• LECTURE NOTE ON OCCUPATIONAL HEALTH

PHS 306
• DR JOHNSON ADEGBOYEGA OYENIYI
• MBBS ,MPH , FWACP,
• DEPARTMENT OF PUBLIC HEALTH
• KWASU
 OUTLINE

• Concept of Health
• Concept and Meaning of Occupation Health
• #Aim and Rationale of Occupational Health
• Principles of Occupational Health
• Basic Concepts in Occupational Health
• Historical Development of Occupational Health in Nigeria
• Concept of Hazard and Occupational Hazard
• Importance and Process of Hazard Identification
• Classification of Hazards
Concept of Health, its Dimensions and its Determinants

• The WHO (1948) defined health as “a state of

complete physical, mental, and social well
being and not the mere absence of disease or
infirmity”. Although this definition attracted
many criticisms, it remains the most widely
quoted and popular definition of health.
 Dimensions of Health

• Based on the proposition of health by WHO

(1948), three dimensions of health have been
identified namely, physical, social and mental
health dimensions. These dimensions are briefly
described below:
• Physical Health: This dimension of health refers to
the anatomical integrity and optimal physiological
functioning of the body. A person with physical
health will exhibit the following attributes:
•
• All the body parts are present, complete and
functional,
• All the body parts are in their natural place and
position
• None of the body parts has any form of pathology
• All the body parts operate at optimal physiological
functions
• All the body parts work with each other in a near
perfect harmonious manner
 DIMENTION OF HEALTH
•
• Mental Health: This dimension refers to ability to
learn and think clearly. A person with good mental
health is able to handle day-to-day events and
obstacles, work towards important goals, and
function effectively in society.
• Social Health: This is the ability to make and
maintain acceptable interactions with other people.
Park (2013) defined it as the ability to be at peace
with self and with others around.
 Concept of Occupational Health

• According to the WHO (2001), occupational health is

a multidisciplinary activity aimed at the protection
and promotion of the health of workers by
preventing and controlling occupational diseases and
accidents and by eliminating occupational conditions
and factors hazardous to health and safety at work.
• It also connotes development and promotion of
healthy and safe work, work environments and work
conditions..
 Concept of Occupational Health
• The International Labour Organisation
(ILO/WHO) defined occupational health as the
“promotion and maintenance of the highest
degree of physical, mental and social well-
being of workers in all occupation.” According
to the WHO, the health of every worker and if
possible, that of his/her family members
should be the responsibility of the
organisation he/she is working for.
 Concept of Occupational Health
• Occupational Health is a diverse science applied by
occupational health professionals engineers,
environmental health practitioners, chemists,
toxicologists, doctors, nurses, safety professionals
and others who have an interest in the protection
of the health of workers in the workplace.
• Occupational health issues are often given less
attention than occupational safety issues because
the former are generally more difficult to
confront.
 Components of Occupational Health

• Occupational health as a discipline covers the following

key components:
• Availabilityof occupational health and safety
regulations at workplace
• The availability of active and functional occupational
health and safety committee at workplace
• Monitoring and control of factory hazards to health
• Supervision and monitoring of hygiene and sanitary
facilities for health and welfare of workers
•.
Inspection of health safety of protective
devices.
Pre-employment, periodical and special
health examination.
Performance of adaptation of work to man
Provision of First Aid.
Health education and safety training for
the workers.
Advice to employers on how to
cater for the health of their
workers.
Reporting of occupational deaths,
diseases, injuries, disabilities,
hazards and their related
preventive measures at working
 Aims of Occupational Health

• Occupational health and safety is a discipline

with a broad scope involving many specialized
fields. In its broadest sense, it aims at:
• The promotion and maintenance of the
highest degree of physical, mental and social
well-being of workers in all occupations;
• The prevention among workers of adverse
effects on health caused
 Aims of Occupational Health
– by their working conditions;
– The protection of workers in their
employment from risks resulting from
factors adverse to health;
– The placing and maintenance of workers in
an occupational environment adapted to
physical and mental needs;
– The adaptation of work to humans.
– To prevent occupational accidents and
illness
– To defend the workers health and safety
– To avoid any possible accidents and risks in
the workplace
– To inform and give advice to the workers
 Rationale for Occupational Health
•
•

• Work plays a central role in people's lives, since most workers

spend at least eight hours a day in the workplace, whether it is
on a plantation, in an office, factory, etc. Therefore, work
environments should be safe and healthy. Yet this is not the
case for many workers. Every day workers all over the world are
faced with a multitude of health hazards, such as:
– Dusts;
– Gases;
– Noise;
– Vibration;
– Extreme temperatures.
 Cost of Occupational Injuries and Diseases

• Work-related accidents or diseases are very

costly and can have many serious direct and
indirect effects on the lives of workers and their
families. For workers some of the direct costs of
an injury or illness are:
– The pain and suffering of the injury or illness;
– The loss of income;
– The possible loss of a job;
– Health-care costs.
• It has been estimated that the indirect costs of
an accident or illness can be four to ten times
greater than the direct costs, or even more.
An occupational illness or accident can have
so many indirect costs to workers that it is
often difficult to measure them.
• One of the most obvious indirect costs is the
human suffering caused to workers' families,
which cannot be compensated with money.
• The costs to employers of occupational
accidents or illnesses are also estimated to be
enormous. For a small business, the cost of
even one accident can be a financial disaster.
For employers, some of the direct costs are:
– Payment for work not performed;
– Medical and compensation payments;
– Repair or replacement of damaged machinery and
equipment;
– Reduction or a temporary halt in production;
– Increased training expenses and administration
costs;
– Possible reduction in the quality of work;
– Negative effect on morale in other workers.
 Some of the indirect costs for employers are:

• The injured/ill worker has to be replaced;

• A new worker has to be trained and given time to adjust;
• It takes time before the new worker is producing at the rate of
the original worker;
• Time must be devoted to obligatory investigations, to the
writing of reports and filling out of forms;
• Accidents often arouse the concern of fellow workers and
influence labour relations in a negative way;
• Poor health and safety conditions in the workplace can also
result in
• poor public relations.
 Key Principles of Occupational Health

• . Key principles as documented in Ali (2008) are briefly

discussed below:

• All workers have rights: Every worker has a right to life

and safety. Workers, as well as employers and
governments, must ensure that these rights are protected
and must strive to establish and maintain decent working
conditions and a decent working environment. More
specifically these conditions as listed by the International
Labour Organisation (1984) must be ensured:
 Key Principles of Occupational Health
•
– work should take place in a safe and healthy
working environment;
– conditions of work should be consistent with
workers’ well- being and human dignity;
– work should offer real possibilities for
personal achievement, self-fulfilment and
service to society.
 Basic Concepts in Occupational Health

•
• There are four basic elements in the working
environment. They are:
• The worker
• The tool
• The process
• The work environment
• The worker
• In developing countries like Nigeria, the work force has
several distinct characteristics:
• Most people who are employed to work in the informal
sectors, mainly in agriculture, or in small-scale
industries, such as garages, tannery and pottery.
• There are high rates of unemployment, some- times
reaching 25% or higher. In many developing countries,
the rates of unemployment and under employment are
increasing each year.
• In general, workers are at greater risk of occupational
hazards for a variety of reasons like unfamiliarity with
work processes and exposures, inadequate training,
predisposition not to complain about working
conditions or exposures because of jobs, whether or
not they are hazardous.
• Workers are relatively scarce; experience high
prevalence of occupational diseases and malnutrition.
There is also inadequate infrastructure and human
resources to diagnose, treat, and prevent work -
related diseases and injuries.
• The Tool
• Tools can range from very primitive tools like a hammer,
chisel, and needle, to automated equipment and other
materials used for working.
• The process
• In the process, materials used can be toxic. The process
itself can affect the potential harmfulness of the
materials. For example, the particle size or physical state
(solid, liquid and gas) of potentially harmful substances
can determine to a large extent what ill effects in workers
may develop from those substances.
• The work environment
• Occupational environment means 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. The industrial
worker today is placed in a highly complicated
environment and the work environment is getting
more complicated as human is becoming more
innovative or inventive.
• Basically, there are three types of interaction
in a working environment: -
• Man and Physical, chemical and biological
agents
• Man and machine
• Man and his psychosocial environment
 Interactions in the Working Environment

• Interactions in the Working Environment

– man and physical, chemical and biological agents.
•
• The physical agents.
• These include excessive level of
– Noise
– Heat and humidity
– Dust
– Vibration
– Electricity or lighting
– Radiation etc.
 • Chemical agents.
• These arises from excessive air borne
concentrations of
– Chemical dust
– Mists
– Fumes
– Liquids
– Vapors
– Gases
– Dust
 biological agents. These include:
• Presence of insects and rodents
• Microorganisms
• Poisonous plants and animals
•
• Ergonomic hazards
• These include excessive improperly designed tools, work areas,
or work procedures. Improper lifting or reaching, poor visual
conditions, or repeated motions in an awkward position can
result in accidents or illnesses in the occupational environment.
•
•
– Man and machine
• An industry or factory uses power driven machines for
the purpose of mass production. Unguarded
machines, protruding and moving parts, poor
electrical and machinery installation of the plant, and
lack of safety measures are the causes of accidents.
Working for long hours in an awkward postures or
positions is the causes of fatigue, backache, diseases
of joints and muscles and impairment of the workers
health and efficiency.
 – Man and his psychosocial environment
• There are numerous psychosocial factors, which
operate at work place. These are the human
relationships among workers themselves and
those in authorities over them.
•
• Examples of psychosocial factors include:-
• The type and rhythm of work.
• Work stability.
• Service conditions.
• Job satisfaction.
• Managers’ leadership style.
• Job security.
• Workers` participation and communication.
• Motivation and incentives.
 Interdisciplinary Relationships
• Environmental Managers: occupational health personnel who
try to eliminate hazards from the workplace cause many
environmental problems.
•
• Toxicology: is the science that studies poison and toxic
substances and their mechanisms and effects on living
organisms. In other words toxicology is the study of adverse
effects of chemical on biologic systems, or when a substance
has a capacity to produce undesirable physiological effect
when the chemical reached a sufficient concentration at a
specific site in the body
•
• Toxicologists: are persons who study poisoning and
responsible defining quantitatively the level of exposure at
which harm occurs and they also prescribe precautionary
measures and exposure limitations so that normal
recommended use of chemical substance does not result in
excessive exposure and subsequent harm
• Ergonomics: is a multidisciplinary activity dealing with the
interaction between man and his total working environment
plus such traditional environmental elements as atmosphere,
heat, light, and sound as well as all tools and equipment of
the work place.
•
• Chemical Engineers are those who design
process plant, they choose values, decide on
how access will be gained and how cleaning
will take place.
• Mechanical Engineers are those who
responsible for choosing materials handling
systems or for specifying noise levels on
machinery.
• Environmental Health Professionals: are those who
apply their knowledge and experience, understand
the environmental health hazards, analyze the
technical and social approaches and reduce and
eliminate human exposures and health impacts.
•
• Industrial Hygienists are scientists, engineers, and
public health professionals committed to protecting
the health people in the workplace and the
community.
• SUMMARY
• Health is widely defined as a state of complete
physical, mental and social well-being and not
merely the absence of disease and infirmity.
• There are three major dimensions of health
including physical, mental and social health
dimensions
• Occupational health is a multidisciplinary activity
aimed at the protection and promotion of the
health of workers by preventing and controlling
occupational diseases and accidents and by
eliminating occupational conditions and factors
hazardous to health and safety at work. It also
connotes development and promotion of healthy
and safe work in work environments and work
conditions
• The overall objective of occupational health is
the promotion and maintenance of the highest
degree of physical, mental and social well-being
of workers in all occupations;
• The basic concepts in occupational health
include: the worker, working tool, working
process and the work environment.
• These concepts interact in a complex manner
to significantly influence the health of workers.
Historical Development of Occupational Health in Nigeria

•
• Occupational health started with man however, as a
discipline and filed, it is traceable to Hippocrates who in
the Fourth Century BC recognized lead toxicity in the
mining industry
• The history of industrial hygiene can be traced back to the
time of Hippocrates, who in the fourth century recognized
and recorded the problem of lead toxicity in the mining
industry. Other incidents include:
• About 500 years after Hipocrates, the Greek physician
Galen wrote at length on occupational diseases and
recognized the dangers of acid mists to copper miners.
Other reports during the subsequent centauries
described mining accidents and offered suggestions
for mine ventilation and protective masks for miners,
and discussed silicosis, a lung disease caused by
inhaling silica dust.
During the 18th and 19th centuries industrial hygiene
become of increasing importance .
The period saw the publication of numerous works on
the subject, as well as the passage in both England
and Europe of the first effective legislation designed
to protect the health of workers.
 people die from occupational illnesses and in 1990 alone
there were about 1.8 million disabling injuries on the job.
World wide there were an average of are 33 million
occupational injuries per year with about 145,000 deaths.
Such conditions may not get better as employment in firms
and industries is increasing from year to year.
Industrialization equally triggered occupational health and
its development in developing countries including Nigeria.
• The establishment of factories, notably the coal factory in
Nigeria marked the beginning of occupational health in Nigeria.

•
 Meaning of Hazard and Occupational Hazard

• A hazard is something which is known to cause

harm, that is, a source of danger to health. Risk is
the likelihood or probability of the hazard occurring
and the magnitude of the resulting effects.
• An occupational hazard is thus any occupational
factor or situation that can cause injury, disease or
death. Occupational hazards on their own are not
harmful but can become harmful if the risk of their
• manifestations are not reduced to the barest
minimum. For instance, the machineries in an
industrial setting are not harmful if they are used
as they should be used. When there is any error
in their operation, this error can result in
accident, injury or even death, depending on its
severity. It is therefore important to reduce
occupational hazard risks to the barest minimum.
•
 Purpose of identification of Occupational Hazards

• The purposes of identifying occupational

hazards include:
• Obtaining information on occupational
health stresses
• Collecting information on working
conditions
• Collecting information on work processes
and products
 The purposes of identifying occupational
hazard

• Obtaining the threshold limit values for

substances
• Collecting information on the effects of
exposure on human
• Collecting data on exposure levels by
conducting elementary measurements
• Determining where problem or potential
problem area exist
 – Importance of Identification of Occupational
Hazards
• Identification of health and safety problems
includes the following:
• Observe workplace
• Investigate complaints from workers
• Examine accident and near-miss records
• Examine sickness figures
• Use simple surveys to ask co-workers
about their health and safety concerns;
• Use check-lists to inspect your workplace;
• Learn the results of inspections that are
done by the employer, the union or
anyone else;
• Read reports or other information about
the workplace
 Classification of Occupational Hazards

• Physical Hazards
• Mechanical Hazards
• Chemical Hazards
• Biological Hazards
• Ergonomic Hazards
• Psychosocial Hazards
 Physical Hazards

• Physical hazards, which can adversely affect

health, include noise, vibration, ionizing and
non-ionizing radiation, heat and other
unhealthy microclimatic conditions. Between
10 and 30% of the workforce in industrialized
countries and up to 80% in developing and
newly industrialized countries are exposed to
a variety of these potential hazards.
• Physical hazard has possible cumulative or
immediate effects on the health of employees.
Therefore, employers and inspectors should
be alert to protect the workers from adverse
physical hazards. Typical examples of physical
hazards are briefly discussed below:
 Extreme Temperature

• The work environment is either comfortable or

extremely cold or hot and uncomfortable. The
common physical hazard in most industries is heat.
• Extreme hot temperature prevails on those who are
working in foundries or in those industries where
they use open fire for energy. Examples of these
include soap factories in large industries and in the
informal sectors that use extreme heat to mold iron
or process other materials.
• Effects of hot temperature in work place include:
• Heat Stress
• Heat stress is a common problem in workplace because
people in general function only in a very narrow
temperature range as seen from core temperature
measured deep inside the body. Fluctuation in core
temperature about 20 C below or 30C above the normal
core temperature of 37.60C impairs performance markedly
and a health hazard exists. When this happens the body
attempt to counteract by:
•
•
– Increasing the heart rate
– The capillaries in the skin dilate to bring more
blood to the surface so that the rate of cooling is
increased.
– Sweating to cool the body
• Heat stroke
• Heat stroke is caused when the body temperature
rises rapidly in a worker who is exposed to a work
environment in which the body is unable to cool itself
sufficiently. Predisposing factors for heat stroke is
excessive physical exertion in extreme heat condition.
• The method of control is therefore, to reduce the
temperature of the surrounding or to increase the
ability of the body to cool itself.
•
• Heat Cramp
• Heat cramp may result from exposure to high
temperature for a relatively long time particularly
if accompanied by heavy exertion or sweating with
excessive loss of salt and moisture from the body.
• Heat Exhaustion
• This also results from physical exertion in hot
environment. Signs of the problem include:
– Mildly elevated temperature
– Weak pulse
– Dizziness
– Profuse sweating
– Cool, moist skin, heat rash
• Cold Stress
• Cold stress could mainly be defined as the effect of the
external working environment (Very low temperatures
i.e. less than 60C)and the resultant inability of the body
to maintain a constant internal body temperature.
• High airflow is a critical factor here, as it will increase
cold stress effects considerably. This is commonly
referred to as the wind chill factor.
• Special condition that occur in cold weather
• Trench Foot
• An injury which results from long exposure of the feet to
continued wet condition at freezing temperature with little
movement causes changes in the circulation of blood in the
feet. Trench foot can result in loss of toes or part of the
feet. To treat trench foot, keep foot dry and warm and
engage in exercise for good circulation.
• Immersion foot
• Immersion of foot in water that is below 100 C, for a
prolonged time, usually in excess of 24 hours
• Frostbite
• This is injury of body tissues due to exposure
to intense cold
• .Body parts most easily frostbitten include
cheeks, nose, ears, chin forehead, wrists ,
hands and feet.
• Prevention of Frostbite
• Frostbite can be prevented by:
• Wearing the proper amount warm, loose, dry clothing.
• Massaging the face, hand, and feet periodically to
promote good circulation.
• Troops travelling in cold weather by, particularly in the
rear of trucks should be allowed to dismount and
exercise periodically to restore circulation.
• If clothing become wet, it should be dried or change at
once.
• Vibration Motion Conditions
• Vibration causes vascular disorders of the arms and bony
changes in the small bones of the wrist. Vascular changes
can be detected by X- ray examination of the wrist. The
most common findings is rarefaction of the lunate bone.
• Atmospheric Pressure (high and low)
• Exposure to increased atmospheric pressure (under
water) leads to aseptic bone necrosis around the knee,
hip and shoulder that can be detected by X-ray
examination
• Non-Ionizing and Ionizing Radiation
• Non-ionizing Radiation
• We take advantage of the properties of non-
ionizing radiation for common tasks:
• microwave radiation-- telecommunications and
heating food
• infrared radiation --infrared lamps to keep food
warm in restaurants
• radio waves-- broadcasting
 Non-ionizing radiation ranges from extremely
low frequency radiation, shown on the far left
through the audible, microwave, and visible
portions of the spectrum into the ultraviolet
range. Extremely low-frequency radiation has
very long wave lengths (on the order of a million
meters or more) and frequencies in the range of
100 Hertz or cycles per second or less.
• Radio frequencies have wave lengths of
between 1 and 100 meters and frequencies in
the range of 1 million to 100 million Hertz.
Microwaves that we use to heat food have
wavelengths that are about 1 hundredth of a
meter long and have frequencies of about 2.5
billion Hertz.
 Ionizing Radiation
• Ionizing radiation has many practical uses, but
it is also dangerous to human health. It
radiation is either particle radiation or
electromagnetic radiation in which an
individual particle/photon carries enough
energy to ionize an atom or molecule by
completely removing an electron from its
orbit.
• If the individual particles do not carry this
amount of energy, it is essentially impossible
for even a large flood of particles to cause
ionization. These ionizations, if enough occur,
can be very destructive to living tissue, and
can cause DNA damage and mutations.
•
• Natural radiation
• Natural background radiation comes from four
primary sources:
• Cosmic radiation,
• Solar radiation,
• External terrestrial sources, and
• Radon.
•
• The effects of ionizing radiation on animals
• Biological effects of radiation on living cells may result in a variety of
outcomes, including:
• Cells experience DNA damage and are able to detect andrepair the
damage.
• Cells experience DNA damage and are unable to repair the damage.
These cells may go through the process of programmed cell death, or
apoptosis, thus eliminating the potential genetic damage from the
larger tissue.
• Cells experience a nonlethal DNA mutation that is passed on to
subsequent cell divisions. This mutation may contribute to the
formation of a cancer.
 Minimizing health effects of ionizing radiation

• There are four ways in which we can protect ourselves from

radiations:
• Time: For people who are exposed to radiation in addition to
natural background radiation, limiting or minimizing the
exposure time will reduce the dose from the radiation
source.
• Distance: In the same way that the heat from a fire is less
intense the further away you are, so the intensity of the
radiation decreases the further you are form the source of
the radiation. The dose decreases dramatically as you
increase your distance from the source.
•
• Shielding: Barriers of lead, concrete, or water give good
protection from penetrating radiation such as gamma
rays and neutrons. This is why certain radioactive
materials are stored or handled underwater or by
remote control in rooms constructed of thick concrete
or lined with lead. There are special plastic shields
which stop beta particles and air will stop alpha
particles. Inserting the proper shield between you and
the radiation source will greatly reduce or eliminate the
extra radiation dose.
•
• Containment: Radioactive materials are confined in
the smallest possible space and kept out of the
environment. Radioactive isotopes for medical
use, for example, are dispensed in closed handling
facilities, while nuclear reactors operate within
closed systems with multiple barriers which keep
the radioactive materials contained. Rooms have a
reduced air pressure so that any leaks occur into
the room and not out of it.
• Noise
• Noise is defined as unwanted sound. Sound is any pressure
variation or a stimulus that produces a sensory response in
the brain. The compression and expansion of air created
when an object vibrates.
• Industry specific studies reveal that:
• 44% of carpenters and 48% of plumbers reported that they
had a perceived hearing loss.
• 49% of male, metal/non-metal miners will have a hearing
impairment by age 50 (vs. 9% of the general
population)rising to 70% by age 60.
•
• While any worker can be at risk for noise-
induced hearing loss in the workplace,
workers in many industries have higher
exposures to dangerous levels of noise.
Industries with high numbers of exposed
workers include: agriculture; mining;
construction; manufacturing and utilities;
transportation; and military.
• General Class of Noise Exposure
• There are three general classes into which
occupational noise exposure may be grouped.
•
– Continuous Noise: Normally defined as broadband noise of
approximately constant level and spectrum to which an
employee is exposed for a period of eight hours per day or
40hours a week.
– Intermittent Noise: This may be defined as exposure to a
given broadband sound pressure level several times during
a normal working day
 – Impact (impulse) type Noise: is a sharp burst of
sound. A sophisticated instrumentation is
necessary to determine the peak levels for this
type of noise.
• Effects of noise exposure
• The effects of noise on humans can be
classified into two types:
• Non auditory effect
• Auditory effect
•
• Effects of noise exposure
• The effects of noise on humans can be classified into
two types:
• Non auditory effect
• Auditory effect
• Non-auditory effects
• This consists of fatigue, interference with
communication, decreased efficiency and annoyance.
 Auditory effects

• Auditory effects consist of permanent or temporary

hearing loss. The ear is especially adapted and most
responsive to the pressure changes caused by airborne
sound or noise. The outer and middle ear structures are
rarely damaged by exposure to intense sound energy
except explosive sounds or blasts that can rupture the
eardrum and possibly dislodge the ossicular chain.
More commonly, excessive exposure produces hearing
loss that involves injury to the cells in the organ of corti
within the cochlea of the inner ear.
 Prevention of hearing exposure
• Noise monitoring
• Hearing testing –Audiometric
• Employee training
• Hearing protectors
• Keeping record
5. Recordkeeping

❖ Lighting/Illumination
Good and sufficient lighting is aimed at promoting
productivity, safety, health, well being and pleasant working conditions at an eco

Purpose of good lighting

• help provide a safe working environment;
• Provide efficient and comfortable sight
• reduce losses in visual performances.
5. Recordkeeping

❖ Lighting/Illumination
Good and sufficient lighting is aimed at promoting
productivity, safety, health, well being and pleasant working conditions at an econ

Purpose of good lighting

• help provide a safe working environment;
• Provide efficient and comfortable sight
• reduce losses in visual performances.
•
• Effects of Poor Illumination
• Some less tangible factors associated with poor illumination are
important contributing causes of industrial accidents. These can
include:
• direct glare
• reflected glare from the work
• dark shadows which may lead to excessive visual fatigue
• visual fatigue, itself may be a causative factor in industrial
accidents
• delayed eye adaptation when coming from bright surroundings
into darker ones .
 Mechanical Hazards

• Mechanical factors include unshielded machinery, unsafe

structures at the workplace and dangerous unprotected
tools are among the most prevalent hazards in both
industrialized and developing countries. They affect the
health of a high proportion of the work force. Most
accidents could be prevented by applying relatively simple
measures in the work environment, working practices, and
safety systems and ensuring appropriate behavioural and
management practices. This would significantly reduce
accident rates within a relatively short period of time.
 Chemical Hazards

• In Nigerian where data are not available it can be estimated that

cases would be staggering.
• Effects of chemical hazards are dependent on their:
• Amount
• Concentration
• Time of exposure
• Mode of entry to the body
• Age of the exposed workers
• Sex of the exposed workers
• Health status of the exposed workers
• Resistance of the exposed workers
• Effects of Chemical Hazards
• The effects of chemical agents are as follows:
• Asphyxiation
• Systemic intoxication
• Pneumoconiosis
• Carcinogens
• Irritation
• Mutagencity
• Teratogenicity
• Among all chemical agents in work place the most
notorious and most in contact with the skin or
respiratory system that deserve attention is solvent.
• Solvent
• In most occupational settings or industries a potential
threat to the health, productivity and efficiency of
workers is their exposure to organic solvents. Exposure
to solvents occurs throughout life .Example, organic
solvent vapor inhaled by a mother could reach the fetus.
• Classification of Solvents
• The term solvent means materials used to
dissolve another material and it includes
aqueous or non-aqueous system. Aqueous
solutions include those based in water.
• Example:
• Aqueous solution of acids
• Aqueous solution of alkalis
• Aqueous solution of detergents.
• Aqueous solutions have low vapor pressure thus
the potential hazard by inhalation and
subsequent systemic toxicity is not great.
Examples of non- aqueous solutions include:
• Aliphatic hydrocarbons.
• Aromatic hydrocarbons.
• Halogenated hydrocarbons.
• Cyclic hydrocarbons.
• The solvent we are concerned in occupational
health and safety will include any organic
liquid commonly used to dissolve other
organic material.
• These are:
• Naphtha
• Mineral spirits
• Alcohol, etc.
• Effects of Solvents
• The severity of a hazard in the use of solvents and
other chemicals depends on the following factors:
– How the chemical is used.
– Type of job operation, which determines
how the workers are exposed.
– Work pattern.
– Duration of exposure.
– Operating temperature.
 – Concentrations of vapors in workroom air.
– House keeping
• Health Effect of Solvent Exposure
• The effect of solvents varies considerably with
the number and type of halogen atoms (fluorine
and chlorine) present in the molecules. Carbon
tetrachloride, which is a highly toxic solvent act
acutely on the kidney, the liver, gastro intestinal
tract (GIT).
• Chronic exposure to carbon tetrachloride also,
damages and cause liver cancer. This solvent
should never be used for open cleaning
processes where there is skin contact or
where the concentration in the breathing zone
may exceed recommended level.
 Fire and Explosion
• Using non-flammable solvents can minimize the potential for
this or solvents with flash point greater than 60 degree
Celsius or 140degree Fahrenheit. However the non-
flammable halogenated hydrocarbons decompose when
subjected to high temperature and give off toxic and
corrosive decomposition products. If flammable solvents
with flash point less than this are used precaution must be
taken to:
– Eliminate source of ignition such as flames, sparks, high
temperature smoking etc.
– Properly insulate electrical equipment when pollutants
are released outdoors.
 Dangerous chemical substances

•
• The following terms are used in the classification of
dangerous substances in the classification, packing and
labeling of dangerous substances regulations 1984.
• Corrosion
• Oxidizing
• Harmful
• Very toxic and toxic
• Irritant
• Highly flammable
• Explosive
 Corrosive

• Hazard: Living tissues as well as equipment are

destroyed oncontact with these chemicals.
• Caution: Do not breathe vapors and avoid contact with
skin eyes,and clothing
• Oxidizing
• Hazard: ignite combustible material or worsen existing
fire and thus make fire fighting more difficult.
• Caution: Keep away from combustible material.
Restrict smoking in that area.
• Harmful
• Hazard: Inhalation and insertion of or skin
penetration by these substances is harmful to
heath.
• Caution: Avoid contact with the human body,
including inhalation of vapors and in cases of
malaise, a doctor should be consulted.
•
toxic and toxic
Very

• Hazard: The substances are very hazardous to health whether breathed, swallowed
or in contact with the skin and may even lead to death.
• Caution: Avoid contact with human body, and immediately consult a doctor in case
of malaise.
• Irritant
• Hazard: May have an irritant effect on skin, eyes and respiratory organs
• Caution: Do not breathe vapors and avoid contact with skin and eye
• Highly Flammable
• Hazard: Substances with flash point less than 60 0 C or 140 0F
• Caution: keep away source of ignition.
• Explosive
• Hazard: Substances which may explode under certain condition
• Caution: Avoid shock, friction, sparks and heat.
•
•
• Chemical Hazards Evaluation
• Toxicity assessment
• Work activity/risk assessment evaluation
• Assessment of controls effectiveness to block
routes of entry
• Exposure monitoring
• Recommendations for improvement
•
• Monitoring Exposure of Chemical Hazards:
• Chemical hazards can be monitored using:
• Special instruments : infrared
absorption, photo ionization, gas
chromatography
• Detector tubes
• Air sampling and lab analysis
• Professional judgment
• Controls of Chemical Hazards:
• Control strategies for chemical hazards include:
• Substitution i.e. use of lower toxicity materials
• Enclose processes and otherwise engineer for low
emission / low risk
• Provide local exhaust to remove air-borne agents
• Local exhaust ventilation
• Need to have even air flow for hoods
• Need to design for adequate capture velocity -usually
about 100 feet/minute
• Need sufficient make up air
• Use ACGIH Ventilation Manual for design
• Reduce exposure time
• Better procedures
• Training
• PPE - gloves, face shields, respirators
• Remote Operation
 Biological Hazards

• Many biological agents such as viruses, bacteria, parasites,

fungi ,moulds and organic dusts have been found to occur in
occupational exposures. In the industrialized countries around 15
% of workers may be at risk of viral or bacterial infection, allergies
and respiratory diseases. In many developing countries the
number one exposure is biological agents.HIV/AIDS, Hepatitis B
and C viruses and other blood borne pathogens, tuberculosis
infections (particularly among health care workers), asthmas
(among persons exposed to organic dust) and chronic parasitic
infections (particularly among agricultural and forestry workers),
are the most common occupational diseases that result from
such exposures.
•
• Exposure to biological hazards in workplace
results in a significant amount of
occupationally associated diseases. Biological
hazards include viruses, bacteria, fungus,
parasites, or any living organism that can
cause disease to humanbeing
• Biological hazards can be transmitted to a
person through:
• Inhalation
• Injection
• Ingestion
• Skin contact
• Contracting a biohazard depends on:
• The combination of the number of organisms
in the environment.
• The virulence of these organisms
• The susceptibility of the individual
• Existence of physical/chemical stresses in the
environment.
•
• Occupational Exposure to Biohazards
• The most obvious work place in which employees
are subjected to hazards as a result that the work
requires handling and manipulation of biological
agents include: surgery, autopsy, contaminated
discharges, blood, pipettes, laboratory specimens,
etc. Occupational settings where the risk of
contracting biohazard is high include:
• Research Laboratories

• Health personnel such as laboratory

technicians and scientists working on
biological specimens are at risk with
biological hazards in the laboratory.
Specimen such as blood, pus, stool and other
tissue samples may expose the workers to
hazards such as HIV, Hepatitis, etc.
• Health Care Facilities
• Many potential biological agents exist in hospital
environment. These are bacterial infection and viral
agents. Those working in laundry, housekeeping,
laboratory, central supply, nursing station and
dietary are highly exposed to biohazard from the
patient they handle, from the specimen they
collect and from the cloth, needle and pans they
handle and from their general day to day activities.
• Housekeeping
• Housekeepers in hospitals are the single
highest group exposed to infectious biological
agents. The areas and condition of
contamination are:
• Contact with discarded contaminated
disposable materials during all general cleaning
activities.
•
• Widespread use of disposable materials, especially those
used in intravenous administration and blood collection.
• Contaminated hypodermic needles and intravenous
catheters
• Dry sweeping of the floor does not remove many
microbes. It rather pushes dust and other materials from
one area to the other. When mops and brooms are
improperly treated dust is dispersed back into the air.
•
• Central Supply
• The most serious problem in this department is the
cleansing of surgical instruments. Grossly contaminated
materials should be sterilized in an autoclave before any
handling or rinsing. Scrubbing action is much more
efficient than soaking, but it is during scrubbing that
exposure to biohazard is the greatest. Direct injection of
microorganisms is possible if the skin is punctured with
dirty instruments or if the skin has a lesion that comes
into contact with contaminated instruments.
•
• Health care staff
• The possibility of exposure to infection of health
care professionals that have direct contact with
patients is always present. Infection can be spread
in health care facilities through:-
• Patient to patient
• Patient to other staff
• Patient to his/her own family
 – Patient to visitors especially if
consulting with family members of the
patient
• Health care workers are not the only persons
susceptible to contracting diseases.
• Others are
• Patient
• Waste handlers and transporters
• Laundry staffs
• Poor health care waste management system hazardous to:-
• Health care workers
• Patients
• Visitors
• Community
• Environment
• To avoid such contamination health care workers should:
• Dispose of contaminated equipment properly so that no
health hazard
• is exposed to infect others.
• Hands should be thoroughly washed with soap
and water after visiting each patient to
minimize the chance of spreading harmful
infection or organisms from patient to patient.
• Gowns, masks and caps must be worn
whenever necessary and removed before
entering clean areas such as rest areas and
lunchrooms.
• Dietary Sections
• Staffs involved in food preparation are exposed to
infection from infectious agents such as salmonella,
botulism, amoeba and staphylococcus, which can
result from contact with raw fish, meat, and some
vegetables contaminated by sewage or human
waste or dirty water.
• Primary prevention against infection or
contamination of the food include:
– Proper handling of food products (raw or cooked)
–Use clean hands and garments in the
food processing areas
–No skin lesion of food handlers
–Refrigeration of food products at a
safe temperature level in order to
prevent growth of bacteria.
–Adequate cooking of foods.
•
• The problem of biological hazard in health care
delivery system is increasing because of:
• Inadequate sanitation, disinfection and
sterilization methods.
• Increase in drug as well as chemical resistant
strains of microbes.
• Increase of high-risk patients (HIV/AIDS and TB).
• Agriculture
• Occupational exposures to biohazard also occur in
agriculture. There are three types of relationships in terms
of disease transmission between humans and animals.
These are:
– Disease of vertebrate animals transmissible to human and other
animals (Zoonosis)
– Disease of humans transmissible to other
animals(Anthropozooonois)
– Disease of vertebrate animals chiefly
transmissible to humans(Zooanthroponosis)
• Zoonosis
• It consists of viral, bacterial, rickettsial, fungal,
protozoal, and helminthic disease. Among the
most important throughout the world are:
Anthrax, brucellosis, tetanus, encephalitis,
leptospirosis, rabies,and salmonellosis. The
infection could enter the body through
inhalation, ingestion, or through the skin or
mucus membrane.
• Biohazard Control Programme
• Employee health
• This can be ensured through:
– Pre-placement examination for new employee.
– Periodic physical examination as part
of a surveillance programme.
– Vaccination.
•
 –

• Laboratory Safety and Health

• This can be realized through:
• Employee training
• Avoid, if possible, entering into a biohazard areas.
• Avoid eating, drinking,smoking and gum chewing in
biohazard areas
• Wearing personal protective equipment is always advisable.
• Biological Safety Cabinet
• This is concerned with protecting workers from exposure to aerosols
especially when there is contact with biohazards in laundry activities.
•
• Animal Care and Handling
– Periodic examination,
– Disposal of manure,
– Cleanliness,
– Collection of medical history and
– Treatment.
 Ergonomic Hazards

• Ergonomics, also known as human engineering or human

factors engineering is the science of designing machines,
products, and systems to maximize the safety, comfort,
and efficiency of the people who use them. Ergonomists
draw on the principles of industrial engineering,
psychology, anthropometry (the science of human
measurement), and biomechanics (the study of muscular
activity) to adapt the design of products and workplaces
to people ’sizes and shapes and their physical strengths
and limitations
• In general, ergonomics deals with the interaction
between humans and such additional
environmental elements such as heat, light,sound,
atmospheric contaminants and all tools and
equipment pertaining to the work place.
• Ergonomics or the proper designing of work
systems based on human factors has the following
advantages:
• There will be more efficient operations
• There will be fewer accidents
• There will be reduced training time
•
• There will be fewer costs of operations
• There will be more effective use of workers or
personnel
• The goal of "Ergonomics" or human factors
ranges from making work safe to humans,
and increasing human efficiency and
wellbeing. To ensure a continuous high level
performance, work system must be tailored to
human capacities and limitations measured by
anthropometry and biomechanics.
• Principles of Biomechanics
• Biomechanics deals with the functioning of the structural
element of the body and the effect of external and internal
forces on various parts of the body. Taking an example of
"lifting" an object from the ground biomechanics seek
relevant information:
• What is the task to be performed (task variable)
• Would the person be able to do the task (human variable)
• What is the type of work environment (environmental
variable)
• Task variable
• Location of object to be lifted
• Size of object to be lifted
• Height from which and to which the object is to be
lifted
• Frequency of lift
• Weight of object
• Working position
• Human Variable
– Sex of worker
– Age of worker
– Training of worker
– Physical fitness of worker
– Body dimension of worker
• Environmental variable
– Extremes of temperature (hot/cold)
– Humidity
– Air contaminants
•
• Workplace design
• Workplace is the establishment or department where the
person or worker is performing his/her duties. The most
basic requirement fora workplace is that it must
accommodate the person working in it.
• Specifically this means that:
• The workspace for the hands should be between hip and
chest height in front of the body.
• Lower location are preferred for heavy manual work.
• Higher locations are preferred for tasks that require close
visual observations
• Another key ergonomic concept is that workplace should be
designed relating the physical characteristics and capabilities of
the worker to the design of equipment and to the layout of the
workplace.
• When this is accomplished:
• There is an increase in efficiency
• There is a decrease in human error
• Consequent reduction in accident frequency.
• Design is accomplished after learning what the worker's job
description will be, kind of equipment to be used for that process
and the biological characteristic of the person (worker).
• Effects of non ergonomic working conditions
• The effects of a non-ergonomic work environment
include:
• Tendosynovitis
• Bursitis
• Carpal tunnel syndrome
• Raynaud’s syndrome (“white fingers”)
• Back injuries
• Muscle strain
 Preventing Ergonomic Hazards

• To avoid ergonomic hazards the following points should

be considered:
• Sensibility and perceptibility (visual, audible, tactile)
• Kinetic ability and muscular power or strength
• Intelligence
• Skill/Ability to learn a new technique or skill
• Social and group adaptability
• Kinetic conditions (body size or physical constitution)
• Effect of environmental conditions on human ability
• Long term short term or short term adaptable
limits of man(desirable or normal,
compensatory or fatal)
• Reflexion and reaction patterns
• Mode of living (custom/culture) and sex
distinction
• Racial differences
• Human relationship
• Factors that affect on synthetic judgment
 Psychosocial hazards

• Psychological stress caused by time pressure,

hectic work, and risk of unemployment has
become more prevalent during the past
decade. Other factors that may have adverse
psychological effects include jobs with heavy
responsibility for human or economic
concerns, monotonous work or work that
requires constant concentration
• . Others are shift-work, jobs with the threat of
violence, such as police or prison work, and
isolated work. Psychological stress and overload
have been associated with sleep disturbances,
burn-out syndromes, stress, nervousness and
depression.
• There is also epidemiological evidence of an
elevated risk of cardiovascular disorders,
particularly coronary heart disease and
hypertension. Within the
• work environment emotional stress may arise from a
variety of psychosocial factors, which the worker finds
unsatisfactory, frustrating, or demoralizing. For
example:
•
• A peasant who migrates from the rural areas to a city
will face entirely different environment if he/she start to
work in an industry. In his /her rural life he used to work
at his /her own speed but in the factory he may have to
work continuously at speeds imposed by the needs of
production.
• Workers may be working in shifts that will
expose them to unusual hours. They may
upset their family’s life as a result of their
work conditions.
• Workers may be working with a person who is
paid more but who is incapable of working.
• Financial incentives are too low etc.
• These and other stresses will have adverse
psychosocial problems on workers. Reduction of
occupational stresses depends not only on helping
individuals to cope with their problems but also on:
• Improved vocational guidance,
• Arrangement of working hours,
• Job design, and work methods;
• Good management.
 Toxicology in Occupational Health

• Toxicology is the scientific study of the

interaction of industrial chemicals (toxic
chemicals) with the human system and
biology. Toxic chemicals in the work place
cover a broad range including mineral
inorganic chemicals, metals and organic
chemicals. Just as the name implies, these
chemicals are toxic to human system and
therefore cause health problems.
 Routes/Portal of Entry for Toxic Chemicals

• The portal for entry for these toxic chemicals

including:
• inhalation (involving breathing them in through
contaminated air),
• skin absorption,
• ingestion (involving swallowing of these chemicals
by accident)
• and injection (involving entry into the blood stream.
This is however very rare in the industrial setting).
 Dose-Response Relationship/Assessment

• Dose defines the actual amount of a chemical that

enters the body. The dose received may be due to
either acute (short) or chronic(long-term) exposure.
• An acute exposure occurs over a very short period
of time, usually 24 hours.
• Chronic exposures occur over long periods of time
such as weeks, months, or years.
• The amount of exposure and the type of toxin will
determine the toxic effect
 Factors Influencing Toxicity

• The toxicity of a substance therefore depends on the following:

• form and innate chemical activity
• dosage, especially dose-time relationship
• exposure route
• species
• Age
• Sex
• ability to be absorbed
• metabolism
• distribution within the body
• excretion
• presence of other chemicals
 Types of organ specific toxic effects are:

• Blood and Cardiovascular Toxicity

• This results from xenobiotic acting directly on cells in
circulating blood, bone marrow, and heart. Examples
of blood and cardiovascular toxicity are:
• hypoxia due to carbon monoxide binding
of hemoglobin preventing transport of oxygen
• decrease in circulating leukocytes due to
chloramphenicol damage to bone marrow cells
• leukemia due to benzene damage of bone marrow
cells
 Dermal Toxicity

• This may result from direct contact or internal

distribution to the skin. Effects range from mild
irritation to severe changes, such as
corrosiveness, hypersensitivity, and skin cancer.
Examples of dermal toxicity are:
– Dermal irritation due to skin exposure to gasoline
– Dermal corrosion due to skin exposure to sodium
hydroxide(lye)
– Skin cancer due to ingestion of arsenic or skin
exposure to Ultra violet light
• Eye Toxicity
• This results from direct contact or internal distribution to
the eye. The cornea and conjunctiva are directly exposed
to toxicants. Thus, conjunctivitis and corneal erosion may
be observed following occupational exposure to chemicals.
• Many household items can cause conjunctivitis.
Chemicals in the circulatory system can distribute to the
eye
• and cause corneal opacity,
• cataracts,
• retinal and optic nerve damage.
• For example:
• Acids and strong alkalis may cause severe corneal corrosion
• Corticosteroids may cause cataracts
• Methanol (wood alcohol) may damage the optic nerve

• Hepatotoxicity
• This refers to toxicity to the liver, bile duct, and gall bladder.
The liver is particularly susceptible to xenobiotic due to a
large blood supply and its role in metabolism. Thus it is
exposed to high doses of the toxicant or its toxic
metabolites
• Immunotoxicity
• This is toxicity of the immune system. It can take
several forms: hypersensitivity (allergy and
autoimmunity), immune deficiency, and
uncontrolled proliferation (leukemia and lymphoma).
• The normal function of the immune system is to
recognize and defend against foreign invaders. This is
accomplished by production of cells that engulf and
destroy the invaders or by antibodies that inactivate
foreign material.
• Nephrotoxicity
• This is the effect of toxic chemicals on the kidney. The
kidney is highly susceptible to toxicants for two
reasons. A high volume of
• blood flows through it and it filtrates and secondly, the
large amounts of toxins which can concentrate in the
kidney tubules.
• Nephrotoxicity can result in systemic toxicity causing:
• decreased ability to excrete body wastes
• inability to maintain body fluid and electrolyte balance
• Neurotoxicity
• Neurotoxicity represents toxicant damage to
cells of the central nervous system (brain
and spinal cord) and the peripheral nervous system
(nerves outside the CNS). The primary types of
neurotoxicity are:
– neuronopathies (neuron injury)
– axonopathies (axon injury)
– demyelination (loss of axon insulation)
– interference with neurotransmission
• Reproductive Toxicity
• This involves toxicant damage to either the
male or female reproductive system. Toxic
effects may cause:
• Infertility
• interrupted pregnancy (abortion, fetal death,
or premature delivery)
• infant death or childhood morbidity
• chromosome abnormalities and birth defects
• childhood cancer
• Respiratory Toxicity
• This relates to effects on the upper respiratory system (nose,
pharynx, larynx, and trachea) and the lower respiratory system
(bronchi, bronchioles, lung and alveoli). The primary types of
respiratory toxicity are:
• pulmonary irritation
• asthma/bronchitis
• reactive airway disease
• emphysema
• allergic alveolitis
• Pneumoconiosis
• lung cancer
Exposure Emergency Care
Eye: Irrigate
immediately If the chemical contacts the eyes,
immediately wash the eyes with
large amounts
occasionally ofActions
lifting
First Aid water,
the lower and
for Toxic Chemicals
upper lids.
Get medical attention immediately.
Contact lenses should not be worn
Skin: Blot/brush away when
If working
irritation occurs,
brush away excess.
withgently
this chemical.
blot or
Skin: Molten flush If this molten chemical contacts the
immediately/solid- skin, immediately flush the skin with
liquid soap wash large amounts of water. Get medical
immediately attention immediately. If this
chemical (or liquids containing thi
chemical) contacts the skin, promptl
wash the contaminated skin with
soap and water. If this chemical or
 EPIDEMIOLOGY OF OCCUPATIONAL DISEASES AND HEALTH PROBLEMS

• Epidemiology of Occupational Health Diseases

• On a general note, Epidemiology deals with the
study of the distribution and determinants of health
problems in a population with a view to controlling
the identified problems.
• When related to occupational health, it involves
distribution and determinants of occupational
health disorders.
• Every work setting predispose workers to health
problems and the risk of manifestation as well as
severity of these hazards are determined by certain
factors.
• These factors are known as determinants of
occupational health disorders.
• They are broadly categorized into three: socio-
demographic (e.g. age, sex, location etc.);
• work environment (type of industry, health
and safety training and hours worked per
week
• And behavioural variable (e.g. alcohol
consumption).
Occupational Disorders by System/Organ

– Respiratory Disorders
• Work-related respiratory disease is frequently a
contributory cause and commonly a primary cause of
pulmonary disability. The clinical evaluation of
pulmonary disease includes a minimum of four
elements:
• a complete history including occupational and
environmental exposures, a cigarette-smoking history,
and a careful review of respiratory symptoms;
• a physical examination with special attention
to breath sounds;
• a chest x-ray with appropriate attention to
parenchymal and pleural opacities, and
• pulmonary function tests. Major occupational
respiratory diseases are summarized in the
table below.
Pathophysi Occupatio Clinical
ologic nal history/
Process disease Symptoms
Example
Fibrosis
Silicosis, Dyspnea on
Asbestosi
s exertion,
shortness
Table 3.3: Major Types of Occupational pulmonaryof
Diseases

breath
air
Rever way Byssinosi Cough,
sible s, wheeze,
obstr Isocyanat chest
uctio e asthma tightness,
n shortness of
breath, asthma
(asth attacks
ma)
Emphysem Cadmium Cough,
a poisoning sputuma,
(chronic) dyspnea
Granuloma Beryllium Cough, loss
s disease weight ,
shortness
of breath
Smoke Frothy, Spu
• Silicosis is a form of occupational lung disease
caused by inhalation of crystalline silica dust.
It is marked by inflammation and scarring in the
form of nodular lesions in the upper lobes of
the lungs. It is a type of pneumoconiosis.
• Silicosis: Symptoms
• Chronic, nagging cough.
• Shortness of breath with exercise.
• Weakness and fatigue.
• Fever.
• Breathing difficulty.
• Weight loss.
• Night sweats.
• Chest pain.
• Asbestosis - is a chronic lung disease caused
by inhaling asbestos fibers. Prolonged
exposure to these fibers can cause lung tissue
scarring and shortness of breath. Asbestosis
symptoms can range from mild to severe
breathing difficulty.
• and usually the symptom don't appear until
many years after prolong exposure.
• Symptoms of asbestosis
• shortness of breath.
• persistent cough.
• wheezing.
• extreme tiredness (fatigue)
• pain in your chest or shoulder.
• in more advanced cases, clubbed (swollen)
fingertips.
• Byssinosis -(Monday fever) is a rare lung
disease. It's caused by inhaling hemp, flax, and
cotton particles and is sometimes referred to
as brown lung disease.
• It's a form of occupational asthma.
 Musculoskeletal Disorders

Work-related musculoskeletal disorders

commonly involve the back, cervical spine, and
upper extremities.
Understanding of these problems has
developed rapidly during the past decade.
Prevention of a low back pain is
a complex challenge. Low back pain prevention
in work settings is best accomplished by a
combination of measures, such as:
• Job design (ergonomics);
• Job placement (selection);
• Training and education: (training of workers,
managers, labour union representatives and
health care providers).
• Prevention and Control of Musculoskeletal
Disorders -Job design (ergonomics)
• Mechanical aids
• optimum work level
• Good workplace layout
• Sit/stand workstations
• Appropriate packaging
• Job placement (selection)
• careful history
• Through physical examination
• No routine x-ray
• Strength testing
• Job-rating programs
• Training and Education Training workers
• Biomechanics of body movement (safe lifting)
• Strength and fitness
• Training managers
• Response to low back pain
• Early return to work
• Ergonomic principles of job design
• Training labour union representatives
• Early return to work
• Flexible work rules
• Reasonable referrals
• Training health care providers
• Appropriate medication
• Prudent use of x-rays
• Limited bed rest
• Early return to work (with restrictions, if necessary)
 Skin Disorders

• This refers to any cutaneous abnormalities or

inflammation caused directly or indirectly by the work
environment is an occupational skin disorder.
• Work-related cutaneous reaction and clinical syndromes
are as varied as the environments in which people work.
• Skin disorders are the most frequently reported
occupational diseases. About half of all occupational
diseases are skin disorders, followed in order by eye
disorders, lung disorders, poisoning involving the body as
a whole.
• A basic understanding of occupational skin
disorders is therefore essential for everyone
involved in occupational health.
• Occupational skin diseases are often
preventable by a combination of
environmental, personal, and medical
measures.
 Eye Disorders
• Occupational vision programmes, including
pre-placement examinations and
requirements for appropriate eye protectors
in certain occupations, can prevent many of
these injuries.
• Symptoms and signs of serious eye injury
• Symptoms of serious eye injury indicating
immediate referral are the following:
• Blurred vision that does not clear with
blinking.
• Loss of all or part of the visual field of an eye
• Sharp stabbing or deep throbbing pain
• Double vision
Signs of eye injury that require ophthalmologic evaluation are the following:

• Black eye
• Red eye
• An object on the cornea
• One eye that does not move as completely as the
other
• One eye protruding forward more than the other
• One eye with an abnormal pupil size, shape, or
reaction to light, as compared to the other eye
• A layer of blood between the cornea and the
iris (hyphema)
• Laceration of the eyelid, especially if it
involves the lid margin.
• Laceration or perforation of the eye
 Disorders of the Nervous System

• The nervous system comprises the brain, spinal cord, and

peripheral nerves, is a complex system responsible for
both voluntary and involuntary control of most body
functions.
• These are accomplished through a process of receiving
and interpreting stimuli as well as transmitting information
to the effectors organs.
• The adverse impacts of stressors from the work
environment (physical, chemical, and psychological) are
experienced in a variety of ways.
• Prevention of Nervous System Disorders
• Work-related psychological disorders have been
identified as a leading occupational health
problem.
• Prevention strategy focuses mainly on reducing
job stress
• providing employee mental health services.
Efforts to prevent stress-related disorders focus
on:
• ameliorating major areas of job stress;
• providing job security and career opportunity,
• providing a supportive social environment,
• providing meaningful, creative and rewarding
work experience;
• making every effort to ensure worker
participation in decision making and
• control of stressful condition in the work
environment.
 Disorders of the Reproductive System

• The prevention of reproductive disorders is an important

public health priority. These problems include
abnormalities that affect the reproductive function of both
men and women as well as a wide range of unwanted
pregnancy outcomes.
• There are two ways by which occupational specialists can
prevent or reduce work-related health risks.
• The first is through patient education and counseling.
• The second is by intervening in the work place to reduce or
eliminate deleterious exposures.
 Disorders of the Cardio-Vascular System

•
• Risk factors associated with CHD can be divided into
three categories: personal, hereditary and
environmental.
• Personal risk factors include sex, age, race, high serum
cholesterol, high blood pressure, and cigarette smoking.
• There are strong interactions between these factors that
act synergic ally, such that a smoker with high blood
pressure and high serum cholesterol is eight times more
at risk developing CHD than a non-smoker
• who has normal serum cholesterol and blood pressure.
• While the association between personal risk factors and
CHD is well documented, our knowledge of the role of
occupational risk factors is on the increase.
• Several chemical and physical agents have been
suspected of causing CHD in workers chronically exposed
to them.
• However scientific evidence indicates a direct causal
relationship for few of them. For most of these agents,
the evidence is based on isolated case reports or on a few
unconfirmed studies.
 Hepatic/Liver Disorders

• Occupations with exposure to hepatotoxins

are found in many different industries
including food processing, refrigeration, paint,
insecticide and herbicide, pharmaceutical,
plastics, and synthetic chemicals. Usually
these workers are exposed by inhalation of
fumes.
• Most hepatotoxins have pungent odours that warn of their
presence, preventing accidental oral ingestion of large
amounts; however,
• ingestion of imperceptible amounts of hepatotoxins over
long periods of time may cause injury.
• Skin absorption has been a significant cause of disease
only with trinitrotoluene (TNT)exposure in munitions
workers and with methylenedianiline exposure in epoxy
resin workers.
• Common hepatic disorders due to occupational exposures
to hepatoxins are summarized in the table below.
Table 3.4: Common Hepatic Disorders
Hepatic Disease Type of agent Example of Agent Susceptible Workers
ACUTE HEPATITIS
Acute toxic Chlorinated Carbon Solventworkers,
hepatitis hydrocarbons tetrachloride degreasers,cleaners,
Chloroform refrigerationworkers
Nitroaromatics Dinitrophenol Chemical Indicator
(DNP) workers

Dinitrobenzene Dye workers, explosives

workers.
Ether Dioxin Herbicide and insecticide
Workers
Halogentaed Polychlorinated Electrical Component
Aromatics biphenyls assemblers
(PCBs)
DDT Insecticide workers,
Chlordecone fumigators,
(kepone) disinfectant workers
 Solvent
workers,
dye
Chloro workers
benzen
es
 Halothane Anesthesiologists
Acute cholestatic Epoxy resin Methylenedianiline Rubber workers, epoxy workers,
hepatitis synthetic fabric workers

Inorganic Yellow phosphorus Pyrotechnics workers

element
Acute viral Virus Hepatitis B Health workers
hepatitis, type B
Subacute hepatic Nitroaromatic TNT Munitions workers
necrosis
CHRONIC LIVER DISEASE
Fibrosis/cirrhosis Alcohol Ethyl alcohol Imbibing bartenders, wine
producers,
whiskey producers
Virus Hepatitis B and C Day care workers, health care
workers
Vintners, smelter
workers
Inorganic element Arsenic Vinyl chloride workers

Haloalkene Vinyl chloride Vinyl chloride workers

Angiosarcoma Haloalkene Vinyl chloride Rubber workers
• Renal and Urinary Tract Disorders
• The kidney is a target organ for a number of toxic
chemical compounds. Renal excretion is the major
route of elimination for many toxic compounds.
The relatively high renal blood flow, about one-
fourth of total cardiac output, exposes the renal
structures to a relatively high toxic burden.
Concentration of toxins in the glomerular ultra-
filtrate through active re- absorption contributes
further to the intensity of toxic exposures.
• The considerable endothelial surface represented by the
extensive capillary network in the kidney,
• The presence in renal tubular cells of numerous important
enzyme systems, the local synthesis of active peptides (for
example, rennin and prostaglandin),
• High metabolic rate of the organ are additional factors
increasing the vulnerability of the kidneys to chemical
toxins.
• These agents can adversely affect the delicate balance
between blood flow, glomerular filtration, tubular
reabsorption ,and filtrate concentration.
 Hierarchy of Occupational Hazard Prevention and Control
Methods

• Occupational hazard and prevention and control measures

have been generally classified into six:
• elimination,
• substitution,
• engineering controls,
• administrative controls,
• use of personal protective equipment and
• industrial health education (Takele and Menghesha, 2006).
 Elimination

• Elimination in Epidemiology connotes the

interruption on the spread or transmission of a
disease or health problem.
• It precedes eradication and as such, it is vital to
realizing the goal of disease or injury eradication. In
an industrial setting,
• Eliminating a hazard completely is the ideal
solution to occupational health problems although
it is nearly difficult to achieve.
 Substitution

Substitution involves replacing a hazardous

product or process by a safer or less hazardous one.

• Substitution, in the agricultural industry could

involve using less hazardous pesticides such as
those based on pyrethrins (prepared from natural
product), which are considered to be less toxic to
humans than some other pesticides.
• This particular substitution is practiced in some
countries because the substitute chemicals do not
leave residues on food and therefore reduced long-
term costs.
• The substituted materials may cost more to buy
and may cause resistance in insects. So it can be
seen that there are many factors to be considered
when choosing a chemical or chemical substitute.
 Engineering Controls

• An engineering control may mean changing a

piece of machinery(for example, using proper,
machine guards) or a work process to reduce
exposure to a hazard;
• working a limited number of hours in a
hazardous area; and there are number of
common control measures which are called
engineering control.
• This includes enclosure, isolation and ventilation.
 Enclosure

• If a hazardous substance or work process cannot be

eliminated or substituted, then enclosure of the
hazard is the next best method of control.
• Many hazards can be controlled by partially or totally
enclosing the work process.
• Highly toxic materials that can be released into the
air should be totally enclosed, usually by using a
mechanical handling device or a closed glove system
that can be operated from the outside.
•
• The plant can be enclosed and workers could
perform their duties from a control room.
• Enclosing hazards can minimize possible
exposure, but does not eliminate them.
Isolation
• Isolation can be an effective method of control if a hazardous
material can be moved to a part of work place where fewer people
will be exposed,

• or if a job can be changed to a shift when fewer people are

exposed (such as weekend or midnight shift).

• The worker can also be isolated from hazardous job for example by
working in an air-conditioned control booth. Whether it is the job
or the worker that is isolated access to the dangerous work areas
should be limited to few people as much as possible to reduce
exposures.
• Ventilation
• Ventilation in work place can be used for two
reasons:
• to prevent the work environment from being
too hot, cold, dry or humid
• to prevent contaminants in the air from
getting into the area where workers breathe.
• Administrative Control
• Administrative controls limit the amounts of
time workers spend at hazardous job locations.
• Administrative control can be used together
with other methods of control to reduce
exposure to occupational hazards. Some
examples of administrative controls include:
• Changing work schedules, for example two
people may be able to work 4 hours each at a
job instead of one person working for8 hours at
that job.
• Giving workers longer rest periods or shorter
work shifts in order to reduce exposure time
• Moving a hazardous work process so that few
people will be exposed
• Changing a work process to a shift when fewer
people are working
• Ensuring workers’ promotion as and at when
due
• Provision of health and sanitation facilities
• Provision of sanitation facilities-bath,toilets
• Use of Personal Protective Equipment
• Personal protective equipment (PPE) is the least effective
method of controlling occupational hazards and should be
used only when other methods cannot control hazards
• PPE can be uncomfortable, may decrease work
performance and may create new health and safety
hazards. For example, ear protectors can prevent hearing
warning signals, respirators can make it harder to breathe,
earplugs may cause infection and leaky gloves can trap and
spread hazardous chemicals against the skin.
• Personal protective equipment includes: Eye
Protection Using Google, Face shield and
gloves, Protective clothing, Respiratory
protective Equipment (RPE) ,Hearing
Protection e.g ear muff or ear plug , boots,
respirators, helmets, lead shield.
 Industrial Health Education

• Industrial Health Education according to Ogundele (2017) is

aimed at empowering industrial workers with the requisite
knowledge, attitude and skills required to adopt safety practices
at the work setting with a view to promoting their health and
well-being.
• Industrial Health Education is therefore an important strategy to
improve, promote and maintain health of workers.
• three components of industrial Health Education:
• Industrial health services
• Industrial health instruction
• Healthful industrial environment
• Industrial Health Services
• These are services rendered by the employers or in
collaboration with the employees to ensure
optimum workers’ health and productive. These
services are both preventive and curative in nature
and are aimed at preventing occupational diseases
as well as treating these diseases, if and when they
occur.
•
• Industrial Health Instruction
• This is an organized programme of instruction
designed to serve as a tool to inculcate accurate
and scientific functional knowledge to aid
attitude formation required to adopt safe and
healthy behavior at the work setting through :
lectures ,group discussions ,Information,
Education and Communication materials like
health posters, hand bills, flyers, etc.
• Healthful Industrial Environment
• Indices of a healthful undustrial environment as
documented in Ogundele (2017) include:
•
• comfortable surrounding with appropriate hearing,
lighting, space, ventilation, sanitation and water
control
• control of noise level
• provision of facilities to rest, obtain and eat healthy
food and perform waste disposal functions.
• Suitabke accommodation for workers and their
families
• Job security
• Proper training of workers to match work
demands
• Safety regulations to protect workers’ health
• Sanitation in the work place
• Provision of accident/life insurance scheme
• Prompt payment of salary.
Questions