Occupational and Environmental

Health
Prepared by
Ms Yasmeen Bibi
Mr Asif shah
 Objectives
By the end of presentation learner will be able to:
1. Define occupational and environmental health
2. Understand trend, issues related occupational health and
workplace safety
3. know about the aims and objective of occupational and
environmental health
4. Figure out occupational environment
5. Understand occupational and environmental diseases and
disorders
6. Know occupational hazard for different category of people
 OCCUPATIONAL HEALTH AS A FUNDAMENTAL HUMAN
RIGHT

Every worker has the right to working conditions which

respect his or her health, safety and dignity.
(Art. 31 of the European Charter)
 Occupation
•A person's usual or principal work especially for earning
• Any activity in which a person is engaged

Classification:
•Professional occupation
•Skilled occupation
•Unskilled occupation

WHO definition of Health

•Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.
 Occupational Health definition
• OCCUPATIONAL HEALTH is a study of the effect
of the work and the working environment on
the health of the worker and influence the
state of the health of the workers on his ability
to perform the work for which he is employed.
• It is concerned with two way relationship of
health and work.
 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.”
 ‘Environmental Health’
• Comprises those aspects of human health, including
quality of life, that are determined by physical,
biological, social and psychosocial factors in the
environment. It also, refers to the theory and practice of
assessing, correcting, controlling, and preventing those
factors in the environment that can potentially affect
adversely the health of present and future generations’
(WHO, 1993a)
 Environmental Health?

Air Sunlight

Food Noise

Water Soil

The study of how the environment

affects your health.
Integrated Environmental Health Middle
School Project • University of Washington 8
© 2005
 Background
• During and after World War I, Industrial Revolution occurred
– rapid introduction of new industries
– Increasing demand of products and production activities
– Indiscriminate hiring of workers to run the manufacturing processes

• This brought about

– Poor and unsafe working conditions
– serious dangers not anticipated
– exposure to various occupational diseases and serious accidents aggravated by
endemic diseases like malnutrition, worm infestation, malaria and others

• Hence the origin of Occupational Health as means of protecting the

health and welfare of employees
 Aim of occupational and environmental
health
• To reduce industrial accidents.
• To prevent occupational hazards/ diseases.
• To achieve maximum human efficiency and machine
efficiency.
• To reduce sick absenteeism.
• To develop, implement and enforce
environmental health, food safety, radiation
protection and poisons control legislation
 Objectives of occupational and
environmental health

• 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
• strengthen health promotion practice at the community
level
• conduct environmental health surveys, research and
development
 Conti……
• Monitor, audit, inspect and risk assess all commercial
premises including take away food shops, markets,
restaurants, boarding houses, beauty salons, hairdressers,
and ear & body piercing establishments
• Work with other program areas of the department and
with other agencies, communities and key stakeholders to
improve environmental health outcomes and support 'at
risk' groups
• Action and resolve complaints received regarding
environmental health, radiation safety, poisons control
and food safety matters
 WHY AN IMPORTANT
• Ill health and injury in the working population
reduces the effective contribution of the
individual to his welfare(benefits), the family,
the community and the nation.
Work & Working environment

affects

Health of worker
leads to
Efficiency / Inefficiency
 Global Burden of Occupational and Environmental
Injury and Disease/Year

Injuries Diseases Total

Fatal 100,000 700,000 800,000

Non-Fatal 99,000,000 10,300,000 109,300,000

100,000,000 11,000,000 111,000,000

*From Leigh, et al., Epidemiology 10(5):626-31, September 2005

 *Estimated Annual Incidence of
Occ Injury & Disease Worldwide
# New Cases/year
Injuries 100,688,000
Diseases
Pesticide poisoning 109,000
Other poisoning 122,000
Cancer 191,000
Mental disorders 318,000
Pneumoconioses 453,000
Noise-induced hearing loss 1,628,000
Skin disorders 1,895,000
Chronic respiratory disease 2,631,000
Musculoskeletal disorders 3,337,000
 Types of Industries in Pakistan
• Agriculture
– 17,518,204 labor force employed
• Manufacturing
– 6,005,487 workers
• Service
31%
– 10,586,309 working
51%
• Statistics as of year 2011

18%
 Accidents – Sector wise
60

49.8
50

40

30

20 16.8
14
11.3
10 8.1

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• Pakistan Board of Statistics (PSB): Labor Force Report FY 2010-11

 Survey report in Pakistan
• A survey by the Lahore based Centre for the Improvement
of Working Conditions and Environment (CIWCE) found
that industry lacks basic hygiene facilities, has inadequate
exhaust filters, fire prevention and medical facilities,
emergency transport, waste disposal systems and hazard
warning signs. Workers in hazardous industries such as
textile, tanning, chemicals, paper, sugar, electrical and
electronic suffer from higher rates of occupational
accidents and are likely to get diseases such as lung
cancer, skin and eye allergies, deafness and headaches
(Awan, 2001).
OCCUPATIONAL HEALTH INCIDENTS
Karachi Baldia Town Factory Fire  11th,
September, 2012
• 1500 workers belonging to nearby areas used to
work in this Baldia Town garments factory.
• more than 250 workers who were present
inside was burnt alive, because dubiously all
exit doors were locked and none of them were
able to depart of the factory – consequently
lost their lives.
 Contt…
• Bhopal disaster (December 3,1984-
India)
A Union Carbide subsidiary pesticide plant
released 40 tonnes of methyl isocyanate (MIC)
gas. Half a million people were exposed to the
gas and 20 thousand have died to as a result
of their exposure. More than 1 lac and 20
thousand people still suffer from the
pollution at the plant site.
What is occupational and environmental
Hazards
Bacteria &
viruses
Harmful
chemicals
Tobacco
smoke

Stress

Loud noises

A hazard is anything in the environment that

can hurt you or make you sick.
Integrated Environmental Health Middle
School Project • University of Washington 22
© 2005
 PHYSICAL HAZARD

ERGONOMIC HAZARD CHEMICAL HAZARD

BIOLOGICAL HAZARD

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CHEMICAL HAZARDS

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 Chemical Hazards
Routes of entry into the body
Inhalation Skin Contact

Ingestion

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 Chemical Hazards
Effects Chemical Agent Industry/Process

Renal Diseases: Battery, chemical

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

Pneumoconiosis Inorganic dust Mining, construction,

sandblasting, coal

Cancer Chromium Plating, metal refining

BOSH Training 2009 OSHC

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

Aplastic anemia Benzene Solvent & soap mfg.

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

Acne Cutting oils, grease Machine-tool

operators
Skin Cancer Arsenic, tar Petroleum refinery

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PHYSICAL HAZARDS

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 Physical Hazards
• Noise

• Vibration

• Extreme Temperature

• Illumination

• Radiation

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BOSH Training 2009 OSHC
 NOISE
Types of Noise-Induced Hearing Loss

• Temporary Threshold Shift (auditory fatigue)

– temporary loss of hearing acuity after exposure to
loud noise
– recovery within 16-48 hrs

• Permanent Threshold Shift

– irreversible loss of hearing
BOSH Training 2009 OSHC
 NOISE
Early Signs of Hearing Loss
• Difficulty in understanding spoken words in a noisy
environment
• Need to be near or look at the person speaking to
help understand words
• Familiar sounds are muffled
• Complaints that people do not speak clearly
• Ringing noises in the ears (tinnitus)

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Other Harmful Effects of Noise

• Hypertension
• Hyperacidity
• Palpitations
• Disturbs relaxation and sleep

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BOSH Training 2009 OSHC
 VIBRATION
• Physical factor which affects man by transmission of
mechanical energy from oscillating sources

• Types
– Segmental vibration
– Whole body vibration

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

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 Whole Body Vibration:

• Health effects:
– Fatigue
– Irritability
– Headache
– Disorders of the spine

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BOSH Training 2009 OSHC
 EXTREME TEMPERATURE

• Sources of heat stress:

– Natural Conditions
– Hot work processes related to furnaces, kilns,
boilers and smelting

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 Health Effects of Heat Stress
Disorders Clinical features

Prickly Heat (Miliaria rubra) Pruritic rash

Heat cramps Cramps in the body,

usually legs

Heat exhaustion Dizziness, fainting attack,

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

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BOSH Training 2009 OSHC
 Inadequate Illumination
Health Effects
– Visual Fatigue
– Double Vision
– Headaches
– Painful irritation
– Lacrimation
– Conjunctivitis

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BOSH Training 2009 OSHC
 RADIATION

Types Sources Health Effects

Ionizing X-rays Cancer, congenital
Gamma rays defects, death

Non-ionizing Ultraviolet skin redness, premature

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

BOSH Training 2009 OSHC

BIOLOGICAL HAZARDS

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 BIOLOGICAL HAZARDS

VIRUSES FUNGI

BACTERIA PARASITES

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Selected Infectious Diseases and Occupations

Agent / Disease Occupation

Colds, influenza, scarlet fever, May be contracted anywhere
diphtheria, smallpox
Tuberculosis Silica workers, people exposed
to heat and organic dusts, and
medical personnel

Anthrax Animal handlers and handlers

of carcasses, skins, hides, or
hair of infected animals,
including wool carpet
processors and handlers.

BOSH Training 2009 OSHC

Selected Infectious Diseases and Occupations

Agent / Disease Occupation

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

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

Tetanus Farmers (spores in soil) or

anyone in contact with manure.

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 Occupational diseases
• Definition:
Diseases arising out of or in the course of
employment.
 Genetic Multiplicity of
factors exposure
Lifestyle
Duration of
Age exposure

WORK- Workplace
Workers’
Factors Physical
Susceptibility RELATED properties
Race DISEASE
Magnitude of
Gender exposure
Medical Timing of
history exposure

BOSH Training 2009 OSHC

 pneumoconiosis:
• Dust in a range of 0.5- 3 micron is hazardous, after a prolong
period of exposure ,a lung disease is called pneumoconiosis.
It leads to lung fibrosis and other complications.
• Hazardous effects on the lungs depend upon following
factors:
1. Chemical composition
2. Fineness
3. Concentration of dust in the air
4. Period of exposure
5. Health status of the person exposed.
 SILICOSIS:

1. lung fibrosis caused by the inhalation of dust

containing silica.
2. It was first reported in 1947 in India from KOLAR
GOLD MINES
3. It occurrence occurs in various industries like mining
industry,( coal, gold, silver, lead, zinc, mangnese and
metals ) pottery, and ceramics, sand blasting ,metal
grinding, construction work, rock mining, iron and
steel industry.
 ANTHRACOSIS:
• This disease occurs in coal miners, and there are
two phases in coal miners pneumoconiosis.
1. Simple pneumoconiosis, associated with little
ventilatory impairments and require 12 yrs of
work exposure for its development
2. The second phase is characterized by
progressive massive fibrosis(PMF) ,it leads to
severe respiratory disability and leads to
premature death.
 BYSSINOSIS:
• IT is due to inhalation of cotton fibre dust over
long period of time.
• Symptoms: chronic cough, progressive
dyspnoea, chronic bronchitis, emphysema.
 Bagassosis:
• It is due to inhalation of sugarcane dust.
• Symptoms : breathlessness, cough,
heamptysis
Slight fever, initially there is impairment in the
pulmonary functions if treated early ,there is
resolution of inflammatory conditions of the
lungs. If left untreated ,there is diffuse fibrosis,
emphysema and bronchiectasis.
 Asbestosis
• It is used in asbestos cement, fire proof textile,
roof tiling, brake lining, gaskets etc.
Asbestos fiber are insoluble and inhaled and
deposited in lung alveoli and causes
pulmonary fibrosis leading to respiratory
insufficiency and death.ca
 How to prevent these occupational diseases

• Placing people in suitable work

This is done through pre-employment medical
examination.
• Maintaining people in suitable work
Routine screening after illness or injury and
deterioration in general health.
 CONT..

• Providing treatment
Efficient and speedy treatment of injuries,
acute illnesses and poisoning etc.
• Controlling recognized hazards
Through preventive measures
 CONT..
• Identifying unrecognized hazards
Clinical observation and epidemiological study
combined with knowledge of toxicological
principles can help identify newer risks.
(thalidomide using for nausea in pregnancy
actually responsible for congenital malforms
babies)
 CONT..
• Health education and safety training
Doctors and nurses collaboration with the management
in formal(official) health and safety training programs.
• Environment control outside the workplace
preventing the industries from adversely affecting the
health of the neighboring communities through the
discharge of toxic effluents from the workplace or
other causes of public nuisance e.g. noise, offensive
smells, gasses and dust etc(nasir bagh waste from
industries
 CONT..
• Screening for early evidence of non-
occupational disease
Through regular screening of working
population for malaria, mental illnesses, heart
disease and hypertension etc.
 CONT..
• Maintenance of medical records
for medical check-up and follow-up for
maintaining health standards and also for
evaluation.
• To carry out other parallel activities
such as nutrition program, family planning,
social services recreation etc., Concerning the
health and welfare of the workers.
Follow occupational safety and health (OSH)

• It is the inter-relationship between the people

at work, the tasks they do and the
environment in which the tasks are carried out
• It is the field that ensures
– Workers safety and healthy being
– The related laws and regulations are enforced
 The Dilemma
• Majority of the workforce in Pakistan is illiterate
and not trained in occupational safety and health
• Moreover OSH is not included in any curricula in
Pakistan
• The number of occupational health physicians
and nurses is far less compared to the total
workforce in Pakistan
– This means that occupational health system is not
established in the country (career opportunity)
“I still need more healthy rest in order to
work at my best. My health is the main
capital I have and I want to administer it
intelligently.”
---Ernest Hemmingway
Nobel Prize winner for literature

THANK YOU FOR YOUR ATTENTION!

BOSH Training 2009 OSHC
Any Questions?

Integrated Environmental Health Middle

School Project • University of Washington 66
© 2005
 References
1.  "Hazardous Work". International Labour Organization.
Retrieved December 26,2012.
2. National Institute for Occupational Safety and Health, Centers for
Disease Control and Prevention. June 28, 2013.
3. International Journal of Occupational and Environmental Health. Abel
Publications Services Inc. 2002
4.  Health, Safety and Environment Management, Retrieved 11/25/2013
5. Ladou, Joseph (2006). Current Occupational & Environmental
Medicine (4th ed.). McGraw-Hill Professional. ISBN 0-07-144313-4.
6.  Environmental Health: from Global to Local (2 Editor= Howard
Frumkin ed.). San Francisco: John Wiley & Sons. 2010v