Health and safety of employees are essential aspects of organization's smooth and effective functioning. Good health and safety performance ensure an accident free work environment.

2. A SIX DAYSWORKSHOP
On the theme “ AnUpdate on Nursing Management”
W.e.f 1st Augustto 8th August 2022.
Organizing chairperson: Dr. Munira Kachroo
Organizing Secretary: Mr. Mohammad Ayub Dar.

3. Topic: Occupational Healthand Policies
Presented by: Maneera Gulzar
Placement: M.Sc. Nursing 2nd Year
Specialty: Medical Surgical Nursing
Subject: Nursing Management

6. INTRODUCTION
 The health and safety of employees are an essential aspect of
an organization's smooth and effective functioning.
 Nurses as care providers are the key persons in the
healthcare system in the delivery of health in every setting.
The health of care providers, in whose hands the health of
others rest, is equally important to keep them healthy, and
ensure safety.
 Safety brings organizational effectiveness. Good health and
safety performance ensure an accident free environment.
 It helps in improving employee morale, reducing
absenteeism and enhancing productivity, minimizing
occupational injuries and illnesses, and increasing the quality
of services.

7. DEFINITION
OCCUPATIONAL HEALTH:
 World Health Organization defines occupational health as
a multidisciplinary activity. It concerns the health and
safety of employees. It focuses on preventing and
controlling work-related disorders, injury, Impairment, or
disease affecting an employee during employment. It also
aims at eliminating the risk factors and workplace
conditions for the health and safety of people at work.
 International Labour Organization (ILO) and World
Health Organization (WHO) emphasize the promotion of
the highest degree of physical, mental, and social well
being of employees, the prevention of health problems, the
protection of workers from risks of diseases, and providing
an environment that should be free from occupational
hazards

8. OCCUPATIONAL SAFETY
Safety is the “absence of danger” and occupational safety
means the “absence of danger at work”.
 It is the protection of employees from occupational
hazards. It is the health and well-being of people
employed in a work environment.
 Occupation health and safety are concerning physical,
social and mental well-being of workers as a whole. The
United States Congress Occupational Safety and
Health Act passed to prevent employees from workplace
illnesses and promoting the safety of employees. India
has also had legislation on occupational safety and health
for 50 years.

9. IMPORTANCEOF OCCUPATIONAL HEALTHANDSAFETY
 The nature of work plays a central role in employee's
health since most nurses spend at least 8 hours a day in
the workplace and with patients suffering variety of
problems both infectious and noninfectious, admitted in
the hospital.

10. AIMS AND OBJECTIVES
The aims and objectives of Occupation health
and safety are as:
 To promote and maintain the highest degree
of physical, social, and mental well-being of
employees.
 To prevent the adverse effects on the health of
employees caused by their working
conditions.
 To reduce injuries, accidents, infections, and
absenteeism.

11. AIMS AND OBJECTIVES contd…
 To protect the employees in their employment from
risks of occupational health hazards.
 To improve the organizational effectiveness by
improving the quality of nursing care.
 To place and maintain the professional environment
for the employees to adapt their physical and mental
needs with the adaptation of their work.

12. OCCUPATIONAL HAZARDS
According to the Dictionary, occupational hazards are
the dangers to health associated with occupation or
work environment. It includes the risk of accident
and of contracting occupational diseases or can lead to
the death of an individual at the workplace.

13. WHY HOSPITALS HAVE A RISKOF OCCUPATIONAL
HAZARDS
There are many reasons to have a risk of occupational
hazards in the hospital. Hospital is not like other factories
where occupational safety can be measured by industrial
accident rates instead in such a setting; occupational
safety is more concerned about illnesses and diseases that
are arising from the workplace. The hazard risks in the
hospitals are mainly due to the hospital environment,
physical layout and working conditions, and nature of the
profession.

14. 1. HOSPITAL ENVIRONMENT
 Nurses come in direct contact with patients having
Infections, suffering from infectious diseases, chest
infections, bacterial and viral infections. The person
handling such patients has a higher risk of getting
infections. These are hospital cross-infections e.g.
tuberculosis, typhoid, hepatitis, cough, cold, fever, and
bronchitis. The staff working in radiotherapy or
chemotherapy unit are susceptible to Infertility,
chromosomal defects, etc.

15. 2. PHYSICAL LAYOUT AND WORKING
CONDITIONS
 Overcrowding, poor sanitation,
 Poor air ventilation, Inadequate lighting arrangement,
 Lack of safe water facility,
 unsafe working conditions, such as unguarded
machinery, slippery floors, or inadequate fire
precautions, can lead to specific physical hazards and
gastrointestinal and respiratory diseases.

16. 3. PROFESSION ITSELF
 Nature of work: Due to the nature of work such as long-
standing duties, all types of physically strenuous tasks,
e.g. shifting patients from trolley to bed, and other
nursing procedures, etc. This nature of work can lead to
problems of the musculoskeletal system such as backache,
cervical spondylosis, leg cramps, and body ache..

17.  Night duties and regular shift duties: Night and
shift duties can also lead to problems of the
musculoskeletal system and of gastrointestinal e.g.
nausea, vomiting, and indigestion. Changes in lifestyle
patterns can even give rise to psychosomatic and
psychosocial issues like family adjustment problems,
unhappily married life, divorce, etc.

18.  Stressful workplace: Nursing staff is also working in
very stressful conditions where they are caring for
acutely ill and dying patients. Their stressful and painful
situations can affect their psychological well-being and
can create psychosomatic problems such as emotional
upset, depression, mania, and cardiovascular diseases
such as hypertension, anxiety, angina etc.

19.  Lack of promotional avenue: Stagnation, low
social prestige although noble profession can lead in
rejection, frustration, and little job satisfaction that
can affect their personality and mental health.

20. COMMON OCCUPATIONAL HAZARDS
Biological
hazards
Physical
hazards
Chemical
hazards
Ergonomic
hazards
Psychosocial
hazards
Mechanical
hazards

21. COMMON OCCUPATIONAL HAZARDS
Biological hazards:
 Biological hazards are commonly known as occupational
infections that arise due to infectious agents such as
bacteria, viruses, fungi, infectious waste, and parasitic
infestations. Biological hazards exist throughout all
health-care settings. The examples are occupational
pulmonary tuberculosis, viral hepatitis B and C,
HIV/AIDS, SARS and other infectious diseases due to
hospital acquired infections.

22. PHYSICAL HAZARDS
 Physical hazards arise from the extreme level of noise,
vibration, lighting, temperatures, ionizing, and non-
ionizing radiation. Excessive noise can cause
annoyance and stress, increased accident rates,
hearing impairment, and hearing loss.
 The extreme vibrations cause congestion of pelvic and
abdominal organs. The physical hazards due to
thermal include thermal stress, both cold
(hypothermia, frostbite, etc.) and heat exhaustion
(headache, dizziness, fainting, lack of concentration,
anorexia). Poor and defective illumination causes eye
strain, fatigue, accidents, etc.

23.  Non-ionizing radiation leads to cataracts, skin
erythema, burn, etc. The exposure to high ionizing
radiation such as X-rays and gamma rays affects various
organs of the body such as skin, bone, lungs, and blood.
The radiation also has an effect on reproductive function
such as sterility, abortions, stillbirths, and congenital
disabilities.

24. CHEMICAL HAZARDS
 Chemical hazards arise from liquids, solids, dust, fumes,,
vapors, and gases. Toxic chemicals in use in hospitals
include cleaners used by contracted cleaning staff. The
staff may develop skin allergy, contact dermatitis, irritation
to eyes, throat, and lungs.
 Exposure to ethylene gas has an association with the
occurrence of disease on reproductive organs and results in
mutagenic changes, neurotoxicity, and sensitization.
 Health hazards from e-waste recycling due to a chemical
such as beryllium, found in computer motherboards,
cadmium in a chip is poisonous and can lead to cancer,
bleeding from throat and breathlessness, lung ailments
including asthma, bronchitis and chronic lung infections.

25. ERGONOMIC HAZARDS
 Ergonomic hazards occur due to heavy lifting, loading
of application of high vibration, pushing, walking,
repetitive motions, poorly designed types of
machinery, broken instruments, and chipped articles.
The most common hazards are musculoskeletal
disorders. The most important locations are shoulders,
arms, knees, lower backache, injures of muscles and
tendons, ligaments and bones. Nurses used to suffer
from low backache pain, cuts, burns, needle stick
injuries, etc.

26. MECHANICAL HAZARDS
 Mechanical hazards refers to unprotected machines,
the protruding moving parts, lack of safety measures.
These may cause accidents and disabilities.

27. PSYCHOSOCIAL HAZARDS
 Psychosocial hazards occur due to psychological risk
factors such as inadequate personal support system,
workplace stress, safety hazards, environmental
exposures, severe patients and relatives, lack of control
over work situation, shift work, overwork, threats to
physical security, and low wage.
 The environmental; physical factors such as noise,
thermal, radiation, poor lighting, and chemical factors,
and individual social factors such as personality,
interpersonal relationship and age.

28. PSYCHOSOCIAL HAZARDS
contd…
 These factors can cause psychological problems such
as anxiety, dissatisfaction, depression, burnout,
headache, backache, hypertension, diabetes, peptic
ulcer, leg cramps, sleep disturbances, and some
behavioral issues such as absenteeism, poor
interpersonal relation, social isolation,
nonparticipation, and substance use.

29. COMMON OCCUPATIONAL DISEASES
Following are some of the common occupational diseases:
 Hypertension, coronary heart diseases.
 Behavioral and psychosomatic disorders such as
headache, backache, diabetes, peptic ulcer, leg cramps.
sleep disturbances, gastrointestinal problems, etc.
 Gastrointestinal diseases such as peptic ulcer.
 Respiratory nonspecific chronic illness and asthma.
 Musculoskeletal disorders such as low backache ,
shoulder and neck pain, muscle cramps.

30. PREVENTION OF OCCUPATIONAL DISEASES
Medical
measures
Engineering
measures
Legislation

31. Medical Measures
Pre-
placement
examination
Periodical
examination
Medical and
health care
services
Supervision
of working
environment

32. Engineering Measures
 Appropriate structural features, maintenance, and
repair of working place.
 Provision of sufficient lighting, ventilation, odor ,
temperature, humidity, and cleanliness.
 Radiation protection.
 Working facilities for changing and storing clothes.
 Supply of safe drinking water and other welfare
facilities.

33. LEGISLATIVE MEASURES
 The Constitutional Employees' Right to Health
Article 21 of the Indian Constitution has the provision of
protection of life and personal liberty of a person. A
worker has the fundamental right to health; medical
aid, while in service or after retirement, is a
fundamental right. The Directive Principles of State
Policy secure the health and strength of workers, men
and women, and the tender age of children. There is also
a provision of just and humane conditions of work and
maternity relief.

34. OCCUPATIONAL HEALTH LAWS
Some occupational health laws are listed below:
 1. Health Provisions Under the Factories Act, 1948:
The Factories Act, 1948, based on the British Factories Act,
is amended from time to time in India. The Factories
(Amendment) Act was implemented on 1 December
1987. But this Act does not cover hospitals. The Factories
Act 1948 protects workers from long hours of manual
labor. Under this act, employees should work in healthy
and sanitary conditions.

35. Contd….
 2. Chapter IX of the Act
This act has the provision of health, safety, and welfare
measures for the workers in factories and prohibits
women and children from working in certain
occupations
 3. The Employees' State Insurance Act, 1948
Under the ESI Act, the insured workers have benefits of
cash in the case of sickness, maternity, and employment
Injury; the ESI Act also provides pension to the
dependants in case of the death of the insured worker
who died of employment Injury and medical benefit to
workers.

36. 4.OCCUPATIONAL HEALTH PROTECTION
Occupational health safety by ILO/WHO committee in
June 1977 recommends that each member should
adopt laws and regulations on occupational and
security to the individual nature of nursing work and
of the environment in which it is carried out. They
should also have access to occupational health service
recommendations and where occupational health
services are not set up. Following recommendations
must be followed and ensured by the employers, each
member, and organizations:

37. Contd…
a. Working time and rest periods :
 The working hours should not exceed more than 40
hours per week.
 The working day, including overtime, should not
exceed 12 hours.
 There should be meal break, rest break, and week rest.
 There should be a provision for leaves and security.

38. b. Measures for pregnant women and children:
The regular assignment of pregnant women and parents
of young children should not be prejudicial to their
health.
c. Mental health:
There should be counseling sessions for nursing
personnel, especially those who are working in
intensive care and emergency units as they might at
risk of low job satisfaction, emotional instability, and
other psychological problems.

39. 5. OCCUPATIONAL SAFETY AND HEALTH
INSTITUTIONS
There are two leading institutions devoted to occupational
health and safety:
Central Labour Institute, Mumbai and Regional Labour
Institutes in Kolkata, Kanpur, and Chennai under
Ministry of Labour and National Institute of Occupational
Health (NIOH), Ahmedabad and Regional Institutes in
Kolkata and Bengaluru under the Indian Council of
Medical Research (ICMR) Ministry of Health.
The National Institute of Occupational Health (NIOH) is
quite active as a research institute, providing enough
training of staff to get aware of health-care facilities of the
dangers surrounding them and take adequate precautions
to avoid hazards and appropriate measures in case of
accidents.

40. National policy on safety, health
and environment (2009)
The main objective of policy on safety and health at the
national level is to reduce occupational risks and
health problems. It also aims to provide a database
for better monitoring and improving performance. Its
focus is to make the public aware of safety and health
at the workplace.

41. INDIANANDTHE INTERNATIONALLABOUR
ORGANIZATION
India is a founder member of ILO. ILO sets up the
“International Labour Standards” in the form of
Recommendations. ILO concerns:
 Worker’s fundamental rights, protection,
 Social security, labour welfare,
 Occupational safety and health,
 Women and child labour, migrant labour, etc.

42. Health and Safety Program at the local
level
1. Nosocomial infection control:
 The hospital’s infection control nurse and infection
control committee are concerning with the prevention,
surveillance, and control of Nosocomial infections.
 The hospitals must have an infection control program
in the hospital’s Infection Control Manual.
 The manual must outline the principles, strategies,
policies, and procedures for infection control in the
hospital.
 All staff should be familiar with the manual.

43. 2. PATIENT SAFETY
The hospital must have standard operative protocols for
patient safety. For example, keeping bed rails up
particularly for those patients with an altered
conscious state from medication or illness,
maintenance of equipments, bathroom/toilet aids
particularly for the elderly or disabled, walking aids for
the disabled, and during recovery, prevention of
pressure ulcers, carefully applying hot water bottle if
required to the unconscious patients, and prevention
of chemical burns, etc.

44. 3. FOOD SAFETY
 Hospital kitchens prepare meals for inpatients, and in
many cases, prepare meals for the staff canteen.
 The food storage, handling, and preparation should be
done to the highest standards to avoid any risk to
already sick or compromised patients.

45. BIOMEDICAL WASTE MANAGEMENT
ISSUES
 The major components of such a waste management
system include the following:
 Waste segregation at the source: There should be
sharp containers, biohazard bins, general waste bins,
and cytotoxic bins; all standardized and color coded.
 Waste streams: These should be general,
contaminated, cytotoxic/pharmaceutical, body parts.
 Storage and transport: There should be the provision
of cold storage for contaminated waste and body parts;
transport in safe, leak-proof containers.

46. Contd….
Waste treatment: the hospital must have the provision
of sterilization of contaminated waste (steam
autoclave); incineration of cytotoxic, pharmaceuticals,
and body parts in an incinerator meeting all relevant
standards.
Waste disposal: there should be clear-cut guidelines for
Local Council approved engineered sanitary landfill.

47. Nurses Role in the prevention of occupational
hazards/ Diseases
At operational level
1. The nurse may identify the need, assess, and plan
interventions to reduce the risk of hazardous exposure.
2. Advocates necessary research ultimately leading to risk
reduction and prevention strategies in the workplace.
3. Engage in routine health surveillance procedures, periodic
health assessment, and in evaluating the results from such
screening processes and maintain a high degree of
alertness to any abnormal findings.
4. Follow universal standard precaution and standard safety
measures. Use personal protective devices where required.

48. 5. Use appropriate techniques and body posture for
lifting and positioning of patients.
6. Take proper sleep, especially after night duties.
7. Follow policies and intervention guidelines.
8. Report incidents to appropriate authority.

49. B. At administrative level
 Ensure the availability of protective equipment and
cleansing agents.
 Establish an immunization program for all nurses.
 Provide personal protective equipment (PPE).
 Establish procedure for the use of diagnostic
equipment and PPE.
 Minimize exposure time to radiation.
 Promote rest breaks.
 A well planned rotation plan with rest breaks during
night shift and the day off after night duty.
 Maintain the right work environment and culture.

51. SUMMARY AND CONCLUSION
 Occupational health and safety are about the physical,
social, and mental well-being of workers as a whole.
 Occupation hazards are the dangers to health
associated with occupation or work environment.
 The typical occupational hazards in the hospital are:
biological, physical, chemical, ergonomic and
psychosocial hazards.
 There is safety legislation at constitutional, national,
and the local level to prevent and control health
hazards of the workplace.

52. BIBLIOGRAPHY
1. Vati. J. Principles and Practice of Nursing Management &
Administration. 2nd edition (2020). JAYPEE Publishers; p. 363-369.
2. Gina. S. Occupational Hazards (2021). Retrieved on 20th July
2022.www.webmd.com/a-to-z.
3. World Health Organization. Occupational Hazards in the health sector
(2021). Retrieved on 22nd July 2022.www.who.int/tool/occupational
hazards.
4. Correll. R. What is Occupational Health and Safety? (February 17, 2022).
Accessed on 1st August 2022. www.verywellhealth.com
5. International Labour Organization. Introduction to Occupational Health
and Safety(2021). Accessed on 1st August 2022. training.itcilo.org/ actrav

53. Q1. Define Occupational health?
Q2. List Occupational hazards?
Q3. List common occupational diseases?
Q4. List few legislations related to occupational health
and safety ?