Community Health Program-l

Community Health Program-l
OCCUPATIONAL HEALTH And safety CHP310: Community Health Program-l Mohamed M. B. Alnoor

CONTENT Occupational Health Definitions Importance of OSH
Objectives/functions/components of OSH Occupational health hazards Physical hazards Chemical hazards Biological hazards Ergonomic hazards Stress Principles of Control of workplace hazards

a cross-disciplinary area concerned with protecting the
Occupational Health DEFINTION OCCUPATIONAL HEALTH: a cross-disciplinary area concerned with protecting the safety, health and welfare JILOCOH: The joint international labor organization committee on Occupational health. World Health Organization : is the promotion and maintenance of the highest degree of physical, mental and social well-being of workers in all occupations by preventing departures from health, controlling risks and the adaptation of work to people, and people to their jobs. National Institutes of Health : refers to the identification and control of the risks arising from physical, chemical, and other workplace hazards in order to establish and maintain a safe and healthy working environment. of people engaged in work or employment

DEFINTION OCCUPATIONAL HAZARD: potentially harmful OUTCOME the harm
Occupational Health DEFINTION OCCUPATIONAL HAZARD: potentially harmful OUTCOME the harm HAZARD: Source or situation with a potential for harm in terms of injury or ill health, with or without, damage to property or workplace environment. OUTCOME: The harm that results from an uncontrolled hazard. RISK: The probability that a particular outcome will occur and the severity of the harm involved. RISK: probability of harm

Occupational Hygiene, and Occupational Medicine I-Occupational Hygiene
Occupational Health Occupational Hygiene, and Occupational Medicine II-Occupational Medicine I-Occupational Hygiene gy Science and art concerned with health status of workers engaged in any occupation Study of adverse environmental factors and stresses arising at work place. gy gy Recognition Assessment Diagnosis gy Engineering control Treatment

Why do we study occupational health?
Importance of OHS Why do we study occupational health? Most people aged of spend 40-50% of waking hours at work. Worldwide workers face dangerous hazards on the job everyday. Workplace accidents constitute 17% of total illhealth . million work-related deaths/year.

OBJECTIVES OF OCCUPATIONAL HEALTH SERVICE
To maintain and promote the physical, mental and social well being of workers. To prevent occupational diseases / injuries. To adapt the work environment to the needs of the workers (application of ergonomics principle). Ergonomics: an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely —called also biotechnology or human engineering. It should be preventive rather than curative.

FUNCTIONS/COMPONENTS OF OCCUPATIONAL HEALTH SERVICE
1. Pre-employment & periodic medical Examination (esp. women and children ) 2. First Aid and emergency service. 3. Health education. 4. Monitoring of working environment for assessment and control of hazards. 5. Development of PPE. 6. Maintenance of medical records . 7. Rehabilitation (Medical, Social, Educational and Vocational).

Occupational health team
FUNCTIONS of Occupational health team Engineers &Chemists Physicians & nurses Social workers Medical examination Working hours Transportation Housing Personal or public problems Nutritional programs Substitution Isolation Enclosure Ventilation Pre- employment Periodic First aid Health education Nutritional programs

Occupational health hazards
WORKPLACE HAZARDS PHYSICAL HAZARD TYPES: ERGONOMIC HAZARD STRESS STRESS STRESS STRESS BIOLOGICAL HAZARD CHEMICAL HAZARD

VENN diagram Venn diagrams, were introduced in 1880 by John Venn (1834–1923). Venn himself did not use the term "Venn diagram" but kept speaking of "Eulerian Circles". The first to use the term "Venn diagram" was Clarence Irving Lewis in 1918, in his book "A Survey of Symbolic Logic"

Factors influencing work-related disease Genetic Physical factors properties Lifestyle Magnitude WORK-RELATED DISEASE Work place Exposure Workers’ Factors Age Timing Race Multiplicity Gender Medical Duration history

WORKPLACE HAZARDS PHYSICAL HAZARDS Noise Vibration Extreme Temperature Illumination Radiation Atmospheric pressure

WORKPLACE HAZARDS PHYSICAL HAZARDS NOISE

PHYSICAL HAZARDS NOISE Types of Noise-Induced Hearing Loss Temporary hearing loss (auditory fatigue) > 85 decibels recovery within hrs Permanent hearing loss (over time) Other Harmful Effects of Noise: Hypertension, hyperacidity and palpitations.

WORKPLACE HAZARDS PHYSICAL HAZARDS VIBRATION

PHYSICAL HAZARDS VIBRATION mechanical energy from oscillating sources Types Segmental vibration Whole body vibration

PHYSICAL HAZARDS VIBRATION Segmental Vibration: Health Effects: Hand Arm Vibration Syndrome (HAVS) HAVS: is a widespread recognized industrial disease affecting tens of thousands of workers. It is a disorder which affects the blood vessels, nerves, muscles, and joints, of the hand, wrist and arm, triggered by continuous use of vibrating hand-held machinery. Its best known effect is vibration-induced white finger (VWF). In extreme cases, the sufferer may lose fingers. The effect is cumulative. When symptoms first appear, they may disappear after a short time. If exposure to vibration continues over months or years, the symptoms can worsen and become permanent. Whole Body Vibration: Health effects: Fatigue, irritability, headache, and disorders of the spine

WORKPLACE HAZARDS PHYSICAL HAZARDS EXTREME TEMPERATURE

PHYSICAL HAZARDS EXTREME TEMPERATURE Sources of heat stress: Natural Conditions( climate) Hot work processes related to furnaces, kilns, boilers and smelting

Health Effects of Heat Stress Disorders Clinical features Prickly Heat Pruritic rash (excessive sweating) 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 twitching, disorientation, delirium, convulsions Prickly heat is a skin condition that appears as discrete, extremely pruritic, erythematous papulovesicles accompanied by a sensation of burning, or tingling. It can appear after taking a hot shower. Heat cramps are muscle spasms that result from loss of large amount of salt and water through exercise. It can be caused by inadequate consumption of fluids or electrolytes. Usually they occur later, especially at night or when relaxing. Although heat cramps can be quite painful, they usually don't result in permanent damage. Heat exhaustion: This condition often occurs when people exercise (work or play) in a hot, humid place and body fluids are lost through sweating, causing dehydration and overheating of the body. The person's temperature may be elevated, but not above 104 F (40 C). Heat stroke: is a life-threatening medical condition. The person's cooling system, stops working and the internal body temperature rises to the point at which brain damage or damage to other internal organs may result (temperature may reach 105 F or greater [40.5 C or greater]).

WORKPLACE HAZARDS PHYSICAL HAZARDS EXTREME TEMPERATURE Health Effects of Heat Stress Disorders Clinical features Prickly Heat Pruritic rash (excessive sweating) 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 twitching, disorientation, delirium, convulsions Prickly heat is a skin condition that appears as discrete, extremely pruritic, erythematous papulovesicles accompanied by a sensation of burning, or tingling. It can appear after taking a hot shower. Heat cramps are muscle spasms that result from loss of large amount of salt and water through exercise. It can be caused by inadequate consumption of fluids or electrolytes. Usually they occur later, especially at night or when relaxing. Although heat cramps can be quite painful, they usually don't result in permanent damage. Heat exhaustion: This condition often occurs when people exercise (work or play) in a hot, humid place and body fluids are lost through sweating, causing dehydration and overheating of the body. The person's temperature may be elevated, but not above 104 F (40 C). Heat stroke: is a life-threatening medical condition. The person's cooling system, stops working and the internal body temperature rises to the point at which brain damage or damage to other internal organs may result (temperature may reach 105 F or greater [40.5 C or greater]).

WORKPLACE HAZARDS PHYSICAL HAZARDS EXTREME TEMPERATURE Health Effects of Heat Stress Disorders Clinical features Prickly Heat Pruritic rash (excessive sweating) 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 twitching, disorientation, delirium, convulsions Heat exhaustion: This condition often occurs when people exercise (work or play) in a hot, humid place and body fluids are lost through sweating, causing dehydration and overheating of the body. The person's temperature may be elevated, but not above 104 F (40 C). Heat stroke: is a life-threatening medical condition. The person's cooling system, stops working and the internal body temperature rises to the point at which brain damage or damage to other internal organs may result (temperature may reach 105 F or greater [40.5 C or greater]).

PHYSICAL HAZARDS EXTREME TEMPERATURE Sources of Cold Environment: Ice plants and freezers in the food industry Health Effects of Cold Temperature Trench foot is caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. The use of the word "trench" in the name of this condition is a reference to trench warfare, mainly associated with World War I. Frostbite: localized damage caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas. Frostbite Trench foot (immersion foot)

WORKPLACE HAZARDS PHYSICAL HAZARDS INADEQUATE ILLUMINATION

Occupational health hazards Min Lighting Level (lux)
WORKPLACE HAZARDS PHYSICAL HAZARDS INADEQUATE ILLUMINATION Recommended Illumination Levels 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

PHYSICAL HAZARDS INADEQUATE ILLUMINATION Health Effects Visual Fatigue Double Vision Painful irritation Lacrimation Conjunctivitis Headaches

WORKPLACE HAZARDS PHYSICAL HAZARDS RADIATION

PHYSICAL HAZARDS RADIATION Types Sources Health Effects Ionizing X-rays Gamma rays Cancer, congenital defects, death

PHYSICAL HAZARDS RADIATION Types Sources Health Effects Non-ionizing Ultraviolet Infrared Laser skin redness, premature skin ageing, and skin cancer corneal and conjunctival burns, retinal injury, cataract Skin and eye problem

WORKPLACE HAZARDS CHEMICAL HAZARDS Routes of entry into the body Ingestion Inhalation Skin Contact

CHEMICAL HAZARDS Routes of entry into the body inhalation most common way ingestion accidental swallowing: eating, drinking, or smoking absorption absorbed through contact with skin or eyes

WORKPLACE HAZARDS CHEMICAL HAZARDS Routes of excretion Gastro- intestinal (feces) Respiratory (exhalation) Skin: Sweat Hair nails) Renal (urine)

WORKPLACE HAZARDS CHEMICAL HAZARDS Measures of concentration of toxic substances Threshold Limit Value (TLV): the level to which most workers can be safely exposed over a forty-hour working week for a working lifetime

CHEMICAL HAZARDS Classification of toxic effects: Local toxicity- occurs at the site of contact Systemic toxicity- occurs distant from point of contact, may involve many organs Acute toxicity- occurs almost immediately (minutes/hours/days) after an exposure Chronic toxicity- represents cumulative damage to specific organs; occurs after many months or years of exposure.

WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Renal Diseases Respiratory Diseases Skin Diseases Hematologic Diseases Cardiovascular Diseases Neurologic Diseases Carcinogenic Teratogenic

CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Chemical industries Solvents, ammonia Resp. Diseases: Irritation, inflammation Mining, construction, sandblasting, coal Inorganic dust Pneumoconiosis Plating, metal refining Chromium Cancer Pneumoconiosis: Fibrosis and scarring of the lungs secondary to repeated inhalation of dust associated with some occupation(Silicosis, anthracosis, asbestosis, byssinosis, bagassosis, and farmer’s lung).

CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Chemical industries , SO2 Cl- Resp. Diseases: Irritant gases CO,CO2, Asphyxiant gases semiconductor industries, pesticide PH3, arsine & stibine Toxic gases Phosphene;(PH3): Hydrogen phosphide; Phosphorus trihydride; Phosphorus hydride. Used in semiconductor industries and as a pesticide. It can be absorbed into the body by inhalation. Overexposure to phosphine gas causes nausea, vomiting, abdominal pain, diarrhea; thirst; chest tightness, dyspnea (breathing difficulty); muscle pain, chills; stupor or syncope; pulmonary edema. Arsine is the chemical compound with the formula AsH3. This flammable and highly toxic gas is one of the simplest compounds of arsenic. Despite its lethality, it finds applications in the semiconductor industry and for the synthesis of organoarsenic compounds. Stibine is the chemical compound with the formula SbH3. This colourless gas is the principal covalent hydride of antimony. This gas has an offensive smell like hydrogen sulfide (rotten eggs). SbH3 is an unstable flammable gas. It is highly toxic. The toxicity of stibine is similar to that of arsine. It binds to the haemoglobin of red blood cells, causing them to be destroyed by the body.

CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Battery mfg, chemical industries, pesticides Mercury, cadmium, chloroform Renal Diseases: acute/chronic renal failure Battery mfg., lead smelting Lead Blood Diseases: Anemia Solvent & soap mfg Benzene Aplastic anemia Mfg: manufacturing

WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Plastic, varnish Plastic epoxides Skin Diseases: Allergic/contact dermatitis Machine-tool operators Cutting oils, grease Acne Petroleum refinery Arsenic, tar Skin Cancer

WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Battery mfg. & recycling Lead, Cadmium Cardiovascular Disease: Hypertension Degreasing, dry cleaning Carbon disulfide Atherosclerosis Refrigeration, solvent workers Fluorocarbon, trichloroethylene Arrhythmias

WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Battery mfg. & recycling Lead, Cadmium Cardiovascular Disease: Hypertension Degreasing, dry cleaning Carbon disulfide Atherosclerosis Refrigeration, solvent works Fluorocarbon, trichloroethylene Arrhythmias

WORKPLACE HAZARDS CHEMICAL HAZARDS Health Effects Industry/Process Chemical Agent Effects Cleaning fluids, dry cleaners Carbon tetrachloride Liver Disease: Acute liver toxicity Plastics & vinyl chloride mfg. Vinyl chloride Liver cancer

WORKPLACE HAZARDS BIOLOGICAL HAZARDS VIRUSES FUNGI PARASITES BACTERIA

BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations Occupation Agent / Disease Silica workers, people exposed to heat and organic dusts, and medical personnel Tuberculosis Farmers (spores in soil) or anyone in contact with manure. Tetanus TETANUS:A neurological disorder characterized by increased muscle tone and spasms, that is caused by tetanospasmin, a toxin released 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, and 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. Directly Observed Therapy Short Course (DOTS) Strategy…the Solution!

BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations Occupation Agent / Disease Animal handlers and handlers of carcasses, skins, hides, or hair of infected animals, including wool carpet processors and handlers. Anthrax Anthrax is an acute disease caused by the bacterium Bacillus anthracis. Most forms of the disease are lethal, and it affects both humans and other animals. There are effective vaccines against anthrax, and some forms of the disease respond well to antibiotic treatment. Anthrax spores can be produced in vitro and used as a biological weapon.

BIOLOGICAL HAZARDS Selected Infectious Diseases and Occupations Occupation Agent / Disease Veterinarians, letter carriers, laboratory research workers, agricultural workers Rabies (e.g. dogs, bats, rats, pigs, cats) Farmers, outdoor workers, animal handlers Fungus

ERGONOMIC HAZARDS

+ Occupational health hazards “ fitting the job to the worker”
ERGONOMIC HAZARDS ERGONOMICS Human Biological Science + Engineering Science ERGONOMICS: an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely — called also biotechnology or human engineering. zzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz MAXIMUM JOB SATISFACTION AND INCREASE PRODUCTIVITY “ fitting the job to the worker”

WORKPLACE HAZARDS ERGONOMIC HAZARDS ERGONOMICS the tool workstation the task (job content & context) organization environment

ERGONOMIC HAZARDS ERGONOMICS The Goal is to reduce work-related musculoskeletal disorders (MSDs). MSDs: are injuries and illnesses that affect muscles, nerves, tendons, ligaments, joints or spinal discs.

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

ERGONOMIC HAZARDS Risk Factors: Static posture Extreme range of motion Repetitive movement

ERGONOMIC HAZARDS Risk Factors: Forceful exertion Awkward posture

WORKPLACE STRESS

WORKPLACE STRESS DEFINITION The harm that occurs when the job does not match the worker

WORKPLACE STRESS DEFINITION The harmful physical and emotional responses that occur when the requirements of the job do not match capabilities, resources or needs of the worker

WORKPLACE HAZARDS WORKPLACE STRESS EFFECTS BRAIN & NERVES SKIN HEART MUSCLES & JOINTS BRAIN AND NERVES: Headaches, feeling of despair, sadness, nervousness, lack of energy, irritability, trouble concentrating, memory problems, sleep disturbance, mental health problems(e.g. panic attacks, anxiety disorders and depression. SKIN : Acne. MUSCLES AND JOINTS: Muscle aches and tension (esp. neck, shoulders and back). HEART: Faster rate, hypertension, increased risk of cholesterol and heart attack. STOMACH: Nausea, stomach pain, heartburn, weight gain. PANCREAS: Increased risk of diabetes. INTESTINES: Diarrhea, constipation. REPRODUCTIVE SYSTEM: Women: Dysmenorrhea, irregular period, reduced sexual desire. Men: impotence, lower sperm count, reduced sexual desire. IMMUNE SYSTEM: Lowered ability to fight or recover from illness STOMACH PANCREAS REPRODUCTIVE SYSTEM INTESTINES IMMUNE SYSTEM

WORKPLACE HAZARDS WORKPLACE STRESS Manifestations of Stress PSYCHOLOGICAL Depression Boredom Inability to concentrate Low esteem Fatigue Anxiety Tension Irritability

WORKPLACE HAZARDS WORKPLACE STRESS Manifestations of Stress PHYSIOLOGICAL Heart rate Blood pressure Indigestion

WORKPLACE HAZARDS WORKPLACE STRESS Manifestations of Stress BEHAVIORAL Drug use Alcohol intake Heavy smoking Impulsive emotional behavior Poor work & family relationship Social isolation Family abandonment Sleep problems

Cardiac Cardiac

Principles of Control of
Occupational Health Principles of Control of Workplace Hazards WORKPLACE HAZARDS Identify Evaluate Control Eliminate Substitute Enclose/separate PPE/vaccinate

Principles of Control of
Occupational Health Principles of Control of Workplace Hazards Prevent and Control of Hazards Systems used to prevent and control hazards include: Engineering Controls Safe Work Practices Administrative Controls Personal Protective Equipment (PPE) Systems to Track Hazard Correction Preventive Maintenance Systems Emergency Preparation Medical Programs

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