Occupational diseases 11

beneficial for studying Occupational diseases

1. Occupational Diseases By MIDHUN RAJIV

2. Definition O ccupational diseases are diseases caused by work or work environment “any chronic ailment that occurs as a result of work or occupational activity” W ork-related diseases are diseases initiated, hampered or easy to get by work

3. Occupational disease occur among workers exposed to physical, chemical, biological or psychosocial factors in the workplace. In some situations may also occur among the general community as a consequence of contamination of the environment from the workplace. e.g lead, pesticides

4. Occur in varying time frames – from instantaneous development of symptoms to gradual development instantaneous reactions - exposure to chemicals such as chlorine or ammonia gas a delay of some six to twelve hours with fumes of aerosolized zinc a delay of weeks to months with lead poisoning a delay of decades with occupational carcinogens even the finding of congenital malformations in children whose parents may have been exposed to hazardous materials So, deaths from such diseases - difficult to enumerate

5. WHO - 100 million occupational injuries  0.1 million deaths in the world India  17 million occupational non-fatal injuries (17% of the world) & 45,000 fatal injuries (45% of the total deaths due to occupational injuries in world) annually 11 million cases of occupational diseases in the world  1.9 million cases (17%) contributed by India Of 0.7 million deaths in the world, 0.12 (17%) from India Adverse occupational factors have been estimated to cost 2-14% of the gross national products for various countries

6. HAZARD EXAMPLES Physical Noise, Vibration, Radiation, Heat Chemical Dusts, Heavy & Heavy reactive Metals, Solvents, Gases, Fumes Biological AIR CONTAMINANTS Human tissue & bodily fluids (blood) causing Hepatitis B,C,HIV ( AIDS) Microbial pathogens causing Anthrax, TB, Brucellosis, asthma & Tetanus. Animal and animal products, Birds, Insects e.g Mosquitoes. PARTICULATE Dusts, Fumes, Mists, Aerosols, Fibers GAS AND VAPOUR Ergonomic/Mechanical Lifting & handling Poor posture Repetition Poor equipment & workplace design Psychosocial Organizational Psychosocial Factors High demand & Low control Violence and verbal abuse Lone working, Shift work, Night work Burn out due to Long working hours Exposure to unnecessary tobacco or smoking.

7. Diseases in Large scale & small scale Industries Gases – gas poisoning . Inorganic dusts: Coal dust - Anthracosis Silica - Silicosis. Asbestos - Asbestosis. Iron - Siderosis Organic dusts : Cane fiber - Bagassosis . Cotton dust – Byssinosis . Asthma – among persons exposed to organic dust Chemicals – Burns, dermatitis, cancer, respiratory illness Metals – lead, mercury, arsenic, chromium cause poisoning

8. Industrial neurosis, hypertension, peptic ulcer, etc . Work-related stress – excessive working time and overwork Violence –  from outside the organization Bullying – emotional and verbal abuse Sexual Harassment Mobbing Burnout Exposure to unhealthy elements – tobacco, uncontrolled alcohol

9. Heat hyperpyrexia, heat exhaustion Occupational cataract, miner’s nystagmus Pressure: Caisson disease, air embolism, blast (explosion ) Occupational deafness Musculoskeletal disorders (MSDs) can affect the body’s muscles, joints, tendons, ligaments and nerves. As well as the back, neck, shoulders and upper limbs; less often they affect the lower limbs. develop over time and are caused either by the work itself or by the employees' working environment

10. Occupational Dermatoses : Types: Acute contact eczema Chronic contact eczema Chloracne Photosensitization Hypo/ hyperpigmentation Keratoses Benign tumors and epitheliomas Ulcerss

11. Diseases in Hospital Industry Hepatitis B Virus Hepatitis C Virus Tuberculosis – particularly among Healthcare Workers Blood-borne Diseases – HIV/AIDS Anthrax Brucellosis Tetanus Occupational dermatosis

12. Diseases in Agriculture: Farmer’s lung- hypersensitivity pneumonitis induced by inhalation of biological dusts. Silo filler's disease ( SFD) - pulmonary exposure to oxides of nitrogen – could manifest into pulmonary oedema Leptospirosis . Hepatitis A, Typhoid. Pesticide : Pesticide are often applied by hand, or without proper protection of workers who use spray equipment Zoonotic diseases – Related to livestock's. Occupational dermatosis

13. Industrial Hygiene It is defined as- “that science and art devoted to the anticipation, recognition, evaluation, and control of those environmental factors or stresses arising in or from the workplace, which may cause sickness, impaired health and well-being, or significant discomfort among workers or among the citizens of the community.”

14. Industrial hygienists analyze, identify, and measure workplace hazards or stresses that can cause sickness, impaired health, or significant discomfort in workers through chemical, physical, ergonomic, or biological exposures.

15. WORKSITE ANALYSIS: first step determine what jobs and work stations are the sources of potential problems measures and identifies exposures, problem 3 tasks, and risks. Eg : all jobs, operations, and work activities. researches , or analyzes how the particular chemicals or physical hazards at that worksite affect worker health.

16. RECOGNIZING AND CONTROLLING HAZARDS: Engineering controls minimize employee exposure by either reducing or removing the hazard at the source or isolating the worker from the hazard. I t include eliminating toxic chemicals and substituting non-toxic chemicals, enclosing work processes or confining work operations, and the installation of general and local ventilation systems

17. Work practice controls :alter the manner in which a task is performed. changing existing work practices to follow proper procedures that minimize exposures while operating production and control equipment; inspecting and maintaining process and control equipment on a regular basis; implementing good housekeeping procedures; providing good supervision; mandating that eating, drinking, smoking, chewing tobacco or gum, and applying cosmetics in regulated areas be prohibited.

18. Administrative controls :include controlling employees' exposure by scheduling production and tasks, or both, in ways that minimize exposure levels. For example, the employer might schedule operations with the highest exposure potential during periods when the fewest employees are present.

19. Use of appropriate personal protective equipments: Examples of personal protective equipment are gloves, safety goggles, helmets, safety shoes, protective clothing, and respirators. To be effective, personal protective equipment must be individually selected, properly fitted and periodically refitted; conscientiously and properly worn; regularly maintained; and replaced, as necessary.

20. Sickness absenteeism Sickness absenteeism occurs when employees miss work for reasons stemming from health problems. The rate of sickness absenteeism is linked to the overall health of the workforce and also to specific factors in each individual profession . Workplace policies and national standards also impact the rate of sickness absenteeism as do cultural norms and personal attitudes among workers.

21. medical professionals are largely responsible for determining which illnesses are of sufficient severity to warrant absence from work . Absenteeism and job satisfaction are closely linked.  

22. The component of an occupational history Job description/nature of job Hours of work/shift work Types of hazards Past occupation Other jobs Domestic exposures Hobbies Do other workers have a similar illness ? Relationship of illness to period away from work

23. Additional information in occupational history Smoking/ alcohol intake/drugs Similar complaints among other workers Time relationship between work and symptoms Degree of exposure Use of protective device Methods of materials handling

24. Occupational diseases ASBESTOSIS Chronic inflammatory and fibrotic medical condition Affecting parenchyma tissue of the lungs. Causes Chronic Inhalaion of asbestos Clinical manifestations Dyspnea Reduction in lung volume Hypoxia lung cancer respiratory failure

25. PNEUMOCONIOSES IT IS A OCCUPATIONAL LUNG DISEASE CAUSED BY INHALATION OF DUST. TYPES COAL WORKER PNEUMOCONIOSES ASBESTOSIS SILICOSIS-MINERS PHTHISIS,GRINDERS ASTHMA,POTTERS ROT. CAUSED BY CRYSTALLINE SILICA DUST. BAUXITE FIBROSIS-IT IS A FORM OF PNEUMOCONIOSES CAUSED BY BAUXITE BERYLLIOSIS-BERYLLIUM SIDEROSIS-IRON BYSSINOSIS -COTTON

26. The most common occupational diseases Are almost always preventable by a combination environmental, personaland medical measures

27. Occupational cancer The cause of cancer is still not completely understood Epidemiological studies  has been associated with certain exposures.

28. Occupational Disease in Developing Countries Asbestos is the major cause of disability and ill health

29. Preventing Occupational Disease Measures Applied to the Process or Workplace Substitution of a Non hazardous Substance for Hazardous One Installation of Engineering Controls and Devices Job Redesign,Work Organization Changes and Work Practice Alternatives Measures Primarily Directed Toward Worker Education and Advice Personal Protective Equipment Organizational Measures

30. The three levels of prevention Primary Prevention Is designed to deter or avoid the occurrence of disease or injury Secondary Prevention Is designed to identify and adequately treat a disease or injury process as soon as possible, often before any symptoms have developed Tertiary Prevention Is designed to treat a disorder when it has advanced beyond its early stages, to avoid complications & limit disability, to address rehabilitative and palliative needs

31. Primary Prevention Secondary Prevention Control of new hazards Screening Control of known hazards Environmental monitoring Biological monitoring Identification of vulnerable workers (pre employment medical examination) Periodic medical examination Substitution Engineering controls to minimise exposure Personal Protective Devices

32. Tertiary prevention aims to minimise the consequences in persons who already have disease The goal is to limit symptoms or discomfort, minimize injury to the body and maximize functional capacity

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