OCCUPATIONAL HEALTH HAZARDS

By
Dr. Gihan Hosny
Professor of Public Health, Molecular Carcinogenesis & Occupational Medicine,
Division of Environmental Health,
Dept. of Environmental Studies,
Institute of Graduate Studies & Research,
Alexandria University
OBJECTIVES:
- Discuss and explain common hazards in the workplace and
their effects to workers’ health.
- Recommend appropriate measures to prevent occupational
and work-related illnesses.
OCCUPATIONAL HEALTH ( ILO/WHO )

Promote and maintain the highest degree of physical, mental &
social well-being of workers of all occupations

Prevent workers from departures due to health caused by their
working conditions

Protect workers in their working environment from hazards
and risks usually causing adverse health effects

Place & maintain a worker in an occupational environment
adapted to his/her physiological ability
HAZARD AND RISK
WORKPLACE HAZARDS
Depending onWorkers’ Susceptibility

HAZARD AND RISK

 HAZARD  RISK
- any source of - the chance or
potential damage, probability that a
harm or adverse person will be
health effects on harmed or
something or experience an
someone under adverse health
certain conditions at effect if exposed to
work. a hazard.
 WORKPLACE HAZARDS
Safety Hazards Health Hazards

 working conditions where  working conditions which

harm to the workers is of an
immediate and violent nature
 result in broken bones, cuts,
bruises, sprains, loss of limbs,
etc.
 the harm results in some kind
of injury to the worker
 associated with poorly
guarded or dangerous
equipment and machinery
result in an illness
 exposure to dangerous
substances or conditions,
such as chemicals, gases,
dusts, noise etc.
 often, latency between
exposure and disease

Genetic Multiplicity of
factors exposure
Lifestyle
Duration of
Age exposure

Workers’ WORK- Workplace

Susceptibility Factors Physical
RELATED properties
Race DISEASE
Magnitude of
Gender exposure
Medical Timing of
history exposure

Measures of concentration of toxic substances

Threshold Limit Value (TLV)- average concentration of an airborne
substance to which most workers could be safely exposed over an
eight-hour working day or forty-hour working week throughout a
working lifetime
Maximal Allowable Concentration (MAC)- peak or maximum
concentration of an airborne to which most workers could be safely
exposed.
Chemical Hazards
Classification of Toxic Effects
Local toxicity- occurs at the site of chemical contact
Systemic toxicity- occurs distant from point of contact, may involve
many organ systems
Acute toxicity- occurs almost immediately (hours/days) after an
exposure
Chronic toxicity- represents cumulative damage to specific organ
systems; occurs many months or years to have recognizable clinical
disease
Health Effects
 Renal Diseases
 Respiratory Diseases
 Skin Diseases
 Hematologic Diseases
 Cardiovascular Diseases
 Neurologic Diseases
 Carcinogenic
 Teratogenic

Chemical Hazards
Effects Chemical Agent Industry/Process

Renal Diseases: Battery, chemical

acute/chronic renal Mercury, cadmium, industries,
failure chloroform pesticide
Respiratory Diseases:
Irritation, inflammation Solvents, ammonia Chemical industries

Pneumoconiosis Inorganic dust Mining, construction,

sandblasting, coal

Cancer Chromium Plating, metal refining

 Chemical Hazards
Blood Diseases:
Anemia Lead Battery mfg., lead
smelting

Aplastic anemia Benzene Solvent & soap mfg.

Skin Diseases:
Allergic/contact Plastic epoxides Plastic, varnish
dermatitis

Acne Cutting oils, grease Machine-tool

operators
Skin Cancer Arsenic, tar Petroleum refinery

Chemical Hazards
Liver Disease:
Acute liver toxicity Carbon Cleaning fluids, dry
tetrachloride cleaners
Liver cancer Vinyl chloride Plastics & vinyl
chloride mfg.

Cardiovascular Disease:
Hypertension Lead, Cadmium Battery mfg. &
recycling
Atherosclerosis Carbon disulfide Degreasing, dry
cleaning
Arrythmias Fluorocarbon, Refrigeration, solvent
trichloroethylene workers

PHYSICAL HAZARDS
Physical Hazards includes:
Noise
Vibration
Extreme Temperature
Illumination
Radiation
NOISE
Types of Noise-Induced Hearing Loss
- Temporary Threshold Shift (auditory fatigue)
Temporary loss of hearing acuity after exposure to loud noise
recovery within 16-48 hrs
- Permanent Threshold Shift
irreversible loss of hearing

Early Signs of Hearing Loss

• Difficulty in understanding spoken words in a noisy
environment
• Need to be near or look at the person speaking to help
understand words
• Familiar sounds are muffled
• Complaints that people do not speak clearly
• Ringing noises in the ears (tinnitus)
Other Harmful Effects of Noise
• Hypertension
• Hyperacidity
• Palpitations
• Disturbs relaxation and sleep

VIBRATION
Physical factor which affects man by transmission of mechanical
energy from oscillating sources
Types
- Segmental vibration
- Whole body vibration

Segmental Vibration:
• Health Effects:
— Hand Arm Vibration Syndrome (HAVS)
— tingling, numbness, blanching of fingers
— pain

Whole Body Vibration:

Health effects:
- Fatigue
- Irritability
- Headache
- Disorders of the spine
EXTREME TEMPERATURE
Sources of heat stress:
- Natural Conditions
- Hot work processes related to welding, furnaces, kilns, boilers
and smelting

Health Effects of Heat Stress

EXTREME TEMPERATURE

Health Effects of Heat Stress

Disorders Clinical features

Prickly Heat (Miliaria rubra) Pruritic rash

Heat cramps Cramps in the body,

usually legs

Heat exhaustion Dizziness, fainting attack,

blurring of vision, cold,
clammy and sweaty skin
Heat stroke Cyanosis, muscle
twitchings, disorientation,
delirium, convulsions

Sources of Cold Environment:

Ice plants and freezers in the food industry
Health effects:
Frostbite: reddening of skin, localized burning pain and numbness.
Fingers, toes, cheeks, nose, ears are most susceptible.

ILLUMINATION
Inadequate Illumination
Health Effects
- Visual Fatigue
- Double Vision
- Headaches
- Painful irritation
- Lacrimation
- Conjunctivitis
 ILLUMINATION
Recommended Illumination Levels
Area of Operation Min Lighting Level (lux)

Cutting Cloth ≥ 2000

Fine machining
Transcribing handwriting 1000
Drafting
Welding 500
First Aid station
Lunch Room 300
Rest Room

RADIATION

Electromagnetic Spectrum

Source Frequency in hertz (Hz)

X-rays, about
1 billion Gamma rays
22
billion Hz 10
20
can penetrate 10
the body and damage X-rays 18
internal organs and tissues 10
by damaging important 16
molecules like DNA.
Ultraviolet radiation 10
14
This is called “ionization.” Visible light 10
12
Microwaves, several billion Hz, Infrared radiation 10
10
can have “thermal” or hearing 10
effects on body tissues Microwaves 8
Power frequency EMFs 50 or 10
Radio waves 6
60 Hz carry very little energy, 10
have no ionizing effects 800 - 900 MHz 4
15 - 30 Hz & Very low frequency (VLF) 10
and usually no thermal 50 - 90 Hz 3,000 - 30,000 Hz 2
effects. They can, however,
Extremely low frequency 10
cause very weak electric 60 Hz
(ELF) 3 - 3,000 Hz
currents to flow in the body. Direct current 0
 RADIATION
Types Sources Health Effects
Ionizing X-rays Cancer, congenital
Gamma rays defects, death

Non-ionizing Ultraviolet skin redness, premature

skin ageing, and skin
cancer
Infrared corneal and conjunctival
burns, retinal injury,
cataract
Laser Skin and eye problem

BIOLOGICAL HAZARDS
BIOLOGICAL HAZARDS

Selected Infectious Diseases

and Occupations

Agent / Disease Occupation

Colds, influenza, scarlet fever, May be contracted anywhere
diphtheria, smallpox
Tuberculosis Silica workers, people exposed
to heat and organic dusts, and
medical personnel
Anthrax Animal handlers and handlers
of carcasses, skins, hides, or
hair of infected animals,
including wool carpet
processors and handlers.
Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Ringworm (in horses, cattle, Pet shop salesmen, stockmen,

deer, pigs, cats, dogs, birds) breeders of cats and dogs, and
other animal handlers

Tetanus Farmers (spores in soil) or

anyone in contact with manure.

Selected Infectious Diseases

and Occupations

Agent / Disease Occupation

Psittacosis (in parrots, Pet shop personnel, gardeners,
parakeets, pigeons, ducks, housewives, veterinary
turkeys, chickens, etc.) surgeons, and researchers.

Hookworm Miners, agricultural laborers,

planters of sugar, tobacco, tea,
rice and cotton, and brick and
tunnel workers.
 Selected Infectious Diseases
and Occupations

Agent / Disease Occupation

Rabies (e.g. dogs, bats, rats, Veterinarians, letter carriers,
pigs, cats) laboratory research workers,
agricultural workers.

Fungus Farmers, outdoor workers,

animal handlers

HIV and AIDS:

A- Acquired
I- Immune
D- Deficiency
S- Syndrome
Serious and usually fatal condition in which the body’s immune
system is severely weakened and cannot fight off infection.

Epidemiology of HIV and AIDS

Modes of HIV Transmission
- Body Fluids with High Viral Load e.g.:
Blood
Semen
Vaginal and cervical mucus
Breastmilk
Amniotic fluid
Cerebrospinal fluid

Modes of Transmission
• Unprotected penetrative sex
— semen, blood, vaginal secretions
• Blood transfusion on infected blood and blood products
• Sharing needles among drug users
 • Vertical/perinatal
— mother to infant
• Breastfeeding

HIV is NOT transmitted…

• through casual contact in any setting– schools, homes, hospitals
• through insect, food, water, clothes, toilets, swimming pools,
and drinking and eating utensils
Prevention of HIV Infection
REMEMBER ABCDE!
 Abstinence
 Be Faithful
 Condom
 Do not inject Drugs/no sharing of needles
 Education

TETANUS
A neurological disorder characterized by increased muscle tone
and spasms, that is caused by tetanospasmin, a protein toxin
elaborated by the organism Clostridium tetani.
It arises from the contamination of wounds with Clostridium spores.
TETANUS
Clinical Manifestations
- Increased tone in the masseter muscle (lockjaw)
- Sustained contraction of the facial muscles (risus sardonicus)
and back muscles (opisthotonus)
Prevention
- Active immunization with tetanus toxoid
- Careful wound management

TUBERCULOSIS
- Caused by the bacteria, Mycobacterium tuberculosis
- Caused by droplet nuclei released when sneezing and coughing
Symptoms: weight loss, low grade afternoon fever, persistent cough
and sometimes, blood-streaked expectoration or hemoptysis

ERGONOMIC HAZARDS
ERGONOMICS: The relation between worker and machine.
Human Biological Science
+
Engineering Science
____________________________________
Goal
To reduce work-related musculoskeletal disorders (MSDs) developed
by workers
MSDs are injuries and illnesses that affect muscles, nerves, tendons,
ligaments, joints or spinal discs.

Symptoms of ERGONOMICS
Common Symptoms of MSDs
- Painful joints
- Pain, tingling, numbness in hands, wrists, forearms, shoulders,
knees and feet
- Shooting or stubbing pains
- Swelling or inflammation
ERGONOMICS
Common Symptoms of MSDs
- Fingers or toes turning white
- Back or neck pain
- Stiffness
Risk Factor: ERGONOMICS
- Static posture
- Forceful exertion
- Repetitive movement
- Extreme range of motion
- Awkward posture
ERGONOMICS

STRESS
The harmful physical and emotional responses that occurs
when the requirements of the job do not match the capabilities,
resources or needs of the worker.

STRESS: Effects:
1. PSYCHOLOGICAL

Fatigue

Anxiety

Tension

Irritability

Depression

Boredom

Inability to concentrate

Low esteem
 2. PHYSIOLOGICAL

Heart rate

Blood pressure

Indigestion

3. BEHAVIORAL

Drug use

Alcohol intake

Heavy smoking

Impulsive emotional behavior

Poor work & family relationship

Social isolation

Family abandonment

Sleep problems

Biological Monitoring
- Measurement of a substance, its metabolites or its effects in
body tissues, fluids or exhaled air of exposed person
- Assess exposure and health risk of workers
- Complements exposure assessment by air sampling
Biological Monitoring depends on:
- Medical Surveillance
- Identify cases
Guidelines:
1. Analyze Trends and Patterns in the Workforce to Guide
Prevention Efforts
2. Meet Regulatory Requirements
3. Medical Surveillance
4. Know the hazard
- How worker is exposed
- How worker is affected
5. Characterize the hazard
- Exposure levels
- Exposure duration
6. Know the worker Susceptibilities
7. Obtain information on
- Directed towards specific medical examinations
0n organ /system
8. Analyze Medical Data
9. Disease, recovery, rehab
10. Effectiveness or failure of control measures
PREVENTION AND CONTROL OF OCCUPATIONAL HAZARDS
Standards, Policies and Guidelines
Occupational Safety and Health Standards
Rule 1050
Notification and Keeping of Records of Accidents and/or
Occupational illnesses
Rule 1070
Occupational Health and Environmental Control
Rule 1960
Occupational Health Services
Rule 1960:
Occupational Health Services
1. Every employer shall establish in his place of employment
occupational health services in accordance with the regulation and
guidelines provided for under this rule.
2. The employer, workers, and their representatives, where they
exist, shall cooperate and participate in the implementation of the
organizational and other measures relating to occupational health
services.
Rule 1960:
Occupational Health Services
1963.01: Medicines and Facilities
1963.02: Emergency Medical and Dental Services
Rule 1960:
Occupational Health Services
An employer may not establish an emergency hospital or dental
clinic in his workplace as required in these regulations where there is
a hospital or dental clinic which is located not more than five (5)
kilometers away from the workplace, if situated in any urban area,
or which can be reached in twenty-five (25) minutes of travel, if
situated in rural area, and the employer has facilities readily
available for transporting workers to the hospital or dental clinic in
case of emergency.
Rule 1960:
Occupational Health Services
Health Examinations:
Entrance
Periodic
Special examination
Transfer examination
Separation examination
 OCCUPATIONAL HEALTH PROGRAMS

PREVENTION AND CONTROL OF

OCCUPATIONAL HAZARDS
Monitoring Activity Workplace-Related Events Health Effects

Exposure at the workplace

Environmental monitoring - Chemicals None
- Physical agents

Biologically significant exposure

Biological monitoring and - Chemicals absorbed Early
surveillance - Early (reversible) changes

Clinical diagnosis
Treatment and surveillance
- measurable health effects Late
- Morbidity
- Mortality

End effects
- diseases
- unfavorable events (spontaneous
abortion)

Key Elements of the Occupational Health Program

- Health Protection
- Health Promotion
- Health Rehabilitation

Health Promotion
 Physical activity, Nutrition, Weight reduction
 Immunization
 OSHS, RULE 1960
 Smoking cessation
 RA 9211 Tobacco Regulation Act of 2003
 HIV/AIDS
 RA 8504 Philippine AIDS Prevention and Control Act of
1998
 National Workplace Policy on STD/HIV/AIDS initiated
by DOLE - 1997
 Health and Safety Programs
Hazards/ Source Health Effect Health Program
Disease
Chemical
Solvents Paints, Irritant, Surveillance for chemical
Thinners Multisystem exposure
effects Exposure monitoring
(Biologic Monitoring)

Physical
Noise Woodwork Hearing Hearing Conservation
Operations Impairment Program

Health and Safety Programs

Hazards/ Source Health Effect Health Program
Disease
Biologic
Tetanus Dirty Nails, soil Lockjaw, rigidity, Immunization
death
Ergonomic
Stresses Awkward Musculoskeletal Management or
Cumulative postures, Heavy Disorders personnel methods;
Trauma loads Workplace
Disorder modification
Worker education
and training;
Back Care Program

Health Promotion
Drug Abuse Prevention and Control
RA 9165 Comprehensive Drugs Act of 2002
Department Order No. 53-03: Guidelines for the Implementation of a
Drug-Free Workplace Policy and Program for the Private Sector
Tuberculosis Prevention and Control
Executive Order No. 187, Instituting a Comprehensive and Unified
Policy for Tuberculosis Control in the Philippines (CUP) (March
2003)
Department Order No. 73-05: Guidelines for the Implementation of
Policy and Program on Tuberculosis (TB) Prevention and Control in
the Workplace

Approach in Ensuring
Well-Being of Workers
 Looking at
developmental  Looking at regulatory
strategies requirements

 Information
 Education  Relevant laws,
 Training standards, issuances
 Campaigns and guidelines
 Good practices  Enforcement
 Successful cases
 Implementation
 Competitions
 Demonstrations  Inspection
 Interventions  Evaluation

Participatory Approach
 Participation and involvement from stakeholders
 Coordinated intervention
 Learning from
 specifications/guidelines,
 scientific data
 best practice
Benefits to the workers
 Enhanced worker motivation and job satisfaction
 Added problem-solving capacity
 Greater acceptance of change
 Greater knowledge of work and organization
 Reduces the extent and severity of work related injuries and
illnesses
 Improves employee morale and productivity
 Reduces workers’ compensation costs