Occupational health

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  • 1. OCCUPATIONAL HEALTH Dr.Siva.P.M Junior Resident Community medicine Copyright © Wondershare Software
  • 2. INTRODUCTION• Occupational health : – promotion and maintenance of highest degree of physical, mental and social well being of workers – All three levels of prevention – Adaptation of work to man and vice versa Copyright © Wondershare Software
  • 3. Ergonomics – ergon – work ; nomos – law • Fitting job to the worker • Objective – achieve mutual adjustment of man and his work for improvement of human efficiency and well being • To reduce industrial accidents and increase efficiency of workers Copyright © Wondershare Software
  • 4. • Occupational environment • Sum of external conditions and influences –prevail at the place of work –bearing on health of workers • 3 interactions – Man and agents(Physical, Chemical, Biological) – Man and machine – Man and man Copyright © Wondershare Software
  • 5. • Occupational hazards 1. Physical 2. Chemical 3. Biological 4. Mechanical 5. Psychosocial Copyright © Wondershare Software
  • 6. PHYSICAL HAZARDSHeat and cold • Common physical hazard – heat • Direct effect of heat – burns, heat exhaustion, heat stroke, heat cramps • Indirect effects – decreased efficiency, increased fatigue, enhanced accident rates Copyright © Wondershare Software
  • 7. • Radiant heat – foundry, glass and steel industry• Heat stagnation – jute and textile industry• High temperature – kolar gold mines – 65degC• Corrected effective temperature > 27deg C- discomfort• Cold – chilblains, erythrocyanosis, immersion foot, frostbite Copyright © Wondershare Software
  • 8. • Light – Poor illumination – eye strain, head ache, eye pain, lacrymation, congestion – Miner’s nystagmus – chronic effects – Intense glare – blurring of vision, accidents Copyright © Wondershare Software
  • 9. • Noise – Auditory effects – hearing loss – Non auditory – nervousness, fatigue, interfere with communication – Degree of injury – intensity & frequency range, duration of exposure, susceptibility Copyright © Wondershare Software
  • 10. • Vibration – Affects hands and arms, joints – Chronic exposure – fine blood vessels- sensitive to spasm (white finger)• UV radiation – Arc welding – Affects –eyes- conjunctivitis, keratitis (Welder’s flash) Copyright © Wondershare Software
  • 11. • Ionizing radiation – X rays and radio active isotopes(cobalt 60, phosphorous 32) – Bone marrow – more sensitive – Genetic changes, malformation, cancer, leukemia, depilation, ulceration, sterilit y, death – Maximum permissible – 5 rem/year to whole body Copyright © Wondershare Software
  • 12. CHEMICAL HAZARDS• Acts in three ways – local action, inhalation, ingestion• Local action – Dermatitis, eczema, ulcer, cancer (irritant action) – Aromatic amino and nitro compounds – systemic• Inhalation – Respirable dust - <5 microns Copyright © Wondershare Software
  • 13. • Dust – organic – cotton, jute – Inorganic – silica, mica, coal, asbestos – Insoluble – retain in lung – pneumoconiosis – Soluble – eliminated by body mechanism Copyright © Wondershare Software
  • 14. • Gases – Simple – oxygen, hydrogen – Asphyxiating – CO, cyanide, sulphur dioxide, chlorine – Anesthetic – chloroform, ether• Metals and their compounds – Lead, antimony, beryllium, cadmium, cobalt, manganese, merc ury, phosphorous, chromium, zinc etc Copyright © Wondershare Software
  • 15. • Ingestion – Lead, antimony, cadmium, mercury, phosphorous, chromium, zinc etc – through – contaminated hand or food or cigarettes• Biological hazards – Brucellosis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus, enc ephalitis, fungal infections, schistosomiasis – Working among animal products Copyright © Wondershare Software
  • 16. • Mechanical hazards – Machinery, protruding and moving parts – 10% of accidents• Psychosocial hazards – Failure to adapt to an alien psychosocial environment – Frustration, lack of job satisfaction, insecurity, poor human relationship, emotional tension – affect physical and mental health Copyright © Wondershare Software
  • 17. OCCUPATIONAL DISEASES• Pneumoconiosis• Dust – 0.5 to 3 microns – health hazard- variable period of exposure – lung disease – pneumoconiosis• Hazardous effect depends on – Chemical composition – Fineness – Concentration – Health status of the person Copyright © Wondershare Software
  • 18. • Important dust diseases – silicosis – anthracosis – byssinosis – bagassosis – asbestosis – farmer’s lung• No cure – only prevention essential Copyright © Wondershare Software
  • 19. SILICOSIS (NOTIFIABLE- FACTORIES ACT 1948 AND MINES ACT 1952)• Major cause of disability and mortality• Inhalation of dust with – silica or silicon dioxide• Higher concentration – higher hazard• Incubation period – few months to 6 years• Particles – phagocytosis – accumulation – block lymph channels• Dense nodular fibrosis – 3-4mm• c/f – insidious onset – irritant cough, dyspnoea, chest pain Copyright © Wondershare Software
  • 20. • Decreased TLC – advanced disease• X ray – snow-storm appearance• Prone to PTB – silico-tuberculosis• No effective treatment• Fibrotic – cant reversed• Rigorous dust control• Regular physical examination by doctors Copyright © Wondershare Software
  • 21. ANTHRACOSIS(NOTIFIABLE-INDIAN MINES ACT 1952, COMPENSATABLE-WORKMEN’S COMPENSATION ACT 1959 • First phase – simple pneumoconiosis – ventilatory impairment – after 12year exposure – anthracite coal dust • Second phase – – progressive massive fibrosis – severe respiratory disability – premature death • Once simple pneumoconiosis – progress even without further exposure Copyright © Wondershare Software
  • 22. BYSSINOSIS• Inhalation of cotton fiber• Chronic cough – progressive dyspnoea – chronic bronchitis – emphysema• India has large textile industry – 35% of factory workers Copyright © Wondershare Software
  • 23. BAGASSOSIS• Inhalation of bagasse or sugar-cane dust• Thermophilic actinomycete – thermoactinomyces sacchari• Breathlessness, cough, haemoptysis, slight fever• Acute diffuse bronchiolitis – initial• Skiagram – mottling in lungs or shadow• Resolution of inflammation– if treated early Copyright © Wondershare Software
  • 24. • Untreated – diffuse fibrosis, emphysema, bronchiectasis• Preventive measures: – Dust control • Wet process • Enclosed apparatus • Exhaust ventilation Copyright © Wondershare Software
  • 25. – Personal protection • Masks • Mechanical filters– Medical control • Initial and periodical medical examinations– Bagasse control • Keeping moisture >20% • Spraying bagasse with 2% propionic acid- fungicide Copyright © Wondershare Software
  • 26. ASBESTOSIS• Fibrous material – commercial name• Silicates of varying composition of bases (Mg,Fe,Ca,Na,Al)• Two types – – Serpentine or chrysolite (90% production) – Amphibole • Crocidolite (blue) • Amosite (brown) • Anthrophyllite(white) Copyright © Wondershare Software
  • 27. • Inhalation – ROE• Insoluble fibers – pulmonary fibrosis – insufficiency – death• Carcinoma of bronchus (high-if add with smoking)• Mesothelioma of pleura or peritoneum(crocidolite)• Disease doesn’t appear – until 5-10 yrs of exposure Copyright © Wondershare Software
  • 28. • Irritation – fibrosis – peribronchial – diffuse –basal in location• Dyspnoea – out of proportion to clinical signs• Clubbing – cardiac distress – cyanosis• Sputum – Asbestos Bodies(fibers coated with fibrin)• X ray – ground glass appearance – lower third of lung fields Copyright © Wondershare Software
  • 29. • Preventive measures – Use of safer type asbestos – Substitution of other insulants – Rigorous dust control – Periodic examination of workers – Continuing research Copyright © Wondershare Software
  • 30. FARMER’S LUNG• Inhalation of mouldy hay grain dust• >30% moisture – favors bacteria, fungi growth – rise temperature 40-50 deg C – favors Thermophilic actinomycete• Micropolyspora faeni – main cause• Repeated attacks – pulmonary fibrosis – damage - corpulmonale Copyright © Wondershare Software
  • 31. CONCLUSION• Pneumoconiosis – one of the occupational disease – due to dust inhalation• No specific treatment• Prevention is important• Periodical examination and preplacement examination of workers also important Copyright © Wondershare Software
  • 32. Thank u…… Copyright © Wondershare Software