Occupational Health & Safety

Learning Objectives

• Lead Poisoning • Sources • Symptoms • Prevention & Control • Occupational Health Services • MCQs & SAQs

9 P’s of Sources of Lead

• • • • • • • • • Paint Petrol Pencils Pottery Plates (Lead plates used in batteries) Pipes (lead pipes) Polish (leather polishing) Printing industry Pesticides

A

Anaemia

ABC of Lead Poisoning B

Bartonian lines

C

Colic abdominal, constipation, convulsions, coma

D

Drop (foot/wrist drop), delirium

E

Encephalopathy

•

F

Fatigue •

G

GIT symptoms (anorexia and dysphagia) •

H

Headache, hyper uricaemia, Haemolysis •

I

Insomnia / irritability •

J

Judgment decreased •

K

Kidney function impaired

•

L

Loss of appetite •

M

Mental confusion and memory loss •

N

Nausea, vomiting diarrhoea •

P

Palsy (Paralysis) / pains in extremities •

R

Red cell stippling / Renal failure (acute) •

T

Teleky’s sign / tremors / teratogenic effects

Advantages of Occupational health care

•Investigates and assesses load factors and hazards and gives expert assistance for eliminating them •Gives information and advice •Estimates employees’ working ability and monitors their health condition •By its knowledge and skills supports action for maintaining working ability in the development of individuals, working environment and working community, in this way also affecting productivity continued

Advantages of Occupational health care

•Prevents occupational diseases and other work related illnesses •Prevents premature incapacity for work, reduces pension costs •Reduces absenteeism due to sickness •Can make calculations of the profitability of occupational safety and health and occupational health care in cooperation with workplaces or encourage workplaces to make these themselves.

• • • • •

Components occupational health services –

CONT..

Assessment of dusts pollution Assessment of noise pollution Assessment of vibration Assessment heat radiation Assessment of radiation

Occupational epidemiology

• The science of the occurrence of diseases in human population as applied to the field of occupational health for the following purpose: – Identification of diseases of occupational origin when the same diseases also occur in the community at large.

– Identification of causes of occupational, disease – Checking the effectiveness of control measures through prospective studies.

• • • • • • • • • • •

Legislation regarding occupational health and safety in pakistan

Mines Act 1923 Factories Act 1934 Ordinance 2001 Docks Labours Act 1934 Petroleum Rules 1937 Pakistan Hazardous Operations Rules 1963 Workman's Compensation act 1923 and Rules 1961 Provincial Employees social Security Regulations 1967 The Oil and Gas (safety in drilling and production) Regulations 1974 Hazardous Substances Rule 2003 OHSAS 18001 Standards

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HIERARCHY OF CONTROLS

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OCCUPATIONAL HEALTH SURVIELLANCE PROGRAMME

• • • • • •

Remedial Action Plan

Remedial action Plan should state the Additional control and recovery measures.

Remedial action plan should be SMART.

S------Specific M-----Measurable A-----Achievable R-----Realistic T-----Time bound This plan should include priorities, responsible person and target dates for actions.

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PRE -EMPLOYEMENT HEALTH SCREENING

• • •

To determine the pre-existing health conditions of individuals prior to commencement of work To make sure that he / she is physically and mentally fit for the type of activity he / she is employed for.

At the time of employment , HR/ IR arrange pre-employment medical examination in liaison with Medical Dept.

•

General physical Examination

• • • • • •

Chest x-ray ECG Urine R/E Stool R/E Hepatitis B Ag Anti HCV Antibodies

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Specialized tests will be conducted for staff deputed on specialized jobs or they have special requirements as part of their job like crane or fork lift operators , drives, Electrical Technicians • • Color blindness Audiometric tests • Pre employment Medical Record will be maintained in personal file of individual by Medical Dept. at HO 15

PREIODIC HEALTH SURVEILLIENCE

• Periodic Health Surveillance to be conducted for staff: • At risk from workplace exposure • In compliance with regulatory requirement • To detect early, reversible health affects • Periodic Surveillance Record will be maintained at Field / Location level.

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Functions of Occupational Health Service

1. Placing people in suitable work 2. Maintaining people in suitable work 3. Providing treatment 4. Controlling recognized hazards 5. Identifying unrecognized hazards 6. Avoiding potential risks

7. Screening for early evidence of non occupational disease 8. Health education and safety training 9. Surveillance of sanitary, catering & welfare amenities 10.Environment control outside the work place

Main Responsibilities of a doctor Working in an Industry

• • • • • Knowledge of the work environment Medical examinations for general as well as occupationally health surveillance Treatment services for illness and injury Health education Ability to access, prevalence studies.

Legislative Measures

The Factories Act

 The factories act covers the matters relating to

Health, Safety & Welfare of the workers

 Lighting , Ventilation & Temperature Standards  Hours of work day (not more than

week & 9 hours per day ) 48 hours per

 Employment of young persons

(< 14yrs)

 Treatment of Waste & Effluent to render them safe

  

Social Security Act (PESSI-1965

)

Applicable to factories employing 10 or more employees Deduction from the employees (7% of the total wages) Benefits to the employees   Medical Sickness   Disablement Maternity  Dependents Benefit

Occupational Hygiene Inspection

• What are you going to inspect???

- Refer to the checklist on factory inspection

Special Characteristics

Silicosis: X-ray chest shows Snow-storm appearance Anthracosis: Small, ill-defined opacities in the mid & upper zones Asbestosis: Ground-glass appearance in lower two thirds of lung fields Byssinosis: Monday morning fever (Tightness in the

chest ) Farmer’s Lung: Due to exposure to grain

Expected Questions

MCQ-1

A person aged 40, who had been working as a labourer in grain market for the last 25 years presented with history of repeated attacks of respiratory infections in the last 1 year. X-ray showed pulmonary fibrosis. The likely diagnosis was: a. Tuberculosis b. Sillicosis c. Sillicotuberculosis d. Farmer’s lung e. Baggassosis 26

MCQ-2

A Ship Breaking Industry worker reported to you with complaints of cough, dyspnoea on exertion and chest pain. His X-ray chest showed ‘Honeycomb’ appearance.

The diagnosis would be: a. Asbestosis b. Siderosis c. Silicosis d. Aspergillosis e. Byssinossis 27

MCQ-3

A worker who had been in the battery manufacturing unit for the last 20 years, reported to you with complaints of lost appetite and abdominal colic of 2 weeks duration. You would prefer to investigate him for: a. Cholecystitis b. Lead poisoning c. Appendicitis d. Ameobiasis e. Stomach cancer 28

MCQ-4

A woman working in an industry during night shifts is exposed to 750 lux of light. She is most probably at risk of: a. Keratomalacia b. Breast cancer c. Dermatitis d. Conjunctival xerosis e. Night blindness 29

MCQ-5

Which of the following disease is more common in rural areas in the agriculturists who are mainly dependent on farming in the fields?

a. Chronic bronchitis b. Lung Cancer c. Zoonotic diseases d. Drug dependence e. Acute Respiratory Tract Infections 30

MCQ-6

Air pollution can lead to which one of the following :

a. Bronchial asthma b. Impetigo c. Chronic bronchitis d. Cholecyctitis e. Lumbago 31

MCQ-7

The cancer seen in aniline industry or with aromatic amines is:

a. Skin cancer b. Lung cancer c. Cancer bladder d. Cancer rectum e. Cancer kidney 32

MCQ-8 X-ray chest shows ground glass appearance in lower two-thirds of lung in:

a. Anthracosis b. Silicosis c. Asbestosis d. Farmer’s lung e. Bagassosis 33

MCQ-9

For Pneumoconiosis following is true:-

a. Byssinosis is due to inhalation of cotton fiber dust b. Anthracosis is due to inhalation of iron dust c. Bagassosis is due to inhalation of coal dust d. Silicosis is due to inhalation of sand particles e. Siderosis is due to inhalation of sugarcane fibres 34

MCQ-10

•

Which of the following is responsible for over half of all deaths from unintentional injuries?

a. Drowning b. Motor vehicle crashes c. Poisoning d. Firearm injuries e. Air Crashes 35

MCQ-11

Majority of the mortality by road traffic accidents can be saved by:

a. Seat belts b. Safety helmets c. Leather clothing d. Goggles e. New Tyres 36

MCQ-12

A farmer of rural Punjab reports to a medical officer in the month of August with the complaints of fever, severe head-ache, anorexia, weakness, prostration, arthralgia, weakness and rash. The doctor noticed petechiae and blood examination shows leucopenia. The probable diagnosis is: a. Malaria b. Classic dengue fever c. Typhoid d. Chicken pox e. Meningococcal meningitis 37

MCQ-13

Bagassosis is due to inhalation of :-

a. Sugar cane fibers b. Sand particles c. Cotton fibers dust d. Tobacco particles e. Sand particles 38

MCQ-14

•

The headquarter of ILO is in:

a. Geneva b. Rome c. Paris d. New York e. London 39

MCQ-15

Anthrax is a disease caused by:

a. Inhalation of coal dust b. Inhalation of silica c. Inhalation of spores d. Inhalation of a virus e. Inhalation of iron dust 40

SAQ-1

• • • A forty year old pottery industry worker presented with complaints of fever and weight loss; he also complained about cough and blood stained sputum.

X-ray confirmed fibrosis of lungs and hilar lymphadenopathy: Which factor in this particular trade has lead to the development of this condition?

Which measures do you recommend for prevention of this condition?

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• What is Occupational Health? What steps you will take for prevention of occupational diseases? • What are sources of lead poisoning? Write signs and symptoms caused by it. Give preventive measures. • Define pneumoconiosis. What are common dusts causing pneumoconiosis? Give detailed account of silicosis.

• Enlist occupational risks to health care providers. • • Write functions of occupational health services.

What are various health hazards to a farmer working in the fields?

Thank you !!