Contains info on the asbestosis related cancers, occupational health cancers and its prevention, workplace stress and ergonomics

1. Occupational
Diseases - VI
Group B

2.  Asbestosis related cancer
 Occupational health cancers and its prevention
 Workplace stress on health workers
 Ergonomics and its objectives

3. 1. Asbestosis related cancers
Asbestos cancers are caused by inhaling or
swallowing microscopic asbestos fibers. The term
“asbestos cancer” most often refers to
mesothelioma. Asbestos Exposure Causes Four Types
of cancers:
 Mesothelioma
 Lung cancer
 Laryngeal cancer
 Ovarian cancer

4. 2. Occupational health cancers
Occupational cancer is caused by exposure to carcinogens in the
workplace. Carcinogens are agents that cause the development or
increase the incidence of cancer.
There are three different types of occupational carcinogens:
i. Biological carcinogens - some micro-organisms such as
viruses have been known to cause cancer, either by
damaging cells directly or by decreasing the body’s ability to
control abnormal cells, for example Hepatitis B, HIV viruses
and so on.
ii. Chemical carcinogens - a number of chemicals are known
to be carcinogenic. These chemicals may occur naturally,
such as asbestos, be manufactured like vinyl chloride, or be
by-products of industrial processes, for example, polycyclic
aromatic hydrocarbons.

5. iii. Physical carcinogens - agents such as ionising and
ultraviolet (UV) radiation have the potential to cause
cancer. Examples of ionising radiation include X-rays and
alpha, beta and gamma radiation. UV radiation can be
divided into a number of bands such as UV-B, UV-C etc,
some of which are known to cause skin cancer.
Certain occupational circumstances, such as working as a painter or
as a welder are also associated with increased risks of some
occupational cancers.
Occupational cancers are also called as ‘Industrial cancers’. These
constitute another important health problem in the industries
because many types of chemicals are employed in the industries,
which act as carcinogens.- The most common types of occupational
cancers are those of skin, lungs, bladder and blood forming organs
(like bone marrow).
A. Agent Factors: These are mainly chemical carcinogens, both
organic and inorganic. Organic chemical carcinogens mainly
result in lung cancer and inorganic ones mainly result in skin
cancer.

6. B. Environmental Factors: Physical environment like heat
and radiation also result in industrial cancers.
C. Influencing Factors: The factors influencing the
development of industrial cancers are potency (intensity)
of the carcinogen, duration of exposure, degree of
personal hygiene and availability of preventive measures.
The different types of occupational cancers, their carcinogens
and ‘at risk’ group in the industries are as follows:
i. Skin cancer:
 Carcinogens: Anthracene, coal-tar, soot, pitch, oils and
dyes, acids, U-V rays, X-rays.
 'At risk' group in the industry: Shepherds, fisherman,
road-builders, oil refiners, dye-stuff makers, radiology
department staff, tar distillers, coke-oven workers.

7. ii. Lung cancer Carcinogens:
 Arsenic, asbestos, beryllium, chromium, uranium,
tobacco, coal tar, nickel.
 'At risk group in the industry: Asbestos factory,
uranium-mines, nickel-refineries, gas industry,
tobacco industry.
iii. Bladder cancer
 Carcinogens: b-naphthylamine, benzidine,
auramine, aromatic amines, para-amino
diphenyl, hemotoxins.
 'At risk' group in the industry: Aniline industry,
rubber industry, electric cable industry.
iv. Leukemia Carcinigens: Ionizing radiations
 (X-rays and gamma rays), radioactive isotopes.
 'At risk' group in the industry: Radiology
department, atomic energy research station.
Note: ‘Dhoti-cancer’ as
described by Khanolkar is
not an industrial cancer
but caused
by mechanical irritation
(friction) of dhoti over
the skin of waist.

9. Occupational skin cancers also include Mule spinner’s cancer and
Chimney sweeper’s cancer (cancer of scrotum).
Cancer of the bladder resulting from the infestation of Schistosoma
hematobium (a biological agent) is not an industrial cancer.
Features of Occupational Cancers
 They occur in those sites, where the action of carcinogens is
constant, most intense and prolonged.
 They appear after a prolonged exposure of about 10 to 15years.
 They can occur even after cessation of exposure as in asbestos
industry.
 The average age incidence of occupational cancers is much earlier
than that for cancers in general.
 It is more among men than among women.
 The localization of the tumor is remarkably constant in any one
occupation.
 Maintenance of high standard of personal hygiene is very important
in the prevention of occupational cancers.

11. Occupational cancer can arise from exposure to many substances or from
certain occupational circumstances such as:
 Asbestos fibres (colorectum, larynx, lung, ovary, pharynx, stomach
cancers, mesothelioma)
 Wood dusts (nasopharynx, sinonasal cancers)
 UV radiation from sunlight (skin cancers)
 Metalworking fluids and mineral oils (bladder, lung, sinonasal, skin cancers)
 Silica dust (lung cancer)
 Diesel engine exhaust (bladder, lung cancers)
 Coal tars and pitches (non-melanoma skin cancer)
 Arsenic (bladder, lung, skin cancers)
 Dioxins (lung cancer)
 Environmental tobacco smoke (passive smoke) (lung cancer)Naturally
occurring radon (lung cancer)
 Tetrachloroethylene (cervix, non-Hodgkin’s lymphoma, oesophagus
cancers)
 Work as a painter (bladder, lung)
 Work as a welder (lung cancer, melanoma of the eye)

12. Prevention of occupational cancers
I. Health Promotion
a. Preplacement examination: This consists of examination of the individual
for assessing his physical and psychological capacity, so as to place him in a
suitable job (Fitting the job to the worker) e.g. person with skin disease
is not placed in handling acids, alkalis and dyes.
b. Sanitation in the working environment: Good housekeeping, ventilation and
the cleanliness are mandatory in the industries.
c. Health education: The workers are educated on the following points:
 To change their attitude towards cancer.
 To know the ‘Danger signals’ of cancers (Cancer education)
 To know the hazards of smoking as an aggravating factor in the dusty
environment.
 To maintain high standard of personal hygiene.
d. Control of dust in asbestos industry.

13. II. Specific Protection
a. Primordial prevention consists of elimination or
avoidance of carcinogens in the industry. This also
consists of discouraging the workers from adopting
harmful lifestyle such as smoking.
b. By the use of protective devices such as: Masks in the
asbestos industry, lead apron, lead gloves and dark
spectacles in radiology department. Use of barrier
creams in dyeing section of the industry.
c. Safety of the worker by wearing ‘Pocket dosimeter’ for
personal monitoring of the radiation dose received.
d. Safety of the machine by proper installation and
maintenance of X-ray machine, use of efficient
fitters so that unwarranted radiations are excluded.
They are operated on high kilo-voltage with fast
films, so that exposure is reduced to minimum dose.

14. III. Early Diagnosis and Treatment
 This is done by ‘Periodical examinations’ of at-risk
group of industrial workers, specially in the cancer
clinics to detect lesions of early and curable stage.
 The periodical examinations should be continued even
after cessation of exposure to carcinogen. This
screening procedure consists of thorough physical
examination followed by procedures like blood
examination, urine examination, X-ray of chest,
cytology, endoscopy and even biopsy.
 Treatment is given by chemotherapy, surgery,
radiotherapy, hormonal therapy or immunotherapy
depending upon the type.

15. IV. Disability Limitation
 This consists of limiting the
development of further disability by
giving intensive treatment, when the
patients come in the advanced stage.
V. Rehabilitation
 This is given for those who have
become handicapped following major
surgery such as amputation, lobectomy,
etc. They are rehabilitated physically,
socially, psycho-logically and vocationally.

16. 3. EFFECT OF STRESS ON WORKERS
The United States' National Institute for Occupational Safety and Health
defines job stress as the harmful physical and emotional responses that
occur when the requirements of the job do not match the capabilities,
resources, or needs of the worker. Job stress can, in turn, lead to poor
health and even injury.
The Impacts of Workplace Stress
 Workplace stressors are classified as physical and psychosocial.
Physical stressors include noise, poor lighting, poor office or work
layout, and ergonomic factors, such as bad working postures.
 Psychosocial stressors are, arguably, the most predominant stress
factors. These include high job demands, inflexible working hours,
poor job control, poor work design and structure, bullying,
harassments, and job insecurity.

17.  Workplace stress not only affects the worker, it also has
adverse effects on company performance well. The
effects of job-related strain are evident in workers'
physical health, mental health, and their behavior.
 Too much stress can be deeply damaging to a person's
health. Energy level will decrease, sleep becomes more
difficult, eating habits worsen, the heart beats more
rapidly and illness becomes more frequent.
 Workplace stress also has adverse effects on workers'
mental health, with an increased risk of anxiety,
burnout, depression and substance use disorders.
 Workers who are stressed at works are more likely to
engage in unhealthy behaviors such as cigarette
smoking, alcohol and drug abuse, and poor dietary
pattern.

18. WHEN EFFECTED BY WORKSTRESS PEOPLE MAY:
 become increasingly distressed and irritable
 become unable to relax or concentrate
 have difficulty thinking logically and making decisions
 enjoy their work less and feel less committed to it
 feel tired, depressed, anxious
 have difficulty sleeping
 experience serious physical problems, such as heart diseases, etc.
 disorders of the digestive system,
 increases in blood pressure, headaches
 musculo-skeletal disorders (such as low back pain and upper limb
disorders)

19. 4. Ergonomics
Ergonomics is derived from the Greek words "Ergon" means
work and "Nomos" means law.
It simply means fitting the job to the work. That means
placing the worker in an environment(job) which is
adopted to his physiological and psychological capacity.
Objectives-
1) The main objective of ergonomics is to achieve the
best mutual adjustment between the man and his
work, for the human efficiency and well-being.
2) improve efficiency of operation by taking into account
a typical person's size, strength, visual acuity and
physiological stress such as fatigue, speed or decision
making and demands on memory and perception.

20. 3) To minimize the risk of injury, illness,
accidents and errors without compromising
productivity.
4) To maximize productivity while lowering the
risk of Musculoskeletal Disorders (MSDs). MSD
develops as a result of long term ergonomic
risk factors such as repetition, high forces and
awkward postures. Ex of MSDs include- Carpel
tunnel syndrome, tendonitis and back
disorders.
5) Promote safety and comfort at work station.
6) To reduce physical workloads
7) Improve quality of life

21. References
 K Park’s PSM
 A H Suryakantha's PSM
 www.who.int