Indudtrial hygiene

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industrial hygiene and occupational

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  • definition,classification of factors affecting ,people contributing to ihl, tlv,role of industrial hygiene,ih and fa
  • Simple asphyxiants, ch4 co2, chemical asphyxiants co Hcn ,Specific target organ-Pb c6h6,Nervous system-TCE.Liver-VCM Ccl4
  • Indudtrial hygiene

    1. 1. INDUSTRIAL HYGIENE AND OCCUPATIONAL HEALTH
    2. 2. <ul><li>When I Asked God for Strength </li></ul><ul><li>He Gave Me Difficult Situations to Face </li></ul><ul><li>When I Asked God for Brain & Brown </li></ul><ul><li>He Gave Me Puzzles in Life to Solve </li></ul><ul><li>When I Asked God for Happiness </li></ul><ul><li>He Showed Me Some Unhappy People </li></ul><ul><li>When I Asked God for Wealth </li></ul><ul><li>He Showed Me How to Work, Hard </li></ul><ul><li>When I Asked God for Favors </li></ul><ul><li>He Showed Me Opportunities to Work Hard </li></ul><ul><li>When I Asked God for Peace </li></ul><ul><li>He Showed Me How to Help Others </li></ul><ul><li>God Gave Me Nothing I Wanted </li></ul><ul><li>He Gave Me Everything I Needed </li></ul><ul><li>- Swami Vivekananda </li></ul>
    3. 3. WHAT IS HEALTH ? <ul><li>Absence of disease </li></ul><ul><li>Harmony-being at peace with the self, the community, god and cosmos </li></ul><ul><li>The condition of being sound in body, mind or sprit especially freedom from physical disease or pain </li></ul>
    4. 4. WORLD HEALTH ORGANIZATION <ul><li>Health is a state of </li></ul><ul><li>complete </li></ul><ul><li>PHYSICAL </li></ul><ul><li>MENTAL and </li></ul><ul><li>SOCIAL </li></ul><ul><li>WELLBEING </li></ul><ul><li>and not merely an absence of disease or infirmity </li></ul>
    5. 5. AMPLIFIED <ul><li>ABILITY TO LEAD A </li></ul><ul><li>SOCIALLY AND </li></ul><ul><li>ECONOMICALLY </li></ul><ul><li>PRODUCTIVE LIFE </li></ul>
    6. 6. NEW PHILOSOPHY OF HEALTH <ul><li>Health is a fundamental human right </li></ul><ul><li>Health is the essence of productive life and not the result of ever increasing expenditure on medical care </li></ul><ul><li>Health is Inter sectoral </li></ul><ul><li>Health is an integral part of development </li></ul><ul><li>Health is central to the concept of quality of life </li></ul><ul><li>Health involves INDIVIDUAL, state, and International responsibility </li></ul><ul><li>Health and its maintenance is a major social investment </li></ul><ul><li>Health is world wide social goal </li></ul>
    7. 7. DETERMINANTS OF HEALTH <ul><li>Heredity </li></ul><ul><li>Environment </li></ul><ul><li>Internal </li></ul><ul><li>External </li></ul><ul><li>Life style </li></ul><ul><li>Socio-Economic Conditions </li></ul>
    8. 8. Heredity <ul><li>-Mental retardation </li></ul><ul><li>-Heart Problems </li></ul><ul><li>Environment </li></ul><ul><li>-Internal Tissue, Organ, Organ system </li></ul><ul><li>-External Housing ,water supply Psycho social Stress, </li></ul><ul><li>WORK ENVIRONMENT and Family Structure </li></ul>
    9. 9. LIFE STYLE <ul><li>Lack of sanitation </li></ul><ul><li>Poor Nutrition </li></ul><ul><li>Personal Hygiene </li></ul><ul><li>Elementary Human Habits </li></ul><ul><li>Culture and cultural patterns </li></ul>
    10. 10. GOODLIFE STYLE <ul><li>Adequate nutrition </li></ul><ul><li>Enough sleep </li></ul><ul><li>Sufficient physical activity </li></ul>
    11. 11. SOCIO ECONOMIC CONDITIONS <ul><li>Economic status </li></ul><ul><li>Education </li></ul><ul><li>Occupation </li></ul><ul><li>Political system </li></ul>
    12. 12. HEALTH SICKNESS SPECTRUM <ul><li> Positive health </li></ul><ul><li> Better health </li></ul><ul><li> Freedom from disease </li></ul><ul><li>--------------------------------------------------------- </li></ul><ul><li> Unrecognized sickness </li></ul><ul><li> Mild sickness </li></ul><ul><li> Severe sickness </li></ul><ul><li> Death </li></ul>
    13. 13. MENTAL HEALTH <ul><li>A Mentally Healthy Person feels right towards others </li></ul><ul><li>The balanced development of the </li></ul><ul><li>individual’s personality and emotional </li></ul><ul><li>attitudes which enables him to live </li></ul><ul><li>harmoniously with his fellow men, </li></ul><ul><li>community and social institution </li></ul>
    14. 14. PARAMETERS <ul><li>His way of living </li></ul><ul><li>Working </li></ul><ul><li>Leisure </li></ul><ul><li>Way he earns and spends his money </li></ul><ul><li>Way he sees happiness, stability and security </li></ul>
    15. 16. ACCIDENT <ul><li>Every disabling “ACCIDENT ” should be looked on NOT </li></ul><ul><li>as an unaccountable misfortune brought by FATE BUT </li></ul><ul><li>As a failure </li></ul><ul><ul><ul><ul><li>By human being </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In foresight </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In action </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In supervision </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In administration </li></ul></ul></ul></ul><ul><ul><ul><ul><li>In example </li></ul></ul></ul></ul><ul><li>The only part to effective accident prevention is </li></ul><ul><li> </li></ul><ul><ul><ul><ul><li>Knowledge </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Action based on that knowledge </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Action practiced so often </li></ul></ul></ul></ul><ul><li>Becomes a HABBIT </li></ul><ul><li>Our Aim: Safe Working </li></ul><ul><li>Our vision: Zero Incidents </li></ul>
    16. 18. INDUSTRIAL HYGIENE AND OCCUPATIONAL HEALTH <ul><ul><li>Industrial Hygiene and Health---Definition </li></ul></ul><ul><ul><li>Classification of factors Affecting Health in work Environments </li></ul></ul><ul><ul><li>People Contributing to Industrial Hygiene /Health </li></ul></ul><ul><ul><li>What is T. L. V. ? </li></ul></ul><ul><ul><li>Role of Industrial Hygiene in a Factory and it ‘s Benefits </li></ul></ul><ul><ul><li>Industrial Hygiene and the Factories Act 1948 </li></ul></ul>
    17. 19. OCCUPATIONAL / INDUSTRIAL HYGIENE <ul><li>Is defined as that science and art devoted to the recognition, evaluation and control of those environmental factors or stresses arising in or from the work place which may </li></ul><ul><li>Cause: </li></ul><ul><li>Sickness </li></ul><ul><li>Impaired Health and Wellbeing </li></ul><ul><li>Significant Discomfort </li></ul><ul><li>In-efficiency among workers or among citizens of community </li></ul>
    18. 20. CLASSSIFICATION OF ENVIRONMENTAL FACTORS AFFECTING HEALTH AT WORK PLACE <ul><li>1] Physical Agents </li></ul><ul><li>2] Chemical Agents </li></ul><ul><li>3] Biological Agents </li></ul><ul><li>4] Psycho Social Factors </li></ul>
    19. 21. Physical Agents <ul><li> Electromagnetic Radiation </li></ul><ul><li> Ionized Radiation </li></ul><ul><li> Thermal Environment [air temperature, humidity, </li></ul><ul><li>air movement ,radiant temperature ] </li></ul><ul><li> Noise and vibration </li></ul><ul><li> Atmospheric Pressure </li></ul><ul><li> Repeated motion and pressure </li></ul><ul><li> Posture </li></ul><ul><li> Illumination </li></ul>
    20. 22. CHEMICAL AGENTS <ul><li>Dust : Mechanically Generated </li></ul><ul><li>Fumes: Chemically Generated </li></ul><ul><li>Mist : Tiny Liquid Particles </li></ul><ul><li>Smoke: Product of Combustion, Organic in nature </li></ul>
    21. 23. Their Effects Depend On <ul><ul><ul><ul><li>Chemical Nature </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Particle size </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Concentration </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Duration of Exposure </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Mode of Entry </li></ul></ul></ul></ul>
    22. 24. EFFECTS OF CHEMICALS CAN BE CLASSIFIED AS <ul><li>IRRITANTS : Chlorine, Ammonia ,HCHO </li></ul><ul><li>FIBROGENIC :Coal ,Silica, Asbestos, Iron dust </li></ul><ul><li>TOXIC :H2S,Manganese,Lead,Mercury,Cadmium </li></ul><ul><li>ALLERGIC :Cutting oils, isocyanides </li></ul><ul><li>DERMATITIC :Coolants, Solvents, Thinners ,Alkalies </li></ul><ul><li>CARCINOGENIC :Benzedine, Dye intermediates, Certain antioxidants, PVC </li></ul>
    23. 25. BIOLOGICAL ENVIRONMENTS <ul><li>Bio aerosol </li></ul><ul><li>Moulds </li></ul><ul><li>Fungi </li></ul><ul><li>Spores </li></ul><ul><li>THEY MAY CAUSE </li></ul><ul><ul><ul><ul><ul><li>INFECTION : Virus, Bacteria </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Infestation : Parasites </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Allergy : Pollen grains, Cotton Dust </li></ul></ul></ul></ul></ul>
    24. 26. PSYCHO SOCIAL FACTORS <ul><ul><li>Company Policy and administration </li></ul></ul><ul><li>Supervision </li></ul><ul><li>Relationship with Superiors </li></ul><ul><li>Relationship with subordinates </li></ul><ul><li>Work conditions </li></ul><ul><li>Salary </li></ul><ul><li>Status </li></ul><ul><li>Security </li></ul>
    25. 27. EDUCATION 0F WORKERS on Personal Hygiene <ul><li>Eating and Drinking habits </li></ul><ul><li>Skin hygiene </li></ul><ul><li>Oral hygiene </li></ul><ul><li>Working cloths </li></ul><ul><li>Discouragement of offensive habits </li></ul><ul><li>Positive health instructions </li></ul><ul><li>House keeping and maintenance </li></ul>
    26. 31. CONTROL CAN BE ACHIEVED BY <ul><li>Enclosure of process </li></ul><ul><li>Making the process wet </li></ul><ul><li>Finding a harmless or less harmless substitute </li></ul><ul><li>Isolating hazardous operations </li></ul><ul><li>Changing the process </li></ul><ul><li>Providing PPE </li></ul><ul><li>Training employees </li></ul><ul><li>Proper maintenance of plant and equipment </li></ul><ul><li>Good house keeping </li></ul><ul><li>Applying preventive standards </li></ul><ul><li>Periodic inspections, tests and examinations </li></ul><ul><li>Natural/ exhaust ventilation </li></ul><ul><li>Use of barrier creams </li></ul><ul><li>Good sanitary facilities </li></ul>
    27. 32. USES OF INDUSTRIAL HYGIENE SURVEYS <ul><li>To determine the workers exposure to toxic agents </li></ul><ul><li>To check the effectiveness of technical services eg Ventilatory systems in a plating shop </li></ul><ul><li>To determine if complaints are justified </li></ul><ul><li>To check adherence to hygiene standards and norms </li></ul><ul><li>To have base line data </li></ul>
    28. 33. <ul><li>To compare the standard of working environment </li></ul><ul><li>To assess fire/explosion level of flammable /explosive substances </li></ul><ul><li>To have safe and healthy work environment </li></ul><ul><li>To find the effectiveness of a new machine process or systems </li></ul><ul><li>To protect the workers health and well being </li></ul>
    29. 34. PEOPLE CONTRIBUTING TO INDUSTRIAL HYGIENE/HEALTH/OHC <ul><li>Occupational Physician </li></ul><ul><li>Industrial Hygienist </li></ul><ul><li>Safety Officer </li></ul><ul><li>Occupational Health Nurse </li></ul>
    30. 35. T. L .V <ul><li>T L V is the time weighted average concentration to which a normal person may be exposed day after day for 7to 8 hours over a period of 40/48 hours a week without adverse effects </li></ul><ul><li>Units of TL V : mg per cubic meter--mg/m3 </li></ul><ul><li>Parts per million parts --ppm </li></ul><ul><li>1ppm =1inch in 16miles </li></ul><ul><li>1ppm =1 minute in 2 years </li></ul><ul><li>1ppm =0.0001% </li></ul><ul><li>1% =10.000ppm </li></ul>
    31. 36. NOW YOU CAN IDENTIFY <ul><li>WHAT IS THE: </li></ul><ul><li>The Agency The Environment </li></ul><ul><li>The Potential Sub Cause </li></ul><ul><li>The Potential Effect </li></ul><ul><li>The Possible preventive Action </li></ul>
    32. 37. WHAT ARE THE BENEFITS? <ul><li>You know the population index of workers </li></ul><ul><li>Exposed </li></ul><ul><li>A relative toxicity index comparing a mild toxic substance </li></ul><ul><li>An incidence index </li></ul><ul><li>Fire and explosion hazard </li></ul>
    33. 38. Example <ul><li>NOISE- IS AN </li></ul><ul><li>Annoyance </li></ul><ul><li>Interferes with working efficiency </li></ul><ul><li>Induces Stress </li></ul><ul><li>Disturb concentration </li></ul><ul><li>Hinders communication esp. warning signal </li></ul><ul><li>Damages workers hearing capacity </li></ul>
    34. 39. COMPARISON OF NOISE LEVELS <ul><li>SPL Typical environment Subjective Description </li></ul><ul><li>160 Turbo jet engine with </li></ul><ul><li>3200 kg thrust </li></ul><ul><li>140 30 meters from Intolerable noise </li></ul><ul><li>military aircraft at take off </li></ul><ul><li>130 Pneumatic chipping </li></ul><ul><li>and riveting- operators </li></ul><ul><li>table </li></ul><ul><li>120 Boiler shop, shipping </li></ul><ul><li>engine room </li></ul><ul><li>SPL dB[A] </li></ul>
    35. 40. <ul><li>110 Sheet metal shop </li></ul><ul><li>Textile weaving room </li></ul><ul><li>100 Automatic lathe shop Very noisy </li></ul><ul><li>90 Heavy lorries at 6 m </li></ul><ul><li>80 Curbside of busy street </li></ul><ul><li>60 Restaurant, Departmental </li></ul><ul><li>stores Noisy </li></ul><ul><li>50 Conversational speech </li></ul><ul><li> at 1m </li></ul><ul><li>40 Average village area </li></ul><ul><li>Quiet </li></ul><ul><li>30 Residential area Very quiet </li></ul><ul><li>20 Recording studio </li></ul>
    36. 41. NOISE CONTROL TECHNIQUES <ul><li>Engineering Control </li></ul><ul><li>Administrative Control </li></ul><ul><li>Personal Protective Equipments </li></ul><ul><li>Medical Control </li></ul>
    37. 42. ENGINEERING CONTROL <ul><li>Acoustical Insulation </li></ul><ul><li>Mufflers </li></ul><ul><li>Covers </li></ul><ul><li>Shields </li></ul><ul><li>Vibration mounts </li></ul><ul><li>Directionality ie change direction of noise away from exposure area </li></ul><ul><li>Equipment design modifications -eg low noise burner </li></ul>
    38. 43. ADMINISTRATIVE CONTROL AND P P E <ul><li>Changing Procedures or duties </li></ul><ul><li>Provide approved and suitable </li></ul><ul><li>Ear Muffs </li></ul><ul><li>Ear Plugs </li></ul>
    39. 44. MEDICAL CONTROL INCLUDES <ul><li>Pre Employment Medical examination </li></ul><ul><li>Periodic medical Examination </li></ul><ul><li>Implementing Hearing Conservation Programme </li></ul>
    40. 45. CAUSES OF RESPIRATORY HAZARDS DUE TO GASES AND VAPOURS <ul><li>Inadequate process control </li></ul><ul><li>Operation and maintenance malpractices </li></ul><ul><li>Inadequate maintenance </li></ul><ul><li>Incomplete understanding of the Process </li></ul><ul><li>Incorrect selection and/ or maintenance of respiratory protective equipments </li></ul>
    41. 46. COMPONENTS OF A RESPIRATORY PROTECTIVE SYSTEM <ul><li>Protection </li></ul><ul><li>Comfort </li></ul><ul><li>Vision </li></ul><ul><li>Speech </li></ul><ul><li>Compatibility </li></ul><ul><li>Robustness </li></ul>
    42. 47. YOU MUST KNOW <ul><li>Administrative Information </li></ul><ul><li>Synonyms and Identifiers </li></ul><ul><li>Special reference </li></ul><ul><li>Manufacturing/use information </li></ul><ul><li>Chemical safety and handling </li></ul><ul><li>Chemical and Physical properties </li></ul><ul><li>Environmental Standards and Regulations </li></ul><ul><li>Environment Fate and Exposure </li></ul><ul><li>Metabolism and pharmacokinetics </li></ul><ul><li>Animal Toxicity </li></ul><ul><li>Human Health Effects </li></ul><ul><li>Emergency Medical Treatment </li></ul>
    43. 48. BENEFITS <ul><li>You can keep the known hazards under control </li></ul><ul><li>Find causes </li></ul><ul><li>Establish Hygiene Standards </li></ul><ul><li>Decide on priorities for preventive action </li></ul><ul><li>Make the work environment ambient </li></ul><ul><li>Prevent accidents </li></ul><ul><li>Increase morale of workers </li></ul><ul><li>Law abiding people </li></ul><ul><li>Eco friendly manufacturer </li></ul><ul><li>Impressive behavioral and attitudinal changes </li></ul>
    44. 49. ECONOMIC BENEFITS <ul><li>Increased production </li></ul><ul><li>Less expenditure on curative aspect on the part of sick people </li></ul><ul><li>Less absenteeism </li></ul>
    45. 50. COMMON UNIT OPERATIONS IN A CHEMICAL FACTORY ARE <ul><li>ALKYLATION </li></ul><ul><li>AMINATION BY REDUCTION </li></ul><ul><li>AMMONOLYSIS </li></ul><ul><li>AROMATIZATION OR CYCLIZATION </li></ul><ul><li>COMBUSTION </li></ul><ul><li>DEHYDRATION </li></ul><ul><li>DEHYDROGENATION </li></ul><ul><li>HALOGENATION </li></ul><ul><li>HYDROLYSIS </li></ul><ul><li>ION EXCHANGE </li></ul>
    46. 51. <ul><li>ISOMERISATION </li></ul><ul><li>Same molecular formula with different molecular structure </li></ul><ul><li>OXIDATION </li></ul><ul><li>Electrons are removed, </li></ul><ul><li>addition of oxygen, electronegative constituents is increased </li></ul><ul><li>REDUCTION </li></ul><ul><li>Addition of electrons </li></ul>
    47. 52. CLASSIFICATION OF HAZARDS ASSOCIATED WITH UNIT OPERATIONS <ul><li>TOXICITY HAZARDS </li></ul><ul><li>ENVIRONMENTAL HAZARDS </li></ul><ul><li>FIRE AND EXPLOTION HAZARDS </li></ul><ul><li>MECHANICAL HAZARDS </li></ul><ul><li>REACTION HAZARDS </li></ul>
    48. 53. TOXICITY HAZARD <ul><li>Inhalation - Vapor ,mist or dust </li></ul><ul><li>Absorption - Skin or eyes </li></ul><ul><li>Oral -Ingestion </li></ul><ul><li>Carcinogenic </li></ul><ul><li>Mutagenic </li></ul>
    49. 54. ENVIRONMENTAL HAZARDS <ul><li>Air releases </li></ul><ul><li>Ground spills </li></ul><ul><li>Handling and disposal of waste </li></ul><ul><li>Odor problem </li></ul>
    50. 55. FIRE AND EXPLOTION HAZARDS <ul><li>Leaks of flammable materials </li></ul><ul><li>Explosive mixtures </li></ul><ul><li>Auto ignition </li></ul><ul><li>Electrical/static discharge </li></ul><ul><li>Toxicity of products </li></ul>
    51. 56. MECHANICAL HAZARDS <ul><li>Over pressurization </li></ul><ul><li>System leak </li></ul><ul><li>Rotating/moving equipments </li></ul><ul><li>Thermal burns </li></ul><ul><li>Noise generation </li></ul><ul><li>Equipment/utility failure </li></ul>
    52. 57. REACTION HAZARDS <ul><li>Failure to control exothermic reactions </li></ul><ul><li>Side reactions </li></ul><ul><li>Feed ratio or rate variation </li></ul>
    53. 58. FACTORS INVOLVING EXPOSURE EVALUATION <ul><li>Continuous or batch or intermittent </li></ul><ul><li>. Open or closed </li></ul><ul><li>. Elevated pressure/temperature </li></ul><ul><li>. Ambient pressure/temperature </li></ul><ul><li>. Controlled or uncontrolled </li></ul><ul><li>. Automated or manual </li></ul>
    54. 59. STRESS WARNING SIGNALS <ul><li>PHYSICAL SYMPTOMS </li></ul><ul><li>BEHAVIOURAL SYMPTOMS </li></ul><ul><li>EMOTIONAL SYMPTOMS </li></ul><ul><li>COGNITIVE SYMPTOMS </li></ul><ul><li>Source- The Hindu </li></ul>
    55. 60. PHYSICAL SYMPTOMS <ul><li>Head ache Back pain </li></ul><ul><li>Indigestion Tight neck, shoulders </li></ul><ul><li>Stomachaches Racing heart </li></ul><ul><li>Sweaty palms Restlessness </li></ul><ul><li>Sleep difficulties Tiredness </li></ul><ul><li>Dizziness Ringing in ears </li></ul>
    56. 61. BEHAVIOURAL SYMPTOMS <ul><li>Excess smoking Grinding of teeth at night </li></ul><ul><li>Business Overuse of alcohol </li></ul><ul><li>Compulsive gum </li></ul><ul><li>chewing Compulsive eating </li></ul><ul><li>Attitude critical of </li></ul><ul><li>others Inability to get things </li></ul>
    57. 62. EMOTIONAL SYMPTOMS <ul><li>Crying Overwhelming sense of pressure </li></ul><ul><li>Nervousness, </li></ul><ul><li>anxiety Anger </li></ul><ul><li>Boredom-no meaning </li></ul><ul><li>to things Loneliness </li></ul><ul><li>Edginess-ready </li></ul><ul><li>to explode Un happiness for no reason </li></ul><ul><li>Feeling powerless </li></ul><ul><li>to change things easily upset </li></ul>
    58. 63. COGNITIVE SYMPTOMS <ul><li>Trouble thinking clearly </li></ul><ul><li>Inability to make decisions </li></ul><ul><li>Forgetfulness </li></ul><ul><li>Thoughts of running away </li></ul><ul><li>Lack of creativity </li></ul><ul><li>Constant worry </li></ul><ul><li>Memory loss </li></ul><ul><li>Loss of sense of humor </li></ul>
    59. 64. <ul><li>1 SPEAK TO PEOPLE : </li></ul><ul><ul><ul><ul><li>There is nothing as nice as a cheerful greeting </li></ul></ul></ul></ul><ul><li>2 SMILE: </li></ul><ul><li>It takes 72 muscles to frown and only 4 muscles to smile </li></ul><ul><li>3 CALL PEOPLE BY NAME : </li></ul><ul><li>Every is pleased when you remember their name </li></ul><ul><li>4 BE FRIENDLY AND HELPFUL : </li></ul><ul><li>and others will respond in like manner </li></ul>
    60. 65. <ul><li>5 SPEAK AND ACT </li></ul><ul><ul><ul><li>As if everything you do were a genuine pleasure </li></ul></ul></ul><ul><li>6 BE GENUINELY </li></ul><ul><li>Interested in people </li></ul><ul><li>7 BE GENEROUS </li></ul><ul><li>with praise and cautious with criticism </li></ul><ul><li>8 BE CONSIDERATE </li></ul><ul><li>with the feelings of others-it will be appreciated </li></ul><ul><li>9 BE THOUGHTFUL </li></ul><ul><li>of the opinions of others, there are 3 sides to any controversy-yours, the other persons and the right one </li></ul><ul><li>10 BE WILLING </li></ul><ul><li>to give, what counts most in life is what we do for others </li></ul>
    61. 66. REMEMBER <ul><li>Important changes take place </li></ul><ul><li>Only when the people </li></ul><ul><li>Themselves </li></ul><ul><li>Become actively responsible </li></ul><ul><li>For their own and </li></ul><ul><li>Their community's health </li></ul>
    62. 67. <ul><li>WISHING YOU A SAFE, </li></ul><ul><li>HEALTHY AND HAPPY LIFE </li></ul><ul><li>Thank you </li></ul><ul><li>C. MUTHU </li></ul>
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