Care Without Scare…!
Occupational Health for Health Care Workers
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OCCUPATIONAL HEALTH
PHYSICAL, MENTAL & SOCIAL WELL
BEING IN RELATION TO WORK AND
WORK ENVIRONMENT.
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What is Occupational Health?
Different Definitions:
FHealth problems arising from or pertaining to work
FHealth of people at work
FThe Health of the gainfully employed
FRelationship between Occupation (work) & Health
Environment
Health
Occupation (work)
Accidents
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Occupational Diseases
Occupational diseases have a long
latent period.
Most occupational diseases cannot be
treated.
All occupational diseases can be
prevented.
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“ What the mind
does not know,
the eyes do not
see”
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OCCUPATIONAL HAZARDS
 Physical Hazards
 Chemical Hazards
 Biological Hazards
 Mechanical Hazards
 Psychosocial Hazards
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OCCUPATIONAL HEALTH DISORDERS
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ROUTE OF EXPOSURE
 INHALATION
 INGESTION
 SKIN ABSORBTION
Eating, Smoking
Gas, Vapour,
Aerosol, Dust,
Fume, Smoke,
Mist, Fog
Primary irritants, Allergy,
Systemic toxicity
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FOUR TYPES
Diseases only occupational in origin (pneumoconiosis)
Where occupation as one of the causal factors
(bronchogenic carcinoma)
Occupation as A contributary factor (chronic bronchitis)
Occupation aggrevating pre-existing condition (asthma)
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OCCUPATIONAL HAZARDS
 Physical Hazards
 Chemical Hazards
 Biological Hazards
 Mechanical Hazards
 Psychosocial Hazards
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OCCUPATIONAL DISEASES
Diseases due to Physical Agents
 Heat - Heat stroke, Burns
 Cold - Frost bite
 Light - Miners Nystagmus, Cataract
 Pressure - Caisson disease, Air embolism
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OCCUPATIONAL DISEASES
Diseases due to Physical Agents
 Noise - NIHL, Hypertension, Irritability
 Vibration - Neuromuscular diseases, Peripheral
vascular diseases
 Radiation - Leukemia, Aplastic anaemia
 Mechanical - Injuries, Accidents
 Electricity - Electric shock, Burns
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OCCUPATIONAL DISEASES
Diseases due to Chemical Agents
 Gases - CO, CO2, HCN, H2S,CS2
 Dusts - Pneumoconiosis
 Metals - Lead, Mercury, Chromium,
Manganese
 Chemicals - Acids, Alkalies
 Solvents - Benzene, Trichloroethylene
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Chemical Hazards
 Metals (lead, mercury, arsenic, cadmium, chromium,
zinc, beryllidum, tin, silver, etc)
 Carbon compounds (organic solvents)
 Benzine, Toluene, Zylene
 Phenol, Nitrate, Napthalene, Isocyanates, Carbon tetrachloride, Carbon
disulphide, Vinyl chloride monomer, etc
 Pesticides & toxic gases (amonia phosgene, carbon
monoxide)
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Lung Diseases Caused by Dust
 Depends on chemical composition, particulate size, concentration,
shape, specific gravity & body’s reaction
 Pneumoconiosis
 Asbestosis
 Silicosis
 Coal workers pneumoconiosis
 Lung diseases caused by dust of organic origin
 Byssinois (exposure to cotton dust)
 Mushroom workers lung
 Suberrosis (Cork dust)
 Bird breeders lung (chickens, parrots, pigeons)
 Man made fibres
 Occupational asthma
 Flour insects and pollens: linseed, soya beans, teak wood, hair,
fur, etc: isocyanates, poly urethane, amines, metals
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OCCUPATIONAL DISEASES
Diseases due to Biological Agents
 Hepatitis B, Rabies, AIDS, Leptospirosis…,
Occupational Cancers
 Cancer of Skin, Lungs, Bladder
Occupational Dermatosis
 Dermatitis, Eczema
Psychosocial Diseases
 Neurosis, Peptic ulcer, Hypertension
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Musculo-skeletal
problems
 Due to Excessive load on the muscles, ligaments, tendons
and bone.
 Due to Insufficient circulation to the Musculoskeletal
system.
 Work that requires activity of a small group of relatively
weak muscles (such as continuous use of fingers of the
dominant hand in data entry).
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Common sites for Musculo-skeletal problems






Neck
Forearm
Wrist
Fingers
Back
Knee
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COMPUTERS / VDU
 RSI / CTD – Tenosynovitis, Tendinitis, Tennis
Elbow, Carpal Tunnel Syndrome, Trigger Finger
 Musculoskeletal Problems in Neck, Shoulder &
Upper Limbs
 Visual Fatigue & Eye Problems
 Bifocals & Computers
 Skin Diseases
 Low Back Pain
 Effects of Shift Work
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Occupational health & Computer work
FMusculo-skeletal
problems
FOcular problems
FReproductive problems
FSkin problems
FPsychosocial problems
FLifestyle problems
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Repetitive Strain Injury
FMuscular
stress caused by the frequent,
repetitive use of the same muscle throughout
the day.
FAccustomed
and unaccustomed repetitive
work with hands.
FWork
that involves repeated wrist flexion or
extreme extension, particularly in
combination with forceful pinching.
FRepeated
wrist.
forces on the base of the palm or
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Common RSIs
FCarpal
tunnel syndrome
FCervical
radiculopathy
FEpicondylitis
FGanglion
cyst
FTendonitis
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New Pathologies








AIDS
Stress
Geriatrics
Space Medicine
Genetic Aberrations (longevity!)
Cancer
Robotics-related Injuries
Migrant Global Workers
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Elements of Occupational Health Services
• Medical treatment
• Assessment and control of work environment
• General preventive health measures
• Preventive medical examinations
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Prevention of Occupational Health Hazards




Administrative Measures
Engineering Measures
Ergonomics
Medical Measures
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Ergonomics
The IEA divides ergonomics broadly into three domains:
 Physical ergonomics: working postures, materials handling,
repetitive movements, work related musculoskeletal
disorders, workplace layout, safety and health.
 Cognitive ergonomics : mental workload, decision-making,
skilled performance, human-computer interaction, human
reliability, work stress and training as these may relate to
human-system design.
 Organizational ergonomics: communication, crew resource
management, work design, design of working times,
teamwork, community ergonomics, cooperative work, new
work programs, virtual organizations, telework, and quality
management.
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Goals Of Ergonomics
 Improve quality of working environment engineered to
the capabilities of the human body
 Increase efficiency and productivity by reducing
fatigue.
 Prevention of Occupational injury & illness.
 Work quality improvement.
 Proactive Ergonomics
Vs
 Reactive Ergonomics
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MEDICAL MEASURES
 Pre-employment medical check up
 Periodic medical examination
 Health promotion
 Health education
 Specific protection
 Assessment of risk by supervision of working
environment
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Pre-employment Medical Examination
 To determine the physical and emotional capacity of
the individual to perform the job.
 To provide base line health data for epidemiological
and legal purposes.
 To counsel the person for correction of diseases /
habits which may harm later.
 Assessment of pre-existing toxicity / impairment due to
past exposure, if any.
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Pre-placement Medical Examination
HAZARD
UNDESIRABLE CONDITIONS
Lead
Anaemia, Hypertension, Peptic ulcer
Dyes
Asthma, Skin & Kidney disease
Solvents
Liver & Kidney disease, Alcoholism
Silica
Tuberculosis, Chronic lung disease
X rays / Radium
Blood diseases
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Periodic Medical Examination
 Evaluation of general health status.
 Earliest detection and prevention of work related
disorders.
 Early detection, control and prevention of any health
disorder which may affect the ability to perform the job.
 To detect deviation in health status from base line data.
 Detection of infectious / communicable diseases which
may affect others.
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OSH IN HEALTHCARE
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Who is a Health Care Worker?
Doctor
Dentist
Nurse
Lab technician
Radiology technician
Physiotherapist
Aaya, Wardboy
Pharmacist
Laundry worker
Maintenance staff ………..
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Occupational Risks in Various Areas
Clinical
Maintenance
Surgical
Housekeeping
Laboratory
Laundry
Radiology
Food Handlers
Physiotherapy
Others
CSSD
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Common Concerns
Shift Work
Emotional Stress
Ergonomic
Slips, trips, falls
Violence ?
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Preventive Measures
Universal Precautions
Training & Education
Medical Surveillance
Immunization
Identify, Monitor & Control exposures
Stress Management
Violence Prevention Program
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Hippocrates Refusing Gift from Alexander
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Thank You
Prepared by Dr. Shyam R. Pingle