OCCUPATIONAL HEALTH Dr Reshma Reghu Lecturer Dept of

OCCUPATIONAL HEALTH Dr. Reshma Reghu Lecturer, Dept. of Community Medicine

Defn. The joint ILO/WHO Committee on Occupational health, in course of its 1 st session held on 1950 as Occupational health should aim at the �promotion & maintenance of the highest degree of physical, mental and social well being of workers in all occupation. �Prevention among workers of departures from health caused by their working condition. �Protection of workers in their employment from risks resulting from factors adverse to health �Placing & maintenance of the worker in an occupational environment adapted to his physiological & psychological equipment �And to summarize the adaptation of work to man & each man to his work

Level of application of preventive measures �Health promotion �Specific protection �Early diagnosis & treatment �Disability limitation & Rehabilitation �Epidemiological approach �Statistics �Health Screening �Health Education

ERGONOMICS �Integral part of advanced occupational health service �The word derived from Greek “Ergon” means work & “nomos” means law simply means “fitting the job to the worker” �Objective – To achieve the best mutual adjustment of man and his work, for the improvement of human efficiency and well being. �To reduce industrial accidents. �Training involves designing of machines, tools, equipment & manufacturing process, lay out of the places of work, methods of work & environment.

3 types of interaction in a working place �Man and physical, chemical & biological agents �Man and machine � Man and man OCCUPATIONAL ENVIRONMENT

�PHYSICAL AGENTS: Heat, Cold, Humidity, Air movement, Heat Radiation, Light, Noise, Vibration. �CHEMICAL AGENTS: Chemicals, Toxic dust, Gases �BIOLOGICAL AGENTS: Viral, Bacterial, Parasitic etc. . Man & Physical, Chemical & Biological Agents

�Unguarded machines, protruding and moving parts, poor installation of the plant, lack of safety measures can cause accidents �Working for long hours in unphysiological posture can cause fatigue, backache, disease of joints and muscles and impairment of worker’s health and efficiency MAN & MACHINE

�Human relationships amongst workers �Authority over them �Towards domestic environment MAN & MAN

a) Physical Hazards a) Chemical Hazards b) Biological Hazards c) Mechanical Hazards d) Psychosocial Hazards OCCUPATIONAL HAZARDS

�Heat & Cold �Light �Noise �Vibration �Ultra violet Radiation �Ionizing radiation PHYSICAL HAZARDS

�Local action �Inhalation a) Dust particles <5 microns respirable dust b) Gases- Simple , Asphyxiated & Anaesthetic gases c) Metals & their compounds �Ingestion CHEMICAL HAZARDS

Exposed to infective and parasitic agents �Brucellosis �Leptospirosis �Tetanus �Fungal infections BIOLOGICAL HAZARDS

� 10% of accidents are due to mechanical causes MECHANICAL HAZARDS

�Frustration �Lack of job satisfaction �Insecurity �Poor human relationship �Emotional tension Classified as 2 categories �Psychological & Behavioural changes �Psychosomatic ill health PSYCHOSOCIAL HAZARDS

�Disease due to physical agents �Disease due to chemical agents �Disease de to biological agents �Occupational Cancers �Occupational dermatitis �Disease of Psychological origin OCCUPATIONAL DISEASE

Disease due to physical agents �Heat- Heat hyperpyrexia, heat exhaustion, heat syncope, heat cramps, burns & local effects �Cold- Trench foot, Frost bite, Chilblains �Light- Occupational Cataracts, Miner’s Nystagmus �Pressure- Caisson disease, Air embolism, Blast �Noise- Occupational Deafness �Radiation- Cancer, Leukemia, Aplastic anemia, Pancytopenia �Mechanical Factors- Injuries, Accidents �Electricity- Burns

Disease due to chemical agents �Gases: CO 2, CO, HCN, CS 2, NH 3, N 2, H 2 S, HCl, SO 2 - these cause gas poisoning. �Dusts: (Pneumoconiosis) INORGANIC DUST 1. Coal dust- Anthracosis 2. Silica- Silicosis 3. Asbestos- Asbestosis, CA Lung 4. Iron- Siderosis ORGANIC DUST 1) Cane fibre- Bagassosis 2) Cotton dust- Byssinosis 3) Tobacco- Tabaccosis 4) Hay or grain dust- Farmer’s Lung

�Metals & their compounds: Lead, Mercury, Cadmium, Manganese, Beryllium, Arsenic, Chromium �Chemicals: Acids, Alkalies, pesticides �Solvents: Carbon bisulphide, Benzene, Trichloroethylene, Chloroform etc. .

�Disease due to biological agents: Brucellosis, Leptospirosis, Anthrax, Actinomycosis, Hydatidosis, Tetanus, Encephalitis, Fungal infections etc. . �Occupational cancers: Cancer of skin, lung & bladder �Occupational dermatitis: Dermatitis, Eczema �Disease of psychological origin: Industrial neurosis, hypertension, peptic ulcer.

PNEUMOCONIOSIS The disease depends upon § Chemical composition § Fineness § Concentration of dust in the air § Period of exposure § Individual susceptibility The important dust diseases are �SILICOSIS �ANTHRACOSIS �BYSSINOSIS �BAGASSOSIS �ASBESTOSIS �FARMER’S LUNG

SILICOSIS �Major cause of permanent disability & mortality �Free silica & silicon dioxide �Incubation period vary from few months to 6 years �Pathologically characterized by nodular fibrosis in the upper part of lungs. �Impairment in lung capacity �X-ray shows, snow-storm appearance �Prone to silico- tuberculotics

�Rigorous dust control measures - Substitution - Complete enclosure - Isolation - Hydroblasting - Good house keeping - Personal protective measures �Regular physical examination of workers �Notifiable disease under Factories Act 1948 & Mines Act 1952 PREVENTIVE MEASURES

ANTHRACOSIS � 2 phase o Simple pneumoconiosis o Progressive massive fibrosis- 12 years exposure- severe respiratory disability to premature death o Risk of death is more among coal miners o Indian Mines Act of 1952 & Workmen’s Compensation (Amendment) Act of 1959.

�Inhalation of cotton fibre �Chronic bronchitis & emphysema �Textile Industry BYSSINOSIS

BAGASSOSIS �Inhalation of sugarcane dust �Thermoactinomyces sacchari �Acute diffuse bronchiolitis, mottling in lungs, impairment in pulmonary function �Untreated, diffuse fibrosis, emphysema & bronchiectasis �PREVENTIVE MEASURES a) Dust control b) Personal protection c) Medical control d) Bagasse control

ASBESTOSIS �Asbestos fibres are 20 – 500 micron length and 0. 5 - 50 micron diameter �Used in manufacture of asbestos cement, fireproof textiles, roof tiling, brake lining etc. . �Enters into the body by inhalation causing pulmonary fibrosis due to mechanical irritation and is peri- bronchial & diffuse in character, basal in location contrast to silicosis. In advanced cases, clubbing of fingers, cardiac distress & cyanosis. Sputum shows asbestos bodies i. e, asbestos fibres coated with fibrin. X-ray shows ground glass appearance in lower two third of lung field.

� 2 Types i. Serpentine or Chrysolite variety- 90% Hydrated magnesium silicate ii. Amphibole- little magnesium. It has different variaties viz; Crocidolite(blue), Amosite (brown), Anthrophyllite (white). Mesothelioma- rare cancer of pleura & peritoneum has strong association with crocidolite variety of asbestos.

�Use of safer types of asbestos �Substitution of other insulants- glass fibres, mineral wool, calcium silicate �Rigorous dust control �Periodic examination of workers- biological monitoring �Continuing research PREVENTIVE MEASURES

�Inhalation of moldy hay or grain dust �Growth of thermophilic actinomycetes of which Micropolyspora faeni �Repeated attack cause pulmonary fibrosis, pulmonary damage & corpulmonale �Widespread in India FARMER’S LUNG