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Occupational health
1.
Copyright © Wondershare
Software Dr.Siva.P.M Junior Resident Community medicine OCCUPATIONAL HEALTH
2.
Copyright © Wondershare
Software INTRODUCTION • Occupational health : – promotion and maintenance of highest degree of physical, mental and social well being of workers – All three levels of prevention – Adaptation of work to man and vice versa
3.
Copyright © Wondershare
Software Ergonomics – ergon – work ; nomos – law • Fitting job to the worker • Objective – achieve mutual adjustment of man and his work for improvement of human efficiency and well being • To reduce industrial accidents and increase efficiency of workers
4.
Copyright © Wondershare
Software • Occupational environment • Sum of external conditions and influences –prevail at the place of work –bearing on health of workers • 3 interactions – Man and agents(Physical, Chemical, Biological) – Man and machine – Man and man
5.
Copyright © Wondershare
Software • Occupational hazards 1. Physical 2. Chemical 3. Biological 4. Mechanical 5. Psychosocial
6.
Copyright © Wondershare
Software PHYSICAL HAZARDS Heat and cold • Common physical hazard – heat • Direct effect of heat – burns, heat exhaustion, heat stroke, heat cramps • Indirect effects – decreased efficiency, increased fatigue, enhanced accident rates
7.
Copyright © Wondershare
Software • Radiant heat – foundry, glass and steel industry • Heat stagnation – jute and textile industry • High temperature – kolar gold mines – 65degC • Corrected effective temperature > 27deg C- discomfort • Cold – chilblains, erythrocyanosis, immersion foot, frostbite
8.
Copyright © Wondershare
Software • Light – Poor illumination – eye strain, head ache, eye pain, lacrymation, congestion – Miner’s nystagmus – chronic effects – Intense glare – blurring of vision, accidents
9.
Copyright © Wondershare
Software • Noise – Auditory effects – hearing loss – Non auditory – nervousness, fatigue, interfere with communication – Degree of injury – intensity & frequency range, duration of exposure, susceptibility
10.
Copyright © Wondershare
Software • Vibration – Affects hands and arms, joints – Chronic exposure – fine blood vessels- sensitive to spasm (white finger) • UV radiation – Arc welding – Affects –eyes- conjunctivitis, keratitis (Welder’s flash)
11.
Copyright © Wondershare
Software • Ionizing radiation – X rays and radio active isotopes(cobalt 60, phosphorous 32) – Bone marrow – more sensitive – Genetic changes, malformation, cancer, leukemia, depilation, ulceration, sterility, death – Maximum permissible – 5 rem/year to whole body
12.
Copyright © Wondershare
Software CHEMICAL HAZARDS • Acts in three ways – local action, inhalation, ingestion • Local action – Dermatitis, eczema, ulcer, cancer (irritant action) – Aromatic amino and nitro compounds – systemic • Inhalation – Respirable dust - <5 microns
13.
Copyright © Wondershare
Software • Dust – organic – cotton, jute – Inorganic – silica, mica, coal, asbestos – Insoluble – retain in lung – pneumoconiosis – Soluble – eliminated by body mechanism
14.
Copyright © Wondershare
Software • Gases – Simple – oxygen, hydrogen – Asphyxiating – CO, cyanide, sulphur dioxide, chlorine – Anesthetic – chloroform, ether • Metals and their compounds – Lead, antimony, beryllium, cadmium, cobalt, manganese, mercury, phosphorous, chromium, zinc etc
15.
Copyright © Wondershare
Software • Ingestion – Lead, antimony, cadmium, mercury, phosphorous, chromium, zinc etc – through – contaminated hand or food or cigarettes • Biological hazards – Brucellosis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus, encephalitis, fungal infections, schistosomiasis – Working among animal products
16.
Copyright © Wondershare
Software • Mechanical hazards – Machinery, protruding and moving parts – 10% of accidents • Psychosocial hazards – Failure to adapt to an alien psychosocial environment – Frustration, lack of job satisfaction, insecurity, poor human relationship, emotional tension – affect physical and mental health
17.
Copyright © Wondershare
Software OCCUPATIONAL DISEASES • Pneumoconiosis • Dust – 0.5 to 3 microns – health hazard- variable period of exposure – lung disease – pneumoconiosis • Hazardous effect depends on – Chemical composition – Fineness – Concentration – Health status of the person
18.
Copyright © Wondershare
Software • Important dust diseases – silicosis – anthracosis – byssinosis – bagassosis – asbestosis – farmer’s lung • No cure – only prevention essential
19.
Copyright © Wondershare
Software SILICOSIS (NOTIFIABLE- FACTORIES ACT 1948 AND MINES ACT 1952) • Major cause of disability and mortality • Inhalation of dust with – silica or silicon dioxide • Higher concentration – higher hazard • Incubation period – few months to 6 years • Particles – phagocytosis – accumulation – block lymph channels • Dense nodular fibrosis – 3-4mm • c/f – insidious onset – irritant cough, dyspnoea, chest pain
20.
Copyright © Wondershare
Software • Decreased TLC – advanced disease • X ray – snow-storm appearance • Prone to PTB – silico-tuberculosis • No effective treatment • Fibrotic – cant reversed • Rigorous dust control • Regular physical examination by doctors
21.
Copyright © Wondershare
Software ANTHRACOSIS(NOTIFIABLE-INDIAN MINES ACT 1952, COMPENSATABLE-WORKMEN’S COMPENSATION ACT 1959 • First phase – simple pneumoconiosis – ventilatory impairment – after 12year exposure – anthracite coal dust • Second phase – – progressive massive fibrosis – severe respiratory disability – premature death • Once simple pneumoconiosis – progress even without further exposure
22.
Copyright © Wondershare
Software BYSSINOSIS • Inhalation of cotton fiber • Chronic cough – progressive dyspnoea – chronic bronchitis – emphysema • India has large textile industry – 35% of factory workers
23.
Copyright © Wondershare
Software BAGASSOSIS • Inhalation of bagasse or sugar-cane dust • Thermophilic actinomycete – thermoactinomyces sacchari • Breathlessness, cough, haemoptysis, slight fever • Acute diffuse bronchiolitis – initial • Skiagram – mottling in lungs or shadow • Resolution of inflammation– if treated early
24.
Copyright © Wondershare
Software • Untreated – diffuse fibrosis, emphysema, bronchiectasis • Preventive measures: – Dust control • Wet process • Enclosed apparatus • Exhaust ventilation
25.
Copyright © Wondershare
Software – Personal protection • Masks • Mechanical filters – Medical control • Initial and periodical medical examinations – Bagasse control • Keeping moisture >20% • Spraying bagasse with 2% propionic acid- fungicide
26.
Copyright © Wondershare
Software ASBESTOSIS • Fibrous material – commercial name • Silicates of varying composition of bases (Mg,Fe,Ca,Na,Al) • Two types – – Serpentine or chrysolite (90% production) – Amphibole • Crocidolite (blue) • Amosite (brown) • Anthrophyllite(white)
27.
Copyright © Wondershare
Software • Inhalation – ROE • Insoluble fibers – pulmonary fibrosis – insufficiency – death • Carcinoma of bronchus (high-if add with smoking) • Mesothelioma of pleura or peritoneum(crocidolite) • Disease doesn’t appear – until 5-10 yrs of exposure
28.
Copyright © Wondershare
Software • Irritation – fibrosis – peribronchial – diffuse –basal in location • Dyspnoea – out of proportion to clinical signs • Clubbing – cardiac distress – cyanosis • Sputum – Asbestos Bodies(fibers coated with fibrin) • X ray – ground glass appearance – lower third of lung fields
29.
Copyright © Wondershare
Software • Preventive measures – Use of safer type asbestos – Substitution of other insulants – Rigorous dust control – Periodic examination of workers – Continuing research
30.
Copyright © Wondershare
Software FARMER’S LUNG • Inhalation of mouldy hay grain dust • >30% moisture – favors bacteria, fungi growth – rise temperature 40-50 deg C – favors Thermophilic actinomycete • Micropolyspora faeni – main cause • Repeated attacks – pulmonary fibrosis – damage - corpulmonale
31.
Copyright © Wondershare
Software CONCLUSION • Pneumoconiosis – one of the occupational disease – due to dust inhalation • No specific treatment • Prevention is important • Periodical examination and preplacement examination of workers also important
32.
Copyright © Wondershare
Software Thank u……
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