Occupational health overview
By
Dr.Ashok laddha
•MBBS, PGDC ,PGDD,

PGDEM, AFIH
•Diploma in Workplace
Health and safety.
M...
Content
 History

 Chemical hazard

 Overview

 Biological hazard

 Definition

 Physical hazard

 Objectives

 Er...
History-Ramazani-18th Century
 Father of OCCUPATIONAL Medicine
 Publish first systematic account on

occupational Diseas...
Hippocrates (470 to 410 B.C.)
 Greek physician
 Father of Medicine (Hippocratic oath)
 Believed in rest, good diet, exe...
The godfather of Occupational Diseases
 “When you come to a patient’s house, you should
ask him what sort of pains he has...
Pliny the Elder (23 – 79 A.D.)
 Roman senator, writer and scientist
 Dangers related to zinc and sulfur

 First to reco...
Georgius Agricola (1494-1555)
 Wrote De Re Metallica – mining, smelting

and refining
 Need for ventilation and fresh ai...
Paracelsus

(1493-1591)

 All substances are poisons; there is none

which is not a poison. The right dose
differentiates...
Bernardino Ramazzini (1633-1714)
 Wrote Diseases of Workers
 Urged physicians to ask “Of what trade are you?”

as part o...
Percival Pott (1713-1788)
 Identified relationship between an

occupation (chimney sweep), a toxin (polyaromatic hydrocar...
Alice Hamilton
 Champion of social responsibility
 Investigated the cause and effect of worker illness
 Interviewed wor...
Overview
 Since

1950, the International Labour
Organization (ILO) and the World Health
Organization (WHO) have shared a ...
Occupational health-definition
 Occupational health should aim at: the
promotion and maintenance of the highest
degree of...
What is Occupational Health?
Different Definitions:
F Health problems arising from or pertaining to work
F Health of peopl...
Gloomy side of Occupational Health
 No man without occupation

 No occupation without Hazards
 No treatment for occupat...
Rosy Truth

 Occupational Disease can

be prevented
Occupational Health Challenges
 Medical surveillance
 Reporting

 Data collection
 Communication
 ROI
Occupational Health
 Work

------------- Health
(occupational disease/work related ill health)
 Health =============

(m...
What is it?
 Occupational health is:
 Part of public health

 Assuring people are safe at work
 Preserving and protect...
Objectives
 The main focus in occupational health is on three different

objectives: (i) the maintenance and promotion of...
Occupational health- broad scope
 Occupational health and safety is a discipline with a

broad scope involving many speci...
Global Plan-Overview
 The present plan of action deals with all aspects
of workers’ health, including primary prevention
...
Global Plan-Objectives
 Objective 1: to devise and implement policy
instruments on workers’ health.
 Objective 2: to pro...
Burden of poor working conditions-1
 The ILO estimates that some 2.3 million women and men

around the world succumb to w...
Burden of poor working conditions-2
 Some of the major findings in the ILO’s latest

statistical data on occupational acc...
Pitfalls in OHS-Indian scenario








Occupational illness and occupational diseases are not well recognized
occu...
New challenges in OHS-Indian
scenario
 There are many factors, which are changing








the industrial environme...
OCCUPATIONAL HAZARDS
 Physical Hazards
 Chemical Hazards
 Biological Hazards
 Mechanical Hazards

 Psychosocial Hazar...
Hazard and Risk
 Hazard:

potentially harmful

 Risk:
probability of harm
(quantifiable as risk assessment)
Occupational Risk Factors
 Chemical risk factors: 100,000






(Carcinogens:400)
Biological agents: 200
Physical fac...
ROUTE OF EXPOSURE
 Ingestion
 Inhalation

 Absorption
Biological Hazards


There are two main groups of biological agents regarded as occupational
hazards:



allergenic and/...
Biological Hazards
 The group of agents causing other, basically not

vector-borne zoonoses, comprises those evoking
emer...
Biological Hazards
 Anthrax
 Histoplasmosis
 AIDS
 Hepatitis-B
 Rabies
 Leptspirosis
 Legionnaire's Disease
 Lyme ...
Diseases due to Physical Agents
 Heat - Heat stroke, Burns
 Cold - Frost bite

 Light - Miners Nystagmus, Cataract
 Pr...
Physical Hazards & disease
 Hearing impairment caused by noise
 Diseases caused by vibration (disorders of
muscles, tend...
Chemical Hazard Definitions
 Toxic/Poison – A substance that can lead to death

if inhaled, ingested, or absorbed by the ...
Chemical Hazard
Chemical Agents
 Gases - CO, CO2, HCN, H2S,CS2
 Dusts - Pneumoconiosis
 Metals - Lead, Mercury, Chromium,

Manganese
 ...
Chemical hazard
 Skin Irritation
 Eye Irritation
 Inhalation Effects
 Ingestion Effects
 Carcinogenicity

 Mutagenec...
3. CHEMICAL HAZARDS










Chemical hazards may be described under three broad headings - flammability,
reactivi...
Chemical HEALTH effect
 Irritants: Inflame skin tissue on contact.
 Corrosives: Destroy skin tissue at point of




...
Hazard Class
 Explosive-Black power, Nitroglycerine
 Non flammable & flammable gases





Cl2,Ammonia,Ethylene oxid...
Flammable liquids
 Liquids with flash point below 23 degree c. — Petrol,

Acetone
 Liquids with flash point above 23 but...
Target ORGAN- Hepatotoxins
 Chemicals which produce liver damage
 Signs and Symptoms: Jaundice, liver

enlargement
 Che...
Nephrotoxins
 Chemicals which produce kidney damage
 Signs and Symptoms: Edema
 Chemicals: Halogenated Hydrocarbons,

u...
Neurotoxins
 Chemicals which produce their primary

toxic effects on the nervous system
 Signs and Symptoms: Narcosis,

...
Agents which act on the blood
 Decrease hemoglobin function, deprive

the body tissues of oxygen
 Signs and Symptoms: Cy...
Agents which damage the lungs

 Chemicals which damage pulmonary

tissue
 Signs and Symptoms: Cough, tightness in

the c...
Reproductive toxins
 Chemicals which damage reproductive

capabilities
 Includes chromosomal damage (mutations)

and dam...
Cutaneous hazards
 Chemicals which effect the dermal

layer of the body
 Signs and Symptoms: Defatting of

the skin, ras...
Eye hazards
 Chemicals which affect the eye or visual

capacity
 Signs and symptoms: Conjunctivitis,
corneal damage, blu...
Hazard Prevention
 Medical control

 Engineering
 Legislative/Administrative
 Ergonomics
Occupational- Ill Health

 People are made sick by the

work they do
 Dr. Craig Jackson,Prof of

Occupational Health
Psy...
History of Occupational illness

Illness


Stone-age was first age of occupational risk



Iron-age and smelting worsene...
Work Related Ill-Health in the
Globe


33 Million days lost per year



Males lose more working days than females



Da...
Occupational Diseases-Fact
 Long latent period

 No treatment
 All Occupational diseases can be prevented
occupational disease
 An occupational disease is a disease or disorder
that is caused by the work or working conditions.
...
Occupational Disease
 Occupational diseases

are diseases caused by work or work environment
 Work-related diseases
are ...
Occupational Disease
 Occupational Disease occur as a result of

exposure to physical, chemical, biological or
psychosoci...
Four Types
Diseases only occupational in origin
(pneumoconiosis)

Where occupation as one of the causal factors
(bronchoge...
Preventive Measures
Universal Precautions
Training & Education
Medical Surveillance
Immunization
Identify, Monitor & Contr...
Medical measures










First –aid
Early diagnosis
Prompt treatment
Health survey
Education an training
Medica...
Medical examination
 Pre-employment
 Pre-placement

 Periodic
 Pre-retirement
 Executive

 Special medical examinati...
LIST OF OCCUPATIONAL DISEASES
(ILO)
1. Diseases caused by agents
1.1. Diseases caused by chemical agents
1.2. Diseases cau...
Recent Work related illness staticsGLOBAL OVERVIEW
 In 2011/12, around 27.0 million working days were lost in total,


...
work related diseases
 WHO categories work related diseases as “

multifactorial” in origin
 There are diseases in which...
Differences between Occupational Disease and
Work Related Diseases
Work Related Diseases

Occupational Disease

Occurs lar...
Occupational Health/Therapy
Occupational Medicine/Health
a branch of medicine concerned with the
interaction between healt...
Goals Of Ergonomics
 Improve quality of working environment

engineered to the capabilities of the human
body
 Increase ...
Ergonomics
 Ergonomics derives from two Greek words:

ergon, meaning work, and nomoi, meaning
natural laws, to create a w...
ergonomics
The IEA divides ergonomics broadly into three domains:
 Physical ergonomics: working postures, materials handl...
A Model Framework for Assessment of Medical
Fitness for Work
Person
•Relevant medical history
•Functional capacity (physic...
International Labor Standards on Occupational safety and
health

 The ILO Constitution sets forth the principle

that wor...
International Labor Standards on Occupational safety and
health

 The list of International Labour Organization
Conventio...
The hidden epidemic: a global picture
 Emerging risks and new challenges
 Traditional risks (e.g., asbestos exposure) co...
The hidden epidemic: a global picture

 Psychosocial risks and work

related stress
have emerged as matters of great conc...
Steps for the prevention of occupational
diseases
 build capacity for recognition








and reporting of occupati...
Steps for the prevention of occupational
diseases
 The role of employers and workers
 The active participation of employ...
Advantage of
“Commit to your health”

 Return of investment
 Reduction in medical cost
 Reduction in absenteeism
 Redu...
Take Home message
 Top Management commitment
 Union and employee involvement

 Provision of safe environment
 Applicat...
Question-1
 Give the names of the two chemical hazards.
 write your answer in given box
Question-2
 What name is given to a chemical which

will burst into flame when contacted by
air? write your answer in giv...
Question-3
 What term is given to chemicals which can

cause and /or support fire in other
materials? write your answer i...
Question-4
 What is a health hazard?
 write your answer in given box
Question-5
 Which kind of health hazard destroys skin on
contact? write your answer in given box
Question-6
 What is a carcinogen? write your answer in

given box
Question-7
 Give the three states in which a chemical can
exist. write your answer in given box
Question-8
 What is risk? write your answer in given box
Question-9
 Give the three ways employees can be





exposed to health hazards.
Ingestion
Inhalation
Absorption
None...
Question-10
 What are the most common skin contact
hazards? write your answer in given box
Question-11
 What is the advantage of commit to health
 Return of investment
 Reduction in medical cost
 Reduction in ...
Question-12
 Who is the father of occupational medicine?
 Ramazani

 Hippocrates
 Georgius Agricola
 Paracelsus
Question-13
 True or False, Occupational diseases can be

prevented?
 True
 False
Question-14
 What is occupational health?
F

F
F
F

F

Health problems arising from or pertaining
to work
Health of peopl...
Question-15
 Which are the main objectives of








occupational health?
The maintenance and promotion of workers’
...
Question-16
 True or False, Worldwide, there are around

340 million occupational accidents and 160
million victims of wo...
Questin-17
 Choose correct answer---Occupational Risk

Factors are








Chemical
Biological agents
Physical fac...
Question-18
 Chemical Hazards---Choose two
 Co

 Mercury
 Heat
 Vibration
Question-19
 Nitroglycerine is example of which chemical







Hazard class?
Oxidizing
Corrosive
Chemical Gases
Expl...
Question-20
 Kerosene is the Liquid with flash point

above 23 but below 65 degree c
 True
 False
Question-21
 Choose correct answer—Target organ







hepatotoxin is
Halogenated Hydrocarbons,
uranium
Carbon Tetrac...
Questin-22
 True or False—Occupation disease has long

latent period and have no treatment.
 True
 False
Question-23
 (pneumoconiosis) -Diseases only occupational in
origin

 True
 False
Question-24
 True or False-In 2011/12, around 27.0 million

working days were lost in total, due to workrelated illness a...
Question -26
 Goals of ergonomics?
 Improve quality of working environment

 Increase efficiency and productivity by re...
Question-27
 Which approach is the best in occupational

health?
 Reactive
 Pro-active
Question-28
 Choose correct , Occupational Safety and







Health Convention, 1981
155
261
170
281
Question-29
 True or False,Pliny the Elder -- First to

recommend animal bladder as respiratory
protection
 True
 False
Question-30
 True or False.Alice Hamilton is the founder of

industrial hygiene
 True
 False
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occupational health overview

  1. 1. Occupational health overview By Dr.Ashok laddha •MBBS, PGDC ,PGDD, PGDEM, AFIH •Diploma in Workplace Health and safety. MBA-HA(In –Progress)
  2. 2. Content  History  Chemical hazard  Overview  Biological hazard  Definition  Physical hazard  Objectives  Ergonomics  Occupational illness  Burden of occupation health  Occupational Disease  Occupational hazards  Hidden epidemic global picture  Prevention
  3. 3. History-Ramazani-18th Century  Father of OCCUPATIONAL Medicine  Publish first systematic account on occupational Diseases-De Morbis Artificum/Disease and occupation  Emphasize Obtaining Occupational History  Introduce the practice of Doctors visit at workplace
  4. 4. Hippocrates (470 to 410 B.C.)  Greek physician  Father of Medicine (Hippocratic oath)  Believed in rest, good diet, exercise and cleanliness  Observed lead poisoning among miners
  5. 5. The godfather of Occupational Diseases  “When you come to a patient’s house, you should ask him what sort of pains he has, what caused them, how many days he has been ill, whether the bowels are working and what sort of food he eats. So says Hippocrates.  I may venture to add one more question: what occupation does he follow? ”  Bernard Ramazinni (16331714)
  6. 6. Pliny the Elder (23 – 79 A.D.)  Roman senator, writer and scientist  Dangers related to zinc and sulfur  First to recommend respiratory protection  Miners should cover their mouths with an animal bladder
  7. 7. Georgius Agricola (1494-1555)  Wrote De Re Metallica – mining, smelting and refining  Need for ventilation and fresh air in mines  Environmental contamination  Management techniques (shift work)  Ergonomics, mechanical lift processes  Butter is antidote for lead toxicity  Goat’s bladder is used as respiratory protection
  8. 8. Paracelsus (1493-1591)  All substances are poisons; there is none which is not a poison. The right dose differentiates a poison and a remedy." Von der Besucht, Paracelsus, 1567  Father of Toxicology  Established concepts of acute and chronic toxicity
  9. 9. Bernardino Ramazzini (1633-1714)  Wrote Diseases of Workers  Urged physicians to ask “Of what trade are you?” as part of medical evaluation  Related occupational diseases to handling of harmful materials or unnatural movements of the body  Father of Occupational Medicine
  10. 10. Percival Pott (1713-1788)  Identified relationship between an occupation (chimney sweep), a toxin (polyaromatic hydrocarbons) and malignancy (testicular cancer).
  11. 11. Alice Hamilton  Champion of social responsibility  Investigated the cause and effect of worker illness  Interviewed workers in their homes and at their     dangerous jobs Reviewed the evaluation and control of industrial hazards such as lead and silica Founder of Industrial Hygiene Wrote Exploring the Dangerous Trades First woman named to Harvard Medical School staff
  12. 12. Overview  Since 1950, the International Labour Organization (ILO) and the World Health Organization (WHO) have shared a common definition of occupational health. It was adopted by the Joint ILO/WHO Committee on Occupational Health at its first session in 1950 and revised at its twelfth session in 1995. The definition reads:
  13. 13. Occupational health-definition  Occupational health should aim at: the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection 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 physiological and psychological capabilities; and, to summarize, the adaptation of work to man and of each man to his job.
  14. 14. What is Occupational Health? Different Definitions: F Health problems arising from or pertaining to work F Health of people at work F The Health of the gainfully employed F Relationship between Occupation (work) & Health
  15. 15. Gloomy side of Occupational Health  No man without occupation  No occupation without Hazards  No treatment for occupational disease
  16. 16. Rosy Truth  Occupational Disease can be prevented
  17. 17. Occupational Health Challenges  Medical surveillance  Reporting  Data collection  Communication  ROI
  18. 18. Occupational Health  Work ------------- Health (occupational disease/work related ill health)  Health ============= (medical fitness for work Work
  19. 19. What is it?  Occupational health is:  Part of public health  Assuring people are safe at work  Preserving and protecting human resources  Multidisciplinary approach to recognition, diagnosis, treatment and prevention and control of work-related diseases, injuries and other conditions
  20. 20. Objectives  The main focus in occupational health is on three different objectives: (i) the maintenance and promotion of workers’ health and working capacity; (ii) the improvement of working environment and work to become conducive to safety and health and (iii) development of work organizations and working cultures in a direction which supports health and safety at work and in doing so also promotes a positive social climate and smooth operation and may enhance productivity of the undertakings. The concept of working culture is intended in this context to mean a reflection of the essential value systems adopted by the undertaking concerned. Such a culture is reflected in practice in the managerial systems, personnel policy, principles for participation, training policies and quality management of the undertaking."  —Joint ILO/WHO Committee on Occupational Health
  21. 21. Occupational health- broad scope  Occupational health and safety is a discipline with a broad scope involving many specialized fields. In its broadest sense, it should aim at:  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 adverse effects on health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of workers in an occupational environment adapted to physical and mental needs; the adaptation of work to humans.
  22. 22. Global Plan-Overview  The present plan of action deals with all aspects of workers’ health, including primary prevention of occupational hazards, protection and promotion of health at work, employment conditions, and a better response from health systems to workers’ health. It is underpinned by certain common principles.  WHO’s work on occupational health is governed by the Global Plan of Action on Workers’ Health 2008-2017, endorsed by the World Health Assembly in 2007.
  23. 23. Global Plan-Objectives  Objective 1: to devise and implement policy instruments on workers’ health.  Objective 2: to protect and promote health at the workplace  Objective 3: to improve the performance of and access to occupational health services  Objective 4: to provide and communicate evidence for action and practice  Objective 5: to incorporate workers’ health into other policies
  24. 24. Burden of poor working conditions-1  The ILO estimates that some 2.3 million women and men around the world succumb to work-related accidents or diseases every year; this corresponds to over 6000 deaths every single day. Worldwide, there are around 340 million occupational accidents and 160 million victims of workrelated illnesses annually. The ILO updates these estimates at intervals, and the updates indicate an increase of accidents and ill health.  The estimated fatal occupational accidents in the CIS countries is over 11,000 cases, compared to the 5,850 reported cases (information lacking from 2 countries). The gross underreporting of occupational accidents and diseases, including fatal accidents, is giving a false picture of the scope of the problem.
  25. 25. Burden of poor working conditions-2  Some of the major findings in the ILO’s latest statistical data on occupational accidents and diseases, and work-related deaths on a world-wide level include the following:  Diseases related to work cause the most deaths among workers. Hazardous substances alone are estimated to cause 651,279 deaths a year.  The construction industry has a disproportionately high rate of recorded accidents.  Younger and older workers are particularly vulnerable. The ageing population in developed countries means that an increasing number of older persons are working and need special consideration.
  26. 26. Pitfalls in OHS-Indian scenario        Occupational illness and occupational diseases are not well recognized occupational health is not integrated with primary health care Concentration on reactive approach Under diagnosis and under reporting of occupational diseases Large number of non organized sector Patchy law enforcement Rapid and uneven production changes have not been accompanied by the transfer of information, technology, skills, and regulatory capacity to ensure that health risks are adequately identified and controlled  Inadequate infrastructure to tackle occupational health problems like communicable diseases  complexities of occupational health related issues due to Globalization and rapid industrial growth
  27. 27. New challenges in OHS-Indian scenario  There are many factors, which are changing        the industrial environment in India, such as globalization outsourcing transfer of technologies, newer type of jobs (IT, Call Centre) change in employment patterns Large number of rural population Increased proportion of female employee
  28. 28. OCCUPATIONAL HAZARDS  Physical Hazards  Chemical Hazards  Biological Hazards  Mechanical Hazards  Psychosocial Hazards
  29. 29. Hazard and Risk  Hazard: potentially harmful  Risk: probability of harm (quantifiable as risk assessment)
  30. 30. Occupational Risk Factors  Chemical risk factors: 100,000     (Carcinogens:400) Biological agents: 200 Physical factors: 50 Adverse ergonomic conditions: 20 Allergens: 3000
  31. 31. ROUTE OF EXPOSURE  Ingestion  Inhalation  Absorption
  32. 32. Biological Hazards  There are two main groups of biological agents regarded as occupational hazards:  allergenic and/or toxic agents forming bioaerosols, and agents causing zoonoses and other infectious diseases. Bioaerosols occurring in the agricultural work environments comprise: bacteria, fungi, high molecular polymers produced by bacteria (endotoxin) or by fungi (β-glucans), low molecular secondary metabolites of fungi (mycotoxins, volatile organic compounds) and various particles of plant and animal origin.  All these agents could be a cause of allergic and/or immunotoxic occupational diseases of respiratory organ (airways inflammation, rhinitis, toxic pneumonitis, hypersensitivity pneumonitis and asthma), conjunctivitis and dermatitis in exposed workers. Very important among zoonotic agents causing occupational diseases are those causing tick-borne diseases: Lyme borreliosis, anaplasmosis,. Agricultural workers in tropical zones are exposed to mosquito bites causing malaria, the most prevalent vector-borne disease in the world.
  33. 33. Biological Hazards  The group of agents causing other, basically not vector-borne zoonoses, comprises those evoking emerging or re-emerging diseases of global concern, such as: hantaviral diseases, avian and swine influenza, Q fever, leptospiroses, staphylococcal diseases caused by the methicillin-resistant Staphylococcus aureus (MRSA) strains, and diseases caused by parasitic protozoa. Among other infectious, non-zoonotic agents, the greatest hazard for health care workers pose the blood-borne human hepatitis and immunodeficiency viruses (HBV, HCV, HIV). Of interest are also bacteria causing legionellosis in people occupationally exposed to droplet aerosols, mainly from warm water
  34. 34. Biological Hazards  Anthrax  Histoplasmosis  AIDS  Hepatitis-B  Rabies  Leptspirosis  Legionnaire's Disease  Lyme Disease  Clostridium Difficile  Toxoplasmosis
  35. 35. Diseases due to Physical Agents  Heat - Heat stroke, Burns  Cold - Frost bite  Light - Miners Nystagmus, Cataract  Pressure - Caisson disease, Air embolism
  36. 36. Physical Hazards & disease  Hearing impairment caused by noise  Diseases caused by vibration (disorders of muscles, tendons, bones, joints, peripheral Blood     vessels or peripheral nerves) Diseases caused by compressed or decompressed air Diseases caused by ionizing radiations Diseases caused by optical (ultraviolet, visible light, infrared) radiations including laser Diseases caused by exposure to extreme temperatures
  37. 37. Chemical Hazard Definitions  Toxic/Poison – A substance that can lead to death if inhaled, ingested, or absorbed by the skin.  Corrosive – A substance that can destroy or burn living tissue and can eat away at other materials.  Irritant - A substance that causes inflammation upon contact with skin or mucous membranes.  Environmental - Substances that are harmful to the environment. They must be disposed of properly, not washed down the drain.
  38. 38. Chemical Hazard
  39. 39. Chemical Agents  Gases - CO, CO2, HCN, H2S,CS2  Dusts - Pneumoconiosis  Metals - Lead, Mercury, Chromium, Manganese  Chemicals - Acids, Alkalies  Solvents - Benzene, Trichloroethylene
  40. 40. Chemical hazard  Skin Irritation  Eye Irritation  Inhalation Effects  Ingestion Effects  Carcinogenicity  Mutagenecity
  41. 41. 3. CHEMICAL HAZARDS        Chemical hazards may be described under three broad headings - flammability, reactivity and health. Flammability Flammable substances are those that readily catch fire and burn in air. A flammable liquid does not itself burn; it is the vapors from the liquid that burn. For a liquid, the flash point, auto-ignition temperature, explosive limits, vapor density and ability to accumulate an electrostatic charge are important factors in determining the degree of fire hazard. Reactivity Reactive chemical hazards invariably involve the release of energy (heat) in relatively high quantities or at a rapid rate. If the heat evolved in a reaction is not dissipated, the reaction rate can increase until an explosion results. Some chemicals decompose rapidly when heated. Light or mechanical shock can also initiate explosive reactions. Some compounds are inherently unstable and can detonate under certain conditions of pressure and temperature, while others react violently with water or when exposed to air. Health Contact with many chemicals can result in adverse health effects. The nature and magnitude of toxic effects will depend on many factors including the nature of the substance, route of exposure, magnitude of the dose, duration of exposure, and individual susceptibility.
  42. 42. Chemical HEALTH effect  Irritants: Inflame skin tissue on contact.  Corrosives: Destroy skin tissue at point of     contact. Sensitizers: Cause allergic reactions. Target-Organ Chemicals: Damage specific body organs and systems. Reproductive Hazards: Change genetic information in egg or sperm cells and/or damage fetus after conception. Carcinogens: Cause cancer.
  43. 43. Hazard Class  Explosive-Black power, Nitroglycerine  Non flammable & flammable gases     Cl2,Ammonia,Ethylene oxide Flammable liquids-Petroleum class-A,B,C Combustible solids- Naphthalene, Sulpher, Sodium nitrite Oxidizing---Potassium chlorate, Sodium nitrite Corrosive— Acid. Alkali, oleum Chemical Gases---Phosgene
  44. 44. Flammable liquids  Liquids with flash point below 23 degree c. — Petrol, Acetone  Liquids with flash point above 23 but below 65 degree c-- --- Kerosene  Liquids with flash point above 65 but below 93 degree c-- --- Furnace oil
  45. 45. Target ORGAN- Hepatotoxins  Chemicals which produce liver damage  Signs and Symptoms: Jaundice, liver enlargement  Chemicals: Carbon Tetrachloride, nitrosamines
  46. 46. Nephrotoxins  Chemicals which produce kidney damage  Signs and Symptoms: Edema  Chemicals: Halogenated Hydrocarbons, uranium
  47. 47. Neurotoxins  Chemicals which produce their primary toxic effects on the nervous system  Signs and Symptoms: Narcosis, behavioral changes, decreased motor function  Chemicals: Mercury, carbon disulfide, lead
  48. 48. Agents which act on the blood  Decrease hemoglobin function, deprive the body tissues of oxygen  Signs and Symptoms: Cyanosis, loss of consciousness  Chemicals: Carbon monoxide, cyanides
  49. 49. Agents which damage the lungs  Chemicals which damage pulmonary tissue  Signs and Symptoms: Cough, tightness in the chest, loss of breath  Chemicals: Asbestos, silica
  50. 50. Reproductive toxins  Chemicals which damage reproductive capabilities  Includes chromosomal damage (mutations) and damage to fetuses (teratogenesis)  Signs and Symptoms: Birth defects, sterility  Chemicals: Lead
  51. 51. Cutaneous hazards  Chemicals which effect the dermal layer of the body  Signs and Symptoms: Defatting of the skin, rashes, irritation  Chemicals: Ketones, chlorinated compounds
  52. 52. Eye hazards  Chemicals which affect the eye or visual capacity  Signs and symptoms: Conjunctivitis, corneal damage, blurred vision, burning or irritation  Chemicals: Solvents, corrosives
  53. 53. Hazard Prevention  Medical control  Engineering  Legislative/Administrative  Ergonomics
  54. 54. Occupational- Ill Health  People are made sick by the work they do  Dr. Craig Jackson,Prof of Occupational Health Psychology
  55. 55. History of Occupational illness Illness  Stone-age was first age of occupational risk  Iron-age and smelting worsened this  Mining in Egyptian period: worse job going  Bernardino Ramazzini (1633-1714). DeMorbis Artificium  Industrial Revolution UK.  Factory Act. 1802
  56. 56. Work Related Ill-Health in the Globe  33 Million days lost per year  Males lose more working days than females  Days lost increase with age  Low managerial / professionals had highest rate of absence  Most sickly occupations are health & social welfare, construction, teaching, and research 
  57. 57. Occupational Diseases-Fact  Long latent period  No treatment  All Occupational diseases can be prevented
  58. 58. occupational disease  An occupational disease is a disease or disorder that is caused by the work or working conditions.  This means that the disease must have developed due to exposures in the workplace and that the correlation between the exposures and the disease is well known in medical research  A disease resulting from exposure during employment to conditions or substances that are detrimental to health (such as black lung disease contracted by miners).
  59. 59. Occupational Disease  Occupational diseases are diseases caused by work or work environment  Work-related diseases are diseases initiated, hampered or easy to get by work  The ILO Employment Injury Benefits Recommendation, defines occupational diseases as following terms: “Each Member should, under prescribed conditions, regard diseases known to arise out of the exposure to substances and dangerous conditions in processes, trades or occupations as occupational diseases
  60. 60. Occupational Disease  Occupational Disease occur as a result of exposure to physical, chemical, biological or psychosocial factors in the workplace.  These factors in the work environment are predominant and essential in the causation of occupational disease exp. Lead in the workplace  essensial for lead poisoning Silica  silicosis
  61. 61. Four Types Diseases only occupational in origin (pneumoconiosis) Where occupation as one of the causal factors (bronchogenic carcinoma) Occupation as A contributory factor (chronic bronchitis) Occupation aggravating pre-existing condition (asthma)
  62. 62. Preventive Measures Universal Precautions Training & Education Medical Surveillance Immunization Identify, Monitor & Control exposures Stress Management Violence Prevention Program
  63. 63. Medical measures          First –aid Early diagnosis Prompt treatment Health survey Education an training Medical examination Health promotion Risk assessment Specific protection
  64. 64. Medical examination  Pre-employment  Pre-placement  Periodic  Pre-retirement  Executive  Special medical examination /and or  Medical examination of employees working in hazardous area
  65. 65. LIST OF OCCUPATIONAL DISEASES (ILO) 1. Diseases caused by agents 1.1. Diseases caused by chemical agents 1.2. Diseases caused by physical agents 1.3. Diseases caused by biological agents 2. Diseases by target organ systems 2.1. Occupational respiratory diseases 2.2. Occupational skin diseases 2.3. Occupational musculo-skeletal disorders 3. Occupational cancer 3.1. Cancer caused by the following agents 4. Other diseases 4.1. Miners' nystagmus
  66. 66. Recent Work related illness staticsGLOBAL OVERVIEW  In 2011/12, around 27.0 million working days were lost in total,      22.7 million due to work-related illness and 4.3 million due to workplace injuries. On average, each person suffering took around 17 days off work, 21 days for ill health and 7.3 days for injuries on average. A more recent estimate for injuries indicates that 5.2 million days were lost in 2012/13 (no data is available for ill health), on average 8.1 days per injury. The number of working days lost has fallen over the past decade. Stress, depression or anxiety and musculoskeletal disorders accounted for the majority of days lost due to work-related ill health, 10.4 and 7.5 million days respectively. The average days lost per case for stress, depression or anxiety (24 days) was higher than for musculoskeletal disorders (17 days).
  67. 67. work related diseases  WHO categories work related diseases as “ multifactorial” in origin  There are diseases in which workplace factors may be associated in their occurrence but need not be a risk factor in each case.  Work related diseases occur much more frequently than occupational disaese.  They are caused by interaction of several extrinsic risk fact
  68. 68. Differences between Occupational Disease and Work Related Diseases Work Related Diseases Occupational Disease Occurs largely in the community Occurs mainly among working population Multifactorial in origin Cause specific Exposure at workplace may be a factor Exposure at workplace is essential May be notifiable and compensable Notifiable and compensable
  69. 69. Occupational Health/Therapy Occupational Medicine/Health a branch of medicine concerned with the interaction between health and work (“occupation”) Occupational Therapy assessment & treatment to enable maximum independent function in daily living, using purposeful activity (“occupation ”)
  70. 70. Goals Of Ergonomics  Improve quality of working environment engineered to the capabilities of the human body  Increase efficiency and productivity by reducing fatigue.  Prevention of Occupational injury & illness.  Work quality improvement.  Proactive Ergonomics Vs  Reactive Ergonomics
  71. 71. Ergonomics  Ergonomics derives from two Greek words: ergon, meaning work, and nomoi, meaning natural laws, to create a word that means the science of work and a person’s relationship to that work.  At its simplest definition ergonomics literally means the science of work. So ergonomists, i.e. the practitioners of ergonomics, study work, how work is done and how to work better.
  72. 72. ergonomics The IEA divides ergonomics broadly into three domains:  Physical ergonomics: working postures, materials handling, repetitive movements, work related musculoskeletal disorders, workplace layout, safety and health.  Cognitive ergonomics : mental workload, decision-making, skilled performance, human-computer interaction, human reliability, work stress and training as these may relate to human-system design.  Organizational ergonomics: communication, crew resource management, work design, design of working times, teamwork, community ergonomics, cooperative work, new work programs, virtual organizations, telework, and quality management.
  73. 73. A Model Framework for Assessment of Medical Fitness for Work Person •Relevant medical history •Functional capacity (physical/psychological) Risks •Employee •Employer •Colleagues •3rd parties (customers/service users/public) Fitness for Work Job •Demands/requirements •Safety critical work •Hours, travel etc
  74. 74. International Labor Standards on Occupational safety and health  The ILO Constitution sets forth the principle that workers should be protected from sickness, disease and injury arising from their employment
  75. 75. International Labor Standards on Occupational safety and health  The list of International Labour Organization Conventions totals 190 laws which aim to improve the labour standards of people around     the world. Occupational Safety and Health Convention, 1981 (No. 155) – Occupational Health Services Convention, 1985 (No. 161) – Promotional Framework for Occupational Safety and Health Convention, 2006 (No. 187) Chemicals Convention, 1990 C170
  76. 76. The hidden epidemic: a global picture  Emerging risks and new challenges  Traditional risks (e.g., asbestos exposure) continue to take a heavy toll on workers’ health  Technological, social and organizational changes in the workplace due to rapid globalization have been accompanied by emerging risks and new challenges  New forms of occupational diseases, such as musculoskeletal and mental health disorders are increasing without adequate preventive, protective and control measures
  77. 77. The hidden epidemic: a global picture  Psychosocial risks and work related stress have emerged as matters of great concern  Stress has been linked to musculoskeletal, cardiovascular and digestive disorders  Workers may turn to unhealthy behaviors' (e.g., alcohol and drug abuse) in an attempt to cope with work related stress  The economic crisis has led to an increase in stress, anxiety, depression and other mental disorders, even bringing people to the extreme of suicide
  78. 78. Steps for the prevention of occupational diseases  build capacity for recognition       and reporting of occupational diseases and establish the related legislative framework Improve mechanisms for collection and analysis of occupational disease’s data improve collaboration of OSH and social security institutions to strengthen employment compensation schemes integrate the prevention of occupational diseases into OSH inspection programmers improve capacity of occupational health services for health surveillance and monitoring of the working environment update national lists of occupational disease using the ILO list as a reference reinforce social dialogue among governments, employers and workers and their organization
  79. 79. Steps for the prevention of occupational diseases  The role of employers and workers  The active participation of employers ’ and workers’ organizations is vital for the development of national policies aimed at preventing occupational diseases  • Employers have a duty to prevent occupational diseases by taking precautionary measures through the assessment and control of occupational hazards and risks, and health surveillance  • Workers have a right to be involved in formulating, supervising and implementing prevention policies and programmes
  80. 80. Advantage of “Commit to your health”  Return of investment  Reduction in medical cost  Reduction in absenteeism  Reduction in com.  Reduction in presenteeism etc
  81. 81. Take Home message  Top Management commitment  Union and employee involvement  Provision of safe environment  Application of safe act  All around Proactive approach  Avoid reactive approach  Transforming a Traditional Occupational Health Center
  82. 82. Question-1  Give the names of the two chemical hazards.  write your answer in given box
  83. 83. Question-2  What name is given to a chemical which will burst into flame when contacted by air? write your answer in given box
  84. 84. Question-3  What term is given to chemicals which can cause and /or support fire in other materials? write your answer in given box
  85. 85. Question-4  What is a health hazard?  write your answer in given box
  86. 86. Question-5  Which kind of health hazard destroys skin on contact? write your answer in given box
  87. 87. Question-6  What is a carcinogen? write your answer in given box
  88. 88. Question-7  Give the three states in which a chemical can exist. write your answer in given box
  89. 89. Question-8  What is risk? write your answer in given box
  90. 90. Question-9  Give the three ways employees can be     exposed to health hazards. Ingestion Inhalation Absorption None of the above
  91. 91. Question-10  What are the most common skin contact hazards? write your answer in given box
  92. 92. Question-11  What is the advantage of commit to health  Return of investment  Reduction in medical cost  Reduction in absenteeism  Reduction in presenteeism etc  All of the above
  93. 93. Question-12  Who is the father of occupational medicine?  Ramazani  Hippocrates  Georgius Agricola  Paracelsus
  94. 94. Question-13  True or False, Occupational diseases can be prevented?  True  False
  95. 95. Question-14  What is occupational health? F F F F F Health problems arising from or pertaining to work Health of people at work The Health of the gainfully employed Relationship between Occupation (work) & Health All of the above
  96. 96. Question-15  Which are the main objectives of     occupational health? The maintenance and promotion of workers’ health and working capacity; The improvement of working environment development of work organizations and working cultures in a direction which supports health and safety at work All of the above
  97. 97. Question-16  True or False, Worldwide, there are around 340 million occupational accidents and 160 million victims of work-related illnesses annually.  True  False
  98. 98. Questin-17  Choose correct answer---Occupational Risk Factors are        Chemical Biological agents Physical factors Adverse ergonomic conditions Allergens Carcinogens All of the above
  99. 99. Question-18  Chemical Hazards---Choose two  Co  Mercury  Heat  Vibration
  100. 100. Question-19  Nitroglycerine is example of which chemical     Hazard class? Oxidizing Corrosive Chemical Gases Explosive
  101. 101. Question-20  Kerosene is the Liquid with flash point above 23 but below 65 degree c  True  False
  102. 102. Question-21  Choose correct answer—Target organ     hepatotoxin is Halogenated Hydrocarbons, uranium Carbon Tetrachloride Asbestos
  103. 103. Questin-22  True or False—Occupation disease has long latent period and have no treatment.  True  False
  104. 104. Question-23  (pneumoconiosis) -Diseases only occupational in origin  True  False
  105. 105. Question-24  True or False-In 2011/12, around 27.0 million working days were lost in total, due to workrelated illness and 4.3 million due to workplace injuries.  True  False
  106. 106. Question -26  Goals of ergonomics?  Improve quality of working environment  Increase efficiency and productivity by reducing fatigue.  Prevention of Occupational injury & illness.  Work quality improvement.  All of the above
  107. 107. Question-27  Which approach is the best in occupational health?  Reactive  Pro-active
  108. 108. Question-28  Choose correct , Occupational Safety and     Health Convention, 1981 155 261 170 281
  109. 109. Question-29  True or False,Pliny the Elder -- First to recommend animal bladder as respiratory protection  True  False
  110. 110. Question-30  True or False.Alice Hamilton is the founder of industrial hygiene  True  False

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