Occupational Health & Safety

Learning Objectives

• Lead Poisoning•Sources•Symptoms•Prevention & Control

• Occupational Health Services• MCQs & SAQs

• Paint• Petrol• Pencils• Pottery• Plates (Lead plates used in batteries)• Pipes (lead pipes)• Polish (leather polishing)• Printing industry • Pesticides

9 P’s of Sources of Lead

A Anaemia

B Bartonian lines

C Colic abdominal, constipation, convulsions, coma

D Drop (foot/wrist drop), delirium

E Encephalopathy

ABC of Lead Poisoning

• F Fatigue

• G GIT symptoms (anorexia and dysphagia)

• H Headache, hyper uricaemia, Haemolysis

• I Insomnia / irritability

• J Judgment decreased

• K Kidney function impaired

• L Loss of appetite

• M Mental confusion and memory loss

• N Nausea, vomiting diarrhoea

• P Palsy (Paralysis) / pains in extremities

• R Red cell stippling / Renal failure (acute)

• T Teleky’s sign / tremors / teratogenic effects

Advantages of Occupational health care

•Investigates and assesses load factors and hazards and gives expert assistance for eliminating them •Gives information and advice •Estimates employees’ working ability and monitors their health condition •By its knowledge and skills supports action for maintaining working ability in the development of individuals, working environment and working community, in this way also affecting productivity continued

•Prevents occupational diseases and other work-related illnesses •Prevents premature incapacity for work, reduces pension costs •Reduces absenteeism due to sickness •Can make calculations of the profitability of occupational safety and health and occupational health care in cooperation with workplaces or encourage workplaces to make these themselves.

Advantages of Occupational health care

• Assessment of dusts pollution

• Assessment of noise pollution

• Assessment of vibration

• Assessment heat radiation

• Assessment of radiation

Components occupational health services – CONT..

Occupational epidemiology

• The science of the occurrence of diseases in human population as applied to the field of occupational health for the following purpose:-– Identification of diseases of occupational origin

when the same diseases also occur in the community at large.

– Identification of causes of occupational, disease– Checking the effectiveness of control measures

through prospective studies.

Legislation regarding occupational health and safety in pakistan

• Mines Act 1923• Factories Act 1934• Ordinance 2001• Docks Labours Act 1934• Petroleum Rules 1937• Pakistan Hazardous Operations Rules 1963• Workman's Compensation act 1923 and Rules 1961• Provincial Employees social Security Regulations 1967• The Oil and Gas (safety in drilling and production) Regulations

1974 • Hazardous Substances Rule 2003• OHSAS 18001 Standards

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HIERARCHY OF CONTROLS

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OCCUPATIONAL HEALTH SURVIELLANCE PROGRAMME

Remedial Action Plan Remedial action Plan should state the Additional control and recovery measures. Remedial action plan should be SMART.

• S------Specific• M-----Measurable• A-----Achievable• R-----Realistic• T-----Time bound• This plan should include priorities, responsible person and

target dates for actions.

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PRE -EMPLOYEMENT HEALTH SCREENING

• To determine the pre-existing health conditions of individuals prior to commencement of work • To make sure that he / she is physically and mentally fit for the type of

activity he / she is employed for.• At the time of employment , HR/ IR arrange pre-employment medical

examination in liaison with Medical Dept. • General physical Examination • Chest x-ray • ECG • Urine R/E • Stool R/E • Hepatitis B Ag • Anti HCV Antibodies

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Specialized tests will be conducted for staff deputed on specialized jobs or they have special requirements as part of their job like crane or fork lift operators , drives, Electrical Technicians

• Color blindness • Audiometric tests

• Pre employment Medical Record will be maintained in personal file of individual by Medical Dept. at HO

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PREIODIC HEALTH SURVEILLIENCE

• Periodic Health Surveillance to be conducted for staff:• At risk from workplace

exposure• In compliance with regulatory

requirement• To detect early, reversible

health affects• Periodic Surveillance Record

will be maintained at Field / Location level.

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Functions of Occupational Health Service1. Placing people in suitable work2. Maintaining people in suitable work3. Providing treatment4. Controlling recognized hazards5. Identifying unrecognized hazards6. Avoiding potential risks

7. Screening for early evidence of non-occupational disease

8. Health education and safety training9. Surveillance of sanitary, catering & welfare

amenities 10.Environment control outside the work place

Main Responsibilities of a doctor Working in an Industry

• Knowledge of the work environment• Medical examinations for general as well as

occupationally health surveillance • Treatment services for illness and injury• Health education • Ability to access, prevalence studies.

The Factories Act The factories act covers the matters relating to

Health, Safety & Welfare of the workers Lighting, Ventilation & Temperature Standards Hours of work day (not more than 48 hours per

week & 9 hours per day) Employment of young persons (< 14yrs) Treatment of Waste & Effluent to render them safe

Legislative Measures

Applicable to factories employing 10 or more employees Deduction from the employees (7% of the total wages)

Benefits to the employees Medical Sickness Disablement Maternity Dependents Benefit

Social Security Act (PESSI-1965)

Occupational Hygiene Inspection

• What are you going to inspect???- Refer to the checklist on factory inspection

Silicosis: X-ray chest shows Snow-storm appearanceAnthracosis: Small, ill-defined opacities in the mid & upper zonesAsbestosis: Ground-glass appearance in lower two thirds of lung fieldsByssinosis: Monday morning fever (Tightness in the chest )Farmer’s Lung: Due to exposure to grain

Special Characteristics

Expected Questions

MCQ-1

A person aged 40, who had been working as a labourer in grain market for the last 25 years presented with history of repeated attacks of respiratory infections in the last 1 year. X-ray showed pulmonary fibrosis. The likely diagnosis was: a. Tuberculosis b. Sillicosis c. Sillicotuberculosis d. Farmer’s lung e. Baggassosis

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MCQ-2A Ship Breaking Industry worker reported to you with complaints of cough, dyspnoea on exertion and chest pain. His X-ray chest showed ‘Honeycomb’ appearance. The diagnosis would be: a. Asbestosisb. Siderosis c. Silicosis d. Aspergillosis e. Byssinossis

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MCQ-3

A worker who had been in the battery manufacturing unit for the last 20 years, reported to you with complaints of lost appetite and abdominal colic of 2 weeks duration. You would prefer to investigate him for:a. Cholecystitis b. Lead poisoning c. Appendicitis d. Ameobiasis e. Stomach cancer

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MCQ-4

A woman working in an industry during night shifts is exposed to 750 lux of light. She is most probably at risk of: a. Keratomalacia b. Breast cancer c. Dermatitis d. Conjunctival xerosis e. Night blindness

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MCQ-5

Which of the following disease is more common in rural areas in the agriculturists who are mainly dependent on farming in the fields?a. Chronic bronchitisb. Lung Cancerc. Zoonotic diseasesd. Drug dependencee. Acute Respiratory Tract Infections

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MCQ-6

Air pollution can lead to which one of the following :a. Bronchial asthmab. Impetigoc. Chronic bronchitisd. Cholecyctitise. Lumbago

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MCQ-7

The cancer seen in aniline industry or with aromatic amines is:a. Skin cancerb. Lung cancerc. Cancer bladderd. Cancer rectume. Cancer kidney

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MCQ-8

X-ray chest shows ground glass appearance in lower two-thirds of lung in:a. Anthracosis b. Silicosisc. Asbestosisd. Farmer’s lunge. Bagassosis

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MCQ-9For Pneumoconiosis following is true:- a. Byssinosis is due to inhalation of cotton fiber dust

b. Anthracosis is due to inhalation of iron dustc. Bagassosis is due to inhalation of coal dustd. Silicosis is due to inhalation of sand particlese. Siderosis is due to inhalation of sugarcane fibres

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MCQ-10

• Which of the following is responsible for over half of all deaths from unintentional injuries?

a. Drowning b. Motor vehicle crashes c. Poisoning d. Firearm injuriese. Air Crashes

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MCQ-11

Majority of the mortality by road traffic accidents can be saved by:a. Seat belts b. Safety helmets c. Leather clothing d. Gogglese. New Tyres

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MCQ-12

A farmer of rural Punjab reports to a medical officer in the month of August with the complaints of fever, severe head-ache, anorexia, weakness, prostration, arthralgia, weakness and rash. The doctor noticed petechiae and blood examination shows leucopenia. The probable diagnosis is:-a. Malariab. Classic dengue feverc. Typhoidd. Chicken poxe. Meningococcal meningitis

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MCQ-13

Bagassosis is due to inhalation of :-a. Sugar cane fibersb. Sand particlesc. Cotton fibers dustd. Tobacco particlese. Sand particles

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MCQ-14

• The headquarter of ILO is in:a. Geneva b. Rome c. Paris d. New York e. London

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MCQ-15

Anthrax is a disease caused by:a. Inhalation of coal dust b. Inhalation of silica c. Inhalation of spores d. Inhalation of a viruse. Inhalation of iron dust

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SAQ-1• A forty year old pottery industry worker

presented with complaints of fever and weight loss; he also complained about cough and blood stained sputum. X-ray confirmed fibrosis of lungs and hilar lymphadenopathy:

• Which factor in this particular trade has lead to the development of this condition?

• Which measures do you recommend for prevention of this condition?

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• What is Occupational Health? What steps you will take for prevention of occupational diseases?

• What are sources of lead poisoning? Write signs and

symptoms caused by it. Give preventive measures. • Define pneumoconiosis. What are common dusts

causing pneumoconiosis? Give detailed account of silicosis.

• Enlist occupational risks to health care providers.

• Write functions of occupational health services.• What are various health hazards to a farmer working

in the fields?

Thank you !!