Occupational Hazards
Occupational Hazards
AND SAFETY
INTRODUCTION:
All occupational fields have their own hazards. There are variety of hazards to
which workers may be exposed and which may cause various diseases. By following
the proper guidelines and precautions, all occupational hazards can be minimized.
OCCUPATIONAL ENVIRONMENT:
Physical agent - 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. The factors act in different ways on the health and
efficiency of the workers, singly or in different combinations. The amount of work and
the breathing place, toilet, washing and bathing facilities are also important factor in
occupational environment.
Chemical agents - these comprises a large number of chemicals, toxic dust and
gases which are the potential hazards to the health of the workers. Some chemical
agents cause disabling respiratory illnesses, some causes injury to health and
deleterious effect on the blood and other organs of the body.
Biological agents- the workers may be exposed to viral, rickettsia, bacterial and
parasitic agents which may result from close contact with animals or their products,
contaminated water, soil or food.
There are numerous psychological factors that operates in the place of work. These
are human relationships amongst workers themselves on the one hand, and those in
authority over them on the other hand. 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. In modern
occupational health, the emphasis is upon the people, the conditions in which they live
and work, their hopes and fears and their attitudes towards their job, their fellow-
workers and employers.
OCCUPATIONAL HAZARDS:
An industrial worker may be exposed to five types of hazards, depending upon his
occupation:
Physical hazards.
Chemical hazards.
Biological hazards.
Mechanical hazards.
Psychosocial hazards.
Physical hazards:
Heat and cold: the common physical hazard in most industries is heat. 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. Important hazards associated with cold work are chilbans, erthrocynosis,
immersion foot, and frostbite as a result of cutaneous vasoconstriction. General
hypothermia is not unusual.
Light: The acute effects of poor illumination are eye strain, headache, eye pain,
lachrymation, congestion around the cornea and fatigue. The chronic effects on health
include ―miner‘s nystagmus‖. Exposure to excessive brightness or ―glare is
associated with discomfort and annoyance and visual fatigue.
Noise: The effects of noise are of two types: auditory effects which consist of
temporary or permanent hearing loss and non-auditory effects which consist of
nervousness, fatigue, interference with communication by speech, decreased
efficiency and annoyance.
Vibration: Vibration usually affects the hands and arms. After some months or years
of exposure, the fine blood vessels of the fine 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.
Chemical hazards:
There is hardly any industry which does not make use of chemicals. The
chemical hazards are on the increase with the introduction of newer and complex
chemicals. Chemical agent acts in three ways: local action, inhalation and ingestion.
The ill-effects produced depend upon the duration of exposure, the quantum of
exposure and individual susceptibility.
Local action: some chemicals cause dermatitis, eczema, ulcers and even cancer by
primary irritant action; some causes dermatitis by an allergic action.
Biological hazards:
Workers may be exposed to infective and parasitic agent of the place of work.
The occupational disease in this category are brucellosis, leptospirosis, anthrax,
hydatidosis, psittacosis, tetanus, encephalitis, fungal infections, schistosomiasis and
a host of others. Persons working among animal products (eg; hair, wool, hides) and
agricultural workers are specially exposed to biological hazards.
Mechanical hazards:
The mechanical hazards in industry centre round machinery, protruding and
moving parts and the like. About 10% of accidents in industry are said to be due to
mechanical causes.
Psychosocial hazards:
The psychosocial hazards arises from the worker‘s failure to adapt to the alien
psychosocial environment. Frustration, lack of job satisfaction, insecurity, poor human
relationship, emotional tension are some of the psychological factors which may
undermine both physical and mental health of the workers.
The health effects can be classified in two main categories: psychological and
behavioural changes- including hostility, aggressiveness, anxiety, depression,
tardiness, alcoholism, drug abuse, sickness, absenteeism. Psychosomatic ill-health:
including fatigue, headache, pain in the shoulders, neck and back; propensity to peptic
ulcer, hypertension, heart disease and rapid ageing.
OCCUPATIONAL DISEASE:
o Gases: Co2, Co, HCN, CS, NH3, N2, H2S, HCL, SO2- these causes gas
poisoning.
o Dusts (pneumoconiosis)
o Inorganic gases: coal dust-anthracosis; silica-silicosis; asbestos-
asbestosis, cancer; iron-siderosis.
o Organic (vegetable) dusts: cane fibre-bagassossis; cotton dust-
byssinosis; tobacco-tobacossis; hay or grain dust-framers lung.
o Metals and their compounds: toxic hazards from lead, mercury,
cadmium, manganese, beryllium, arsenic, chromium etc.
o Chemicals: acids, alkalies, pesticides
o Solvents: carbon bisulphide, benzene, trichloroethylene, chloroform, etc.
o Chemical composition
o Fineness
o Concentration of the dust in the air
o Period of exposure
o Health status of the person exposed.
2. SILICOSIS:
Among the occupational disease, silicosis is the major cause of permanent
disability and mortality. It is caused by inhalation of dust containing free silica
or silicon dioxide. Pathologically, silicosis is characterized by a dense
―nodular‖ fibrosis, the nodules ranging from 3 to 4mm in diameter. Some of
the early manifestations are irritant cough, dyspnoea on exertion and pain in
the chest.
3. ANTHRACOSIS:
Anthracosis exhibits two general phases in coal miners pneumoconiosis:
the first phase is labelled as simple pneumoconiosis which is associated with
little ventilator impairment. This phase may require 12 years of work exposure
for its development. The second phase is characterized by progressive
massive fibrosis; this causes severe respiratory disability and frequently
results in premature death.
4. BYSSINOSIS:
It is due to inhalation of cotton fibre dust over long periods of time. The
symptoms are chronic cough and progressive dyspnoea, ending in chronic
bronchitis and emphysema.
5. BAGASSOSIS:
Is the name given to an occupational disease of the lung caused by
inhalation of bagasse or sugar-cane dust. It was first reported in India by
Ganguli and Pal in 1955 in a cardboard manufacturing firm near Kolkata. The
sugarcane fiber which until recently went to waste is now utilized in the
manufacture of paper, cardboard and rayon. The symptoms consists of
breathlessness, cough.
6. ASBESTOSIS:
Asbestos are silicates of varying composition(magnesium, iron, calcium,
sodium, aluminium). Asbestos is of 2 types – serpentine (hydrated magnesium
silicate) and amphibole type (contain magnesium). Asbestos is used in the
manufacture of asbestos cement, fire proof textiles, roof tiling, brake lining,
etc.
Asbestos enters the body by inhalation, and fine dust may be deposited
in the alveoli. The disease is characterized by dyspnoea, clubbing of fingers,
cardiac distress and cyanosis. Chest x- ray shows a ground-glass appearance
in the lower two third of the lungs. It causes pulmonary fibrosis leading to
respiratory insufficiency and death, carcinoma of the bronchus and
gastrointestinal tract.
Preventive measures:
Use of safer types of asbestos(chrysolite and amosite)
Substitution of other insulants – glass fiber, mineral wood, calcium
silicate, plastic foams.
Dust control and biological monitoring(x-ray, lung function)
Periodic examination of workers and continuing research.
FARMER’S LUNG:
It is due to the inhalation of mouldy hay or grain dust which contains
micropolyspora faeni , the main cause of farmer‘s lung. Its growth is encouraged
by moist hay or grain dust. The disease is characterized by respiratory
symptoms and finally leads to pulmonary fibrosis and pulmonary damage.
OCCUPATIONAL CANCER
SKIN CANCER:- Skin cancer is a main occupational hazard among gas workers,
oven workers, tar distillers, oil refiners, dye-stuff makers, road makers and in industries
associated with the use of mineral oil, tar and related compounds.
BLADDER CANCER: - The industries associated with bladder cancer are the dye-
stuffs and dyeing industry, rubber, gas, and the electric cable industries. The major
bladder carcinogens are benzidine, auramine, beta-naphthylamines, etc.
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.
OCCUPATIONAL DERMATITIS:
Occupational dermatitis is a big problem in many industries. The causes may be
PREVENTION:
RADIATION HAZARDS:
A number of industries use radium and other radio-active substances. 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 and glass
blowing. The main effects of radiation are acute burns, dermatitis malignancies,
genetic effects etc. Preventive measures:
Shielding of workers in x-ray field, so that direct contact to skin can be avoided.
The employees should be monitored at intervals not exceeding 6 months.
Suitable protective clothing
Adequate ventilation in work place to prevent inhalation of harmful gases and
dust.
Replacement and periodic examination of workers in every 2 months.
LEAD POISONING:
Lead is used in variety of industries such as manufacture of storage batteries,
glass manufacture, ship building, printing and potteries, rubber industry etc.
Thousands of tons of lead every year is exhausted from automobiles. All lead
components are toxic – lead oxide, lead carbonate, lead arsenate, etc. Lead has an
effect on membrane permeability. Mode of absorption is of 3 ways – inhalation,
ingestion and absorption through skin. Normal adult ingest about 0.2 to 0.3 mg of lead
per day from food and beverages. Confirmation of lead poisoning shows a blood count
more than 70 mue gm. /100 ml and urine lead more than 5mg/lt.
The toxic effect of inorganic lead exposure are abdominal colic, constipation, loss
of appetite, blue-line on the gums, anaemia, wrist drop and foot drop. The toxic effects
of organic lead compounds are mostly on the CNS- insomnia, headache, mental
confusion, delirium, etc.
Preventive measures:
Substitution of lead with less toxic materials.
Isolation of all processes which gives rise to lead dust and fumes.
Local exhaust ventilation.
Personal protection, personal hygiene and good housekeeping
Periodic examination of workers and health education.
Medical management- saline stomach wash if ingested, d-penicillamine.
No child below the age of 14 shall be employed to work in any factory or mine
or engaged in any other hazardous employment.
HEALTH EDUCATION:
It is an important health promotional measure. It should be given in all levels –
management, supervisory staff, workers, trade union leaders and community.
MEDICAL MEASURES:
Pre-placement examination
Periodical examination
Medical and health care services
Notification
Supervision of working environment
Maintenance and analysis of records
Health education and counselling
ENGINEERING MEASURES:
Design of building
Dust – enclosure and isolation
Good housekeeping
Local exhaust ventilation
General ventilation
Protective devices
Mechanization
Environmental monitoring
Statistical monitoring and research
LEGISLATION:
The most important factory laws in India today are ;
The Factory Act , 1948
The Employees State Insurance Act , 1948
Some of other specialized acts adapted to the particular circumstances of the industry
are – The Mines Act, The Plantation Act, The Minimum Wages Act, The Maternity
Benefit Act, etc. OHSMS:
In the changed industrial scenario, an emphatic worldwide Endeavour is visible in
improving quality in all functions of an organization. Recognizing that the workplace
safety and health is a decisive factor in an organizational effectiveness, several
management frameworks have been proposed to implement cost-effective
occupational health safety(OHS) in preventing work place aliments and promoting
health and welfare of workers resolving around the international standards
organization families of management standards(e.g.: ISO 9000 and 14000).
Broadly, an ideal OHS management system (OHSMS) should provide a structured
process to minimize potentials of work-related injuries and illness, increase
productivity by reducing the direct and indirect cost associated with accidents, and
increase the quality of manufactured products for rendered services. It must provide a
direction to OHS activities, in accordance with organizational policies, regulatory
requirements, industry practices and standards, including negotiated labour
arguments. Therefore, conforming to an OHSMS may be significant value to an
organization. This approach has drawn significant attention among the standard
organizations, the accreditation and certification bodies and the national agencies in
formalizing, implementing and evaluating OHSMS.
The framework for certification of OHSMS, namely occupational health and safety
assessment series (OHSAS) specification (OHSAS 18001; 1999) has been developed
by an association of national standards and certification bodies, and specialist
consultants. It has been developed to be compatible with the ISO 9000 (quality) and
ISO 14000 (environment) standards in order to align and integrate quality,
environment and OHS, management systems in organizations.
Back Injury
Hospital staff and particularly nurses are prone to back injury from the need to lift
and roll immobilized or disabled patients for toilet, washing, dressing and pressure
care. Hospitals are now required to give training on back care to all new staff. This
training, combined with the use of wards persons to assist nurses and the use of
hydraulic lifting devices, has decreased the risk of back injury considerably.
Laser Burns
Lasers are now frequently used in Operating Theatres and appropriate protective
equipment must be used, especially eye protection to prevent retinal burns. The use
of this equipment is covered by set protocols.
Electrical Defibrillators
Use of this equipment is restricted to those staff who have undergone competency
based training and certification.
Personal Violence
Risk of injury from personal violence is an important hazard in Emergency
Departments who at times deal with mad, bad or intoxicated patients. Similarly,
Psychiatric Units who have to look after the psychotically disturbed are also at risk.
Again, staff education and set policy and procedure needs to be in place for dealing
with aggressive patients. Personal security alarms, a system for rapidly mobilizing
ancillary staff, and a set approach to safely restraining, immobilizing and sedating
violent patients are all important components.
Hospitals are stressful places for sick and injured patients and their families. However
they can also be stressful for staff due to such factors as:
Hospitals are part of a high demand, high expectation service industry and are heavily
reliant on staff for the friendly, safe, effective and efficient delivery of services. To
optimize productivity and attitude of staff, senior management must be committed to
ensuring a conducive organizational climate with high staff morale. Clear priorities and
direction, realistic performance goals and workloads, commitment to continuing
education and quality assurance, reception to staff feedback, and support with
counselling services for stressed staff are all important components.
Food Safety
Hospital kitchens prepare meals for inpatients and in many cases prepare meals
for the staff canteen. It is obviously imperative that food storage, handling and
preparation is done to the highest standards and poses no risk to already sick or
compromised patients.
DEFINITION:-
Occupational Health Nurses (OHN) s are registered nurses who independently
observe and assess the worker's health status and to respect them from job tasks and
hazards. Using their specialized experience and education, these registered nurses
recognize and prevent health effects from hazards exposure.
SCOPE
CLINICIAN:
Individual and group care plan - The nurse can act on the individual, group,
enterprise or community level.
General Health advice and health assessment - The occupational health nurse
will be able to give advice on a wide range of health issues, and particularly on
their relationship to working ability, health and safety at work or where
modifications to the job or working environment can be made to take account of
the changing health status of employees.
SPECIALIST:
Occupational health policy, and practice development, implementation and
evaluation- The specialist occupational health nurse may be involved, with senior
management in the enterprise, in developing the workplace health policy and
strategy including aspects of occupational health, workplace health promotion and
environmental health management.
Hazard identification - The occupational health nurse often has close contact
with the workers and is aware of changes to the working environment. Because of
the nurses expertise in health and in the effects of work on health they are in a
good position to be involved in hazard identification.
Risk assessment - Legislation is increasingly being driven by a risk
management approach. Occupational health nurses are trained in risk assessment
and risk management strategies depending upon their level of expertise.
MANAGER:
Management - In some cases the occupational health nurse may act as the
manager of the multidisciplinary occupational health team, directing and co-
ordinating the work of other occupational health professionals. The OH nurse
manager may have management responsibility for the whole of the occupational
health team, or the nursing staff or management responsibility for specific
programmes.
Budget planning - Where the senior occupational health nurse is the budget
holder for the occupational health department they will be involved in securing
resources and managing the financial assets of the department. The budget holder
will also be responsible for monitoring and reporting within the organization on the
use of resourses.
Marketing
Quality assurance
Professional audit
Continuing professional development
CO-ORDINATOR:
Occupational health team - The occupational health nurse, acting as a
coordinator, can draw together all of the professionals involved in the occupational
health team. In many instances the nurse will be the only member of the team who
is permanently employed by the institution.
Worker education and training - The occupational health nurse has a role in
worker education. This may be within existing training programmes or those
programmes that are developed specifically by occupational health nurses to, for
example, inform, educate and train workers in how to protect themselves from
occupational hazards, workplace preventable diseases or to raise awareness of
the importance of healthy practices.
Environmental health management - The occupational health nurse can advise
the enterprise on simple measures to reduce the use of natural resources,
minimise the production of waste, promote re-cycling and ensure environmental
health.
ADVISER:
To management and staff on issues related to workplace health management -
Occupational health nurses act as advisers to management and staff on the
development of workplace health policies and practices, and can fulfil an advisory role
by participating in, for example, health and safety committee meetings, health
promotion meetings, and may be called upon to provide independent advice to
managers or workers who have specific concerns over health related risks.
As a conduit to other external health or social agencies - Occupational health
nurses act in an advisory role when seeing individuals who may have problems that,
whilst not directly related to work may affect future work attendance or performance.
HEALTH EDUCATOR:
Workplace Health promotion - Health education as one of the key prerequisites of
workplace health promotion is integral aspect of the occupational health nurses‘ role.
In some countries the nurse is required to support activities aimed at adoption of
healthy lifestyles within on-going health promotion process, as well as participate in
health and safety activities. Occupational health nurses can carry out a needs
assessment for health promotion.
COUNSELLOR:
Counselling and reflective listening skills - Where the nurse has been trained in
using counselling or reflective listening skills they may utilise these skills in delivering
care to individuals or groups.
Problem solving skills - Due to the close working relationship which occupational
health nurses have with the working population, and because of the nurses‘ position
of trust, occupational health nurses are often approached for advice on personal
problems.
RESEARCHER:
Research skills - Nurses are becoming increasingly familiar with both
quantitative and qualitative research methodologies, and can apply these in
occupational health nursing practice. In the main, occupational health nurses
working at the enterprise level, are more likely to use simple survey techniques, or
semi-structured interviews, and to use descriptive statistical techniques in their
presentation of the data. Evidence based practice - Occupational health nurses
are skilled in searching the literature, reviewing the evidence available, which may
be in the form of practice guidelines or protocols, and applying these guidance
documents in a practical situation. Occupational health nurses should be well
skilled in presenting the evidence, identifying gaps in current knowledge.
Epidemiology - The most widely used and accepted form of investigation into
occupational related ill health and disease is based on large-scale epidemiological
studies.
CONCLUSION:
Occupational diseases should not be neglected and should give proper attention at
time. It is the main role of a nurse to work as an educator and protector in the field of
occupation. Early detection and timely management can control occupational
diseases.