Occupational health hazards

OCCUPATIONAL HEALTH HAZARDS

CHEMICAL HAZARDPHYSICAL HAZARDBIOLOGICAL HAZARDERGONOMIC HAZARD

OBJECTIVES:

Discuss and explain common hazards in the workplace and their effects to workers’ health.
Recommend appropriate measures to prevent occupational and work-related illnesses.

OCCUPATIONAL HEALTH ( ILO/WHO )

Promote and maintain the highest degree of physical, mental & social well-being of workers of all occupations
Prevent workers from departures due to health caused by their working conditions
Protect workers in their working environment from hazards and risks usually causing adverse health effects
Place & maintain a worker in an occupational environment adapted to his/her physiological ability


HAZARD AND RISK

WORKPLACE HAZARDS

Workers’ Susceptibility

CHEMICAL HAZARDS
Routes of entry into the body
Skin Contact

Ingestion

Inhalation

Routes of excretion

Respiratory (exhalation)
Skin (sweat, hair, nails)
Renal (urine)
Gastro-intestinal (feces)

LD 50 - Dose lethal to 50% of test animals

Threshold:

point at which toxicity first appears
occurs at the point where the body's ability to detoxify or repair toxic injury has been exceeded.

Measures of concentration of toxic substances

Threshold Limit Value (TLV)- average concentration of an airborne substance to which most workers could be safely exposed over an eight-hour working day or forty-hour working week throughout a working lifetime
Maximal Allowable Concentration (MAC)- peak or maximum concentration of an airborne to which most workers could be safely exposed.


Classification of Toxic Effects
Local toxicity- occurs at the site of chemical contact
Systemic toxicity- occurs distant from point of contact, may involve many organ systems
Acute toxicity- occurs almost immediately (hours/days) after an exposure
Chronic toxicity- represents cumulative damage to specific organ systems; occurs many months or years to have recognizable clinical disease

Health Effects

Renal Diseases
Respiratory Diseases
Skin Diseases
Hematologic Diseases
Cardiovascular Diseases
Neurologic Diseases
Carcinogenic
Teratogenic

Effects

Chemical Agent
Industry/Process
Renal Diseases: acute/chronic renal failure
Mercury, cadmium, chloroform
Battery, chemical industries, pesticide
Respiratory Diseases:
Irritation, inflammation
Solvents, ammonia
Chemical industries
Pneumoconiosis
Inorganic dust
Mining, construction, sandblasting, coal
Cancer
Chromium
Plating, metal refining


Blood Diseases:
Anemia
Lead
Battery mfg., lead smelting
Aplastic anemia
Benzene
Solvent & soap mfg.
Skin Diseases:
Allergic/contact
dermatitis
Plastic epoxides
Plastic, varnish
Acne
Cutting oils, grease
Machine-tool operators
Skin Cancer
Arsenic, tar
Petroleum refinery

Liver Disease:

Acute liver toxicity
Carbon tetrachloride
Cleaning fluids, dry cleaners
Liver cancer
Vinyl chloride
Plastics & vinyl chloride mfg.
Cardiovascular Disease:
Hypertension
Lead, Cadmium
Battery mfg. & recycling
Atherosclerosis
Carbon disulfide
Degreasing, dry cleaning
Arrythmias
Fluorocarbon, trichloroethylene
Refrigeration, solvent workers


PHYSICAL HAZARDS
Noise
Vibration
Extreme Temperature
Illumination
Radiation

NOISE

Ear Anatomy

Types of Noise-Induced Hearing Loss

-Temporary Threshold Shift (auditory fatigue)
temporary loss of hearing acuity after exposure to loud noise
recovery within 16-48 hrs
-Permanent Threshold Shift
irreversible loss of hearing

Early Signs of Hearing Loss

Difficulty in understanding spoken words in a noisy environment
Need to be near or look at the person speaking to help understand words
Familiar sounds are muffled
Complaints that people do not speak clearly
Ringing noises in the ears (tinnitus)
Other Harmful Effects of Noise
Hypertension
Hyperacidity
Palpitations
Disturbs relaxation and sleep


VIBRATION
-Physical factor which affects man by transmission of mechanical energy from oscillating sources
-Types
Segmental vibration
Whole body vibration

Segmental Vibration:

Health Effects:
Hand Arm Vibration Syndrome (HAVS)
tingling, numbness, blanching of fingers
pain

Whole Body Vibration:

Health effects:
Fatigue
Irritability
Headache
Disorders of the spine

EXTREME TEMPERATURE

Sources of heat stress:
Natural Conditions
Hot work processes related to furnaces, kilns, boilers and smelting


Health Effects of Heat Stress
Disorders
Clinical features
Prickly Heat (Miliaria rubra)
Pruritic rash
Heat cramps
Cramps in the body, usually legs
Heat exhaustion
Dizziness, fainting attack, blurring of vision, cold, clammy and sweaty skin
Heat stroke
Cyanosis, muscle twitchings, disorientation, delirium, convulsions

EXTREME TEMPERATURE
Sources of Cold Environment:
Ice plants and freezers in the food industry

Frostbite: reddening of skin, localized burning pain and numbness. Fingers, toes, cheeks, nose, ears are most susceptible.

trench foot or immersion foot: numbness, pain, cramps, ulceration and gangrene.

ILLUMINATION
Area of Operation
Min Lighting Level (lux)
Cutting Cloth
Fine machining
2000
Transcribing handwriting
Drafting
1000
Welding
First Aid station
500
Lunch Room
Rest Room
300


Inadequate Illumination
Health Effects
Visual Fatigue
Double Vision
Headaches
Painful irritation
Lacrimation
Conjunctivitis

RADIATION

BIOLOGICAL HAZARDS

VIRUSES

FUNGI

BACTERIA

PARASITES

Selected Infectious Diseases and Occupations

Agent / Disease
Occupation
Colds, influenza, scarlet fever, diphtheria, smallpox
May be contracted anywhere
Tuberculosis
Silica workers, people exposed to heat and organic dusts, and medical personnel
Anthrax
Animal handlers and handlers of carcasses, skins, hides, or hair of infected animals, including wool carpet processors and handlers.
Ringworm (in horses, cattle, deer, pigs, cats, dogs, birds)
Pet shop salesmen, stockmen, breeders of cats and dogs, and other animal handlers
Tetanus
Farmers (spores in soil) or anyone in contact with manure.
Psittacosis (in parrots, parakeets, pigeons, ducks, turkeys, chickens, etc.)
Pet shop personnel, gardeners, housewives, veterinary surgeons, and researchers.
Hookworm
Miners, agricultural laborers, planters of sugar, tobacco, tea, rice and cotton, and brick and tunnel workers.
Agent / Disease
Occupation
Rabies (e.g. dogs, bats, rats, pigs, cats)
Veterinarians, letter carriers, laboratory research workers, agricultural workers.
Fungus
Farmers, outdoor workers, animal handlers


HIV and AIDS
A- Acquired
I- Immune
D- Deficiency
S- Syndrome
*serious and usually fatal condition in which the body’s immune system is severely weakened and cannot fight off infection.

Epidemiology of HIV and AIDS

Modes of HIV Transmission

Reported Mode of
Transmission
Feb
2009
n=47
Jan-Feb
2009
n= 112
Cumulative Data:
1984—2009
N=3,701
Sexual Contact
43
107
3,297
Heterosexual contact
13
36
2,034 (62%)
Homosexual contact
14
37
872 (26%)
Bisexual contact
16
34
391 (12%)
Blood / Blood Products
0
0
19
Injecting Drug Use
0
1
8
Needle Prick Injury
0
0
3
Mother-to-Child
1
2
49
No data available
3
3
325


Body Fluids with High Viral Load
Blood
Semen
Vaginal and cervical mucus
Breastmilk
Amniotic fluid
Cerebrospinal fluid

Modes of Transmission

Unprotected penetrative sex
semen, blood, vaginal secretions
Blood transfusion on infected blood and blood products
Sharing needles among
I.V. drug users
Vertical/perinatal
mother to infant
Breastfeeding

HIV is NOT transmitted…

through casual contact in any setting– schools, homes, hospitals
through insect, food, water, clothes, toilets, swimming pools, and drinking and eating utensils
Prevention of HIV Infection


REMEMBER ABCDE!
Abstinence
Be Faithful
Condom
Do not inject Drugs/no sharing of needles
Education

TETANUS

A neurological disorder characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a protein toxin elaborated by the organism Clostridium tetani.
It arises from the contamination of wounds with Clostridium spores.
Clinical Manifestations
Increased tone in the masseter muscle (lockjaw)
Sustained contraction of the facial muscles (risus sardonicus) and back muscles (opisthotonus)
Prevention
Active immunization with tetanus toxoid
Careful wound management

TUBERCULOSIS

caused by the bacteria, Mycobacterium tuberculosis
caused by droplet nuclei released when sneezing and coughing
Symptoms: weight loss, low grade afternoon fever, persistent cough and sometimes, blood-streaked expectoration or hemoptysis


Ten Leading Causes of Death by Sex Number, Rate/100,000 Population & Percentage, Philippines, 2004
Cause
Male
Female
Both Sexes

No.

Rate
Percent*
1. Heart Diseases
40,361
30,500
70,861
84.8
17.6
2. Vascular System Diseases
28,930
22,750
51,680
61.8
12.8
3. Malignant Neoplasm
21,395
19,129
40,524
48.5
10.1
4. Accidents**
28,041
6,442
34,483
41.3
8.6
5. Pneumonia
15,822
16,276
32,098
38.4
8.0
6. Tuberculosis, all forms
17,841
8,029
25,870
31.0
6.4
7. Ill-defined and unknown causes of mortality
10,941
10,362
21,278
25.5
5.3
8. Chronic lower respiratory diseases
13,084
5,891
18,975
22.7
4.7
9. Diabetes Mellitus
7,970
8,582
16,552
19.8
4.1
10. Certain conditions from perinatal period
7,809
5,371
13,180
15.8
3.6


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ERGONOMIC HAZARDS

ERGONOMICS
Human Biological Science
+
Engineering Science

MAXIMUM SATISFACTION AND INCREASE PRODUCTIVITY

“ fitting the job to the worker

____________________________________

ERGONOMICS
Goal
to reduce work-related musculoskeletal disorders (MSDs) developed by workers
MSDs are injuries and illnesses that affect muscles, nerves, tendons, ligaments, joints or spinal discs.

Common Symptoms of MSDs

Painful joints
Pain, tingling, numbness in hands, wrists, forearms, shoulders, knees and feet
Shooting or stubbing pains
Swelling or inflammation
ERGONOMICS
Fingers or toes turning white
Back or neck pain
Stiffness


Risk Factor: ERGONOMICS
Static posture
Forceful exertion
Repetitive movement
Extreme range of motion
Awkward posture

STRESS

The harmful physical and emotional responses that occurs when the requirements of the job do not match the capabilities, resources or needs of the worker.
STRESS: Effects

Manifestations of Stress

PSYCHOLOGICAL
Fatigue
Anxiety
Tension
Irritability
Depression
Boredom
Inability to concentrate
Low esteem
PHYSIOLOGICAL
Heart rate
Blood pressure
Indigestion
BEHAVIORAL
Drug use
Alcohol intake
Heavy smoking
Impulsive emotional
Behavior
Poor work & family relationship
Social isolation
Family abandonment
Sleep problems


MONITORING
Systematic, continuous, repetitive health-related activities that should lead to corrective action
Types of monitoring
1. Ambient / Environmental
2. Biological
3. Medical Surveillance

Biological Monitoring

Measurement of a substance, its metabolites or its effects in body tissues, fluids or exhaled air of exposed person
Assess exposure and health risk of workers
Complements exposure assessment by air sampling

Chemical /

Determinant
Sampling Time
BEI
LEAD
Lead in Blood
Not critical
30ug/100ml
MERCURY
Total inorganic in urine
Total inorganic in blood
Prior to shift
End of shift at end of workweek
35ug/g
15ug/L
CARBON MONOXIDE
Carboxyhemoglobin in blood
End of shift
3.5% of Hgb


Medical Surveillance
Identify cases
Analyze Trends and Patterns in the Workforce to Guide Prevention Efforts
Meet Regulatory Requirements
Know the hazard - How worker is exposed
- How worker is affected

Characterize the hazard - Exposure levels

- Exposure duration

Know the worker - Susceptibilities

Obtain information on - Directed towards specific
medical examinations organ system

Analyze Medical Data - Disease, recovery, rehab

- Effectiveness or failure of control measures

PREVENTION AND CONTROL OF OCCUPATIONAL HAZARDS

Standards, Policies and Guidelines
Occupational Safety and Health Standards
Rule 1050
Notification and Keeping of Records of Accidents and/or Occupational illnesses
Rule 1070
Occupational Health and Environmental Control
Rule 1960
Occupational Health Services
1. Every employer shall establish in his place of employment occupational health services in accordance with the regulation and guidelines provided for under this rule.
2. The employer, workers, and their representatives, where they exist, shall cooperate and participate in the implementation of the organizational and other measures relating to occupational health services.
1963.01: Medicines and Facilities
1963.02: Emergency Medical and Dental Services
Rule 1960:Occupational Health Services
Hazardous Workplaces
Number of workers
OH Physician
OH Dentist
OH Nurse
First Aider
1 – 50


1 Full time
51 - 99

1 Part time

4 hours/day 6x/week
1 Full time
100 – 199
1 Part time
4hrs/day 3x/week *
1 Part time
4hrs/day 3x/week *
1 Full time
1 Full time
200 - 600
1 Part time
4hrs/day 6x/week **
1 Part time
4hrs/day 6x/week **
1 Full time
1 Full time
601 - 2000
1 Full time or
2 Part Time
4hrs/day 6x/week
1 Full time
1 Full time every shift
1 Full time every shift
2000 and more
1 Full time
1 Part time
4hrs/day 6x/week
1 Full time
1 Full time every shift
1 Full time every shift


Non - Hazardous Workplaces
Number of workers
OH Physician
OH Dentist
OH Nurse
First Aider
1 - 99

1 Full time

100 – 199

1 Part time

4hrs/day 6x/week
1 Full time
200 - 600
1 Part time
4hrs/day 3x/week *
1 Part time
4hrs/day 3x/week *
1 Full time
1 Full time
601 - 2000
1 Part time
4hrs/day 6x/week **
1 Part time
4hrs/day 6x/week **
1 Full time every shift
1 Full time every shift
2000 and more
1 Full time
1 Part time
4hrs/day 6x/week
1 Full time
1 Full time every shift
1 Full time every shift


Rule 1960:Occupational Health Services
An employer may not establish an emergency hospital or dental clinic in his workplace as required in these regulations where there is a hospital or dental clinic which is located not more than five (5) kilometers away from the workplace, if situated in any urban area, or which can be reached in twenty-five (25) minutes of travel, if situated in rural area, and the employer has facilities readily available for transporting workers to the hospital or dental clinic in case of emergency.
Rule 1960:Occupational Health Services
Health Examinations:
Entrance
Periodic
Special examination
Transfer examination
Separation examination

OCCUPATIONAL HEALTH PROGRAMS

Key Elements of the Occupational Health Program
Health Protection
Health Promotion
Health Rehabilitation
Hazards/ Disease
Source
Health Effect
Health Program
Chemical
Solvents
Paints, Thinners
Irritant, Multisystem effects
Surveillance for chemical exposure
Exposure monitoring (Biologic Monitoring)
Physical
Noise
Woodwork
Operations
Hearing Impairment
Hearing Conservation Program


Hazards/ Disease
Source
Health Effect
Health Program
Biologic
Tetanus
Dirty Nails, soil
Lockjaw, rigidity, death
Immunization
Ergonomic Stresses
Cumulative Trauma Disorder
Awkward postures, Heavy loads
Musculoskeletal Disorders
Management or personnel methods;
Workplace modification
Worker education and training;Back Care Program

Health Promotion

Physical activity, Nutrition, Weight reduction
Immunization
OSHS, RULE 1960
Smoking cessation
RA 9211 Tobacco Regulation Act of 2003
HIV/AIDS
RA 8504 Philippine AIDS Prevention and Control Act of 1998
National Workplace Policy on STD/HIV/AIDS initiated by DOLE - 1997


Drug Abuse Prevention and Control
RA 9165 Comprehensive Drugs Act of 2002
Department Order No. 53-03: Guidelines for the Implementation of a Drug-Free Workplace Policy and Program for the Private Sector

Tuberculosis Prevention and Control

Executive Order No. 187, Instituting a Comprehensive and Unified Policy for Tuberculosis Control in the Philippines (CUP) (March 2003)
Department Order No. 73-05: Guidelines for the Implementation of Policy and Program on Tuberculosis (TB) Prevention and Control in the Workplace

DEPARTMENT ORDER NO. 56-03

SECTION 2. New Priorities of the Family Welfare Program
a) Reproductive Health and Responsible Parenthood
b) Education/Gender Equality
c) Spirituality or Value Formation
d) Income Generation/Livelihood/Cooperative
e) Medical Health Care
f) Nutrition
g) Environmental Protection, Hygiene and Sanitation
h) Sports and Leisure
i) Housing
j) Transportation


Approach in Ensuring Well-Being of Workers
Looking at developmental strategies
Information
Education
Training
Campaigns
Good practices
Successful cases
Competitions
Demonstrations
Interventions
Looking at regulatory requirements
Relevant laws, standards, issuances and guidelines
Enforcement
Implementation
Inspection
Evaluation

Participatory Approach

Participation and involvement from stakeholders
Coordinated intervention
Learning from
specifications/guidelines,
scientific data
best practice


Benefits to the workers
Enhanced worker motivation and job satisfaction
Added problem-solving capacity
Greater acceptance of change
Greater knowledge of work and organization
Reduces the extent and severity of work related injuries and illnesses
Improves employee morale and productivity
Reduces workers’ compensation costs