Summary
Community Health Nursing II
Topic: Occupational Health (12-01pm, 04-05pm)
Definition
By ILO/WHO committee on Occupational health (at its first session in 1950 and revised at its twelfth
session in 1995)
“Occupational health should aim at the promotion and maintenance of the highest degree of physical
health, mental and social well-being of workers in all occupations.”
Components of Occupational Health
Occupational health include: Prevention of accidents related to their working conditions.
 Protection of workers in their employment.
 Placing and maintenance of worker in an occupational environment adapted to his
physiological and psychological equipment .
 Adaptation of work to man & each man to his job.
Trends
 As long as humans have existed they have had to work.
 Initially, there was a need to hunt to catch food and have materials to make clothing.
 Food would be preserved by drying, salting, or other methods for use over time; clothing
would be made; and shelter would be fashioned from the hides of animals.
 Trends
 When societies became more complex and humans changed into settled creatures, agriculture
became a dominant force in their existence.
 As crops became cultivated and animals domesticated, there was still a need for essentially
year-round labor, with both cultivation and processing activities being divided among the
males and females of families.
 As societies became more complex the nonagricultural activities become possible, such as
work from artisans & fashioning
 Throughout recorded history, there have been references to work under a variety of
conditions.
 The Old Testament includes rules about safe practices with regards to agriculture and how to
treat workers.
 In the 15th century:-Paracelsus were the first to write discussions specifically directed toward
matters of occupational safety and health.
 In the early eighteenth century:- Bernadino Ramazzini wrote the first text on occupational
medicine and he is generally regarded as the
 "father of occupational medicine."
 Ramazzini wrote about the health hazards for dozens of occupations ranging from ditch
diggers to tailors, from religious activities to those quite secular.
 In the United States, in the early twentieth century, Dr. Alice Hamilton became the first
woman physician appointed to a faculty position at Harvard University, where she worked at
the School of Public Health promoting safe and healthful work practices in the United States.
 Beginning in earnest in the eighteenth century, the Industrial Revolution of Europe led to
large numbers of individuals settling in cities and working in factories.
 As more and more people worked in factories, and the hazards of factory work became
known, regulations came into place regarding who could work, and under what conditions.

Initially, there were no restrictions on ages or hours of work, but gradually child-labor laws,
laws regulating the work of women, and mandated maximum hours of work were put in
place.
Modern concept of Occupational health include: Employment in commercial enterprises, service trades, forestry and agriculture.
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It also includes the subjects of industrial hygiene , industrial diseases, industrial accidents,
toxicology in relation to industrial hazards, industrial rehabilitation and occupational health in
agriculture and ergonomics.
Occupational Environment
It means the sum of external conditions and influences which prevail at the place of work and
which have a influence on the health of the working population.
 3 type of interaction occur in environment: Man & physical, chemical& biological agents
 Man & machine
 Man & man
Objectives of Occupational Health
 Moral - An employee should not have risk injury or death at work, nor should others
associated with the work environment.
 Economic - Many governments realize that poor occupational safety and health
performance results in more cost.
 Employing organizations also sustain costs in the event of an incident at work (such as
legal fees, fines, compensatory damages)
 Legal- Occupational safety and health requirements may be reinforced in civil law
and/or criminal law.
Hazards, Risks, Outcomes
 A hazard is something that can cause harm if not controlled.
 The outcome is the harm that results from an uncontrolled hazard.
 A risk is a combination of the probability that a particular outcome will occur and the severity
of the harm involved.
Aim of Occupational Health
 To prevent the occurrence of illnesses among workers because of the exposures of certain ill
factors at their place of work
 Risk Assessment
This assessment should: Identify the hazards
 Identify all effects of the hazard and how it affects the health
 Evaluate the risk
 Identify and prioritize appropriate control measures
OCCUPATIONAL HEALTH HAZARDS
A. Physical
B. Chemical
C. Biological
D. Mechanical
E. Psychosocial
PHYSICAL HAZARDS
 Temperature - Heat / Cold
 Noise
 Vibration
 Radiation
 Atmospheric pressure
 Ionizing radiation
 Electricity
 Asphyxiation
Hazards due to Physical Agents
 Heat - Heat hyperpyrexia, Heat Exhaustion
 Heat Syncope, Heat Cramps, burns,
 Prickly heat
 Cold - Frost bite
 Light -Occupational Cataract
 Atmospheric-pressure-air embolism, explosion.
 Noise- Occupational deafness
 Radiation- Cancer, Leukemia, aplastic anemia,
 Pancytopenia (deficiency of RBC, WBC & platelets).
 Electricity- Burns, Shocks
HEAT ILLNESS
 Predisposing Factors
 Physical activity
 Extremes of age, poor physical condition, fatigue
 Excessive clothing
 Dehydration
 Cardiovascular disease
 Skin disorders
 Obesity
 Drugs
Chemical hazards
Routes of entry–
 Inhalation
 Ingestion
 Skin absorption
 (Inhalation is the main route of entry)
Chemical agents can be classified into1) Metals - Lead, As, Hg, Cd, Ni , Co etc.
2) Aromatic Hydrocarbons - Benzene, Toluene, phenol etc.
3) Aliphatic Hydrocarbons - Methyl alcohol
4) Gases–
* Simple asphyxiants : N2, CH4, CO2
* Chemical asphyxiants : CO, H2S, HCN
* Irritant gases : Ammonia, SO2
* Systemic poison : CS2
TLV -Concept
The Threshold Value:- Time weighted Average(TLV-TWA)
“Time weighted average concentration for a normal 8-hour working day & a 40-hour working week ,
to which nearly all workers may be repeatedly exposed day after day, without adverse effect
TLV Concept
The Threshold limit Value:-Short term exposure Limit(TLV-STEL)
It is defined as a 15 min ,time weighted average which should not be exceeded at any time during a
working day ,even if the 8-hour time –weighted average is within the TLV.
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.
Psychosocial Hazards
Work-related stress, whose causal factors include excessive working time and overwork
Violence from outside the organisation
Bullying, which may include emotional, verbal and sexual harassment .
Burnout
Exposure to unhealthy elements during meetings with business associates, e.g.Tobacco, uncontrolled
alcohol.
Mechanical Hazards
By type of agent:
 Impact force
 Collisions
 Falls from height
 Struck by objects
 Confined space
 Slips and trips
 Falling on a pointed object
 Compressed air/high pressure fluids
 Entanglement
 Equipment -related injury
 Injuries-Falls,cuts,abrasions,concussions,contusions,etc.
Ergonomic DisordersMusculo-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/ ergo friendly tools : Tools which reduce the stresses
or problems.
Back Injuries
``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
*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
*avoid changing grip or ‘jerking’ the load
*deposit the load by bending the knees
keeping the back straight
ERGONOMIC GUIDELINES
*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
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 ``)
*Optimal viewing angle is 20 degrees below the horizontal line from the eyes
Komal Rana
Clinical Instructor