OCCUPATIONAL HEALTH
NURSING
VIVEK SIR
• Harry McShane, age 16,
1908. Pulled into
machinery in a factory
in USA. His arm was
ripped off at the
shoulder and his leg
broken.
• No compensation paid.
VIVEK SIR
Definition
VIVEK SIR
3
health;
• "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;
• the prevention among workers of departures from
health caused by their working conditions;
• the protection of workers in their employment
from risks resulting from factors adverse to
Definition
• the placing and maintenance of the worker in an
occupational environment adapted to his
physiological and psychological equipment, and,
• to summarize, the adaptation of work to man and of
each man to his job.
The Joint ILO/WHO Committee on
Occupational Health,1950
Vivek sir 4
VIVEK SIR
Objectives
• The maintenance and promotion of workers’ health and working
capacity
•
•
The improvement of working environment and work to become
conducive to safety and health
Development of work organizations and working cultures in a
direction which supports health and safety at work and in doing so
also promotes a positive social climate and smooth operation and
may enhance productivity of the undertakings.
—Joint ILO/WHO Committee on Occupational Health
Vivek sir 5
VIVEK SIR
OCCUPATIONAL HAZARDS
11/20/15
Vivek sir 6
VIVEK SIR
Physical hazards
VIVEK SIR 7
• Heat and cold
• Light
• Noise
• Vibration
• Ultraviolet radiation
• Ionizing radiation
• Burns
• Heat exhaustion
• Heat stroke
• Heat cramps
HEAT
• Decreased
efficiency,
• Increased fatigue
• Enhanced accident
rates.
8
VIVEK SIR
Cold
• Chilblains
• Erythrocyanosis
• Immersion foot
• Frostbite as a result of
cutaneous
vasoconstriction.
•11
G
/20/
e
15
neral hypothermia
9
VIVEK SIR
Light
The acute effects of poor illumination are
• Eye strain,
• Headache,
• Eye pain,
• Lacrymation,
• Congestion around the cornea
• Eye fatigue.
• The chronic effects on health include "miner's
nystagmus"
10
VIVEK SIR
Noise
(i) Auditory effects
Temporary or permanent hearing
loss
(ii) Non auditory effects
Nervousness,
Fatigue,
Interference with communication
by speech,
Decreased efficiency
1
a1
nnoyance 11
VIVEK SIR
Vibration
• Exposure to vibration may also produce
injuries of the joints of the hands elbows and
shoulders.
12
VIVEK SIR
Ultraviolet radiation
VIVEK SIR
• Conjunctivitis
• Keratitis (welder's flash).
Ionizing radiation
VIVEK SIR
The radiation hazards comprise
• Genetic changes
• Malformation
• Cancer
• Leukaemia
• Depilation
• Ulceration
• Sterility
• in extreme cases death.
Ionizing radiation
• The International Commission of
Radiological Protection has set the
maximum permissible level of occupational
exposure at 5 rem per year to the whole
body.
VIVEK SIR
Chemical hazards
VIVEK SIR
Chemical hazards
VIVEK SIR
1)Local Action :
Dermatitis
Eczema
Ulcers
Cancer by primary irritant action
Chemical hazards
VIVEK SIR
(2) Inhalation :
• Dusts
• Gases
• Metals and their
compounds
Chemical hazards
VIVEK SIR
• Dusts
Dusts are finely divided solid particles with size ranging from
0.1 to 150 microns
Dust particles larger than 10 microns settle down from the
air rapidly,
IndefinitelyParticles smaller than 5 microns are directly
inhaled into the lungs and are retained there and is mainly
responsible for pneumoconiosis.
VIVEK SIR
Chemical hazards
VIVEK SIR
Classification of dusts
• Inorganic and organic dusts;
• Soluble and insoluble dusts.
Chemical hazards
VIVEK SIR
Gases
• Simple gases (e.g., oxygen, hydrogen),
• Asphyxiating gases (e.g. carbon monoxide,
cyanide gas, sulphur dioxide, chlorine)
• Anaesthetic gases (e.g., chloroform, ether,
trichlorethylene).
Chemical hazards
• Lead, antimony, arsenic, beryllium,
cadmium, cobalt, manganese, mercury,
phosphorus, chromium, zinc and others
VIVEK SIR
• Metals and their compounds
Chemical hazards
(3) Ingestion:
Occupational diseases may also result from
ingestion of chemical substances such as lead,
mercury, arsenic, zinc, chromium, cadmium,
phosphorus etc.
VIVEK SIR
Biological hazards
• Brucellosis
• Leptospirosis
• Anthrax
• Hydatidosis
• Tetanus
• Encephalitis
• fungal infections
• Schistosomiasis
25
VIVEK SIR
VIVEK SIR
26
Mechanical hazards
VIVEK SIR
27
Psychosocial hazrds
VIVEK SIR
Factors affect health
• Frustration
• Lack of job
satisfaction,
• Insecurity
• Poor human
relationships,
• Emotional tension
28
Psychosocial hazrds
VIVEK SIR
The health effects can be classified in two
(a) Psychological and behavioural changes
(b) Psychosomatic ill health
29
OCCUPATIONAL DISEASES
• DISEASE DUE TO
PHYSICALAGENT
• Heat
• Cold
• Light
• Pressure
• Noise
• Radiation
• Mechanical factors
• Electricity
VIVEK SIR 30
VIVEK SIR
OCCUPATIONAL DISEASES
VIVEK SIR 31
DISEASE DUE TO CHEMICALAGENT
Gases
•
• Dusts (pneumoconiosis)
Inorganic dust: coal dust; silica; asbestos; iron
Organic(vegetable dust): cane fiber; cotton dust; tobacco; hay or
grain dust
•
•
• Metals and their compounds: lead ,mercury, cadmium, manganese,
beryllium, arsenic,chromium.
Chemicals: acids, alkalies, pesticides
Solvents: carbon bisulphide, chloroform , benzene
VIVEK SIR
OCCUPATIONAL DISEASES
VIVEK SIR 32
III. DISEASE DUE TO BIOLOGICALAGENT
• Brucellosis, leptospirosis, anthrax, tetanus, encephalities,
fungal infection.
IV. OCCUPATIONAL CANCER
• Cancer of the skin, lungs, bladder
V. OCCUPATIONAL DERMATOSIS
• Dermatitis, eczema
VI. DISEASE OF PSYCHOLOGICAL ORIGIN
• Industrial neurosis, hypertension, peptic ulcer.
VIVEK SIR
PNEUMOCONIOSIS
VIVEK SIR 33
• Dusts within the range of 0.5 micron to 3
micron is a health hazard producing, after a
variable period of exposure, a lung disease
known as pneumoconiosis, which may
gradually cripple a man by reducing his work
capacity due to lung fibrosis and other
complications.
VIVEK SIR
PNEUMOCONIOSIS
VIVEK SIR 34
• Silicosis
• Anthracosis
• Byssinosis
• Bagassosis
• Asbestosis
• Farmers lungs
VIVEK SIR
Silicosis
• Caused by inhalation of
dust containing free
silica or silicon dioxide
• Snow storm appearance
in X ray
35
VIVEK SIR
Anthracosis
VIVEK SIR
36
• It is caused by inhalation of dust containing
coal miners.
• First phase is called simple pneumoconiasis
which is associated with little impairment.
• Second phase is characterized by Progressive
massive fibrosis
Byssinosis
• Inhalation of cotton fibre dust over long periods of,
time.
The symptoms are
• Chronic cough
• Progressive dyspnoea,
• Chronic bronchitis
• Emphysema. 37
VIVEK SIR
Bagassosis
• Caused by inhalation of bagasse or sugar-cane
dust.
• Bagassosis has been shown to be due to a
thermophilic actinomycet for which the
name
The symptoms
• Breathlessness
• Cough
• haemoptysis
Slight fever. 38
VIVEK SIR
Bagassosis
Preventive measures
• Dust control
• Personal protection
• Medical control
• Bagasse control
VIVEK SIR 39
VIVEK SIR
Asbestosis
• Asbestos is of two types- serpentine or chrysolite
variety and amphibole type.
• Clinically the disease is characterized by dyspnoea.
• Clubbing of fingers,
• Cardiac distress and cyanosis.
• The sputum shows "asbestos bodies"
• An X-ray of the chest shows a ground-glass
Appearance in the lower two thirds of the lung fields40
VIVEK SIR
Asbestosis
PREVENTIVE MEASURES
• Use of safer types of asbestos (chrysolite and amosite)
• Substitution of other insulants: glass fibre, mineral wool,
calcium silicate, plastic foams, etc.
Rigorous dust control
•
• Periodic examination of workers; biological monitoring
(clinical, X-ray, lung function), and Continuing research
41
VIVEK SIR
Asbestosis
• Ground glass
apperance in X
ray chest
42
VIVEK SIR
Farmer's lung
VIVEK SIR
43
Farmer's lung is due to the inhalation of
mouldy hay or grain dust.
LEAD POISONING
VIVEK SIR
MODE OFABSORPTION
(1) INHALATION.
(2) INGESTION.
(3) SKIN
44
LEAD POISONING
VIVEK SIR
45
CLINICAL PICTURE
•
•
•
•
•
•
•
•
•
The toxic effects of inorganic exposure
abdominal colic
Constipation
loss of appetite
blue-line on the gums
stippling of red cells
Anaemia
wrist drop
foot drop.
LEAD POISONING
VIVEK SIR
46
• The toxic effects of organic lead compounds
are mostly on the central nervous system
• Insomnia
• Headache
• Mental confusion
• Delirium.
VIVEK SIR
47
LEAD POISONING
VIVEK SIR
48
DIAGNOSIS
(1) HISTORY
(2) CLINICAL FEATURES
(3) LABORATORY TESTS:
• Coproporphyrin in urine (CPU) :
• Amino levulinic acid in urine (ALAU) :
Lead in blood and urine:
•
• Basophilic stipling of RBC
LEAD POISONING
VIVEK SIR
PREVENTIVE MEASURES
•
•
•
•
•
•
•
•
•
Substitution
Isolation
Local exhaust ventilation
Personal protection.
Good house-keeping
Working atmosphere:
Periodic examination of workers
Personal hygiene.
Health education :
49
OCCUPATIONAL CANCER
• Skin cancer: gas workers, oil refiners, tar
distillers, oven workers.
• Lung cancer: gas industry, nickle and
chromium work, mining of radio active
substance
Vivek sir 50
VIVEK SIR
OCCUPATIONAL CANCER
• Bladder cancer: dye stuff,
dyeing industries, rubber, gas
and electrical cable industry.
• Leukemia: benzol, roengent
rays and radioactive
substance.
Vivek sir 51
VIVEK SIR
OCCUPATIONAL CANCER
The control measures
•
•
•
•
•
•
• Elimination or control of industrial carcinogens.
Medical examinations
Inspection of factories,
Notification,
Licensing of establishments,
Personal hygiene measures,
Education of workers and management, research.
52
VIVEK SIR
OCCUPATIONAL DERMATITIS
Causes
• Physical
• Chemical
• Biological
• Plant products
Vivek sir 53
VIVEK SIR
OCCUPATIONAL DERMATITIS
PREVENTION
(1) Pre-selection
(2) Protection
(3) Personal hygiene
(4) Periodic inspection
Vivek sir 54
VIVEK SIR
RADIATION HAZARDS
• Shielding of workers
• Monitoring the employees
• Protective clothing
• Adequate ventilation
• Replacement and periodic examination
• Avoidance of pregnant women to work
Vivek sir
VIVEK SIR
Sickness Absenteeism
56
Causes
• Economic
• Social
• Medical
• Non occupational causes
VIVEK SIR
Sickness Absenteeism
57
Prevention
• Good factory managementand practices
• Adequate preplacement examination
• Good human relations
• Application of ergonomics
VIVEK SIR
Accidents
Causes
• Human factors
• Physical
• Physiological
• Psychological
• Environmental factors
58
VIVEK SIR
Accidents
Prevention
• Adequate preplacement examination
Adequate job training
Continuing education
•
•
• Ensure safe working conditions
•
Establishing safety department in the organization under a
competent safety engineer.
• Periodic surveys for finding out hazards
• Care full reporting
59
VIVEK SIR
HEALTH PROBLEM DUE TO
INDUSTRIALIZATION
• Environmental sanitation problems
• Communicable disease
• Food sanitation
• Mental health
• Accidents and social problems
• Morbidity and mortality
Vivek sir 60
VIVEK SIR
MEASURES FOR HEALTH
PROMOTION OF WORKERS
• Nutrition
• Communicable disease control
• Environmental sanitation
• Mental health
• Measures for women and children
• Health education
• Family planning
Vivek sir 61
VIVEK SIR
Nutrition
VIVEK SIR
• Under Indian factory act,
One canteen when number of
employees exceeds 250
• Education of workers on the
value of balanced diet.
62
Communicable disease control
VIVEK SIR
• Adequate
immunization against
communicable
diseases
63
Environmental sanitation
VIVEK SIR
• Water supply
Installation of drinking water fountains
• Food
Sanitary preparation, storage and handling
of food
Education of food handlers
64
Environmental sanitation
VIVEK SIR 65
• Toilet
One sanitary convenience for 25 employees for the
first 100 employees and thereafter one for 50
• General plant cleanliness
Environmental sanitation
VIVEK SIR
66
•Sufficient space
The recommended standard is of minimum of 500cuft
• Lighting
Standards for illumination
High precision work 50-75 foot candles Regular
work- 6 to 12 foot candles Corridoors and
passages- 0.5 foot candles
Environmental sanitation
VIVEK SIR 67
• Ventilation, temperature
• Protection against hazards
• Housing
Mental health
• To promote the health and happiness of the
workers.
• To detect signs of emotional stress and strain and
to secure relief of stress and strain where possible
• The treatment of employees suffering from
mental illness and the rehabilitation of those who
become ill.
68
VIVEK SIR
MEASURES FOR WOMEN AND CHILDREN
(1)Expectant mothers are given maternity leave for 12
weeks,
(2) Provision of free antenatal, natal and postnatal services.
(3)The Factories Act (Section 66) prohibits night work
between 7 p.m. and 6 a.m.;
(4)The Indian Mines Act (1923) prohibits work
underground.
(5) The Factories Act, 1976 provides for creches in factories
Were more than 30 women workers are employed, 69
VIVEK SIR
Health education
VIVEK SIR
Family planning
VIVEK SIR
PREVENTION OF
OCCUPATIONAL DISEASE
VIVEK SIR
PREVENTION OF OCCUPATIONAL DISEASE
MEDICAL MEASURES
Pre-placement examination
Periodical examination
Medical and health care services
Notification
Supervision of working environment
Maintenance and analysis of records
Health education and counseling
Vivek sir
73
VIVEK SIR
PREVENTION OF
OCCUPATIONAL DISEASE
• ENGINEERING MEASURES
Design of building
Good housekeeping
General ventilation
Mechanization
Substitution
Vivek sir 74
VIVEK SIR
PREVENTION OF
OCCUPATIONAL DISEASE
ENGINEERING MEASURES
Dust-enclosure and isolation
Local exhaust ventilation
Protection device
Environmental monitoring
Statistical monitoring and research
Vivek sir 75
VIVEK SIR
PREVENTION OF OCCUPATIONAL
DISEASE
• LEGISLATION
The Factory Act-1948
The Employees state
insurance act-1948
Vivek sir 76
VIVEK SIR
FACTORIES ACT,1948
VIVEK SIR
Scope
For purposes of the act, a factory means an establishment,
•
•
In which 10 or more workers have been employed during
the preceding 12 months in a manufacturing process,
operated on power Or
In which 20 or more workers have been employed during
the preceding 12 months in manufacturing process
without power.
FACTORIES ACT,1948
VIVEK SIR
Appointment and employment
• Inspector of factories
• Medical practitioners
FACTORIES ACT,1948
VIVEK SIR
Provisions for Industrial workers
• Employment provisions
• Welfare provisions
• Safety provisions
• Sanitary provisions
THE EMPLOYEE STATE INSURANCE
ACT,1948
• The ESI Act of 1948 covered all power-using
factories other than seasonal factories where in
20 or more persons were employed (excluding
mines, railways and defense establishments).
VIVEK SIR
ESI Act
The provisions of the ESI (Amendment) Act of 1975 were
extended to the following new classes of establishments:
a) Small power-using factories employing 10 to 19 persons, and
non-power-using factories employing 20 or more persons
b) Shops:
c) Hotels and restaurants;
d) Cinemas and theatres;
e) Road-motor transport establishments; and
f1)1/2N0/e15wspaperestablishments 81
VIVEK SIR
ESI Act- Administration
• ESI Corporation
• Chairman – The Union Ministry of labour
• Vice Chairman- Secretary to Govt. of
India
Vivek sir 82
VIVEK SIR
ESI Act- Administration
Chief executive officer- Director general
Assisted by four principal officers
• Insurance commissiners
• Medical commissioners
• Finance commissioners
• Acturay
Vivek sir 83
VIVEK SIR
THE EMPLOYEE STATE INSURANCE ACT,1948
Benefits to employees
(1) Medical benefit
(2) Sickness benefit
(3)Maternity benefit
(4 Disablement benefit
(5) Dependent’s benefit
(6) Funeral expenses
Vivek sir (7) Rehabilitation allowance84
VIVEK SIR
THE EMPLOYEE STATE INSURANCE
ACT,1948
Medical benefit
•
• The services comprises
(1) out-patient care
(2) supply of drugs and dressings
(3) specialist services in all branches of medicine
(4) pathological and radiological investigations
(5) domiciliary services
11
(/6
20)
/15
antenatal, natal and postnatal services 85
VIVEK SIR
THE EMPLOYEE STATE INSURANCE ACT,1948
• Medical benefit
(7) immunization services
(8) family planning services
(9) emergency services
(10) ambulance services
(11) health education and
(12) in-patient treatment.
VIVEK SIR
THE EMPLOYEE STATE
INSURANCE ACT,1948
VIVEK SIR
Sickness benefit
• The benefit is payable for a maximum period of
91 days, in any continuous period of 365 days, the
daily rate being about 50% of the average daily
wages
• 34 diseases for which Extended Sickness Benefit
where the insured person has been in continuous
employment for 2 years:
THE EMPLOYEE STATE INSURANCE
ACT,1948
Maternity benefit
• For confinement, the duration of benefit is 72
weeks, for miscarriage 6 weeks and for
sickness arising out of confinement etc. 30
days.
VIVEK SIR
THE EMPLOYEE STATE INSURANCE
ACT,1948
VIVEK SIR
Disablement benefit
• The rate of temporary disablement benefit is about 70
per cent of the wages as long as the temporary
disablement lasts.
• In case of total permanent disablement, the insured
person is given life pension on the basis of loss of
earning capacity determined by a medical board
THE EMPLOYEE STATE
INSURANCE ACT,1948
VIVEK SIR
Dependent’s benefit
• Pension at the rate of 70 per cent of wages is payable,
on monthly basis.
Funeral expenses
•The amount not exceeding Rs. 5000.
Rehabilitation
• On monthly payment of Rs 10
VIVEK SIR
OCCUPATIONAL HEALTH TEAM
• Occupational health
nurse
• Physiotherapist.
• Specialist doctor
• Industrial manager
• Supervisor
VIVEK SIR
OCCUPATIONAL HEALTH TEAM
VIVEK SIR
• Shift in charge
• Rehabilitation specialist
• Labour welfare officer
• Labour union representative.
• Representative of voluntary organizations
• Other invited members as per the need
FUNCTIONS OF OCCUPATIONAL HEALTH
NURSE
VIVEK SIR
• Primary prevention
• Secondary prevention
• Tertiary prevention
ROLE OF OCCUPATIONAL HEALTH NURSE
VIVEK SIR
• Clinician
• Primary prevention
• Emergency care
• Treatment services
• Nursing diagnosis
• General Health advice and health assessment
• Research and the use of evidence based practice
ROLE OF OCCUPATIONAL
HEALTH NURSE
VIVEK SIR
Specialist
• Occupational health policy, and practice
development, implementation and evaluation
• Occupational health assessment
• Health surveillance
• Sickness absence management
ROLE OF OCCUPATIONAL HEALTH NURSE
Specialist
VIVEK SIR
• Rehabilitation
• Maintenance of work ability
• Health and safety
• Hazard identification
• Risk assessment
• Advice on control strategies
ROLE OF OCCUPATIONAL HEALTH NURSE
VIVEK SIR
• Manager
• Co-ordinator
• Adviser
• Health educator
• Counsellor
• Researcher
ROLE OF COMMUNTY HEALTH NURSE IN
OCCUPATIONAL HEALTH
• Home care
• Cooperation of plant department
• Special provision for services for women and
children
• Creche work
• Rehabilitation of the ill and injured workers
• Industrial plant survey
• Administrative responsibilities
11/20/15 99
VIVEK SIR

occupational diseases MSN II.pptx

  • 1.
  • 2.
    • Harry McShane,age 16, 1908. Pulled into machinery in a factory in USA. His arm was ripped off at the shoulder and his leg broken. • No compensation paid. VIVEK SIR
  • 3.
    Definition VIVEK SIR 3 health; • "Occupationalhealth should aim at the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations; • the prevention among workers of departures from health caused by their working conditions; • the protection of workers in their employment from risks resulting from factors adverse to
  • 4.
    Definition • the placingand maintenance of the worker in an occupational environment adapted to his physiological and psychological equipment, and, • to summarize, the adaptation of work to man and of each man to his job. The Joint ILO/WHO Committee on Occupational Health,1950 Vivek sir 4 VIVEK SIR
  • 5.
    Objectives • The maintenanceand promotion of workers’ health and working capacity • • The improvement of working environment and work to become conducive to safety and health Development of work organizations and working cultures in a direction which supports health and safety at work and in doing so also promotes a positive social climate and smooth operation and may enhance productivity of the undertakings. —Joint ILO/WHO Committee on Occupational Health Vivek sir 5 VIVEK SIR
  • 6.
  • 7.
    Physical hazards VIVEK SIR7 • Heat and cold • Light • Noise • Vibration • Ultraviolet radiation • Ionizing radiation
  • 8.
    • Burns • Heatexhaustion • Heat stroke • Heat cramps HEAT • Decreased efficiency, • Increased fatigue • Enhanced accident rates. 8 VIVEK SIR
  • 9.
    Cold • Chilblains • Erythrocyanosis •Immersion foot • Frostbite as a result of cutaneous vasoconstriction. •11 G /20/ e 15 neral hypothermia 9 VIVEK SIR
  • 10.
    Light The acute effectsof poor illumination are • Eye strain, • Headache, • Eye pain, • Lacrymation, • Congestion around the cornea • Eye fatigue. • The chronic effects on health include "miner's nystagmus" 10 VIVEK SIR
  • 11.
    Noise (i) Auditory effects Temporaryor permanent hearing loss (ii) Non auditory effects Nervousness, Fatigue, Interference with communication by speech, Decreased efficiency 1 a1 nnoyance 11 VIVEK SIR
  • 12.
    Vibration • Exposure tovibration may also produce injuries of the joints of the hands elbows and shoulders. 12 VIVEK SIR
  • 13.
    Ultraviolet radiation VIVEK SIR •Conjunctivitis • Keratitis (welder's flash).
  • 14.
    Ionizing radiation VIVEK SIR Theradiation hazards comprise • Genetic changes • Malformation • Cancer • Leukaemia • Depilation • Ulceration • Sterility • in extreme cases death.
  • 15.
    Ionizing radiation • TheInternational Commission of Radiological Protection has set the maximum permissible level of occupational exposure at 5 rem per year to the whole body. VIVEK SIR
  • 16.
  • 17.
    Chemical hazards VIVEK SIR 1)LocalAction : Dermatitis Eczema Ulcers Cancer by primary irritant action
  • 18.
    Chemical hazards VIVEK SIR (2)Inhalation : • Dusts • Gases • Metals and their compounds
  • 19.
    Chemical hazards VIVEK SIR •Dusts Dusts are finely divided solid particles with size ranging from 0.1 to 150 microns Dust particles larger than 10 microns settle down from the air rapidly, IndefinitelyParticles smaller than 5 microns are directly inhaled into the lungs and are retained there and is mainly responsible for pneumoconiosis.
  • 20.
  • 21.
    Chemical hazards VIVEK SIR Classificationof dusts • Inorganic and organic dusts; • Soluble and insoluble dusts.
  • 22.
    Chemical hazards VIVEK SIR Gases •Simple gases (e.g., oxygen, hydrogen), • Asphyxiating gases (e.g. carbon monoxide, cyanide gas, sulphur dioxide, chlorine) • Anaesthetic gases (e.g., chloroform, ether, trichlorethylene).
  • 23.
    Chemical hazards • Lead,antimony, arsenic, beryllium, cadmium, cobalt, manganese, mercury, phosphorus, chromium, zinc and others VIVEK SIR • Metals and their compounds
  • 24.
    Chemical hazards (3) Ingestion: Occupationaldiseases may also result from ingestion of chemical substances such as lead, mercury, arsenic, zinc, chromium, cadmium, phosphorus etc. VIVEK SIR
  • 25.
    Biological hazards • Brucellosis •Leptospirosis • Anthrax • Hydatidosis • Tetanus • Encephalitis • fungal infections • Schistosomiasis 25 VIVEK SIR
  • 26.
  • 27.
  • 28.
    Psychosocial hazrds VIVEK SIR Factorsaffect health • Frustration • Lack of job satisfaction, • Insecurity • Poor human relationships, • Emotional tension 28
  • 29.
    Psychosocial hazrds VIVEK SIR Thehealth effects can be classified in two (a) Psychological and behavioural changes (b) Psychosomatic ill health 29
  • 30.
    OCCUPATIONAL DISEASES • DISEASEDUE TO PHYSICALAGENT • Heat • Cold • Light • Pressure • Noise • Radiation • Mechanical factors • Electricity VIVEK SIR 30 VIVEK SIR
  • 31.
    OCCUPATIONAL DISEASES VIVEK SIR31 DISEASE DUE TO CHEMICALAGENT Gases • • Dusts (pneumoconiosis) Inorganic dust: coal dust; silica; asbestos; iron Organic(vegetable dust): cane fiber; cotton dust; tobacco; hay or grain dust • • • Metals and their compounds: lead ,mercury, cadmium, manganese, beryllium, arsenic,chromium. Chemicals: acids, alkalies, pesticides Solvents: carbon bisulphide, chloroform , benzene VIVEK SIR
  • 32.
    OCCUPATIONAL DISEASES VIVEK SIR32 III. DISEASE DUE TO BIOLOGICALAGENT • Brucellosis, leptospirosis, anthrax, tetanus, encephalities, fungal infection. IV. OCCUPATIONAL CANCER • Cancer of the skin, lungs, bladder V. OCCUPATIONAL DERMATOSIS • Dermatitis, eczema VI. DISEASE OF PSYCHOLOGICAL ORIGIN • Industrial neurosis, hypertension, peptic ulcer. VIVEK SIR
  • 33.
    PNEUMOCONIOSIS VIVEK SIR 33 •Dusts within the range of 0.5 micron to 3 micron is a health hazard producing, after a variable period of exposure, a lung disease known as pneumoconiosis, which may gradually cripple a man by reducing his work capacity due to lung fibrosis and other complications. VIVEK SIR
  • 34.
    PNEUMOCONIOSIS VIVEK SIR 34 •Silicosis • Anthracosis • Byssinosis • Bagassosis • Asbestosis • Farmers lungs VIVEK SIR
  • 35.
    Silicosis • Caused byinhalation of dust containing free silica or silicon dioxide • Snow storm appearance in X ray 35 VIVEK SIR
  • 36.
    Anthracosis VIVEK SIR 36 • Itis caused by inhalation of dust containing coal miners. • First phase is called simple pneumoconiasis which is associated with little impairment. • Second phase is characterized by Progressive massive fibrosis
  • 37.
    Byssinosis • Inhalation ofcotton fibre dust over long periods of, time. The symptoms are • Chronic cough • Progressive dyspnoea, • Chronic bronchitis • Emphysema. 37 VIVEK SIR
  • 38.
    Bagassosis • Caused byinhalation of bagasse or sugar-cane dust. • Bagassosis has been shown to be due to a thermophilic actinomycet for which the name The symptoms • Breathlessness • Cough • haemoptysis Slight fever. 38 VIVEK SIR
  • 39.
    Bagassosis Preventive measures • Dustcontrol • Personal protection • Medical control • Bagasse control VIVEK SIR 39 VIVEK SIR
  • 40.
    Asbestosis • Asbestos isof two types- serpentine or chrysolite variety and amphibole type. • Clinically the disease is characterized by dyspnoea. • Clubbing of fingers, • Cardiac distress and cyanosis. • The sputum shows "asbestos bodies" • An X-ray of the chest shows a ground-glass Appearance in the lower two thirds of the lung fields40 VIVEK SIR
  • 41.
    Asbestosis PREVENTIVE MEASURES • Useof safer types of asbestos (chrysolite and amosite) • Substitution of other insulants: glass fibre, mineral wool, calcium silicate, plastic foams, etc. Rigorous dust control • • Periodic examination of workers; biological monitoring (clinical, X-ray, lung function), and Continuing research 41 VIVEK SIR
  • 42.
    Asbestosis • Ground glass apperancein X ray chest 42 VIVEK SIR
  • 43.
    Farmer's lung VIVEK SIR 43 Farmer'slung is due to the inhalation of mouldy hay or grain dust.
  • 44.
    LEAD POISONING VIVEK SIR MODEOFABSORPTION (1) INHALATION. (2) INGESTION. (3) SKIN 44
  • 45.
    LEAD POISONING VIVEK SIR 45 CLINICALPICTURE • • • • • • • • • The toxic effects of inorganic exposure abdominal colic Constipation loss of appetite blue-line on the gums stippling of red cells Anaemia wrist drop foot drop.
  • 46.
    LEAD POISONING VIVEK SIR 46 •The toxic effects of organic lead compounds are mostly on the central nervous system • Insomnia • Headache • Mental confusion • Delirium.
  • 47.
  • 48.
    LEAD POISONING VIVEK SIR 48 DIAGNOSIS (1)HISTORY (2) CLINICAL FEATURES (3) LABORATORY TESTS: • Coproporphyrin in urine (CPU) : • Amino levulinic acid in urine (ALAU) : Lead in blood and urine: • • Basophilic stipling of RBC
  • 49.
    LEAD POISONING VIVEK SIR PREVENTIVEMEASURES • • • • • • • • • Substitution Isolation Local exhaust ventilation Personal protection. Good house-keeping Working atmosphere: Periodic examination of workers Personal hygiene. Health education : 49
  • 50.
    OCCUPATIONAL CANCER • Skincancer: gas workers, oil refiners, tar distillers, oven workers. • Lung cancer: gas industry, nickle and chromium work, mining of radio active substance Vivek sir 50 VIVEK SIR
  • 51.
    OCCUPATIONAL CANCER • Bladdercancer: dye stuff, dyeing industries, rubber, gas and electrical cable industry. • Leukemia: benzol, roengent rays and radioactive substance. Vivek sir 51 VIVEK SIR
  • 52.
    OCCUPATIONAL CANCER The controlmeasures • • • • • • • Elimination or control of industrial carcinogens. Medical examinations Inspection of factories, Notification, Licensing of establishments, Personal hygiene measures, Education of workers and management, research. 52 VIVEK SIR
  • 53.
    OCCUPATIONAL DERMATITIS Causes • Physical •Chemical • Biological • Plant products Vivek sir 53 VIVEK SIR
  • 54.
    OCCUPATIONAL DERMATITIS PREVENTION (1) Pre-selection (2)Protection (3) Personal hygiene (4) Periodic inspection Vivek sir 54 VIVEK SIR
  • 55.
    RADIATION HAZARDS • Shieldingof workers • Monitoring the employees • Protective clothing • Adequate ventilation • Replacement and periodic examination • Avoidance of pregnant women to work Vivek sir VIVEK SIR
  • 56.
    Sickness Absenteeism 56 Causes • Economic •Social • Medical • Non occupational causes VIVEK SIR
  • 57.
    Sickness Absenteeism 57 Prevention • Goodfactory managementand practices • Adequate preplacement examination • Good human relations • Application of ergonomics VIVEK SIR
  • 58.
    Accidents Causes • Human factors •Physical • Physiological • Psychological • Environmental factors 58 VIVEK SIR
  • 59.
    Accidents Prevention • Adequate preplacementexamination Adequate job training Continuing education • • • Ensure safe working conditions • Establishing safety department in the organization under a competent safety engineer. • Periodic surveys for finding out hazards • Care full reporting 59 VIVEK SIR
  • 60.
    HEALTH PROBLEM DUETO INDUSTRIALIZATION • Environmental sanitation problems • Communicable disease • Food sanitation • Mental health • Accidents and social problems • Morbidity and mortality Vivek sir 60 VIVEK SIR
  • 61.
    MEASURES FOR HEALTH PROMOTIONOF WORKERS • Nutrition • Communicable disease control • Environmental sanitation • Mental health • Measures for women and children • Health education • Family planning Vivek sir 61 VIVEK SIR
  • 62.
    Nutrition VIVEK SIR • UnderIndian factory act, One canteen when number of employees exceeds 250 • Education of workers on the value of balanced diet. 62
  • 63.
    Communicable disease control VIVEKSIR • Adequate immunization against communicable diseases 63
  • 64.
    Environmental sanitation VIVEK SIR •Water supply Installation of drinking water fountains • Food Sanitary preparation, storage and handling of food Education of food handlers 64
  • 65.
    Environmental sanitation VIVEK SIR65 • Toilet One sanitary convenience for 25 employees for the first 100 employees and thereafter one for 50 • General plant cleanliness
  • 66.
    Environmental sanitation VIVEK SIR 66 •Sufficientspace The recommended standard is of minimum of 500cuft • Lighting Standards for illumination High precision work 50-75 foot candles Regular work- 6 to 12 foot candles Corridoors and passages- 0.5 foot candles
  • 67.
    Environmental sanitation VIVEK SIR67 • Ventilation, temperature • Protection against hazards • Housing
  • 68.
    Mental health • Topromote the health and happiness of the workers. • To detect signs of emotional stress and strain and to secure relief of stress and strain where possible • The treatment of employees suffering from mental illness and the rehabilitation of those who become ill. 68 VIVEK SIR
  • 69.
    MEASURES FOR WOMENAND CHILDREN (1)Expectant mothers are given maternity leave for 12 weeks, (2) Provision of free antenatal, natal and postnatal services. (3)The Factories Act (Section 66) prohibits night work between 7 p.m. and 6 a.m.; (4)The Indian Mines Act (1923) prohibits work underground. (5) The Factories Act, 1976 provides for creches in factories Were more than 30 women workers are employed, 69 VIVEK SIR
  • 70.
  • 71.
  • 72.
  • 73.
    PREVENTION OF OCCUPATIONALDISEASE MEDICAL MEASURES Pre-placement examination Periodical examination Medical and health care services Notification Supervision of working environment Maintenance and analysis of records Health education and counseling Vivek sir 73 VIVEK SIR
  • 74.
    PREVENTION OF OCCUPATIONAL DISEASE •ENGINEERING MEASURES Design of building Good housekeeping General ventilation Mechanization Substitution Vivek sir 74 VIVEK SIR
  • 75.
    PREVENTION OF OCCUPATIONAL DISEASE ENGINEERINGMEASURES Dust-enclosure and isolation Local exhaust ventilation Protection device Environmental monitoring Statistical monitoring and research Vivek sir 75 VIVEK SIR
  • 76.
    PREVENTION OF OCCUPATIONAL DISEASE •LEGISLATION The Factory Act-1948 The Employees state insurance act-1948 Vivek sir 76 VIVEK SIR
  • 77.
    FACTORIES ACT,1948 VIVEK SIR Scope Forpurposes of the act, a factory means an establishment, • • In which 10 or more workers have been employed during the preceding 12 months in a manufacturing process, operated on power Or In which 20 or more workers have been employed during the preceding 12 months in manufacturing process without power.
  • 78.
    FACTORIES ACT,1948 VIVEK SIR Appointmentand employment • Inspector of factories • Medical practitioners
  • 79.
    FACTORIES ACT,1948 VIVEK SIR Provisionsfor Industrial workers • Employment provisions • Welfare provisions • Safety provisions • Sanitary provisions
  • 80.
    THE EMPLOYEE STATEINSURANCE ACT,1948 • The ESI Act of 1948 covered all power-using factories other than seasonal factories where in 20 or more persons were employed (excluding mines, railways and defense establishments). VIVEK SIR
  • 81.
    ESI Act The provisionsof the ESI (Amendment) Act of 1975 were extended to the following new classes of establishments: a) Small power-using factories employing 10 to 19 persons, and non-power-using factories employing 20 or more persons b) Shops: c) Hotels and restaurants; d) Cinemas and theatres; e) Road-motor transport establishments; and f1)1/2N0/e15wspaperestablishments 81 VIVEK SIR
  • 82.
    ESI Act- Administration •ESI Corporation • Chairman – The Union Ministry of labour • Vice Chairman- Secretary to Govt. of India Vivek sir 82 VIVEK SIR
  • 83.
    ESI Act- Administration Chiefexecutive officer- Director general Assisted by four principal officers • Insurance commissiners • Medical commissioners • Finance commissioners • Acturay Vivek sir 83 VIVEK SIR
  • 84.
    THE EMPLOYEE STATEINSURANCE ACT,1948 Benefits to employees (1) Medical benefit (2) Sickness benefit (3)Maternity benefit (4 Disablement benefit (5) Dependent’s benefit (6) Funeral expenses Vivek sir (7) Rehabilitation allowance84 VIVEK SIR
  • 85.
    THE EMPLOYEE STATEINSURANCE ACT,1948 Medical benefit • • The services comprises (1) out-patient care (2) supply of drugs and dressings (3) specialist services in all branches of medicine (4) pathological and radiological investigations (5) domiciliary services 11 (/6 20) /15 antenatal, natal and postnatal services 85 VIVEK SIR
  • 86.
    THE EMPLOYEE STATEINSURANCE ACT,1948 • Medical benefit (7) immunization services (8) family planning services (9) emergency services (10) ambulance services (11) health education and (12) in-patient treatment. VIVEK SIR
  • 87.
    THE EMPLOYEE STATE INSURANCEACT,1948 VIVEK SIR Sickness benefit • The benefit is payable for a maximum period of 91 days, in any continuous period of 365 days, the daily rate being about 50% of the average daily wages • 34 diseases for which Extended Sickness Benefit where the insured person has been in continuous employment for 2 years:
  • 88.
    THE EMPLOYEE STATEINSURANCE ACT,1948 Maternity benefit • For confinement, the duration of benefit is 72 weeks, for miscarriage 6 weeks and for sickness arising out of confinement etc. 30 days. VIVEK SIR
  • 89.
    THE EMPLOYEE STATEINSURANCE ACT,1948 VIVEK SIR Disablement benefit • The rate of temporary disablement benefit is about 70 per cent of the wages as long as the temporary disablement lasts. • In case of total permanent disablement, the insured person is given life pension on the basis of loss of earning capacity determined by a medical board
  • 90.
    THE EMPLOYEE STATE INSURANCEACT,1948 VIVEK SIR Dependent’s benefit • Pension at the rate of 70 per cent of wages is payable, on monthly basis. Funeral expenses •The amount not exceeding Rs. 5000. Rehabilitation • On monthly payment of Rs 10
  • 91.
  • 92.
    OCCUPATIONAL HEALTH TEAM •Occupational health nurse • Physiotherapist. • Specialist doctor • Industrial manager • Supervisor VIVEK SIR
  • 93.
    OCCUPATIONAL HEALTH TEAM VIVEKSIR • Shift in charge • Rehabilitation specialist • Labour welfare officer • Labour union representative. • Representative of voluntary organizations • Other invited members as per the need
  • 94.
    FUNCTIONS OF OCCUPATIONALHEALTH NURSE VIVEK SIR • Primary prevention • Secondary prevention • Tertiary prevention
  • 95.
    ROLE OF OCCUPATIONALHEALTH NURSE VIVEK SIR • Clinician • Primary prevention • Emergency care • Treatment services • Nursing diagnosis • General Health advice and health assessment • Research and the use of evidence based practice
  • 96.
    ROLE OF OCCUPATIONAL HEALTHNURSE VIVEK SIR Specialist • Occupational health policy, and practice development, implementation and evaluation • Occupational health assessment • Health surveillance • Sickness absence management
  • 97.
    ROLE OF OCCUPATIONALHEALTH NURSE Specialist VIVEK SIR • Rehabilitation • Maintenance of work ability • Health and safety • Hazard identification • Risk assessment • Advice on control strategies
  • 98.
    ROLE OF OCCUPATIONALHEALTH NURSE VIVEK SIR • Manager • Co-ordinator • Adviser • Health educator • Counsellor • Researcher
  • 99.
    ROLE OF COMMUNTYHEALTH NURSE IN OCCUPATIONAL HEALTH • Home care • Cooperation of plant department • Special provision for services for women and children • Creche work • Rehabilitation of the ill and injured workers • Industrial plant survey • Administrative responsibilities 11/20/15 99 VIVEK SIR