OCCUPATIONAL

HEALTH HAZARDS

MARK L. DENOSTA
DOLE Accredited OSH Practitioner
1033-140728-N-0458
 OBJECTIVES:

To identify and explain common hazards in

the workplace and their effects to workers’
health.
Occupational Health

The promotion and maintenance of the

highest degree of physical, mental and social
well-being of workers in all occupations

ILO/WHO
 WORKPLACE HAZARDS
Safety Hazards
 working conditions where
harm to the workers is of an
immediate and violent nature
 result in broken bones, cuts,
bruises, sprains, loss of
limbs, etc.
 the harm results in some kind
of injury to the worker
 associated with poorly
guarded or dangerous
equipment and machinery
Health Hazards
 working conditions which
result in an illness
 exposure to dangerous
substances or conditions,
such as chemicals, gases,
dusts, noise etc.
 often, latency between
exposure and disease
 Genetic Frequency of
factors exposure
Lifestyle
Duration of
Age exposure
Workplace
Personal WORK- Factors Physical
Factors RELATED properties
Race DISEASE
Magnitude of
Gender exposure
Medical Timing of
history exposure
TYPES OF HAZARDS
 Physical
 Chemical
 Biological
 Ergonomic
 Mechanical
 Electrical
PHYSICAL HAZARDS
Physical Hazards
 Noise
 Vibration
 Extreme temperature (heat/cold)
 Illumination
 Pressure (atmospheric)
 Radiation
Physical Hazard

Noise
Harmful / unwanted Sound:
 Frequency - measured in (Hertz) cycles
per second
 Loudness or intensity - Decibel (dB)
 Duration
 NOISE

Types of Noise-Induced Hearing Loss

Temporary Threshold Shift

(auditory fatigue)

Permanent Threshold Shift

 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)
Other Harmful Effects of Noise

• Hypertension
• Hyperacidity
• Palpitations
• Disturbs relaxation and sleep
VIBRATION
Physical factor which affects man by
transmission of mechanical energy from
oscillating sources

Types
◦ Segmental vibration
◦ Whole body vibration
 Segmental Vibration:
• Health Effects:
—Hand Arm Vibration Syndrome (HAVS)
—tingling, numbness, blanching of fingers
—pain
 Whole Body Vibration:

Health effects:
◦ Fatigue
◦ Irritability
◦ Headache
◦ Disorders of the spine
 EXTREME TEMPERATURE

Heat Stress
Exposure settings:
 High temperature
 High humidity
 Poor ventilation
 Multiple heat sources
 Thermoregulatory Mechanism

◦ The body’s attempt to

maintain a temperature
of 37.0ºC (+0.5ºC) at
all times, in the
response to change of
outside temperature
Mechanisms of heat removal / transfer

 Conduction
 Convection
 Radiation
 Evaporation
 HEAT Transfer
Direct Contact

Movement
of liquids
and gases

Thermal
Radiation /
Electromagnetic
waves
Evaporation
“Ex. Sweating”
Evaporation
“Ex. Sweating”
Cross section of Skin

Cross Section of the Skin

Acute Health Effects of Heat
 Prickly heat - immature sweat glands
 Heat fatigue - bad mood (water loss)
 Heat cramps - muscle spasm(water + salts)
 Heat exhaustion - fatigue, diaphoresis,
dehydration, nausea, vomiting
(water + salts + electrolytes)
 Heat stroke - overheating, seizure, coma
(failure of thermoregulatory system)
EXTREME TEMPERATURE

Sources of Cold Environment:

◦ Ice plants and freezers in the food industry

Health Effects of Cold Temperature

 Frostbite: reddening of skin, localized

burning pain and numbness. Fingers,
toes, cheeks, nose, ears are most
susceptible.

 trench foot or immersion foot:

numbness, pain, cramps,
Inadequate Illumination
Health Effects
◦ Visual Fatigue
◦ Double Vision
◦ Headaches
◦ Painful irritation
◦ Lacrimation
◦ Conjunctivitis
 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
corneal and conjunctival
Infrared
burns, retinal injury,
cataract
Laser Skin and eye problem
STRESS
 STRESS

The harmful physical and emotional responses that

occurs when the requirements of the job do not
match the capabilities, resources or needs of the
worker.
 STRESS
Manifestations of Stress
PSYCHOLOGICAL PHYSIOLOGICAL BEHAVIORAL
 Fatigue  Heart rate  Drug use
 Anxiety  Blood pressure  Alcohol intake
 Tension  Indigestion  Heavy smoking
 Irritability  Impulsive emotional
 Depression
behavior
 Boredom
 Inability to
concentrate
 Low esteem
 Poor work & family
relationship
 Social isolation
 Family abandonment
 Sleep problems
CHEMICAL HAZARDS
 Chemical Hazards
Routes of entry into the body
Inhalation Skin Contact

Ingestion
 Chemical Hazards
Body’s natural defense

Gastro-intestinal Renal (urine) Respiratory Skin (sweat, hair, nails)

(feces) (exhalation)
 Chemical Hazards

Measures of concentration of toxic substances

 Threshold Limit Value (TLV)- average concentration of

an airborne substance to which most workers could be
safely exposed to day after day without harmful effects.
TLV can be expressed in different ways.
Chemical Hazards

Classification of Toxic Effects

 Local toxicity

 Systemic toxicity

 Acute toxicity

 Chronic toxicity
 Chemical Hazards

Health Effects
 Renal Diseases
 Respiratory Diseases
 Skin Diseases
 Hematologic Diseases
 Cardiovascular Diseases
 Neurologic Diseases
 Carcinogenic
 Teratogenic
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

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
Chemical Hazards
Liver Disease:
Acute liver toxicity Carbon Cleaning fluids, dry
tetrachloride cleaners
Liver cancer Vinyl chloride Plastics & vinyl
chloride mfg.

Cardiovascular Disease:
Hypertension Lead, Cadmium Battery mfg. &
recycling
Atherosclerosis Carbon disulfide Degreasing, dry
cleaning
Arrythmias Fluorocarbon, Refrigeration, solvent
trichloroethylene workers
BIOLOGICAL HAZARDS
 BIOLOGICAL HAZARDS

VIRUSES FUNGI

BACTERIA PARASITES
 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.
 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.
 Selected Infectious Diseases and
Occupations

Agent / Disease Occupation

Rabies (e.g. dogs, bats, rats, Veterinarians, letter carriers,
pigs, cats) laboratory research workers,
agricultural workers.

Fungus Farmers, outdoor workers,

animal handlers
 HIV and AIDS
A- Acquired
H- Human

I- Immunodeficiency I- Immune

V- Virus D- Deficiency
 virus which causes
AIDS
S- Syndrome
 serious and usually fatal
condition in which the body’s
immune system is severely
weakened and cannot fight off
infection.
 Epidemiology of HIV and AIDS

Demographic Data Feb 2009 Jan – Feb 2009 Cumulative Data

1984 – 2009
Total Reported Cases 47 112 3,701
Asymptomatic Cases 45 107 2,893
AIDS Cases 2 5 808
Males 38 95 2,595*
Females 9 17 1,095*
Youth 15-24 y/o 12 31 537
Children <15 y/o 1 2 52
Reported deaths due to 0 0 317
AIDS
Source: HIV / AIDS Registry, Department of Health, Philippines * Note: No data available on sex for eleven (11) cases.
 Modes of HIV Transmission

Reported Mode of Feb Jan-Feb Cumulative Data:

Transmission 2009 2009 1984—2009
n=47 n= 112 N=3,701
Sexual Contact 43 107 3,297
Heterosexual contact 13 36 2,034 (62%)
Homosexual contact 14 37 872 (26%)
Bisexual contact 16 34 391 (12%)
Blood / Blood Products 0 0 19
Injecting Drug Use 0 1 8
Needle Prick Injury 0 0 3
Mother-to-Child 1 2 49
No data available 3 3 325
Body Fluids with High Viral Load
Blood
Semen
Vaginaland cervical mucus
Breastmilk
Amniotic fluid
Cerebrospinal fluid
 Modes of Transmission
• Unprotected penetrative sex
— semen, blood, vaginal secretions
• Blood transfusion on infected blood and blood products
• Sharing needles among
I.V. drug users
• Vertical/perinatal
— mother to infant
• Breastfeeding
HIV is NOT transmitted…
• through casual contact in any setting– schools, homes,
hospitals

• through insect, food, water, clothes, toilets, swimming

pools, and drinking and eating utensils
Prevention of HIV Infection
REMEMBER ABCDE!
 Abstinence
 Be Faithful
 Condom
 Do not inject Drugs/no
sharing of needles

 Education
 TETANUS
 Clinical Manifestations
◦ Increased tone in the
masseter muscle (lockjaw)
◦ Sustained contraction of
the facial muscles (risus
sardonicus) and back
muscles (opisthotonus)

 Prevention
◦ Active immunization with
tetanus toxoid
◦ Careful wound
management
 TUBERCULOSIS
caused by the bacteria,
Mycobacterium tuberculosis
caused by droplet nuclei
released when sneezing and
coughing
Symptoms: weight loss, low
grade afternoon fever,
persistent cough and
sometimes, blood-streaked
expectoration or hemoptysis
ERGONOMIC HAZARDS
 ERGONOMICS
Human Biological Science
+
Engineering Science
____________________________________
MAXIMUM SATISFACTION AND INCREASE
PRODUCTIVITY

“ fitting the job to the worker”

ERGONOMICS
the task
(job content &
context)

the the
organization tool

the the
environment workstation
ERGONOMICS
Goal
◦ to reduce work-related musculoskeletal
disorders (MSDs) developed by workers

MSDs are injuries and illnesses that affect

muscles, nerves, tendons, ligaments, joints or
spinal discs.
 ERGONOMICS
Common Symptoms of MSDs

 Painful joints
 Pain, tingling, numbness in hands, wrists, forearms,
shoulders, knees and feet
 Shooting or stubbing pains
 Swelling or inflammation
 ERGONOMICS
Common Symptoms of MSDs

 Fingers or toes turning white

 Back or neck pain
 Stiffness
Risk Factor: ERGONOMICS

Static
posture
Risk Factor: ERGONOMICS

Forceful exertion
Risk Factor: ERGONOMICS

Repetitive movement
Risk Factor: ERGONOMICS

Extreme range of motion

 Risk Factor: ERGONOMICS

Awkward posture
 MONITORING

•Systematic, continuous, repetitive health-

related activities that should lead to
corrective action

• Types of monitoring
1. Ambient / Environmental (WEM)
2. Biological
3. Medical Surveillance
WORK ENVIRONMENT MEASUREMENT
(WEM)
is the direct measurement of hazards,
environmental stresses and their hazardous
effects on worker’s health.
PURPOSE OF WORK ENVIRONMENT
MEASUREMENT (WEM)

To determine magnitude of harmful environmental

agents;
To predict the harmfulness of new facilities,
materials, processes and methods;
To monitor worker’s exposure to hazards;
To evaluate the effectiveness of control measures
adopted for improvement;
To maintain a favorable working conditions.
WORK ENVIRONMENT MEASURING
INSTRUMENT (WEM)
1) PHYSICAL AGENTS:

a) NOISE:
 SOUND LEVEL METER

b) LIGHT:
 LUXMETER OR LIGHT METER

c) EXTREME OF TEMPERATURE:
 WET/DRY BULB THERMOMETER

d) RADIATION:
 Film Badge
 Pocket dosimeter
2) CHEMICAL AGENTS:
 Gas and Vapors Monitors
 Direct-reading instrument exemplified by calorimetric-type
devices, thermal, gas chromatography.

3) BIOLOGIC AGENTS:
 Microscope

4) OTHER USEFUL EQUIPMENT:

 Atomic Absorption Spectrophotometer – for heavy metals
 Gas Chromatograph – for organic solvents
 X-ray Diffraction – for dust asbestos fibers
 High Performance Liquid Chromatograph – for inorganic
chemicals
 MEDICAL
SURVEILLANCE
Medical Surveillance

Identify cases

Analyze Trends and Patterns in the Workforce to

Guide Prevention Efforts

Meet Regulatory Requirements

 Medical Surveillance
 Know the hazard - How worker is exposed
- How worker is affected

 Characterize the hazard - Exposure levels

- Exposure duration

 Know the worker - Susceptibilities

 Obtain information on - Directed towards specific

medical examinations organ system

 Analyze Medical Data - Disease, recovery, rehab

- Effectiveness or failure of
control measures
Standards, Policies and Guidelines
 Occupational Safety and Health Standards
◦ Rule 1050
 Notification and Keeping of Records of Accidents
and/or Occupational illnesses

◦ Rule 1070
 Occupational Health and Environmental Control

◦ Rule 1960
 Occupational Health Services
Rule 1960:
Occupational Health Services
1961: General Provisions
1. Every employer shall establish in his place of
employment occupational health services in accordance
with the regulation and guidelines provided for under this
rule.

2. The employer, workers, and their representatives, where

they exist, shall cooperate and participate in the
implementation of the organizational and other measures
relating to occupational health services.
Rule 1960:
Occupational Health Services
1963: Emergency Health Services

1963.01: Medicines and Facilities

1963.02: Emergency Medical and Dental Services

Rule 1960:
Occupational Health Services
Hazardous Workplaces:
Number of workers OH Physician OH Dentist OH Nurse First Aider

1 – 50 1 Full time
51 - 99 1 Part time 1 Full time
4 hours/day 6x/week

100 – 199 1 Part time 1 Part time 1 Full time 1 Full time
4hrs/day 3x/week * 4hrs/day 3x/week *
200 - 600 1 Part time 1 Part time 1 Full time 1 Full time
4hrs/day 6x/week ** 4hrs/day 6x/week **
601 - 2000 1 Full time or 1 Full time 1 Full time every shift 1 Full time every shift
2 Part Time
4hrs/day 6x/week
2000 and more 1 Full time 1 Full time 1 Full time every shift 1 Full time every shift
1 Part time
4hrs/day 6x/week
*Alternate each day
** Alternate workshift in a day
Rule 1960:
Occupational Health Services
Non - Hazardous Workplaces:

Number of workers OH Physician OH Dentist OH Nurse First Aider

1 - 99 1 Full time
100 – 199 1 Part time 1 Full time
4hrs/day 6x/week

200 - 600 1 Part time 1 Part time 1 Full time 1 Full time
4hrs/day 3x/week * 4hrs/day 3x/week *

601 - 2000 1 Part time 1 Part time 1 Full time every shift 1 Full time every shift
4hrs/day 6x/week ** 4hrs/day 6x/week **

2000 and more 1 Full time 1 Full time 1 Full time every shift 1 Full time every shift
1 Part time
4hrs/day 6x/week

*Alternate each day

** Alternate workshift in a day
Rule 1960:
Occupational Health Services

Health Examinations:
◦ Entrance
◦ Periodic
◦ Special examination
◦ Transfer examination
◦ Separation examination
OCCUPATIONAL HEALTH
PROGRAMS
Key Elements of the
Occupational Health Program

Health Protection

Health Promotion

Health Rehabilitation
 Health and Safety Programs

Hazards/ Source Health Effect Health Program

Disease
Chemical
Solvents Paints, Irritant, Surveillance for chemical
Thinners Multisystem exposure
effects Exposure monitoring
(Biologic Monitoring)

Physical
Noise Woodwork Hearing Hearing Conservation
Operations Impairment Program
 Health and Safety Programs
Hazards/ Source Health Effect Health Program
Disease
Biologic
Tetanus Dirty Nails, soil Lockjaw, rigidity, Immunization
death
Ergonomic
Stresses Awkward Musculoskeletal Management or
Cumulative postures, Heavy Disorders personnel methods;
Trauma loads Workplace
Disorder modification
Worker education
and training;
Back Care Program
 Health Promotion
 Physical activity, Nutrition, Weight reduction

 Immunization
◦ OSHS, RULE 1960

 Smokingcessation
◦ RA 9211 Tobacco Regulation Act of 2003

 HIV/AIDS
◦ RA 8504 Philippine AIDS Prevention and Control Act of
1998
◦ National Workplace Policy on STD/HIV/AIDS initiated by
DOLE - 1997
 Health Promotion
 Drug Abuse Prevention and Control
◦ RA 9165 Comprehensive Drugs Act of 2002
◦ Department Order No. 53-03: Guidelines for the
Implementation of a Drug-Free Workplace Policy and
Program for the Private Sector

 TuberculosisPrevention and Control

◦ Executive Order No. 187, Instituting a Comprehensive and
Unified Policy for Tuberculosis Control in the Philippines
(CUP) (March 2003)
◦ Department Order No. 73-05: Guidelines for the
Implementation of Policy and Program on Tuberculosis
(TB) Prevention and Control in the Workplace
Benefits to the workers

Enhanced worker motivation and job satisfaction

Added problem-solving capacity
Reduces the extent and severity of work related
injuries and illnesses
Improves employee morale and productivity
Reduces workers’ compensation costs
 -END-

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