Occupational hazards, occupational health Occupational safety and health should not be sidelined as a service delivery issue. Health worker health and well-being is an important aspect of workers’ motivation and job satisfaction, which influence productivity as well as retention. Health worker safety also affects the quality of care; caring for the caregiver should be a priority area of concern for the health system’s performance.

1. OCCUPATIONAL HEALTH &
SAFETY
Presented BY
Priyanka Kumari
M.Sc. Nursing

2. DEFINITION:
“Occupational health is the promotion &
maintenance of the highest degree of
physical, mental & social wellbeing of the
workers in all occupations”.
Hazard is, “something that can cause harm if
not controlled.”
Occupational disease is, “Disease directly
caused by a person’s occupation.

3. AIM
“The promotion and maintenance of the
highest degree of physical, mental and social
well-being of workers in all occupations"

4. OBJECTIVES OF OH
To maintain and promote the physical, mental
and social well being of the workers.
To prevent occupational diseases and injuries.
To adapt the work place and work environment
to the needs of the workers i.e application of
ergonomics principle.
It should be preventive rather than curative.

5. FUNCTIONS OF OCCUPATIONAL
HEALTH SERVICE -
 Pre-employment medical examination.
 First Aid and emergency service.
 Supervision of the work environment for the
control of dangerous substances in the work
environment.
 Special periodic medical examination
particularly for the workers in dangerous
operations.
 Health education for disseminating information
on specific hazards and risks in the work
environment.

6. Special examination and surveillance of
health of women and children
Advising the employer or management for
improving working conditions, and
placement of hazards.
Monitoring of working environment for
assessment and control of hazards.
Supervision over sanitation, hygiene and
canteen facilities.
Liaison and cooperation with the safety
committees

7. Maintenance of medical records for
medical check-up and follow-up for
maintaining health standards and also for
evaluation.
To carry out other parallel activities such
as nutrition programme, family planning,
social services recreation etc., Concerning
the health and welfare of the workers.

8. COMPONENTS OF OCCUPATIONAL
HEALTH
 INDUSTRIAL HYGIENE.
 INDUSTRIAL DISEASE.
 INDUSTRIAL ACCIDENTS.
 INDUSTRIAL HAZARDS.
 INDUSTRIAL REHABILITATION.
 OCCUPATIONAL PSYCHOLOGY.

9. ILO RECOMMENDATION
Focus on providing the following to promote
health of the employees as follows:
Nutrition.
Prevention & control of communicable disease.
Environmental sanitation.
Water supply.
Provision food & snacks .
Toilet facilities.

10. General Plant cleanliness.
 Floor Space /air space (500 cu ft)
Wastage & Garbage disposal.
Lighting & Ventilation.
Protection against hazards.
Housing.
Maternity benefit.
First Aid.
Crèches.
Family Planning.
Mental Health.
Health Education.

11. DIRECTIVE PRINCIPLES OF
STATE POLICY
INDIAN CONSTITUTION States; “The state
shall in particular direct it’s policy towards
security that the health & strength of the
workers, man, woman, & the tender age of
children are not abused & that citizens are not
forced by economic necessity to enter a vocation
unsuited to their strengths”.
The state shall make provisions for securing
just & humane conditions of work

12. OCCUPATIONAL HAZARDS

13. OCCUPATIONAL DISEASES
1. Diseases due to physical agents.
2. Diseases due chemical agents.
3. Diseases due to biological agents.
4. Occupational cancers.
5. Occupational dermatitis.
6. Diseases of psychological origin.

14. PHYSICAL HAZARDS
• Heat and cold
• Light
• Noise
• Vibration
• Ultraviolet radiation
• Ionizing radiation

15. HEAT
The direct effects are:
• Burns
• Heat exhaustion
• Heat stroke
• Heat cramps
The indirect effects are
• Decreased efficiency,
• Increased fatigue
• Enhanced accident rates.

16. COLD
 Chilblains
 Erythrocyanosis
 Immersion foot
 Frostbite as a result of cutaneous
vasoconstriction.
 General hypothermia

17. 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"

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

19. VIBRATION
Exposure to vibration may also produce
injuries of the joints of the hands elbows and
shoulders.

20. ULTRAVIOLET RADIATION
Conjunctivitis
Keratitis (welder's flash).

21. IONIZING RADIATION
The radiation hazards comprise
 Genetic changes
 Malformation
 Cancer
 Leukaemia
 Depilation
 Ulceration
 Sterility
 In extreme cases death.

22. CHEMICAL HAZARDS
• Acids
• Bases
• Heavy Metals – Lead
• Solvents – Petroleum
• Particulates – Asbestos, Silica and
other fine dust/fibrous materials
• Fumes – noxious gases/vapors
• Highly- reactive Metals

23. 1)Local Action :
Dermatitis, Eczema, and Ulcers
Cancer by primary irritant action
(2) Inhalation :
Dusts
Gases
Metals and their compounds

24. CLASSIFICATION OF DUSTS:
Inorganic and organic dusts;
Soluble and insoluble dusts.
GASES:
Simple gases (e.g., oxygen, hydrogen),
Asphyxiating gases (e.g. carbon monoxide,
cyanide gas, sulphur dioxide, chlorine)
Anaesthetic gases (e.g., chloroform, ether,

25. INGESTION:
Occupational diseases may also result
from ingestion of chemical substances
such as:
lead, mercury, arsenic, zinc, chromium,
cadmium, phosphorus etc.

26. BIOLOGICAL HAZARDS
Bacteria
Viruses
Fungi – molds
Insects – mosquitoes
Hazardous Plants – Poison Ivy
Birds
Animals
Blood-borne Pathogens

27. Diseases due to Biological Agents
 Hepatitis B Virus
 Hepatitis C Virus
 Tuberculosis – particularly among Healthcare Workers
 Asthma – among persons exposed to organic dust
 Blood-borne Diseases – HIV/AIDS
 Anthrax
 Brucellosis
 Tetanus
 Leptospirosis

28. Psychosocial hazrds
The health effects can be classified in two
(a) Psychological and behavioural
changes
Frustration
Lack of job satisfaction,
Insecurity
Poor human relationships,
Emotional tension

29. (b) Psychosomatic ill health:
Depression, sickness
Absenteeism,
Peptic ulcer,
Rapid ageing,
Heart disease,

31.  WHO - 100 million occupational injuries
 0.1 million deaths in the world
 India: 17 million occupational non-fatal injuries
(17% of the world) & 45,000 fatal injuries
(45% of the total deaths due to occupational
injuries in world) annually
 11 million cases of occupational diseases in the
world: 1.9 million cases (17%) contributed by
India
 Of 0.7 million deaths in the world, 0.12 (17%)
from India
 Adverse occupational factors have been
estimated to cost 2-14% of the gross national
products for various countries

32. Classification
I. Diseases due to physical agents:
 Heat: Heat hyperpyrexia, heat exhaustion
 Cold: Trench foot, frost bite
 Light: Occupational cataract, miner’s nystagmus
 Pressure: Caisson disease, air embolism, blast (explosion)
 Noise: Occupational deafness
 Radiation: Cancer, leukaemia, aplastic anaemia,
pancytopenia
II. Diseases due to chemical agents:
 Gases: Gas poisoning
 Pneumoconiosis
 Metals and their compounds: Chemicals & Solvents

33. III. Diseases due to biological agents:
Leptospirosis, anthrax, actinomycosis,
tetanus
IV. Occupational cancer:
Cancer of skin, lungs, bladder
V. Occupational dermatosis:
Dermatitis, eczema
VI. Diseases of psychological origin:
Industrial neurosis, hypertension, peptic
ulcer, etc.

34. Agricultural Worker’s Diseases
Farmer’s Lung
 a hypersensitivity pneumonitis induced by inhalation of
biological dusts
 could progress into a potentially dangerous chronic
condition.
 Fluid, protein and cells accumulate in the alveolar wall,
slows blood-gas interchange and compromises the
function of the lung.
Silo filler's disease (SFD)
 pulmonary exposure to oxides of nitrogen – could
 manifest into pulmonary oedema

35. Circadian Rhythm Sleep Disorder
Persistent/recurring pattern of sleep disruption
resulting either from an altered sleep-wake
schedule or an inequality between a person's
natural sleep-wake cycle and the sleep-related
demands placed on him/her.
Extrinsic: Jet Lag, Shift Work Sleep Disorder
Intrinsic: Delayed sleep phase syndrome,
advanced sleep phase syndrome

36. Hand-arm vibration syndrome
Repeated and frequent use of hand-held
vibrating tools/vibrating machinery
(power drills, chainsaws, pneumatic drills)
Probably due to slight but repeated injury
to the small nerves and blood vessels in
the fingers
Raynaud's phenomenon (“white finger”)
nerve symptoms, aches and pains

37. Occupational Dermatitis
Inflammation of the skin caused by exposure to a
substance in the workplace. Exposure usually
occurs from direct contact but may, in rare
circumstances, occur through the airborne route
Allergic contact dermatitis - when a person
becomes sensitized to a substance (allergen)
Irritant contact dermatitis when the skin is
exposed to a mild irritant (such as detergent or
solvents) repeatedly over a long period of time or to
a strong irritant (such as acids, alkalis, solvents,
strong soaps, or cleansing compounds) that can
cause immediate skin damage

38. Pneumoconiosis
chronic lung disease caused due to the
inhalation of various forms of dust
particles, particularly in industrial
workplaces, for an extended period of
time
Shortness of breath, wheezing and chronic
coughing are some of the symptoms

39. Prevention Methods
Medical Methods
Engineering Measures
Legislative protection

40. MEASURES FOR HEALTH
PROMOTION OF WORKERS
 Nutrition
 Communicable disease control
 Environmental sanitation
 Mental health
 Measures for women and children
 Health education
 Family planning

41. PREVENTION OF OCCUPATIONAL DISEASE
MEDICAL MEASURES
Pre-placement examination
Periodical examination
Medical and health care services
Supervision of working environment
Maintenance and analysis of records
Health education and counseling

42. ENGINEERING MEASURES
 Design of building
 Good housekeeping
 General ventilation
 Mechanization
 Substitution
Dust-enclosure and isolation
Protection device Environmental monitoring

43. LEGISLATION
The Factory Act.1948.
The Employees State Insurance Act 1948.

44. THE FACTORIE’S ACT- 1948
HEALTH SAFETY & WELFARE:
The act addresses matters as cleanliness,
lighting, ventilation, treatment of waste &
effluents, disposal & elimination of dust,
fumes – provision of spittoons, control of
temperature, supply of safe drinking water,
employment of cleaners.

45. OTHER RECOMMENDATIONS INCLUDE
500 cu ft space for each worker.
Precautions regarding the safety of the workers.
Appointment of safety officers 1976
amendment.(1000 or more workers.).
Specific welfare measures.– washing facilities,
facilities for drying & storing, facilities for
sitting, first aid appliances, rest rooms, lunch
rooms, canteens, crèches, welfare officer – 500
employees. (200 worker – canteen, 30 women –
crèche.)

46. EMPLOYMENT OF CHILDREN
The act prohibits employment of children
below the age of 14 yrs.,
15 – 18 years – Adolescents for
employment should be certified by
surgeon for fitness of work.(6AM- 7PM).
The act prohibits employment of women
& children in dangerous occupations.

47. HOURS OF WORK
The act prescribes a maximum of 48 hrs/week
not exceeding 9 hrs / day with half an hour
rest after continuous work.
Work – The act promotes spread over work –
10 -12 hrs work.
The total working hours must not exceed incl
OT- 60 hrs.

48. LEAVE WITH WAGES
Workers are entitled for a leave with
wages after 12 months continuous service.
1 day / 20 days – adults.
1 day / 15 days – children.
The leave can be accumulated up to 30
days in adults, 40 days in children.

49. OCCUPATIONAL DISEASES.
The act enlists the schedule of notifiable
diseases.
The act includes for provision for
occupational health surveys in factories &
industries.

50. EMPLOYMENT IN HAZARDOUS
PROCESS
The amendment act specifies procedures
relating to hazardous process.
The site appraisal committees is to be
involved in examining the service
conditions of employees involved in the
hazardous process.

51. THE ESI ACT – 1948
The act was amended in 1975, 84 & 89. The ESI
act is an important measure of social security &
health insurance.
SCOPE : The act covers whole of India.
The act covers all factories using power.
The following are the areas that the act extends.
Small power using factories.(10 -19 workers).
Factories having 20 workers without power.
Shops & Hotels & Restaurants.

52. Cinemas & theatres.
Road – motor transport establishments.
News paper establishments.
The act involves employees of all cadres (
manual, clerical, supervisory, technical
drawing up to 7500/mo.

53. ESI Act- Administration
 ESI Corporation
Chairman – The Union Ministry of labour
Vice Chairman- Secretary to Govt. of India
Chief executive officer- Director general
Assisted by four principal officers
• Insurance commissiners
• Medical commissioners
• Finance commissioners
• Acturay

54. EXTRA BENEFITS
Extended sickness' benefit.
Artificial limbs/dentures/family planning.
Family medical care.
Protection against dismissal / discharge
from service.
Funeral expenses.
Rehabilitation allowances.
Medical facilities to dependents.

55. FINANCE --- ESI
The ESI scheme is run by contributions of
employers, employees & grant from
central & state govt.
Employee – 4.75 % of the total wage bill.
Employer – 1.75 % (1.1.97).
Employees getting wages below Rs
15/day are exempted from contribution.

56. BENEFITS.
Medical benefits : Full medical care, out
patient care, supply of drugs & dressings,
specialist services in all specialties –
(pathological & radiological services),
ambulance services, immunization, family
planning, AN,PN services, & in- patient
care.
ESI dispensaries : & insurance for
medical practitioners in having 1000
employees. out patient & inpatient
services available.
Dentures , spectacles, hearing aids,
artificial limbs & special appliances.

57. SICKNESS BENEFIT
Cash payment to injured sick person(91 days) on
certification by insurance medical officer.( 365 Days –
at daily rate – 50 % of the daily wages.).
Extended sickness benefit : for TB, leprosy, chronic
empyema, AIDS, neoplasm, and endocrine disorder
like DM and nephropathy payable upto 730 days.
Maternity : Confinement services for insured women,
miscarriage or sickness arising out of pregnancy.
Maternity leave – 28 wks., miscarriage – 6 wks.,
sickness – 30 days.

58. DISABLEMENT BENEFIT : 70% of the
wage for temporary disabled. Pension at
partial & at full rate.
DEPENDENT’S BENEFIT : Pension at
the rate of 70 % to widows & children.
And Rs 14 / day – for children up to the
age of 18 or marriage.
FUNERAL EXPENSES – Rs 5000 cash
payment.
REHABILITATION : on payment of RS
10 insured person & his family members
continue to avail treatment.

60. Rules of safety at workplace
 HIGH RISK SITUATIONS: You cannot start up or start
down any equipment without having proper knowledge of
that machine. Well while doing same you may put
yourself in danger.
 MACHINE & TOOLS: Do not carry unnecessary Tools
with you if you do not have to work with that tool that
may cause a physical harm.
 PERSONAL PROTECTIVE EQUIPMENT: These is a
major part while working in industries. You have to wear
a suitable PPE (Personal Safety Product) according to
your work. I.e. Helmet, Hand Gloves, Safety Shoes,
Respiratory System(Mask), Safety Eye Wear, etc.

61. SAFETY IN THE
CONSTRUCTION INDUSTRY

62.  WORK PERMITS: Do not perform work without a valid
work permit.
 LIFTING: Do not walk under a load while lifting is taking
place. For any work involving a crane, hoist or other
mechanical system, a preliminary risk analysis is required.
Equipment must be in good condition. Personnel must be
qualified and access to the area must be restricted.
 WORK ON POWERED SYSTEMS: Do not perform work
without checking that the power and product source supply
has been rendered inoperative.
 CONFINED SPACES: Do not enter a confined space until
isolation has been verified and the atmosphere checked.

63.  EXCAVATION WORK: Do not perform
excavation work without a valid work permit
comprising a map of all underground hazards.
Manual or mechanical excavation work,
including dragging rivers and seabeds, can only
start after a risk analysis has been performed to
identify all hazards in the zone and related
precautions have been taken.
 WORKING AT HEIGHTS: Do not work at
heights without a safety harness when there is no
collective protective equipment.

64. OCCUPATIONAL HEALTH TEAM
 Occupational health nurse
 Physiotherapist.
 Specialist doctor
 Industrial manager
 Supervisor
Shift in charge
Rehabilitation specialist
Labour welfare officer
Labour union representative.
Representative of voluntary organizations
Other invited members as per the need

65. FUNCTIONS OF OCCUPATIONAL
HEALTH NURSE
 Occupational health nurses work in a variety of
settings mainly industry, health services,
commerce and education. They can be employed
as independent practitioners or as part of a
occupational health service team, often attached
to a personnel or HR department.
 Primary prevention
 Secondary prevention
 Tertiary prevention

66. Clinician
• Primary prevention
• Emergency care
• Treatment services
• Nursing diagnosis
• General Health advice and health assessment
• Research and the use of evidence based practice

67. Specialist
• Occupational health policy, and practice
development, implementation and evaluation
• Occupational health assessment
• Health surveillance
• Sickness absence management
• Rehabilitation
• Maintenance of work ability
• Health and safety
• Hazard identification
• Risk assessment
• Advice on control strategies

68. Manager
Co-ordinator
Adviser
Health educator
Counsellor
Researcher

69. CONCLUSION
 Occupational safety and health should not be sidelined as a
service delivery issue. Health worker health and well-being
is an important aspect of workers’ motivation and job
satisfaction, which influence productivity as well as
retention. Health worker safety also affects the quality of
care; caring for the caregiver should be a priority area of
concern for the health system’s performance. What is good
for employee health is good for patient health. The PPE
Campaign represents an important approach to bringing
occupational safety and health policies to practice, ensuring
the well-being of the health sector’s most important resource
and in turn that of the patients and populations they serve,
thus helping to transform the health system at large.

70. THANK
YOU…