Occupational health

Dr. Md. Arifur RahmanAssistant Professor

Dept. of Public HealthNorth East University Bangladesh

E-mail: [email protected]

OCCUPATIONAL HEALTH

1

2

OCCUPATIONAL HEALTH IS DEFINED AS:the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention among workers of departures from health causes by their working conditions; the promotion of workers in their employment from risks resulting from factors adverse to health;

the placing and maintenance of the worker in an occupational environment adapted to his/her physiological and psychological equipment;

to summarize and most importantlyTHE ADAPTATION OF WORK TO MAN AND EACH MAN TO HIS JOB

DR. MD. ARIFUR RAHMAN . NORTH EAST UNIVERSITY BANGLADESH . E-MAIL: [email protected]

3

OCCUPATIONAL HEALTH

The modern definition of Occupational Health (ILO and WHO) is:

“The promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations – total health of all at work”


4

KEY CONSIDERATIONS

• A healthy workforce is always a prerequisite for increased production.

Increased production contributes to increased Gross National Product (GNP).

Ultimately improved the socio-economic condition of the individual, family and the community.

• An unhealthy workforce is not only a negative factor in GNP increase, but also places a burden on the already over burdened disease load.


5

OCCUPATIONAL DISEASES IN BANGLADESH

• The workers in addition to being susceptible to health problems as the general population, is also exposed to agents related to their nature and type of workplace in which they are employed in.


6

OCCUPATIONAL WORKRELATEDDISEASES DISEASES

Diseases Burden of the Workers

GENERAL DISEASES


7

WHAT IS “OCCUPATIONAL DISEASE?”

Occupational diseases are usually defined as “diseases arising out of or in the course of employment.”

Occupational diseases cover all pathological conditions induced by prolonged work such as excessive exertion or exposure to harmful factors inherent in materials, equipment or the working environment.


8

WHAT IS “OCCUPATIONAL DISEASES?” (CONTINUED)

In occupational diseases there is always a direct causal relationship between work hazards, which are in excess of tolerable limits and leads to the disease process.


9

OCCUPATIONAL DISEASES (CONTINUED)

the most common occupational diseases are:

Musculo-skeletal disorders Noise induced hearing loss Dermatitis Asthma Pneumonia


10

- diseases aggravated by work or

- having a higher incidence owing to conditions of work

- multiple causal agents, where factors in the work environment may play a role together with other risk factors, in the development of such diseases

Work-related diseases


11

In Industrialized countries the traditional occupational diseases are rare. Work-related diseases are becoming important.

e.g Work a contributory cause- Coronary heart disease Work provoking a latent or aggravating an established condition- Peptic ulcer, asthma

Work-related diseases (con.)


12

OCCUPATIONAL HAZARD:

``Source or situation with a potential for harm in terms of injury or ill health, damage to property, damage to the workplace environment, or a combination of these``


13

OCCUPATIONAL HEALTH HAZARDS

TYPES OF OCCUPATIONAL HEALTH HAZARDS A. Physical B. Chemical C. Biological D. Mechanical E. Psychosocial


14

PHYSICAL HAZARDS

Temperature - Heat / Cold Illumination Noise Vibration Radiation Atmospheric pressure


15

DISEASES DUE TO PHYSICAL AGENTS - HEAT

Heat hyperpyrexia, Heat Exhaustion, Heat Syncope, Heat Cramps, burns, Prickly heat


16

• Cold - Frost bite,

DISEASES DUE TO PHYSICAL AGENTS - COLD


17

DISEASES DUE TO PHYSICAL AGENTS - LIGHT

• Light – Occupational Cataract,


18

DISEASES DUE TO PHYSICAL AGENTS

• Atmospheric-pressure-Caisson disease, air embolism.

• Noise - Occupational deafness,

• Radiation -Cancer, Leukemia, aplastic anemia, Pancytopenia

• Electricity - Burns, Shocks,


19

HEAT ILLNESS Predisposing Factors

• Physical activity• Extremes of age, poor physical condition, fatigue• Excessive clothing• Dehydration• Cardiovascular disease• Skin disorders• Obesity• Drugs

• Phenothiazines, anticholinergics, B and Ca channel blockers, diuretics, amphetamines, LSD, cocaine, MAOIs


21

SYMPTOM Caused by freezing conditions

which cut off circulation, usually in extremities (hands, feet, ears, nose), which may be permanently affected. Frost-bitten areas are cold, pale or marbled-looking, solid to the touch, and painless (until circulation is restored).

FROST BITE


22

TREATMENT

Giving warm drinks, and covering with blankets.

Warm the injured part with body heat only-put a hand under an armpit, for example.

Do not rub the skin or apply direct heat to the injured area.

FROST BITE (CON.)



23

Occupational hazards in my Organization & in my job. Identification & suggestions to control those Hazards.

Minimum 1500 words

Submission Deadline: 1st August 2015

ASSIGNMENTS 1

24

CHEMICAL HAZARDSRoutes of entry - Inhalation, Ingestion, skin absorption. (inhalation is the main route of entry)

Chemical agents can be classified into- Metals – Lead (Pb), Mercury (Hg), Cadmium (Cd), etc.Aromatic Hydrocarbons - Benzene, phenol etc. Aliphatic Hydrocarbons - Methyl alcohol Gases



25

CHEMICAL HAZARDS- GASES • A SIMPLE ASPHYXIANT does not allow oxygen to be

transferred to the cells. Examples are: Carbon dioxide, hydrogen, methane, and nitrogen.

• A CHEMICAL ASPHYXIANT prevents the uptake of oxygen by the cells. Examples are: Carbon Monoxide - prevents oxygen transport by combining with hemoglobin developing carboxy hemoglobin. Hydrogen Sulfide - at high enough concentrations, it paralyzes the respiratory center of the brain.

• RESPIRATORY IRRITANTS cause injury to the nose, mouth, throat and lungs. Example - Formaldehydes. Ammonia.

• Systemic poison Carbon Disufide (CS2)

26

BIOLOGICAL HAZARDSo Bacteria- Tetanus, Tuberculosis, Anthrax, Brucellosis

(Milkmen), Gonorrhea(Sex-workers-Genital organs get affected).

• Virus - Hepatitis, AIDS

• Protozoal & Parasitic - Malaria, Hydatid (Dog handlers) ,Hookworms, tapeworms (Agri-workers), etc.

• Fungi - (Agri-workers)-Tinea-infections, Coccidiomycosis, Psittacoses, ornithosis, etc .


27

COMMON BIOLOGICAL OCCUPATIONAL HAZARDS


28

MECHANICAL HAZARDS

• Injuries- Falls, cuts, abrasions, concussions, contusions ,etc.

• Ergonomic Disorders- Musculo-skeletal disorders(MSDs), Cumulative-trauma-Disorders (CTDs) etc.

Ergonomics: ``Adjustment of Man & Machine``• Application of human biological sciences with engineering science to

achieve optimum mutual adjustment of man & his work, the benefit being measured in terms of human efficiency and well being

• Tool / machine design to fit to work. Ergo tools/ ergo friendly tools : Tools which reduce the stresses or problems resulting in CTD’s / MSD’s.)


29

Carpel tunnel syndrome Cubital tunnel syndrome Thoracic outlet syndrome Raynaud’s syndrome

(white finger)

MUSCULO-SKELETAL DISORDERS(MSDS)


30

PSYCHOSOCIAL HAZARDS

Lack of job satisfaction, insecurity, poor interpersonal relations, work pressure, etc.

Psychological & behavioral changes – aggressiveness, anxiety, depression, alcoholism, drug addiction.

Psychosomatic disorders- Hypertension, headache, body-ache, peptic ulcers, asthma, diabetes, heart disorders, etc.


31

NOISE

Noise- Unwanted or Undesired Sound

Wrong sound, which is experienced in a wrong place at the wrong time

Source

Cutting, Grinding, Drilling, Conveyer belt etc.


32

ALLOWABLE NOISE Maximum Duration of Exposure to Noise:Noise Level-dB Max. Duration

90 8 hr 93 4 hr 96 2 hr 99 1 hr 100 30 mln 105 15 mln 108 7 min 117 1 min 120 30 sec


33

THE BODY’S RESPONSE TO NOISE

1) Dilation of the pupil

2) Secretion of thyroid hormone

3) Heart palpitations

4) Secretion of adrenaline

5) Secretion of adrenaline cortex hormone

6) Movements of the stomach and intestines

7) Muscle reaction

8) Constriction of the blood vessels


34

EFFECTS OF NOISE ON HUMAN HEALTH

Non-Auditory Effect:• Palpitation• Variations in Pressure• Increase Gastric

Motility• Peptic Ulcer• Muscle spasm

• Annoyance• Fatigue• Decrease Efficiency• Increase Secretions

many Hormones


35

EFFECTS OF NOISE ON HUMAN HEALTH

Auditory Effects: Tinnitus or Ringing, Acoustic trauma Temporary Hearing loss- reversible

occurs immediately after exposure to significant loud sounds, Permanent Hearing loss- irreversible

results from long term exposure to loud noises Acoustic trauma- resulting from explosion or very loud

impulses


36

OCCUPATIONAL NOISEPrevention:• Pre-placement examination- Previous

history of any ear disorders• Substitution of agent or parts (less noisy)• Proper use of PPE –ear plug, ear mask• Periodical examination• Change of Sections


37

EAR PROTECTION - PPE


38

OCCUPATIONAL RESPIRATORY ILLNESS


• Occupational lung diseases are a branch of occupational diseases concerned primarily with work related exposures to harmful substances, dusts or gases, and the subsequent pulmonary disorders that may occur as a result.

• Substances known to cause lung disease include coal dust, Asbestos, crystalline silica, a form of Silicon dioxide (which is usually in the form of quartz) ,Barium etc.

39

OCCUPATIONAL RESPIRATORY ILLNESS – WORKERS AT GREATEST RISK Handle grains and cereals (silo workers, millers and bakers) Workers exposed to dusts from castor or coffee beans and those

involved in tea sifting and packing; Workers in Tobacco industry, Woodworkers, sawmill operators, Workers in the furniture industry workers, Laboratory workers, handling animals, workers in the chemical and pharmaceutical industries.


40

OCCUPATIONAL RESPIRATORY ILLNESSES : TYPES

1.Respiratory cancers2.Chronic Obstructive Pulmonary Disease

(COPD)3.Occupational asthma4.Pneumoconiosis5.Other non-cancerous respiratory diseases


41

OCCUPATIONAL RESPIRATORY ILLNESSES : TYPES

1. Respiratory cancers include lung cancer, which may be caused by a range of exposures – such as asbestos, silica, diesel engine exhaust emissions, and mineral oils – and mesothelioma, a cancer of the lining of the lungs which is caused by asbestos.

2. Chronic Obstructive Pulmonary Disease (COPD) is a serious long-term lung disease in which the flow of air into the lungs is gradually reduced by inflammation of the air passages and damage to the lung tissue. Bronchitis and emphysema are common types of COPD. A wide range of vapors, dusts, gases and fumes potentially contribute to causing the disease or making it worse.


42

OCCUPATIONAL RESPIRATORY ILLNESSES : TYPES (CONTINUED)3. Occupational asthma can be defined as adult asthma that is specifically caused by agents that are present in the workplace, however, a wider definition of work-related asthma includes all cases where there is an association between symptoms and work, including cases that are exacerbated by work.

4. Pneumoconiosis is a long-term and irreversible disease characterized by scarring and inflammation of the lung tissue. The main types of pneumoconiosis are defined in terms of their causative agents: coal worker’s pneumoconiosis due to coal dust exposure, asbestosis due to exposure to asbestos fibers, and silicosis due to silica dust exposure.


43

OCCUPATIONAL RESPIRATORY ILLNESSES : TYPES (CONTINUED)

5. Other non-cancerous respiratory diseases include diffuse pleural thickening and pleural plaques (non-malignant diseases of the lung lining caused by asbestos), allergic alveolitis (inflammation of the air sacs within the lungs due to an allergic reaction to organic material), allergic rhinitis (inflammation within the nose, mouth or throat that can be caused by an allergic reaction to a range of agents), and byssinosis (an asthma like disease in which the air passages become constricted in reaction to exposure cotton dust).


44

OCCUPATIONAL ASTHMAOccupational Asthma is caused by the inhalation of

sensitizing agents or irritants such as dusts, droplets and gases.

Sensitizing Agents cause bronchial hyper-reaction to : Dust-plant origin such as grain, flour, coffee beans, tobacco, tea

fluff, woods

Dusts- animal origin - shellfish and laboratory animals e.g. rats, mice, guinea pigs, & mites.

Metals- platinum, chromium, nickel, organic compounds, reactive dyes and many others.

Drugs- particularly antibiotics and enzymes


DR. MD. ARIFUR RAHMAN . NORTH EAST UNIVERSITY BANGLADESH . E-MAIL: [email protected] 45

OCCUPATIONAL ASTHMA (CONTINUED)

Irritant agent: cause chemical asthma:

strong alkalis, acids, oxidizing agents (ammonia, chlorine, zinc chloride, etc.)

Inert dust (non-fibrous and non-toxic dust).

46

DUSTS (PNEUMOCONIOSIS)Inorganic Dust Coal Dust -Anthracosis Silica -Silicosis Asbestos -Asbestosis

Organic Dusts Cane Fiber -Bagassosis (Bronchi gets affected)

Cotton dust -Byssinosis(In Textile industries)

Tobacco - Tobaccosis,Lung Cancer

Grain Dust -Farmer’s Lungs


47

TOBACCOSIS Chronic Cough Chronic Bronchitis Dyspnea Emphysema Irritation Conjunctivitis Dryness Dermatitis


48

OCCUPATIONAL RESPIRATORY DISORDERS PREVENTION Pre-placemat examination- Previous history of

asthma, allergy to particular dust Substitution of agent Use of PPE- Filter Mask Ventilation Proper House Keeping Change of Sections


49

OCCUPATIONAL SKIN DISORDERS:A cutaneous (skin) abnormality directly or indirectly

by the work environment is an occupational skin disorders. Skin disorders are the second most frequently reported type of occupational disease.

About 90 % of the occupational skin disease is

confined to the hands and forearms, less frequently to face, while sometimes other parts of the body are involved:


50

OCCUPATIONAL SKIN DISORDERS (CON.)

Depending on the acting chemical factor or agent the occupational skin lesions may be divided into:

1) Irritant contact dermatitis,

2) Allergic contact dermatitis

3) Photo allergic contact dermatitis

4) Acne form eruptions

5) Occupational cancer of the skin.


51

OCCUPATIONAL SKIN DISORDERS – PREVENTION Pre-placemat examination- Previous history of

allergy with the particular agent, Eczema, other dermatitis

Patch Test Proper personal hygiene Substitution of agent Use of PPE Change of Sections


52

PREVENTION & CONTROL OCCUPATIONAL HEALTH HAZARDS (PRINCIPLES) : OBJECTIVES• The primary objective of occupational health hazard control is

to ensure that workers’ exposure to harmful chemical, stresses and physical agents does not result in occupational illness.

To lower exposures, first determine the contaminant source or hazard source, concentration, the path it travels to the workers, and the employee’s work pattern and use of protective equipment.

• Hazards can change with time, so health hazards control systems requires continuous review and updating.


53

CONTROL OCCUPATIONAL HEALTH HAZARD

Control occupational health hazard is a multidisciplinary approach, it includes:

1. Engineering Measures2. Administrative controls3. Medical Measures /Control of Host4. Training, Education and Motivation 5. Legislative Measures


54

General Ventilation Local exhaust ventilationWet methods Isolation & Enclosure Substitution Enclosing/Machine

guarding

Mechanization Personal Protective

Equipment PPE/ Personal Protective Devices PPD

MonitoringResearch

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD : ENGINEERING MEASURES


55

PERSONAL PROTECTIVE EQUIPMENT (PPE)

• Personal protective equipment (PPE) refers to protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury. The hazards addressed by protective equipment include physical, electrical, heat, chemicals, biohazards, and airborne particulate matter.


56

PERSONAL PROTECTIVE EQUIPMENT (PPE)


57

1. Eye and Face Protection: - Safety Glasses / Goggles - Face Shields- Eye Protection for Intense

Light Sources (example- welding, glassblowing, gas welding, oxygen cutting, laser use, etc)

TYPES OF PERSONAL PROTECTIVE EQUIPMENT:


58

Respirators: Respirators serve to protect the user from breathing in contaminants in the air, thus preserving the health of one's respiratory tract. There are two main types of respirators. One type of respirator functions by filtering out chemicals and gases or airborne particles from the air breathed by the user. Gas masks and particulate respirators are examples of this type of respirator. A second type of respirator protects users by providing clean, reparable air from another source. This type includes airline respirators and self-contained breathing apparatus (SCBA).



59

• Hearing Protection: PPE for hearing protection consists of earplugs and earmuffs.

• NIOSH recommends that worker exposures to noise be reduced to a level equivalent to 85 dBA for eight hours to reduce occupational noise induced hearing loss.



60

• Skin protection: Any form of PPE that acts as a barrier between the skin and the agent of exposure can be considered skin protection. Because a lot of work is done with the hands, gloves are an essential item in providing skin protection. Some examples of gloves commonly used as PPE include rubber gloves, cut-resistant gloves, and heat-resistant gloves.

• Other than gloves, any other article of clothing or protection worn for a purpose serve to protect the skin. Lab coats for example, are worn to protect against potential splashes of chemicals.



61

PPE – FACTS TO CONSIDER 1. Identifying the appropriate PPE based on the hazards of the task/ work

area. 2. Providing and paying for required PPE. Assure appropriate equipment

is available.3. Enforcing the proper use of PPE4. Maintaining PPE in a clean and reliable condition (clean, sanitary,

replace worn or defective parts)5. Training employees (document the training) on the following: - When PPE is needed - What PPE is needed - How to properly put on, adjust, wear, and remove the PPE - Useful life and limitations of the PPE - Proper care, storage, and disposal of the PPE


62

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD : ADMINISTRATIVE CONTROLS

1. Housekeeping2. Education and Training3. Limiting time of exposure4. Restricted areas5. Labeling and Signs6. Waste Disposal Practices7. Materials Handling8. Medical Monitoring9. Environmental Monitoring10. Personal Hygiene Facilities


63

Pre-employment selection of workers

I. find out pre-existing diseases

II. identification of susceptible host

III. find out pre-existing lung condition or any other organic disorders.

Periodical Medical Examination

I. Early detection of Occupational Diseases/ health impairment

II. Once in two years –every employee

III. Once in a year-hazardous job

IV. Special circumstances- more frequently

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD - MEDICAL MEASURES /CONTROL OF HOST


64

• Special Medical Examination

I. Specific Hazards

II. Specific investigations-Pathological or other

• Medical & Health Care Services

I. Prevention of Occupational diseases

II. Health Exam of employees

III. Early Diagnosis, treatment and Management

IV. First Aid

V. Health Education

VI. Report & Records

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD MEDICAL MEASURES /CONTROL OF HOST (CON.)


65

Functions of Medical Care Services:

1) To identify occupational hazards.

2) To advise on the control of occupational hazards.

3) To recognize at an early stage occupational or other diseases and to screen vulnerable groups

4) To give initial treatment for injuries and illness of sudden onset; to treat illness to prevent people from going off work.

5) To give advice about the placement of people in suitable work, on starting of work, following illness or injury, or at other times when problems may exist.


PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD MEDICAL MEASURES /CONTROL OF HOST (CON.)

66

6)To provide general advice and supervision of conditions at work which may influence health and general sanitation.

Medical surveillanceMedical Surveillance

includes

- health screening, - monitoring diseases - control of diseases,- counseling, guidance and education of various groups of employees

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD- MEDICAL MEASURES /CONTROL OF HOST (CON.)


67

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD- TRAINING, EDUCATION AND MOTIVATION


New worker Transfer to other section New machine Re- orientation Proper & regular use of PPE House keeping & maintenance

68

PREVENTIVE/CONTROL MEASURES: HEALTH HAZARD - LEGISLATIVE MEASURES

Improving the working environment Reasonable comfort to the workers Proper health & safety measures Welfare facilities


69

MANUAL HANDLING - BACK INJURIES

All forces which come down the spine compresses discs and as a result of

Continuous squeezing they can rupture and bulge causing severe pain.

Most back injuries are built over along period of time by repetitive pounding on discs caused by improper methods. After sometime some minor lift can produce such rupture

``Straight back rule``

‘Thinking before lifting’


70

MANUAL HANDLING - BACK INJURIES 1. CONTROL any risk by reducing

necessity for manual handling by using alternative means of handling

2. consider the load; size, awkward shape, etc3. consider need for mechanical or manual assistance4. position legs apart - one foot level with the load5. keep back straight, look up


71

MANUAL HANDLING - BACK INJURIES (CON..)

*bend from the hips, avoid ‘twisting’ the body*tighten the stomach muscles, but don’t hold breath*BEND THE KNEES*keep the load close to the body*lift with the legs, not the back*keep carrying distance short*avoid changing grip or ‘jerking’ the load*deposit the load by bending the knees and keeping the back straight.


72

VDT (VIDEO DISPLAY TERMINAL) USER`S-ERGONOMIC GUIDELINES

*Seat height to be adjusted so that thighs are horizontal & feet are resting flat on the floor*Thigh-torso angle is not less than 90 degrees, with 100 degrees as preferable*Chair should have ``Backrest``with support for curvature in lumbar area

SEATING POSITION

Natural S-curvature of the spine


73

VDT USER`S-ERGONOMIC GUIDELINES

*Wrist and forearm-held in straight line to reduce tendon & nerve stress*Upper & lower arm-at 90 degree angle *Elbows to be kept close to the sides*Head-Screen distance=25-48 inches(min 12 ``) from the VDT users eye*Optimal viewing angle is 20 degrees below the horizontal line from the eyes

WORKING POSTURE


74


*NO GLAIR*VDT to be placed 90 degrees to the light source, adjust screen angle *Use screen filters to reduce glare*Screen intensity needs to be adjusted*Frequent breaks from the screen to reduce stress on eyes*Optical illusion

VISION & LIGHTING


75


*Change positions, Stretch or walk around if feeling tiredness*``LIGHT TOUCH`` on Keyboard to reduce hand stress or developing CTD`s (cumulative trauma disorders)*Look at ``Optical Illusion`` for 1-2 minutes after every 20 minutes of work with vdt to reduce eye stress*Rotate eye ball and also concentrate on a distant object & near object alternatively to reduce eye stress*Keep the vdt screen and eyeglasses clean

GENERAL GUIDELINES



76

77

THANK YOU!
