OCCUPATIONAL HEALTH

EVAH MAINA
 OCCUPATIONAL HEALTH
• DEFINITION
The joint international labor organization
committee on Occupational health, 1950
defined occupational health as “The
highest degree of physical, mental and
social well-being of workers in all
occupations.”
 HISTORICAL BACKGROUND
Occupational medicine dates back to the middle of the
16 th Century where we find Georgius Agricola and
Paracelsus both studied and wrote on the subject of
miners diseases.

Paracelsus
Born: Phillip von Hohenheim
11 November 1493) or
17 December 1493)
Died: 24 September 1541 (aged 47)
Cause of death Unknown
Citizenship: Swiss

Georgius Agricola
Born: 24 March 1494
Died: 21 November 1555
Citizenship: German
 What is Occupational Health?
BERNADINO RAMAZINI :

The father of Occupational Medicine

observed a labourer cleaning
cesspits in the town of Medina who
was in some distress.

The man is reported to have said:

“No one who has tried it can imagine

Bernardino Ramazzini
what it cost to spend more than 4
hours on this job. Born:
Died:
3 November 1633
5 November 1714
Nationality: Italian

It is as bad as going blind.”

 What is Occupational Health?
BERNADINO RAMAZINI :

His book on occupational diseases,

De Morbis Artificum Diatriba
(Diseases of Workers), outlined the health
hazards of chemicals, dust, metals, repetitive or
violent motions, odd postures, and other disease-
causative agents encountered by workers in 52
occupations.

This was one of the founding and seminal works

of Occupational Medicine and played a
substantial role in its development.
 GOALS

• To reduce industrial accidents.

• To prevent occupational hazards/ diseases.
• To achieve maximum human efficiency and
machine efficiency.
• To reduce sick absenteeism.
 OBJECTIVES
• To maintain and promote the physical,
mental and social well being of the
workers.
•   To prevent occupational diseases and
injuries.
•   To adapt the work place and work
environment to the needs of the workers
i.e application of ergonomics principle.
• It should be preventive rather than
curative.
• OCCUPATIONAL HEALTH- It represents a
dynamic equilibrium between the
worker and his occupational environment.
• WHAT ISOCCUPATIONAL HEALTH CARE?
Occupational health care is preventive health
care, which is provided on the basis of the
Occupational Health Care Act. The objective
of occupational health care is a healthy and
safe working environment, a well-functioning
working community, prevention of work-
related diseases as well as the maintenance
of employees’ working ability and functional
capacity, and promotion of their health.
History of occupational health services in kenya
• The enactment of the Factories Act Cap 514 in 1951
saw the emergence of occupational safety and
health in Kenya. The crafting of this legislation was
prompted by the enactment of the Workers’
Compensation Act Cap 236 in 1948.
• Although occupational health services were referred
to in several statutes of Kenya such as the Public
Health Act Cap 242, the Environmental Management
and Coordination Act 1999, the Petroleum Act Cap
116, the Food, Drugs and Chemical Substances Act –
Cap 354, the Factories Act Cap 514 was the primary
Occupational Safety and Health Act.
 History of OH ctd’
• The Act was been revised several times in order to reflect not
only developments in technology and knowledge but also to
address new areas of coverage other than factories/industries
and some of the amendments done included among others:
• · “Other places of work”
• · List of occupational diseases
• · Establishment of health and hygiene standards
• · Reporting of occupational diseases
• · Direct penalties for medical practitioners failing to report
occupational diseases that they diagnose
• · Pre-employment, periodic and post-employment medical
examinations
• · Research into causes of work-related diseases among others
 History of OH ctd’

• A new Bill “Occupational Safety and Health

Bill” was drafted in 2003 to replace the
“Factories and Other Places of Work” Act. The
Bill was passed and is currently referred to as
the Occupational Health and Safety Act, 2007.
 
 Definition of terms
• Health
The World Health Organization has defined health as “a state of
complete physical, mental, and social well-being and not merely the
absence of disease or infirmity”.
Hazard
A hazard means anything that may result in injury or harm to the health
of a person; any source of potential damage, harm or adverse health
effects on something or someone under certain conditions at work. In
providing an environment where employees are not exposed to
hazards, employers must consider health as well as safety.
Injuries could result from the traditional range of physical safety issues
such as falls, strains, being hit by objects and electric shock to the non-
traditional emerging risks.
 occupational health and safety
• Is the discipline concerned with preserving and protecting human and
capital resources in the workplace (According to Professor Lee
Reynolds)
 Definition of terms ctd’
• Risk
Is the chance or probability that a person will be harmed or
experience an adverse health effect if exposed to a hazard.
It may also apply to situations with property or equipment
loss.
•  occupational hygiene
Is the discipline of anticipating, recognizing, evaluating and
controlling health hazards in the working environment
with the objective of protecting worker health and well-
being and safeguarding the community at large.
In many cases it concerns chemical safety, workplace health
hazards, identification of workplace hazards prevention
and control, methods of controlling workplace hazards.
Advantages of occupational health
• Investigates and assesses load factors and
hazards and gives expert assistance for
eliminating them
• Gives information and advice
• Estimates employees’ working ability and
monitors their health condition
• By its knowledge and skills supports action
for maintaining working ability in the
development of individuals, working
environment and working community, in this
way also affecting productivity continued
 Advantages ctd’
• Prevents occupational diseases and other
work-related illnesses
• Prevents premature incapacity for work,
reduces pension costs
• Reduces absenteeism due to sickness
• Can make calculations of the profitability
of occupational safety and health and
occupational health care in cooperation
with workplaces or encourage workplaces
to make these themselves.
The undertakings for the need of Occupational health

1. Any undertakings, which employ more than

the prescribed number.
2. Public sector undertakings
3. Atomic energy unit, explosive production
unit, mining unit, and asbestos production
unit etc.,
4. A unit where workers are exposed to health
hazards from toxic substances.
 Functions of occupational health service;
1.Pre-employment medical examination.
  2. First Aid and emergency service.
  3. Supervision of the work environment for
the control of dangerous substances in the
work environment.
  4. Special periodic medical examination
particularly for the workers in dangerous
operations.
  5. Health education for disseminating
information on specific hazards and risks in the
work environment.
 
 Functions of OH ctd’
6. Special examination and surveillance of
health of women and children
7. Advising the employer or management for
improving working conditions, and placement
of hazards.
8. Monitoring of working environment for
assessment and control of hazards.
9. Supervision over sanitation, hygiene and
canteen facilities.
10. Liaison and cooperation with the safety
committees
 Functions of OH ctd’
11. Maintenance of medical records for
medical check-up and follow-up for
maintaining health standards and also for
evaluation.
12. To carry out other parallel activities such
as nutrition programme, family planning,
social services recreation etc., Concerning
the health and welfare of the workers.
Components of occupational health services
• Medical treatment, First aid treatment in
emergency.
• Health education, First aid education.
• Pre employment examination
• Medical examination
• Pre employment examination
• Periodic medical examination
• Special medical examination
 Components of occupational health services ctd’

• Health counseling
• Stress management
• Mental health
• And Physical health
• Rehabilitation programme
 Medical rehabilitation
 Social rehabilitation
 Educational rehabilitation
 Vocational rehabilitation
 Components of OH services ctd’
• Assessment of dusts pollution
• Assessment of noise pollution
• Assessment of vibration
• Assessment heat radiation
 Components of OH services ctd’

• Supervision of the working environment

• Hazard identification
• Monitoring
• Evaluation
• Engineering project review
• Control measures
• Development of personal protective
devices
 Components of OH services ctd’
•Family welfare program
• To take care of employee and
dependents
•Disaster management
•Health records maintenance
 Principles and concepts
HAZARDS
DEFINITION:
Source or situation with a potential for harm in
terms of injury or ill health, damage to
property, damage to the workplace
environment, or a combination of these``
 TYPES OF HAZARDS
• Physical
• Chemical
• Biological
• Ergonomics
• Psychosocial
• Mechanical
 CHEMICAL & DUST
HAZARDS
(cleaning products,
pesticides, asbestos, etc.)
BIOLOGICAL ERGONOMIC
HAZARDS HAZARDS
(repetition, lifting, awkward
(mold, insects/pests,
communicable diseases, etc.) postures, etc.)
WORK
ORGANIZATION
HAZARDS
Things that cause STRESS!

SAFETY HAZARDS PHYSICAL HAZARDS

(slips, trips and falls, faulty (noise, temperature
equipment, etc.) extremes, radiation, etc.)
 Physical hazards
Temperature - Heat / Cold
        Illumination
     Noise
    Vibration
      Radiation
     Atmospheric pressure
 Diseases due to physical hazards
Heat - Heat hyperpyrexia, Heat Exhaustion
Heat Syncope, Heat Cramps, burns,
Prickly heat
Cold - Frost bite,
Light – Occupational Cataract,
Atmospheric-pressure-Caisson disease,air
embolism, explosion.
Noise - Occupational deafness,
Radiation -Cancer,Leukemia,aplastic anemia,
Pancytopenia
Electricity - Burns, Shocks,
 Chemical hazards
Routes of entry - Inhalation, Ingestion, skin absorption.
(inhalation is the main route of entry)
Chemical agents can be classified into-
1) Metals - Lead, Nikel , Cobalt etc.
2) Aromatic Hydrocarbons - Benzene, Toluene,phenol etc.

3) Aliphatic Hydrocarbons - Methyl alcohol

4) Gases –
*Simple asphyxiants : N2-nitrogen, CH4-methane, CO2

• Chemical asphyxiants : CO, H2S-hydrogen sulphide, HCN –

hydrogen cyanide
• Irritant gases : Ammonia, SO2-sulphur dioxide.
• Systemic poison : CS2 –carbon disulfide.
Dusts (pneumoconiosis)
Inorganic Dust
-      Coal Dust -Anthracosis
¨       Silica -Silicosis
¨       Asbestos -Asbestosis
 
       Organic Dusts
¨       Cane Fiber -Bagassosis (Bronchi gets affected)

- Cotton dust -Byssinosis (In Textile industries)

¨       Tobacco - Tobaccosis,Lung Cancer
¨       Grain Dust -Farmer’s Lungs
 Biological hazards
Bacteria-Tetanus,Tuberculosis, Anthrax, Brucellosis
(Milkmen),Gonorrhea(Sex-workers-Genital organs
get affected).
Virus - Hepatitis, AIDS
Protozoal&Parasitic-Malaria,Hydatid(Dog
handlers),Hookworms, tapeworms (Agri-workers),
etc.
Fungi-(Agri-workers)-Tinea-infections,
Coccidiomycosis, Psittacoses, ornithosis, etc.
 Mechanical hazards
Injuries-
Falls,cuts,abrasions,concussions,contusions,etc.
Ergonomic Disorders-
Musculo-skeletal disorders(MSDs),Cumulative-
trauma-Disorders (CTDs) etc. 
Ergonomics: ``Adjustment of Man & Machine``/
Application of human biological sciences with
engineering science to achieve optimum mutual
adjustment of man & his work, the benefit being measured
in terms of human efficiency and well being
Tool / machine design to fit to work. Ergo tools/ ergofriendly
tools : Tools which reduce the stresses or problems resulting in
CTD’s / MSD’s.)  
 Pyshosocial hazards
• Lack of job satisfaction, insecurity, poor
interpersonal relations, work pressure,
ambiguity, etc.
• v      Psychological & behavioral changes –
hostility, aggressiveness, anxiety, depression,
alcoholism, drug addiction, sickness
absenteeism.
• v      Psychosomatic disorders- Hypertension,
headache, body-ache, peptic ulcers, asthma,
diabetes, heart disorders, etc.
 
Principles of Control of Workplace Hazards

• Identify
• Evaluate
• Control
– Eliminate
– Substitute
– Enclose/separate
– PPE/vaccinate
examples of controls:Manual Handling - Back Injuries

All forces which come down the spine

compresses discs and as a result of
Continuous squeezing they can rupture
and bulge causing severe pain.
Most back injuries are built over along
period of time by repetitive pounding on
discs caused by improper methods. After
sometime some minor lift can produce
such rupture
``Straight back rule``
‘Thinking before lifting’
Manual Handling - Back Injuries
*CONTROL any risk by reducing
necessity for manual handling by using
alternative means of handling
*consider the load; size, awkward
shape, etc
*consider need for mechanical or
manual assistance
*position legs apart - one foot level
with the load
*keep back straight, look up
 Manual Handling - Back Injuries

*bend from the hips, avoid ‘twisting’ the body

*tighten the stomach muscles, but don’t hold breath
*BEND THE KNEES
*keep the load close to the body
*lift with the legs, not the back
*keep carrying distance short
*avoid changing grip or ‘jerking’ the load
*deposit the load by bending the knees and
keeping the back straight
VDT USER`S-ERGONOMIC GUIDELINES
SEATING POSITION

*Seat height to be adjusted so that thighs

are horizontal & feet are resting flat on
the floor
*Thigh-torso angle is not less than 90
degrees, with 100 degrees as preferable
*Chair should have ``Backrest``with support
for curvature in lumbar area
Natural S-curvature of the
spine
VDT USER`S-ERGONOMIC GUIDELINES
WORKING POSTURE

*Wrist and forearm-held in straight line to

reduce tendon & nerve stress
*Upper & lower arm-at 90 degree angle
*Elbows to be kept close to the sides
*Head-Screen distance=25-48 inches(min
12 ``) from the VDT users eye
*Optimal viewing angle is 20 degrees below
the horizontal line from the eyes
VDT USER`S-ERGONOMIC GUIDELINES
VISION & LIGHTING

*NO GLARE
*VDT to be placed 90 degrees to the light
source, adjust screen angle
*Use screen filters to reduce glare
*Screen intensity needs to be adjusted
*Frequent breaks from the screen to
reduce stress on eyes
VDT USER`S-ERGONOMIC GUIDELINES
GENERAL GUIDELINES

*Change positions, Stretch or walk around if feeling

tiredness
*``LIGHT TOUCH`` on Keyboard to reduce hand stress or
developing CTD`s
*Look at ``Optical Illusion`` for 1-2 minutes after every
20 minutes of work with vdt to reduce eye stress
*Rotate eye ball and also concentrate on a distant
object & near object alternatively to reduce eye stress
*Keep the vdt screen and eyeglasses clean
TYPE OF CONTROL MEASURES

Medical (required to monitor

effectiveness of Engg. Controls) 

  Engineering (Best Engg. Control is to

reduce exposure)
 
Administrative / Legal. (Emphasis given to
reduce the exposure
 ENGINEERING CONTROLS
 Designing-building, Work station.
 Good Housekeeping.
 Ventilation
  Mechanization
 Substitution.
 Enclosure
  Isolation
 Personal Protective Devices.
 Work Environment Monitoring
  Statistical Monitoring.
THANK YOU
QUESTIONS??