, describes the economic situation that the nations of the Caribbean face: ‘They have had a long history of cultivating sugar cane, the world’s most cost-effective feedstock for ethanol; that, with the exception of Trinidad and Tobago, they are almost totally dependent on imported fossil fuels; and that the reduction of preferential prices for Caribbean sugar by European buyers is forcing sugar producing countries to find new sources of revenue.’

The present economic situation of the Caribbean nations is characterised by stifled economic growth, poor basic infrastructure (for providing water and energy) and an economic system mired in the production of low valueadded commodities and low45

margin services such as tourism.

The World Bank (WB), in a report prepared for the Development committee of the Board of Governors 2006 meeting, stated that ‘Developing countries must accelerate access to affordable and reliable modern energy services to decrease poverty, increase productivity, enhance competitiveness, and thus improve their economic growth prospects. Without access to modern, clean, and sustainable energy services, the poor are exposed to unhealthy air pollution and deprived of modern energy services, which provide lighting, cooking, heating, refrigeration, transportation, motive power and electronic communication that are indispensable to increasing productivity, creating enterprises, employment and incomes.’

This, in summary, is the economic problem faced by the majority of Caribbean countries.

It is a problem characterised by poor terms of integration into the world’s economic system, inefficient use of productive resources and a technological capital stock that is not directly derived from and adapted to the domestic resource base.

Low Cost Renewable Energy as a Solution to facilitate Economic Growth

and shallow water will have the strongest marine currents. Locations where island chains interact with major ocean currents are prime areas for exploiting As aforementioned, we see emerging a three prong these energy resources. The Caribbean islands, with strategy for achieving the objectives of economic an abundance of marine features such as shallow growth and development in the Caribbean.This strategic waters with high tidal variation, interaction with initiative depends on the following: major ocean currents and many narrow straits, keys and inlets among the islands are ideally situated for • An external source of capital for investment cheap energy production from tidal and ocean current in infrastructural development with respect sources. to areas of energy, transportation, water and telecommunications; Johns et al. (2002) has indicated that of the total • A cheap and reliable source of energy; Caribbean inflow of about 28 Sverdrup (Sv), the • A transfer of technology modified for the division of volumes is almost equal among the environment and resources of the region.

Windward Islands, Leeward Islands and Greater Antilles passages. The most consistent and strongest Capital surface current inflow velocities occur in the Grenada and St. Vincent passages with typical speeds that Funding sources of capital may be provided by range from 40–60 cms−1, with observed highs of internally-generated, private sector investments, 90 cms−1 (Wilson and Johns 1997). Average volume public sector government-led investments and transports for the Grenada and St. Vincent passages externally-based, multilateral, lending agencies. were 4.7 and 3.4 Sv (Wilson and Johns 1997). Later These areas together form the major source of research (Johns et al. 2002) has shown a mean of 5.7 funds. Two divisions of the WB–the International Sv and 3.2 Sv respectively. The Greater Antilles have Finance Corporation (IFC) and the Overseas Private two major passages, the Shallow Mona Passage Investment Corporation (OPIC), the United Nations which accounts for 3 Sv and the Windward Passage (UN), the Organisation of American States (OAS) and which accounts for 7 Sv of the total inflow of 10 Sv the IDB are some of the major multilateral funding (Johns et al. 2002). The Lesser Antilles shows a total sources for infrastructural development projects in of 18 Sv flow compared to about 10 Sv for the Greater the Caribbean.

Antilles. This establishes the Grenada and St. Vincent passages in the Lesser Antilles and the Windward Energy and Mona Passage in the Greater Antilles as the most significant sources of motive power from ocean The Caribbean region has a strong comparative current flow. advantage in ocean/tidal current-driven energy production. This is because the region has one of the world’s major ocean currents–the North Equatorial Current, which is driven by the Trade Winds, and the forces generated by the earth’s rotation joining with the Guiana current, to move huge masses of water from the Atlantic through the passages between the islands into the Caribbean Sea. Among the findings, the team at Garifuna Energy Limited determined that the strongest marine currents are generally found in narrow straits, around headlands, between islands Figure 1: Caribbean Topography/Bathymetry. and at the entrances of bays. In these locations, (Source: The Cooperative Institute for Marine the areas that have the greatest tidal variation and Atmospheric Studies) 46

In particular, the consistently high ocean current velocities and high surface inflow volumes of the various island passages, present an ideal location for deploying technology solutions for generating energy from ocean and tidal currents. These small islands, many of them uninhabited, volcanic in nature and separated by narrow channels can be used to anchor large arrays of turbines stretching across the channels directly in the stream, at a depth between 40–60 feet below sea level.

Technological Basis Figure 2: The Full-scale Model of the Turbine The main technological objective is to efficiently extract energy from moving water and then use that energy in downstream industrial activity. The extractor device should be mass produced with a decentralised installation base. A five-bladed turbine, designed as a variant on the common pelton turbine, installed in the shallow areas around headlands and inlets between islands where the water, moving with a velocity of approximately 1.5 m/sec or greater, turns the turbine blades, is used.

The rotating turbine drives an electrical generator, directly attached to the main shaft, producing electricity. This device is designed with a hollow, inner cylinder that allows it to float on the surface.

The waves and water currents both act on the blades causing a rotation around the shaft. The system is anchored to the seafloor in at least 20 feet of water.

Figure 3: The Structure of the Generator Model The full-scale model of the turbine, as shown above in Figure 2, is a system designed for high torque, low rotation speed energy generation.

This turbine operates in a range of 50–70 RPM. Figure 3 shows a diagrammatic representation of the generator’s model designed for use with the turbine. This generator uses a torus-type, doublesided, axial-flux, disc-type permanent magnet and brushless machine. It has a simple toroidal, stripwound stator core with a slotless, three phase winding. These machines are relatively simple to construct, have a low cost of manufacture and operate at high efficiency.

The motive power from the marine current flow is represented by the equation P=1/2ρV3A where P=power output, ρ=water density V= ocean current velocity and A=turbine rotor area. From this equation one can observe that power is directly proportional to area and proportional to the cube of velocity.

Developmental strategy The main goal here is to use the resources available to the island economies to facilitate economic development. As island states, the aim is to use the energy of moving water (hydropower) to provide energy for industry and society. Furthermore, the mineral resources of the sea can be used to provide raw materials for industrial production.

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Physical plant capacity can be increased by scaling known as bleach) could be further produced from up production in modular blocks to accommodate the processing of caustic soda and chlorine. The increase in demand if required. The combination commercial by-products of this activity: of the energy of ocean-driven hydropower systems with seawater-derived mineral resources • Generate a continuous supply of clean will produce high value-added, energy intensive, renewable energy downstream industrial goods, with minimal impact • Produce fresh water from desalination of on the environment. seawater • Generate sea salt Desalinated Water Production • Generate oxygen from electrolysis of steam • Generate hydrogen from the electrolysis of steam • Generate chlorine from the electrolysis of brine • Generate hydrogen from the electrolysis of brine Figure 4: Seawater Reverse Osmosis Desalination Plant (4-8 kw/m3 of water) The desalination plant uses Sea Water Reverse Osmosis Membrane Technology that allows only fresh water to pass through its membrane, thus leaving the salt behind. This is accomplished by separating salt at a higher pressure than the osmotic pressure of seawater using a highpressure pump together with an energy recovery unit. Plants manufactured can that range from a capacity of approximately 20 tons of fresh water per day for a compact model to 100,000 tons per day for a large model. The energy utilisation for this class of plant lies within the 4-8 kw/h per M3 range.

Francis Acquah (1998) notes ‘The other product of electrolysis of brine is hydrogen. It is used in the synthesis of ammonia, hydrogenation of oils production of margarine, production of hydrochloric acid and in the petroleum industry.

The use of hydrogen depends on the capacity of the chloro-alkali plant. For example, a 40,000 ton/ year ammonium factory could be integrated with a 300,000 ton chlorine per year plant’. Similar units are available for the production of chlorine, oxygen and fresh water. These containers are built 20 to 40 feet long based on output capacity. The modular design allows for increasing or decreasing production based on market demand.

The by-product of Reverse Osmosis Desalination is a concentration of dissolved salts, commonly known as brine. Instead of discarding brine as a waste product of desalination, brine can be utilized as an input into the chloro-alkali industry plant.

This type of industrial plant utilises ocean energy to produce three basic chemicals derived from the electrolysis of brine. These are the primary products of electrolysis–chlorine gas or oxygen (depending on the electrodes), hydrogen gas Figure 5: A Self-Contained Modular Unit for the and sodium hydroxide solution (‘caustic soda’). Production of Hydrogen. (Hydrogenics Corporation) Sodium chlorate or sodium hypochlorite (also 48

Hydrogenics Corporation states that the ISO container is ideal for outdoor installations or industrial applications, offers heated interior access to equipment for maintenance and operation, and is a transportable container. For the ISO Option 1 20 ft Container the Hydrogen Production Range is up to 60 (2280) Nm3 /h (scfh) and the ISO Option 2 420 ft Container the Hydrogen Production Range is up to 120 (4560) Nm3 /h (scfh).

Chlorine / Caustic Soda Production Figure 6: The Various Industrial Uses of Chlorine A hydrogen chlorine, caustic soda-based chemical industry using minerals extracted from the sea, powered by energy derived from the sea promises to revitalise the economies of small island states in the Caribbean. Of this energy generating process, Francis Acquah (1998) expresses ‘A large potential exists for the utilisation of chlorine in the manufacture of ethylene dichloride, vinyl chloride, polyvinylchloride (PVC), hexachlorobenzene, dichlorobenzene, phenol, etc. … of resins for the manufacture of various thermoplastic products (plastic water tanks, plastic crates, PVC pipes, polyethylene bags, etc.) …. The plastic industry has grown significantly in the past decade with increased demand for plastic packaging materials particularly for the food and beverage industries.

Production of thermoplastics promises to be the main consumer of chlorine from the chloro-alkali plant.’ He continues ‘In general the chemical industry is characterised by the use of complex process technologies, sophisticated marketing strategies and inter-industry competition. For the sector to remain competitive, it requires linkages with local production of basic chemicals.

The chloro-alkali industry provides the necessary linkage. The major requirement of the existing chemical and allied industries is the intermediate product–caustic soda. The largest consumers of caustic soda are soaps and detergents factories, plastics, paints and pharmaceutical industries.

Large quantities of caustic soda are used in the textiles, paper and metallurgical industries and in the production of synthetic fibres.’

Summary A positive economic and social benefit to theCaribbean islands can be expected by significantly reducing the high-energy dependence on fossil fuels, which has such a ruinous effect on the local economies as a result of high-energy costs. As a renewable energy source, it is also expected that our energy production will ultimately reduce greenhouse gas production, thus having a very beneficial impact on the environment.

Moreover, it is hoped that export of the downstream products of Hydrogen, Oxygen Caustic Soda and Chlorine, will subsequently earn hard currency for the islands, and produce fresh water and electricity for domestic consumption.

References Acquah, Francis. 1998. “Prospects for a Chloro-Alkali Industry Brighten in the Ecowas.” The Ghana Engineer: Journal of the Ghana Institution of Engineers. http://home.att.net/~africantech/GhIE/chloro-alkali.htm.

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Ghoroghchian, J., and Bockris, J O’M. 1985. Use of a Homopolar Generator in Hydrogen Production fromWater. International Journal of Hydrogen Energy 10 (1): 101-112

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Johns, W.E., T.L. Townsend, D.M. Fratantoni, Wilson W.D. 2002: On the Atlantic inflow to the Caribbean Sea. Deep-Sea Research Part I 49: 211-243.

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Copper Development Association. http://www.cda.org.uk/megab2/ corr_rs/pub-157-preventing-biofouling-with-copper-nickel.pdf Profumo, F., A. Tenconi, M. Cerchio, J.F. Eastham, and P.C. Coles.

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Ronghai Qu, M. Aydin, andT.A. Lipo. 2003. Performance comparison of dual-rotor radial-flux and axial-flux permanent-magnet BLDC machines. 2003 Electric Machines and Drives Conference, 19481954. NewYork: The Institute of Electrical and Electronics Engineers (IEEE) International Rosenberg, L.T., 1982. Abnormal Vibration Problems in Large Turbine-Driven Generators and Their Solutions. The Institute of Electrical and Electronics Engineers (IEEE) Transactions on Power Apparatus and Systems. PAS-101 (10) (October): 4131-4135.

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