Occupational medicine activities &Main work-related pathologies

2. Occupational medicine and health
Occupational medicine is the branch of medicine active in the field of
occupational health. This discipline fundamentally aims promoting and
maintaining the highest degree of health.
Nowadays the main goal is to prevent occupational diseases and
injuries from occurring.

3. identification and
assessment of the risks
surveillance
of workers
recording, reporting and
notifying occupational
injuries and diseases
advising on
occupational health,
safety and hygiene
organizing first aid
and emergency
treatment
training and
education
promoting work
ability
working as part of a
multidisciplinary
service
OHS management
Core competences of
occupational health
physicians
Occupational
health
professionals with
a predominantly
medical
background are
occupational
health physicians
and occupational
health nurses.

4. Epidemiology
The epidemiological method is based on available records -questionnaires, job
titles or other “proxies” of exposure; this makes the conduct of epidemiological
studies and the interpretation of their findings relatively simple.
The information of an
epidemiological study
depends on:
the quality and extent of
available exposure data
health effects
data about other potential
influences on the disease
of interest
Epidemiologists use a variety of study designs generally categorized as descriptive or analytic.

5. Toxicology
• Toxicology is the study of the nature and action of
anything that can cause adverse health effects on living
systems and that may be chemical (i.e. cyanide), physical
(i.e. radiation) or biological (i.e. snake venoms) in form. It
studies the symptoms, mechanisms, treatments and
detection of poisoning.
• Mechanistic toxicology is the study of how chemical or
physical agents interact with living organisms to cause
toxicity. Knowledge of the mechanism of toxicity of a
substance:
• enhances the ability to prevent toxicity and design
more desirable chemicals;
• constitutes the basis for therapy upon overexposure;
• frequently enables a further understanding of
fundamental biological processes.

6. Activities of occupational medicine
Worker’s health surveillance
It is the ongoing systematic collection, analysis,
interpretation, and dissemination of data for the purpose of
prevention. Surveillance is essential to the planning,
implementation and evaluation of occupational health
programms and control of work-related health and injuries
and the protection and promotion of workers’ health.
Biological monitoring and other investigations
For the biological monitoring are especially important the
biomarkers. Biomarkers are molecular, biochemical or
cellular alterations that can be measured in biological
media such as human tissue, cells or fluids.
Occupational health care
Activities with regard to occupational illnesses:
treatment of workers who have not stopped work or who
have resumed work after an absence; treatment of workers
with occupational diseases or health impairments
aggravated by work; treatment of victims of occupational
accidents and injuries; medical aspects of vocational re-
education and rehabilitation.

7. Activities of occupational medicine
Data collection and record keeping
Record keeping is a necessary part of the activities of health
professionals. They must maintain at least two types of
records: personal health records and environmental health
records.
Advisory role
Occupational health services have an important task to
perform by providing advice to the enterprise management,
the employers, the workers, and health and safety
committees in their collective as well as individual capacities.
Rehabilitation
It is particularly crucial in guiding worker’s rehabilitation and
their return to work. This is becoming more and more
important owing to a large number of occupational
accidents in developing countries and the ageing of the
working populations in industrialized societies.

8. Health promotion programs
These programs are not usually considered as occupational health programs, but as public health services
delivered in the workplace, because they focus attention and resources on personal health habits rather than
on the protection of workers against occupational hazards.
Some examples:
General health education
Cancer prevention
Breast cancer
Common minor illnesses
Cardiovascular risk factors
Cardiopulmonary resuscitation
Pulmonary function testing
Mental health
Diabetes
Dietary interventions
Back care (rehabilitation)
Weight control & monitoring
Prescriptive exercise regimes
Allergies
Stress reduction
Family health Substance abuse
Automotive safety
Smoking cessation
Occupational hazards
Back care (prophylactic)
Hypertension screening
Nutrition
Physical Conditioning
Aerobic & fitness activities
Strength and stretch

9. Future directions of occupational health
Occupational health physicians are therefore facing the
problem of diagnosing less evident diseases. A couple of
examples of future challenges, one in the field of physic-
chemical agents and the other regarding biological risk, are
the following:
• newly engineered materials with peculiar characteristics
such as “nanomaterials” pose many doubts and concerns
to occupational health physicians, as their behavior and
toxicity in biological systems is poorly known.
• diseases by unconventional or emerging agents such as
prions, SARS, avian flu, potentially endangering selected
categories of workers.

10. Main work related pathologies

11. Respiratory system
Asphyxiants exert their
effects by interfering with the
oxygenation of the tissues.
There are simple and
chemical asphyxiants.
Irritants produce a pattern of
generalized, non-specific
tissue inflammation, and
destruction may result at the
area of contaminant contact.
Pneumoconioses are due to
the inhalation and
subsequent selective
retention of certain dusts
Infectious agents can cause
tuberculosis, anthrax,
ornithosis, brucellosis,
histoplasmosis, legion- naires’
disease and so on.
Examples of air pollutants
that can produce cancer of
the lungs are arsenic and its
compounds, chromates, silica,
particles containing polycyclic
and aromatic hydrocarbons

13. Cardiovascular system
The term cardiovascular diseases (CVDs) refer to organic and functional disorders of the heart and circulatory system,
including the resultant damage to other organ systems. Cardiovascular diseases are among the most common causes
of illness and death in the working population; particularly in industrialized countries.
Hypertension (increased systolic and/or diastolic blood
pressure) is the most common circulatory disease.
Atherosclerotic changes in the major blood
vessels, often associated with hypertension,
cause disease in the organs they serve.
Heart rhythm disorders. Although they can
have a significant impact on the ability to work,
they are often asymptomatic and transitory.

14. Musculoskeletal system
Musculoskeletal disorders are among the most
important occupational health problems in both
developed and developing countries.
• Carpal Tunnel Syndrome (CTS): Compression of
the median nerve in the carpal tunnel
• Epicondylitis (Tennis Elbow): When strained or
subjected to overuse, the tendons become ir-
ritated and radiate pain from the elbow down to
the forearm.
• Low back pain is a common musculoskeletal
disorder which affects the lumbar segment of the
spine.

15. Digestive system
Solvents have particular
affinity for lipid rich
tissues. The toxic action
involves different mecha-
nisms.
Liver damage constitutes
an important part of the
pathology of occupational
poisons, since the liver is
the prime organ in
metabolizing toxic agents
and acts with the kidneys
in detoxication pro-
cesses.
Physical fatigue may also
disturb digestive
functions, and heavy work
may cause functional and
mor- phological
alterations, especially in
the stomach.

16. Renal urinary system
Nephrotoxicity can be defined as dysfunction or renal
disease that arises as a direct or indirect result of
exposure to medicines, and industrial or
environmental chemicals.
The chemicals that have the potential to cause
nephrotoxity are metals (lead, cadmium, mercury,
gold, bismuth, uranium, chro- mium, arsenic,
germanium); organic chemicals and solvents (volatile
hydrocarbons, chloroform, halogenated alkenes,
hydrocarbon-induced nephrotoxicity, bipyridyl
herbicides); ethylene glycol; my- cotoxins (toxins
produced by an organism of the fungus); and, silicon.

17. Nervous system
Damage to the various components of the nervous system can occur in
different ways:
• direct physical injury from falling objects, collisions, blows or undue
pressure on nerves;
• changes in the internal environment, such as insufficient oxygen due
to asphyxiants and heat exposure;
• interference in the cellular processes through chemical action by
substances, such as metals, or- ganic solvents and pesticides that are
neurotoxics.

18. Reproductive system
Reproductive toxicity has been defined as the occurrence of adverse
effects on the functionality of the reproductive system. The
manifestations of such toxicity may include:
1. alterations in sexual behaviour
2. reduced fertility
3. adverse pregnancy outcomes
4. modifications of other functions that are dependent on the
integrity of the reproductive system.

19. Skin
From experience we know that the skin can react to a large
number of mechanical, physical, biological and chemical
agents, acting alone or in combination.
Mechanical: Friction,
pressure or other forms of
more forceful trauma
Physical agents: Heat, cold,
electricity, sunlight,
artificial ultraviolet, laser
radiation and high energy
sources such as X- rays
Biological agents:
Occupational exposures to
bacteria (acne, impetigo,
etc), fungi (boils, folliculitis,
verrucas, ringworm etc.)
Chemical agents: Organic
and inorganic chemicals
are the major source of
hazards to the skin.

20. Allergies
Allergies may be defined as the adverse health effects which result
from the induction and elicitation of specific immune responses to
chemicals and drugs. Allergic responses involve the phenomenon
known as sensitization.

21. Cancer
Cancer is the common term for
neoplasms, or tumors. The
characteristics of the cancer cells are:
• loss of contact inhibition
• invasiveness of surrounding tissues
• metastasis, or spreading via the
lymph system or blood to other
tissues and organs

22. Bibliography
• https://www.iosh.co.uk/Books-and-resources/Our-OH-
toolkit/Occupational-cancer.aspx
• The American Board of Industrial Hygiene. 1995. Available on-line:
http://www.abih.org/
• https://www.toxicology.org/
• ILO Code of Practice Safety in the Use of Chemicals at Work (ILO
1993).