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Test on Occupational Health. Dr. Pracheth R. Occupational diseases classification. Physical agents: Heat: hyperpyrexia, exhaustion, syncope, cramps, burns Cold: trench foot, frost bite, chillblains Light: occupational cataract, miner’s nystagmus Noise: occupational deafness
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Test on Occupational Health Dr. Pracheth R.
Occupational diseases classification • Physical agents: • Heat: hyperpyrexia, exhaustion, syncope, cramps, burns • Cold: trench foot, frost bite, chillblains • Light: occupational cataract, miner’s nystagmus • Noise: occupational deafness • Radiation: cancer, leukaemia • Mechanical: accidents, injuries • Electricity: burns
Continued…. • Chemical agents: • Gases: CO2, CO, HCN, CS2 • Dusts: • Inorganic: Coal dust: anthracosis Silica: silicosis Asbestos: asbestosis Iron: siderosis
Continued…. • Organic (vegetable) dusts: Cane fibre: bagassosis Cotton dust: byssinosis Tobacco: tobaccosis Hay or grain dust: farmer’s lung • Metals: lead, mercury, cadmium, manganese • Chemicals: acids, alkalies, pesticides
Continued…. • Biological agents: brucellosis, leptospirosis, tetanus • Occupational cancers: skin, lungs, bladder • Dermatosis: dermatitis, eczema • Psychological origin: industrial neurosis, hypertension, peptic ulcer.
Prevention of occupational diseases • Medical • Engineering • Legislative
Medical measures • Pre-placement examination: • Lead: anaemia, hypertension, peptic ulcer • Dyes: asthma, skin, bladder diseases • Silica: tuberculosis • Periodical examination: • Slow development, once a year • Lead, toxic dyes: monthly • Irritants: dichromates-daily
Medical measures • Medical and health care services: • Schemes: worker+ family • First aid services, immunization • Notification: • Factories Act: 22 diseases • To initiate measures: prevent
Medical measures • Supervise working environment: • Periodic inspection: environment • Physician: check lighting, ventilation, humidity, noise • Maintenance of records: • Worker’s health, occupational disability record
Medical measures • Health education, counseling: • Risks : explained • Correct use of protective devices • Simple rules of hygiene: hand-washing
Engineering measures • Design of building: • Type of floor, roof, ceiling, door, windows: planned • Good house keeping: • Cleanliness, ventilation, food arrangements, maintenance • White-wash: once a year • Dusts: removed • Protective devices: clean
Engineering measures • General ventilation: • Ventilation openings: 5 sq feet per worker • Continued supply of fresh air • Dust: exhaust ventilation • Minimum 500 cu feet air space/worker • Mechanization: • To reduce contact: harmful substances
Engineering measures • Substitution: • Replace harmful-harmless • White phosphorous by phosphorous sesquisulphide- phossy jaw • Dusts: • Control at point of origin by water sprays. Eg : wet drilling of rock
Engineering measures • Enclosure: • Enclose harmful materials, processes-escape • Isolation: • Offensive processes: separate building-workers protected • Certain operations: night
Engineering measures • Local exhaust ventilation: • Dusts, fumes trapped and extracted at source- before atmosphere • Heart: hood-as near to point of origin. • Protective devices: • Respirators: know how to use • Not substitute to other control
Engineering measures • Environmental monitoring: • Periodic surveys: factory atmosphere • Whether dusts, gases: permissible limits • Statistical monitoring: • Review data : regularly • To evaluate adequacy preventive measures • Research
Legislations: Factories Act, 1948 • Scope: Factory : 10 or more-power, 20: no power • Health, safety and welfare: • Minimum 500 Cu ft • Precautions : ensure safety • No worker lift loads-injury • Safety Officers: 1000 • More than 250 workers: canteen, creches: 30 women, 500 workers : Welfare Officer
Factories Act, 1948 • Employment young : • Prohibits: below 14 years • Age 15-18: adolescents- certified : fitness-surgeons • Adolescent: 6 am to 7 pm
Factories Act, 1948 • Hours of work: • Maximum : 48 hours per week , not more 9 hours/day • Rest ½ hour after 5 hours work • Adolescents : 4 and half hours work-rest • In 1976: hours in a week : 60 hours
Factories Act, 1948 • Leave with wages: • After 12 months continuous service: 1 in 20 days, children: 1 in 15 days • Occupational diseases: • Give information: accidents, diseases • Notifiable diseases: byssinosis, asbestosis, occupational dermatitis, noise-induced hearing loss
Factories Act, 1948 • Employment in hazardous process: • Site Appraisal Committee: examine factories - hazardous processes • Workers participate : safety management.
Employees State Insurance Act, 1948 • Passed in 1948. Amended: 1989. • Scope: All power using factories : more than 10 people. New classes: • Small factories • Shops, hotels, restaurants • Cinemas, theatres • Newspaper establishments • Private medical, educational institutions: more than 20 persons: some states
Employees State Insurance Act, 1948 • All employees: manual, clerical, supervisory, technical: upto 15,000 month • Administration: • ESI Corporation • Chief Executive Officer: assisted by 4 officers • Medical facilities: ESI dispensaries, hospitals • Branch offices: pay cash benefits • Inspection officers: inspect factories
Employees State Insurance Act, 1948 • Finance: • Employer: 4.75% -total wage bill • Employee: 1.75% wages • Those: below Rs. 70 exempted • Grants from State and Central Governments • ESI Corporation
Benefits to employees • Medical benefit: • Full medical care: hospitalization; free • Out-patient, drug supply, specialist services • Investigations, antenatal, postnatal services, family planning services • Ambulance , in-patient
Benefits to employees • Sickness benefit: • Periodical cash payment : sickness-certified by Insurance Medical Officer. • Maximum of 91 days: 50% daily wages • Should remain in treatment under Act
Benefits to employees • Maternity benefit: • Insured woman: confinement/ miscarriage • Confinement: 12 weeks • Miscarriage : 6 weeks • Sickness due to confinement: 30 days. • At about full wages
Benefits to employees • Disablement benefit: • Temporary or permanent : employment injury, occupational diseases • Temporary : 70% wages • Permanent: life pension
Benefits to employees • Dependant’s benefit: • Death : employment injury, occupational diseases: pension 70% wages; fixed ratio- monthly • Upto 18; withdrawn : daughter marries early.
Benefits to employees • Funeral expenses: • Expenses not exceeding Rs.5000 • Rehabilitation: • Monthly payment Rs 10: person, family: medical treatment after retirement/ permanent disablement.
Pneumoconiosis • Size: 0.5-3 Micron • Lung fibrosis • Chemical composition, concentration in air • Health status • No cure
Silicosis • Inhalation of dust: free silica/silicon dioxide • Mining (coal, gold, silver, lead) • Pottery, ceramic, sand blasting • In Bihar: 34.1% miners • Long duration: more risk • IP: few months- years
Continued…. • Particles: ingested by phagocytes- block lymph channels • Dense nodular fibrosis • Insidious onset • Irritant cough, dyspnoea on exertion • Snow storm appearance: X ray • Prone to pulmonary TB
Continued…. • No effective treatment • Dust control-substitution • Enclosure, isolation • Regular physical examination
Anthracosis • Coal miners pneumoconiosis • First phase: simple • Second phase: Progressive Massive Fibrosis: severe respiratory disability-premature death
Byssinosis • Inhale cotton fibre dust- long time • Chronic cough, progressive dyspnoea • India: large textile industry
Bagassosis • Sugar cane dust • Sugar cane fibre: to make- paper, cardboard • Thermophillicactinomycete-Thermoactinomycessacchari • Breathlessness, cough, haemoptysis, slight fever • Mottling in lungs/shadow • If treated early: resolves • Emphysema, fibrosis
Asbestosis • Silica combined with magnesium, iron, calcium: asbestos • Cement, fire-proof textiles, roof tiling • Deposits : alveoli • Fibrosis, respiratory insufficiency, death • Carcinoma bronchus, mesothelioma: rare cancer of pleura, peritoneum • Dyspnoea out of proportion to clinical signs
Continued…. • Asbestos bodies in sputum • Prevention: • Safer types: two: chrysolite (safer), amphibole • Substitution • Dust control • Periodic examination
Farmer’s lung • Inhalation of hay/grain dust • Moisture content : over 30%- bacteria, fungi grow rapidly • Rise in temperature: 40 to 50 degree C: encourages growth of thermophilicactinomycetes- Microplysporafaeni • Respiratory symptoms, repeated attacks, pulmonary fibrosis • Inevitable pulmonary damage
Occupational hazards: agricultural workers • Zoonotic diseases: leptospirosis, tetanus, tuberculosis, brucellosis • Accidents: machinery, insect, snake bites • Toxic hazards: chemicals: fertilizers, pesticides • Physical: temperature, humidity • Respiratory diseases: dusts: grains, rice, tobacco: byssinosis, bagassosis, farmer’s lung, occupational asthma
Prevention • Health promotion: hygiene, education • Specific protection: TT, avoid allergens, protective devices • Early diagnosis, treatment • Periodic examination
Occupational cancer • Skin cancer: • Coal tar, x-rays • Nearly 75%: skin • Gas workers, dye makers, road makers • Lung cancer: • Gas, asbestos, mining of uranium • 9/10th : tobacco, air pollution, occupational exposure
Continued….. • Cancer bladder: • Aniline, rubber, dye, electric cables • Beta-naphthylamines • Leukaemia: • Benzol, X-rays, radio-active substances
Characteristics of occupational cancer • Prolonged exposure • Period: 10-25 years • Even after stoppage of exposure • Average age earlier
Control • Elimination carcinogens: well-designed building, closed system • Medical examination • Inspection of factories • Notification • Licensing • Personal hygiene • Education • Research
Accidents in industry • Some industries: known-accidents • Coal, mining, construction work • Increased human suffering
Causes • Human: • Physical • Physiological: gender, age, time, working hours • Psychological: careless, over confidence • Environmental: • Temperature, poor illumination • Humidity, noise • Unsafe machines
Prevention • 98% accidents : preventable • Pre-placement examination • Job training • Continuing education • Safe working environment • Safety department: safety engineer • Periodic surveys • Careful reporting, maintain records
Sickness absenteeism • Affect production, impede cost • Absenteeism: 15 to 20 percent • Causes: • Economic: sick leave with pay-privilege • Social: weddings, festivals • Medical • Non-occupational: alcohol, drug addiction