Lecture of Occupational Health of Community Medicine

1. DR. FARHANA YASMIN
DEPARTMENT OF COMMUNITY MEDICINE
Occupational
health

4. OCCUPATIONAL HEALTH
 The Joint ILO/WHO Committee on Occupational
Health, in the course of its first session, held in 1950,
gave the following definition: "Occupational health
should aim at the promotion and maintenance of
the highest degree of physical, mental and social
well-being of workers in all occupations; the
prevention among workers of departures from
health caused by their working conditions; the
protection of workers in their employment from
risks resulting from factors adverse to health; the
placing and maintenance of the worker in an
occupational environment adapted to his
physiological and psychological equipment, and,
to summarize, the adaptation of work to man and
of each man to his job.

5. OCCUPATIONAL HEALTH
 In the past, it was customary to think of
occupational health entirely in relation to
factories and mines;
 Modern concepts of occupational health now
embrace all types of employment including
mercantile and commercial enterprises,
service trades, forestry and agriculture and
includes the subjects of industrial hygiene,
industrial diseases, industrial accidents,
toxicology in relation to industrial hazards,
industrial rehabilitation and occupational
psychology.

6. AIMS OF OCCUPATIONAL HEALTH
1. The prevention of disease and maintenance of the
highest degree of physical, mental and social well-being of
workers in all occupations
2. The levels of application of preventive measures are the
same - health promotion, specific protection, early diagnosis
and treatment, disability limitation and rehabilitation; the
tools are the same - epidemiologic approach, statistics,
health screening, health education etc.
3. One of the declared aims of occupational health is to
provide a safe 'occupational environment' in order to
safeguard the health of the workers and to step up industrial
production.

7. ERGONOMICS
 The term "ergonomics" is derived from the
Greek ergon, meaning work and nomos,
meaning law.
 It simply means: "fitting the job to the
worker".
 Training in ergonomics involves designing of
machines, tools, equipment and manufacturing
processes, lay-out of the places of work,
methods of work and environment in order to
achieve greater efficiency of both man and
machine .

8. ERGONOMICS
The object of ergonomics is "to achieve the
best mutual adjustment of man and his
work, for the improvement of human
efficiency and well-being".
The application of ergonomics has made a
significant contribution to reducing industrial
accidents and to the overall health and
efficiency of the workers .

9. OCCUPATIONAL ENVIRONMENT
 By "occupational environment" is meant
the sum of external conditions and
influences which prevail at the place of
work and which have a bearing on the
health of the working population.

10. OCCUPATIONAL ENVIRONMENT
 Basically, there are three types of interaction
in a working environment:
 (a) Man and physical, chemical and
biological agents
 (b) Man and machine
 (c) Man and man.

11. MAN AND PHYSICAL, CHEMICAL AND
BIOLOGICAL AGENTS
 (1) Physical agents: The physical factors in the
working environment which may be adverse to health
are heat, cold, humidity, air movement, heat radiation,
light, noise, vibrations and ionizing radiation.
 (2) Chemical agents: These comprise a large
number of chemicals, toxic dusts and gases which
are potential hazards to the health of the workers.
 (3) Biological agents: The workers may be exposed
to viral, rickettsial, bacterial and parasitic agents
which may result from close contact with animals or
their products, contaminated water, soil or food.

12. MAN AND MACHINE
 The unguarded machines, protruding and
moving parts, poor installation of the
plant, lack of safety measures are the
causes of accidents which is a major
problem in industries.
 Working for long hours in
unphysiological postures is the cause of
fatigue, backache, diseases of joints and
muscles and impairment of the worker's
health and efficiency.

13. MAN AND MAN
 There are numerous psychosocial factors which
operate at the place of work.
 These are the human relationships amongst
workers themselves on the one hand, and those in
authority over them on the other. Examples of
psychosocial factors include the type and rhythm
of work, work stability, service conditions, job
satisfaction, leadership style, security, workers
participation, communication, system of
payment, welfare conditions, degree of
responsibility, trade union activities, incentives
and a host of similar other factors, all entering the
field of human relationships.

14. OCCUPATIONAL HAZARDS
 An industrial worker may be exposed to five
types of hazards, depending upon his
occupation:
 (a) Physical hazards
 (b) Chemical hazards
 (c) Biological hazards
 (d) Mechanical hazards
 (e) Psychosocial hazards.

16. OCCUPATIONAL HAZARDS (CONTD.)
 a. Physical hazards:
 (1) HEAT AND COLD: - The direct effects of
heat exposure are burns, heat exhaustion, heat
stroke and heat cramps; the indirect effects
are decreased efficiency, increased fatigue and
enhanced accident rates.
 Many industries have local "hot spots" ovens
and furnaces, which radiate heat. Radiant heat
is the main problem in foundry, glass and steel
industries, while heat stagnation is the principal
problem in jute and cotton textile industry .

21. OCCUPATIONAL HAZARDS (CONTD.)
 High temperatures are also found in mines for
instance in the Kolar Gold Mines of Mysore
which is the second deepest mine of the world
(11,000 feet), temperatures as high as 65 deg.
C are recorded .
 Important hazards associated with cold work are
chilblains, erythrocyanosis, immersion foot,
and frostbite as a result of cutaneous
vasoconstriction. General hypothermia is
not unusual .

22. OCCUPATIONAL HAZARDS (CONTD.)
 (2) LIGHT: The workers may be exposed to the
risk of poor illumination or excessive brightness.
The acute effects of poor illumination are eye
strain, headache, eye pain, lachrymation,
congestion around the cornea and eye fatigue.
 The chronic effects on health include "miner's
nystagmus". Exposure to excessive brightness or
"glare" is associated with discomfort, annoyance
and visual fatigue. Intense direct glare may also
result in blurring of vision and lead to accidents.
There should be sufficient and suitable lighting,
natural or artificial, wherever persons are working

24. OCCUPATIONAL HAZARDS (CONTD.)
 (3) NOISE: Noise is a health hazard in many
industries. The effects of noise are of two
types: (i) Auditory effects which consist of
temporary or permanent hearing loss.
 (ii) Non-auditory effects which consist of
nervousness, fatigue, interference with
communication by speech, decreased
efficiency and annoyance

28. OCCUPATIONAL HAZARDS (CONTD.)
 (4) VIBRATION: Vibration, especially in the
frequency range 10 to 500 Hz, may be
encountered in work with pneumatic tools such
as drills and hammers.
 Vibration usually affects the hands and arms.
After some months or years of exposure, the
fine blood vessels of the fingers may become
increasingly sensitive to spasm (white fingers).
 Exposure to vibration may also produce injuries
of the joints of the hands, elbows and shoulders

32. OCCUPATIONAL HAZARDS (CONTD.)
 (5) ULTRAVIOLET RADIATION :
Occupational exposure to ultraviolet radiation
occurs mainly in arc welding. Such radiation
mainly affects the eyes, causing intense
conjunctivitis and keratitis (welder's flash).
Symptoms are redness of the eyes and pain,
these usually disappear in a few days with no
permanent effect on the vision or on the
deeper structures of the eye .

33. OCCUPATIONAL HAZARDS (CONTD.)
 (6) IONIZING RADIATION : Ionizing radiation is finding
increasing application in medicine and industry, e.g., X-
rays and radio-active isotopes. Important radio-isotopes
are cobalt 60 and phosphorus 32.
 Certain tissues such as bonemarrow are more sensitive
than others and from a genetic standpoint, there are
special hazards when the gonads are exposed.
 The radiation hazards comprise genetic changes,
malformation, cancer, leukaemia, depilation,
ulceration, sterility and in extreme cases death. The
International Commission of Radiological Protection has
set the maximum permissible level of occupational
exposure at 5 rem per year to the whole body

34. OCCUPATIONAL HAZARDS (CONTD.)
 b. Chemical hazards - Chemical agents act
in three ways : local action, inhalation and
ingestion.

36.  (1) LOCAL ACTION : Some chemicals cause
dermatitis, eczema, ulcers and even cancer
by primary irritant action; some cause
dermatitis by an allergic action. Some
 chemicals, particularly the aromatic nitro
and amino compounds such as TNT and
aniline are absorbed through the skin and
cause systemic effects.
 Occupational dermatitis is a big problem in
industry.

38. OCCUPATIONAL HAZARDS (CONTD.)
 (2) INHALATION : (i) DUSTS : Dusts are
finely divided solid particles with size ranging
from 0.1 to 150 microns. They are released
into the atmosphere during crushing,
grinding, abrading, loading and unloading
operations. Dusts are produced in a number
of industries mines, foundry, quarry, pottery,
textile, wood or stone working industries

40. OCCUPATIONAL HAZARDS (CONTD.)
 Particles smaller than 5 microns are directly
inhaled into the lungs arid are retained there.
This fraction of the dust is called "respirable
dust", and is mainly responsible for
pneumoconiosis. Dusts have been
·classified into inorganic and organic dusts;
soluble and insoluble dusts. The inorganic
dusts are silica, mica, coal, asbestos dust,
etc. the organic dusts are cotton, jute and the
like.

41. OCCUPATIONAL HAZARDS (CONTD.)
 The insoluble dusts remain, more or less,
permanently in the lungs. They are mainly
the cause of pneumoconiosis. The most
common dust diseases in this country are
silicosis and anthracosis

42. OCCUPATIONAL HAZARDS (CONTD.)
 (ii) GASES : . Gases are sometimes
classified as simple gases (e.g., oxygen,
hydrogen), asphyxiating gases (e.g.
carbon monoxide, cyanide gas, sulphur
dioxide, chlorine) and anaesthetic gases
(e.g., chloroform, ether, trichlorethylene).
Carbon monoxide hazard is frequently
reported in coal-gas manufacturing plants
and steel industry.

43. OCCUPATIONAL HAZARDS (CONTD.)
 (iii) METALS AND THEIR COMPOUNDS: A
large number of metals, and their
compounds are used throughout the industry.
The chief mode of entry of some of them is
by inhalation as dust or fumes. The
industrial physician should be aware of the
toxic effects of lead, antimony, arsenic,
beryllium, cadmium, cobalt, manganese,
mercury, phosphorus, chromium, zinc and
others.

44. OCCUPATIONAL HAZARDS (CONTD.)
 (3) INGESTION: Occupational diseases may
also result from ingestion of chemical
substances such as lead, mercury, arsenic,
zinc, chromium, cadmium, phosphorus etc.

45. OCCUPATIONAL HAZARDS (CONTD.)
 B) Biological hazards :The occupational
diseases in this category are brucellosis,
leptospirosis, anthrax, hydatidosis,
psittacosis, tetanus, encephalitis, fungal
infections, schistosomiasis and a host of
others. Persons working among animal
products (e.g., hair, wool, hides) and
agricultural workers are specially exposed to
biological hazards

46. OCCUPATIONAL HAZARDS (CONTD.)
 d. Mechanical hazards : The mechanical
hazards in industry centre round machinery,
protruding and moving parts and the like.
About 10 per cent of accidents in industry are
said to be due to mechanical causes.

48. OCCUPATIONAL HAZARDS (CONTD.)
 . Psychosocial hazards :Frustration, lack of
job satisfaction, insecurity, poor human
relationships, emotional tension are some of
the psychosocial factors which may
undermine both physical and mental health
of the workers.

54. OCCUPATIONAL DISEASES
 Occupational diseases are usually defined as diseases
arising out of or in the course of employment. For
convenience, they may be grouped as under:
 I. Diseases due to physical agents (1) Heat : Heat
hyperpyrexia, heat exhaustion, heat syncope, heat cramps, burns
and local effects such as prickly heat.
 2)Cold: Trench foot, frost bite, chilblains
 (3) Light : Occupational cataract, miner's nystagmus : Caisson
disease, air embolism, blast
 4) Pressure (explosion)
 (5) Noise : Occupational deafness
 (6) Radiation : Cancer, leukaemia, aplastic anaemia,
pancytopenia
 (7) Mechanical : Injuries, accidents factors (8) Electricity : Burns.

55. OCCUPATIONAL DISEASES (CONTD.)
 II. Diseases due to chemical agents :
 (1) Gases: COv CO, HCN, CS2, NH3, N2,
H2S, HCI, S02 these cause gas poisoning.
 (2) Dusts (Pneumoconiosis) (i) Inorganic
dusts : (a) Coal dust Anthracosis (b) Silica
(c) Asbestos (d) Iron Silicosis Asbestosis,
cancer lung Siderosis (ii) Organic
(vegetable) dusts (a) Cane fibre Bagassosis

57. OCCUPATIONAL DISEASES (CONTD.)
 Cotton dust (c) Tobacco (d) Hay or grain dust
 Byssinosis Tobacossis (11) Farmers' lung
 (3) Metals and their compounds Toxic hazards from lead,
mercury, cadmium, manganese, beryllium, arsenic, chromium etc.
 (4) Chemicals : Acids, alkalies, pesticides
 (5) Solvents : Carbon bisulphide, benzene, trichloroethylene,
chloroform, etc.
 III. Diseases due to biological agents Brucellosis, leptospirosis,
anthrax, actinomycosis, hydatidosis, psittacosis, tetanus,
encephalitis, fungal infections, etc.
 N. Occupational cancers Cancer of skin, lungs, bladder.
 V. Occupational dermatosis Dermatitis, eczema.
 VI. Diseases of psychological origin Industrial neurosis,
hypertension, peptic ulcer, etc.

66. PNEUMOCONIOSIS

72. PNEUMOCONIOSIS
 Dust within the size range of 0.5 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 working capacity due to lung fibrosis
and other complications.

74. PNEUMOCONIOSIS
 The hazardous effects of dusts on the lungs depend
upon a number of factors such as :
 (a) chemical composition
 (b) fineness
 c) concentration of dust in the air
 (d) period of exposure and
 e) health status of the person exposed.
 In addition to the toxic effect of the dust on the lung
tissues, the super-imposition of infections like
tuberculosis may also influence the pattern of
pneumoconiosis.
 There is no cure for pneumoconiosis .Hence prevention is
essential.

76. PNEUMOCONIOSIS
 Definition (ILO) : Pneumoconiosis is the
accumulation of dust in the lungs and the tissue
reaction to its presence .
 ‘Pneumoconioses ’ is the plural
 Dust within the size range of 0.5 to 3 micron
pose maximum risk as these can easily enter
the alveoli.
- Particles larger than 3 microns don’t reach the alveoli
- Particles smaller than 0.5 microns are exhaled out
- The dust particles which get deposited in the alveoli, cause
inflammation in the lungs that can eventually lead to fibrosis
of the lung tissue.

77. PNEUMOCONIOSIS
 Greek words : pneuma=air and konis=dust
 In addition to causing fibrosis ,the deposition of
dust also leads to :
-Reduced cilliary clearance
-The chemical composition may be cytotoxic
-Some dust may cause more fibrosis than others
e.g.silica
-coal appears to be relatively inert and may
accumulate in sizable amounts with minimal tissue
response

78. PNEUMOCONIOSIS
 Mostly the exposure to dust occurs as a
result of occupation hence pneumoconioses
are included under occupational diseases.
 The specific types of pneumoconeuses are
named by the substance inhaled (e.g.
silicosis,asbestosis,anthracosis).

79. PNEUMOCONIOSIS
Type of dust Disease
Mineral or inorganic
dust
Coal dust Anthracosis
Silica Silicosis
Asbestos Asbestosis,cancer lung
Iron Siderosis

80. PNEUMOCONIOSIS
Organic Dust (Hypersensitivity
Pneumoconiosis)
Type of dust Disease
Sugarcane fiber Bagassosis
Cotton dust Byssinosis
Tobacco Tobaocossis
Hay or grain dust Farmers’s lung

81. SILICOSIS
 Among the occupational diseases, silicosis is
the major cause of permanent disability and
mortality.
 It is caused by inhalation of dust containing
free silica or silicon dioxide (Si02).
 It was first reported in India from the Kolar
Gold Mines (Mysore) in 1947.

82. SILICOSIS (CONTD.)
Silica exposure occurs in industries like:
-Mining of :
.Coal
.Mica
.Gold and silver
.Lead ,Zinc, Manganese etc.
-Pottery and ceramic
-Sand blasting
-Metal grinding
-Building and construction
-Rock mining
-Iron and steel etc.

86. SILICOSIS (CONTD.)
 The higher the concentration of free silica in
the dust, the greater the hazard.
 The longer the duration of exposure, the
greater the risk of developing silicosis. It is
found that the incubation period may vary
from a few months up to 6 years of exposure,
depending upon the above factors.

87. SILICOSIS (CONTD.)
 The particles are ingested by the phagocytes which
accumulate and block the lymph channels. -----
Pathologically, silicosis is characterized by a dense
"nodular" fibrosis, the nodules ranging from 3 to 4
mm in diameter.
 Clinically the onset of the disease is insidious. Some of
the early manifestations are irritant cough, dyspnea· on
exertion and pain in the chest.
 With more advanced disease, impairment of total lung
capacity (TLC) is commonly present. An X-ray of the
chest shows "snow-storm" appearance in the lung fields.
Silicosis is progressive and what is more important is that
silicotics are prone to pulmonary tuberculosis, , a
condition called "silico-tuberculosis."

89. SILICOSIS (CONTD.)
 There is no effective treatment for silicosis.
Fibrotic changes that have already taken place
cannot be reversed.
 The only way that silicosis can be controlled (if not
altogether eliminated) is by
 (a) rigorous dust control measures, e.g.,
substitution, complete enclosure, isolation,
hydroblasting, good house-keeping, personal
protective measures and
 (b) regular physical examination of workers .
 Silicosis was made a notifiable disease under the
Factories Act 1948 and the Mines Act 1952.

90. ANTHRACOSIS
 Carbon dust (coal mine dust ):
 Coal miner’s pneumoconiosis
 t there are two general phases in coal miners
pneumoconiosis - (1) the first phase is labelled simple
pneumoconiosis which is associated with little
ventilatory impairment. This phase may require about
12 years of work exposure for its development
(2) the second phase is characterised by progressiue
massiue fibrosis (PMF); this causes severe respiratory
disability and frequently results in premature death.
Once a background of simple pneumoconiosis has
been attained in the coal worker, a progressive massive
fibrosis may develop out

101. LEAD POISONING
 More industrial workers are exposed to lead than to
any other toxic metal.
 Lead is used widely in a variety of industries because
of its properties :
 ( 1) low boiling point
(2) mixes with other metals easily to form alloys
(3) easily oxidised and
(4) anticorrosive.
All lead compounds are toxic - lead arsenate, lead
oxide and lead carbonate are the most dangerous;
lead sulphide is the least toxic

102. LEAD POISONING
 INDUSTRIAL USES :
 Over 200 industries are counted where
lead is used - manufacture of storage
batteries; glass manufacture; ship
building; printing and potteries; rubber
industry and several others.

103. LEAD POISONING
 INDUSTRIAL USES :
Over 200 industries are counted where lead is used
- manufacture of storage batteries; glass
manufacture; ship building; printing and potteries;
rubber industry and several others.
NON-OCCUPATIONAL SOURCES :The greatest
source of environmental (non-occupational) lead is
gasoline. Thousands of tons of lead every year is
exhausted from automobiles. Lead is one of the few
trace metals that is abundantly present in the
environment Lead exposure may also occur
through drinking water from lead pipes; chewing
lead paint on window sills or toys in case of
children.

104. LEAD POISONING
 MODE OF ABSORPTION : Lead poisoning may occur in
three ways:
 (1) INHALATION: Most cases of industrial lead poisoning is
due to inhalation of fumes and dust of lead or its
compounds.
 (2) INGESTION: Poisoning by ingestion is of less common
occurrence. Small quantities of lead trapped in the upper
respiratory tract may be ingested. Lead may also be
ingested in food or drink through contaminated hands.
 (3) SKIN : Absorption through skin occurs only in respect of
the organic compounds of lead, especially tetraethyl lead

105. LEAD POISONING
 BODY STORES : The body store of lead in
the average adult population is about 150 to
400 mg and blood levels average about
25µg/100 ml. An increase to 70µg/100 ml
blood is generally associated with clinical
symptoms. Normal adults ingest about 0.2 to
0.3 mg of lead per day largely from food and
beverages

107.  CLINICAL PICTURE :The toxic effects of
inorganic lead exposure are abdominal
colic, obstinate constipation, loss of appetite,
blue-line on the gums, stippling of red cells,
anaemia, wrist drop and foot drop.
 The toxic effects of organic lead
compounds are mostly on the central
nervous system insomnia, headache, mental
confusion, delirium, etc.

108. LEAD POISONING
 DIAGNOSIS :Diagnosis of lead poisoning is based on :
 (1) HISTORY: a history of lead exposure
 (2) CLINICAL FEATURES : such as loss of appetite, intestinal colic,
persistent headache, weakness, abdominal cramps and
constipation, joint and muscular pains, blue line on gums,
anaemia, etc.
 (3) LABORATORY TESTS :
 (a) Coproporphyrin in urine (CPU) : Measurement of CPU is a
useful screening test. In non-exposed persons, it is less than 150
microgram/litre. (b) Amino levulinic acid in urine (ALAU) : If it
exceeds 5 mg/ litre, it indicates clearly lead absorption.
 (c) Lead in blood and urine : Measurement of lead in blood or urine
requires refined laboratory techniques. They provide quantitative
indicators of exposure. Lead in urine of over 0.8 mg/litre (normal is
0.2 to 0.8 mg) indicates lead exposure and lead absorption. A blood
level of 70µg/100 ml is associated with clinical symptoms. (d)
Basophilic stipling of RBC : Is a sensitive parameter of the
haematological response

109. LEAD POISONING
 PREVENTIVE MEASURES :(1)
Substitution : That is, where possible lead
compounds should be substituted by less
toxic materials.
 (2) Isolation : All processes which give
rise to harmful concentration of lead dust
or fumes should be enclosed and
segregated.
 (3) Local exhaust ventilation: There
should be adequate local exhaust
ventilation system to remove fumes and

110. LEAD POISONING
 (5) Good house-keeping : Good house-keeping is
essential where lead dust is present. Floors, benches,
machines should be kept clean by wet sweeping.
(6) Working atmosphere : Lead concentration in the
working atmosphere should be kept below 2.0 mg per 10 cu.
metres of air, which is usually the permissible limit or
threshold value.
 (7) Periodic examination of workers : All workers must
be given periodical medical examination. Laboratory
determination of urinary lead, blood lead, red cell count,
haemoglobin estimation and coproporphyrin test of urine
should be done periodically.

111.  (8) Personal hygiene : Handwashing before
eating is an important measure of personal
hygiene. There should be adequate washing
facilities in industry. Prohibition on taking
food in work places is essential.
 (9) Health education : Workers should be
educated on the risks involved and personal
protection measures

112. LEAD POISONING
 MANAGEMENT :
 The major objectives in management of lead
poisoning are the prevention of further
absorption, the removal of lead from soft tissues
and prevention of recurrence. Early recognition of
cases will help in removing· them from further
exposure.
 A saline purge will remove unabsorbed lead from
the gut. The use of d-penicillamine has been
reported to be effective. Like Ca-EDTA, it is a
chelating agent and works by promoting lead
excretion in urine.
 Lead poisoning is a notifiable and compensatable
disease in India since 1924.

113. OCCUPATIONAL CANCER
 Occupational cancer is a serious problem in
Industry. The sites of the body most commonly
affected are skin, lungs, bladder, and blood-
forming organs.
 1. Skin cancer :Percival Pott was first to draw
attention to cancer of scrotum in chimney
sweeps in 1775.
 It was subsequently found that cancer of the
scrotum and of the skin in other parts of the
body was caused by coal tar, X-rays, certain oils
and dyes.
 Statistics now show that nearly 75 per cent of
occupational cancers are skin cancer

114. OCCUPATIONAL CANCER
 Skin cancers are an occupational hazard among gas
workers, coke oven workers, tar distillers, oil refiners, dye-
stuff makers, road makers and in industries associated
with the use of mineral oil, pitch, tar and related
compounds.
 2. Lung cancer :Lung cancer is a hazard in gas
industry, asbestos industry, nickel and chromium
work, arsenic roasting plants and in the mining of
radio-active substances (e.g., uranium). Nickel,
chromates, asbestos, coal tar (presumably 3-4
benzpyrene), radio-active substances and cigarette-
smoking are proved carcinogens for the lungs.
Arsenic, beryllium and isopropyl oil are suspected
carcinogens.
 More than ninetenths of lung cancer are attributed to
tobacco smoking, air pollution and occupational

115. OCCUPATIONAL CANCER
 3. Cancer bladder :Cancer bladder was first
noted in man in aniline industry in 1895.
 In more recent years, it was noted in the
rubber industry.
 It is now known that cancer bladder is
caused by aromatic amines, which are
metabolized in the body and excreted in the
urine.
 The industries associated with cancer
bladder are the dye-stuffs and dyeing

116. OCCUPATIONAL CANCER
 The following have been mentioned as possible
bladder carcinogens. : Betanaphthylamines,
benzidine, para-amino-diphenyl, auramine
and magenta.
 4. Leukaemia :Exposure to benzol, roentgen
rays and radio-active substances give rise to
leukaemia.
 Benzol is a dangerous chemical and is used
as a solvent in many industries.
 Leukaemia may appear long after exposure
has ceased.

117. OCCUPATIONAL CANCER
 The characteristics of occupational cancer
are :
 1) they appear after prolonged exposure,
 2) the period between exposure and
development of the disease may be as long as
10 to 25 years, {
 3) the disease may develop even after the
cessation of exposure,
 (4) the average age incidence is earlier than
that for cancer in general,
 (5) the localization of the tumours is remarkably

118. CONTROL OF INDUSTRIAL CANCER
 The control measures comprise the following -
(1) elimination or control of industrial
carcinogens. Technical measures like exclusion
of the carcinogen from the industry, well-
designed building or machinery, closed system
of production, etc.,
 (2) medical examinations,
 (3) inspection of factories,
 (4) notification,
 (5) licensing of establishments, (6) personal
hygiene measures, (7) education of workers and
management, and (8) research

129. RADIATION HAZARDS
 A number of industries use radium and other radio-
active substances, e.g., painting of luminous dials for
watches and other instruments, manufacture of radio-
active paints.
 Exposure to radium also occurs in mining of radio-
active ores, monozite sand workers and handling of
their products.
 X-rays are used both in medicine and industry.
Exposure to ultraviolet rays occurs in arc and other
electric welding processes. Infrared rays are
produced in welding, glass blowing, foundry work and
other processes where metal and glass are heated to
the molten state, and in heating and drying of painted
and lacquered objects.

130. RADIATION HAZARDS
 Effects of radiation :
 Occupational hazards due to ionizing
radiation may be acute burns, dermatitis
and blood dyscrasias;
 chronic exposure may cause
malignancies and genetic effects. Lung
cancer may develop in miners working in
uranium mines due to inhalation of radio-
active dust.

131. RADIATION HAZARDS
 Preventive measures :
 (1) Inhalation, swallowing or direct
contact with the skin should be avoided.
 (2) In case of X-rays, shielding should be
used of such thickness and of such
material as to reduce the exposure below
allowable exposures.
 (3) The employees should be monitored at
intervals not exceeding 6 months by use
of the film badge or pocket electrometer

132. RADIATION HAZARDS
 (4) Suitable protective clothing to prevent
contact with harmful material should be
used.
 (5) Adequate ventilation of work-place is
necessary to prevent inhalation of harmful
gases and dusts.
 (6) Replacement and periodic examination of
workers should be done every 2 months. If
harmful effects are found, the employees
should be transferred to work not involving
exposure to radiation, and
 (7) Pregnant women should not be allowed
to work in places where there is continuous

158. SICKNESS ABSENTEEISM

159. SICKNESS ABSENTEEISM
 Sickness absence is an important health
problem in industry.
 It may seriously impede production with
serious cost repercussions, both direct as
well as indirect .
 Absenteeism is a useful index in industry to
assess the state of health of workers, and
their physical, mental and social well-being

179. HEALTH PROBLEMS DUE
TO INDUSTRIALIZATION

180.  Industrialization implies the transformation of a
peasant society into a community dependent
upon the industries.
 It involves individual and collective technical
skills for the manufacture of particular goods
through highly specialized processes.
 There is division of work under the same roof
with emphasis on mass production and
community profit.
 In short, industrialization means a social and
economic revolution in the culture of a nation.
 Any such revolution is bound to carry with it
some associated hazards.

181. HEALTH PROBLEMS DUE TO INDUSTRIALIZATION
 The community health problems ansmg out
of industrialization may be enumerated as
follows.
 1. ENVIRONMENTAL SANITATION
PROBLEMS :
 - HOUSING
 -Water pollution
 -Air pollution
 -Sewage disposal
2 .COMMUNICABLE DISEASES :

182. HEALTH PROBLEMS DUE TO INDUSTRIALIZATION
 3.Food Sanitation
 4.Mental health
 5.Accidents
6. Social problems
7.Morbidity and mortality

183. MEASURES FOR HEALTH PROTECTION OF
WORKERS
 The measures for the general health protection
of workers was the subject of discussion by an
ILO/WHO Committee on Occupational Health in
1953. The Committee recommended the
following .
 1. Nutrition .
 2. Communicable disease control
3. Environmental sanitation
-water supply
-Food
-Toilet

184. MEASURES FOR HEALTH PROTECTION OF
WORKERS
 - GENERAL PLANT
CLEANLINESS
 - SUFFICIENT SPACE
 - LIGHTING
 - VENTILATION,
TEMPERATURE
 -PROTECTION AGAINST
HAZARDS
 -HOUSING

185. MEASURES FOR HEALTH PROTECTION OF
WORKERS
6. Health education
7. Family planning

186. PREVENTION OF OCCUPATIONAL DISEASES
 The various measures for the prevention of
occupational diseases may be grouped
under three heads:
 -medical,
 -engineering and
 -statutory or legislative.

187. PREVENTION OF OCCUPATIONAL DISEASES
 1. MEDICAL MEASURES –
 1. Pre-placement examination
 2. Periodical examination
 3. Medical and health care services
 4. Notification
 5. Supervision·of working environment
 6. Maintenance and analysis of records
 7. Health education and counselling

188. PREVENTION OF OCCUPATIONAL DISEASES
 2. ENGINEERING MEASURES –
 - Design of building
 - Good house-keeping
 - General ventilation
 - Mechanization
 - Substitution
 - Dusts
 - Enclosure
 - Isolation

189. PREVENTION OF OCCUPATIONAL DISEASES
- Local exhaust ventilation
- Protective devices
-Environmental monitoring
- Statistical monitoring
- Research
3. LEGISLATION

190. BENEFITS TO EMPLOYEES
 ( 1) Medical benefit
 (2) Sickness benefit
 (3) Maternity benefit
 (4) Disablement benefit
 (5) Dependant's benefit
 (6) Funeral expenses
 (7) Rehabilitation allowance

191. PRE-PLACEMENT EXAMINATION
 Pre-placement examination is the foundation of
an efficient occupational health service.
 It is done at the time of employment and
includes the worker's medical, family,
occupational and social history; a thorough
physical examination and a battery of
biological and radiological examinations,
e.g., chest X-ray, electro-cardiogram, vision
testing, urine and blood examination, special
tests for endemic disease.

192. PRE-PLACEMENT EXAMINATION
 The purpose of preplacement
examination is to place the right man in
the right job, so that the worker can perform
his duties efficiently without detriment to his
health. This is ergonomics.
 Pre-placement examination will also serve
as a useful bench-mark for future
comparison.

193. PERSONAL PROTECTIVE DEVICES
 Respirators and gas masks are among
the oldest devices used to protect
workers against air-borne contaminants
and they are still used for that purpose.
 The other protective devices comprise ear
plugs, ear muffs, helmets, safety shoes,
aprons, gloves, gum boots, barrier
creams, screens and goggles.

194. OCCUPATIONAL HEALTH PROGRAMMES IN
BANGLADESH
 With the rapid progress of industrialization in
Bangladesh, numerous occupational hazards
are being encountered in various production
processes.
 These hazards involve very often
occupational accidents diseases leading to
reduction of productivity ,damage of
establishment or equipments , loss of skilled
workers as well as compensation for the
dead or injured.

195. OCCUPATIONAL HEALTH PROGRAMMES IN
BANGLADESH
 The government is conscious about the need
for a proper welfare programme.
 The laws which regulate the health, safety
and welfare provisions and working
conditions of workers are-
 -The Factories Act ,1965
 -Workmen’s Compensation Act
1980
 -Tea Plantation Labour Ordinance
,1962

196. OCCUPATIONAL HEALTH PROGRAMMES IN
BANGLADESH
 -Maternity Benefit Act ,1939
 -The Dock Labourer’s Act ,1934
 -The shops and Establishment’s Act ,1965
 -Minimum wages Ordinance ,1961
 -Employment of Children Act,1938
 -The Payment of Wages Act ,1936
 -The Minimum Wages Ordinance ,1961
 -The Railway Act,1980.

197. OFFENSIVE TRADES
 Any trade which impairs health of an
individual in any way and is a source of
public nuisance is known as offensive
trade.

198. OFFENSIVE TRADES
 These trades are offensive because evolution of
foul smell ,usage of poisonous chemicals and
having injurious waste products.
 These are –
 -Tannery and leather processing
 -Slaughtering of animals
 -keeping animals and animal trading
 -Fat melting or boiling in grease
factory.

199. OFFENSIVE TRADES
 -Bone boiling and drying in fertilizer factory
,manure manufacturing.
 -Gut scrapping
 -Fellmongering
 -Corrosive chemical producing factory
 -Glue making
 -Tallow melting

200. OFFENSIVE TRADES
 Preventive measures:
 1)Engineering :
 -Isolation of the offensive trade
zone.
 - Environmental sanitation.
 -Use of PPDs.
 -Prevention of dust escape or
removal
 -Strict cleanliness and hygienic

201. OFFENSIVE TRADES
 -2) Medical measures :
 -Scheduled medical examinations.
 -Routine immunization.
 3) Legislative measures :
 -smoking cessation
 - Compulsary provision of PPD
 -Strict factory rules.
 -Compensation and maintenance of
proper workplace hygiene.
 4)Health education.

202. OCCUPATIONAL HEALTH
AND SAFETY

212. OSHA STANDERDS
 OSHA standards are rules that describe the
methods that employers must use to protect
their employees from hazards.
 There are OSHA standards for Construction
work, Maritime operations, and General
Industry, which is the set that applies to most
worksites.

213. OHS REGULATIONS
 WHS/OH&S acts, regulations and codes of
practice. ... Regulating agencies (also known
as regulators) administer health and safety
laws. They're responsible for inspecting
workplaces, providing advice and help, and
handing out notices and penalties where
necessary.

214. OHS REGULATIONS
 The Occupational Health and Safety
Regulations 2017 (OHS Regulations) build
on the OHS Act. They set out how to fulfil
duties and obligations, and particular
processes that support the OHS Act. For
example, they include requirements for: safe
operation of major hazard facilities and
mines. training for high risk work.

215. TOP 10 REASONS WHY WORKPLACE SAFETY IS
IMPORTANT

216. TOP 10 REASONS WHY WORKPLACE SAFETY IS
IMPORTANT
 1. Aware about the surroundings
 2. Reduce workplace stress
 3. Use tools appropriately
 4. Keep crisis exits which are easily
accessible
 5. Update Your Supervisor about the unsafe
conditions.
 6. Use mechanical assistance

217. TOP 10 REASONS WHY WORKPLACE SAFETY IS
IMPORTANT
 7. Stay Alert.
 8. Reduce Workplace Environment Stress.
 9. Wear the right safety equipment’s.
 10. Sit in a proper posture.
 These days, workplace health and safety
procedures are important for the well-being
of both employees and employers because
human loss is immeasurable and intolerable.
As, such loss or injuries can employ major
loss to the families.

218. WHAT IS WHS AND OH&S?
 Fundamentally, WHS and OH&S share the
same meaning. WHS was a term adopted
after January 2012 following the
harmonisation of various OH&S laws across
Australian states and territories. WHS
involves the assessment and mitigation of
risks that may impact the health, safety or
welfare of the workplace. This may include
the health and safety of customers,
employees, contractors, volunteers and
suppliers.

219. WHAT IS WHS AND OH&S?
 Examples of common practices in work
health and safety include:
 Providing a safe workplace
 Assessing the workplace layout and
providing safe systems of work
 Having insurance and workers’
compensation insurance for employees

220. TYPES OF CONTROL MEASURES
 There are several types of control measures
that fall into three main categories (in order of
priority and effectiveness):
 ...
 Elimination.
 Engineering.
 Administrative.
 Personal Protective Equipment.

222. SAFETY AND HEALTH AT WORK IN BANGLADESH

223. OCCUPATIONAL HEALTH AND COUNTRY PROFILE
-BANGLADESH
 It is estimated that over 11,000 workers
suffer fatal accidents and a further 24,500 die
from work related diseases across all sectors
each year in Bangladesh. It is also estimated
that a further 8 million workers suffer injuries
at work – many of which result in permanent
disability.

224.  Although little research has taken place in
Bangladesh, it is internationally recognized
that most occupational deaths and injuries
are entirely preventable, and could be
avoided if employers and workers took
simple initiatives to reduce hazards and risks
at the workplace.
SAFETY AND HEALTH AT WORK IN BANGLADESH

225. SAFETY AND HEALTH AT WORK IN BANGLADESH
 The ILO is working in cooperation with the
Ministry of Labour and Employment ,
Bangladesh Employers’ Federation (BEF),
National Coordination Committee for Workers
Education (NCCWE), Industriall Bangladesh
Council (IBC) and social partners such as the
Occupational Safety and Health and
Environment (OSHE) Foundation and the
Bangladesh Institute of Labour Studies (BILS),
work to foster a preventative safety and health
culture by strengthening national occupational
safety and health (OSH) systems.

226. SAFETY AND HEALTH AT WORK IN BANGLADESH
 This includes support in the following areas:
 Updating the National OSH Profile and developing a
National Plan of Action on OSH.
 Working with employers organisations to cascade basic
OSH training to 750,000 – 800,000 workers in 400 RMG
factories.
 Providing OSH capacity building to master trainers from
NCCWE and IBC who will pass on these skills to some
3,000 workers.
 Developing an OSH KIT for initiating and functioning Safety
Committees at factory level.
 Preparing advocacy and outreach campaign on OSH to
help foster a culture of OSH in the country.
 Supporting the establishment of OSH committees in Better
Work factories.