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A General Overview on Occupational Health and Safety and Occupational

Disease Subjects

Article  in  Journal of Family Medicine and Health Care · January 2015

DOI: 10.11648/j.jfmhc.20150101.15

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İzzet Fidancı Onur Ozturk

Hacettepe University Samsun Education And Research Hospital
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Journal of Family Medicine and Health Care
2015; 1(1): 16-20
Published online August 5, 2015 (http://www.sciencepublishinggroup.com/j/jfmhc)
doi: 10.11648/j.jfmhc.20150101.15

A General Overview on Occupational Health and Safety and

Occupational Disease Subjects
İzzet Fidancı*, Onur Ozturk
Atakum Community Health Center, Samsun, Turkey

Email address:
[email protected] (İ. Fidancı)

To cite this article:

İzzet Fidancı, Onur Ozturk. A General Overview on Occupational Health and Safety and Occupational Disease Subjects. Journal of Family
Medicine and Health Care. Vol. 1, No. 1, 2015, pp. 16-20. doi: 10.11648/j.jfmhc.20150101.15

Abstract: Unhealthy factors and working conditions in working environment cause many health problems. While employees
have rights and related tasks to work in a healthy and secure environment, employers have the liability to provide this
environment and services. Every year a substantial amount of people die or become handicapped due to easily preventable
occupational accidents and diseases which should legally be prevented. This compilation was prepared by studying
occupational health and safety subjects, frequency of occupational diseases and laws made in the world in recent years.
Keywords: Occupational Health and Safety, Occupational Diseases, Occupational Accidents

occupational diseases. It is stated that every year 438.000

1. Introduction workers die because of toxic materials and 10% of the skin
According to the definition by International Labour cancers in the world is due to contact with toxic materials at
Organization (ILO) and World Health Organization (WHO), work. It is estimated that 100.000 people die because of
labour health is the work carried out for keeping, continuing asbestos every year. Besides since 1970's, asbestos
and developing body, mental and social well-being of manufacturing is continuously decreasing in the world. But
individuals working in all occupations at utmost level. the risk continues for those who had contact with asbestos
Occupational health is bringing the well-being of workers, before (1,3).
partners and children to the uppermost level, developing
living conditions, protecting them from unhealthy conditions 2. Occupational Health and Safety
both in working and living environments, making them work
in suitable jobs for their talents and providing a healthy and Occupational accidents and occupational diseases are
high-quality production with healthy people and being among the most important problem areas of working life.
protected from all kinds of stress factors as far as possible International Labour Organization estimates that 358,000
(1,2). work accidents involving death, 337 involving injury
Working life is the most important factor determining the occurred in the world in 2003 and 1,95 million people died
body, mental and social well-being of employee. because of occupational diseases (4,5).
Occupational health and safety is on the agenda of developed Income losses of the people left behind in case of death
industrial countries as well as developing countries with its and of the injured person and family in case of mutilation
constantly developing and changing dynamic structure. reach enormous dimensions. Economic cost of occupational
Every year a substantial amount of people die or become accidents and diseases reach 5% of natural incomes in the
handicapped due to easily preventable occupational accidents world (4,5). Social protection is a broad concept covering the
and diseases which should legally be prevented. countermeasures for occupational accidents and occupational
According to numbers reported by ILO, nearly 6,000 diseases and compensation systems for income loss and
people die due to occupational accidents or diseases every expenditure increases of the injured person and family after
day. A total of 350.000 people die due to occupational the accident or disease. It is observed that the first efforts for
accidents and 1.700.000 people die from occupational constituting a modern social security system in the world are
diseases every year. Every year 2700 million occupational for the compensation of the damage caused by occupational
accidents take place and 160 million people have accident and diseases. In developing countries the social
 Journal of Family Medicine and Health Care 2015; 1(1): 16-20 17

insurance systems for occupational accidents and diseases enterprises and informal sector should be solved in
were started after World War II. But still a significant ratio of developing countries (4,7,11,12,13).
the employees in developing countries is outside this Globalization and economic crisis adversely effect
insurance. Occupational health and safety legislation is working environment quality. Economic crisis cause a
effectively applied in highly developed countries(4). decline also in occupational health and safety services.
Providing occupational health and safety services from
3. Occupational Accidents and Diseases external sources (suppliers) is becoming more common in
Europe. Many institutions providing education and making
Globalization is an economical, social, cultural and research on occupational health and safety are getting
political process in which the capital can expand in all smaller or closed due to institutional budgetary savings.
countries without a boundary. In the mentioned period, Acceptance level for occupational health and safety services
developed countries secure technological superiority, lead increasing productivity and prosperity is very low in many
profitable activities and make the transnational transfer of the sectors (4,14).
capital easier and secure the capital. Developing countries Occupational diseases are another important problem.
are making the capital inflow easier by providing freedom in Many workers are unaware of the fact that they have
goods and financial markets, forming free zones, applying occupational diseases. Since occupational diseases also occur
high interests, privatizing, suppressing payments in order to after leaving the job, employees and doctors generally don't
increase capital profits (4,6). recognize and evaluate them as normal diseases. If the
Globalization effects developed and developing countries occupational disease occurs after leaving work, during the
in different scales in occupational health and safety fields occupational and social safety legislation investigation of the
(4,7). While the rate of occupational accidents involving subject, shutdown workplace or inability to determine
death is low in developed countries (Europe, USA and Asia occupational health and safety conditions or execution
Pacific areas), it is observed that the rate of occupational conditions in the working period of the employee also make
accidents involving death is high in developing countries. the determination of occupational diseases harder(4,15).
Globalization is also one of the main factors highly effective A globally accepted occupational disease list is not
on occupational health and safety legislation and application. available. Countries determine the standards evaluating
Particularly in difficult and dangerous jobs, the production which events should be accepted as occupational diseases
moves from central countries to the surrounding countries considering their own conditions. On the other hand, as there
globally. While secure labour force mainly works in research is no certain proof showing that a disease is occupational in
and development, marketing activities in central countries, some cases, lists showing occupational diseases were
the hard and dangerous part of manufacturing is fulfilled by prepared in order to prevent arguments and if an employee
unsecured, low-paid employees in surrounding countries(4,8). worked in a related job, the disease was accepted
In globalization period, the increased capital flow increases occupational.
the negotiation power of public institutions and enterprises. When the examples are considered, although employees
States are obliged to draw foreign capital and sacrifice in who worked in denim sandblasting job for years demand
order to make this consistent (4,9). Investors in global constant incapacity income, they couldn't gain social
markets immigrate to countries with low labour costs in insurance due to uninsured employment, difficulties in
order to increase competition forces and increase their profits determining occupational disease, etc. Agricultural labourers
benefiting from informal labour forms (10). working without social security cause inability to treat the
Together with globalization, while developing countries diseases most of the time and compensate income losses of
take a lower share from global national income, labour force the employees (12,16).
in these countries works in insecure and poor quality jobs. Occupational diseases are completely preventable diseases.
Ancient technologies prohibited or prevented in developed There are cases effecting not only one factor, but many
countries cause negative working and living conditions in factors. Nutrition, individual sensitivity or variations,
developing countries. During globalization, enterprises buy medicine used, smoking and drinking habits, fatness, etc. can
service directly or externally and assign a part of the main be named among them. Occupational diseases effect family
job to subcontractors. Small and medium-sized enterprises and social life. Specific organization and regulations are
have difficulty in taking occupational health and safety required in order to diagnose occupational diseases. The
measures due to their weak financial structures. Company reason is the fact that occupational diseases can only be
spin-off would be encountered less with globalization. The diagnosed if they are searched for consciously. Occupational
mentioned situation would require more attention on diseases have different, distinctive diagnosis and scanning
occupational health and safety subjects by small-sized methods from other diseases. Occupational diseases can be
enterprises and self-employed people. Problems such as lack diagnosed without any complaint of workers with periodical
of national policies on occupational health and safety and environment measurement and medical examinations
occupational health safety legislation, inadequate education, required by legislation and necessary precautions can be
inability to spare a satisfactory budget to occupational health taken. Informing and providing awareness among employers
safety and inadequacy of staff for including small-sized and employees on occupational diseases are important.
18 İzzet Fidancı and Onur Öztürk: A General Overview on Occupational Health and Safety and Occupational Disease Subjects

Occupational disease diagnosis provides early diagnosis measures adequately and continuously decreases(13,17).
chance to close colleagues of the employee diagnosed with Occupational diseases are grouped under three categories
the disease. Since occupational disease diagnosis brings in ILO Occupational Diseases List:
"indemnity", "high incapacity fee", "investment for 1. Occupational diseases which occur with agents
developing working environment" and "criminal liability", a (physical, chemical and biological),
mistake such as hiding can be made(16,17). 2. Occupational diseases of target organ and systems
When it is verified that a disease is related to occupational (respiratory, skin, skeletal muscle),
exposure legally and medically, it is defined as occupational 3. Occupational cancers.
disease. On the other hand determining this relation is not Occupational diseases can be classified according to the
always so easy. Most of occupational diseases occur due to causing factors(17):
multi-factored interaction. Work and disease relationship is 1. Chemical sourced occupational diseases
defined in three categories: 1.1. Heavy metals
1. Occupational Diseases; Occupational disease is 1.2. Solvents
diagnosed when a unique and strong occupational 1.3. Gases
relation occurring due to one factor is determined. 2. Physical sourced occupational diseases
2. Work Related Diseases; These are diseases which have 2.1. Noise and vibration
a complicated aetiology in which many factors are 2.2. Working under high and low pressure
mutually observed, working environment may have a 2.3. Working in cold and hot environment
role and different risks occur together. 2.4. Dusts
3. Diseases Affecting Working Populations; These are 2.5. Radiation
diseases occurring more with occupational harmful 3. Biological occupational diseases
factors although not related to work. Two important 3.1. Bacteria sourced ones
criteria on diagnosing occupational disease are 3.2. Virus sourced ones
presence of factor-exposure relationship between a 3.3. Biotechnological ones.
certain working environment and/or activity and a 4. Psychological occupational diseases
certain disease and higher occurrence of diagnosed 5. Occupational diseases based on ergonomic negligence.
disease in mentioned occupation workers compared to Many occupational diseases may be diagnosed in scope of
public average. In order to determine factor-exposure main occupational health services. But in many of them
relationship in a more definite way, clinical and specialized occupational medical clinics should be applied.
pathological diagnosis, occupational anamnesis and In both cases a special plan for diagnosis is followed:
occupation analysis and epidemiological data stating Defining the exposure which may cause the disease,
the disease and factor relationship are useful. Examining clinical findings known to be related to
Definitive criteria to add a disease to international special exposure,
occupational disease list are mentioned below: Excluding non-occupational factors as a possible
Strong and scientifically proven exposure and reason of disease,
influence relationship; Result about the presence and lack of occupational
Disease occurring in certain jobs or working areas, disease (diagnosis),
A strong relationship between the number of exposed Forming suggestions for preventing precautions at
workers and severity of risk, workplace,
Disease enlisted in international occupational disease Informing authorities about occupational diseases.
list of many countries. Diagnosis of work related diseases doesn't have a certain
Epidemiological studies and researches made in recent legal status in terms of indemnity but may have an important
years on occupational disease increased information and effect on preventing and control measures. There are a few
intervention possibilities on occupational diseases. diseases with pathognomonic clinical and laboratory findings
Diagnosing an occupational disease is a rather complicated among occupational diseases. As in anaemia related to
process and with the medical diagnosis and measurement benzene intoxication, peripheral neuritis seen in acrylamide
results, causality connection is stronger. Indemnity system intoxication, byssinosis related bronchitis, asbestosis related
changes between countries. ILO Occupational Diseases List fibrosis, berylliosis granuloma or silicosis nodulation
(Contract No 121 and recommendation no R194) is the basic samples, satisfactory findings for etiological agent cannot be
document on developing and motivating the formation and reached from clinical and laboratory findings in many
protection of occupational diseases policy of member occupational diseases and the main factor cannot be
countries. Occupational diseases are completely preventable determined. In addition to clinical findings, individual
diseases and they have a special and important place in exposure information may diagnose the disease. So
public health and country health policies. In the light of the occupation and exposure story of the employee is of vital
information received, the protection measures are varied and importance in occupational disease diagnosis(17).
developed and as a result occupational disease occurrence Laboratory tests used in occupational disease diagnosis
rate in countries which can take prevention and protection may be separated to five groups:
 Journal of Family Medicine and Health Care 2015; 1(1): 16-20 19

1. General health evaluation: blood count, lung graphy, employee damage caused after an occupational accident or
ECG, complete urine analysis. disease takes place is limited in developing countries. Even
2. Non-specific test for exposure: average corpuscular though the social security programs for occupational
volume, average corpuscular haemoglobin accidents and diseases provide satisfactory protection, lack
concentration, eosinophil, liver enzymes, respiration of social security continues due to the limited informal sector
function test. and operational content common in developing countries. On
3. Tests for exposed agent and metabolites: hippuric acid the other hand while deaths caused by occupational accidents
in urine in toluene exposure, lead analysis in blood in decrease in developing countries, there is an increase in the
inorganic lead poisoning, etc. number of occupation related diseases caused by reasons
4. Genetic and allergy tests: serum alpha 1 antitrypsin such as obesity, stress, etc(4,12).
deficiency in chronic obstructive pulmonary diseases, Applying occupational health and security rules in law,
glucose 6-phosphate dehydrogenase deficiency in legislation and regulation level in order to prevent
haemolytic chemicals sensitivity, IgE, IgG test in occupational accidents and diseases would be one of the
organic material hyper sensitivities, etc. most important steps in social protection.
5. Chromosomal changes: Some physical and chemical Both compulsory social security coverage widening and
agent exposures may make chromosomal changes(17). unregistered employment lowering are necessary in order to
Doctor at workplace should provide information on legal actively indemnify income loses and expenditure increases
rights and illness to the person diagnosed with occupational of the insurance holder or beneficiaries after the accident or
disease, provide psychological support and "protection". In occupational disease. No matter how perfect the laws are, the
proportion to the employee-employer relationship until that application level would determine their effect on social
day, the person who was diagnosed with an occupational protection.
disease may have psychological reactions such as unhidden
hostility, anger and depression because of the decision for or
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