This document provides an overview of occupational health services. It defines key terms like occupational health, hazards, and diseases. It describes the aims of occupational health to promote worker well-being and prevent health issues from work. Various occupational hazards are outlined like physical, chemical, biological and mechanical hazards. Common occupational diseases and disorders are explained in relation to different hazards. The roles of an occupational health team and nurse are summarized.

1. OCCUPATIONAL HEALTH
(Industrial health)SERVICES
BY KUNAL SONI (Msc.N)
COMMUNITY HEALTH
NURSING

2. INTRODUCTION
• Occupational health is the health science which is related to human work,
work-place and work environment.
• Occupational health is entirely preventive medicine.
• The main objectives of occupational health is safety of workers in all
occupations from injuries and diseases and improve their health status.
• Occupational health science gives priority to the welfare of workers
Terminology:
• Occupational health
 refers to the potential risks to health and safety for those who work
outside the home
• Hazard
 something that can cause harm if not controlled.

3. Conti.
• Occupational disease
 Disease directly caused by a person‟s occupation.
DEFINITION OF OCCUPATIONAL HEALTH:
“Occupational health is the promotion & maintenance of the highest
degree of physical, mental & social wellbeing of the workers in all
occupations”
According to joint committee of WHO and ILO(1950), Occupational
health in all occupations should be:
i) care and improve the physical, mental and social well-being of workers
ii) Prevent hindrances to health including those which occur due to work place.

4. Conti.
iii) Protect the workers engaged in occupation
iv) Provide them a healthy environment
Ergonomics or human engineering:
• It is derived from Greek term-
a. Ergon means „work‟
b. Nomos means „law‟
• It simply means-
• ‘ fitting the job to the worker

5. Conti.
• Ergonomics is a well established and important aspects of occupational
health.
• The science of ergonomics deals with layout design of work places, work
environment, methods of work, designing equipment's, machines etc. with
an aim to prevent and control accidents, disabilities etc. and to improve
efficiency and well-being of workers.
• The application of science of ergonomics resulted in improvements in
working condition by detecting existing's health hazards and designing the
work place and activities according to workers, physical and psychological
abilities and requirements.

6. Conti.
Aims and objectives of occupational services
• The maintenance and promotion of workers‟ health and working capacity
• The improvement of working environment and work to become conducive
to safety and health
• 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.
—Joint ILO/WHO Committee on Occupational Health

7. OCCUPATIONAL HAZARDS
There are variety of hazards to which workers may be exposed and which may
cause various diseases. These are briefly here:
1. PHYSICAL HAZARDS
2. CHEMICAL HAZARDS
3. BIOLOGICAL HAZARDS
4. MECHANICALHAZARDS
5. PYSCHO_SOCIAL HAZARDS

8. Conti.
1. Physical Hazards :
• Heat and cold
Heat :
The workers may be exposed to high temp. either by working in the sun as farmers, road
builders in building construction or working in factories or inside rooms such as bakeries,
metal works, asbestos factory, engine room
Cold :
Many workers may be exposed to low temp. like those working in high attitudes, ice
factories, cold storages, cold laboratories
• Light: (poor light or glaring or bright light cause many problems)
• Noise:(Noise is hazard in many industries like steel, oil, textile, automobile factories
• Vibration:(occurs while working on machine like grinding, cutting, drilling, boring
machines
• Ultraviolet radiation :(sunburn also seen in road builders, sailors, shepherds and farmers)
• Ionizing radiation:(X-ray and radioactive isotopes is very hazardous)1

9. 2.Chemical hazards

10. Conti.
I)Local Action :
• Dermatitis
• Eczema
• Ulcers
• Cancer by primary irritant action
II) Inhalation :
• Dusts
• Gases
• Metals and their compounds

11. Conti.
 Dusts
• Dusts are finely divided solid particles with size ranging from
• 0.1 to 150 microns
• Dust particles larger than 10 microns settle down from the air rapidly,
• Indefinitely Particles smaller than 5 microns are directly inhaled into
the lungs and are retained there and is mainly responsible for
pneumoconiosis.

13. Conti.
Gases:
• Simple gases (e.g., oxygen, hydrogen),
• Asphyxiating gases (e.g. carbon monoxide, cyanide gas, sulphur dioxide,
chlorine)
• Anaesthetic gases (e.g., chloroform, ether, trichloroethylene).
Metals and their compounds:
Lead, antimony, arsenic, beryllium, cadmium, cobalt, manganese, mercury,
phosphorus, chromium, zinc and others

14. Conti.
III)Ingestion:
• Occupational diseases may also result from ingestion of chemical
substances such as lead, mercury, arsenic, zinc, chromium, cadmium,
phosphorus etc.

15. Conti.
3.)BIOLOGICAL HAZARDS: Causes the infection

16. Conti.
4.Mechanical hazards
• Mechanical hazards refers to mechanical agents such as unprotected machines,
their protruding moving parts, lacks of safety measures these may causes
variety of accidents which may result in partial or permanent disabilities
5.Psycho-social hazards
Factors affect health
• Frustration
• Lack of job satisfaction,
• Insecurity
• Poor human relationships,
• Emotional tension

17. Conti.
The health effects can be classified in two:
(a) Psychological and behavioral changes
(b) Psychosomatic ill health

18. OCCUPATIONAL DISEASES
Classification of occupational Diseases:
I. Classification of occupational Diseases
according to the technical report of WHO
• According to the 1975 report of WHO at Geneva, “Early recognition of
occupational Hazards‟‟ are classified into the following 4 groups
I. Such diseases which occur primarily due to occupation only.
E.g. Pneumoconiosis
II. Diseases for which occupation is one of the causes.
E.g. Bronchogenic carcinoma

19. Conti.
iii. Diseases in which occupation is a factor in
complicating the situation.
E.g. Chronic Bronchitis
IV. Diseases which become more severe due to
occupation
E.g. Bronchial Asthma

20. II) Classification according to occupational
Hazards or Factors
I)DISEASE DUE TO PHYSICALAGENT:
HEAT
The direct effects are
• Burns
• Heat exhaustion
• Heat stroke
• Heat cramps
The indirect effects are
• Decreased efficiency,
• Increased fatigue
• Enhanced accident rates.

21. Conti.
Cold:
• Chilblains
• Erythrocyanosis
• Immersion foot
• Frostbite as a result of cutaneous
• vasoconstriction.
• Hypothermia

22. Conti.
LIGHT
The acute effects of poor illumination are
• Eye strain,
• Headache,
• Eye pain,
• Lacrimation,
• Congestion around the cornea
• Eye fatigue.
• The chronic effects on health include "miner's Nystagmus"

23. Conti.
• NOISE
i) Auditory effects
• Temporary or permanent hearing loss
(ii) Non auditory effects
• Nervousness,
• Fatigue,
• Interference with communication by speech,
• Decreased efficiency

24. Conti.
VIBRATIONS:
Exposure to vibration may also produce injuries of the joints of the hands
elbows and shoulders.
Ultraviolet radiation
• Conjunctivitis
• Keratitis (welder's flash)

25. Conti.
Ionizing radiation:
The radiation hazards comprise:
•Genetic changes
•Malformation
•Cancer
•Leukaemia
•Depilation
•Ulceration
•Sterility in extreme cases death

26. II)DISEASE DUE TO CHEMICALAGENT
 Gases: (Carbon dioxide, carbon monoxide, hydrogen sulphide,
hydrochloric, ammonia, sulphur dioxide) produces gas toxicity and
respiratory diseases.
 Dust(Pneumoconiosis):
• Organic and inorganic dust(Particles of Asbestos, cotton, tobacco, coal,
silica, metal) causes many diseases
 Metals and their compounds: lead ,mercury, cadmium, manganese,
beryllium, arsenic,chromium.
 Chemicals: acids, alkalies, pesticides
 Solvents: carbon disulphide, chloroform , benzene
Causes several dosorders

27. PNEUMOCONIOSIS
• Dusts within the range of 0.5 micron to 3 micron is a health hazard
producing, after a variable period of exposure, a lung disease known as
pneumoconiosis, which may gradually cripple a man by reducing his work
capacity due to lung fibrosis and other complications .Pneumoconiosis is
the group of disorder produce by variety of dusts.
These are:
• Silicosis
• Anthracosis
• Byssinosis
• Bagassosis
• Asbestosis
• Farmers lungs

28. Silicosis
• Caused by inhalation of dust containing
free silica or silicon dioxide
• Snow storm appearance in X ray

29. Anthracosis
• It is caused by inhalation of dust containing coal miners.
• First phase is called simple pneumoconiosis which is
associated with little impairment.
• Second phase is characterized by Progressive massive fibrosis

30. Byssinosis
• Inhalation of cotton fiber dust over long periods of, time. Also called
Monday fever.
The symptoms are:
• Chronic cough
• Progressive dyspnea,
• Chronic bronchitis
• Emphysema

31. Bagassosis
• Caused by inhalation of bagasse or sugar-cane dust. It‟s a air bone
diseases.
The symptoms are:
• Breathlessness
• Cough
• Hemoptysis
Preventive measures:
• Dust control ,Personal protection
• Medical control
• Bagasse control

32. Asbestosis
• Asbestos is of two types- serpentine or chrysolite variety and
amphibole type.
Symptoms are :
• dyspnea.
• Clubbing of fingers,
• Cardiac distress and cyanosis.
• The sputum shows "asbestos bodies"
• An X-ray of the chest shows a ground-glass appearance in the lower two
thirds of the lung fields

33. Conti.
• PREVENTIVE MEASURES
• Use of safer types of asbestos (chrysolite and amosite)
• Substitution of other insulates: glass fiber, mineral wool, calcium silicate,
plastic foams, etc.
• Rigorous dust control
• Periodic examination of workers; biological monitoring (clinical, X-ray,
lung function)
Farmer's lung
• Farmer's lung is due to the inhalation of mouldy hay or grain dust

34. Occupational Cancer
• Bladder cancer: dye stuff, dyeing industries, rubber, gas and electrical
cable industry.
• Leukaemia: benzoyl, roengent rays and radioactive substance.
Preventive measures:
• Elimination or control of industrial carcinogens.
• Medical examination Inspection of factories, Notification, Licensing of
establishments,
• Personal hygiene measures,
• Education of workers and management, research.

35. Occupational Dermatitis
Causes:
• Physical
• Chemical
• Biological
• Plant products

36. Conti.
III. DISEASE DUE TO BIOLOGICALAGENT
• Brucellosis, leptospirosis, anthrax, tetanus, encephalitis, fungal infection.
IV. OCCUPATIONAL CANCER
• Cancer of the skin, lungs, bladder
V. OCCUPATIONAL DERMATOSIS
• Dermatitis, eczema
VI. DISEASE OF PSYCHOLOGICAL ORIGIN
• Industrial neurosis, hypertension, peptic ulcer.

37. MEASURES FOR HEALTH PROMOTION
OF WORKERS
Nutrition
Communicable disease control
Environmental sanitation
Mental health
Measures for women and children
Health education
Family planning
Measures to prevent occupational Diseases

38. Conti.
Nutrition
• Malnutrition is the major problem among worker.
• There need to be a canteen if the number of employees exceeds 250
• Provide diet and snacks at reasonable rates
• Dining room
Communicable disease control
• Early diagnosis and treatment.
• Isolate the cases from working environment
• Protective measures
• Immunization against specific diseases-TB, Typhoid, Hepatitis
• Anthrax, undulant fever,Q-fever diseases have occupational origin

39. Conti.
Environmental sanitation:
• Avoid common glass tumbler to drink water and install drinking water
fountains.
• Food hygiene and Education to food handlers
• Sufficient number of toilets and urinals separately for males and females.
• One sanitary convenience for 25 employees till 100;thereafter one for every
50
• General cleanliness to be maintained
• Adequate lighting
• Protection from dust, fumes, and toxic hazards
• Housing facility near to work area desirable

40. Conti.
Mental health:
• Mental health facilitates good physical health. We cannot separate mind
and body
• Promotion of health and happiness
• Detection of any signs of emotional stress
• Rehabilitation of the ill.
Measures for women and children:
• Maternity leave for 12 weeks with cash benefit under ESI Act.
• Ante/intra/postnatal services.
• Provision of crèches for children
• Prohibition of employing women and children in certain dangerous
occupation

41. Conti.
• Prohibition of night work between 6 PM and 7 AM
• Prohibition of work-underground
• No child below 14 shall be employed
Health education:
Health education is encouraged in all levels of planning to promote employees
health and to protect them from occupational hazards and other communicable
,non-communicable diseases.
Family planning:
Employees are encouraged to adopt „‟small family norm”& lead physically and
economically health family.

42. Conti.
Measures to prevent occupational Diseases:
The various measures to prevent occupational diseases are classified into-
 Medical
 Engineering
 Legislative
Medical Measures
Pre-placement examination:
• This refers to the medical examination carried out to placement in order to
place right man in right in job.
• Preplacement examination of employees will function as yardstick to make
future comparisons.

43. Conti.
Periodical Examination:
• Periodical examination will help in diagnosing the disease since
occupational disease take very slow process of development.
• Usually, the workers are examined once in a year, again it also depends
upon the kind of occupational exposure. Like as lead, toxic dyes needs
monthly examination.
Medical Health care services:
• In India, Employees State Insurance (ESI)scheme provides medical
services to the employee and his family, prompt first aid & vaccination
services rendered to protect the worker and the family
Visit to working Environment:
• Physician takes all the efforts to visit the work environment periodically.
• He Assess for adequate light, ventilation, noise level, fatigue also
SU2NJU4

44. Conti.
Engineering measures:
• Design of building
• Good housekeeping
• General ventilation
• Mechanization
• Substitution
• Dusts
• Enclosure
• Isolation
• Local Exhaust ventilation
• Protective devices

45. Conti.
Legislative measures: It may include
• The factories Act,1948
• The ESI Act,1948
• Mine and Mineral Act,(Development & Regulation act,1957)
• Noise Pollution(Regulation and control) Rules,2000
• The child Labor (Prohibition and regulation) Act,1986
• The Air (prevention and control of pollution ) Act,1981
• Maternity Benefit Act(1961)
• Minimum Wages Act(1948)

46. OCCUPATIONAL HEALTH TEAM
• Occupational nurse
• Physiotherapist
• Specialist doctor
• Industrial manager
• Supervisor
• Shift in-chare
• Rehabilitation specialist
• Labour welfare officer
• Labour union reprentative
• Reprentative of voluntary organization

47. ROLE AND FUNCTION OF
OCCUPATIONAL HEALTH NURSE
Roles of occupational health nurse:
• Nurse as a practitioner
• Health educator
• Health administrator/manager
• Counsellor
Function of occupational health nurse:
• Identify occupational dangers at work place
• Health survey and preparing programme for health improvement
• Health assessment and examination
• In times of emergency or accident providing health facilities and first aid to
workers as per the need
• Provide health education

48. • Finding out community resources for health needs of worker and company.
• Developing workers assistance programme
• Organising resuscitation training programme and first aid health education.
• Informing the management /administration about health hazards
• Participation in referral services of the workers
• Keeping up to date health record of the worker
• Working as a occupation health team member
• Evaluation of occupational programme.