International Journal of Tasnim et al.

, Int J Pub health safe 2016, 1:1

Public Health & Safety http://dx.doi.org/10.4172/ijphs.1000102

Research Article
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OpenAccess
Access

A Review on Occupational Health Safety in Bangladesh with Respect to

Asian Continent
Fabiha Tasnim, Imon Rahman*, Monica Sharfin Rahman and Ridwan Islam
Department of Pharmacy, BRAC University, Dhaka, Bangladesh

Abstract
In the recent scenario, occupational health hazard has been the reason of great concern for a long period of
time in this industrialized and digital generation. It is obviously because their significant impacts in terms of human,
social and economic sufferings both on national and international arena, but mostly on Asian region. However, there
were attempts to take measures and strategies to prevent, control, reduce or eliminate these hazards; they were not
adequate to eliminate this issue completely. As a result, occupational hazards are still continued to be significantly
disastrous in developing countries like Bangladesh. In Bangladesh it is estimated that 11.7 thousand workers suffer
from fatal accidents and a further 24.5 thousand die from work related diseases across all sectors each year which
lead the victims spend an average of US $4 on each injury where 17.6% of the population lives below the lower
poverty line. Therefore, in order to raise required concern this article will provide a brief overview of occupational
hazard exposures, accidents and their hazardous impacts on human health, keeping in concern the most hazardous
occupational sectors in a developing country of Asia with a close comparison with other developed and developing
countries of the world. And at the end, it will also provide possible recommendations among industrialists, researchers
and policy makers.

Keywords: Occupational health hazard; Occupational safety;
Occupational health; Diseases; Pesticides; Garment industries;
Tanneries
Abbreviations: BBS: Bangladesh Bureau of Statistics; BEF: Bangladesh
Employers’ Federation; BILS: Bangladesh Institute of Labour Studies;
BTA: Bangladesh Tanners Association; COPD: Chronic Obstructive
Pulmonary Disease; DOE: Department of Environment; EPB: Export
Promotion Bureau; GDP: Gross Domestic Product; ILO: International
Labor Organization; NCCWE: National Coordination Committee
for Workers Education; NCLS: National Child Labour Survey; NGO:
Non-Governmental Organization; NIPSOM: National Institute of
Preventive and Social Medicine; OSD: Occupational Skin Diseases;
OSH: Occupational Safety and Health; OSHE: Occupational
Safety; Health and Environment Foundation; PAN: Pesticide Action
Network; USA: United States of America; U. S. EPA: United States
Environmental Protection Agency; WHO: World Health Organization
Introduction
At the present scenario occupational hazard lies as the hazardous
genesis of almost all fatalities in this digital and industrialized
generation. The reason behind this statement came from the statistics
estimated by the International Labor Organization (ILO) according to
which, from over the 2.3 million fatalities that take place annually, over
2 million fatalities are caused by work related diseases [1]. This burning
issue has made a huge impact in different sectors (Human, Social and
Economic) because of their contribution to significant losses both on
the national and international arena, but especially on the Asian arena.
The fatalities of occupational hazards (occupational accidents,
injuries, diseases and major industrial disasters) which had caused
human, social and economic costs have raised concern in all levels
of people starting from the working individuals, employers, to the
national and international skeleton, mostly in Asian region. However,
to keep pace with technological and economic changes, measures and
strategies are designed, developed and applied to prevent, control,
reduce or eliminate these occupational hazards and risks over the years,
particularly, when it is compared with the ancestral period. But despite
these consistent slow improvements, considering the human suffering
and economic burden, occupational accidents and diseases are still too
frequent and still continuing to be significantly disastrous in Asia [2].
Asia is the largest and most populous continent of the Earth. The
vast demographic, cultural, political and economic differences among
the countries of Asia have often been the basis for a lively engagement
of this continent with the world. While diversity is a universal feature,
Asia represents an extreme form of it comprising some of the highly
performing sub groups of economics. It contains some of the developed
countries as well as those that have performed relatively poorly,
commonly characterized as developing countries [3]. Therefore, this
article will provide a brief overview of health risk due to occupational
hazard and will also provide recommendations for Asian region with
a close comparison with other developed and developing countries of
the world.
Occupational Safety
Occupational health hazards usually refer to the materials and
processes that have the potential to cause harm to the workers.
Thus, the evaluation, control and entailing the identification of these
hazards must be the inaugural actions to ensure occupational safety.
Occupational safety and health is key element in achieving sustained
decent working conditions and strong preventive safety cultures. As
a result, since the creation of organization in 1919, it has continued
*Corresponding author: Imon Rahman, Department of Pharmacy, BRAC
University, Dhaka, Bangladesh, Tel: +8801920199955; E-mail: imon9585@gmail.
com
Received February 17, 2015; Accepted March 21, 2016; Published March 25,
2016
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on
Occupational Health Safety in Bangladesh with Respect to Asian Continent. Int J
Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
Copyright: © 2016 Tasnim F, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.

Int J Pub health safe

ISSN: IJPHS, an open access journal Volume 1 • Issue 1 • 1000102
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
till today [2]. It is generally illustrated as the science of anticipation,
recognition, evaluation and control of hazards arising in or from the
workplace that could impair the health and wellbeing of workers.
In addition, it may also take account the possible impacts on the
surrounding communities and the general environment [2].
However, assurance of the occupational safety and health may be
achieved by a multidisciplinary act, which aims at the protection and
promotion of the health of the workers. It may work by preventing and
controlling occupational diseases and accidents and by eliminating
the occupational factors and conditions that are hazardous to health
and safety of the workers at the working place. It may also include
the development and promotion of healthy and safe work, working
environment and working organizations. Thus, occupational health will
be gradually developed from a risk oriented activity to a comprehensive
approach that may consider an individual’s physical, mental and social
well-being with general health and personal development [4].
Effects of occupational hazards/occupational diseases
Before ensuring occupational safety, one should be very much clear
about occupational diseases. Occupational diseases are the adverse
health conditions of human being, occurrence or severity of which
is related to the exposure to hazardous health factors in the job or in
the working environment. However, in most of the time, occupational
cause of these diseases is overlooked by the health care providers and
professionals. This is because of the several special characteristics of
occupational and work related diseases that may obscure their actual
occupational origins. Again, the clinical and pathological presentation
of most of the occupational diseases is identical to that of non-
occupational diseases. For example, in the occupational sector, most of
the workers suffer asthma which is caused by the excessive narrowing
of the airways of the lungs due to airborne exposure to toluene
diisocyanate. But often the disease is clinically indistinguishable from
asthma which is caused by some other non-occupational reasons.
Occupational disease may also occur long after being exposed
to an occupational hazardous factor. An extreme example would be
asbestos related mesothelioma which is a cancer affecting the lungs and
abdomen. The disease may occur from about 30 to 40 years after being
exposed to it while working in an industry. It is one of the occupational
factors which can act in combination with other non-occupational
factors to produce disease. For example, exposure to asbestos alone
increases the risk of lung cancer five-fold, whereas long term smoking
of cigarettes increases the risk of lung cancer in somewhere between
50 and 70 fold [5]. Again, in many occupations, workers are exposed
to numerous combinations of various potential hazards which might
be chemical, physical, biological, ergonomic or psychological but all
of which ultimately result in occupational diseases. It was estimated in
one study that more than about 13 million workers in the United States
are potentially exposed to chemicals which can be absorbed through
skin. Several observations have also indicated us that dermal exposure
to hazardous agents like dusts, fumes, mists, aerosols, fibers, toxic gases,
catastrophic chemicals can result in a variety of occupational diseases
and disorders. It might also include occupational skin diseases (OSD) as
well as systemic toxicity which may follow some different mechanisms
[5]. However, it is observed from studies that in industries, poisoning
with metals usually takes chronic form and results usually from the
absorption of small amounts of them over long periods of time. Acute
poisoning may also occur from the accidental intake of large doses
of toxic compounds like arsenicals. Nevertheless, metals and their
compounds with most physical hazards may also gain access into the
body by inhalation, ingestion and in a few cases through the skin.
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Apart from these, homogenous organic solvents or chemicals produce
similar hazards as organic liquids in which other substances can also be
dissolved without changing their chemical composition or not. These
chemicals are used in the extraction of oils and fats in food industry,
chemical industry, paint, varnishes, enamel, degreasing process, dry
cleaning, printing and dying in the textile and rayon industries and can
contribute to the occupational hazards. All these compounds have a
risk to be absorbed mainly through the lungs, via the gastrointestinal
tract if taken by mouth and for many of them via the intact skin [4] and
cause adverse effects. Some of the effects are discussed below:
• Nervous system: Any poisoning to the nervous system may cause
dizziness, peripheral neuritis, affected vision, insomnia, headache,
easy fatigue, unconsciousness and even death. This type of poisoning
works faster when the hazardous agent is absorbed through the
respiratory system than via the other routes. This is because of the
numerous blood vessels of the lungs which make possible for the
inhaled disastrous nerve agent to be rapidly diffused into the blood
circulation and thereby reach the target organs. In case of skin
nerve agents, they are more or less fat-soluble and have to penetrate
the outer layers of the skin, thus, they take time before reaching
the deeper blood vessels. However, the toxic effects of these nerve
agents depends on their ability to be bound with the enzyme, acetyl
cholinesterase and thereby inhibiting this vital enzyme’s normal
biological activity in the cholinergic nervous system. This is quite
alarming since it becomes extremely disastrous for the workers
anyway long after the time of exposure to these agents [6].
• Gastrointestinal system: Exposure to different chemicals through
foods or inhalation may cause dyspepsia, anorexia, nausea and
maybe secondary effect to the liver affection [4].
Toxins and microorganisms that are able to breach the single layer
of epithelial cells have unimpeded access to the systemic circulation
and cause these symptoms [7]. For example, alcohol can impair the
function of muscles by separating the esophagus from stomach,
which may favor the occurrence of heartburn, even in some cases
may lead to the stomach cancer [8].
• Respiratory tract: Effect of hazardous chemicals and other toxins
may show upper respiratory irritation in some cases [4]. In chemical
plants, workers who are producing pesticides are frequently
experiencing chronic bronchitis and disturbed pulmonary
ventilation [9]. A significant fraction of hazardous particles that
are inhaled by a worker can deposit within the respiratory tract
such as in the lung airways during the inspiratory phase of a tidal
breath which can cause harm to the respiratory system and result in
respiratory tract infection to various diseases [10].
• Urinary system: A considerable amount of epidemiological data
supports the casual relationship of occupational exposures with
bladder cancer but the precise contributions of workplace exposures
to kidney failure and kidney cancer are difficult to estimate. In a
recent report, it was estimated that up to 10% of end stage renal
disease could be attributed to workplace exposures. But this result is
difficult to validate because of changing environmental and chemical
hazards, variations in diagnostic criteria and the often long latency
period between exposure and disease. It is predicted from study
that function of two-thirds of the nephrons of both kidneys may be
lost before renal damage is clinically evident. However, evidence is
mounting that what were previously thought to be socioeconomic
or ethnic causes of nephrotoxicity may in fact be environmental,
adding validity to the role of toxicants in disease development [11].
Volume 1 • Issue 1 • 1000102
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
Thus, toxic affection to kidney may have high chances to cause
nephritis or renal failure [4].
• Skin: The growth of industry, agriculture, mining and manufacturing
has been paralleled by the development of occupational diseases of
the skin. The earliest reported harmful effects were ulcerations of the
skin from metal salts in mining. As populations and cultures have
expanded, the uses of new materials, new skills and new processes
have emerged. Such technological advances brought changes to the
working environment and during each period some aspect of the
technical change has impaired workers’ health. Fifty years ago in
the United States occupational diseases of the skin accounted for no
less than 65-70% of all reported occupational diseases [12]. Though
recently statistics collected by the United States Department of Labor
indicate a drop in frequency to approximately 34%. But still many
people are in conditions which are conducive to the occupational
diseases like cement dermatitis, chrome holes, chloracne, fiberglass
itch, oil bumps, rubber rash etc. [12]. Therefore, exposure to toxic
components to skin may show contact dermatitis or acne to skin
cancer depending on the exposure intensity [4].
In the context of occupational health hazards, sleep problems
may be a relevant risk factor for occupational injuries due to the
sleep deprivation caused from overtime work or work stress.
Insufficient sleep may not have led the news in reporting on serious
occupational accidents in recent decades, but that doesn't mean fatigue
and inattention due to sleep loss did not play a role in occupational
health disasters. For instance, investigators have interpreted that sleep
deprivation was a significant factor in the 1979 nuclear accident at Three
Mile Island Nuclear Plant, USA as well as the 1986 nuclear meltdown
at Chernobyl Nuclear Plant, Ukraine [13]. Since sleep is essential for
the functioning of the human body, disrupted sleep has numerous
negative consequences, including increased mortality [14], diabetes,
obesity, burnout, and poor performance Recent reviews have indicated
that 10% to 40% of the population suffer from insomnia, 2% to 10%
suffer from obstructive sleep apnea, 4% to 29% suffer from restless
legs syndrome, and about 25% suffer from non-specific sleep-related
problems. Furthermore, approximately 13% of work injuries are due to
sleep problems and the risk for sleep related work injuries has increased
by a factor of 1.62 [14].
Objectives
1. The review is about to give a brief demonstration about the
profound health consequences of the world especially in emerging
economic countries like Bangladesh if occupational health hazard is
not tackled.
2. To identify the effects of different occupational exposures and
accidents on human health taking Bangladesh as a developing country.
3. To raise a concern though a possible recommendation among
industrialist, researcher and policy makers.
Methodology
Data collection process
The review is based upon the information collected from articles
that are especially written in English language with English abstracts.
For relevance, studies were justified on the abstracts. A systemic
search of international peer-reviewed literature was carried out on
occupational hazard and its impact on global and Bangladeshi sectors.
Using generic search engines like Google, yahoo etc., grey literature
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such abstracts, presentation, technical reports were identified on these
topics. The search terms used were occupational hazard, impact on
human health due to occupational hazard in global arena, impact on
Bangladesh due to occupational hazard etc.
Studies selection
The data’s were analyzed by the search result individually to find
potentially eligible studies. The publications were sorted by titles and
abstract and only eligible studies were selected for full text review.
During this stage all the irrelevant studies were excluded.
A concern on Bangladesh as a developing country
In many rapidly developing countries, industrialization bring a
radical alteration with it in the lives of the countries. But if industries are
not well designed and appropriate safety measures are not adequately
adopted, serious adverse health consequences can ensue [13]. For
example, in country like Bangladesh, agricultural profession as well as
fishing or forestry can make people face substantial risks due to their
occupational and geographical setting [14]. According to the ILO, it
is estimated that 11.7 thousand workers suffer fatal accidents and a
further 24.5 thousand die from work related diseases across all sectors
each year in Bangladesh [15] whereas work related diseases result in
approximately over 2 million fatalities from over the 2.3 million fatalities
that are caused throughout the whole world annually [15]. It was also
observed that a further 8 million workers suffer injuries at work–many
of which will result in permanent disability. Although little research has
taken place in Bangladesh, it is internationally recognized that most
of the occupational deaths and injuries are entirely preventable, and
could also be avoided if organization provide proper environment with
all kinds of safety facilities and employers and workers took simple
initiatives to reduce hazards and risks at the workplace [15].
Considering the statistical scenario, latest labor force survey of
Bangladesh published in 2009 (Table 1), about 51 million people are
in the occupational sector in Bangladesh, of whom 22.2 million are
involved in agriculture, forestry and fisheries sector, 7.8 million in
trade, hotel and restaurant service occupations, about 7 million in
manufacturing, 2 million in construction sector, and about 4.2 million
people are involved in transport, storage and communication sector
(Figures 1 and 2) [16,17]. But the alarming news is most of these
employees operate under poor working conditions and also quite
terrifyingly, in absence of occupational health and safety standards [16].
A study conducted in Bangladesh revealed that about 79.52% of the
injured (by occupational injuries) workers were in between 40–59 age
group and about 73.26% of the accidents that caused injury to hands,
feet, torso, arms and eyes result in different forms of disability [18]. It
was also observed from a study conducted by Mohammad Muhsin Aziz
Khan, Zaheed Ibne Halim and Mohammad Iqbal which was published
in the International Journal of Occupational Safety and Ergonomics
(JOSE) that of all the respondents suffered from occupational hazards,
75.24% of total injured workers faced hand, feet, arm, eye, face and head
injury, among which 27.72, 18.81, 7.92 and 5.94% of the total injury
occurred in hands, feet, eyes and head respectively and the rest (24.76%)
of the injured workers suffered injury in other parts of the body [18].
However, that type of injury pattern was seen due to the ignorance of
workers for not using precautionary measures such as gloves, helmets,
eye shields, etc., during their working hours. The illustrates the number
and percentages of the risk susceptibility of the different organs of the
workers obtained from the above mentioned study (Figure 3).
The real scenario of occupational health hazard in Bangladesh
Volume 1 • Issue 1 • 1000102
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102

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Employed
Population
27.72
(Million)
Total 51 18.81
Male 38.5
9.91 8.91 7.92
Female 12.5 5.94 5.94 4.95 3.96
1.98 1.98 1.98 %
Urban 12.2
Male 9.3
Female 2.9
Rural 38.8
Male 29.2 Figure 3: Susceptibility of various body parts to occupational injuries [18].
Female 9.6
Table 1: Bangladesh labor force characteristics, 2009.
by occupational hazards. As in USA there were fewer fatalities in 2013,
lower than the revised count of 4,628 fatal work injuries in 2012 [21].
Agriculture, Forestry and Fisheries
On the contrary statistics from the Bangladesh Occupational Safety,
2.9 Mining and Quarrying
Health and Environment Foundation (OSHE) revealed that 1,310
3.6
1.2 Manufacturing workers were killed and 899 others were injured during the first six
Electricity, Gas and Water months of 2010 [22,23] and some 622 workers were killed and 395
4.2
22.2 Construction
others injured in various work related incidents across the country in
the first six months of 2011 which are much higher than the number
Trade, Hotel and Restaurant
of fatalities caused in the previous years [16]. List of casualties caused
7.8 Transport, Storage and Communication
from occupational incidents in the year 2012 and 2013 in Bangladesh is
Finance and Business Services and Real mentioned in the (Table 2).
Estate
2 Health, Education, Public administration
6.9 and Defense Since 1985, expert committee, clinical and epidemiological research
0.1 0.1 Community and Personal Services teams have provided a great deal of new evidences on the relationship
of work to diseases. The attribution by work varies widely depending on
Figure 1: Employment distribution in Bangladesh by major industries diseases and type of work, as well as on local working conditions and
(Bangladesh Labor Force Characteristics, 2009). health conditions of the community. A substantial part of work-related
morbidity has been associated with common non-communicable
and communicable diseases prevalent among populations, such as
cardiovascular disorders, respiratory disorders and musculoskeletal
0.3 Unemployed
10.3 disorders [24]. It is observed that adults as well as children working
Self Employed/Own Account in hazardous jobs are subjected more to acute or chronic physical
Workers illness, and this number of population is not at all insignificant [25].
10.8
Employer The National Child Labour Survey (NCLS) 2002-2003 conducted in
Bangladesh found that about 7.9 million children who are working
Employee
49 are between the ages of 5 and 17 and 8 percent of these children are
8.7
Unpaid Family Helper
hurt or become sick due to work. These child workers were often found
0.2 to work long hours in a variety of hazardous occupations and sectors
Day Laborers that have the potential to seriously damage their health (e.g., in bidi
factories, manufacturing, construction, tanneries, and the seafood and
20 Others garments industries) [26]. Even in the developed countries like USA
it has been found that younger workers who are in between 15 to 24
age group represent 14% labor force. This labor force face high risk
Figure 2: Status of employment in Bangladesh (Bangladesh Labor Force for injury when on the job during the period 1998- 2007 but there is a
Characteristics, 2009).
moderate decline in the number of fatalities by year unlike Bangladesh
[27]. The following illustrates the percentages of various illness related
can be inferred if the regular media reports concerning workplace to different employment sectors (Table 3).
accidents and injuries are taken into account. A media scan report of
2007 showed that almost half of all worker deaths took place in the Occupational hazard and agro-based sector
construction sector, with 164 separate incidents which ultimately Bangladesh is an agro-dominant country where about 62% of the
results in a combined total of 222 deaths [19,16], whereas in Thailand population is involved directly or indirectly in agricultural sector [28].
which is another developing country there were 189,621 cases of Bangladesh economy draws its main strength from agriculture sector.
occupational injuries in 2001 [20]. It is also observed that in spite of The sector contributes about 19.10% to the GDP (at current prices) and
being one of the most developed countries, a preliminary total of 4,405 employs approximately for about 50.28% of the labor force [29]. The
fatal work injuries were also recorded in the United States in 2013 [21]. most alarming concern about the farmers regarding their occupational
Therefore Bangladesh is not only the hazardous prey of occupational safety is the indiscriminate use of pesticides due to their ease of
health injuries but it has been estimated that at least, in the developed availability, relatively cheap cost and ease of application [28,30]. Even
world, they have taken drastic measures to discard the fatalities caused though occupational health hazard can be found in most agricultural

Int J Pub health safe

ISSN: IJPHS, an open access journal Volume 1 • Issue 1 • 1000102
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102

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24-Nov-12 A fire at Tazreen Fashions at Ashulia district on the outskirts of Bangladesh which used to produce T-shirts, polo shirts and jackets for various companies and
organizations leads resulted in the deaths of 112 workers.

26-Jan-13 A fire at Smart Exports Garments in the Mohammadpur suburb of Dhaka resulted in the deaths of seven workers.

24-Apr-13 The Rana Plaza building which was an eight story commercial building in Savar, a sub district in the greater Dhaka area collapsed leading to the loss of 1,135
lives. Most of the victims were workers from the ready-made garment factories housed in the building.

8-Oct-13 A fire at Aswad Composite Mills resulted in the deaths of seven workers.

Table 2: List of incidents and casualties in Bangladesh in the year 2012 and 2013 [23].

By Tiredness/ Body
Other in developing countries like Thailand, Bangladesh, 70% of all pesticide
Injury/Illness Backache health poisonings and 99% of resulting deaths occur in these countries, despite
health conditions Exhaustion injuries
problems
the fact that of all pesticides used globally, only 25% are applied there
Agriculture 48.84 60.93 20.1 47.02 58.74
[36]. It also reveals that in the countries including Bangladesh as well
Manufacturing 22.87 18.04 29.73 30.09 19.45
having traditional agricultural occupation still have the most significant
Construction 8.21 5.5 18.75 3.45 4.34
occupational health effects among the workers. On the contrary,
Wholesale though in USA, more than 18,000 products are licensed for use and
17.07 12.43 26.07 19.44 13.63
and Retail
each year more than 2 billion pounds of pesticides are applied to crops,
Service 3.02 3.11 3.35 0 3.84
gardens, in homes etc. [37] it is seen that they are able to overcome
Table 3: Percentages of health conditions by sectors of employment (NCLS data these losses and adverse effects caused by pesticides. This is because of
2002) [26].
their technological, economic and medical advancement which make
workers among the developing countries including Bangladesh, not them capable of spending 1.1 billion dollars per year to overcome the
many studies have been performed in this sector. The reason may be it losses due to the application of pesticides which is quite difficult for
is not quite an alarming issue in the developed world because of their any developing countries resembling Bangladesh to implement [38,39].
less dependency on agriculture due to their industrialized technological
The activities identified by the pesticide users which resulted in
advancement.
poisoning may include spraying using knapsack spray equipment,
Yet in 1990, WHO estimated that about one million unintentional mixing and diluting pesticides and repairing or cleaning of spray
acute pesticide poisonings occurred worldwide annually and the equipment etc. [34]. Since exposure to pesticides can lead to unspecific
estimated number of people who died worldwide as a result of adverse health effects, this exposure may be referred to here as
poisonings was 20,000 in the respective year [31]. However, since 2008, poisonings. The adverse health effects of insecticides may range from
more current statistics have become available, among them, according damage of nerve impulses transmission, inhibition of blood clotting
to WHO data, 346,000 people die annually worldwide as a result to paralysis of the respiratory and circulatory centers. The typical
of pesticide poisonings and two-third of them are in the developing symptoms of poisoning in humans that are relatively easy to diagnose
countries which includes Bangladesh as well [32,33]. Nevertheless, it as acute pesticide poisoning are fatigue, headaches and body aches,
should be strongly mentioned that occupational health hazard have skin discomfort, skin rashes, poor concentration, feelings of weakness,
always been a serious issue in the agricultural communities since the circulatory problems, dizziness, nausea, vomiting, excessive sweating,
ancient ages [34]. impaired vision, tremors, panic attacks, cramps, etc., and in severe cases
coma and death [40,41]. Besides causing acute poisoning, pesticides
In 1983, a study was investigated on the extent of acute pesticide can also cause chronic illnesses if they are incorporated over a longer
poisoning and their contributing factors in selected agricultural period, even if the amounts taken up are relatively small. Symptoms are
communities alike Bangladesh such as Indonesia, Malaysia, Sri Lanka often diffuse or do not become apparent for a long time, which then
and Thailand. The study confirmed the existence of this problem, which may lead to late effects. Although the results of various epidemiological
was found to be due to inadequate knowledge of the safe practices in studies are inconsistent, some findings leave no doubt that agricultural
the use of pesticides among users and to the lack of suitable protective workers exposed to pesticides have a significant risk of contracting
clothing for use by agricultural workers in hot and humid climates, non-Hodgkin lymphomas and leukaemia [42]. Other studies have also
which is still observed among the Bangladeshi agricultural workers. revealed a correlation between pesticide use and sarcomas, multiple
The result of the study reflecting the pesticide users perception of a myelomas, cancer of the prostate, pancreas, lungs, ovaries, the breasts,
pesticide-related acute illness, revealed that in Sri Lanka and Malaysia, testicles, liver, kidneys, and intestines as well as brain tumors [40-44].
7.1% and 7.3%, respectively, of the workers had suffered an episode
of poisoning during the previous year, compared with only 0.3% in Occupational safety in garment sector
Indonesia [34]. In all of the four countries, spraying, mixing and diluting
In Bangladesh, garment sector plays an important role in the
of pesticides were the most frequently identified activities associated
overall economic development. The sector is providing employment
with poisoning; unfortunately, these activities are still included in the
to approximately 20 lakh workers (among which 80% is female) of
traditional agricultural system of Bangladesh [34].
the country [45]. But it is unfortunate that working condition of these
However, when it is compared to the past a much recent study in industries is also putting at risk the health of these workers.
2004 showed that in 2001, of the 3035 cases of reported occupational
From a study conducted with 90 random correspondents in three
diseases in a study of Thailand, 87.4% were caused by pesticide
garment factories of Bangladesh, it was found that working condition
poisoning and 3.4% were by petro-chemical poisoning [35]. It is also
of those three garment factories severely affected worker’s health,
observed that as a result of frequently problematic handling of pesticides

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ISSN: IJPHS, an open access journal Volume 1 • Issue 1 • 1000102
Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
because of their confinement in a closed environment during working
hours [46]. In the study the particular nature of work created various
types of health hazards among the selected respondents such as sleep
deprivation, headache, malnutrition, musculoskeletal pain, eye strain,
less appetite, chest pain, fainting, diarrheal disease, hepatitis (jaundice),
food poisoning, asthma, fungal infection, helminthiasis and dermatitis.
Results of the study also showed that at most 95.6 percent of the workers
were experiencing headache. In total 90, 58.89 percent respondents
implied that their extent of headache was severe. About 52.22 percent
of the respondents opined that they suffered from severe malnutrition,
followed by 78.89 percent by musculoskeletal pain, 72.22 percent by
eye strain, 68.89 percent by less severe malnutrition, respectively [46].
The following illustrates the patterns of diseases and illness among the
respondents (Figure 4).
It is also observed from the study that, 45.56 percent respondents
mentioned that they had severe diarrheal diseases and 36.67 percent
replied that they had not affected by diarrheal diseases yet. The study
also showed that amount of absenteeism of diarrheal diseases was high
on those who were involved in the garments sector less than two years.
This is may be due to the transmission of diarrheal diseases by faeco-
oral route and its relation to poor sanitation and poor socioeconomic
status [46].
Apart from these, asthma, a Chronic Obstructive Pulmonary
Disease (COPD) is also commonly found in the garment workers due
to the production of excessive dust like, cotton during preparation
and handling of garments product in the working place. The disease
progresses very slowly over many years and commonly occurs due to
inhalation of dust particle which ultimately causes chronic irritation
of lungs. From the table it is clear that 41.11 percent of the garment
workers experienced severe asthma severity of which was related to
the duration of work. The explanation of their relation to duration of
work is also similar to fungal infection, helminthiasis and dermatitis.
It is predicted from different observation that those who had less work
experience the existence of these disease was absent in them, on the
contrary who are involved in the garments sector for over a long time
the existence of these diseases was severe [46].
However, although there has been a number of evidences of these
severe diseases among garment workers of Bangladesh, the most
heartrending fact of the fate of the garment workers is being injured
or dead in the consecutive accidents being occurred in the industries.
Table 2 reveals the deadliest recent accidents occurred in four industries
of Bangladesh among which three are garment industries [23]. Unlike
58%
31%
19%
12%
Gastrointestinal Skin diseases Hypertension Jaundice
diseases
Figure 4: Distribution of common diseases among tannery workers [49].
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Page 6 of 9
Bangladesh the garment workers of the developed world are safer and
no recent fatal incident could be found among them, except some
news reports which mentioned the workers turning violent due to the
recent harassments abuses and death of some workers in India [47].
It obviously explains the lack of righteous, secured work environment
among garment workers not only in Bangladesh but also in other
countries.
Hazardous practices that are observed in tanneries
Tanneries are probably the oldest sectors which have been playing
a significant role in the national economy of Bangladesh. As the sector
is fully privatized since 2010 at present, Bangladesh has approximately
more than 1750 big, small and medium size tanneries which are
providing employment to approximately 0.5 million people [48].
However, it is also observed from the report of Human Right Watch
(2012) that 58% of these tannery workers in Bangladesh suffer from
gastrointestinal disease, 31% from skin diseases, 12% from hypertension
and 19% from jaundice (DOE, 2011) [49,50].
However, though illness among these tannery factory workers is
quite a serious issue, there is still no monitoring and action taken by the
law enforcements of Bangladesh [51]. Moreover, Human Right Watch
reported hazardous child labor practices in these tanneries [50]. It is
observed that a range of health conditions including prematurely aged,
discolored, itchy, peeling, acid-burned, and rash-covered skin, fingers
corroded to stumps, aches, dizziness and nausea and disfigured or
amputated limbs have been displayed by the past and present tannery
workers [51]. These health problems may arise from repeated exposure
to a hazardous cocktail of chemicals while measuring and mixing them,
adding them to hides in drums, or manipulating hides saturated in
them and in several other situation. However, some of these chemicals
can be injurious to health in the short term such as sulfuric acid and
sodium sulfide which can burn tissue, eye membrane, skin and the
respiratory tract. On the contrary, some chemicals like formaldehyde,
azocolorants and pentachlorophenol which are confirmed or potential
human carcinogens show symptoms or health effects years after
exposure to them [51].
Considering the geographical aspects, Occupational Health
hazards among the workers of tannery industries are not only a matter
of concern in developing country like Bangladesh but also in western
countries as well. Studies of leather-tannery workers in Sweden and
Italy found cancer risks between 20% and 50% of the workers which is
above expectation in case of their developed and safer health conditions
of their inhabitants [52]. Moreover according to a survey conducted
recently by Bangladesh Occupational Safety, Health and Environment
Foundation (OSHE), at least 21 people die in Bangladesh due to toxic
chemicals each month and as per an International Labour Organisation
(ILO) report, about two million people die annually across the world
due to chemical related diseases while about 160 million people are
affected by such diseases [53]. Therefore the occupational hazard
among tannery workers which is a matter of distress Bangladesh is also
an alarming issue throughout the world.
A study revealed that irrespective of the severity of injuries, victims
in rural Bangladesh spent an average of US $4 on each injury although
this is a country where 17.6% of the population lives below the lower
poverty line [17]. With a poor public health care system, insufficient
health insurance and social safety nets, injured and sick victims and
their families are forced to cover the cost of treatment through their own
means [54]. Therefore, though work-related diseases are amenable to
prevention through recognition, evaluation and control of the hazards
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Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
in an ideal world, effective practice of occupational health and safety is
yet to be fully developed in the developing countries like Bangladesh.
Gaps & Recommendation
Considering the economic situation of the world, Bangladesh is still
lying in the developing stage. So, it is predicted that by far the occupational
health and safety service in Bangladesh is in the developing situation.
The current state of law and regulation system of the country refers to
the extreme need for more workers, industries or new manufacturing
process as the current condition does not at all completely cover all
the occupational sectors of the country (Figure 2). In addition, the
laws that are run by the country to cover up the health impacts due
to occupation hazards, are lacking I standard values, in fact they are
not specific, rather general in nature. However, from 2009, significant
initiatives have been taken against these occupational health hazards
in Bangladesh such as TVET Reform Project. The project was jointly
funded by the Bangladesh Government, the European Commission
and the International Labour Organization (ILO). The project arranged
a day long workshop on “Occupational Safety and Health” (OSH) to
raise awareness among the industry stakeholders [55]. In addition, the
amendments of Bangladesh Labour Act 2006, adopted on 15 July 2013,
were supposed to be the first step towards fulfilling the Government’s
obligation to the fundamental rights of freedom of association. The
amendments were also adopted to address the critical need of bolstering
the occupational safety and health [56]. The conformity of the amended
legislation with international labour standards ratified by Bangladesh
was reviewed by the ILO supervisory machinery later in that year. An
initial review by International Labour Organization suggested that the
amendments did address some of the ILO’s specific concerns, while fall
short of several important steps for which the organization requested
the country to bring them into conformity with ratified international
labour standards [56]. Though several provisions to improve workplace
safety have now been included in the law, the disastrous incidences
caused by occupational health hazards are yet to be reduced. Since
Bangladesh has ratified category only or sector specific Conventions on
OSH which are not directly related to the Labour Act, the specific steps
taken in this area detailed below can only be welcomed. However the
country is encouraged to ratify the key international labour standards
on OSH policy, namely Promotional Framework for Occupational
Safety and Health Convention, 2006 (No. 187) and Occupational Safety
and Health Convention, 1981 (No. 155) [56]. But even in this bigger
platform no such organization or agencies have developed which could
be a referral center for different standard or occupational permissible
limit. Moreover, it is also important to raise concern among out country
workers because the labor law in Bangladesh has been framed which
requires employers to undertake corrective measures on occupational
safety and health. Lack of awareness, training program of the OSH
standards by the employers made this area vulnerable to the workers.
The ILO Country Office for Bangladesh in cooperation with
the Ministry of Labour and Employment, Bangladesh Employers’
Federation (BEF), National Coordination Committee for Workers
Education (NCCWE), social partners such as the Occupational Safety
and Health and Environment (OSHE) Foundation and the Bangladesh
Institute of Labour Studies (BILS), are working to foster a preventative
safety and health culture by strengthening national occupational safety
and health (OSH) systems [15] which includes:
• Development of a National OSH policy, National OSH profile
(2002) update;
• Promotion on ratification of the Occupational Safety and
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Page 7 of 9
Health Convention, 1981, as well as Occupational Health Services
Convention, 1985 (No. 161) and Private Employment Agencies
Convention, 1997 (No. 181);
• Capacity building of the key OSH stakeholders;
Promotion of safe and environmentally friendly ship recycling; and
Promotion of better working conditions in the garment industry [15].
Even in these acts, there is no legal requirement for safety committee
and employment of the safety officers. The provisions of medical care are
nonspecific and vague. The inspectorate of factories and establishment,
the enforcing agency for different legislation are under-staffed and
unequipped both in terms of training and technology, in fact they are
unable to execute the enforcing activities adequately. The NGO activity
of the OSH is limited even. Only a few conducts awareness, training
and research activities regarding OSH issues. Training and education
facilities on OSH are inadequate and limited mainly in governmental
undertakings.
Considering the data management systems, OSH is inadequate
since it gathers information mainly from the secondary sources and has
no primary data collection system in place. So there is an increasing
number of events that are under reported or miss reported. Moreover,
while the data for occupational injuries and accidents are available
from the department of inspection, the data for occupational illness
are not found from these departments of inspectorate as they are not
normally reported. Nevertheless, in the studies conducted by NIPSOM,
a number of occupational diseases have been found to be prevailing in
various industries.
All these gaps are needed to be minimized by government, NGO
and private sectors by incorporating proper initiatives. It is also
necessary to give specific ideas to the policy makers to revise our
legislation process so that they can reduce these OSH problems. OSH
management and framing of national occupational safety and health
policy should also be incorporated to the national policy. Training
awareness and motivating workers regarding the safety and health in
their working place are needed to be undertaken by their owners and
it should be forced by the government agency. Development of and
strengthen of institutional capacity to provide education and training
related to the OSH in all sectors has now become an urgent need.
Thus, qualified OSH personnel-occupational physicians, occupational
nurse and industry hygienist and safety officers etc. are needed in each
company as well as all occupational sector to share their strength of
knowledge to disseminate their OSH information and its vulnerability.
Occupational health care facilities for employees must be ensured in
all the workplaces. Considering the business perspective, interim
incentives for adoption and implementation of OSH program can be
encouraged. Apart from them, researchers and academicians are also
needed to come forward with their research ideas to go through this
problem. Moreover, national statistics has to be developed by active
data collection system by establishing occupational disease surveillance
and national and regional accidents and occupational disease database
system.
Conclusively, based on the present review study, OSH has a became
a problem that needs to be addressed both in developed and developing
countries, but particularly in the countries where there is a high density
of industries producing or using manpower as their main strength.
This review shows that occupational health hazard can be extremely
harmful to the humans’ health to make any kind impact that can’t be
measured. All these factors point at a single conclusion that we must
take immediate steps to protect our country through proper rules,
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Citation: Tasnim F, Rahman I, Rahman MS, Islam R (2015) A Review on Occupational Health Safety in Bangladesh with Respect to Asian Continent.
Int J Pub health safe 1: 102. doi: 10.4172/ijphs.1000102
regulation and implementation. Otherwise, we cannot ascertain a
healthy and safe life for those who are yet to see a healthy family beside
them.
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