Occupational Health

Prof. Raihana Begum

Dept. of Community
Occupational Health: Definition by ILO & WHO

It is the branch of medical and engineering

science that deals with promotion and
maintenance of the highest degree of
physical, mental & social well-being of
workers in all occupations
 Objectives of Occupational Health

 The promotion & maintenance of the

highest degree of physical, mental &
social well being of workers in all
occupations

 The prevention of departures from health

among workers caused by their working
conditions
 Objectives of Occupational Health

 The protection of workers in their employment

from risks resulting from factors adverse to health

 The placing & maintenance of the workers in an

occupational environment adapted to his
physiological & psychological equipment,
and to summarize the adaptation of work to man
& of each man to his job
 Occupational Environment

“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
 Three types of interactions in the
working environment

1. Man and Physical,chemical and biological

agents

2. Man and Machine

3. Man and Man

 Man and Agent Man and Man
Relates mainly to psychological
Physical factors e.g.
Chemical • Type & rhythm of work
• Work stability
Biologiical • Service condition
• Job satisfaction
• Leadership style
Man and Machine • Security
• Unguarded machines • Worker’s participation
• Protruding and moving parts • Communication
• Poor installation of the plant • System of payment
• Lack of safety measures • Welfare condition
• Working for long hours in un- • Degree of responsibility
physiological postures • Trade union activities
(fatigue, backache, joint & • Incentives
muscle pain)
 Occupational hazards
 Five types

1. Physical hazards
2. Chemical hazards
3. Biological hazards
4. Mechanical hazards
5. Psychosocial hazards
Occupational Hazards

Physical hazards
• Heat
• Cold
• Light
• Noise
• Vibration
• Pressure
• Electricity
• Radiation
• Altitude
 Occupational Hazards
 Chemical hazards:

Act in three ways:

1. Local action: Arsenic, Mercury, Ulceration, Burn

2. Inhalation :Gases, dust,metals & their
compounds
3. Ingestion: Mercury, Arsenic, Zinc, Chromium,
Cadmium etc.
 Chemical hazards

Gases: CO2, CO, CS2, HCN, HCl, H2S, SO2, N2, NH3

Dusts:
• Inorganic – Coal dust, Silica, Iron, Asbestos
• Organic – Cane fibre, Cotton dust, Tobacco, Grain dust

Metals: Lead, Hg, Cd, Mn, Berrylium, Arsenic, Chromium

Chemicals: Acid, Alkali, Pesticide

Solvents: CS2, Benzene, Trichloroethylene, Chloroform

 Biological hazards

Tuberculosis, Brucellosis, Anthrax, Tetanus,

Actinomycosis ,

Psittacosis, Hook worm infection, Encephalitis,

Fungal infection, Hepatitis-B infection,

HIV infection, Leptospirosis , Hydatidosis.

 Mechanical hazard

 Caused by the protruding & moving parts of

the machineries and instruments

 Results from lack of

Safety measures or
Training of workers
 Psychosocial hazard
Occurs due to failure of the workers to adapt to an alien and
sometimes hostile environment. e.g. frustration, insecurity, lack
of job satisfaction, poor human relationship, emotional tension

2 types of illnesses are recognized:

Behavioural
Hostility, Aggressiveness, Anxiety, Depression, Alcoholism,
Drug abuse, Sickness absenteeism

Psychosomatic
Fatigue, Headache, Neck & shoulder pain, Hypertension, Heart
disease, Peptic ulcer.
 Offensive Trade

Definition: The trades which are sources of nuisense from the

public health point of view are called offensive
trade.

These are offensive in relation to sight smell & hearing

Example
Tannery house, Slaughter house, Brick fields, Bone
boiling, Blood boiling & drying, Gut scrapping, Paper
industry, Keeping & maintaining of animals, Rice mill,
Oil mill
Prevention of hazards of Offensive Trade
 Should be away from the residential area.

 Minimization of dust production

 Screening

 Use of mask, protective device, gloves and

aprons
 Occupational diseases

Occupational diseases are usually defined as –

‘Diseases arising out of or in the course of
employment’
 Disease burden of the workers

Occupational
Diseases Work
Related
Diseases

General
Diseases
 Occupational diseases (cont.)

Among the reported countries the most

common occupational diseases are:

(i) Musculo-skeleton disorders

(ii) Noise induced hearing loss
(iii)Dermatitis
(iv)Asthma
(v) Pneumonia
 Occupational diseases (cont.)

Diseases due to Biological hazards

Brucellosis Leptospirosis
Actinomycosis Hydatidosis
Psittacosis Schistosomiasis Encephalitis
Tetanus
Anthrax Tuberculosis
Hepatitis-B Infection HIV Infection
Hook Worm Infection Fungal infection
 Occupational diseases (cont.)

Diseases due to Chemical hazards

Gas poisoning
CO2, CO, CS2, HCN, HCl, H2S, SO2, N2, NH3

Effects
Loss of consciousness, coma, anoxic brain
injury, headache, malaise, ischaemia etc
 Diseases due to Chemical hazards

Dust diseases (Inorganic)

Coal dust (Anthracosis): Coal mine

Silica (Silicosis): Ceramic/glass industry
Iron (Siderosis): Steel/iron industry
Asbestos (Asbestosis): Tin/cement factory
 Diseases due to Chemical hazards

Dust diseases (Organic)

Cane fibre (Bagassosis): sugar, pulp, paper industry

Cotton dust (Byssinosis): cotton & textile industry
Tobacco (Tobaccosis): bidi & cigarette industry
Grain dust (Farmer’s lung): agricultural workers
Jute (Jute bronchitis): jute & jute product industry
Diseases due to Chemical hazards

Metal & compounds

Toxic hazards from Lead, Hg, Cd, Mn,

Berrylium, Arsenic, Chromium

Diseases due to Chemical hazards

Solvents

Poisoning from –

CS2
Benzene
Trichloroethylene
Chloroform
 Diseases due to Physical hazards

Heat
Heat (Stroke, Exhaustion, Syncope, Cramps), Prickly heat,
Burns

Cold
Trench foot, Immersion foot, Frost bite, Chill blain,
Erythro-cyanosis

Light
Occ. Cataract, Miner’s nystagmus, Lachrymation, Eye
pain-strain.
 Diseases due to Physical hazards

Noise
Auditory: Occupational deafness,
Temporary / Permanent hearing loss
Non auditory: Speech annoyance, reduction in efficiency,
fatigue, high BP, tachytcardia.
Pressure
Caisson’s disease, Air embolism, Blast explosion.

Vibration
Affects joints of the upper extremities, spasm of the
fine blood vessels, occasional cramps.
 Diseases due to Physical hazards

Ionizing radiation
Genetic change, malformation, cancer, sterility, ulceration.

Electricity
Burn
 Diseases due to Mechanical hazards

 Accidents

 Injuries
Diseases due to psychosocial hazards

Neuroses, Peptic Ulcer,

Hypertension Drug abuse,

Depression, C.H.D
 Occupational diseases

Occupational Cancer Blood, skin, Lung, Bladder

Occupational Dermatosis Eczema, Dermatitis

.
 Occupational hazards of Agricultural workers

Physical hazards

• Agents are Heat, Cold, Noise, Vibration, Light,

• Organic injury: Occupational deafness

Occupational hazards of Agricultural workers

Toxic/Chemical hazard

• Agents are: Fertilizer, Insecticide, Pesticide, Rodenticide

• Acute toxicity is characterized by GIT symptom &

Chronic toxicity is characterized by the damage to CNS,
CVS, Respiratory, Digestive & Blood formation
 Occupational hazards of Agricultural workers

Chemical hazard

Agents: Disease:
Dusts of grains or hay Farmer’s lung
Cane fibre Bagassosis
Cotton dust Byssinosis
Tobacco Tobaccosis
Coconut fibre, Occupational asthma
Tea, &
Rice husks Other respiratory illness
Wood
 Occupational hazards of Agricultural workers

Biological hazard

Diseases: Brucellosis, Bovine Tuberculosis, Leptospirosis,

Actinomycosis , Tetanus, Anthrax, Fungal infection ,
Hook worm infection, Snake bite, insect bite
Occupational hazards of Agricultural
workers

Mechanical hazards

It is usually caused by the increased use of

machineries

Traumatic injuries: Burn, Fracture,

Amputation, Cuts
Occupational hazards of Agricultural
workers

Psychosocial hazards

Poverty, Depression, Suicide, Homicide,

Peptic ulcer etc.
 Health problems due to
industrialization
 Environmental problems
 Communicable diseases
 Problems of food sanitation
 Mental health disturbances
 Accidents
 Social problems
 Mortality and morbidity.
 Causes of Industrial Accidents
A. Human factors-
Physical
Physiological : Age
Sex
Time
Experience
Working hours
Psychological
 Causes of Industrial Accidents

B. Environmental factors:
Temperature
Poor illumination
Humidity
Noise
Unsafe machine
 Prevention of Industrial Accidents
 Adequate pre-placement examination
 Adequate job training
 Continuing education
 Ensuring safe working environment
 Establishing a safety dept.in the organization
under a competent safety engineer
 Periodic survey for finding out hazards
 Careful reporting, maintenance of records and
publicity
 Measure for general health
protection of the workers
 Nutrition

 Communicable disease control

Prevention of diseases
Early diagnosis and treatment
Rehabilitation
 Measures for general health protection of the workers
 Environmental sanitation
> Safe water supply
> Food sanitation and nutrition education
> Sufficient numbers of sanitary latrines and
urinals for both sexes
> General cleanliness of industrial establishment
> Sufficient floor space,
> Adequate lighting
> Proper ventilation
> Adequate temperature maintenance
> Protection against hazards by using protective devices
> Adequate housing facilities near the plant
Measures for general health protection of the
workers

 Mental health

> To promote health and happiness of workers

> To relief the stress and strain
> Treatment of mental illness
> Rehabilitation
 Measures for general health protection of the
workers
 Measures for women and children:

> Maternity leave

> Free antenatal, intranatal, and postnatal services
> Prohibition of night works & carrying excessive loads
> Prohibition of works in underground mines
> Adequate arrangement of nursery for children of the working
mothers
> Children under 14 years should not to be employed

 Family Planning
 Measures for general health protection of the
workers

 Health Education:
An important health promotional measures should
be organised at all levels.

Health Education should include:

> Personal hygiene
> Preventive and promotive health aspects
> Operation of the total health service program in
the industry
 Pneumoconiosis
 Dust borne lung diseases are collectively called
pneumoconiosis.
 Size of dust: 0.5 -3 microns
 Depends on :
Chemical composition
Fineness
Concentration of dust in the air
Period of exposure
Health status of the exposed person
 Pneumoconiosis
 Prevention:
1. Dust control
2. Personal protection
3. Periodic medical check up.
 Silicosis
 Major cause of permanent disability and mortality

 Caused by inhalation of free silica / silicon dioxide

 Found in –mining industry, pottery and ceramic

industry, sand blasting, metal grinding, iron and
steel industry, building and construction works, rock
mining etc.
 Silicosis
 Early manifestations are Irritant cough, dyspnoea on
exertion,chest pain, & ultimately impairment of total
lung capacity (TLC).

 Pathological finding: Dense nodular fibrosis

(diameter ranges from 3-4 mm)

 Radiological finding: Snow storm appearance

of the lung field
 Silicosis
 Silico-tuberculosis

 Prevention of Silicosis:
1. Rigorous dust control: Substitution, complete
enclosure, isalation, hydroblasting, good house
keeping etc.
2. Use of protective device
3. Regular physical examination.
 Asbestosis
 Asbestos is a fibrous material
 They are silicates of varying materials like
Mg,Iron, Ca, Na, & Al)
 Used for manufacturing asbestos cement, fire
proof textiles, roof tiling, brake lining etc.
 Asbestosis
 It causes pulmonary fibrosis leading to respiratory
insufficiency and death; Ca bronchous & GIT,
mesothelioma of the pleura and peritonium

 C/F: Dyspnoea, clubbing of fingers, cardiac distress,

cyanosis , in advance stage.

 Sputum shows asbestos bodies (asbestos fibre coated with

fibrin)

 X ray shows ground glass appearance in the lower two

thirds of the lung field.
 Asbestosis
 Prevention:
1. Use of safer type of asbestos
2. Substitution of other insulants: Glass fibre,
plastic foam, mineral wool, calcium silicate
etc.
3. Rigorous dust control
4. Continuing research.
 Farmer’s Lung
 It occur due to inhalation of mouldy hay or
grain dust.

 In grain dust or hay ,bacteria and fungi grow

rapidly and thermophilic actinomycetes named
Micropolyspora faeni causes Farmer’s lung
(as the moisture content is >30 % and
temperature between 40-50 0 C.)
 Lead poisoning (Plumbism)
 Industrial use: Manufacture of storage
batteries, glass manufacture, ship building,
printing and potteries,rubber industry etc.

 Environmental lead is Gasoline mainly

exhausted from automobiles.
 Diagnosis of Lead poisoning

 History of lead exposure.

 C/F: Loss of appetite, Intestinal colic,
Persistent headache, weakness, abdominal
cramp, constipation, joint and muscular pain,
wrist drop, foot drop, blue line on gum,
anaemia, mental confusion, delirium etc.
 Diagnosis of Lead poisoning
 Lab. Test:
1. Coproporphyrin in urine (CPU)
2. Lead in blood and urine:
In urine, > 0.8 mg/Litre
In blood: 70 microgm/100 ml produce
clinical symptoms.
3. Basophilic stipling of RBC
 Prevention of Lead poisoning
 Substitution
 Isolation : By Complete enclosure and
segregation.
 Local exhaust ventilation
 Personal protection
 Good house-keeping
 Working atmosphere
 Periodic examination of the workers
 Personal hygiene
 Health education
 Occupational Cancer
 Characteristics of Occupational cancer
 They appear after prolonged exposure.
 The period between exposure and development of
disease varies from 10-25 years.
 Disease may develop even after cessation of
exposure.
 The average age incidence is earlier than that for
cancer in general
 Localisation of cancer is remarkably constant in
any one occupation
 Occupational Cancer
Occupational group Type of cancer
1.Chemist : Lymphatic tissue, haematopoitic
tissue, brain , pancreas.
2. Textile workers: Nasal cavity, sinuses
3. Leather workers: Bladder, mouth, larynx, pharynx.
4. Wood workers: Hodgkin lymphoma.
5. Petrochemical workers: Stomach, oesophagus, lung,
Brain, Leukaemia, Multiple myeloma.
 Occupational Cancer
Occupational group Type of cancer
6. Printing workers: Lung, mouth, pharynx
7. Rubber workers: Bladder, prostate, lung,
stomach, brain
8. Coal miners: Stomach
9. Metal miners: Lung
10. Painters: Leukaemia
11. Foundry workers: Lung
 Prevention of occupational cancer
1. Elimination or control of industrial carcinogens
> Technical measures like exclusion of the
carcinogen from the industry
> Well designed buildings or machineries
> Closed system of production etc.
2. Medical examinations
3. Inspection of factories
4. Notification
5. Licensing of establishment
6. Personal hygiene.
7. Education of the workers and management
8. Continuing research.
 Occupational dermatoses
 It may be caused by physical agent, chemical
agent, biological agent, mechanical agent etc.
 Excessive heat, cold, radiation, moisture may
cause dermatitis

 Chemical agents like soap, detergent,rubber,

metals, tar, plastics, radioactive substances,
solvents, acids and alkalies can cause Irritant or
allergic contact dermatitis.
 Occupational dermatoses

 Dermatoses can be caused by machanical agents

 Trauma of a particular occupation may produce
characteristic stigma “Badge of the trade.”
 Exp: >Discoloured nails of the photographers
and hairdressers,
>White fingers due to traumatic vasospasm
in workers handling vibrating tools.
 Occupational dermatoses

 Biological agents also cause dermatoses.

 Exp: Candidosis due to exposure in moisture
Milker’s nodule(viral) among cow milkers
Erysipelas among butchers and fish handlers
 Prevention of Occupational dermatoses
 Pre-placement examination
 Protection for the machineries & for the workers
 Personal and environmental hygiene.
 Periodic medical examination.
 Education of the management and the workers.
Prevention of Occupational disease
A. Medical Measures
B. Engineering measures
C. Legislative measures
Prevention of Occupational disease

A. Medical Measures:
1. Pre-placement examination
2. Periodical examination
3. Medical and health care sevices
4. Notification of occupational diseases
5. Supervision of working environment
6. Maintenance and analysis of records
7. Health education and counselling
 Prevention of Occupational disease

B. Engineering Measures:
1. Design of building
2. Good housekeeping
3. General ventilation
4. Mechanisation
5. Substitution
6. Dust control
7. Enclosing of harmful materials
 Prevention of Occupational Disease
B. Engineering Measures:

8. Isolation of the offensive processes

9. Local exhaust ventilation
10. Use of protective devices
11. Environmental monitoring
12. Statistical monitoring
13. Continuing research for improvement of
processes and products
 Prevention of Occupational disease

C. Legislative Measures:
It supplements for safeguarding the workers
from the occupational hazards.
1. Factory Act, 1965.It refers to the act in
relation to health, safety and welfare of the
worker
2. The Workmen’s Act, 1923.It refers to the
employers liability for the compensation.
 Benefits of the employees
 Medical benefit
 Sickness benefit
 Maternity benefit
 Disablement benefit
 Dependant’s benefit
 Funeral expenses
 Rehabilitation allowance.
 Medical Benefits
 Consists of full medical care including
hospitalization at free of cost to the insured
persons in case of sickness, employment injury
and maternity.

 The service comprises;

1) Out-patient care
2) Supply of drugs and dressings
3) Specialist services in all branches of Medicines.
 Medical Benefits
4) Pathological and Radiological
investigations
5) Domiciliary services
6) Antenatal, natal & postnatal services.
7) Immunization services
8) Family planning services
9) Emergency services
10) Ambulance services
11) Health education
12) In-patient treatment
 Sickness benefit
 It consists of periodical cash payment to an
insured person in case of sickness if he is duly
certified.

 Sickness benefit is payable maximum period of

91 days in any continuous period of 365 days.
 Extended sickness benefit

 The insured person is protected from dismissal

or discharge from service by the employer
during the period of sickness.
 Maternity benefit
 Payable in cash to an insured woman for
confinement/ miscarriage/ or sickness out of
pregnancy and child birth.

 Maternity leave for 4 months in our country.

 Sickness absenteeism
 It is an important index in industry to assess
the state of health of worker and their physical,
mental and social wellbeing.
 It seriously hamper production
 Cause financial loss
 It breaks the chain of continuity of work
 It demoralizes the fellow colleagues by
adopting the same strategy.
 Consequences of Sickness absenteeism
 It seriously hamper production
 Cause financial loss & increase cost
 Increase workload
 It breaks the chain of continuity of work
 It demoralizes the fellow colleagues by
adopting the same strategy.
 Frustated managers and supervisors.
 Non-achievement of objectives
 Consequences of Sickness absenteeism
 Low quality product
 More training cost and loss of skilled personnel.
 Increases supervisory and administrative cost
 Adverse public perception and consumer’s
confidence.
 Benefits of Sickness absenteeism
 Reduces risk of injuries
 Maximises the rate of recovery
 Reduce transmission of infectious diseases
 Maintain productive workforcr.
 Maintain workplace safety.
 Legitimate exemption from work.
 Increase job satisfaction and job security
 Increase morale and spirit of enthusiasm.
 Causes of Sickness absenteeism
1. Medical causes:
a) Occupational cause: Occupational
accidents, respiratory illness, alimentary
illness etc.
b) Non-occupational cause: Nutritional
disorder, GIT upset, drug addiction,
alcoholism, any common disease etc.
 Causes of Sickness absenteeism

2. Economic cause: to avail the benefit of sick

leave with pay.

3. Social causes: Wedding, festivals, repair and

maintenance of house, outing programme etc.
 Prevention of Sickness absenteeism

 Good factory management and practices

 Adequate pre-placement examination.
 Good human relations
 Application of Ergonomics (Ergon means
work nomos means law. It means fitting the
job to the worker. By placing the right man to
right job one can perform his duties efficiently
and effectively.
THANK YOU