Occupational Health Introduction

1. Occupational HealthIntroduction Ass. Prof. Dr. Laith A. Alrudainy MD, MSc, PhD

2. Occupational health (WHO definition) According to WHO, occupational health can be defined as a multidisciplinary activity aiming at: • Protection and promotion of the health of workers by eliminating occupational factors and conditions hazardous to health and safety at work

3. Occupational health (WHO definition) • Enhancement of physical, mental and social well-being of workers and support for the development and maintenance of their working capacity • Development and promotion of sustainable work environments and work organizations

4. Occupational health and development The health status of the workforce in every country has an immediate and direct impact on national and world economies.

5. Characteristics of occupational diseases 1- The clinical and pathological presentation of most occupational diseases is identical to that of non- occupational diseases. e.g., asthma

6. Characteristics of occupational diseases 2- Occupational disease may occur after the termination of exposure. e.g., asbestose-related mesothelioma

7. Characteristics of occupational diseases 3- The clinical manifestations of occupational disease are related to the dose and timing of exposure; e.g., elemental mercury

8. Characteristics of occupational diseases 4- Occupational factors can act in combination with non-occupational factors to produce disease; e.g. exposure to asbestose and smoking

9. Occupationally Associated Diseases Ass. Prof. Dr. Laith A. Alrudainy MD, MSc, PhD

10. Occupationally associated respiratory diseases 1- Pulmonary asphyxiants - Simple asphyxiants (Carbon Dioxide, Methane, and Nitrogen) - Chemical asphyxiants (Carbon Monoxide, Hydrogen Cyanide, and Hydrogen Sulfide) 2- Pulmonary irritant - Water Soluble: Ammonia, Chlorine, and Sulfur Dioxide - Water Insoluble: Phosgene, Ozone

11. Occupationally associated respiratory diseases 3- Hypersensitivity pneumonitis 4- Pneumoconiosis: - Coal dust pneumoconiosis - Silicosis - Asbestosis 5- Occupational asthma

12. Hypersensitivity Pneumonitis Hypersensitivity pneumonitis is a lung disease that is often related to occupation. This inflammation of the lungs is caused by repeated inhalation of foreign substances such as: - Bacteria in Moldy Hay  Farmers Lung - Fungi in Wood Dust  Wood workers Lung - Avian Dust  Bird Breeders Lung

13. Hypersensitivity Pneumonitis Acute  Severe Shortness of breath, cough, fever and chills. Occurs within 4 to 6 hours Chronic  Progressive fibrosis of Lung due to continuous exposure to organic material. (Progressive shortness of breath and cough).

14. Coal Dust Pneumoconiosis Coal Workers Pneumoconiosis (Black Lung) Exposure Mining Chronic ExposureChronic bronchitis / Emphysema Prevention  Annual Chest X-rays, Low Dust Levels, Respirators, Frequent mine inspections.

15. Silicosis The lungs caused by inhaling silica particles. Exposure  Sandblasting, Glass & Pottery making, Foundry Workers, Granite & sandstone Mining

16. Silicosis Acute  respiratory impairment & death Chronic - Exposed to low level silica for > 20 years. (Cough, Shortness of breath, increased risk for tuberculosis)

17. Silicosis Prevention  (Chest X-ray), Respirator use, annual screen for tuberculosis.

18. Asbestosis - Naturally occurring mineral with thin, separable fibers. - Fibers do not dissolve in water or evaporate. - Resistant to heat, fire, chemical & biological degradation. - Are not broken down into other compounds, and remain virtually unchanged over long periods of time. May remain suspended in the air for a long time and be carried long distances by wind or water before settling.

19. Asbestosis Exposure Used as insulation for pipes & broilers, vehicle brakes It is fibrous material (Unlike Coal & Silica which is Dust) Chronic  Pleural plaques & fibrosis Cancer  Lung Cancer (Increased Risk in smokers) and Mesothelioma (Latency 30-40 yrs, unrelated to smoking)

20. Occupational asthma - Occupational asthma is caused by specific sensitizing agents inhaled in the workplace. - It does not include bronchoconstriction induced by irritants such as exercise and cold air that are encountered at work.

21. Occupational asthma Example (it has recently been recognized that workers such as those in health services can develop occupational asthma as a result of wearing latex gloves). The allergen is latex protein, which becomes airborne as the gloves are used.

22. Occupational asthma Diagnosis - Occupational History: It is essential in the initial assessment of a worker thought to have occupational asthma. - Coughing at work or at the end of a shift is often the first symptom and precedes wheezing.

23. Occupational asthma • - Concurrent rhinorrhoea, nasal congestion, and lacrimation may be associated with exposure to allergic substances. - The symptoms generally improve at weekends and holidays, but at advanced stages the respiratory symptoms may persist.

24. Occupational asthma Physical examination is rarely helpful-- even in confirmed cases the chest often seems to be normal. Peak expiratory flow: A drop in peak expiratory flow or substantial diurnal variability in peak expiratory flow on working days but not on days away from work supports a diagnosis of occupational asthma.

25. Occupational asthma Management Although treatment of acute occupational asthma is the same as for asthma generally, it is important to be aware that, once a person has been sensitized to a specific substance, subsequent exposure to even minimal quantities of this substance may precipitate severe bronchoconstriction.

26. Occupational asthma Note: A worker who develops occupational asthma should avoid further exposure to the causative agent.

27. Any question?