Introduction
• The
trend
in
India
is
towards
industrialization.
• As industries develop both in sizes &
complexity occupational health will rise new
& more difficult problems.
• It aims at the promotion & maintenance of
high degree of physical , mental & social well
being of workers in all occupations.
• Occupational
medicine.
health
is
essentially
preventive
• In the past ,it was entirely in relation to factories &
mines ; hence the terms “ Industrial Hygiene” or “
Industrial Health” were used.
• Modern concepts of Occupational health now
embrace all types of employment including
commercial & trades, Forestry & agriculture.
Occupational Health
In1950, the joint ILO / WHO Committee
on Occupational health decided upon broad
definition
“Occupational health should aim at the promotion
and maintenance of the highest degree of
physical, mental
and social well being of workers in all occupations”.
Ergonomics
It is relatively a new concept in occupational
health.
It is derived from the greek
‘ Ergon’ meaning work &
‘ nomos’ meaning law.
• It simply means “ fitting the job to the
worker”.
Objective of Ergonomics
• It is to achieve the best mutual adjustment of man
& his work , for the improvement of human
efficiency & well being.
Outcome :
There will be reduction in the industrial
accidents & to the overall health & efficiency of
the workers.
Occupational Environment
•
•
It is meant the sum of external conditions &
influences which prevail at the place of work &
which have a bearing on the health of the working
population.
There are 3 types of interaction in a working
environment :
1. Man & physical , chemical & Biological agents.
2. Man & Machine
3. Man & man.
Man & physical , chemical & Biological agents
1. Physical agents :
Heat, Cold, Humidity, air movement,
radiation, light, noise ,vibrations & ionizing
radiation.
2. Chemical agents :
chemicals, toxic dusts , gases.
3. Biological agents :
viral, bacterial & parasitic agents because of
close contact with animals or their products.
Man & Machine
• Unguarded machines in Industries,
• Protruding machines
• Lack of safety measures & procedures which
cause accidents.
Man & man
• Relationship among workers
• Between workers & management
• Ex. Psycho social factors include type of work, job
satisfaction, security, communication, incentives,
leadership style etc which cause stress.
• If stress not managed , it leads to psycho somatic
ailments.
Health problems caused by Industrialization
• Environmental sanitation
(Housing, Air & Water pollution, Sewage
disposal)
• Communicable diseases
(malaria, Filariasis, TB, AIDS etc.)
• Food & Sanitation ( typhoid, Hepatitis etc)
• Mental Health ( delinquency etc)
• Accidents
• Social problems
( alcoholism , Drug addiction, substance abuse,
prostitution etc )
• Morbidity & mortality
incidence of chronic diseases.
Occupational Hazards
Physical
Hazards
Chemical
Hazards
Biological
Hazards
Psycho social
Hazards
Mechanical
Hazards
1. Physical hazards
• Heat - Exposure to excessive heat results in muscular
fatigue, severe cramps, skin rashes and boils.
• Light – eye fatigue, Nystagmus (i.e. rapid involuntary
oscillation of the eyeballs) because of low illumination
and nervous symptoms like headache, insomnia,
photophobia to marked mental depression.
• Radiation - mercury, uranium, thorium, arsenic, and other
heavy metals resulting in Lung cancer, leukemia &
sterility.
• Noise – increase BP , pulse rate.
• 2. Chemical Hazards
• Gases
Release of carbon dioxide, Sulphur dioxide a
greenhouse gas, which causes climate change and global
warming.
• Inorganic Dusts - Pneumoconiosis ex. anthracosis
• Metals and their compounds - power plants emit
mercury, selenium, and arsenic which are harmful
to human health and the environment.
• Chemicals - ulceration , dermatitis, also cancer.
• 3. Biological Hazards
• Risk of malaria and dengue fever is substantial
at some remote mining locations.
• Leptospirosis and ankylostomiasis were
common in mines, but eradication of rats and
improved sanitation has controlled these
hazards effectively.
4. Mechanical Hazards
• Protruding equipments
• Moving parts of machines
• Unsafe placement of machinery in factories
& industries constitute mechanical hazards.
B. Accidents and Injuries
5. Psychosocial Hazards –
leads to
stress, Industrial
hypertension, peptic ulcer, etc.
neurosis,
Occupational Diseases
Pneumonoconiosis
 Lead poisoning
 Occupational Cancer
 Occupational dermatitis
 Carbon di sulfide poisoning
 Carbon mono oxide
 Insecticide poisoning
 Noise pollution
 Radiation Hazards
 Accidents
 Diseases of Agricultural workers.
Pneumonoconiosis
• It is a lung disease which is caused by dust.
• Depending on the type of dust, diseases varies, It
may be :
 Silicosis (silica or silicon di oxide – mine workers)
 Anthracosis ( Coal dust)
 Asbestosis
 Farmer’s lung
 Bagassosis
 Byssinosis
Silicosis
• All mine workers suffer because of inhalation of dust
particles containing silica or silicon di oxide.
• Silicosis is nodular fibrosis & produces respiratory
symptoms like cough, dyspnoea on exertion, pain in
the chest etc.
• X-ray of upper zone of lungs will give the appearance
of a ‘ snow storm’.
• It can’t be reversed . But workers can be shifted to
less hazardous sections.
Anthracosis
• Coal dust
2 phases in coal miners pneumonoconiosis :
1. First phase is Simple pneumonoconiosis with little
ventilatory impairment. This phase requires 12
years of work exposure.
2. The
second phase is characterized by progressive
massive fibrosis (PMF); this causes severe
respiratory disability & frequently results in
death.
If early diagnosis is done during the first phase
& the worker shifted to less hazardous section,
the second phase of the disease can be
prevented.
Asbestosis
• It is a fibrous magnesium silicate mineral
which is used in asbestos production.
• The fibers are insoluble settle in alveoli &
cause fibrosis.
• It may even lead to death.
• X – ray reveal a “ ground glass” appearance.
Farmer’s lung
• Hay dust
• This occurs due to inhalation of actinomycetes or
microbes in dusts from moldy ( decaying )hay.
• Symptoms similar to pneumonoconiasis.
Bagassosis
• Cane dust fibre.
• It is caused by an allergic response to bagasse ,
the fungi containing debris left after the syrup
has been extracted from sugar cane.
• Symptoms are fever , dyspnoea & malaise.
Byssinosis
• Cotton dust fibre
• It is caused by inhalation of cotton dust fibre.
• This conditions an allergic reaction to dust or fungi in
cotton .
• 7-8 % of textile workers suffer from this disease.
Lead poisoning
• Industrial workers are exposed to lead than any
other toxic substances, ex. Storage battery , ship
building, printing & dyeing industries.
• It occurs in 3 ways :
1. Inhalation of fumes
2. Ingestion through contaminated hands
3. Contact with the skin ( especially organic
compounds)
Clinical symptoms
Inorganic lead :
produces abdominal colic, loss of appetite,
bleeding of gums, anemia , wrist drop & foot
drop.
Organic lead:
CNS symptoms like Insomnia, headache , mental
confusion & delirium.
Occupational Cancer
• Exposure to radiation , inhalation of fumes, contact
with carcinogenic substances etc.
• Commonly seen is skin & lung cancer
• Skin cancer: 75% of cancers are skin cancers.
Commonly found in Dyeing industry among gas workers ,
tar distillers & road workers.
 Lung cancer : occur in gas industry , Asbestos & coal tar
industry.
Cancer bladder
• Common in dyeing industry , in Gobar gas &
electric cable industry.
• The aromatic iron absorbed by the body is
excreted through urine & the bladder becomes the
targeted organ.
Leukemia
It is caused by radiation & exposure to the chemical
benzol which is used in many industries.
Control of occupational Cancer
• Elimination or control of industrial
carcinogens like well designed building or
machinery etc
• Medical examinations
• Inspection of factories
• Notification
• Licensing of establishments
• Personal hygiene measures
• Education of workers & management
• Research
Occupational Dermatitis
• This occurs when skin comes in contact with
hazardous substances.
• The hazards may be physical, chemical or
biological which act as irritants or sensitizing
substances.
• Prevention:
1. pre selection examination,
2. protection like clothings, leather gloves, aprons &
boots.
3. Personal hygiene & periodic examination
Radiation Hazards
• Use of Radium & other radio active
substances.
• Ex; painting of luminous dials for watches &
other instruments, R/A paints, X-Rays,
Exposure to UV rays & IR rays ( welding)
• Effects: Burns, dermatitis, MALIGNANCIES,
Genetic effects, lung cancer.
Preventive measures
1. Inhalation, swallowing or direct contact with skin
should be avoided.
2. In case X-rays , shielding to be used
3. Employees to be monitored at intervals not
exceeding 6 months by use of film badge or pocket
electrometer devices.
4. Suitable protective clothing to prevent contact.
5. Ventilation of work place to prevent inhalation
6. Replacement & periodic examination of workers
7. Pregnant women should not be allowed to work in
places of exposure to radiation.
Diseases of Agricultural workers
• They are exposed to :
1. Zoonotic diseases from cattle like brucellosis, TB,
tetanus & anthrax
2. Accidents
3. Toxic hazards from insecticidal spraying ( insecticidal
poisoning)
4. Physical hazards : exposure to light & solar radiation
5. Parasitic infestations : hook worm infestations from
manure.
6. Respiratory diseases – farmers lung, bysinnosis,
bagassosis, bronchitis & asthma
7. Insect bites & snake bites
Accidents
• It is common in most industries.
• Ex.. Coal & other mining industries, Quarries ,
construction work.
• Causes : Human and Environmental
• Environmental factors :
Temperature, poor illumination, humidity,
noise & unsafe machines.
Human factors
1) Physical : vision problem & hearing deficit .
2) Physiological :
Sex : women prone to less accidents.
Age : younger ages involved more in accidents than
older age groups.
Time : minimum in the beginning of the day &
increase gradually.
Experience :50 % of accidents occur in the first 6
months of employment & only 3% accidents as
years exceeds.
3) Psychological : carelessness, Inattentiveness & over
confidence.
Prevention
Pre placement examination
• Adequate job training
• Continuing education
• Safe working environment
• Periodic survey for finding out hazards.
• Maintenance of records & careful reporting.
General Measures for health Protection of workers
• ILO \ WHO committee recommended the
measures for the general protection of workers
as following :
1. Nutrition
According to Factories Act , one canteen
should be provided when employees number
exceeds 250.
2. Prevention of Communicable diseases
• Vaccinations & early treatment.
• The spread of TB , Malaria, typhoid, Viral
Hepatitis, Amoebiasis, Intestinal parasites &
STD should be controlled.
3. Environmental Sanitation
a) Water & food supply & toilet :
b) General plant cleanliness :
paint once in 3 years & washing walls atleast
every 6 months.
c) Sufficient space :
500 cubic feet per each worker to prevent
respiratory diseases.
d) Lighting :
sufficient lighting should be provided.
e) Ventilation / Temperature
f) Protection against hazards : protective devices.
g) Housing : adequate housing facilities.
4. Mental Health
• Facilities for recreation
• Recognition for good work
• Measures to sustain the attitude of workers
• Incentives , promotion etc.
• Regular health check up & prompt treatment.
• Provision of counseling
• Rehabilitation of those who recover from illness.
5. Measures for Women & Children
Women worker require special protection because :
1. Females may be less suited for some tasks than
men, if women becomes pregnant , her work
output decreases.
2. Women tend to feed themselves less amount than
men.
3. IMR is more among infants of working women
employed in Industrial work.
The following types of protection are available for
women workers in India :
• Maternity leave for 12 weeks, of which 6
weeks precede the EDD, during this period
they are not allowed “maternity benefit”,
which is a cash payment, under ESI Act, 1948.
• Provision of free Antenatal, Natal & post Natal
services.
• Factories Act prohibits carrying excessive
weight & prohibits night work B/W 7 pm to 6
am.
• The Indian Mines Act (1923) prohibits work
underground.
• The Factories Act 1976 provides Creches in
Factories where more than 30 women are
employed.
• No child below the age of 14 shall be
employed to work in any factory or mine or
engaged in any hazardous employment.
6, Health Education
7, Family planning
All contraceptives methods
must be made available for workers
& adopt the small family norm.
Specific Measures for Prevention of
Occupational Diseases
1, medical Measures
2, Engineering Measures
3, Legislative Measures.
Medical measures
• Pre placement examination
• Periodical examination
• Medicare & Health services
ESI, First aid , MCH, Family welfare,
Immunization etc.
• Notification
• Supervision of working environment
• Health education & counseling.
Engineering Measures
• Design of the building
floors, wall height , ceiling ,roof ,doors,
windows , cubic space etc.
• Good house keeping
water supply, washing , sweeping, disposal of
waste , food hygiene etc.
• Mechanization
instead of manual work use machines when
handling harmful substances.
• Substitution
replacing harmful material by a harmless
one in the manufacturing process ex. Silver
salts instead of mercury salts
• Control of Dust
watering in Drilling section reduces dust
• Isolation
most harmful materials to be used in
separate building.
• Enclosure
proper space to be provided at all hazardous
sections.
• Local exhaust ventilation
dust,gases & fumes to be sucked into a hood &
conveyed through ducts into the collecting units.
• Protective devices
ear plugs, ear muffs, helmets, safety shoes,
aprons, gloves, gum boots, barrier creams,
goggles, screens, lead aprons.
• Environmental & statistical monitoring
to measure the dose of hazardous agents in the
environment.
Social security by Legislation
a) Workmen Compensation act, 1923
b) Employees State insurance act, 1948
c) The Factories Act, 1948
Workmen Compensation act, 1923
WCA
• The act provides for the payment of
compensation by certain classes of employers
to their workers who sustain (prolong) injuries
by accidents during the course of their work.
Provisions of the Act
•
•
•
•
•
•
•
Employers liability
Employer liability exemption
Amount of Compensation
Notification of death or injury.
Time limit for payment of compensation
Occupational diseases such as injuries
Power of commissioner (WCA)
1. Employers liability
• If employee is injured caused by an accident during his
job timing , his employer shall be liable to pay
compensation.
2.Employer liability exemption
The employer no need to pay compensation in the
following reasons like :
Alcohol or drugs, disobedient of an worker of an rules
for the purpose of safety, willful removal of safety
devices etc.
3. Amount - based on the nature of injury or death
4. Notification – it should be given by the
employer with in 7 days of death / serious
injury of a worker to the commissioner, WCA.
5. Time limit _ the compensation amount shall
be paid to the workers with in one month
from the due date & in default the employer
will pay simple interest or penalty as decided
by the commissioner, WCA.
Employees State insurance Act, 1948
• It is an important measure of social security &
health insurance in the country.
• It provides certain cash & medical benefits to
industrial workers in case of sickness,
maternity, leave & employment injuries.
Scope
• Small power using – 10-19 persons
• Non power using - 20 or more persons
• Shops
• Cinema theatre
• Hotels & newspaper establishment
Organizational setup of ESI
ESI Corporation
Chairman , Union ministry of Labour
Vice chairman, secretary to the Govt of India,
Ministry of Labour
Director General of ESI
Insurance Commissioner
Medical Commissioner
Finance Commissioner
Benefits of the Act
1.
2.
3.
4.
5.
Medical benefits
Sickness benefits (91 days allowed with payment)
Maternity benefits
Disablement benefits
Dependant benefits( payment done to a
dependant of an insured person as a result of
injury or death)
6. Funeral benefits (Rs 1000 given for funeral)
7. Rehabilitation benefits ( monthly payment of Rs 10
as rehabilitation allowance)
Rajiv gandhi Shramik Kalyan Yojana
came into effect from 1st April ,2005
• This schemes provides an unemployment
allowance for the employees covered under ESI
scheme
• who are rendered unemployed involuntarily due
to retrenchment (reduction in production) or
closure of factory or permanent invalidity
arising out of non employment injury etc.
• During this period, he/she is eligible for himself
& his/her family from ESI dispensaries , ESI
clinics & ESI hospitals to which he/she was
attached prior to the date of loss of employment.
3, The Factories Act , 1948
•
To provide health, safety & welfare to the worker.
•
Provisions of this Act :
1.
2.
3.
4.
5.
6.
Health, safety & Welfare
Employment of young persons
Hours of work
Leave with wages
Occupational disease
Safety management
Health, safety & Welfare
• Provisions of cleanliness, lighting and ventilation.
• Provision of safe drinking water
• Employment of sanitary workers for cleaning latrines.
• Provision of minimum space of 500 cu ft per person.
• Specific welfare measures – canteen, creches, rest
rooms, lunch room , first aid appliances
Employment of young persons
• The Act prohibits employment of children below the age of 14 &
declares 15 to 18 years of age as adolescence.
• An adolescent employee is allowed to work only B/W 6 am to 7
pm.
Hours of work
Total hours of work is 8 hours a day with rest for half
an hour after 5 hours of continuous work.
Total hours of work in a week shall not exceed 60.
Leave with wages
• Every worker is availed leave with wages
after 12 months of continuous service,
• Adult : 1 day for every 20 days.
Safety management
Industries involving hazardous processes should
constitute a committee for examining the service
conditions of employees, allowing workers also to
participate in any meetings.
Occupational Health Nurses
• Occupational Health Nurses (OHN)s are
registered nurses who independently observe
and assess the worker's health status with
respect to job tasks and hazards. Using their
specialized experience and education, these
registered nurses recognize and prevent
health effects from hazardous exposures and
treat workers' injuries/illnesses.
Functions
•Observation and assessment of both the worker and
the work environment
•Interpretation and evaluation of the worker's medical
and occupational history, subjective complaints, and
physical examination, along with any laboratory
values or other diagnostic screening tests, industrial
hygiene and personal exposure monitoring values
•Interpretation of medical diagnosis to workers and
their employers
Contd …
•Appraisal of the work environment for potential
exposures
•Identification of abnormalities
•Description of the worker's response to the
exposures
•Management
of
occupational
and
nonoccupational illness and injury
•Documentation of the injury or illness