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tHChIVGovt. ~

of India

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Ministry of Labour &. Employment,.

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Directorate-General of Mines Safety

DGMS (Tech.) (S&T) Circular No. 01..

of 2011.

Dhanbad, Dated

.2 i 01·

2011.

The Owners, Agents and Managers of all mines.

Sub Guidelines on Occupational Health Survey (Medical Examination) of person working at places or operations/processes prone to generate airborne dust.
Secretary General, National Human Rights Commission, New Delhi, vide his D.O. Letter No. 11/3/2005-PRP&P dated 10th January, 2011 (copy enclosed) expressed deep concern about the health hazards posed by silicosis and advised the Directorate to take suitable action the recommendations made by the Expert Group and stakeholders on Preventative, Rernedlal, Rehabilitative and Compensation aspects relating to Silicosis. In view of NHRC recommendations and in continuation of DGMS (Tech.)(S&T) Circular no. 01 of 2010, accordingly the guidelines framed on Occupational Health Survey (Medical Examination) of person working at places or operations/processes prone to generate airborne dust are as follows:-

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(A) The Medical Examination of Identified persons or Group of persons working at places or operations/processes prone to generate airborne dust should be conducted once in every six months .It is advised that the health assessment for workers exposed to silica dust should include the following: i) A history should be taken covering: a. the worker's occupational exposure to dust containing silica; b. any past or present medical diagnosis of respiratory disease; and c. the worker's smoking history.

ii) A clinical examination should be carried out on the respiratory tract system. A spirogram (Pulmonary Function Test) should be carried out including determinations of forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1). . (8) Sputum examination for Tuberculosis once in every year.

(C) A single posterior-anterior chest X-ray should be done every 5 years on workers without signs of silicosis or other. pneumoconiosis and every 3 years on workers who do have X-ray changes. All chest radiographs should be classified according to International labour Office (IlO) Classification of Radiographs of the Pneumoconiosis,2000. (D) Initial medical examination should be conducted for all mining workers whether permanent, temporary or contractual, before they are engaged in any mining job. This include a single posterior-anterior chest X-ray and A spirogram (Pulmonary Function Test) should be carried out including determinations of forced vital capacity (FVC) and forced expiratory volume at 1 second (FEYl).

diseases. degree of disability." ~ (E) In any person employed in a mines contacts any notifiable.1961/CMR.' . medical history and expenses.1957) (F) In case. therefore requested to all concerned that an integrated efforts in line with the above guidelines be made at all levels to ensure that the incidence of diseases due to respirable dust is detected in the mining industry.' . ~ (Satish Puri) Director General of Mines Safety . should be sent to this Directorate immediately in enclosed format. It is. a person is found to be affected with pneumoconiosis or silicosis. the case shall be reported to this Directorate immediately in the prescribed format Form. compensation and the status of health and rehabilitation measures taken by the company etc. the details regarding his work profile.V (Regulation 10 MMR.

INFORMATION IN RESPECT OF REPORTED CASES OF PNEUMOCONIOSIS / SILICOSIS Name of employee Designation Name of Mine date of detection Length of Service on the date of detection Percentage of disability Expenses incurred on medical treatment Compensation paid in Rupees Compensat -ion due in Rupees Present Health Status Rehabilitation Measures taken Remarks .

5. devices for agate. 1 . Implementation of precautionary measures including the protective gears for the workers of silicosis prone ~ industries may make mandatory by the concerned enforcement authorities. Recommendations of National Human Rights Commission on Preventive. All the enrolled workers must be medically examined before entering into the employment. Remedial. State/U'T governments should encourage development and promotion of various cost-effective engineering control measures. The use of wet drilling and dust extractors may be enforced by respective regulatory authorities. . The workers vulnerable to silicosis need to be made aware of the disease through wide publicity campaigns with the use of electronic and print media. Dust control devices should be installed to reduce the dust generation at the workplace. 2.~:. The workers should be clinically examined with Chest radiography and pulmonary function test to rule out any respiratory disorder. National Institute of Occupational Health (NIOH) has developed control. Rehabilitative and Compensation Aspect of Silicosis Preventive Measures: 1. The occupational health survey and dugt survey on half yearly basis may be made rnandatory Jn vsuspected hazardous industries. This will also improve self responding of cases and facilitate early detection. 4. to manage silica dust through surveillance of processes or operations. /' . where silica is involved. 3. grinding and quarts crushing industries based on the principle of local exhaust ventilation.

evolve an appropriate strategy to deal with the dual problems of silicosis and tuberculosis may be set up at the center and state level. In each of the district where silicosis prone industry. Silicosis may also be made a notifiable disease under . Remedial'Measures: 1. Directorate General of Factory Advice Services Labour Institute. Silicosis is a notified disease under Mines Act 1952 and the factories Act 1948.":. Tuberculosis Association of India and civil society organizations to. A mechanism to have intersectoral coordination among departments such as Ministry of Health & Family Welfa're.. There is a necessity to develop Master Trainers to impart training to all public health doctors/paramedics for early diagnosis and detection-of silicosis. . there is a need to identify a facility for diagnosis of silicosis. The District Tuberculosis Officer must collect and maintain accurate information and documentation on 2 /. / 6. 8. Industrial units which are silica prone should have an Occupational Health and Safety Committees (OHSC) with the representation from workers and Health Care Providers.the Public Health Act./ 2.. Silicosis control programme should be integrated with already existing Revised National Tuberculosis Control Programme (RNTCP). 9."Ministry of Labour & Employment. national Institute of Occupational Health. 7. . \i / 10. 11. As such all district/primary health centres/hospitals in the country will have to report the cases/suspected cases of silicosis to the Government. quarrying or a big construction projects are on. Less hazardous substitutes to silica should be found out for use in place of silica.

The accountability for the implementation and control over the rules & regulation of Laws must be reviewed time to time.) ~/' r / / . a health insurance scheme for BPL families and extended subsequently to some other vulnerable groups. The victims of silicosis should be rehabilitated by offering an alternative job or a sustenance pension if they are unable to work. 4. Rehabilitative 1. 2008 should recommend welfare schemes to be formulated' for the welfare of the unorganized workers who are at the risk of contracting silicosis as well as those already affected and their families. 3 . to the workers at risk of contracting silicosis and their families. / The National IState Social Security Board set up' under The Unorganized Worker's Social Security Act. The treat./ r' . The Central Government may consider extending the Rashtriya Swasthya Sima Yojna. NGOs should be involved in monitoring and / implementation of the programmes initiated for the benefit of silica exposed workers. temporary or contractual worker should be borne by the employer. number of workplaces and workers at risk from silica exposure. be provided to the v' 3. The district administration should ensure its implementation and treatment.ment cost of the silica affected" 'person including permanent. . 4. Measures: / 5. 3. Appropriate Counseling should person affected by silicosis. 2.

Silicosis is a compensable injury enliste~ under the ESI Act and the Workmen's' Compensation Act. The Board can carry out surveillance of silicosis cases and assessment of disability/loss of earning capacity resulting from the diseases for the purpose of compensation and rehabilitation. 4. 3. The attached annexure could be used as a reference for calculating compensation. Therefore a separate Silicosis Board similar to the one set up by the Government of Orissa may be formed in every State. The compensation could be calculated based on Disability Adjusted Life Year COALY) developed by World Health Organisation. person should be adequately 2. 4 . The silica affected compensated.\ " Compensation: 1. The guidelines and model calculation of' compensation may be framed under the ESI Act and the Workmen's Compensation Act.

different are 12 values for silicosis. a calculation to arrive at the DALY of NIOH studies 1981 to 2004. agate workers. Wherever possible the data for the focal population . it might be possible to arrive at DALY values associated to the silicosis.eJjusted Life Year (DAL Y) lost due to the disease. shown studies herewith. lost year of 'healthy' measurement ideal situation One DALY can be thought of as one of disease as a life and the burden of the gap between current health status and an where everyone lives into old age free of diseases and disability. have some observations During the period from been conducted at NIOH· and work processes such as slate pencil workers. should be used. burden of disease essentially looks into the flew metric of the Disability A. DAL Ys for a disease or health condition are calculated as the sum of the years of life lost (YLL) due to premature mortality in the population and the years lost due to disability (YLO) for incident cases of the health condition.Annexure Calculation of compensation 1 WHO adopted strategy of the. As a hypothetical example. measure of population health The DALY is a summary that combines In a single indicator years of life lost from premature death and years of life lived with disabilities. VVith due consideration of different estimates. quarry I It is a model calculation.

the life expectancy at the age of 40 yrs becomes 21. The summated YLL and Yl.is 31. Taking the.82 yrs.3% calculation (Nakaqawa. The prevalence pf has been reported in the .range of 12 to ·54% in occupational groups. -twenty the mortality due to silicosis et. detailed .al 1985). For the purpose of the is taken as 2. and accordingly the total the DALY value as -520262 humber of years lost per silicosis patient can be arrived at -23 6 .Dvyielded yrs. The average age . calculation method available one can arrive at average age of death of silicosis patient of around -40 yrs. prevalence of silicosis at 32%. 1989) of silicosis patients after diagnosis is 12. The life expectancy at the age of 40 yrs . the total workers that might have contracted silicosis -9.workers.-5 yrs and taking discount of 3% into consideration.of workers ranged from 27 to 43 with the duration of exposure varied from 5 to 19 years.2 years..6 silicosis In lakhs. for DALY With the . Current data regarding mortality due to India are not available. . reported mean survival time (Lou and Zhou. silicosis different ceramic and pottery workers."" Let us consider that the total number of workers exposed to silica in India with potential risk to contract with silicosis is -30 lakhs and the onset of silicosis is at the age of 27_years and the duration of exposure when silicosis reported is 8 years.. The survival time data regarding silicosis diagnosis of the disease patients in India after The literature are not available. That means the mortality number is two thousand.

_.. .. "I.W~c~fij calculation the disability weight for silicosis pati 0.' after diagnosis..006.' "':'':'''~'' adjusted life year lost of -23 years.:~:. .::~'.: " limitations due to the non-availability such as the total exposed of some. ...3l~. :.·'· ~g..?X' " '.:.: .:::~:r~~~·~~fd.. ...~ " . etc..:~". .~l. ' YLD Years Lost due to Dis~'bdify' ·i~lN:}./ / years. .t.. DALY Disability Adjusted Life"Y ES I Employee State lnsu ..::. i .~. " . Abbreviation .~. ..· : • '.. .v(.. .. (. A" . ..1 .j. With minimum income of a worker of Rs:'36.h~~ : . . ' _:. ""13lakhs . NIOH National Institute of 0 OHSC Occupational Health"an Committees ' .\ .~ I:.' prevaf . :'1 .~ YLL Years of Life Lost " 1.' >.t:~'~\~Gf .j{J~.:". '..' Limitations This approach of estimation of compensatior ...: -.. . ':...::·. the estimated amount of compensationjto.. ':1 -':"" J' .." f': .. ~ ·:~.:'.~'.. .'000/':'::' annum. .. population. '. 7 .. " '. . ...j'i'J:~... '.i.z·~~.i~ " : . " ~~:. survival time ~.. d'~:'~''.J~~::.:f':::":' :·~..~!~:?y I j :. :~.(~' .~:~ .~> ~tbased' on large scale. study. " ~ .j .. In. . . ~~:)'~./.. .. :.: patient might be arrived at' Rs.~~l~ i . F~. disability weights. .'.