Welcome

….
OCCUPATIONAL HEALTH AND SAFETY

Mrs Gayathri R
2nd year MSc Nursing
UCON Kollam
INTRODUCTION
Occupational health is an important branch in community health.
Previously it was thought that its entirely related to factories and mines.
Hence the term “industrial health” and “industrial hygiene” were
common. Now the concept was changed according to concept in the
society/community. Modern concept of “occupational health” now
embraces all types of employment including mercantile and commercial
enterprises, service traders, forestry, agricultural and various other
sectors.
DEFINITION

Occupational health is defined in the occupational health and safety

encyclopedia as being concerned with physical, mental & social
wellbeing of man in relation to his work & working environment, his
adjustment to work & adjustment of work to man.
- Forsman(1976)

Occupational health is the branch of medicine dealing with the

prevention and treatment of job related injuries & illness.
- Oxford dictionary
AIMS
Promotion and maintenance of high degree of physical, mental &
social wellbeing of workers in all occupation.

Prevention among workers of the departures from health caused by

their working condition.

Protection of workers in their employment from risks resulting from

factors adverse to health.
AIMS….
Placing & maintenance of workers in an occupational
environment.

To summarize the adaptation of work to man of each man to

his job.

Joint ILO & WHO committee

OBJECTIVES
Promote & maintain highest degree of possible health.

Prevent health declination.

Protect from adverse factors.

Assist the injured & disabled for rehabilitation.

Improve human efficiency in work by application of ergonomics.

Provide self occupational environment.

Ergonomics
• Ergonomics is the study of men at work with
a view to identify stress factors operating in
work environments and impairing the
physical, mental and psychological health of
workers and interfering with their work
performance.
IMPORTANCE OF OCCUPATIONAL
HEALTH
Decrease staff turnover.
Having safe & conducive environment.
Reduce cost of injury.
Minimal property & equipment damage.
Minimizing penalties.
Reduce risk premium.
Secure investors confidence.
OCCUPATIONAL ENVIRONMENT

۞Man & physical, chemical and biologic agents.

۞Man & machine.

۞Man & man.

OCCUPATIONAL HAZARDS
PHYSICAL HAZARDS
• Heat and cold

• Light

• Noise

• Vibration

• Ultraviolet radiation

• Ionizing radiation
Heat
Direct effect Indirect effect
• Burns
• Decreased
• Heat exhaustion efficiency,
• Heat stroke • Increased fatigue
• Heat cramps • Enhanced accident rates.
 Cold

• Chilblains

• Erythrocyanosis

• Immersion foot

• Frostbite as a result of cutaneous vasoconstriction.

• General hypothermia
Light
•The acute effects of poor illumination are
• Eye strain,
• Headache,
• Eye pain,
• Lacrymation,
• Congestion around the cornea
• Eye fatigue.
• The chronic effects on health include "miner's nystagmus"
Noise
•(i) Auditory effects

•  Temporary or permanent hearing loss

•(ii) Non auditory effects
 Nervousness,
 Fatigue,

 Interference with communication by speech

 Decreased efficiency
 Annoyance
Vibration

• Exposure to vibration may also produce injuries of the joints

of the hands elbows and shoulders.
Ultraviolet radiations

• Conjunctivitis

• Keratitis (welder's flash).

Ionizing radiations
• Genetic changes

• Malformation

• Cancer

• Leukaemia

• Depilation

• Ulceration

• Sterility
Ionizing radiation

• 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
Chemical hazards- Local action

•Dermatitis

• Eczema

• Ulcers

•Cancer by primary irritant action

Chemical hazards-Inhalation

• Dusts

• Gases

• Metals and their compounds

 Dust

• Dusts are finely divided solid particles with size ranging from
• 0.1 to 150 microns

• Dust particles larger than 10 microns settle down from the air
rapidly,
• Indefinitely Particles smaller than 5 microns are directly inhaled
into the lungs and are retained there and is mainly responsible for
pneumoconiosis.
Classification of dusts

• Inorganic and organic dusts;

• Soluble and insoluble dusts.

Gases

• Simple gases (e.g., oxygen, hydrogen),

• Asphyxiating gases (e.g. carbon monoxide, cyanide gas,

sulphur dioxide, chlorine)

• Anaesthetic gases (e.g., chloroform, ether,

trichlorethylene).
Metals & other compounds
• Lead
• Antimony & Arsenic
• Zinc
• Beryllium
• Cadmium
• Cobalt
• Manganese
• Mercury & Phosphorus
Ingestion

• Occupational diseases may also result from ingestion

of chemical substances such as lead, mercury, arsenic,
zinc, chromium, cadmium, phosphorus etc.
BIOLOGICAL
• Brucellosis
• Leptospirosis
• Anthrax
• Hydatidosis
• Tetanus
• Encephalitis
• fungal infections
• Schistosomiasis
MECHANICAL HAZARDS

• Accidents

• Injury
PSYCHOSOCIAL HAZARDS

•Factors affect health

• Frustration

• Lack of job satisfaction,

• Insecurity

• Poor human relationships,

• Emotional tension
PSYCHOLOGICAL HAZARDS

•The health effects can be classified in

two

(a) Psychological and behavioral

changes

(b)Psychosomatic ill health

OCCUPATIONAL DISEASES
DISEASE DUE TO PHYSICAL AGENT
• Heat

• Cold

• Light

• Pressure
• Noise

• Radiation

• Mechanical factors

• Electricity
DISEASE DUE TO CHEMICAL AGENT
• Gases
• Dusts (pneumoconiosis)
 Inorganic dust: coal dust; silica; asbestos; iron
 Organic(vegetable dust): cane fiber; cotton dust; tobacco;
hay or grain dust
• Metals and their compounds: lead ,mercury, cadmium,
manganese, beryllium, arsenic,chromium.
• Chemicals: acids, alkalies, pesticides
• Solvents: carbon bisulphide, chloroform , benzene
•III. DISEASE DUE TO BIOLOGICAL AGENT
• Brucellosis, leptospirosis, anthrax, tetanus, encephalities, fungal
infection.
•IV. OCCUPATIONAL CANCER
• Cancer of the skin, lungs, bladder
•V. OCCUPATIONAL DERMATOSIS
• Dermatitis, eczema
•VI. DISEASE OF PSYCHOLOGICAL ORIGIN
• Industrial neurosis, hypertension, peptic ulcer.
Pneumoconiosis

• Dusts within the range of 0.5 micron to 3 micron is a

health hazard producing, after a variable period of exposure,
a lung disease known as pneumoconiosis, which may
gradually cripple a man by reducing his work capacity due to
lung fibrosis and other complications.
Silicosis

• Caused by inhalation of dust

containing free silica or silicon dioxide
• Snow storm appearance in X ray
Anthracosis

• It is caused by inhalation of dust containing coal miners.

• First phase is called simple pneumoconiosis which is

associated with little impairment.
• Second phase is characterized by Progressive massive
fibrosis
Byssinosis

• Inhalation of cotton fibre dust over long periods of, time.

•The symptoms are
• Chronic cough
• Progressive dyspnoea,
• Chronic bronchitis
• Emphysema
Bagasosis

• Inhalation of cotton fibre dust over long periods of, time.

•The symptoms are
• Chronic cough
• Progressive dyspnoea,
• Chronic bronchitis
• Slight fever
Bagassosis
•Preventive measures

• Dust control

• Personal protection

• Medical control

• Bagasse control
Asbestosis
• Asbestos is of two types- serpentine or chrysolite
variety and amphibole type.

• Clinically the disease is characterized by

dyspnoea.

• Clubbing of fingers,

• Cardiac distress and cyanosis.

• The sputum shows "asbestos bodies"

• An X-ray of the chest shows a ground-glass

appearance in the lower two thirds of the lung
fields
Preventive measures
• Use of safer types of asbestos (chrysolite and amosite)

• Substitution of other insulants: glass fibre, mineral

wool, calcium silicate, plastic foams, etc.
• Rigorous dust control
• Periodic examination of workers; biological monitoring
(clinical, X-ray, lung function), and Continuing research.
Farmers lung

• Farmer's lung is due to the

inhalation of mouldy hay or

grain dust.
 Lead poisoning
•MODE OF ABSORPTION

(1) INHALATION.
(2) INGESTION.
(3) SKIN
Clinical features
•The toxic effects of inorganic exposure

•abdominal colic Constipation loss of

appetite
•blue-line on the gums stippling of red cells
Anaemia
•wrist drop

•foot drop.
• The toxic effects of organic lead compounds are mostly on
the central nervous system
• Insomnia

• Headache

• Mental confusion

• Delirium.
Diagnosis
(1)HISTORY

(2)CLINICAL FEATURES

(3)LABORATORY TESTS:

• Coproporphyrin in urine (CPU) :

• Amino levulinic acid in urine (ALAU) :

• Lead in blood and urine:

Occupational cancer

• Skin cancer: gas workers, oil refiners, tar distillers, oven

workers.
• Lung cancer: gas industry, nickle and chromium work,
mining of radio active substance
• Bladder cancer: dye stuff, dyeing industries, rubber,
gas and electrical cable industry.
• Leukemia: benzol, roengent rays and radioactive
substance.
 Control measures
• Elimination or control of industrial carcinogens.
• Medical examinations
• Inspection of factories,
• Notification

• Licensing of establishments,

• Personal hygiene measures,

• Education of workers and
Occupational dermatitis
•Causes
• Physical
• Chemical
• Biological
• Plant products
PREVENTION

(1)Pre-selection
(2)Protection
(3)Personal hygiene
(4)Periodic inspection
 Radiation hazards
• Shielding of workers

• Monitoring the employees

• Protective clothing

• Adequate ventilation

• Replacement and periodic examination

• Avoidance of pregnant women to work

HEALTH PROBLEMS DUE TO
INDUSTRIALIZATION
• Environmental sanitation problems

• Communicable disease

• Food sanitation

• Mental health

• Accidents and social problems

• Morbidity and mortality

MEASURES FOR HEALTH PROMOTION
OF WORKERS
• Nutrition
• Communicable disease control
• Environmental sanitation
• Mental health
• Measures for women and
children
• Health education
• Family planning
Nutrition
• Under Indian factory act,

• One canteen when number of employees

exceeds 250

• Education of workers on the value of

balanced diet.
Communicable disease control
• Adequate immunization against communicable diseases
Environmental sanitation
• Water supply
•Installation of drinking water fountains
• Food
• Sanitary preparation, storage and handling
of food
•Education of food handlers
•Protection against hazards
• Toilet

• One sanitary convenience for 25 employees for the first 100

employees and thereafter one for 50
• General plant cleanliness

• Sufficient space

• The recommended standard is of minimum of 500cuft

• Lighting
•Standards for illumination
•High precision work 50-75 foot candles
•Regular work- 6 to 12 foot candles
• Corridors and passages- 0.5 foot candles
•Ventilation, temperature

• Housing
Mental health

• To promote the health and happiness of the workers.

• To detect signs of emotional stress and strain and to secure

relief of stress and strain where possible
• The treatment of employees suffering from mental illness
and the rehabilitation of those who become ill
Measures for woman & children
(1)Expectant mothers are given maternity leave for 12 weeks,
(2) Provision of free antenatal, natal and postnatal services.

(3)The Factories Act (Section 66) prohibits night work between 7

p.m. and 6 a.m.;

(4)The Indian Mines Act (1923) prohibits work

underground.
(5) The Factories Act, 1976 provides for creches in factories
where more than 30 women workers are employed,
Health education
Family planning
PREVENTION OF OCCUPATIONAL DISEASE
MEDICAL MEASURES
•Pre-placement examination
•Periodical examination
•Medical and health care services
•Notification
•Supervision of working environment
•Maintenance and analysis of records
•Health education and counseling
ENGINEERING MEASURES
•Design of building

•Good housekeeping

•General ventilation

•Mechanization

•Substitution
•Dust-enclosure and isolation

•Local exhaust ventilation

•Protection device

•Environmental monitoring

•Statistical monitoring and research

LEGISLATION
•The Factory Act-1948

• The Employees state insurance

act-1948
Occupational
health and safety (OHS) management system 
• An occupational health and safety 
(OHS) management system encompasses
more than just your health and safety
program. It includes health and safety 
policies, systems, standards, and
records, and involves incorporating
your health and safety activities and
program into your other business
processes.
IMPORTANCE OF OCCUPATIONAL HEALTH IN
HOSPITAL
• PERSONAL (STAFF) PROTECTION

• Physical hazards

• Chemical hazards

• Biological hazards

• Psychological hazards

• Patient safety
ROLE OF OCCUPATIONAL HEALTH
NURSE
• CLINICIAN
• Primary prevention
• Emergency care
• Treatment services
• Nursing diagnosis
• Individual & group care plan
• General health advise & assessment
SPECIALIST
• Rehabilitation

• Maintenance of work ability

• Health and safety

• Hazard identification

• Risk assessment

• Advice on control strategies

MANAGER
• Management
• Administrator
• Budget planning
• Marketting
• Quality assurance
• Professional audit
• Continuing professional development
COORDINATOR

• Occupational health team

• Worker education and training

• Environmental health management

• ADVISOR

• HEALTH EDUCATOR

• COUNSELLOR

• RESEARCHER
SCOPE
• Writing policies and procedures
• Assessing risks
• Investigating accidents
• Advising managers and directors
• Consulting with employees
• Training
• Managing Contractors
• Liaising with third parties including auditors, regulators and
insurers
• Environmental Management

• Quality Management

• Security

• Training

• Food Safety

• Transport
• Communicate effectively

• Maintain their independence

• Work at all levels of the organisations they work within

• Organise their workload

• Prioritise

• Delegate

• Maintain their own competence.

 ETHICS

• Improving professional standard

• Protecting the life

• Professional independence
 JOURNAL ABSTRACT
• OCCUPATIONAL HEALTH AND SAFETY IN INDUSTRIES IN
DEVELOPING WORLD

Iftikhar Ahmad1, Abdul Sattar2, Allah Nawaz2 1Department of Community

Medicine, Gomal Medical College, 2Department of Public Administration, Gomal
University, Dera Ismail Khan, Pakistan. ABSTRACT: Current global workforce
stands at about 2.8 billion. Workers spend about one third of their lifetime at
workplace. Workers expect safe working environment as their fundamental human
right. However there are still poor working conditions especially in developing
countries due to lack of practicing simple preventive measures.
• The standard of Occupational health and safety available at any work place is
the main determinant of workers’ health. Workers all over the world, face dual
occupational hazards, the traditional as well as novel in the complex work
settings due to rapid industrialization, technological advancement and
globalization, over the last few years. An equally wide variety of chemical,
physical and psychological hazards in production. Occupational health issues
affect individuals, families and communities, as well as the citizens of the
world. All the stake holders including the state, the manager, the employer and
the worker have certain responsibilities to take up medical, engineering and
legislative interventions to make work environment safer.
CONCLUSION

Occupational disease not been

neglected and should give proper
attention at time. It’s the main role
of a nurse to work as an educator
and protector in the field of
occupation.