Medical Surveilance Workshop 2010 04 16


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Briefing given by Sr. Nellie Nel at a meeting in April 2010 on the necessity and overview of medical surveilance in occupational health.

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Medical Surveilance Workshop 2010 04 16

  1. 1. Occupational HEALTH
  2. 2. The Occupational Health Timeline <ul><li>BC: Hypocrates describes the symptoms of lead poisoning, not realising it is an occupational disease </li></ul><ul><li>1700: Ramazinni, the “Father of occupational health” says the patient must always be asked what their occupation is. </li></ul><ul><li>1833: The first factory inspectors and medical examinations in occupational health conducted in England. </li></ul><ul><li>1895: The first occupational disease is declared notifiable. </li></ul><ul><li>1980: South Africa starts training doctors and nurses in OH </li></ul><ul><li>1993: The OHS Act is published as well as compensation legislation </li></ul><ul><li>1996: The Mine Health and Safety Act is published </li></ul>
  3. 3. OH Timeline (cont) <ul><li>South African health care professionals only received training from 1980! </li></ul><ul><li>Mining (open diamond mining) already started in 1872, gold mines in 1887. </li></ul><ul><li>Farmers have been using pesiticides for decades prior. </li></ul><ul><li>Factories have been using chemicals and operated in high noise levels long before 1980. </li></ul><ul><li>Construction sites have been operating for even longer, full of dust and noise. </li></ul><ul><li>The fishing industry have been operating for centuries before 1980. </li></ul><ul><li>The industries have been in existence long before occupational health care in South Africa. </li></ul>
  4. 4. OH Timeline (cont) <ul><li>According to a study conducted and published in the SASHON Journal of 2009, occupational disease in South Africa is made up of the following: </li></ul><ul><ul><li>NIHL – 56% </li></ul></ul><ul><ul><li>Depression/PTHD – 13% </li></ul></ul><ul><ul><li>Dermatitis – 12% </li></ul></ul><ul><ul><li>TB – 5% </li></ul></ul><ul><ul><li>Pneumoconiosis – 4% </li></ul></ul><ul><ul><li>Occupational asthma – 3% </li></ul></ul><ul><li>This brings us to today's topic: </li></ul>
  5. 5. Medical Surveilance <ul><ul><li>Hazard identification </li></ul></ul><ul><ul><li>Risk assesment </li></ul></ul><ul><ul><li>Risk mitigation </li></ul></ul><ul><ul><li>Medical serveilance </li></ul></ul>
  6. 6. Medical Surveilance Medical surveilance according to OHS Act: A planned programme or periodical examinations of employees by an OHP or OMP (in prescribed cases).
  7. 7. Medical Surveilance <ul><li>Periodical examinations may include: </li></ul><ul><ul><li>Clinical examination </li></ul></ul><ul><ul><li>Biological monitoring </li></ul></ul><ul><ul><li>Medical tests </li></ul></ul>
  8. 8. Medical Surveilance <ul><li>Clinical examinations: </li></ul><ul><li>Examining the body </li></ul><ul><li>Biological monitoring: </li></ul><ul><li>Collecting body fluid, tissue or exhaled air to detect of quantify the exposure or absorption of any substance or organism by a person. </li></ul><ul><ul><li>Medical tests: </li></ul></ul><ul><ul><li>X-rays </li></ul></ul><ul><ul><li>Audiometry </li></ul></ul><ul><ul><li>Special vision screening </li></ul></ul>
  9. 9. Steps toward Medical Surveilance <ul><li>Hazard identification </li></ul><ul><li>Risk assesment </li></ul><ul><li>Risk mitigation </li></ul><ul><li>Medical surveilance </li></ul>
  10. 10. Hazard Identification <ul><ul><li>Physical Hazards </li></ul></ul><ul><ul><li>Chemical hazard </li></ul></ul><ul><ul><li>Biological hazards </li></ul></ul><ul><ul><li>Ergonomical hazards </li></ul></ul><ul><ul><li>Psycho-social hazards </li></ul></ul>
  11. 11. Physical Hazards <ul><ul><li>Noise </li></ul></ul><ul><ul><li>NIHL </li></ul></ul><ul><ul><li>Vibration </li></ul></ul><ul><ul><li>Raynoud's Phenomenon (vibration white fingers) </li></ul></ul><ul><ul><li>Osteo Arthritis (hand arm vibration) </li></ul></ul><ul><ul><li>Lower back pain (whole body vibration) </li></ul></ul><ul><ul><li>Early degeneration of lumber spine (whole body vibration) </li></ul></ul>
  12. 12. Physical Hazards (cont) <ul><ul><li>Electricity </li></ul></ul><ul><ul><li>Burns </li></ul></ul><ul><ul><li>Electrocution (death) </li></ul></ul><ul><ul><li>Electrification (shock) </li></ul></ul>
  13. 13. Physical Hazards (cont) <ul><ul><li>Extreme temperatures </li></ul></ul><ul><ul><li>Heat Stroke </li></ul></ul><ul><ul><li>Frostbite </li></ul></ul><ul><ul><li>Radiation </li></ul></ul><ul><ul><li>Cancer </li></ul></ul>
  14. 14. Physical Hazards (cont) <ul><ul><li>Dust </li></ul></ul><ul><ul><li>Pneumoconiosis (inorganic dust) </li></ul></ul><ul><ul><li>Silicosis </li></ul></ul><ul><ul><li>Asbestosis </li></ul></ul><ul><ul><li>Occupational Asthma </li></ul></ul>
  15. 15. Chemical Hazards <ul><ul><li>Solvents </li></ul></ul><ul><ul><li>Benzene – Leukemia </li></ul></ul><ul><ul><li>Toluene – NIHL (Noise & Toluene) </li></ul></ul><ul><ul><li>Etc. </li></ul></ul>
  16. 16. Chemical Hazards (cont) <ul><ul><li>Metals </li></ul></ul><ul><ul><li>Metal fume fever </li></ul></ul><ul><ul><li>Pesticides </li></ul></ul><ul><ul><li>Organophosphate poisoning (lethal) </li></ul></ul><ul><ul><li>Chemical Asphyxiants </li></ul></ul><ul><ul><li>Carbon monoxide (coma, lethal) </li></ul></ul>
  17. 17. Biological Hazards <ul><ul><li>Snake/Spider bites (loss of limb, lethal) </li></ul></ul><ul><ul><li>HIV </li></ul></ul><ul><ul><li>TB </li></ul></ul>
  18. 18. Ergonomical Hazards <ul><ul><li>Illumination (glare, headaches, poor vision) </li></ul></ul><ul><ul><li>Repetitive actions (repetitive strain disorders, poor work performance, pain, pain, pain!) </li></ul></ul>
  19. 19. Psycho-social Hazards <ul><ul><li>Stress </li></ul></ul><ul><ul><li>High-blood pressure </li></ul></ul><ul><ul><li>Stroke </li></ul></ul><ul><ul><li>Depression </li></ul></ul>
  20. 20. Psycho-social Hazards (cont) <ul><ul><li>Boredom </li></ul></ul><ul><ul><li>Stress </li></ul></ul><ul><ul><li>Depression </li></ul></ul>
  21. 21. Psycho-social Hazards (cont) <ul><ul><li>Substance abuse </li></ul></ul><ul><ul><li>Injuries </li></ul></ul><ul><ul><li>Death </li></ul></ul><ul><ul><li>Lung disease </li></ul></ul>
  22. 22. Psycho-social Hazards (cont) <ul><ul><li>Night Work </li></ul></ul><ul><ul><li>Stress </li></ul></ul><ul><ul><li>Social issues </li></ul></ul><ul><ul><li>Metabolic disorders (i.e. Diabetes), due to biological clock disturbances (controlled metabolic illnesses can become uncontrolled) </li></ul></ul>
  23. 23. Risk Assessment <ul><ul><li>Using a measuring tool, ranking the hazards as low, med and high. </li></ul></ul><ul><ul><li>Risk matrix </li></ul></ul><ul><ul><li>Risk rating sheet </li></ul></ul><ul><ul><li>Basic risk scale </li></ul></ul><ul><ul><li>One might need: </li></ul></ul><ul><ul><li>Occupational hygienist </li></ul></ul><ul><ul><li>Material safety data sheets </li></ul></ul>
  24. 24. Risk Mitigation <ul><ul><li>Reducing the effect of the hazard on the employee's health </li></ul></ul><ul><ul><li>Engineering controls (ex. Less noisy machines) </li></ul></ul><ul><ul><li>Adminstrative controls (shift rotation, less personel in area, rules and regulations) </li></ul></ul><ul><ul><li>Personal protective equipment (gloves, safety specs, etc) </li></ul></ul><ul><ul><li>AND THEN: </li></ul></ul>
  25. 25. Medical Surveilance <ul><ul><li>Plan the examinations and the intervals or frequency. Medical surveilance will only change if the process or the environment changes. </li></ul></ul>
  26. 26. Frost Bite
  27. 27. Heat Stroke
  28. 28. Sunburn
  29. 29. Skin Cancer
  30. 30. Electrocution
  31. 31. Electrical Burns
  32. 32. Raynoud's Phenomenon
  33. 33. Spider bites
  34. 34. Stroke
  35. 35. Metal Fume
  36. 36. Visit our website & blog: