Occupational Health

Dr.S.Sujatha MD., DPH.,

Assistant Professor
Department Of Community Medicine
Chengalpattu Medical College
 LEGISLATIONS

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Legislations for Health, Welfare and
Safety of Workers
 The Factories Act,1948
 The Mines Act,1952
 The Employees State Insurance (ESI) Act,1948
 The Workmen’s Compensation Act,1923
 The Trade Union Act,1926
 The Minimum Wages Act,1948
 The Dangerous Machine (Regulation)Act,1983
 The Plantation labor Act,1951
 The Bonded Labor System(Abolition)Act,1970
 The Contract Labor Act,1970

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The Employees State Insurance
Act, 1948
An Act to provide for certain benefits to employees in case of
sickness, maternity and injury during employment and to make
provision for certain other matters in relation thereto.

 Originally called as “Workmen’s State Insurance Bill” 1946

 Came into force on 19th April 1948
 Amended in 1975, 1984, 1987 , 2010 and 2016-17

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 Applicability

 The ESI Act of 1948 – covered all non-seasonal factories employing 10

or more persons ( excluding mines, railways & defence establishments )

 The provisions of the ESI (Amendment ) Act of 1975 were extended to;

 small factories employing 10 or more persons irrespective of power

usage
 Shops, hotels, restaurants
 Cinemas, theatres
 Road-motor transport undertakings, and
 Newspaper establishment
The scheme has been extended to private medical &
educational institutions employing 20 or more persons in
some states
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Employees State Insurance Act,
2016 updates
Coverage of employees:

 an ‘employee’ means any person employed for wages in

or in connection with the work of a factory or
establishment to which this act applies.
All employees – manual, clerical, supervisory and
technical getting up to Rs.21000 / month
 the monthly wage ceiling of Rs.21000

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 ESI - Administration

Autonomous body – ESI Corporation

 Chairman - Union Minister for Labour

 Vice-Chairman - The Secretary to Govt. of India,

Ministry of Labour

 Consists of members representing Central & State Govts,

employers & employees organisations, medical
profession & parliament

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 ESI- Administration

Standing Committee :

 Constituted from the members of the corporation,

 Acts as an executive body for administration of the

scheme
Chief Executive
Officer (Director
General)

Insurance Medical Financial Actuary

Commissisoner Commissioner Commissioner

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 Medical Benefit Council

Medical Benefit Council :

• Headed by Director General of Health Services, GOI

• Assisted by the Medical Commissioner in all matters

relating to medical relief

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 Employees State Insurance Act,
2016 updates
 Finance: ESI Fund
* State Government share 1/8th of expenditure on
medical treatment & attendance
* 7/8th of the expenditure borne by ESIC
 Employers: 4.75% of the total wage bill
 Employees: 1.75% of the wages
 Employees with a daily average wage upto Rs. 137 are
exempted from payment of contribution. Employers will
however contribute their share

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 2017 Updates In ESI

1. Wage Limit for Coverage:

– Upto Dec-2016 : Rs 15000/- pm
– From 01-01-2017 : Rs. 21000/-pm
2. Rate of Contribution:
– Employee Share : 1.75 %
– Employer Share : 4.75 %
– Total Payable 6.5 %
– In newly Implemented areas for the Initial 2
years rate of contribution will be :
– Employee Share : 1%
– Employer Share : 3%
– Total Payable 4%

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 Employees State Insurance Act,
1948
Benefits:

 Medical Benefit
 Sickness Benefit
 Maternity Benefit
 Disablement Benefit
 Dependant Benefit
 Funeral Expenses
 Rehabilitation
 Unemployment Benefit

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 Medical Benefits
1. MEDICAL BENEFIT :
• Consists of full & reasonable medical care including
hospitalization
• Free of cost to the insured person & his family members
from the day he enters insurable employment
• There is no ceiling on expenditure on treatment
Old Age Medical Care :
• Retired & disabled insured persons & their spouses
• Annual premium of Rs. 120
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 Services

 Out-patient care
 Supply of drugs
 Specialist services
 Pathological & Radiological investigations
 Antenatal, Natal & Postnatal services
 Family Planning services
 Emergency services
 In-patient treatment

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 Provision Of Medical Care

Medical care services to beneficiaries are provided by two

ways:-

Direct Provision through ESI schemes own network of

dispensaries, diagnostic centres and hospitals.

By service dispensaries ,part time dispensaries and mobile

dispensaries

 Indirect Provision through tie-up with private clinics (panel

system), diagnostic centres and hospitals

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 System & Level
of Medical Care Services
The various systems prevalent are:-

 Allopathy

 AYUSH

ESI Scheme provides all three different levels of care i.e. Primary care,
Secondary care and Tertiary care (Super Speciality care).

 Primary care is provided through dispensaries & panel clinics.

 Secondary care is provided through diagnostic centres and hospitals.

 Tertiary care is provided by entering into tie up arrangement with

specialized private and government diagnostic facilities and hospitals

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 Sickness Benefit

BENEFIT CONTRIBUTORY DURATION RATE

CONDITION
SICKNESS Payment of contribution for Upto 91 days 70% of
BENEFIT 78 days in corresponding in 2 the average
contribution period consecutive daily wages
benefit periods
ENHANCED Payment of contribution for Tubectomy – 100% of
SICKNESS 78 days in corresponding 14 days the average
BENEFIT contribution period Vasectomy – daily wages
7 days

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 Extended Sickness Benefit

CONTRIBUTORY DURATION RATE

CONDITION

EXTENDED For 34 specified long term Extended upto 80% of

SICKNESS diseases continuous 2 years on the average
BENEFIT insurable employment for 2 medical advice daily wages
years with minimum 156 days
contribution in 4 consecutive
contribution periods

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 List of 34 Diseases
1. TB 21. Cardiomyopathies
2.
3.
Leprosy
Chronic empyema L 22.Heart disease with surgical interventions
along with complications
4. AIDS 23. Bronchiectasis
5. Malignant diseases 24. Interstitial Lung Disease
6. DM with proliferative retinopathy/ Diabetic 25. COPD with congestive heart failure
foot/Nephropathy 26. Cirrhosis of liver with ascitis / chronic active
7. Monplegia hepatitis
8. Hemiplegia 27. Dislocation of vertebra / prolapse of
9. Paraplegia intervertebral disc
10. Hemiparesis 28. Non union or delayed union of fracture
11. Intra cranaial space occupying lesion 29. Post Traumatic surgical amputation of lower
12.Spinal cord compression extremity
13. Parkinson’s disease 30. Compound fracture with chronic
14. MG/ Neuromuscular dystrophy osteomyelitis
15. Immature cataract with vision 6/60 or less 31. Psychosis
16. Detachment of retina a. Schizophrenia
17.Glaucoma b. Endogenous depression
18.Coronary artery Disease c. Manic Depressive Psychosis
a. Unstable angina d. Dementia
b. MI with EF <45% 32.Morethan 20% burns with
19. Congestive Heart Failure- Left, Right infection/complication
20.Cardiac valvular diseases with failure / 33. CRF
complications 34. Reynaud’s disease/ Burger’s disease
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 Maternity Benefit

CONTRIBUTORY
CONDITION DURATION RATE

Payment of Confinement – 26 weeks 100% of

contribution of Miscarriage – 6 weeks the
70 days in 2 Extendable upto 1 month on medical average
preceding advice incase of sickness arising out daily
contribution periods of wages
pregnancy/confinement/miscarriage

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 2017 Amendments on
Maternity Leave
 Maternity Leave -26 Weeks
 Can avail 8 weeks before delivery.
Eligibility:
 A Commissioning Mother – biological mother wishes to
have a child and prefer to get embryo implanted in any
other women
 A women legally adopts a child upto 3 months of age
 An insured mother with 2 or more than 2 surviving
children can avail 12 weeks of leave with 6 weeks before
delivery

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 Disablement Benefit
CONTRIBUTORY
CONDITION DURATION RATE

TEMPORARY From day 1 of As long as 90% of the average

DISABLEMENT insurable temporary daily wages
BENEFIT employment for disablement
disablement due lasts
to employment
injury
PERMANENT From day 1 of For whole Total - 90% of the
DISABLEMENT insurable life average daily wages
BENEFIT employment for Partial –
disablement due proportionate to the
to employment loss of earning
injury capacity
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 Dependent Benefit

CONTRIBUTORY DURATION RATE

CONDITION

From day 1 of Wife – lifelong 90% of the

insurable Dependent children – average daily
employment in case till 25 yrs wages sharable
of death due to (daughter – till her marriage) in fixed
employment injury proportion
among all
dependents

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 Other Benefits Offered
by ESI
 Funeral expenses on death of an I.P. subject to a maximum of a
Rs10,000/- payable at the Branch Office. The claim of such
payment should be made within three month of the death of IP.

 Vocational Rehabilitation in case of physical disablement due to

employment injury under 45 years of age with 40 percent or more
disablement. Payable as long as vocational training lasts - actual
fee charged or Rs.123/- a day whichever is higher

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 Other Benefits Offered

 Free supply of physical aids and appliances such as crutches,

wheelchairs, dentures, spectacles and other such physical aids.

 Preventive health care services such as immunization, family

welfare service, HIV/AIDS detection, treatment etc.

 Confinement Expenses Rs.5000/- is paid to an insured woman or

insured person in respect of his wife in case confinement occurs at a

place where necessary medical facilities under ESI Scheme are not

available. This is paid for two confinements only

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 Unemployment Allowance
2016 update
RAJIV GANDHI SHRAMIK KALYAN YOJANA (RGSKY)
In case of involuntary loss of employment due to closure of factory or
permanent invalidity due to non employment injury
CONTRIBUTORY DURATION RATE
CONDITION
Should have Maximum 24 months 1. 0-12 Months:
contributed under 50 % of Last
the scheme for Average
minimum 2 yrs. Wages
prior to loss of 2. 13-24 Months:
employment 25 % of Last
Average
Wages.

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 Super Speciality Treatment
(SST)

 The insured persons and their family members are entitled to

Super Speciality medical care and /or reimbursement along with
the cost of supply of medicines .
 If the I.P completes 3 months service and contribution for
39 days w.r.t self and
 6 month service and 78 days contribution in case of family
members.

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 Incentives To Employers
In The Pvt. Sector Providing
Employment To
The Persons With Disablities

Persons with disabilities employed on or after

01.04.2008 and drawing monthly wages upto Rs.25000/-
are covered under the Scheme and Employers’ share of
contribution is paid by Government for three years.

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 Benefits to Employers

 Exemption from applicability of Workmen’s compensation

act,1923
 Exemption from Maternity Benefit Act,1961
 Exemption from payment of medical allowance to
employees & their dependants or arranging for their
medical care
 Rebate under the Income Tax Act on contribution
deposited in the ESI account
 Healthy work force

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 Panchdeep Project
IT enabled

PEHCHAN cards for IP and family which will enable

availment of benefits anywhere anytime.
Insurance number & Card to remain same even if job changes.
 Online registration of factory/estt., employees
Online submission of challan and contribution payment
IP can access eligibility, status of claims
Registration of patients in hospitals/dispensaries &
Medical history of patient.

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 Pehchan Cards

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 Recent Initiatives

 Modernisation/upgradation/expansion of all ESI

Hospitals to bring them at par with best Corporate
hospitals.
 Hospital Development Committees constituted in all
ESI Hospitals with executive/financial powers and
representation of stakeholders.

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 Recent Initiatives

 Medical Colleges, Para-medical and nursing training

institutions will be set up to improve quality of medical
care and to overcome shortage of medical/para-medical
personnel.
 Tie-up arrangements

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 ESIC

Our Motto:

Efficient
Services to
Insured-persons

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 The Factories Act,1948
It is one of the noble & comprehensive labour legislation

which is in force in our country

Secures - Safety, health & welfare

Regulates - Working hours

Ensures - Annual leave with wages

Provides - Protection from hazardous processes

Protection to women workforce
Prohibition of employment of children

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 Factories Act
 The original Act was passed in 1881

 The Act has been revised & amended several times; latest –
2005

 Major amendment was in 1987 – following the Bhopal Gas

Tragedy in Dec. 1984

 The Act has;

 11 Chapters

 120 Sections

 3 Schedules

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CHAPTER I : SCOPE & DEFINITIONS

• SCOPE : The Act extends to the whole of India except

Jammu & Kashmir

• DEFINITIONS :

CHILD • Not completed 15th year

ADOLESCENT • Completed 15th year but not 18th year

ADULT • An individual who has completed 18th year

• Means an energy transmitted mechanically

POWER & is not generated by human agency
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 CHAPTER I : SCOPE & DEFINITIONS

• An establishment employing 10 or more

persons where power is used &, 20 or more
FACTORY persons where is not used
• Includes both seasonal & perennial factories

• A person employed directly or through any

agency, whether for wages or not, in any
WORKER manufacturing process, or in any kind of
work incidental to or connected with the
manufacturing process

• Introduced in 1987 Amendment Act

OCCUPIER • The person who has control over the affairs
of the factory

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CHAPTER II : THE INSPECTING STAFF

INSPECTORS :

• The State Govt. may appoint Chief Inspector & Additional

Inspectors of factories

• District Magistrate – Inspector for his district

POWERS :

• An Inspector can enter any factory, within his local limits &
make an examination of premises, machineries or records

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CHAPTER II : THE INSPECTING STAFF

CERTIFYING SURGEONS :

• The State Govt. may appoint qualified medical practitioners to be

certifying surgeons, for;

 The examination & certification of young persons under this

Act

 The examination of persons engaged in factories in

dangerous occupations or processes

 Supervising the factories where cases of illness or injury to

workers have occurred due to manufacturing process
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 CHAPTER III : HEALTH

• Section 11 : Cleanliness
• Section 12: Disposal of refuse
• Section 13: Ventilation and Temperature
• Section 14: Dust and Fumes
• Section 15: Artificial humidification
• Section 16: Over-crowding
• Section 17: Lighting
• Section 18: Drinking water
• Section 19: Latrines and urinals
• Section 20: Spittoons
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 CHAPTER IV : SAFETY

• Casing / fencing of the machinery

• The Act provides that no worker shall be

required to lift or carry loads which are likely
to cause him injury

• The 1976 Amendment provides for the

appointment of “Safety Officers” in every
factory wherein 1000 or more workers are
employed

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 CHAPTER V : WELFARE MEASURES

• Facilities for washing, drying & storing the

cloths
• Facilities for rest & recreation
• Canteen - > 250 workers
• Creches - > 30 women workers
• First aid appliances – 1 box for every 150
workers
• Welfare Officer – 500 or more workers are
employed
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 CHAPTER VI : WORKING HOURS

• Weekly hours – Not more than 48 hrs in a week

Not more than 60 hrs including over-time

• Weekly holiday – 1 day / week; preferably Sunday

• Daily hours – Not more than 9 hrs, with half hr rest after 5

hrs of continuous work (adolescents- after

4 and ½ hours per day)

• Women – No women shall be allowed to work

between 7pm to 6am
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 CHAPTER VII : EMPLOYMENT &
YOUNG PERSONS

• No child, who has not completed his 14th yr, shall be allowed
to work in any factory

• Adolescents – duly certified by the “Certifying Surgeons”

regarding their physical fitness

• Adolescent employee – work only between 6 am to 7 pm

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 CHAPTER VIII: ANNUAL LEAVE
WITH WAGES

• Every worker is entitled to leave with wages, after 12

months of continuous service

• At the rate of 1 day for every 20 days of work ( for young –

1 day for every 15 days of work)

• Leave can be accumulated upto 30 days and in young

persons - can accumulate leave for 40 days.

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CHAPTER IX: SPECIAL PROVISIONS

Section 88 :

• Certain accidents, including death or serious injuries , should be

notified by the manager to District Magistrate & Police

Section 89 :

• Acts gives a schedule of notifiable diseases

• Notified to Chief Inspector & Certifying Surgeon by the manager

• The 1976 Amendment Act includes Byssinosis, Asbestosis,

Occupational Dermatitis & Noise Induced Hearing Loss to the list of
other notifiable diseases
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CHAPTER X: PENALTIES & PROCEDURES

In case of violation of any rules or order, the Occupier &

Manager of the factory - is punishable with 2 yrs
imprisonment / fine upto 1 lakh or both

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 CHAPTER XI: SUPPLEMENTAL

Display of notices :

• Abstracts of this Act & rules, name & address of the Inspector
& Certifying Surgeon

• In English & local language understood by majority of

workers

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 CHAPTER XI: SUPPLEMENTAL

Right of workers :

• Right to obtain from the occupier,

information relating to workers’ health &
safety at work

• Represent to the Inspector directly or

through his representative in the matter of
inadequate provision for protection of his
health or safety in the factory
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 FIRST SCHEDULE
List of factories involving hazardous
processes
• Coal industries
• Fertiliser Industries
• Cement Industries
• Petroleum Industries
• Drugs and Pharmaceutical Industries
• Rubber (Synthetic) Industries
• Glass and Ceramics
• Manufacture, handling and processing of asbestos and its
products
• Dyes and Dyestuff including their intermediates
• Highly flammable liquids and gases
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 SECOND SCHEDULE
Permissible levels of certain chemical substances
in work environment
• Chlorine – 1ppm
• Ammonia- 25ppm
• Carbon disulphide -Skin- 10ppm
• Carbon Monoxide- 50 ppm
• Carbon Tetrachloride Skin – 5ppm
• Chlorine- 1ppm

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 THIRD SCHEDULE
List of notifiable diseases
• Lead poisoning
• Mercury poisoning
• Arsenic poisoning
• Phosphorous poisoning
• Silicosis
• Byssinosis
• Asbestosis
• Noise induced hearing loss
• Carbon monoxide
• Coal miners' pneumoconiosis
• Occupational cancer
4/3/2018 • Radio or radioactive
Community substances
Medicine , CH.M.C 54
 CHILDREN AND WORK

Article 45 : Right to Education

Free & compulsory education to all children
up to the age of 14 yrs

Article 24 : Prohibition of
employment of children
No child below the age of 14 yrs shall be
employed in work in any factory or mine or
engaged in any other hazardous employment

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 References
 Park K. Textbook of Preventive And Social Medicine. 23rd Edition.
Bhanot Publication;2015: pgs.803-819

 Suryakantha AH. Community Medicine with Recent Advances. 3rd ed.

Jaypee Brothers Medical Publishers; 2014: pgs.213-238

 Rajvir Bhalwar. Text book of Public Health & community Medicine. 1st
edition. AFMC Pune & WHO Publications, 2009, 1291-1293

 Wallace/Maxcy- Rosenau- last, Public Health & Preventive Medicine,

15th edition, TMH Publication, 2008, 763-778

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 References

 Roger Detels. Oxford Textbook of Public Health,

4thEdition, OkDokey Publications, 2002, 2163-2197

 http://www.ilo.org/global/lang--en/index.htm

 http://www.dgfasli.nic.in/statutes5.htm

 http://labour.nic.in/industrial-safety-health

 http://www.nioh.org/
 http://www.esic.nic.in/
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