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Occupational health
1.
OCCUPATIONAL HEALTH
Dr.Siva.P.M Junior Resident Community medicine Copyright © Wondershare Software
2.
INTRODUCTION • Occupational health
: – promotion and maintenance of highest degree of physical, mental and social well being of workers – All three levels of prevention – Adaptation of work to man and vice versa Copyright © Wondershare Software
3.
Ergonomics – ergon
– work ; nomos – law • Fitting job to the worker • Objective – achieve mutual adjustment of man and his work for improvement of human efficiency and well being • To reduce industrial accidents and increase efficiency of workers Copyright © Wondershare Software
4.
• Occupational environment
• Sum of external conditions and influences –prevail at the place of work –bearing on health of workers • 3 interactions – Man and agents(Physical, Chemical, Biological) – Man and machine – Man and man Copyright © Wondershare Software
5.
• Occupational hazards
1. Physical 2. Chemical 3. Biological 4. Mechanical 5. Psychosocial Copyright © Wondershare Software
6.
PHYSICAL HAZARDS Heat and
cold • Common physical hazard – heat • Direct effect of heat – burns, heat exhaustion, heat stroke, heat cramps • Indirect effects – decreased efficiency, increased fatigue, enhanced accident rates Copyright © Wondershare Software
7.
• Radiant heat
– foundry, glass and steel industry • Heat stagnation – jute and textile industry • High temperature – kolar gold mines – 65degC • Corrected effective temperature > 27deg C- discomfort • Cold – chilblains, erythrocyanosis, immersion foot, frostbite Copyright © Wondershare Software
8.
• Light
– Poor illumination – eye strain, head ache, eye pain, lacrymation, congestion – Miner’s nystagmus – chronic effects – Intense glare – blurring of vision, accidents Copyright © Wondershare Software
9.
• Noise
– Auditory effects – hearing loss – Non auditory – nervousness, fatigue, interfere with communication – Degree of injury – intensity & frequency range, duration of exposure, susceptibility Copyright © Wondershare Software
10.
• Vibration
– Affects hands and arms, joints – Chronic exposure – fine blood vessels- sensitive to spasm (white finger) • UV radiation – Arc welding – Affects –eyes- conjunctivitis, keratitis (Welder’s flash) Copyright © Wondershare Software
11.
• Ionizing radiation
– X rays and radio active isotopes(cobalt 60, phosphorous 32) – Bone marrow – more sensitive – Genetic changes, malformation, cancer, leukemia, depilation, ulceration, sterilit y, death – Maximum permissible – 5 rem/year to whole body Copyright © Wondershare Software
12.
CHEMICAL HAZARDS • Acts
in three ways – local action, inhalation, ingestion • Local action – Dermatitis, eczema, ulcer, cancer (irritant action) – Aromatic amino and nitro compounds – systemic • Inhalation – Respirable dust - <5 microns Copyright © Wondershare Software
13.
• Dust
– organic – cotton, jute – Inorganic – silica, mica, coal, asbestos – Insoluble – retain in lung – pneumoconiosis – Soluble – eliminated by body mechanism Copyright © Wondershare Software
14.
• Gases
– Simple – oxygen, hydrogen – Asphyxiating – CO, cyanide, sulphur dioxide, chlorine – Anesthetic – chloroform, ether • Metals and their compounds – Lead, antimony, beryllium, cadmium, cobalt, manganese, merc ury, phosphorous, chromium, zinc etc Copyright © Wondershare Software
15.
• Ingestion
– Lead, antimony, cadmium, mercury, phosphorous, chromium, zinc etc – through – contaminated hand or food or cigarettes • Biological hazards – Brucellosis, leptospirosis, anthrax, hydatidosis, psittacosis, tetanus, enc ephalitis, fungal infections, schistosomiasis – Working among animal products Copyright © Wondershare Software
16.
• Mechanical hazards
– Machinery, protruding and moving parts – 10% of accidents • Psychosocial hazards – Failure to adapt to an alien psychosocial environment – Frustration, lack of job satisfaction, insecurity, poor human relationship, emotional tension – affect physical and mental health Copyright © Wondershare Software
17.
OCCUPATIONAL DISEASES • Pneumoconiosis •
Dust – 0.5 to 3 microns – health hazard- variable period of exposure – lung disease – pneumoconiosis • Hazardous effect depends on – Chemical composition – Fineness – Concentration – Health status of the person Copyright © Wondershare Software
18.
• Important dust
diseases – silicosis – anthracosis – byssinosis – bagassosis – asbestosis – farmer’s lung • No cure – only prevention essential Copyright © Wondershare Software
19.
SILICOSIS (NOTIFIABLE- FACTORIES
ACT 1948 AND MINES ACT 1952) • Major cause of disability and mortality • Inhalation of dust with – silica or silicon dioxide • Higher concentration – higher hazard • Incubation period – few months to 6 years • Particles – phagocytosis – accumulation – block lymph channels • Dense nodular fibrosis – 3-4mm • c/f – insidious onset – irritant cough, dyspnoea, chest pain Copyright © Wondershare Software
20.
• Decreased TLC
– advanced disease • X ray – snow-storm appearance • Prone to PTB – silico-tuberculosis • No effective treatment • Fibrotic – cant reversed • Rigorous dust control • Regular physical examination by doctors Copyright © Wondershare Software
21.
ANTHRACOSIS(NOTIFIABLE-INDIAN MINES ACT
1952, COMPENSATABLE-WORKMEN’S COMPENSATION ACT 1959 • First phase – simple pneumoconiosis – ventilatory impairment – after 12year exposure – anthracite coal dust • Second phase – – progressive massive fibrosis – severe respiratory disability – premature death • Once simple pneumoconiosis – progress even without further exposure Copyright © Wondershare Software
22.
BYSSINOSIS • Inhalation of
cotton fiber • Chronic cough – progressive dyspnoea – chronic bronchitis – emphysema • India has large textile industry – 35% of factory workers Copyright © Wondershare Software
23.
BAGASSOSIS • Inhalation of
bagasse or sugar-cane dust • Thermophilic actinomycete – thermoactinomyces sacchari • Breathlessness, cough, haemoptysis, slight fever • Acute diffuse bronchiolitis – initial • Skiagram – mottling in lungs or shadow • Resolution of inflammation– if treated early Copyright © Wondershare Software
24.
• Untreated –
diffuse fibrosis, emphysema, bronchiectasis • Preventive measures: – Dust control • Wet process • Enclosed apparatus • Exhaust ventilation Copyright © Wondershare Software
25.
– Personal protection
• Masks • Mechanical filters – Medical control • Initial and periodical medical examinations – Bagasse control • Keeping moisture >20% • Spraying bagasse with 2% propionic acid- fungicide Copyright © Wondershare Software
26.
ASBESTOSIS • Fibrous material
– commercial name • Silicates of varying composition of bases (Mg,Fe,Ca,Na,Al) • Two types – – Serpentine or chrysolite (90% production) – Amphibole • Crocidolite (blue) • Amosite (brown) • Anthrophyllite(white) Copyright © Wondershare Software
27.
• Inhalation –
ROE • Insoluble fibers – pulmonary fibrosis – insufficiency – death • Carcinoma of bronchus (high-if add with smoking) • Mesothelioma of pleura or peritoneum(crocidolite) • Disease doesn’t appear – until 5-10 yrs of exposure Copyright © Wondershare Software
28.
• Irritation –
fibrosis – peribronchial – diffuse –basal in location • Dyspnoea – out of proportion to clinical signs • Clubbing – cardiac distress – cyanosis • Sputum – Asbestos Bodies(fibers coated with fibrin) • X ray – ground glass appearance – lower third of lung fields Copyright © Wondershare Software
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• Preventive measures
– Use of safer type asbestos – Substitution of other insulants – Rigorous dust control – Periodic examination of workers – Continuing research Copyright © Wondershare Software
30.
FARMER’S LUNG • Inhalation
of mouldy hay grain dust • >30% moisture – favors bacteria, fungi growth – rise temperature 40-50 deg C – favors Thermophilic actinomycete • Micropolyspora faeni – main cause • Repeated attacks – pulmonary fibrosis – damage - corpulmonale Copyright © Wondershare Software
31.
CONCLUSION • Pneumoconiosis –
one of the occupational disease – due to dust inhalation • No specific treatment • Prevention is important • Periodical examination and preplacement examination of workers also important Copyright © Wondershare Software
32.
Thank u…… Copyright
© Wondershare Software
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