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Training Manual on Occupational Safety and Health

Preprint · January 2013

DOI: 10.13140/RG.2.2.27327.05280

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 Training Manual

on

Occupational Safety and Health

 Training Manual

On

Occupational Safety and Health

Edited by

Sk. Akhtar Ahmad

A. Wazed
Manzurul Haque Khan
Mahmud Hossain Faruquee
Rabeya Yasmin
Md. Shafiur Rahman
Salamat Khandkar

Department of Occuaptional and Environmental Health

National Institute of Preventive & Social Medicine (NIPSOM)
Mohakhali, Dhaka-1212
Bangaldesh University of Health Scinces (BUHS),
Mirpur, Dhaka-1216
2013

Supported by
WHO, Bangladesh
 Acknowledgments

This manual has been developed because there has been a long-felt need for compiled and update
knowledge and information regarding occupational safety and health in Bangladesh. Now
Bangladesh is in the way of rapid industrialization and development, and implementing mega
projects. There needs a huge number of skilled manpower to promote and maintain a safe and
healthy work environment both in industries and developmental projects. We hope this training
manual will meet this need to some extent.

This training manual mainly deals with basic concepts and principles in relation to occupational
safety and health. It includes the introduction OSH in Bangladesh, legislations, hazard
assessment, exposure and risk in the workplace; safety management and personal protection;
occupational diseases and case studies in some important sectors. We hope this manual will be a
helpful document for the concerned personnel.

This manual is a compiled and edited version of the documents and information taken from
different books, journals and reports. We greatly acknowledge them and very sorry for not being
individually or specifically refer their name and source. However, some reference has been cited
at the end of this manual but not conclusive.

We are thankful to WHO, Dhaka, Bangladesh for their support in developing this manual.
Without their support, the development of this Training Manual would not be possible.

We will be encouraged and regarded as rewarding if readers value this manual useful,
Suggestion for further improvement of this manual will be welcome and highly appreciated.
Thanks
 Objectives of this Training Manual

To provide knowledge and skills for the OSH management committee members,
Doctors, Engineers, Paramedics, Safety supervisors who will be the working force for
safe and healthy work environment and develpoment, and to enable them to:

 have up-to-date knowledge on the concepts of Occupational Safety and Health;

 keep the workplace safe and healthy and undertake appropriate and effective
measures and practices; and
 contribute to the consistency of relevant workplace safety information and messages
and sustainability of activities in the working area.

This mannual will help us to:

 discuss information on Occupational Safety and Health promotion;

 explore how to improve workplace healthy and safe; and
 learn how to identify workplace health hazards, timely measures taken.
 Major Contents

01. Introduction and History of Occupational Health

02. Occupational Safety and Health in Bangladesh and Role of Stakeholders
03. OSH Legislations
04. Occupational Hazards
05. Occupational Diseases
06. Personal Protective Equipment
07. Identification of potential hazards and their health outcome in different workplace
08. Occupational Health & Safety Checklist

Training Method

 Lecture
 Demonstration/display
 Group Discussion and Group Work
 Q&A Session
 Field work
 Feed back

Training Plan
 Orientation in the insitute – 2 days
 Field work in the respective area-1 month
- Observe and Collect data according to checklist
- Prepare Report
 Re-oreintation, feed back and experinece sharing in the instituete – 2 days
 General Instruction for the Facilitator

1. Before the starting of training the facilitator should prepare himself with the content of each
session and the training process. Facilitator will go through the manual properly acquiring
knowledge about the subject and contents of the training, otherwise it will not possible for
him to conduct the session efficiently;
2. The materials to be used in the training session like handout etc and along with this a muti-
media presentation should be prepared and copies of handout should be available to the
participants before the session start.
3. Besides, additional materials i.e., blank poster paper, VIPP card, marker, scotch tape, push pin
and writing pad, pen etc will be needed for the participants during the training session and
these will be collected before the training session;
4. During training, the facilitator should ensure attention of every participant. They should be
given chance to share their experience and opinions to make the training more effective and
participatory; Every participant should get equal attention and treat them equally.
5. If any participant is found absent minded the facilitator should make an effort to attract his/her
attention.
6. Any issue/point that can create negative impression or make the participants embarrassed
should not be discussed or exemplified in the session. Besides, if it is not necessary no
question should be asked the participant directly. This also makes the participant embarrassed.
7. The facilitator should be careful about the discussion to be always pertinent. If any discussion
is found irrelevant the facilitator will retract the discussion strategically.
8. Training environment should be open and spontaneous. For this reason, there should be some
sort of entertainment during the training session.
9. At the beginning of every session the facilitator should mention the content of the session so
that the participants can understand the topics and sequences easily.
10. At the end of each session there should be a conclusion following a summary.
11. The training session should be conducted confidently so that the participants receive training
with confidence.
 Session
Orientation- 2 days

1st Day
 Session 1: COURSE OPENING
Background
Training sessions & session plan
 Session 2: Introduction and History of Occupational Health and
 Occupational Safety and Health in Bangladesh
 Session 3: OSH Legislations
 Session 4: Occupational Hazards
 Session 5: Occupational Diseases (general)
2nd Day
 Session 6: Review
 Session 7:Occupational Diseases (sector specific)
 Session 8: Personal Protective Equipment
 Session9: Case Studies-hazards and health outcomes in different workplace
 Session 10: Hazard Assessment
 Session11: COURSE CLOSING

Re-Orientation and Feed Back- 2 days

 Session 1: Opening Session

 Session 2: Re-orientation
 Session 3: Presentaion of Reports and Experience Sharing
 Session 4: Re-orientation and discussion
 Session 5: Group Work
 Session 6: Group Presentaion
 Session 7: Discussion and Feed Back
 Closing Session
SESSION 1: COURSE OPENING

Objectives of the Session:

At the end of this session, participants should:

- Have their course materials;
- Understand the aims and structure of the course;
- Have opportunity to introduce themselves and familiar to each other.

Duration: 30 min

Session 1
SESSION 2: HISTORY OF OCCUPATIONAL HEALTH AND
SITUATION IN BANGLADESH

Summery:

The Occupational Health and Safety Services in Bangladesh are still in the developmental stage and
refer to some extent to the needs of workers in the industry (both formal and informal). Capacity
building and short and long-term training of health and safety professionals have been used in
Bangladesh by study tours overseas to centers of excellence with WHO sponsorship. Trained
occupational health specialists undertake limited research studies. However, there is lack of real
operation research from public health perspectives that could be used to address prevalent
occupational conditions. Related occupational health personnels should recapitulate the history of
occupational health, situation in Bangladesh and role of stakeholders which will be discussed in this
chapter.

Objectives of the Session:

At the end of the session the participants will be able to describe:

Session 2
- history of occupational health
- Occupational Health and Safety situation in Bangladesh and
- Role of stakeholders

Duration: 45 minutes

Method:
 Lecture, MultiMedia Presentation
 Presentation and discussion
 Feed back

Materials:
Multimedia, Handouts
 HISTORY OF OCCUPATIONAL HEALTH AND
SITUATION IN BANGLADESH

Introduction

Occupational Safety and Health (OSH) is a cross-disciplinary area concerned with protecting the
safety, health and welfare of people engaged in work or employment. The overall objective of the
occupational safety and health programs is to promote and maintain a safe work environment.
Further, it may also protect co-workers, family members, employers, customers, suppliers, nearby
communities, and other members of the public who are in contact directly or indirectly with the
workplace environment. It has interactions among various subjects such as occupational medicine,
occupational or industrial hygiene, public health, safety engineering, chemistry, health physics etc.

Since 1950, the International Labour Organization (ILO) and the World Health Organization
(WHO) have shared a common definition of occupational health.
―Occupational Health is the promotion and maintenance of the highest degree of physical, mental
and social well-being of workers in all occupations by preventing departures from health,
controlling risks and the adaptation of work to people, and people to their jobs.‖
(ILO / WHO 1950). However, the definition was modified at twelfth session of ILO/WHO
Committee in 1995 to address the emerging occupational health challenges, and the modified
definition is "Occupational health should aim at: the promotion and maintenance of the highest
degree of physical, mental and social well-being of workers in all occupations; the prevention
amongst workers of departures from health caused by their working conditions; the protection of
workers in their employment from risks resulting from factors adverse to health; the placing and
maintenance of the worker in an occupational environment adapted to his physiological and
psychological capabilities; and, to summarize, the adaptation of work to man and of each man to his
job".
Healthy and safe work environment is the basic right of every worker. However, the global as well
as national occupational safety and health situation falls far beyond this goal. The International
Labor Organization (ILO) has estimated that approximately 270 million workers meet occupational
accidents and 160 million people are suffering from occupational diseases each year.
Approximately 2.2million people die of occupational accidents and diseases each year.
Principles of Occupational Safety and Health
Occupational health is considered to be multidisciplinary activity aiming at:
 Protection and promotion of the health of workers by preventing and controlling
occupational diseases and accidents and by eliminating occupational factors and conditions
hazardous to health and safety at work
 Development and promotion of healthy and safe work, work environments and work
organizations.
 Enhancement of physical, mental and social well-being of workers and support for the
development and maintenance of their working capacity, as well as professional and social
development at work
 Enablement of workers to conduct socially and economically productive lives and to
contribute positively to sustainable development.
History of Occupational Health
Workers of today may go to their jobs confident that they will return safely, and in good health.
Because most of their hazards in workplace and thereby risks have been controlled. However, this
was certainly not the case for much of our history. Rapid and extensive developments in
occupational health began in the early 1940s when the Second World War made an impact on
manpower. There are four factors that imparted a positive effect on occupational health:
 The economic need to conserve the efficiency of the work force
 Changing attitudes of workers and their trade unions towards health and safety
 Compassion which induces a sense of caring for others
 Increasing competence of health and safety professionals
Historical perspectives
From the history it could be realize that both modern and ancient societies did not show much
interest to identify and take necessary measures to reduce or eliminate the exposure to hazards of
workers from their working environments. There are examples how the workers protected
themselves from the hazardous work condition but the measures were not effective. Following are
some examples how the hazards in work environment were recognized and the measures taken
towards safety work condition.
 1600-BC Ancient Egyptians recognized the hazards of breathing the fumes produced by
melting silver and gold.
 400 BC- The environment and its relationship to workers‘ health was recognized when
Hippocrates noted lead toxicity in the mining industry.
 100 AD- Pliny the Elder, a Roman scholar, identified health risks to those working with
zinc and sulphur. He devised a face mask made from an animal bladder to protect workers
from exposure to dust and lead fumes.
 200 AD-The Greek physician Galen accurately described the pathology of lead poisoning
and also recognised the hazardous exposures of copper miners to acid mists.
 1200-1500 AD- Guilds worked at assisting sick workers and their families.
 1556 AD- The German scholar Agricola advanced the science of industrial hygiene when,
in his book De Re Metallica, he described the diseases of miners and prescribed preventive
measures. The book included suggestions for mine ventilation and worker protection,
discussed mining accidents and diseases in mining occupations, such as silicosis.
 1700 AD-Bernadino Ramazzini, known as the ‗Father of Industrial Medicine’,
published the first comprehensive book on occupational health, De Morbis Artificum
Diatriba (The Diseases of Workmen). The book contained accurate descriptions of the
occupational diseases of most of the workers of Ramazzini‘s time.
 1774 AD- Percival Potts established a link between exposure to soot and nasal and scrotal
cancer in chimney sweeps. It became the first official link between the work environment
and cancer. The British Parliament passed the Chimney Sweepers Act in 1778.
 1743AD- Ulrich Ellenborg published a pamphlet on occupational diseases and injuries
among gold miners. He also wrote about the toxicity of carbon monoxide, mercury, lead,
 1775 AD- Sir Percival Pott an English doctors discovered that chimney sweeps, who were
exposed to coal tar residues in their daily work, showed a higher incidence of cancer than
did the general population.
 1833 AD- The passage of the English Factory Acts beginning in 1833 marked the first
cross-industry legislative acts in the field of industrial safety.
 1845 AD- Friedrich Engels provided a detailed account of the impact of industrialisation in
his book The Condition of the Working Class in England: ―In Manchester, this premature
old age among the operatives is so universal that almost every man of forty would be taken
for 10 to 15 years older. The influence of factory work upon the female physique also is
marked and peculiar. The deformities entailed by long hours of work are much more serious
among women. Protracted work frequently causes deformities of the pelvis, partly in the
shape of abnormal position and development of the hip bones, partly of malformation of the
lower portion of the spinal column.‖
 1888 AD- One of the most famous strikes in history, the Matchgirls Strike of 1888, had the
disease of ‗phossy jaw‘ (phosphorus necrosis of the jaw) as a central issue. The company
banned the use of yellow and white phosphorus in 1901. Eventually there was an
international ban introduced by the Berne Convention in 1906, implemented in the UK in
1908.
 1898 The ‗evil effects‘ of asbestos were first noted in the Factory Inspectors report.
 1911 - tragedies in Triangle Shirtwaist Company: The Triangle Shirtwaist Company was a
New York City ―sweatshop‖ where dozens of mostly young female immigrant workers
crowded together to cut and sew shirtwaists. Due to fire accident146 workers died in the
upper floors of that ―fireproof‖ building
o Fire exits were inadequate or locked
o Many victims jumped to their deaths
The tragedy led to 36 laws reforming the state labor code.
 1930 - Gauley Bridge Disaster: Also known as the Hawks Nest tragedy, this was America‘s
worst industrial disaster. Construction of the Hawks Nest tunnel near Gauley Bridge, West
Virginia, caused massive exposures to silica dust. At least 476 men died and 1500 disabled
by silicosis. Pneumatic drilling equipment and rock high in silica content magnified the risk.
Silica exposures were so high men were dying from acute silicoses from only two months
exposure
 1942 Publication of the Beveridge Report. During the nineteenth and twentieth centuries
various aspects of industrial disease were studied. However, it wasn‘t until the publication
of the Beveridge Report that any kind of comprehensive plan to tackle them was put
forward.
  1946 The World Health Organisation (WHO) defined health as the ―state of complete
physical, mental and social well-being and not merely the absence of disease and infirmity‖.
 1972 Report of the Committee on Safety and Health at Work under the Chairmanship of
Lord Robens. stated: ―We have interpreted ‗occupational health‘ as being concerned with
preventing ill health through control of the working environment…‖
 1974 The report led to the passing of the Health and Safety at Work Act and the Regulatory
Framework. This framework has failed to address Occupational Health (OH) issues
effectively. With no state scheme in place it has been left to employers to provide a
prevention and rehabilitation service. As a result the UK has one of the worst systems for
Occupational Health Services (OSH) in the European Union.

Occupational Safety and Health (OSH) in Bangladesh

Bangladesh is a relatively young and developing country. At the present time, like in most
developing countries, a clear demarcation between occupational health care and general medical
care is difficult to be recognized in Bangladesh. Occupational health activities are operated by
several ministries, such as Labour, Health, Industry and Transport. Major industries are tea
processing, cotton textiles, jute, garments, paper newsprint, cement, chemical fertilizer, light
engineering and sugar. The country has reserves of coal, oil and natural gas, and minerals such as
limestone and uranium.

Labour force of Bangladesh Agriculture (45%), industry (30%), services (25%) (2008 est.)
Unemployment 5.1% (2010 est.) GDP by sector: Agriculture: 52.3% Industry: 28.6%, Services:
19.1%.There is a rapidly growing labour force that cannot be absorbed by agriculture and industry
development is restricted by limited power generation and slow economic reforms. Many people
work overseas, primarily in the Middle East and East Asia.

The International Labour Organisation estimates that each year in Bangladesh 11,700 workers
suffer fatal accidents, and a further 24,500 die from work-related diseases. It also estimates that a
further 8 million workers suffer injuries at work – many of which result in permanent disability.
Situation of Occupational Safety and Health (OSH) in Bangladesh
The constitution of Bangladesh adopted on 4th November 1972 recognizes productivity as basic
need for economic development and covers the right to work and reasonable wages, medical care
and protection from disease and disablement. Thus it is assumed the health and safety of
industrial workers has been taken care of.
The OSH related objectives of the fifth five year plan (1197-2002) for the labour and manpower
were:
 ―To ensure fair wages welfare and social protection of workers under the structural
adjustment programs adopted by the government.‖
 To initiate steps to protect children from economic exploitation.‖
To achieve the objectives of the fifth five year plan the strategies related to OSH to be pursued
were:
 ―Review of existing labour related laws. Rules, regulation and directives and adoption of
necessary modification.‖
 ―Stress on gradual elimination of child labour and protection of children from economic
exploitation and hazardous work ―
In the labour sector the OSH related programs that were to be undertake under the fifth five year
plan included strengthening inspectorate of factories and establishments in terms of manpower and
resources so as to enable them to enforce various labour laws / rules concerning working hours,
working condition, safety and maternity benefits in different mills, shops and factories, etc. With
increased urbanization industrialization, the number of burn and trauma cases due to traffic and
industrial accidents, unsafe use of chemicals, fire, etc., has been increasing every year for which the
following needs were identified:
 ―Need to establish hospitals near major highways, traffic black spots and industrial areas
with trauma and burn units to treat burn and trauma cases in time.‖
 ―Promote industrial and occupational health through IEC activities so as raise awareness of
industrial workers and protect them from industrial hazards.‖

Situation analysis of the Occupational Health and Safety Services:

The Occupational Health and Safety Services in Bangladesh is still in the developmental stage and
refers to some extent to the needs of workers in the industry (both formal and informal) or in some
manufacturing process but does not cover all recognized occupations of the country. For example,
construction, transport and agricultural workers are not covered under present legislation. Currently
Occupational Health & Safety is concerned mainly with the Ministry of Labour and employment.
The occupational health & safety services are not well organized. Different ministries such as
railway, port and shipping, jute, textile etc. operate the occupational health care programme through
various departments and directorates. It is the legal obligation of the employers to provide medical
care in cases of deterioration of health or where injuries result from exposure to toxic agents related
at work. Physicians have been employed by various agencies in accordance with section 44 of
Factories Act 1965, which is obligatory for the factories having 500 or more workers. A National
Safety Committee was formed under the Ministry of Industries in 1992 to look after OSH issues.

As a direct consequence of fragmented policy, different ministries and affiliated divisions or

departments are responsible for administration of occupational health services in the country..
However, the overall responsibility for health and safety at work rests with the ministries of labour
and health. The responsibility is divided in the sense that the ministry of labour is involved in
formulating legal instruments and enforcing these, while the ministry of health is involved in
education and training. Both the ministries of health and labour often have affiliated institutes as
arms for carrying out environmental monitoring of the work-place, biological monitoring and
providing laboratory facilities for diagnosis and confirmation of occupational diseases.

A variety of mechanisms is used for funding occupational health activities in the country. Funds are
usually provided either by the national government and supplemented from WHO and donor
agencies. However, the infrastructure should be strengthened to provide occupational health
services in accordance with the joint WHO/ILO convention 161, emphasizing prevention and
health promotion to the workers. To achieve these goals, inter-sectoral coordination, at all
administrative levels of health services and with other sectors, is crucial for avoiding duplication of
scarce resources and maximizing the outputs.

Capacity for Development of Human Resources for Occupational Health:

Capacity building and short and long-term training of health and safety professionals have been
organised by study tours to overseas with WHO sponsorship. Bangladesh received assistance from
WHO and ILO in organizing conferences and training in occupational health and safety. Posters,
pamphlets, booklets and even books have been produced to spread the message of occupational
health and safety in Bangladesh. Some very basic research in occupational health has been carried
by various institutes. However, there is lack of real operation research from public health
perspectives that could be used to address prevalent occupational conditions.

Role of Stakeholders

ILO Convention regarding OSH:

To date 33 ILO conventions have been ratified by Bangladesh. The ILO convention C 155 and C
161 are concerned with the occupational health and safety and the occupational health services
respectively. Although these two conventions are not yet ratified by Bangladesh, many of the
recommendations of these conventions have been practiced to some extent through the
implementations of existing various laws and regulations. In response to the ILO Convention 81
Factory Inspectorate was established in 1965. In the Factory Act 1965 and Factory Rules 1979 and
in some other laws and regulations, there are various chapters that are relating to OSH. But by the
existing laws and regulations, qualitative inspections regarding safety and health in the working
condition is possible but could not be monitored in terms of quantitative standards due to the
lacking of specific exposure limit of the regulations.

Director General of Health Services

Director General of Health Services acts on the issues of OSH only with one assistant director and
who is mainly involved in awareness building and training of health personnel and other concerned,
having little scope to undertake activity to identify occupational health hazards and occupational
diseases and the preventive measures as well. And the existing occupational health unit is not
empowered to look into the occupational health and occupation related diseases. However, DGHS
provides health care services to the workers and other related personal through its general health
care facilities in the industrial areas.

Department of Labour:
This department is responsible to maintain industrial peace and healthy labour management
relations through out the country. Every office of this department administers and implement the
provisions of Industrial relations Ordinance to keep harmonious industrial peace, uninterrupted
production process and solves the raised industrial disputes using it‘s conciliation machinery.
Moreover, through it‘s four IRIS (Industrial Relations Institutes) situated in four divisional cities,
training courses of various durations are being conducted with a view to achieve higher
productivity and to make healthy management relations.

Department of Inspection for Factories and Establishments:

The Department of Inspection for Factories and Establishments under the administrative control of
the Ministry of Labour and Employment is empowered by law to oversee the enforcement of
almost all legislation relating to welfare safety and health of workers. The Chief Inspector of
Factories and Establishments heads the department and is assisted by 7 Deputy Chief Inspectors.

The setup of the Department of Inspection for Factories and Establishment has 3 sections-
Engineering, Medical and General.
• The Engineering section is responsible for occupational safety, accident investigations,
workmen's compensation.
• The General Section deals with general welfare measures, payment of wages, working
hours, conditions of employment.
• The Medical section is responsible for occupational health and hygiene, maternal benefit,
working environment.
In Dhaka the Chief Inspector of Factories is assisted by 3 Deputy Chief Inspector of Factories each
of whom is in charge of one of the 3 sections.

The department operates through 4 Divisional Headquarters located at the administrative divisions
of Dhaka (17 districts), Chittagong (15 districts), Khulna (16 districts) and Rajshahi (16 districts)
and 4 Regional Offices located in the industrial zones of Narayanganj, Comilla, Sreemangal and
Rangpur; and 29 branch offices. Each divisional setup is headed by a Deputy Chief Inspector of
Factories (General), and also consists of 3 sections.
Trade unions, Employers organizations and NGOs:
Labour union, (trade unions) are allowed in almost all sectors in accordance to Industrial Relations
Ordinance 1969, except in export processing zones. For a trade union to be recognized it has to be
registered. To be registered a union has to have at least support of 30% of the workers or employees
of the enterprise in the form of formal membership. No worker is allowed to be a member of two
trade unions at the same time. The registered trade unions are allowed to form a federation of trade
unions, which again has to be registered.

There are 5450 trade unions and 25 federations of trade unions in Bangladesh, The trade unions
have currently focused their activities on the sectors of female workers, child workers, part-time,
temporary and casual workers, Informal sectors and migrant workers. Trade unions mainly focus on
issues of workers rights and functions as collective bargaining agents but comparatively, the OSH
activities do not get emphasis to them properly. This is true for largest to the smallest unions. In
hazardous industries like tanneries, foundries, petroleum, jute and textiles, the trade unions mainly
concentrate their activities related to wages and other issues concerned with monitory benefit. Thus
effective OSH functions in respect to Health & Safety in labor unions are lacking, including the
training programmes for its members.

Employers:
Employer's organizations can be grouped as non-sectoral and sectoral organizations. The non-
sectoral organizations include the chamber of commerce and industries. There is such organization
in Divisional as well as in district level.
a. Federation of Bangladesh Chamber of Commerce and Industries.
b. Bangladesh Employers Federation.
c. Chambers of Commerce and Industries.
Some of the Employers organization provides OSH information to their members through
organizing workshops and seminars.

NGOs:
NGO activities in Bangladesh are very limited. Amongst them BILS and OSHE to some extent are
working for longer time. The Bangladesh Institute of Labor Studies (BILS) is an active NGO which
has been working on OSH since its inception in 1995.They undertake awareness, training and
research activities concerning OSH. They also provide institutional support to the' International
Confederation of Free Trade Union-Bangladesh Council. The main activities of BILS related to
OSH are as follows:
• Strengthening the democratic functioning of the trade union
• Assists trade unions through education training, research, campaign and communication
• Improve occupational health and safety, and welfare of the work

Governmental Occupational Health Care Services::

Ministry of Labour: The Ministry of Labour runs 22 dispensaries established in various industrial
and tea plantation areas of the country for the benefit of workers which include facilities for
emergency treatment of casualties and family planning. Seven Labour Welfare Centers were
constructed and are situated in tea estates. Under this department there are 4 Industrial Relation
Institutes (IRI), which in addition to welfare services they also provide awareness and training
activities on OSH.
This ministry is responsible for legislation concerning working environment, inspection with regard
to health and hygiene, safety, benefit, compensation and setting standards. The Inspectorate of
Factories under this Ministry is responsible for implementation and enforcement of Factories Act.
The Inspectorate has three wings- medical, engineering and general, all under the Chief Inspector of
Factories and Establishment. The medical wing is headed by the Deputy Chief Inspector of
Factories (medical person). An Inspector may, within the local limits for which he is appointed,
enter to' each and every workplace in Bangladesh to ascertain safety of the work environment and
enforcement of the provisions of the Factories Act and other laws relating to health and hygiene.
Ministry of Industry: Industries in different corporations under this Ministry have provisions of
individual occupational health services, which include employment of full-time or part-time
Medical Officers, Labour Welfare Officers, etc.
• Aviation- individual medical services affiliated hospital.
Ministry of Health & Family Welfare
• Health care as part of national health services is provided through hospitals, dispensaries,
clinics, etc., but does not have any special role in terms of occupational health services viz.
in industries, factories and agriculture, etc.
 • Civil Surgeon acts as factory inspector (Medical) for the district.
• One Assistant Director, Industrial Hygiene is posted in the office of the Director General
of Health Services,
• Department of Occupational & Environmental Health (DOEH) of National Institute of
Preventive & Social Medicine (NIPSOM) conducts a course on Master of Public Health in
Occupational & Environmental Health i.e. MPH (OEH) where in each year about 15-20
doctors are enrolled for one year postgraduate study program on Occupational &
Environmental Health. This department also organizes workshops, seminars, short
trainings and conducts researches on Occupational Health issues.
Ministry of Transport: Health care services provided by the different branches of this ministry
include: railway- medical services through hospitals, health units, clinics and health inspectors for
sanitation in large stations; shipping and aviation- medical services through respective affiliated
hospitals. Health care services provided in private sector generally include medical services through
private clinics and medical centers, first aid, medical examination, determination of losses, medical
benefits, etc.
Services provided include;
• Railway-hospitals, health units, clinics and large stations health inspectors for sanitation;
• Shipping- individual medical services, affiliated hospitals, dock labour welfare hospital;
Ministry of Home Affairs
Under which the Directorate of Fire service & Civil Defense provides OSH services in case of
emergency and also training programmes for industrial workers in fire protection.
Ministry of Local Government
Every Deputy Commissioner is declared as Factory Inspector (General) for that district as per
provision of Factory Act of 1965.
Ministries of Textiles, Jute, Agriculture, Energy and Mineral Resources Industries under
different sectors have the provisions of individual OSH service, which include;
• Employment of full-time or part time Medical Officers;
• Labour Welfare Officers.
Future Prospects of Occupational Health in Bangladesh:
Bangladeshi workers being employed in different countries of the world bring with them the
consequences of the previous exposures from the country they served and their absorption after
returning home will have significant effects in the future on the prevalence of occupational diseases
in Bangladesh.
Although the Labour laws are in force, child labour can be noticed in many industries in
Bangladesh. Different initiations are taken place to counteract this problem. For instance, the
Bangladesh Garment Manufacturers' and Exporter's Association signed an agreement in 1995 with
the ILO and UNICEF to remove all child workers below 14 years of age from more than 2,000
garment factories and set up a program to rehabilitate them and their families.

Special attention should be given to the real enforcement of all Labour laws for the health, safety
and welfare of the workers in Bangladesh. Overtime work is frequent in privet sector jobs,
sometime willingly and sometime on demand of employers. As it is a tradition in Bangladesh,
house works are done by women. Thus, working women in Bangladesh have to work more than
usual working hours. On the other hand, women do not get the equal remuneration. For example,
there is a considerable gap remains in women's nonagricultural wages which is as 42% of men's.
There is sufficient evidence to raise concerns about the risks to health and safety of long working
hours''. Therefore, the issue of working women will receive special emphasis from the occupational
health system. More emphasis will be placed on the interaction between work and environmental
exposures (occupation-related accidents, noise-induced hearing loss, occupationally related skin
diseases and occupational cancer). Worksite health-promotion, reaching out to workplaces and
advertising health-promotion programs (e.g., time management, smoking cessation, proper
nutrition, physical activity, stress reduction), will be of great importance.

Bangladesh is experiencing a rapid industrial growth. Safe and hazard free work and workplace are
needed for higher productivity, efficiency, quality of any industrial process .Most of the workers
have little scope to know about health and safety. They have very little practice and poor
knowledge about occupational health and safety. With the advancement of technology they are
facing apprehensive health hazard. So this area is to be seriously attended and addressed. The
classic approach to ensuring health and safety in the workplace has depended mainly on the
enactment of legislation and inspection of workplaces to ensure compliance with health and safety
standards.

Fig: Major industries and their location in Bangladesh

 SESSION 3: Occupational Safety and Health Legislations

Summery:

The Government of Bangladesh is conscious about the need for a proper welfare program for the
health, safety and welfare of the workers, and statutory provisions have been stipulated in the
existing laws which are required to be implemented by the employers. The government of
Bangladesh have adopted the Bangladesh Labour Act, 2006 after repealing of 1855 severe Accident
Act, 38 Labour Act from British and Pakistan period and 12 Labour Act of Bangladesh period. The
OHS has received much priority in the present Labour Act 2006 than the previous Acts.
occupational health and safety personnels should learn about the features of the Bangladesh Labour
Law 2006 in relation to Occupational Health Safety and Labour Welfare.

Objectives of the Session:

At the end of the session the participants will be able to describe:

Session 3
- Chronology of Factory Legislations
- Legislation of occupational health in Bangladesh
- Features of the Bangladesh Labour Law 2006

Duration: 45 minutes

Method:
 Lecture, Multimedia Presentations
 Presentation and discussion
 Feed back

Materials:
Multimedia, Handouts
 Occupational Safety and Health Legislations

Occupational Safety and Health Legislations

Chronology of factory legislations
 1802 health and morals of apprentices act (Peel) :12 hours per day maximum; no night work;
schooling ; hygiene; I suit of clothes per year; walls whitewashed twice a year (ineffectual )

 1819 factory act (Owen/Peel): cotton workers 9 years minimum age for employment. 12 hours
maximum per day (ineffectual)

 1825 and 1831: similar acts, equally ineffectual. 1833 factories act (textiles) (Shaftesbury/ Chad
wick): first bill of importance and effect. Age certification of children. No night work under 18 years
of age. No employment under 9 years of age. 9-13 years of age- 8 hours per day. 14-18 years of age
12 hours per day. Factory inspectorate started with messrs horner .sanders, rickards and Howell.
Salary 1000 pound per annum with 3000 factories to report on at 6 monthly intervals.

 1844 and 1845 factories act (textiles): 12 hours maximum for women and young persons. Birth
certifications required for employment. Fencing of machinery .certified factory surgeons to report
accidents.

 1847 ―10 hours act ―(Sadler and Shaftesbury): 58 hours per week maximum for women and young
persons. 1850 act to establish ‗normal ‗working day: 5.5 days per week. 1864 mach making , paper,
pottery, glass metal trades act 1867,1847 1878; extension and consolidation of previous acts raising
minimum working age to 10 years and centralizing inspectorate, descriptions of many occupational
diseases, ranging from those of cesspit workers to those of the mirror silverers of Murano.

 1880 employer‘s liability act

 1895 first notification of disease: lead, arsenic, phosphorus, anthrax.

 1897 workers compensation act.

 1898 sir Thomas legge was appointed first medical inspector of factories

 1899 mercury poisoning notified , appointed factory doctor system started

  1901-37: further acts concerning laundries, electricity boiler, women and children in lead process
work, shift work, night work.

 1961 factory act: consolidating all related laws

 Most of the present legislations in Bangladesh are inherited from British acts and rules.

 Labour act -2006

The constitution of Bangladesh adopted on 4th November 1972 recognizes productivity as a

basic need for economic development and covers the right to work and reasonable wages,
medical care and protection from disease and disablement. Thus it is assumed the health and
safety of industrial workers has been taken care of.

Legislation of occupational health in Bangladesh

The Government of Bangladesh is conscious about the need for a proper welfare program for the health,
safety and welfare of the workers, and statutory provisions have been stipulated in the existing laws which
are required to be implemented by the employers. Legal foundations of the occupational healthcare system,
based on British India and Pakistani era, were adopted and amended by the Government of Bangladesh after
the liberation of the country in 1971. Most of the Labour laws have been rectified by the Government of
Bangladesh according to the ILO Conventions. Recently Bangaldesh has implaemented Bangladesh Labour
Law, 2006, this law combines most of the previous laws and acts of Bangladesh related to occupational
safety & health and welfare.

Bangladesh Labour Law 2006

The government of Bangladesh have developed the new law the ‗Bangladesh Labour Law 2006‘.
This new law incorporates 33 ILO conventions that Bangladesh has ratified. The OHS has received
much priority in the present Labour Act 2006 than the previous Acts. Recently the law has been
amendated for various modifications. Some Important features of the Bangladesh Labour Law 2006
in relation to occupational health & safety and labour welfare are as follows:
1. Composition: It is a single updated code instead of the 25 previuos scattered Acts and
Ordinances in Bangladesh
2. Sections: There are 354 sections in 21 different chapters in the legal text.
3. Scope: The scope and applicability of the law has been extended and definitions of different
teem have been clarified. Ambiguities regarding the age limit of an individual to qualify as a
child have been eliminated. According to this law, any person below the age of 14 shall be
treated as a child.
4. Employment: The issuance of appointment letters and identity cards for workers has been
made compulsory.
5. Death Benefits: It has been ensured that benefits would be provided even for cases of
normal deaths along with deaths due to accidents or occupational hazards during the service
life of an employee.
6. Retirement Age: The normal retirement age for workers has been fixed at 57, and at the
time of retirement, the worker shall be entitled to get all the benefits as are applicable under
this law. Even the case of a worker‘s voluntary retirement, after his continuous service of 25
years with his employer, is also a subject which will come under this retirement benefit.
7. Child labour: Child labour has been prohibited even for non-hazardous regular work.
Appointments of adolescent and female workers have been prohibited during the night and
in dangerous occupations.
8. Maternity Benefit: Maternity benefits have been increased to 16 weeks and the qualifying
service length has been decreased to six months, but this benefit is limit only for births up to
two living infants.
9. OSH: Special importance has been given on occupational health and safety and the work
environment. Out of the 354 clauses of the labour law, 78 happen to be about the
environment.
10. Records: Maintenance and preservation of safety record books and introduction of group
insurances for the workers have been ensured.
11. Wage-Administration: Time limits for payment of wages have been determined at a
maximum of 7 days from the date on which the payment become due, and a provision has
been made for workers to be able to realize any unpaid wages through the labour court.
12. Revision: Provisions have been made for the revision of sector wise minimum wage rates
after every five years.
13. Disability Compensation: Amount of compensation to be paid in case of death or
permanent disability arising from accidents at the workplace, have been increased. For
 deaths the amount of compensation has been raised to Taka 100,000.00 per worker and for a
permanent and complete disability, the amount has been increased to Taka 125,000.00 per
worker. In the case of accidents, which might happen due to employer‘s negligence, the
compensation amount shall be double according to this law.
14. National Industrial Health and Safety Council: A provision has been made for the
formation of a ―National Industrial Health and Safe Council‖ to enact the national policy for
ensuring occupational health and safety in all companies.
15. Sick Leave: 14 days sick level with full average wages have been mandated in the Labour
Law whereas, previously it was the same number of days but at half pay.
16. Health Certificate: Previously health certificates of the workers would have to be obtained
from the civil surgeon of the district, but at present it has been allowed that such certificates
can be obtained from any registered health practitioner at the cost of the employer.
17. Day care center for children: It has been made mandatory for day care centers for children
to be provided in all company premises that employ more than 40 female workers having
their children below the age of 6 years. Previously it was provided for every 50 female
workers.
18. Grievance Procedure: The time for initiation of a formal grievance procedure has been
extended from 15 to 30 days according to this new law.
SAFETY

Fire
Section 62 deals with the provisions for measures to be taken by a factory to avoid dangers and
damage due to fire. The section provides for the following:
1. At least one alternative exit with staircases connecting all the floors of the factory building
as described in the rules for each and every factory.
2. No door affording exit can be locked or fastened during the working hours so that they can
be easily or immediately opened from inside.
3. The doors affording exit must be open outwards, unless it is sliding in nature, if the door is
between two rooms it must open in the direction of the nearest exit.
4. Marking in red letter in proper size, in the language understood by the majority of the
workers, on such doors, windows or any alternative exit affording means of escape in case
of fire.
 5. There shall be an effective and clearly audible means of fire-warning system to every
worker.
6. There shall be a free passage-way giving access to each means to escape.
7. Where more than ten workers are employed other than in the ground-floor, there shall be a
training for all the workers about the means of escape in case of fire.
8. There shall be at least one fire-extinction parade and escape-drill at least once a year in a
factory where more than fifty workers are employed.
Floors, stairs and means of access (Section 72)
Section 72 of the new labour law deals with the floors, stairs and means of access. The section
states as follows:
1. All floors, staircases, and passages shall be of sound construction and properly maintained
and if it is necessary to ensure safety, hand-railings shall be provided with them.
2. Reasonable safe passageway or access shall be maintained in a place where employees
work.
3. All the floors, passageways, and staircases shall be maintained in a neat and clean manner,
wide enough, and free from any blockade.
Energy isolation (Section 65)
 Emergency power cut off switch must be installed with all movable equipment.
Crane and other lifting equipment (Section 68)
 All such equipment shall be maintained properly
 All such equipment shall be inspected, tested and certified annually by a competent person
 Inspection, testing and certification documentation of such equipment shall be kept in a
register.
 All such equipment shall not be used to lift excessive weight than the operation capacity of
that equipment.
 Movement area of such equipment must be guarded to prevent human access.
Hoist and Lift (Section 69)
 All such equipment shall be maintained properly
 All such equipment shall be inspected, tested and certified every after six months by a
competent person
  Inspection, testing and certification documentation of such equipment shall be kept in a
register.
 All such equipment shall not be used to lift excessive weight than the operation capacity of
that equipment.
 Safe load carrying capacity must be clearly written on to the equipment body.
Excessive Weights (Section 74)
Section 74 of the new labour code states that, no person shall be employed in any factory to lift,
carry or move any load as heavy as to be likely to cause him injury.
Safety of building and machineries
Section 61 of the labour law 2006 provides for the measures to be taken as regards the safety
measures related to building and machineries. The present law entrusts everything to be done in this
regard with the Inspectors. The section goes as follows:
1. If it appears to an Inspector that any building or part thereof or any passageway or machine
of the factory is in such a condition which is injurious for the life and health of the workers
working therein, the Inspector may issue an order to the owner of the factory to take
necessary steps immediately within the specified time therein.
2. If the Inspector is of the opinion that the building or any machine is seriously dangerous for
the life of the worker, he shall issue an order to repair or alter that immediately failing
which, to not run the factory unless and until the building is so repaired or replaced.
Fencing of machinery (Section 63)
1. Factories are required to secure the following parts of machinery in order to ensure safety of
the workers:
a) Every moving part of a prime mover and every fly wheel connected to a prime mover.
b) The head-race and tail-race of every water wheel and water turbine
c) Any part of a stock-bar which projects beyond the head stock of a lathe
d) Every part of an electric generator, transmission machinery and other dangerous part of any
machinery.
2. Fencing must also be done on any other parts (in motion) that contains screw, bolt and key
on any revolving shaft, spindle wheel or pinion and all spur, toothed friction gearing, etc.
The fencing is required to prevent these items from harming the workers coming in close
contact to them.
 3. The Government may exempt fencing of the aforesaid objects, if and only if certain other
measures are adopted that will ensure safety of the workers.
4. The Government may prescribe such further precautions to fence certain other parts of the
machineries which are not mentioned above for ensuring safety of the workers.
Work on or near machinery on motion (Section 64)
1. In case of examining, adjusting and lubricating part of machinery in motion, it is required to
employ a well-trained adult male worker. The worker must wear tight-fitted clothing while
conducting such jobs and no other person will be allowed to work on behalf of her/him
during her/his absence.
2. Women and adolescent are not allowed to do the above-mentioned tasks and they are not
also entitled to work in places between fixed and moving parts of any machinery in motion.
3. The Government may prohibit the cleaning, lubricating and adjusting, of any machinery in
motion, by any person.
Explosive or inflammable dust or gas (Section 78)
1. The following practicable measures must be taken in factories to avoid explosions caused
by inflammable dust, gas or vapour produced during the manufacturing process:
a) Effective enclosure of the plant or machinery used in the process
b) Removal or prevention of the accumulation of inflammable objects
c) Proper enclosure of all possible sources of ignition.
2. In case of the impossibility of placing a strong enclosure for the above-mentioned sources of
inflammable objects, provisions of chokes, baffles, vent or other effective appliances have
to be kept.
3. Enclosed parts of the plant that contain potentially explosive materials shall only be opened
if certain required precautionary measures are met:
a) Stop valves should be used to stop flow of gaseous objects in pipelines before working on
any joint of that pipeline.
b) Practicable measures should be taken to reduce pressure inside the pipeline before working
on joints of that pipeline.
c) Entrance of inflammable gases or vapours, into the pipeline through the joints that are to be
worked on, must be carefully prevented.
 4. Operation that requires actions of heat, such as welding, brazing, soldering or cutting, shall
not be conducted in a factory that contains or previously contained inflammable objects
without taking appropriate safety measures.
Precautions against dangerous fumes(Section 77)
1. No person shall be allowed to enter potentially hazardous chambers, containing dangerous
fumes, such as tank, vat, pit, pipe, flue or confined spaces if there is not any manhole of
adequate size.
2. No portable light of voltage exceeding 24 volts shall be permitted to use inside places
mentioned above.
3. No person shall be allowed to enter the places mentioned above until the following
measures are taken:
a) A certificate in writing has to be given by a competent person stating that the space is free
from dangerous fumes and is fit for persons to enter.
b) It has to be ensured that the worker wears a suitable breathing apparatus and a belt securely
attached to a rope before going into any confined space.
4. No person shall be allowed to enter the places mentioned above for the purpose of working
or making any examination before sufficiently cooling the places down by ventilation.
5. Suitable breathing apparatus, reviving apparatus and belts and ropes shall be kept ready
beside the confined space for instant use. Other workers must also be trained and proficient
in the use of all such apparatus.
Personal Protective Equipment
There are several sections in the new law where the personal protection of the worker has been
discussed. Section 75 deals with the protection of eyes.
 Effectives screens or suitable goggles shall be provided for the protection of person‘s eye
where there is a risk ……..
 Of injury to eyes from particles or fragments thrown off in the course of the processing.
 To the eyes, by reason of exposure to excessive light or heat.
Section 79 also makes a provision of personal protection, sub-section (d) and (e) stated as follows:
a. Providing for the protection of all persons employed in the operation or in the
vicinity of the places where it is carried on, and
b. Providing notice about the hazardous chemical to the workers.
Risk assessment and prevention
There are several sections in the labour code regarding the assessment of risk and prevention
thereof. Section 40 and 79 of the labour law made provisions for the government to asses
certain occupation. The section state as follows:
a) The government shall, by notification in the official gazette, provide a list of the dangerous
machines and risky operations for the adolescent worker (section 40)
b) The workers employed in such machines and / or operations shall be sufficiently trained and
supervised.
c) The Government shall identify and provide a list of dangerous operations (section 79)

WELFARE
First aid appliances
Section 89 of the new labour law provided the following:
1. A well equipped first aid box or cabinet for every 150 labour.
2. A person, who has to be always available in the factory, trained in first aid knowledge
assigned for every first aid box.
3. Notice regarding the availability of that person in every working room and a special badge
issued for that person.
4. An ambulance and a well-equipped dispensary for every 300 workers employed in a factory.
Washing facilities
Section 91 provides for the washing facilities for workers in a factory. But the new law is
exactly the same as the earlier Factories Act 1965. Rules regarding the washing facilities are yet
to be made.
The number of taps in the workplace was fixed in the earlier laws as per the following schedule:
1. One tap for every 15 worker who are coming into close contact of noxious substances.
2. Workers who are not working with noxious substances shall be entitled to get the following
facilities:
Number of Worker Number of Taps
0-20 1
21-35 2
36-50 3
 51-150 4
151-200 5
200-500 5+1 for every additional 50 or part thereof
More then 500 11+1 for every additional 100 or part thereof

3. At lest two gallons of water supply for each and every worker employed in a factory.
Canteens
Section 91 of the labour law 2006 provides a canteen for every 100 workers.
Shelters/ rest rooms and lunch rooms
Section 93 of the new labour code makes a provision of a rest room for every 50 or more workers
and a separate rest room for the female workers numbering over 25. But if the number of female
workers is below 25 then the factory management shall manage a curtain in the same rest room to
create a separate resting space for the female workers.
Rooms for children
The law has made a provision of a children‘s room for every 40 female workers with children
below 6 years of age. The room is required to be of such an area so that it can provide 600 square
centimeters of space for each child and the minimum height of such room shall not be less than 360
centimeters.

HEALTH AND HYGIENE

Cleanliness
Section 51 of the law deals with the provisions of cleanliness. The law provides for the
following:
1. Every factory shall be kept clean and free from effluvia arising out of any drain, privy, or
any other nuisance in the following manner:
a) Accumulation of dirt and refuge shall be moved daily by sweeping from floors and benches
of workrooms, staircases and passages;
b) The floors of every work room shall be cleaned by washing at least once in a week using
disinfectant;
c) Effective drainage shall be provided and maintained where the floor is liable to become wet
in course of any manufacturing process to such extent as is capable of drainage;
d) All inside walls and partitions, all ceilings or tops of the rooms and walls, side and top of
the passageways and staircase shall be-
 Repainted or re-varnished at least once in every five years from when they are
painted or varnished
 Cleaned at least once in every fourteen mouth where they are painted and varnished
and have smooth impervious surfaces.
 Kept whitewashed or colour washed at least once in every fourteen months
2. A register shall be maintained in every factory for all the required activities as described in
the clause (d) above.

Drinking water
Section 58 of the new labour law provides for an effective arrangement of sufficient supply of
wholesome drinking water conveniently located at suitable point for all workers. The section
further provides for the following
1. The word ―Drinking water‖ shall be legibly marked on the place;
2. Cooling the drinking water in a factory during the hot weather where more than 250
workers are employed;
3. Oral Re-hydration Therapy for the workers, working close to the machine producing
excessive heat.

Overcrowding
Section 56 of the labour law 2006 makes provisions for required spaces for a single worker
employed in a factory. Following are the points important in this regard.
1. 9.5 (nine and half) cubic meters of space for every single worker in a factory;
2. For calculating the dimension of the aforementioned-space, ignore the height beyond 4.25
meter;
3. The Factory shall post a notice in each workroom, specifying the maximum number of
workers who can be employed therein as per the above calculation, if the Inspectors so
require;
4. The Inspector can exempt any workroom of any factory from the compliance of this rule if
satisfied that for the health of the worker it is not necessary.
Lighting
Section 57 of the new labour law provides for the arrangement of sufficient and suitable
lighting of natural or artificial or both. The section further provides for the following:
1. Glazed windows or skylights shall be kept clean on both the pouter and inner surface free
from obstructions;
2. Provisions shall be made to prevent glare either directly from any source of light or by
reflection from a smoothened or polished surface;
3. Provisions shall be made for the prevention of the formation of shadow to such extent as to
cause eye strain or risk of accident to any worker.
Latrines and urinals
Section 59 of the new labour law makes the provisions of the latrines and urinals for the
workers employed in a particular factory. The section provides for the following:
1. Sufficient number of latrines and urinals located at convenient places and accessible to all
the workers.
2. Separate arrangements for male and female workers.
3. Properly illuminated and ventilated and sufficient supplied with water at all times.
4. Clean and sanitary condition be maintained by detergents or disinfectants or with both.
5. The number and kind of latrines and urinal shall be prescribed by the rules (formulated later
on)
Dust bins and spittoons
Section 60 of the present law deals with the provisions of dustbins and spittoons. The sections
provides for the following:
1. Every factory shall provide sufficient number of dustbins and spittoons at convenient places
in clean and hygienic conditions.
2. No person shall spit or litter except in the spittoon or bins, kept and maintained for this
purpose.
3. A notice shall be posted at every conspicuous places for the workers to the effect that
―Spitting or littering in contravention of clause 2 is a punishable offence‖
Compensation for occupational accident and injure in labour act -2006
Measures for the compensation of occupational accident in described in section 151.
Amount of compensation (section 151, 5th schedule)
Layer of Amount of compensation Monthly rate of compensation for temporary
the wages Death Temporary loss disability
For any 100000/- 125000/- Amount of compensation depends upon the total
amount of BDT BDT amount of money which is less between the
monthly Duration of disability and one year wages.
wages of Distribution of compensation :
the labour -Total monthly salary for first two month
-2/3 of monthly salary for next two month
-1/2 of the monthly salary for the following month
In case of long term occupational disease
distribution of the compensation should follow by
1/2 of the monthly salary for the duration of the
disability but it never exceed 2 years
 SESSION 4: Occupational Hazards

Summery

Occupational safety and health (OSH) is a cross-disciplinary area concerned with protecting the
safety, health and welfare of people engaged in work or employment. The goals of occupational
safety and health programs include to foster a safe and healthy work environment. A working
condition that can lead to illness or death. Often, people in jobs which pose a high level of risk are
paid more than similar but less risky jobs to compensate for the danger involved. any condition of a
job that can result in illness or injury endangerment, hazard, jeopardy, peril, risk - a source of
danger; a possibility of incurring loss or misfortune;

Objectives of the Session:

At the end of the session the participants will be able to describe:
- What is occupational hazrds
- Types of occupational hazards
- Detrimental health problems due to workplace hazards

Session 4
Duration: 60 minutes

Method:
 Lecture, Multimedia Presentation
 Discussion
 Feed back

Materials: Multimedia
 Occupational Hazard

Hazard
Any real or potential condition exposure to that may cause injury illness damage or death is known
as hazard.
Hazards are the work place conditions or actions that can result in injuries, illnesses or other
organizational losses.
Hazard is an inherent properties of a substances, mixture of substances or a process involving
substances that, under production, usage or disposal conditions, make it capable of causing adverse
effects to worker or the environment, depending on the degree of exposure.
Hazard is a source of danger, risk or harmful factor.
Exposure
Exposure is the concentration, amount or intensity of a particular physical or chemical agent or
environmental agent that reaches the target population, usually expressed in numerical terms of
substance concentration, intensity, duration and frequency the process by which a substance
becomes available for absorption by the target population, organism, organ, tissue or cell, by any
route. Exposure Assessment is expressed by dose, duration and frequency
Risk
Risk is the possibility that a harmful event (death, injury, loss) arising from a exposure to a Hazard.
Possibility of suffering from harm due to exposure to a risk agent which includes hazardous
materials like chemicals, heavy metals, radiation, or hazardous process/ condition. A chemical or
heavy metal that is hazard to human health, does not constitute risk unless there is exposure. For
determination of risk - three elements must be present;
 a hazard,
 a probability of exposure to the hazard,
 and probability of harmful effect or adverse consequences
Different occupation has different hazards, depending upon the working environment, work
process, raw materials,production, waste disposal, the occupational health hazards may grouped as:
Occupational Hazards
An occupational hazard is a thing or situation with the potential to harm a worker. Occupational
hazards can be divided into two categories: safety hazards that cause accidents that physically
injure workers, and health hazards which result in the development of disease. It is important to
note that a "hazard" only represents a potential to cause harm. Whether it actually does cause harm
will depend on circumstances, such as the toxicity of the health hazard, exposure amount, and
duration. Hazards can also be rated according to the severity of the harm they cause - a significant
hazard being one with the potential to cause a critical injury or death.

Most workplace health hazards target a particular part of the body such as the lungs, skin or liver. A
large number of workplace diseases and disease agents are recognized. Virtually any part of the
body can be affected in some way by some workplace health hazard. An important consideration is
how exposure occurs.

For some hazards, there can be one type of effect from a single, high exposure (an acute effect) and
a quite different result when exposure is at a low level, but repeated regularly over a prolonged time
period (chronic effect). Acute effects depend on the degree of exposure. It is therefore relatively
easy to control exposure (keep it at a low enough level) to avoid acute effects. Or, to put it another
way, if workers are experiencing acute effects, they know exposure to the hazard is not being
properly controlled. With chronic effects there is no immediate warning. Where long-term exposure
is known to cause disease without any warning of the hazard, it may be necessary to control worker
exposure through regulations that prescribe occupational exposure limits (OELs). A worker may be
exposed to five types of hazards, depending upon his/her occupation:
 Physical hazards,  Mechanical hazards,
 Chemical hazards,  Psychological hazards,
 Biological hazards,  Ergonomic hazard

Physical Hazards
Heat and Cold
The direct effects of heat exposure are burns, heat exhaustion, heat stroke and heat cramps; the
indirect effects are decreased efficiency, increased fatigue and enhanced accident rates. Many
industries have local ―hot spots‖ – ovens and furnaces, which radiate heat. Radiant heat is the main
problem in foundry, glass and steel industries, while heat stagnation is the principal problem in jute
and cotton textile. High temperatures are also found in mines. Physical work under such conditions
is very stressful and impairs the health and efficiency of the workers. For gainful work involving
sustained and repeated effort, a reasonable temperature must be maintained in each work room.
Important hazards associated with cold work are chilblains, erythrocyanosis, immersion foot,
and frostbite as a result of cutaneous vasoconstriction. General hypothermia is not unusual.
Light
The workers may be exposed to the risk of poor illumination or excessive brightness. The acute
effects of poor illumination are eye strain, headache, eye pain, lachrymation, congestion around the
cornea and eye fatigue. The chronic effects on health include ―miners‘s nystagmus‖. Exposure to
excessive brightness or ―glare‖ is associated with discomfort, annoyance and visual fatigue. Intense
direct glare may also result in blurring of vision and lead to accidents. There should be sufficient
and suitable lighting, natural or artificial, wherever persons are working.
Noise
Noise is a health hazard in many industries. The effects of noise are of two types:
(i) Auditory effects - which consist of temporary or permanent hearing loss
(ii) Non-auditory effects – which consist of nervousness, fatigue, interference with communication
by speech, decreased efficiency and annoyance.

The degree of injury from exposure to noise depends upon a number of factors such as
intensity and frequency range, duration of exposure and individual susceptibility.
Vibration
Vibration, especially in the frequency range 10 to 500 Hz. May be encountered in work with
pneumatic tools such as drills and hammers. Vibration usually affects the hands and arms. After
some months or years of exposure, the fine blood vessels of the fingers may become increasingly
sensitive to spasm (white fingers). Exposure to vibration may also produce injuries of the joints, of
the hands, elbows and shoulders.
Ultraviolet Radiation
Occupational exposure to ultraviolet radiation occurs mainly in arc welding. Such radiation
occurs mainly affects the eyes, causing intense conjunctivitis and keratitis (welder‘s flash).
Symptoms are redness of the eyes and pain, these usually disappear in a few days with no
permanent effect on the vision or on the deeper structures of the eye.
Ionizing Radiation
Ionizing radiation is finding increasing application in medicine and industry, e.g. x-rays and
radio active isotopes. Important radio-isotopes are cobalt60 and phosphorus32. Certain tissues such
as bonemarrow are more sensitive than others and from a genetic standpoint, there are special
hazards when the gonads are exposed. The radiation hazards comprise genetic changes,
malformation, cancer, leukaemia, depilation, ulceration, sterility and in extreme cases death. The
International Commission of Radiological Protection has set the maximum permissible level of
occupational exposure at 5 rem per year to the whole body.

Chemical Hazards
There is hardly any industry which does not make use of chemicals. The chemical hazards are
on the increase with the introduction of newer and complex chemicals. Chemical agents act in three
ways: local action, inhalation and ingestion. The ill-effects produced depend upon the duration of
exposure, the quantum of exposure and individual susceptibility.
Local Action
Some chemicals cause dermatitis, eczema, ulcers and even cancer by primary irritant action;
some cause dermatitis by an allergic action. Some chemicals, particularly the aromatic nitro and
amino compounds such as TNT and aniline are absorbed through the skin and cause systemic
effects. Occupational dermatitis is a big problem in industry.
Inhalation
(i) Dusts – Dusts are finely divided solid particles with size ranging from 0.1 to 150 microns.
They are released into the atmosphere during crushing, grinding, abrading, loading and
unloading operations. Dusts are produced in a number of industries – mines, foundry quarry,
pottery, textile, wood or stone working industries. Dust particles larger than 10 microns
settle down from the air rapidly, while the smaller ones remain suspended indefinitely.
Particles smaller than 5 microns are directly inhaled into the lungs and are retained there.
This fraction of the dust is called ―respirable dust‖, and is mainly responsible for
pneumoconiosis.
 Dusts have been classified into inorganic and organic dusts. The inorganic dusts are silica,
mica, coal, asbestos dust, etc.; the organic dusts are cotton, jute and the like. They are
mainly the cause of pneumoconiosis. The most common dust diseases are silicosis,
asbestosis, anthracosis
(ii) Gases – Exposure to gases is a common hazard in industries. Gases are sometimes classified
as simple gases (e.g. oxygen, hydrogen), asphyxiating gases (e.g. carbon monoxide, cyanide
gas, sulphur dioxide, chlorine) and anesthetic gases (e.g. chloroform, ether,
trichlorethylene). Carbon monoxide hazard is frequently reported in coal-gas manufacturing
plants and steel industry.
(iii) Metals and their Compounds – A large number of metals and their compounds are used jn
industries. The chief mode of entry of some of them is by inhalation as dust or fumes. Lead,
antimony, arsenic, beryllium, cadmium, cobalt, manganese, mercury, phosphorus,
chromium, zinc are commonly used in industry. The ill-effects depend upon the duration of
exposure and the dose or concentration of exposure. Unlike the pneumoconiosis, most
chemical intoxications respond favourably to cessation, exposure and medical treatment.
3. Ingestion
Occupational diseases may also result from ingestion of chemical substances such as lead, mercury,
arsenic, zinc, chromium, cadmium, phosphorus, etc. Usually these substances are swallowed in
minute amounts through contaminated hands, food or cigarettes..
 Biological hazards
Workers may be exposed to infective and parasitic agents at the place of work. The
occupational diseases in this category are brucellosis, leptospirosis, anthrax, hydatidosis,
psittacosis, tetanus, encephalitis, fungal infections, schistosomiasis and a host of others.
Persons working among animal products (e.g. hair, wool, hides) and agricultural workers
are specially exposed to biological hazards.
 Mechanical hazards
The mechanical hazards in industry centre round machinery, protruding and moving parts
and the like. About 10% of accidents in industry are said to be due to mechanical causes.
 Psychosocial hazards
The psychosocial hazards arise from the workers‘ failure to adapt to an alien psychosocial
environment. Frustration, lack of job satisfaction, insecurity, poor human relationships,
 emotional tension are some of the psychosocial factors which may undermine both physical
and mental health of the workers. The health effects can be classified in two main categories
a) Psychological and behavioural changes – including hostility, aggressiveness,
anxiety, depression, tardiness, alcoholism, drug abuse, sickness absenteeism
b) Psychosomatic illhealth – including fatigue, headache; pain in the shoulders, neck
and back; propensity to peptic ulcer, hypertension, heart disease and rapid aging.
The physical factors (heat, noise, poor lighting) play a major role in adding to or
precipitating mental disorders among workers. The increasing stress on automation,
electronic operations and nuclear energy may introduce newer psychosocial health problems
in industry. Psychosocial hazards are there fore assuming more importance than physical or
chemical hazards.
Ergonomic Hazards:
Ergonomics is fitting the job to the worker. It is the science of fitting workplace conditions and job
demands to the capabilities of the working population. It is the study of man in his working
environment, to find a best fit between worker and job conditions.The aim of ergonomics to
promote efficiency, safety, and comfort of work through better relationship between man and his
tools and the work environment. The goal is to make sure workers are safe, comfortable and
uninjured as well as productive. Common ergonomic hazarads in workplace:
a) Work environment
 Vibrations  Repetitive and forceful motions
 Extreme Temperatures  Awkward positions
b) Improperly designed
 Workstations  Equipment
 Tools  Improper work method
Eeronomic disorders- Work Related Musculo-skeletal Disorders Usually refered as
 Chronic trauma disorders  Overuse syndrome
 Repetitive strain injuries  Wear and Tear Syndrome
 Repetitive motion injuries  Degenerative trauma disorders
 Repetitive trauma disorders
Control of Occupational Hazard
Following measures should be undertaken for hazard contorl:
1. Engineering controls.
2. Administrative controls.
3. Personal Protective Equipment.
 The most effective controls are engineering controls that physically change a machine or
work environment to prevent employee exposure to the hazard.
 The more reliable or less likely a hazard control can be circumvented, the better.
 If this is not feasible, administrative controls may be appropriate.
 This may involve changing how employees do their jobs.
 Discuss the recommendations with all employees who perform the job and consider their
responses carefully.
 If it is planned to introduce new or modified job procedures, be sure they understand what
they are required to do and the reasons for the changes.
Engineering controls include the following:
 Elimination/minimization of the hazard
 Substitution of equipment or process to decrease hazard
 Isolation of the hazard with interlocks, machine guards, blast shields, or other means;
and
 Removal or redirection of the hazard such as with local and exhaust ventilation.
Administrative controls include the following:
 Written operating procedures, work permits, and safe work practices;
 Exposure time limitations (used most commonly to control heat stress and ergonomic
hazards);
 Monitoring the use of highly hazardous materials;
 Alarms, signs, and warnings;
 Buddy system; and training
Personal Protective Equipment is acceptable as a control method in the following
circumstances:
 When engineering controls are not feasible or do not totally eliminate the hazard;
 While engineering controls are being developed;
 When safe work practices do not provide sufficient additional protection; and
 During emergencies when engineering controls may not be feasible
Hazard Symbols
There are many differents dangers when handling chemicals. Each chemical has a different hazard.
Some may be poisonous, cause‘s burns, catch fire easily or even explode. To warn us of the hazards
chemicals use hazard symbols. These symbols are used all over the world, so no matter what
language it‘s in you'll understand the hazard
Sign Charecteristics Description
Corrosive A substance that may destroy
living tissue on contact.
It causes a burn.

Flammable A substance that can catch fire

easily.

Oxidising This type of substance gives of a

large amount of heat when in
contact with other substances.

Explosive A substance that may explode if

it comes into contact with a
flame or heat. It may also
explode due to friction or shock.
Harmful A substance that may cause harm
in some way

Irritant A substance that may cause

irritation to the skin, eyes or
inside your body.

Toxic A substance that is poisonous if

swallowed or breathed in. It may
even go through your skin!

Biohazard These are living organisms that

may cause infection.

Radiation. These substances are radioactive.

Radiation can damage cells and
cause cancer
 SESSION 5 : Occupational Diseases
(General) and Accident & Injury

Summery:
An occupational disease is a health problem caused by exposure to a workplace health hazard. For
occurrence of occupational diseases causal agents must be present in the workplace. To diagnose
occupational disease occuipational history of the patient is very important. To provide right
information on these issues an effort has been made to encompass in this session so that the
particapnts can diagnose the disseases properly

Objectives of the Session:

At the end of the session the participants will be able to describe:
- What is occupational diseases
- Types of occupational disesases
- Clinical features, diagnosis, management and preventive measures of different

Session 5
occupational diseases

Duration: 90 min

Method:
 Lecture, Multimedia Presentsion
 Presentation and discussion
 Feed back

Materials:
Multimedia, Handouts
 Occupational Diseases
(General) and Accident & Injury
Diseases
Occupational Diseases
An occupational disease is a disease or disorder that is caused by the work or working conditions. It
is a health problem caused by exposure to a workplace health hazard. According to ILO the term
―occupational disease‖ covers any disease contracted as a result of an exposure to risk factors
arising from work activity. Legally Occupational diseases are usually referred as “diseases arising
out of or in the course of employment.” Occupational diseases cover all pathological conditions
induced by prolonged work such as excessive exertion or exposure to harmful factors inherent in
materials, equipment or the working environment.
In occupational diseases there is always a direct causal relationship between work hazards, which
are in excess of tolerable limits and the disease process. The diseases the whose primary cause is a
physical, chemical or biological factor at the workplace and are eligible for compensation as
occupational diseases. Two main elements are present in the definition of an occupational disease:
 the causal relationship between exposure in a specific working environment or work activity
and a specific disease; and
 the fact that the disease occurs among a group of exposed persons with a frequency above the
average morbidity of the rest of the population.
Work Related Disease comprises all diseases presenting in the working population, in which "work
environment and the performance of work contribute significantly, but as one of a number of
factors, to the causation of disease". The diseases aggravated by work or having a higher incidence
owing to conditions of work. In work related disease there is multiple causal agents, where factors
in the work environment may play a role together with other risk factors, in the development of
such diseases. In Industrialized countries the traditional occupational diseases are rare. Work-
related diseases are becoming important. e.g
- Work a contributory cause- Coronary heart disease
- Work provoking a latent or aggravating an established condition-Peptic ulcer, Eczema, asthma
The effect that occupation may have on a worker's health is dependent on the exposure to
 relevant agents, and on host factors. Taking a history is often very important in identifying
relevant exposures and linking them to ill-health. .
Occupational lung disease is first in the list of National Institute of Occupational Safety & Health
(NIOSH). Silicosis, asbestosis and byssinosis are still prevalent in many parts of the world. NISOH
considers occupational cancer to be the second leading work-related disease, followed by cardio-
vascular diseases disorder of reproduction, neurotoxicity, noise induced hearing loss,
dermatological conditions, and psychological disorders. The most important occupational cause of
mortality and morbidity in workers is accidental injury. Each year about 5000 workers are killed,
injured and impaired due to industrial accidents in Bangladesh. Major occupational diseases can be
divided in following categories for better understanding
a) Occupational injuries e) Occupational Infections
b) Occupational lung diseases f) Occupation toxicology
c) Occupational cancers g) Occupational mental disorders
d) Occupational dermatitis h) Others
Some examples of occupational disease according to organ involve (starting with the lungs and
skin, the organs of first contact for most chemical occupational exposures).
Organ Disorders Exposure substances
Skin Eczema/ dermatitis Chemicals , allergic substances, etc
Cancer Sunlight, carcinogenic chemicals, toxic metals ,
petroleum oil , radiation etc
Lung Asthma Food grain, metal and organic and inorganic chemical
dust , di-isocyanates glutaraldehyde exposure
Pneumoconiosis Cotton dust, silica dust , coal dust
Cancer, mesothelioma Asbestos exposure and others contaminants
Musculoskeletal Back disorder , Manual handling Repetitive trauma , ergonomic issue ,
upper limb disorder workload etc
Nervous system Peripheral neuropathy Lead or hexane exposure etc
and mental Hearing loss Noise exposure
Stress Psychosocial factor , mercury exposure etc
Blood and bone Anemia Lead exposure
marrow disease Aplastic anemia Benzene and other toxic chemicals and gases
Leukemia Benzene
Genitourinary Kidney damage some solvent exposures, cadmium and other exposure
and endocrine Bladder cancer aromatic aminesnaphthylamine and organic compound
Infertility Endocrine disruption due to Organo phosphates, etc
Liver Hepataitis Toxic chemical and viral exposure
Cancer Vinyl chloride monomer
List of occupational disease (3rd schedule, section 150) and Notifiable occupational disease (2 nd
schedule, section 82 & 83) in the Bangladesh Labour Law -2006

List of Occupational disease List of Notifiable Occupational Disease

1. Anthrax 1. Lead poisoning
2. COPD/ Occupational asthma 2. Tetraethyl Lead poisoning
3. Tetraethyl Lead poisoning 3. Phosphorous poisoning
4. Mercury poisoning
4. Nitrous fume poisoning
5. Mica/talc poisoning
5. Manganese poisoning 6. Arsenic poisoning
6. Carbon- disulphide poisoning 7. Alcohol fume poisoning
7. Tetraphlorythene poisoning 8. Carbon- disulphide poisoning
8. Pesticides poisoning 9. Benzene and its bi product poisoning
9. Laptospera ectero hemorrhagic 10. Chrome ulcer
10. Dinitrophenol poisoning 11. Anthrax
12. Silicosis
11. Trychrisil phosphate poisoning
13. Halogens poisonings
12. Chrome ulcer 14. X-ray, radium or others radio active
13. Melted glass and metalic glow induced 15. induce disease
infection 16. Primary epithelial cancer of skin
14. Beryllium poisoning 17. Poisoning induce Anemia
15. Primary carcinoma of lung , sinus, bronchus 18. Poisoning induce jaundice
16. Papilloma of urinary bladder 19. Skin irritation and acne due to
mineral oil
17. Lead poisoning 20. Byssinosis
18. Phosphorous poisoning 21. Asbestosis
19. Mercury poisoning 22. Skin irritation / allergies due contact
20. Benzene and its bi product poisoning with
21. Primary epithelial cancer of skin chemical and dye
22. x-ray, radium or others radio active induce \ 23. Noise induced deafness
24. Beryllium poisoning
23. disease
25. Carbon monoxide poisoning
24. Arsenic poisoning 26. Pneumoconiosis in coal miners
25. Silicosis 27. Phosgene gas poisoning
26. Byssinosis 28. Occupational cancer
27. Asbestosis 29. Isocyanides poisoning
28. Pneumoconiosis in coal miners 30. Kidney infection due to poisoning
29. Bagassosis 31. Vibration syndrome
30. Muscle contraction of writers
31. Muscle contraction of twister (cotton)
32. Nystagmus of mine workers
33. Skin irritation
34. Lung fibrosis
Occupational Deafness
Occupational hearing loss or deafness is damage to the inner ear from noise due to certain types of
jobs. Occupational hearing loss means prolonged exposure to injurious noise in employment.
Occupational hearing loss is a form of acoustic trauma caused by exposure to loud noise.
Causes
Exposure to sounds above 90 decibels (dB) for a long time may cause vibration intense enough to
damage the inner ear. In Industry, the worker normally should not be exposed to > 90 dB in 8
hours duty. Continuous noise exposure throughout the workday and over years is more damaging
than interrupted exposure to noise. Workers of Construction, Farming jobs involving loud music,
Airline ground maintenance, Steel engineering, Saw mills, Stone crushing, Furniture Shops, and
Automobile repairing shops etc are exposed to high noise pollution.
Permissible Noise Exposure in Occupation
Duration (hrs) dBA
8 90
6 92
4 95
2 100
1 105
Effects of Noise on Human Health
Duration of the adverse effects of noise is proportional to the duration of exposure and appears to
be related to the total amount of energy reaching the inner ear. Impulsive noise is harmful,
particularly one or more bursts of sound energy of less than one second‘s duration.
Auditory Effects:
• Tinnitus or Ringing
• Temporary Hearing loss- reversible
• Permanent Hearing loss- irreversible
Non-Auditory Effect:
• Palpitation • Muscle spasm
• Variations in Pressure • Annoyance
• Increase Gastric Motility, Peptic ulcer • Fatigue
• Increase Secretion of many Hormones • Decrease Efficiency
Hearing effects:
• Temporary Threshold Shift in hearing occurs immediately after exposure to significant loud
sounds. Quiet sounds no longer can be heard, and the condition may last for minutes to
hours. The hair cells in the hearing organ become reversibly desensitized.
• Permanent Noise Induced hearing loss results from long-term exposure to loud noises,
particularly higher pitched noises. Hearing loss due to continuous or intermittent
noise exposure increases most rapidly during the first 10 to 15 years of exposure,
and the rate of hearing loss then decelerates as the hearing threshold increases. It is
irreversible as it results in the destruction of the hair cells in the hearing organ.
• Tinnitus or ‗ringing in the ears‘ sometimes accompanies noise induced hearing loss. It may
manifest as ringing, clicking, continuous tones and be extremely distraction or even
tormenting.
• Acoustic trauma, resulting from explosion or exceedingly loud impulses which may destroy
hair cells and the ear architecture.
Examination and Tests
A physical examination will not usually show any specific changes. Tests that may be performed
include: Audiology/audiometry. The instrument used-
Sound Measurement –Sound Level Meter (SLM), Noise Dosimeter
Hearing Test- Audiometer
Prevention
Occupational hearing loss is preventable. All individuals should understand the hazards of noise
and how to practice good hearing health in everyday life. To protect the hearing loss
 Reduction of noise at the source by engineering method substitution, damping, cushion
impact. Noisy machinery or equipment may be covered with insulating material
 Use of PPE like earmuffs, ear plug etc.
 Regulations and enforcement to reduce noise etc. Regular monitoring of noise of level
 Education of the workers about noises that can cause damage
 Pre-employment and Periodical examination of the workers for hearing status
Heat Stress in Work Place
Operations involving high air temperatures, radiant heat sources, high humidity, direct physical
contact with hot objects, or strenuous physical activities have a high potential for causing heat-
related illness. Workplaces with these conditions may include iron and steel foundries, nonferrous
foundries, brick-firing and ceramic plants, glass products facilities, rubber products factories,
electrical utilities (particularly boiler rooms), bakeries, confectioneries, commercial kitchens,
laundries, food canneries, chemical plants, mining sites, smelters, and steam tunnels. Excessive
exposure to heat can cause a range of heat-related illnesses, from heat rash and heat cramps to heat
exhaustion and heat stroke. Heat stroke can result in death and requires immediate medical
attention.
Heat Stress Effect
Excess of heat can cause ill-effects as follows:
Prolonged exposure to heat or high temperature may lead to-
a) either excessive fluid loss and or salt loss.
b) failure of heat mechanism
Ill Effects are:
 Heat cramps  Heat Syncope
 Heat exhaustion  Heat Hyper-pyrexia
 Heat stroke  Prickly Heat etc.
Heat cramps
Hot ctamp may occur among workers who do hard physical work in hot places. This cuases
excessive loss of water and sodium chloride from the body through sweating. This usually occurs
during manual labour at high temperature. Onset is abrupt.
• Pain usually first occur at extremities, cramps occur in abdominal muscle.
• The skin may hot and dry
• Relief can be obtained by giving the person a salt solution or I/v saline.
Heat exhaustion –
Excessive sweating may cause excessive fluid loss and may lead to hypo-volumic shock The
worker may complain of weakness tiredness, dizziness and faintness. He may faint, and have
diarrhoea and vomiting.
• There may be circulatory collapse with slow thready pulse, imperceptible BP, cold, clammy
& pale skin, temperature below normal level.
• The patient may be unconscious.
• Management: Patient should be kept flat, assurance, small amount cool, slightly salty fluid
may be given orally.
Heat stroke
Due to inadequate or failure of heat loss mechanism, hyper-pyrexia occurs. Onset is abrupt with or
without headache, vertigo, fatigue.
• Absence or cessation of sweating (key sign) with hot flush dry skin.
• Pulse rapid (100-160), respiration increase, BP usually unaffected. Temperature rises
rapidly 400 to 410c.
• The worker may suddenly lose consciousness & become blue.
• Medical treatment must be sought, if needed hospitalized,
• Should be wrapped in clothing or bedding. However, temperature should not be allowed to
fall 38.50c (101 F) for avoiding hypothermia.
• Electrolytes, fluid, bed rest for few days for convulsion diazepam may be given
Heatstroke is classified as a medical crisis that happens when over exposure to extreme heat (not
always direct sunlight) overcomes the inner heat-regulating device. As a result, the protective
sweating response will stop functioning, although sweat evaporating on the surface of the skin is
one of the main reasons for dispelling excess heat.
Cause of Heat Stroke
 Extended exposure to high humidity and hot climates.
 Lack of fluids or dehydration
 Performing demanding work or exercising in hot temperatures.
 Older adults are at a higher risk for heatstroke since inner temperature-regulating devices
will not be as responsive; people who are overweight because heat is retained in additional
layers of fat on the body.
 A current dehydrating sickness (one where diarrhea or extreme vomiting was involved) will
increase vulnerability.
Heat Hyper–pyrexia
Due to inadequate or failure of heat regulating mechanism hyper-pyrexia occurs. Temperature
above 1060F, but without characteristics sign and symptoms of heat stroke.
Heat Syncope:
This is a common effect of heat. A person standing under sun become pale, blood pressure falls,
and collapse. Usually no rise of body temperature. It is common among the persons who work
under sun
How can heat-related illness be prevented?
Heat-related illnesses can be prevented by reducing heat exposure from the work environment
 Engineering controls- such as air conditioning and ventilation, that make the work
environment cooler
 Work practices- such as periodical work rest, drinking water often, and providing an
opportunity for workers to build up a level of tolerance to working in the heat.
 Worker- Use of proper and light clothing, prevent heat effects by taking sufficient salt and
water where heat is excessive
 Employers- should include the prevention steps in worksite training and plans and aware
symptoms of heat-related illness during hot weather. Plan for an emergency and what to do
quickly during emergency can save lives!

Vibration Related Illness

Employees in the construction sector are frequently exposed to vibration at work. As well as
reducing their performance, vibration also damages their health. Efforts have been made both by
legislators and the manufacturers of machinery to cut the risks. The main sources of vibration are
an unbalanced mass of rotating parts, friction between machine components and bearings, and
shocks caused by internal and external forces. Vibration, which is either hand-arm or whole-body,
is generally transmitted to the human body through the hands, buttocks, back or feet.
Hand-arm vibration syndrome
Hand-arm vibration syndrome (HAVS) is a pattern of damage to the blood vessels and nerves in the
fingers following exposure to vibration. Miners and construction workers mainly affect by this
syndrome.
Sign symptoms
The fingers or fingertips go white in cold conditions. Colour returns when the blood flow is
restored, often with painful ‗cold aches‘. Numbness, tingling and reduced sense of touch result
from damage to the sense cell in the fingers. Early effects include tingling after using vibrating
tools. Late effects include severe and permanent damage to the flesh of the fingers, particularly the
fingertips
Other effects
Hand-arm vibration can also affect the muscles, bones and joints in the arms. Arthritis is more
common in affected joints. Pressure on the nerves in the wrist can occur, resulting in numbness in
the hands. Carpal tunnel syndrome is a recognised effect of vibration.
Diagnosis
Tests cover the sensitivity of the fingers to edges, temperature changes and vibrations. A simple test
with a widening groove can be done by anyone with an interest. Tests for blanching are not yet
reliable; if blanching occurs when the fingers or body are exposed to cold this is strong
confirmation of HAVS, but if blanching does not occur the negative result does not rule out white
finger
Rehabilitation
Continued exposure makes HAVS worse. Stopping exposure can lead to small improvements to the
circulation of the hand over a period of years. However, if there is evidence of nerve damage this is
largely irreversible. So introducing better equipment or changing tasks is essential. Moderate to
severe HAVS is a disability and under disability, must change to suitable alternative work
Prevention of Vibration Risks
Reduction of whole-body vibration
 Selection of new machine by testing vibration
 Smooth road surface
 Suspension seats
Reduction of hand-arm vibration
 Replacing the current work procedure  Suitable tool attachments
 Anti-vibration handles  Reduction of grip and feed forces
 Auto balancers  Anti-vibration gloves
 Mass balancing
Occupational Stress
Stress is simply a fact of nature -- forces from the inside or outside world affecting the individual.
Causes of work stress
There is no single cause of work-related stress, multiple numbers of factors related to stress in
workplace stressed at work, including:
 poor working conditions  lack of job security
 Mandatory overtime  difficult journeys to and from work
 Understaffing  relationships with colleagues
 Downsizing/Privatization  mismatch
 WorkerParticipation schemes  inflexible working hours
 Shift work/Rotating schedules  too much or too little responsibility
 Contingent work (e.g. part-time or temporary)  Violence/Harassment

Symptoms of work stress

Physical symptoms include Psychological symptoms includes
 Headaches  Anxiety
 muscular tension  Irritability
 backache and/or neck ache  Low morale
 tiredness and sleep problems  Depression
 digestive problems  Alcohol & drug use
 a raised heart rate  Feeling powerless
 sweating  Isolation from co-worker
Stress Management
 Ensure comfortable work environment with the help of organizer
 Avoid long working hour
 Respectable relationship with colleagues
 removing or changing the source of stress
 Learning alternative ways of coping.
 Medicines drugs for anxiety
 Cognitive Behavioral Therapy (CBT)
Occupational Musculoskeletal Disorders
Occupational Musculoskeletal Disorders often called as Work-related musculoskeletal disorders are
a group of painful disorders of muscles, tendons, and nerves. Some examples of Occupational
Musculoskeletal Disorders are Carpal tunnel syndrome, tendonitis, thoracic outlet syndrome, and
tension neck syndrome. Work activities which are frequent and repetitive, or activities with
awkward postures cause these disorders and may be painful during work or at rest.
Almost all work requires the use of the arms and hands. Therefore, most Occupational
Musculoskeletal Disorders affect the hands, wrists, elbows, neck, and shoulders. Work using the
legs can lead to Occupational Musculoskeletal Disorders of the legs, hips, ankles, and feet. Some
back problems also result from repetitive activities. The other names Occupational Musculoskeletal
Disorders are-
 Repetitive motion injuries  Overuse syndrome
 Repetitive strain injuries  Regional musculoskeletal disorders
 Cumulative trauma disorders  Soft tissue disorders
 Occupational cervicobrachial disorders

Factors responsible for Occupational Musculoskeletal Disorders

The occupational risk factors are mostly ergonomical factors, which include continual repetition of
movements, fixed body positions, forces concentrated on small parts of the body, and lack of
sufficient rest between tasks. Occupational Musculoskeletal Disorders may arise from ordinary arm
and hand movements such as bending, straightening, gripping, holding, twisting, clenching and
reaching. These common movements are not particularly harmful in the ordinary activities of daily
life. but continual repetition in work, often in a forceful manner, and most of all, the speed of the
movements and the lack of time for recovery between them causes Musculoskeletal Disorders.
Heat, cold and vibration also contribute to the development of musculoskeletal disorders.
Musculoskeletal Disorders which are associated with work patterns that include:
 Fixed or constrained body positions
 Continual repetition of movements
 Force concentrated on small parts of the body, such as the hand or wrist
 A pace of work that does not allow sufficient recovery between movements
Occupational Musculoskeletal Disorders do not occur as a result of a single accident or injury.
Rather, they develop gradually as a result of repeated trauma. Excessive stretching of muscles and
tendons can cause injuries that only last a short time. But repeated episodes of stretching causing
tissue inflammation can lead to long-lasting injury or musculoskeletal disorders.
Musculoskeletal Disorders include three types of injuries:
 muscle injury
 tendon injury
 nerve injury
Some important factors contributing to Musculoskeletal Disorders
Factor Result/consequence Example Good practice
Exertion of high Acute overloading of Lifting, carrying, Avoid manual handling
intensify forces the tissues pushing, pulling heavy of heavy objects
objects
Handling heavy Degenerative disease Manual materials Reduce mass of objects
loads over long especially of the lumber handling or number of handlings
period of time spine per day
Frequently repeated Fatigue and overload of Assembly work long Reduce repetition
manipulation of muscular structures time typing , check- frequency
objects out work
Working in Overload of skeletal and Working with heavily Working with and
unfavorable posture muscular elements bent or twisted trunk , upright trunk and the
or hands and arms arms close to the body
above shoulders
Static muscular load Long lasting muscular Working overload , Repeated change
activity and possible working in a confined between activation and
overload space relaxation of muscles
Muscular activity Loss of functional Long term sitting Repeated standing up,
capacity of muscles. with low muscular stretching of muscles ,
tendon and bones demands remedial gymnastics, etc
Monotonous Unspecific complaints Repeated activation Repeated interruption
repetitive in the upper extremities of the same muscles of activity and pauses
manipulations without relaxation alternating tasks
Application of Dysfunction of nerves Use of vibrating Use of vibration –
vibration reduced blood flow, hand-tools , sitting on attenuating tools and
degenerative disorder vibrating vehicles seats
Physical Interaction with Use of had held tools Use gloves and heated
environment factors mechanical load at low temperatures tools at low temperature
Psychological Augmentation of High time pressure , Job rotation , job
factors physical strain , increase low job decision enrichment , reduction
in absence from work latitude , low social of negative social
support factors
Sign & Symptoms of Occupational Musculoskeletal Disorders
Pain is the most common symptom associated with Occupational Musculoskeletal Disorders. In
some cases there may be joint stiffness, muscle tightness, redness and swelling of the affected area.
Some workers may also experience sensations of "pins and needles," numbness, skin colour
changes, and decreased sweating of the hands.Occupational Musculoskeletal Disorders may
progress in stages from mild to severe.
Early stage: Aching and tiredness of the affected limb occur during the work shift but disappear at
night and during days off work. No reduction of work performance.
Intermediate stage: Aching and tiredness occur early in the work shift and persist at night.
Reduced capacity for repetitive work.
Late stage: Aching, fatigue, and weakness persist at rest. Inability to sleep and to perform light
duties.
Management of Occupational Musculoskeletal Disorders
The management of Occupational Musculoskeletal Disorders involves several approaches including
the following:
 Restriction of movement  Exercise
 Application of heat or cold  Medication and surgery

Preventive Measures for Occupational Musculoskeletal Disorders

Work place Hazards – Hazards responsible for Occupational Musculoskeletal Disorders (MSD)
should be eliminated or reduced. The source of hazard in work are the repetitiveness of work,
applied force, fixed body positions, the pace of work requiring repetition of the same movements
over and over again etc should be avoided through job design which may include mechanization,
job rotation, job enlargement and enrichment or teamwork. Where elimination of the repetitive
patterns of work is not practical, prevention strategies involving workplace layout, tool and
equipment design, and work practices should be considered.
Training of Workers- Training should be provided for workers who are involved in jobs that
include repetitive tasks. Workers need to know how to adjust workstations to fit the tasks and their
individual needs. Training should also emphasize the importance of rest periods and teach how to
take advantage of short periods of time between tasks to relax the muscles, and how to consciously
control muscle tension throughout the whole work shift. To make the preventive and control
measures, truly effective, require significant involvement on the part of the workers, their
representatives, and management to improve occupational health and safety

Occupational Accident and Injuries

An accident may be defined as an unexpected, unplanned occurrence, which may involve injury.
Occupational accident is the accident arising out of and in the course of employment. Every year,
throughout the world, millions of industrial accidents occur. Some of them are fatal and some result
in permanent disablement, complete or partial, the great majority cause only temporary disablement
An occupational injury is an injury that happened while working or as a result of the work.
Common causes of industrial injury are poor ergonomics, manual handling of heavy loads, misuse
or failure of equipment, exposure to general hazards, inadequate safety training and clothing,
jewellery or long hair that becomes tangled in machinery. General hazards in a work environment,
exposure to which results accident and injuries such as electricity, explosive, materials, fire,
flammable, gases, heat, height, high pressure gases and liquids, hot gases and liquids, powerful or
sharp moving machinery, oxygen-free gases or spaces, poisonous, gases, radiation, toxic materials,
work on, near or under water,, work on, near or under weak or heavy structures.
Situation in Bangladesh:
• In Bangladesh, all occupational accidents are legally reportable to the chief inspector of factory
according to Factories Act. 1965 (Labour Law 2006). But all accidents are not generally
reported, large and formal factories usually sent the accident report. However general tendency
is not to reporting any accident There are standardized national reporting form. But all accidents
are not generally reported to the Department of Inspection so, under reporting is usual.
• In Workmen‘s Compensation Act of Bangladesh occupational diseases are defined as diseases
arising out of or in the course of employment, and 36 occupational diseases and accidents are
listed in this act for Compensation payable
• Workmen’s Compensation Act of Bangladesh: Occupational Injuries- caused by an accident
arising out of and in the course of employment
Fatal and Serious Injuries/Accidents- when there occurs in any factory an accident to any
person which results in death or such injury that there is no reasonable prospect that he will be
able to resume his employment in the factory within 20 days, such accidents shall be called as
Fatal or Serious as the case may be.
 Minor Injuries/Accidents- when there occurs in any factory an accident to any person less
serious than those described as above (fatal or serious injury) about which prevents or is likely
to prevent him from resuming the employment in the factor within 48 hour after the accident
occurred, such accidents shall be called as Minor Accidents
Causes of Accident

Prime movers: (Engine, pump, compressor fan and blower etc.)

- entanglement of clothing, hair, jewelry etc. trapping of any part of the body between
running nips between belts and pulleys, gea wheels, rollers etc.
Working Machinery: Lather, Press, saw, drill etc
- . power, presses, garment press,etc.
- trapping by moving part of the machine e.g. paper metal cutting guillotine, metal and
wood cutting saws etc.
Lifting machinery: (Elevators and hoisting machine)
 faulty lifting technique  failure of hoists and cranes and
 load too heavy or over loaded  other lifting machinery
Falling objects:
 inadequately protected heavy objects  badly stacked materials and goods
 elevated floor
Falls:
 badly maintained uneven  unprotected openings in floor
or slippery floors  insufficient lighting
 unsuitable foot wear  poor housekeeping
 defective of insecure ladders
Rolling stock:
 overcrowding premises  poor housekeeping
 stores in gangways  poor lighting
Electricity:
 failure to provide or  poor electrical fittings
 maintain efficient earthling .  over loaded power line
Burning and Explosives:
- misuse of gas-burning equipment and gas cylinders
- welding or cutting of vessels containing flammable vapour or liquid
- smoking
Hand tools: (axe, chisel, file, knife, hammer etc.)
- defective and unsuitable hand tools
- in adequately maintained or misused hand tools
- failure to wear personal Protective Equipment (PPE)
Others:
 plant and machinery failures:  untrained drivers/ operator
 works transport accident  obstructed gang ways etc
(delivery lorries and vans etc)
 over loaded or misused
Factors Responsible for the Occurrence of Accidents
Human factors:
Physical factors - age and sex
Psycho-social factors-
 education
 inattentiveness
 slow cerebrations
 job satisfactions
 carelessnes
 fatigue
 lack of experience
 overconfidence
Lack of knowledge regarding-
 machine unuse,  poor ventilation
 weaknesses of machinery  noise
 defects of machine  bad weather
 materials used etc.  poor housekeeping
 environment, surrounding hazards  dust
 general safety instructions  lack of familiarity of working
Environmental factors: enviromentment
 poor lighting
 discomfort humidity,
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Common Occupational Injuries

It is difficult to categorize the common occupational injury. Occupational injuries depend upon
various factors which varies industry to industry. However, some are more common than others.
For example, back and neck injuries are extremely common. Workers can sustain injuries from
lifting or moving heavy objects.
 Strains and sprains are damage to the tendons
 Facet joint pain results from irritation of the area where the ribs meet the spinal column.
 Disk erosion occurs from prolonged pressure on the spinal disks, which causes them to
become permanently compressed.
 Sciatic nerve impingement, also called sciatica, is common for people who sit for prolonged
periods of time.

Prevention and Control of Accident

There are many methods of preventing or reducing industrial injuries, including anticipation of
problems by risk assessment, safety training, control banding, personal protective equipment safety
guards, mechanisms on machinery, and safety barriers. In addition, past problems can be analyzed
to find their root causes by using a technique called root cause analysis.
Principles of accident prevention-
A. Identification and elimination of hazards
- all accidents should be carefully investigated to find all those factors and circumstances
which contributes to the accident
- periodical survey
- carefully reporting and recording
- eliminations of hazards factors
B. Physical measures to improve work situation
- machineries of risk machinery
- maintenance of plant equipment and building ]
- to secure machinery by guarding to the best
- good housekeeping and cleanliness
- maintenance of good environmental conditions to such as lighting, humidity,etc.
- avoidance of over crowding

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C. Medical measures:
- adequate preplacement examination
- periodical medical examination
D. Training Information and Motivation
- adequate job training, motivation, orientation training any continuing health education
- health education material regarding safety measures.
- establishment of safety committee
E. Legislation
- for proper observance of the rules and regulation
- for successfulness of health and safety programme.

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SESSION 7 : Occupational Diseases

(Sector wise specific diseases)

Summery:
Some occupational diseases are common in most of the sectors and usually these dieases occurred
due to physical and ergonomic hazards in workplace. But some occupational disease are very
specific, becuase the cuasal agent is present only in the respective industry. To diagnose these
occupational diseases the causal agent must be identified in the particular industry. In this session
the occupational diseases relted to Textile industryl, Jute industry, Ceramic industry and Garment
industry will be discussed. This will help the participants to diagnose the occupational diseases in
the particular industry correctly and quickly.

Objectives of the Session:

At the end of the session the participants will be able to describe:

Session 7
- occupational diseases relted to Textile industryl, Jute industry, Ceramic industry
- specific causal agents for particular occupational disease
- diagnostic criteria of the particular occupational diseases

Duration: 120 min

Method:
 Lecture, Multimedia Presentsion
 Presentation and discussion
 Feed back

Materials:
Multimedia, Handouts

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Occupational Diseases- Sectorwise

(Sector wise specific
diseases)
Occupational Lung Disorders
nal Diseases Diseases
The diseases, which occur in the respiratory tract due to reaction to an inhaled agent or responses in
work or work environment. The following are the most common symptoms of occupational lung
diseases, regardless of the cause. However, each individual may experience symptoms differently.
Symptoms may include:
 coughing  chest tightness
 shortness of breath  abnormal breathing pattern
 chest pain
Occupational lung disease comprises a wide variety of disorders caused by the inhalation or
ingestion of dust particles or noxious chemicals. The occupational lung disorders include:
1. IRRITATIVE LUNG INJURIES – caused by irritants to the airways causing a burning
sensation in the nose and throat, pain in the chest, coughing and producing inflammation of the
mucosa (tracheistis, bronchitis) edema. Caused by gases such as chlorine, fluorine, sulphur
dioxide, phosgene and nitrogen, mists of acids, alkali, fumes of cadmium, dust of zinc chloride.
2. HYPERSENSITIVITY REACTIONS: as a result of repeated contact with an agent.
There are two main types- bronchial asthma and extrinsic allergic alveoli. (e.g. Byssinosis and
Berylliosis)
3. PNEUMOCONIOSIS - Fibrogenic minerals – reaction in the lung tissue causing scarring of
the lungs (examples include silicosis, asbestosis, and coal workers‘ pneumoconiosis
4. LUNG INFECTIONS-tuberculosis, anthrax, brucellosis, histoplasmosis, legionnaires‘ disease,
5. CANCER – chromates, particles containing polycyclic aromatic hydrocarbons and certain
nickel-bearing dusts and asbestos fibers etc.

Occupational Asthma
Asthma is a chronic lung disease characterized by reversible inflammation of the airways (bronchi).
Occupational asthma caused by sensitising agents and irritants in work environment. Occupational
asthma is characterised by:

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a. acute reversible obstruction of the airways caused by bronchoconstriction, airway oedema or

inflammation; and
b. mucous excretion induced by exposure to agents inherent in the work processes. Clinically,
these disorders do not differ from other types of asthma. In some circumstances the same
agents may cause allergic alveolitis
Most of the sensitising agents stimulate, after repeated exposure, the production of specific
antibodies which trigger the asthmatic reaction.
• Symptoms usually begin several weeks after exposure begins.
• Early in the syndrome, the patient may just notice a dry cough.
• Patient may not be continuously exposed to provoking antigen.
In an already sensitised individual, the asthmatic reaction usually starts within a few minutes after
exposure, but delayed reaction some four to eight hours after exposure i.e. after the shift or at night
– may also occur, sometimes in combination with the immediate reaction. Recovery may take more
than 24 hours.
Irritants causes asthma by direct tissue injury. No previous sensitisation is needed. Asthmatic
attacks usually develop during or immediately after the exposure, however some of the irritants (e.
g. phosgene or oxides of nitrogen) may induce effects after a latency of several hours.
The asthmatic condition is characterised by
 transitory chest tightness,
 shortness o breath,
 wheezing and lung function impairment.
Symptoms and signs of occupational asthma
Wheezing, shortness of breath, and chest tightness weeks to years after workplace exposure. Often,
runny nose (rhinorrhea) and inflammation of the lining around the eyes (conjunctivitis) cough with
or without phlegm (sputum).
Diagnosis
 History  Lung function test
 Physical examination  Tests for specific lung irritant
 Chest X-ray
Treatment
 Avoid of exposure  bronchodilators

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 Changing jobs or changing the particular duty at  Respiratory masks

the workplace
Prevention:
 Identification of highly susceptible workers and locating them to areas without exposure to
known sensitizers.
 Medical surveillance and examinations- The medical examination should include a medical
history (with special) attention to possible skin and respiratory allergy, a physical examination,
and simple lung function tests.
 Limitation of exposure to potential respiratory irritants among those with pre-existing asthma to
reduce work-related aggravation of asthma.
 Use of engineering controls, such as elimination of a responsible agent, substitution with a safer
substance/chemical, ventilation, process or equipment modification, process enclosure, dust
reduction techniques, housekeeping and work practices.
 Administrative controls to reduce number of workers exposed or duration of exposure, e.g. job
rotation, rest periods, and shift or location changes where fewer people are working with
sensitizers or irritant exposures.
 Personal Protective Equipment particularly respirators, mask etc. may be necessary in some
opeations.

Pneumoconiosis
Pneumoconiosis is a group of interstitial lung diseases caused by inhaled dust particles in industry.
It is a disease of chronic fibrosis and caused by prolonged inhalation of mineral dusts, especially
silica and asbestos. It is seen in specific occupations such as coal mining, ceramic and construction
industries where the concentration of dust particles is very high. The most common types of
pneumoconiosis include silicosis, asbestosis and coal worker‘s pneumoconiosis. Other form of
silicosis can be caused by prolonged inhalation of some mineral dust.
Inhaled dust collects in the alveoli, or air sacs, of the lung, causing an inflammatory reaction in the
lung tissue. Which causes scarring and thickening of normal lung tissue and results in fibrosis, and
thus reduces the elasticity of the lung. If enough scar tissue forms, lung function is seriously
impaired, and the clinical symptoms of pneumoconiosis are manifested.
Sign and Symptoms

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Pneumoconiosis usually takes more than 10 years of exposure to develop, workers often do not
notice symptoms until they work for long time. A person with pneumoconiosis initially may not
show any symptoms. Subsequently, he/she develop symptoms due to due to deceased oxygen
circulating in the blood, respiratory and heart failure. Typically, the early symptoms of mild
pneumoconiosis include chest tightness, shortness of breath, and cough, progressing to more
serious breathing impairment, chronic bronchitis, and emphysema in the most severe cases. In
severe caese the symptoms include –
 Cough,  Wheezing,
 Shortness of breath,  Bluish coloration of the skin
 Chest pain,  Swelling of feet
 Difficulty breathing  Liver enlargement due to heart failure.
Diagnosis
 Radiological examination  History of exposure
 Lung function tests  Physical examination
 Radiological tests  Bronchoscopy

Treatment and prevention

There is no treatment for pneumoconiosis, because the dust cannot be removed from the lungs.
Except in a mild form called simple pneumoconiosis, the disease is progressively disabling. The
only treatment is to avoid smoking and further exposure to dust, and to treat complications. It is
important to diagnose pneumoconiosis early to prevent further complications. There is some
supportive treatment, which includes- corticosteroids and oxygen treatment
Prevention
Pneumoconiosis can be prevented by controlling dust through enforcing maximum allowable dust
levels in industries, mines and at other work sites, and by using protective masks. Regular medical
examinations, including chest x-rays for people at risk, can detect pneumoconiosis during its earlier
stages, before it becomes disabling.

.Silicosis
Silicosis is an occupational lung disease caused by inhalation of silica dust in a industry where
silica dust is used as raw materials. Silicosis is marked by the formation of nodules and fibrous scar
tissue in the lungs. When crystalline silica (a component of silica dust) is inhaled, it causes

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inflammation of the lung tissue. This inflammation leads to scar tissue formation on the lungs. The
scar tissue obstructs the flow of oxygen into the lungs and into the bloodstream. If silicosis is left
untreated it may cause occurrence of tuberculosis and eventual result in death. Silicosis typically
affects workers in the following professions: construction workers, ceramic workers, foundry
workers, concrete blasters and cutters, pottery workers, miners workers, glass workers, welders etc.
Silica is found in granite, sandstone, limestone, and is the principle component of sand. Crystalline
or free silica is the form, which is most likely to produce harmful effects
Silicosis usually develop after 10 or more years exposure. In some cases acute silicosis may
develop within 5 years of exposure with large amount of silca exposure. The development of
silicosis depends on:
 Dust Concentration  Size of particles (respirable gut)
 Percent of free silica  Shape of particles
 Duration of exposure  Physio-Chemical reaction of particles
Patients with chronic disease may be asymptomatic with an abnormal chest radiograph or have
dyspnea. In some cases, the onset of dyspnea signifies a complication, such as progressive massive
fibrosis (PMF), tuberculosis, or airway disease. Cough may accompany the disease or signify
chronic bronchitis, tuberculosis, or lung cancer.
Sign and Symptom
 Dyspnea (shortness of breath) exacerbated by exertion
 Cough, often persistent and sometimes severe
 Fatigue
 Rapid breathing which is often labored
 Loss of appetite and weight loss
 Chest pain
 Fever
In advanced cases, the following may also occur:
 Cyanosis(blue skin)
 Cor-Pulmonale
 Respiratory insufficiency
Patients with silicosis are particularly susceptible to tuberculosis infection which is known as
Silicotuberculosis. The reason for the increased risk of tuberculosis incidence is not well

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understood. It is thought that silica damages pulmonary macrophages, inhibiting their ability to kill
mycobacteria. Even workers with prolonged silica exposure, but without silicosis, are at a similarly
increased risk for TB.
Diagnosis
A medical examination that includes a complete work history and a chest X-ray and lung function
test is the only sure way to determine if a person has silicosis.
Diagnosis of silicosis is based on
• A detailed occupational history.
• Chest x rays- X rays will usually show small round opaque areas in chronic silicosis.
• Lung function tests.
• Bronchoscopy.
• Occupational history and chest radiographs are usually sufficient for diagnosis of
uncomplicated silicosis.
Treatment and Management
There is no specific treatment for silicosis. Removal of the source of silica exposure is important to
prevent further worsening of the disease. Supportive treatment includes cough suppression
medications, bronchodilators, and oxygen if needed. Antibiotics are prescribed for respiratory
infections as needed. Other treatment include limiting continued exposure to irritants, smoking
cessation, and routine tuberculosis skin testing.
Prevention
The way to prevent silicosis is to eliminate or control the dust to minimize workplace exposure to
silica dust. If possible substitution of silica. Identification of dangerous areas in the workplace and
to inform the workers about the dangers of overexposure to silica dust. Training of workers about
in safety techniques, and giving them appropriate protective mask and other equipment.

Asbestosis
Asbestosis is a occupational respiratory disease caused by inhalation of asbestos fibers. Prolonged
accumulation of asbestos fibers can cause scarring of lung tissue and shortness of breath.Asbestosis
symptoms can range from mild to severe, and usually don't appear until many years after exposure.
Diseases associated with asbestos exposure includes Asbestosis, Pleural Plaques, Mesothelioma and
Lung Cancer. Asbestos usually strikes workers in the textile, cement, insulating and ship breaking

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industries. The word asbestos is derived from Greek and means inextinguishable. Asbestos is
naturally occurring, heat-resistant mineral fibrous silicates. It is indestructible and fireproof.
Asbestosis is a pulmonary perenchymal disease with fibrosis. It is usually develop after 10 to 25
years exposure of asbestos containing dust. The earliest deposition of this dust is in the respiratory
bronchioles. The earliest lesion is peritubular fibrosis, which can extend proximally in to the
respiratory bronchioles and distally into alveolar ducts. As the fibrosis extends out into surrounding
tissue, alveolar sepal fibrosis occurs. As the interstitial fibrosis progresses there is a gradual loss of
normal spaces. The end stage or cystic appearance gives rise the lung gross appearance of
honeycomb. The lesions commonly occur in the lower lobes.
Workers at Risk
Workers who were involved in milling, manufacturing, installation or removal of asbestos products
are at risk of asbestosis. Examples include:
 Building construction workers  Shipyard workers
 Workers removing asbestos insulation around  Boiler operators
steam pipes in older buildings  Railroad workers
 Electricians
Sign and Symptoms
Asbestosis is a slowly progressing disease and usually sign and symptoms appear after 10 to 25
years of exposure to Asbestos dust. The early symptoms of Asbestosis typically include dyspnea
(Shortness of breath) upon exertion and worsens as the disease progresses.
 Chronic Cough,
 Tightness in the chest,
 Chronic chest pain (associated with fluid buildup)
 Decreased tolerance for physical activity
 Finger clubbing: finger tip enlargement; round or club-like shaping of the fingers
 Congestive heart failure may develop
There may be a basal crackling sound, or persistent high–pitched sounds
Diagnosis
Diagnosis of asbestosis can be made only when a patient has a history of exposure to asbestos, and
a clinical exam, typically with an x-ray or CT scan, has indicated a positive result. An x–ray may
show small irregular opaque areas, usually in the lower lobes of the lungs. Pleural plaques

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indicative of asbestos pleural lung disease may also show up in an x–ray. However, x–rays are
limited in detecting early asbestos disease. In severe case there may be honeycomb appearance of
the lungs. Other tests used to detect asbestosis can include a pulmonary function test (PFT) or lung
biopsy
Treatment:
Unfortunately, currently there is no cure for Asbestosis. Treatment focuses only preventing
progression of the disease and relieving symptoms. Victims exposed should immediately stop
smoking and make sure that they have no more asbestos exposure. Coughing can be treated with
supplemental oxygen and treatments to remove secretions from the lung. Coughing can also be
treated with humidifiers, breathing therapies and chest percussion.
Prevention
 reducing the level of exposure to asbestos is the best prevention against asbestosis by strictly
following recommended methods to control asbestos fibres and dust control measures in the
work environment, and substitution with a less harmful variety of asbestos
 wearing a personal protective equipment such as protective mask with a supply of clean air
through proper ventilation system
 periodic medical examination of the employees, rotation of work station for the employees and
good ventilation facilities can help to minimize the risks.
 Smoking must be stopped

Byssinosis
Byssinosis is a disease of the lungs resulting from the inhalation of dust produced by cotton or
vegetable fibers. It is a form of reactive airways disease characterized by broncho-constriction in
cotton, flax, and hemp workers. Byssinosis occurs in workers who contact with unprocessed raw
cotton. In cotton industry the workers in ginneries where seeds are removed are at risk. In textile
industry workers especially those exposed to open bales or who work in cotton spinning or in the
card room where fibers are cleaned and combed.
Etiologic agent
The etiologic agent is unknown. Evidence suggests that some agent in the cotton leaves but not in
the fibers or seeds cause broncho-constriction. Evidence also suggest that endotoxin from Gram-
negetive bacteria which are found in cotton plants may be the etiology. Severity of the byssinosis

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depend upon amount of dust and length of exposure, other factors are cigarette smoking and
previous respiratory infection
Sign and Symptoms:
At early stage the sign and symptoms of byssinosis are chest tightness and dyspnea. Symptoms
develop on the first day of work after a weekend or vacation and diminish or disappear by the end
of the week. In the western countries, this occurs on Monday. Signs of acute exposure are
tachypnea and wheezing. With repeated exposure over a period of years, chest tightness tends to
return and persist through midweek and occasionally to the end of the week or as long as the person
continues to work. As the disease progresses the chest tightness accompanied by breathlessness
worsens and extends to other days of the week. Patients with more chronic exposure may have
crackles. In the final stage the diseases cannot be distinguished from chronic bronchitis and
emphysema. Past history of chest tightness begins at first day of the week is the differential point
Diagnosis
Diagnosis is based on occupational history
Characteristic history of chest tightness in the early stage at the beginning of week
Pulmonary function tests that show typical airflow obstruction and a reduction in ventilatory
capacity (FEV1), especially if measured at the start and end of a first work shift.
Chest x-rays do not show changes specific for Byssinosis, the changes (x-ray) in the chest are same
as those are found in chronic bronchitis and emphyesma
Severity of Byssinosis:
Severity of Byssinosis is graded as follows:
Grade ½- Occasional chest tightness or respiratory irritation on the first day
Grade 1- Chest tightness and/or shortness of breath on every first day of the working week
Grade 2- Chest tightness and/or shortness of breath on every first day and other days of the
working week
Grade 3- Symptoms accompanied be evidence of permanent incapacity from diminished effort
intolerance and /or reduced ventilator capacity
Treatment
There is no cure for Byssinosis. The most important treatment is to stop exposure to the dust. To
avoid further cotton dust exposure in the factory the section/ job may have to change.

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Medications used for asthma, such as bronchodilators, will usually improve symptoms.
Corticosteroids may be prescribed in more severe cases.
Stopping smoking is very important for people with this condition. Breathing treatments, including
nebulizers, may be prescribed if the condition becomes long-term. Home oxygen therapy may be
needed if blood oxygen levels are low.Physical exercise programs, breathing exercises, and patient
education programs are often very helpful for people with a chronic lung disease.
Prevention
Dust control has been effective in reducing the prevalence of byssinosis. Reducing dust levels in the
factory (by improving machinery or ventilation) will help to prevent byssinosis. Using a face mask
can reduce the risk of byssinosis. Stop smoking prevent occurrence or progression of byssinosis.
Workers at risk should receive a periodical medical examination including at least a pulmonary
function test at intervals of one year or less.

Occupational Skin Disorders

Occupational skin disease is a skin disorder wholly or partially caused by a person's work activity
or by the work environment. Occupational skin diseases are caused by physical, biological or
chemical factor in work. Skin disorders are the second most frequently reported type of
occupational disease. In occupation the skin can come into contact with substances through:
 immersion
 contact with contaminated tools or surfaces, for example a workbench, tools or clothing
 splashing
 the substance landing on the skin
About 90 % of the occupational skin disease is confined to the hands and forearms, less frequently
to face, while sometimes other parts of the body are involved. Occupational dermatitis is usually
characterised by itching, pain, redness, swelling and small blisters.
Depending on the acting agent or chemical factor or the occupational skin divide into :
 Irritant contact dermatitis,  Acne form eruptions
 Allergic contact dermatitis  Occupational Skin Infections
 Photo allergic contact dermatitis  Occupational cancer of the skin

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Irritant Dermatitis
In irritant contact dermatitis, the substance that damages the skin is known as the irritant. A highly
irritant substance is known as a corrosive. Irritant contact dermatitis usually occurs only on the
parts of the body in direct contact with the irritant substance e.g. hands, forearms, face. Irritant
dermatitis makes up about 80% of contact dermatitis, the other 20% is allergic contact dermatitis.
An irritant contact dermatitis should be suspected when rash occurs in areas that are in contact with
oil, grease, or other substances. Examples of substances responsible for irritant contact dermatitis
are as follows-
 Detergents  Lubricants
 Solvents  Fibreglass
 Engine oils  Acid and Alkali etc.
 Cutting fluid
Allergic Contact Dermatitis
In Allergic contact dermatitis, the substance causes the worker to become sensitised or to develop
an allergic reaction some time after initial contact. Once sensitised, the problem is life long and any
exposure to that substance will result in an attack of dermatitis. Worker does not become allergic to
a substance immediately at first contact. Once the individual becomes sensitised, each time he/she
comes into contact with the sensitising substance, even in very small amounts, dermatitis will
develop. The risk of substance becoming allergic depends on several factors:
The nature of the substance. Substance with a higher likelihood to cause allergy is known as a skin
sensitiser.
Common sensitisers are chromate's (found in cement), nickel (cheap jewellery), epoxy resins,
formaldehyde, wood dust, flour, printing plates, chemicals and adhesives. Examples of allergens-
 Salts  Resins
 Nickel  Dyes
 Epoxy  Rubber
Photo Allergic Contact Dermatitis
Photo allergic contact dermatitis (PACD) is a type of allergic contact dermatitis. The causative
agent becomes biologically active as an allergen only after it absorbs UV light. Patients experience
delayed itching and vesiculation, and only sensitized individuals react. Occupational PACD is most
prevalent among pharmacists and pharmaceutical workers who handle sulfanilamide, promethazine,

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or chlorpromazine. However, the patient may continue to develop lesions in the presence of
sunlight even after removal of the photo-allergen and may present recurrent transient or persistent
light reactions (chronic actinic dermatitis).
Acne Form Eruptions
Exposure to oils and greases and resultant mechanical blockage of the glands of skin can lead to
―Oil Acne. Acne form eruptions may be present a comedones, pustules, and papules. A key feature
is the occurrence of these lesions in areas with exposure to oil-soaked clothing (e.g., hands, arms,
thighs). Occupational acne can be caused by exposure to oil, halogenated aromatic hydrocarbons
and coal tar in occupations. It can also be caused by long term contact with oily clothes.
Occupational Skin Infections
A number of skin infections may occur in different occupations depending on the working
environment and level of exposure to a particular agent. Occupational Skin Infections may be
present as folliculitis. Occupational Skin Infection is common in workers in the metal industry who
are exposed to mineral and soluble oils. Occupational skin infections are also often caused by
contact with animals or plants. The infections are
 Scabies  Erysipeloides
 Fleas  Anthrax
Occupational Cancer of the Skin
Skin cancer can have an occupational link in workers with prolonged exposure to sunlight and
certain chemicals, although it can take decades for lesions to develop. Occupational Skin Cancers
can result from exposure to substances such as polycyclic hydrocarbons, inorganic metals, and
arsenicals. Co-carcinogenesis, such as the interaction of sunlight and tar, is often implicating. The
occupational skin cancer tumors usually do not appear until two or three decades after the exposure.
Examples of Occupational Cancer
• Basal cell carcinoma
• Spinous cell carcinoma
• Malignant melanoma
Diagnosis of Occupational Skin Diseases
If occupational skin disease is suspected, questions should be asked about the exact time
relationship between the skin condition (i.e., onset, improvement, and recurrence) and the work

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exposure, including the effects of time off and return to work. The cause of a skin disease may be
work related if:
 The lesion is mainly on the hands and exposed skin
 The condition improves away from work and relapses on return
 More than one person is affected in same work area or handling same materials
The following suggest a non occupational cause:
 There is a history of childhood/ endogenous eczema
 There is major involvement of the body trunk or covered area of skin
To diagnose skin disease linked with occupation, following questions should be asked:
 Patient history: Does skin disease relate to work?
 Exposure: Are there causative agents (allergens, irritants) in the work-place?
 Clinical symptoms: Are they in accordance to clinical disease?
 When did disease start?
 In which skin area was the first symptom?
 What is work technique?
 Are the lesions present or appear in free time, other works vacation, holidays?
 Are the skin lesions start on the area of contact (dorsal aspects of hands and fingers, volar
aspects of arms etc.)
 Are the lesions are characterized by Redness, edema , blisters, ulcerations, itch, pain, heat,
stinging
 Is the contact dermatitis heals after exposure is discontinued
There is some diagnostic test can be performed to confirm the diagnosis-
 PATCH TESTS  OPEN SKIN ALLERGY TEST
 PRICK TESTS  USAGE TEST
 SCRATCH TEST

Prevention
 Pre-placemat examination- Previous history of allergy with the particular agent, eczema, other
dermatitis, Patch Test and other skin testshould be done
 Proper personal hygiene- Hand wash including the exposed area should be properly done.. For
which sufficient number of wash hand basins with hot and cold running water or a mixture of

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both, hand cleaners, drying facilities and hand creams should be provided. Clean dry towels,
disposable paper towels, or hot air dryers may be used.
 Exposure may reduced or eliminated by substitution of agent by a less hazardous substance, or
by removal of the substance, or change of sections
 Use of PPE - the objective of to use personal protective equipment, in this case gloves and
clothing is to prevent direct skin contact with the hazardous substance. Gloves are useful but
carefully appropriate glove should be chosen. If possible latex gloves should be avoided
because it may cause allergy. Sometimes barrier creams may be used with gloves may be used
and but with caution. Apart from gloves and protective overalls, aprons and face masks may be
required
 Education of the workers about the possible occupational dermatitis in their work environment
 Maintenance of proper housekeeping, many dermatoses can be prevented by improved work
environment and workplace cleanliness.

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SESSION 8: Personal Protective Equipment

Summery
Personal protective equipment (PPE) refers to protective clothing, helmets, goggles, or other
garment or equipment designed to protect the wearer's body from injury. The hazards addressed by
protective equipment include physical, electrical, heat, chemicals, biohazards, and airbourne
particulate matter. In this session Types of Personal protective equipment (PPE), necessity and
criteria for selecting PPE will be discussed

Objectives of the Session:

At the end of the session the participants will be able to describe:
- What is Personal protective equipment (PPE)
- Types of Personal protective equipment (PPE)
- When PPE is necessary
- Criteria for selecting PPE

Session 8
Duration: 60 min

Method:
 Lecture ,Multimedia
 Presentation and discussion
 Practice

Materials:
Multimedia, Materials

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Personal Persotetive Equipment

What is Personal Protective Equipment?

Personal Protective Equipment (PPE) is safety equipment and clothing for specified circumstances
or areas, where the nature of the work involved or the conditions under which people are working,
requires it‘s wearing or use for their personal protection to minimize risk. It shoud be keep in mind
that PPE use mean a worker is working in hazardous condition
When PPE is necessary
When engineering controls are not feasible or do not totally, eliminate the hazard or safe work
practices do not provide sufficient additional protection; or temporary basis during emergencies or
inaddition to engineering control. PPE should be used to prevent exposure to hazard in work
process and environment such as
 Physical Hazards
Heat Hazards-hot work areas and sources of high temperature
Noise Hazards: excessive noise
Optical Radiation: Sources of light radiation (welding, cutting, lasers, high intensity lights).
 Chemical Hazards: Chemical exposures from inhalation or contact with the skin and eyes.
Must maintain a current list of hazardous chemicals used in their local operations
 Impact hazards: Falling objects or potential for dropping objects.
 Penetration Hazards: Objects or machinery that may cause punctures, cuts, or abrasions.
 Compression Hazards: Machinery/heavy objects that may roll over and crush or pinch feet.
 Harmful Dust: Dust from sandblasting, sawing, grinding, or other generation of airborne dust.
 Biological Hazards: Exposures to blood or other body fluids, mold, or other biological exposures
 etc
Personal protective equipment program
PPE is the last line of defence, a comprehensive PPE programe is required to ensure that workers
are protected when PPE is used. There are four key elements in a suitable PPE program.
1. Selection
The equipment must meet the basic criteria of providing adequate protection to cope with the
particular workplace hazard against which it is being applied. It is important to take into account

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factors such as the nature of the hazard, the circumstances of the task to be performed, the
acceptable level of exposure and the performance requirement of the device.
2. Fitting
Correct fit and comfort are essential if the expected degree of protection is to be achieved. For
most items of PPE, a range of sizes is needed to accommodate the full range of shapes and
dimensions of users. This is often the only method to ensure that each user is supplied with
equipment that correctly fits him or her.
3. Maintenance and storage
Poorly maintained equipment may result in serious health consequences. Cleaning and maintenance
of personal protective equipment and clothing :
 All protective equipment necessarily provided should be maintained in good condition and replaced,
at no cost to the worker, when no longer suitable for its purpose.
 The protective equipment should not be used longer than the time indicated by the producer.
 Workers should make proper use of the equipment provided, and maintain it in good condition, as
far as this is within their control.
 Respiratory protective equipment, other than one-shift disposable respirators, should be cleaned,
disinfected and thoroughly examined either (depending on which is first) each time it is reissued
 A record should be kept of the cleaning, disinfection and examination of such respiratory protective
equipment, and of its condition and of any defects,.
 The record should be authenticated by the person carrying out the test, who should be properly
trained for the purpose.
 Employers should provide for the laundering, cleaning, disinfection and examination of protective
clothing or equipment which have been used and may be contaminated by chemicals hazardous to
health.
 It should be prohibited for protective equipment which may be contaminated by chemicals
hazardous to health to be laundered, cleaned or kept at workers‘ homes.
 When a contract laundry is employed, care should be taken to ensure that the contractor fully
understands the precautions necessary for handling contaminated clothing.
4. Education and training
It is important that PPE users be trained in the correct manner to use their equipments . Instructions
should cover topics such as the need for the devices , its design features , its application and
limitation and mainatinence. .

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Responsibilities
In general, employers are responsible for:
 Performing a "hazard assessment" of the workplace to identify and control physical and
health hazards.
 Identifying and providing appropriate PPE for employees.
 Training employees in the use and care of the PPE.
 Maintaining PPE, including replacing worn or damaged PPE.
 Periodically reviewing, updating and evaluating the effectiveness of the PPE program.
In general, employees should:
 Properly wear PPE,
 Attend training sessions on PPE,
 Care for, clean and maintain PPE, and
 Inform a supervisor of the need to repair or replace PPE.
Training Employees in the Proper Use of PPE
Employers are required to train each employee who must use PPE. Employees must be trained to
know at least the following:
 When PPE is necessary.
 What PPE is necessary.
 How to properly put on, take off, adjust and wear the PPE.
 The limitations of the PPE.
 Proper care, maintenance, useful life and disposal of PPE.
Employers should make sure that each employee demonstrates an understanding of the PPE
training as well as the ability to properly wear and use PPE before they are allowed to perform
work requiring the use of the PPE. Examples of some Hazard situation and PPE:

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Hazardous Condotion and Requirment od Personal Protective Equipment

Body parts Situation PPE

Eye and Where machines or operations Goggles, lasers safety goggles, full face
face present a danger from flung objects, shields, safety glasses, side-shields,
protection hazardous liquids, etc. welders‘ lenses (should meet standards).

Head Where there is danger from impact Hard Hats -lightweight comfort and
and penetration from falling or flying impact protection
objects or from limited electric shock

Foot/Toe In areas where there is a potential for Leggings (lower legs and feet) Metatarsal
foot or toe injuries. guards, toe guards, safety shoes

Hand Danger of cuts, or from handling Cotton/leather gloves, gauntlets, heat-

corrosives, solvents, or other resistant gloves, barrier creams, chain mail
chemicals. gloves, haly-gloves, rubber gloves.

Hearing Noise exposure exceeds 85 dBA in Full muffs, disposable plugs, swedish
an 8-hour time-weighted period. wool, non-disposable plugs.

Respiratory In areas that present a limited Masks, Air-purifying respirators, chemical

breathable environment cartridge respirators, air-supplied respirators
combination respirators, self contained
breathing devices.

Body Workplace where need to protection Fully encapsulating suits, non-encapsulating

protection from extreme temperature , hot suits, gloves, boots, and hoods, firefighter's
splashes , molten metals and other protective clothing, blast or fragmentation
liquid, impacts from tools and suits, radiation-protective suits and chemical
machinery and hazardous chemicals. protective clothing

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Some common Personal Protective Equipments (PPE)

Table : Some Personal Protective Equipments (PPE)

Head protection

Safety glass and

Eye Protection

Face shields

Ear Plugs and Ear

Muff

Hand Gloves

Safety shoes

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SESSION 9: Identification of potential hazards and their health

outcome in different workplace

Summery:

Hazrards differ in workplace to workplace depend on the work process, work environment, raw
materials use and bioproducts. Therefore, identification of health problems, PPE use prtevetion and
control measures will not be similar. For which in this session hazards and health problems will be
discussed sectorwise, so that the partiipants can have knowledge sector wise and able to identify
proper health problems and suggest appropriate and specific measures. In this session Textile, Jute,
Ceramaic and Garment industry will be discuassed.

Objectives of the Session:

At the end of the session the participants will be able to describe:
- Workprocess in different types of industries
- Potential hazards

Session 9
- Related health problems

Duration: 90 minutes

Method:
 Lecture, Multimedia presentation
 Practice and discussion
 Exerience Shairing

Materials:

Multimedia, Checklist, Practice

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Textile industries

The textile industry produces fabric, yarn, thread and other finished cloth goods. Textiles are
manufactured by weaving, knitting, crocheting or pressing fibers together. The main raw materials
in textile mill is cotton

Cotton is a fiber that grows in a seed pod. When the pod pops open, the cotton is ready for picking.
Cotton is picked by machines and then transported to cotton gins for removal of seeds. Once it is
cleaned, it is then packed in bales and delivered to the opening room of the textile mill.

Process:
Opening Rooms are large rooms where bale openers break the metal straps and cut the burlap cloth
that contains the cotton. The bale openers use a machine to break the straps and loosen the tightly
packed cotton. The machines remove most of the dirt found in the cotton so it is important for the
machines to be well oiled and clean. Workers tending these machines must be careful because the
machines move very fast and can be dangerous.

Once the cotton is loosened, it moves on to a machine called a picker. The picker breaks the cotton
apart into small pieces. Workers feed cotton into the picker by manually throwing armfuls of cotton
into it. The picker produces a product consisting of a long continuous sheet of fiber called a lap.
The lap is then rolled into large round packages that weigh forty pounds. Workers in the opening
and picker rooms must be strong because they are required to lift these heavy round packages onto
power lifts that move them into the Carding Room.

The Carding Room produces long, untwisted strands of cotton called slivers. Slivers are made by
feeding cotton into the rollers of the card machine. The rollers are covered with fine wires and
metal teeth that pull the cotton into sheets. The sheets are then fed into a narrow opening shaped
like a funnel to give the sliver a round like shape that is similar to rope. Slivers are automatically
collected in empty cans, and cans are replaced by employees when they become full.. Work in the
carding room is tedious because there are more machines then people. The rooms are noisy, dusty,
hot, and humid. At times, workers have a hard time staying awake.

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Combing is the next step in the cloth making process. In the combing process, cotton is cleaned and
blended. Cotton carded slivers are put into machines running at high speeds. These machines
stretch the sliver and combine it with other slivers to give it a uniform texture. These slivers are
then sent to machines called roving frames which make the slivers thin so they could be spun into
yarn. Once the sliver is thinned, it gets twisted, and wound on a bobbin. Slivers that have been
thinned, twisted, and wound are then called roving.

In the spinning process, roving becomes even thinner and receives more twists. In the spinning
department, workers wind roving on bobbins. Workers use rows of bobbins to wind roving.
Bobbins contain either warp yarn, which is the thread that runs lengthwise through woven cloth, or
filling yarn, which is the thread that runs at right angles to the warp yarn. Workers to the slashing
department bring the filled bobbins for starching. The slashing department applies a protective
starch solution to warp yarn to make the yarn stiff and strong. Once the yarn is on the loom beam,
workers then take it to the weaving department to be woven into cloth.

In the weaving department, workers known as weavers use a weaving machine called a loom to
turn yarn into cloth. The looms are high-speed running machines that lock two or more sets of
thread together. One set called the warp runs lengthwise while the other set runs across the width of

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the fabric. Weavers set-up the machines by guiding warp threads through a set of pointed wires so
that the weaving can begin. In addition, weavers carefully watch for breaks in the warp thread. If a
break occurs, the looms stop automatically and weavers repair breaks and fix any mistakes that are
woven into cloth. Once the weavers finish weaving, the woven cloth goes to the cloth room.

In the Cloth Room, workers grade the quality of woven cloth and prepare the cloth for marketing or
shipment. Sometimes the woven cloth is sent to other plants for design printing. To prepare cloth
for shipment, some workers sew rolls of materials together, remove stains from the cloth, or use
machines to cut knots and loose ends from thread in the material. Those workers using machines
must be careful because the machines have large knives which can cause injury. The folded cloth is
sent to workers who cover the cloth with paper or burlap and compress it into a bale of cloth
fastened with metal straps. At this point the work of the cotton mill is finished, however because
the woven cloth is naturally gray-like in color the cloth may be sent to other companies to be
bleached, finished or dyed.

Bleaching is the process of removing all natural gray-like color from the woven cloth and making it
look white. Before the cloth can be bleached, it must be singed so that the cloth gets a smooth
surface. Singeing is the process in which woven cloth passes over a gas flame or heated metal plate
to remove fuzz or lint from the cloth. In addition, the singeing process creates a lot of heat and
makes the working environment extremely hot. After singeing, workers wash and boil cloth in large
tubs for several hours or they wash the cloth in a hot chemical solution made from salt called
caustic soda. In either bleaching method, the process is repeated several times until the cloth turns
white and becomes ready for finishing or dyeing.

Dyeing is the process of adding color to woven cloth. Dyeing is usually done using synthetic or
man-made dyes because it is cheaper and the color lasts longer than natural dyes. Workers in the
dyeing department dip woven cloth into large vats of dye which is called piece dyeing. Cloth is
rolled on large perforated beams that are set on perforated spindles. Dye is pumped into the
spindles to dye the cloth from inside while at the same time, dye is added around the beams to dye
cloth on the outside. When the cloth has finished dyeing, workers feed the cloth into rollers that
squeeze out the dye and remove excess liquid. When necessary, workers supply hot steam to

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increase temperatures in the dyeing solution. By doing this, the steam creates a hot and sticky
working environment. In addition, the synthetic chemicals emit strong odors, but because the
workers are too busy tending to their work, they do not realize that they are breathing in those
chemicals, which may later create health problems for them.
Common hazards in textile sector and their health outcome
Cotton industry workers are exposed to various hazards in the different departments of textile
factories. Especially in the spinning and weaving sections which play a role in the high incidence of
health hazards. They include:
 chemical exposure from the processing and dyeing of materials,
 exposure to cotton and other organic dusts,
 musculoskeletal stresses, and
 noise exposure.
The major health problems associated with cotton dust are respiratory problems, which include
 byssinosis,  bronchial asthma
 bronchitis and  dermatitis
List of occupational hazards and their outcome in Textile industries
Chemical hazards Source Health effect
Cotton dust Cotton,silk, wool, flax, hemp, sisal,etc
Byssinosis
Formaldehyde, dyes, benzidine Dyeing, printing, finishing, bleaching,Allergies,dermatitis, respiratory
solvents and fixatives, heavy washing, dry cleaning, weaving, problem, carcinogenic risk (cancer
metals, organ phosphorus and spinning, slashing/sizing of nasogastric tract lung , brain ,
organ bromine leukemia)
Physical & mechanical hazards Source Health effect
Manual handling Lifting, holding, putting down, Musculoskeletaldisorders(MSD)
pushing, pulling, carrying or lower back pain, neck pain, and
movement of a load osteoarthritis of the knees
Noise and vibration, poor Expose to during wokingl like Hearing loss, MSD, Eye strain,
lighting , humidity, poor weaving, spinning, sewing, twisting, vibrationsyndrome, dehydration
ventilation cutting and ironing etc
Fire and explosions, vapour wet working environment, heating MSD‘s, burn, other injury and
generation plants, chemical containers respiratory problem.
Biological hazards Source Health effect
Anthrax, clostridium tetani Activities like carding and willowing Allergies, respiratory disorders,
coxiella burnetti etc anthrax, tetanus, Q fever
Psychological hazards Source Health effect
Stress and violence Poor work desigh, shifting attitude of absentism , epilepsy and other
co -worker, monotonous work overload psychosis and neurosis

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Jute Industries

The Jute ndustry produces yarn, thread, sac, fabric and other finished jute goods. Jute goods are
manufactured by batching carding spinning, weaving, crocheting or pressing fibers together. The
main raw materials in jute mill is jute
Process:
Batching: There are several types of fabrics are prepared in Jute Mills likeor - Hessian, Sacking
and Carpet backing Cloth (CBC) and for which different grades of Jute are needed. Three batches
are prepared for the three types of fabric. Different grades of Jute are mixed up to make a particular
Batch. After selection of Jute, Jute is treated by Oil and Emulsifier to make the fiber soften and
flexible. Jutes are kept in a row for a definite time for maturity which is called piling. After the
maturity of jute; it is sent to the Breaker Card Machine for making a jute fiber roll which is called
breaker roll.
Carding & Drawing: Jutes are carded in the Breaker Card and Finisher Card for straightening the
fiber and removing the dust. At the finisher card the particular batch system is maintained. Card roll
to more straightened, larger and individualized. At the Finisher Drawing or 3rd Drawing machine,
slivers are delivered as Crimp from so that it can be run on Spinning Frame without any problem.
Spinning: Spinning is a very important stage to make a Jute Fabric. Yarn is one of the vital parts
of a fabric and by applying proper twist and draft in spinning frame the jute yarn are produced.
There are two types of yarn are generally used in the Jute Mills named 1. Slip Draft 2. Apron Draft.
The twisted or spun yarn then sent to the Winding Section.
Winding: The yarn Bobbin that has been found from Spinning is then put on Winding Machine to
make a Cop or Spool Winding Package for making it in a usable form in next process. Cop is used
in Shuttle at Loom, which provides the weft yarn, and Spool is used in Beam, which provides the
warp yarn while fabrics are made on Loom.
Beaming & Sizing: To provide Warp yarn in Loom, the yarn should be formed in Beam which is
done in Beaming section. As spool is used in beam and in Loom a beam have to face lots of friction
by Shuttle and Reed; the Beam should be sized with various enzymes and other related materials
like starch, seeds powder etc in order to give strength on Warp yarn which is called sizing. After
sizing; beam is sent to the Loom section.

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Weaving: Weaving is done by interlacing the Warp and Weft yarn. Weft yarn is come from
Winding section as a Cop from and Warp yarn is from beam. Loom is used to interlace the Warp
and Weft yarn. A motion which is called Shedding, Picking and Beating is used here to make a Jute
Fabric. After weaving the cloth is sent to the Finishing Section.
Finishing: Finishing is the utmost and last stage of making a fabric where the quality and faults of
fabric care checked. Later the cloth are formed in roll from or in other forms cut form. In the
Hessian and Sacking section the cloth is calendared and then cut for making the Jute Bags.

Process Flow Chart of Jute Fabric Production: In the process of Jute Fabric; firstly the Jute Yarn
is taken. There are two types of Jute Yarn is to be taken which are– 1.Warp yarn and 2 Weft Yarn.

Warp Yarn ——————-Weft Yarn

Spool Winding ————Cop Winding
Beaming or Dressing
Weaving
Finishing ———————Jute Bag Making
Damping
Calendaring
Lapping ——Bale Presss——- Hessian Cloth
Cutting
Sewing
Bundling
Branding
Bale Press ——— Sacking Bag in Bale Form.

List of Occupational hazards and their health Problems in Jute industry

Hazard Source area Health effects
Jute dust ,irritant Common hazards in the work area of Bronchitis, emphysema and
fumes and other jute processing industry pneumonia Mill fever,
contaminant gases occupational asthma
Batching oil and Jute processing during the softening Dermatitis,Oil acne (folliculitis)
dyes process termed as mineral oil , Degenerative change in
women
Noise, Humidity, Carding, spinning and weaving and Hearing loss, Prickly heat, Heat
temperature, fire others area concern. cramps, Heat exhaustion, eye
Ventilation, lighting, irritation and burn injuries
Guarding of Bale opening and sorting, root cutting,
machinery and softening, carding, drawing, spinning, Injuries, and MSD‘s
material handling winding, eaming,weaving, calendaring,
sewing, lapping, baling and packing,

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Cement Factory

The term cement is commonly used to refer to powdered materials which develop strong adhesive
qualities when combined with water. These materials are more properly known as hydraulic
cements. Gypsum plaster, common lime, hydraulic limes, natural pozzolana, and Portland cements
are the more common hydraulic cements, with Portland cement being the most important in
construction.
Cement is a fine grayish powder which, when mixed with water, forms a thick paste. When this
paste is mixed with sand and gravel and allowed to dry it is called concrete.
About ninety-nine percent of all cement used today is Portland cement. The name Portland cement
is not a brand name
There are two types of raw materials, which are combined to make, cement:
 Lime-containing materials, such as limestone, marble, oyster shells, marl, chalk, etc.
 Clay and clay-like materials, such as shale, slag from blast furnaces, bauxite, iron ore, silica,
sand, etc.
It takes approximately 3,400 lbs. of raw materials to make one ton (2,000 lbs.) of Portland cement.
The mixture of materials is finely ground in a raw mill. The resultant raw mix is burned in a rotary
kiln at temperatures around 4482 degrees Celsius to form clinker. The clinker nodules are then
ground with about 3 % gypsum to produce cement with a fineness typically of less than 90
micrometers.
Process
1. Raw Materials
The main raw materials used in the cement manufacturing process are limestone, sand, shale, clay,
and iron ore. The main material, limestone,is usually mined another source of raw materials is
industrial by-products. The use of by-product materials to replace natural raw materials is a key
element in achieving sustainable development.
2. Raw Material Preparation
Mining of limestone requires the use of drilling and blasting techniques. The blasting techniques
use the latest technology to insure vibration, dust, and noise emissions are kept at a minimum.
Blasting produces materials in a wide range of sizes from approximately 1.5 meters. Through a
series of crushers and screens, the limestone is reduced to a size less than 100 mm and stored until

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required. Depending on size, the minor materials (sand, shale, clay, and iron ore) may or may not
be crushed before being stored in separate areas until required.
2. Crushing and Pre-homogenization.
During producing concrete, most of the raw materials must be first crushed before being used to
make concrete. Among these raw materials which include lime stone, clay, iron ore and coal, etc.
The lime stone is of the greatest usage to make concrete. with comparatively larger particles and
higher hardness, crushing the lime stone to required fineness after mining is of relatively important
consequence among crushing all those raw materials. According to the raw materials' different
particles and hardness, there are several suitable crushers which can be used in the crushing.
Pre-homogenization of raw materials.
4. Raw material Homogenization.
In the process of new dry concrete production, the stability of pit entry clinker raw material
component is the premise of the whole system. Raw material homogenization system plays very
important role in the stability of pit entry clinker raw material component.
5. Pre-heater and calciner
6. The burning of concrete clinker.
7. Grinding
Grinding is the last process of cement produce and also is the most current consuming working
procedure. Cement clinker get grinded into the right size. The smaller the particle size is, the better
the final cement is.
8. Concrete Packaging.
The cement plant that at present Bangladesh registers in all has 74. The cement manufacturing
industry is labor intensive and uses large scale and potentially hazardous manufacturing processes.
Cement mill workers are exposed to dust at various manufacturing and production processes, such
as quarrying and handling of raw materials, during grinding the clinker, blending, packing and
shipping of the finished products. The aerodynamic diameter of cement particles range from 0.05-
5.0 micrometer in diameter. These particles are respirable in size. These are potential cause of
occupational lung disease due to cement deposition. The industry experiences accident rates that
are high compared with some other manufacturing industries

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Common occupational hazards and their health outcome in cement industry

Checimal hazards
Substances Source Health effects
Allergy-inducing Quarrying and handling of raw Skin and eye iritatation and
substances materials, grinding the clinker, dermatitis ,bronchial asthma
Chromate blending, packing of the products Carcinogenic (lung, stomach,
components colon and oral cavity)
Crystalline silica Silicosis , gingivitis
Physical hazards
Noise Heavy equipment – such as fans, Deafness , fatigue
engines, generators, cement grinding
plant, blasting and drilling operations.
Vibration Driving older heavy mobile equipment Vibration syndrome
Heat and fire Contact with hot cement kiln dust Burn injure
(CKD), dust on pre-heater systems.
hemical (alkali) and contact with CKD.
Vehicles Dumper trucks, front loading shovels, vehicle impact,twisted ankles
fork lift trucks in some operation of
materials
Slips, Trips and Uneven surfaces in the quarries roads Common injuries and MSD‘s
fall and from lapses in good housekeeping
within the manufacturing plants
Visual impact Quarrying and transport Eyeproblem, accident

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Garments Industry

The Readymade Garments (RMG) Industry is the only multi–billion-dollar manufacturing and
export industry in Bangladesh.. About 80% of garments worker are women.

Production Process Flow Chart

Basic Process
Design or Sketch: Before making an apparel of garments there must have design or sketch.
Pattern Design: Every piece of Apparel or Garment is built upon a pattern. The pattern is made by
the standard sizes of Men and Women. Pattern must be followed while manufacturing a garment
product. It saves time and increase the rate of accuracy of making.
Sample Making: Before going for a bulk production complete sample of the desired apparel i. s
made. After OK of the sample further bulk apparel or garment production is carried out by
following the exact size and quality of that sample.

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Production Pattern: After making the cloth sample that i have mentioned in the previous process
step; its wise to make a production sample that will be hanged out in front of every labor that are
recruited to make this clothing eventually.
Grading: Grading is done in order to grade various sizes of garment in separate place so that it
would be easier to inspection and maintain the export works at last.
Marker Making: Market making is the process to sketch on fabric before cutting it. Market is to be
in standard size required by the buyers.
Spreading: After making a market; we have to spread the whole fabric over the spreading table in
order to put Marker and pattern over it.
Cutting: After successfully spread the fabric and putting all the marks and sketch by the marker;
this is the time to cut the fabrics according to design.
Shorting & Bundling: Some shorting task is done in order to list the same number of parts in a
separate place.
Sewing & Assembling: Each of the parts of a clothing should be sewed or assembled in order to
make a complete apparel that are wearable.
Inspection: In this step of garment manufacturing process each of the complete apparel or garment
is to be checked and recheked. If any faults is found; then the whole process should be repeated.
Pressing or Finishing: After making an apparel it is to be pressed by the Compressed Machine in
order to bring it in bale form for export.
Packing: After making a bale of these garment clothing; Packing is done!

Occupational health problems

Various illnesses and diseases were widespread among the garment workers. A large number of
workers were found to continue their work even they were suffering from various diseases and
illness. Though the garment workers were young they suffered from anemia, female diseases,
dysentery, etc. Moreover, the competitiveness of the garment industry in the world market was
seriously affected by the ill health of the workers, since ill health decreases the labour productivity
to a great extent. Most of the health problems that the garment workers suffered from arose from
the occupational hazards which include long working hours, absence of leave facilities, congested
and over-crowded working conditions, absence of health facilities and safety measures, absence of
staff amenities, lack of safe drinking water etc.

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Hazards in Grament Industry and Health Problems

Hazards and Sources Health Problems
1. Mechanical Hazards
 Machines and machine parts;  Cuts, wounds, loss of fingers, hands etc;
 Transport, aisles;  Bruises, sprains, fractures and, in extreme cases,
 Floors, platforms;  Fatal injury
 Ladders and other means of access;
 Poor housekeeping
2. Physical Hazards
Noise and vibration  temporary and permanent hearing loss;
 Sew machines,  nervousness, fatigue, decreased efficiency, annoyance
 Cutting machine musle spasm, high blood pressure etc.
 Trolley movement  Vibration disease such as White Finger.
 Over crowding
Electricity  fire accident: burns, death
 Faulty electric line and fittings  electric shock and death
 Short Circiut
 Over loaded power
Lighting  eye strain,
 too much light without shades  headaches
 shining and glares  failing eye sight;
 inadequate lighting  fatigue;
 inadequate use of natural light;  accidents
Housekeeping  accident and injuries
 Unhygienic work place  stress;
 Confind place  discomfort
 Stack in open space and corridors
3. Chemical hazards
Chemicals used  irritant or corrosive;
 workplace chemicals;  allergies;
 toxic materials and waste;  fibrogenic;
 fires and explosions.  asphyxiant;
 poisonous;
 carcinogenic;
 teratogenic and mutagenic.
4. Biological hazards
 Bacteria;  hepatitis (jaundice)
 Viruses;  food poisoning Asthma

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 Fungi.  COPD
 musculoskeletal pain,
5. Ergonomic hazards
 Manual handling of heavy loads;  Strain injuries often referred to as RSIs
 Unsuitable tools and controls;  lower back problems;
 Mopving macines  shoulder pain
 Poor seating & standing positions;  fatigue
 Poor working methods.  other musculoskeletal pain,
6. Psychosocial hazards
 Quality of work (boring,  Stress;
monotonous, repetitive work;  discomfort;
continuous alertness, etc);  fainting
 Poor human relations, violence  irritation;
 Less salary  psychosomatic diseases;
 Excess over time, overwork  accident and injury.

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Session 10: Hazard Assessment

Hazard Assessment in the industry
Worksite hazard analysis involves a variety of worksite examinations, to identify not only existing
hazards, but also conditions and operations where changes might occur to create hazards
Hazard surveys should be performed depending on the business size, industry size, industrial
process and work environment in 1-3 years.
A hazard analysis is an exercise and the answer of following questions should be findout:
 What can go wrong?
 What are the consequences?
 How could it arise?
 What are other contributing factors?
 How likely is it that the hazard will occur?

Stressor Hazard Type Hazard Type Hazard Type

Chemical Corrosive Fire Explosion Toxic
Electrical Shock Short Circuit Fire-Static
Mechanical Moving Parts Failure Noise Pressure
Ergonomic Strain Human Error Fatigue
Radiation Ionizing Non Ionizing
Contact Struck By Struck Against Caught In
Environment Temp. Visibility Weather
Misc. Slips Trips Falls

Review of Hazard Analysis

Reviewing hazard analysis ensures that it remains current and continues to prevent accidents and
injuries. During the review process you will identify hazards that were not identified in the initial
analysis. Review the Hazard Analysis after accidents, you may determine that you need to change
the job procedure to prevent similar incidents. Review after all close calls and discuss the situation
with all employees that do the job.

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Check List of Hazard Assessemnt

Sk Akhtar Ahmad

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SESSION 11: COURSE CLOSING

Objectives of the Session:

At the end of this session, participants should:
- Have the evaluation information;
- Have the opportunity to discuss outcomes of the training and provide suggestions for
future improvement;
- Have their certificates;
- Closing remarks of the participants and trainers;

Session 10
Duration: 30 minutes

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References:

1) Park K. Textbook of Preventive and Social Medicine. 21st1 Edition Published by

BanarsidasBhanot Jabalpur, Madhya Pradesh, India 2011, February: pp-868
2) ILO. Occupational safety and health in Bangladesh http://www.ilo.org/wcmsp5/groups
/public/---ed_protect/---protrav/---safework/documents/policy/wcms_187745.pdf
3) WHO. Occupational health. A manual for primary health care workers, World Health
Organisation, Easter Mediterian, Cairo, 2011.
4) ILO. Introduction to Occupational Health And Safety. http://actrav.itcilo.org/actrav-
english/telearn/osh/intro/introduc.htm
5) Alli BO. Fundamental Principles of Occupational Health And Safety, 2nd Edition
International Labour Office.Geneva, 2008
6) OSHA. Ergonomics: The Study of Work. Occupational Safety and Health Administration,
U.S. Department of Labor, 2000
7) Tadesse T and Admassu M. Occupational Health and Safety. Ethiopia Public Health
Training Initiative, The Carter Center, Ethiopia Ministry of Health and, and Ethiopia
Ministry of Education, 2006 August.
8) Haddad SA. Ergonomic Risk Factors and Ergonomic Risk Analysis. Ministry of Health,
Kingdom of Bahrain
9) OSHA. Personal Protective Equipment. OSHA Facr Sheet. Occupational Safety Health
Administration. US Department of Labour, 2006, April.
10) Personal Protection Equipment. http://www.ncsu.edu/ehs/www99/right/ handsMan
/worker/ppe/
11) Dale M. Hizon,Occupational Health Hazards Occupational Safety and Health Center,
BOSH Training 2009
12) Gochfeld M. Chronologic History of Occupational Medicine. (J Occup Environ Med.
2005;47:96–114)
13) Hazard and Risk OSH Answer. ///H:/Hazard/Env Hazard/Hazard and Risk
14) Bangladesh Labour Act, 2006, Bangladesh Gazette, 2006, October 11.

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