Occupation
Occupation
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
•
• 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
•
• 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
• Physical Hazards
• Mechanical Hazards
• Chemical Hazards
• Biological Hazards
• Ergonomic Hazards
• Psychosocial Hazards
Physical Hazards
❖ Lighting/Illumination
Good and sufficient lighting is aimed at promoting
productivity, safety, health, well being and pleasant working conditions at an eco
❖ Lighting/Illumination
Good and sufficient lighting is aimed at promoting
productivity, safety, health, well being and pleasant working conditions at an econ
•
• 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: 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
• 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
– 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
• 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
•
• 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
• 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