OCCUPATIONAL HEALTH

YAA NYARKO AGYEMAN

 Introduction
• Most adults spend a considerable amount
of time at their workplace and are exposed
to a variety of work related situations.
• Some of these situations are pleasant, but
others expose the workers to stressful
situations and to physical, chemical,
mechanical, ergonomic and biological
hazards.
• The effects of these hazards are not
always immediate and some have a long
 Occupational Health
• It 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 (ILO / WHO 1950)
 OH Objectives
• To maintain and promote the physical,
mental and social well being of the workers.
• To prevent occupational diseases and
injuries.
• To adapt the work place and work
environment to the needs of the workers i.e.
application of ergonomics principle.
• It should be preventive rather than curative.
 Occupational health
▪ It represents a dynamic equilibrium
between the worker and his
occupational environment.
 Occupational health
• Protecting the worker from exposure to these
factors requires a commitment on the part of
management to ensure that activities are
carried out in the areas of
1. health promotion (worker education and
work design),
2. health protection and disease prevention
(protecting workers from hazards
3. monitoring the health of the worker), and
rehabilitation (returning the worker to safe,
meaningful, productive work).
To meet the above objectives, it is necessary
for the occupational health workers to:
• Identify and bring under control at the work
place, all physical, chemical, mechanical and
psychological agents that are known to be or
suspected to be hazardous
• Provide effective measures to protect those
who are vulnerable to adverse working
conditions and also to raise their level of
resistance
• Educate management and workers to fulfill
their responsibilities relevant to health
promotion and protection
• Carry out comprehensive health
programmes which deal with man’s total
health which assist PH authorities to raise
the level of community health
• Discover and improve work conditions that
may contribute to the overall ill health of
workers to ensure that the burden of general
illness in different occupational groups is not
increased in the country or community
• Ensure the physical and mental demands
imposed on people at work by their
respective jobs are properly matched with
their individual anatomical, physiological and
psychological capabilities
 SERVICES
• Diagnosis and treatment
• Environmental surveillance and
supervision
• Health screening and supervios
• Health education
• Counselling services
• Record keeping and research
• Liaising and cooperating with other
agencies
• Rehabilitation of victims
• Vaccination programme: hep. B, TT
The various types of health
screening
 Pre-placement (Pre-employment)
Examination
• This examination is to ensure that the
employee is fit to undertake the job without
risk to himself or his colleagues.
• The baseline medical examination
conducted at the start of employment will
define the initial health status: Subsequent
examinations will be used to evaluate the
evident health effects of the work
environment and other working conditions.
 Periodic Examination
• This consists of examinations conducted
periodically to identify vulnerable groups
among the staff which can be of immense
value to prevention.
• The frequency and types of examinations
will be determined for each vulnerable
group based on nature of work, ages and
sex of the group members.
 Post Sickness Absence
Examination
• This is to ensure that an employee who
has been absent with a medical condition
for a considerable length of time is fit to
undertake his/her usual job.
• On the other hand, it will facilitate the
rehabilitation or temporary or permanent
resettlement of those who are not fit to
return to their usual occupations.
 Exit Medical Examination
• This is to provide data on employees at
the point of exit from a particular
occupation or workplace.
• This provides the opportunity for
employees with ailments which have a
causal relationship to any factor in the
work environment to continue to receive
assistance for managing it after they have
left the employment or moved on to
another schedule.
Health promotion and protection
• The workplace directly influences the
physical, mental, economic and social
well-being of workers and in turn the
health of their families, communities and
society.
• It offers an ideal setting and infrastructure
to support the promotion of health of a
large audience.
• The health of workers is also affected by
non-work related factors.
Health promotion and protection
• Injury and illness prevention is an important
issue in OH for maintaining the physical,
mental, and social well being of employees in
the workplace.
• Occupational health deals with all aspects of
health and safety in the workplace and has a
strong focus on primary prevention of hazards.
• The goal of primary prevention is to take action
in the workplace so that the worker is protected
from injury and illness
Health promotion and protection
• The preferred level of prevention (Primary)
and includes activities as;
- identifying hazards at the workplace (hazard
identification),
- assessing the actual level of risk associated
with the identified hazards ( risk
assessment),
- and reducing exposure to environmental
stressors in the workplace(through risk
control and communication).
• Risk control is achieved through the
reduction of exposure.
• Employers in Ghana are required by the
Ghana Labour Act 2003, Act 651 to ensure
their employees are not exposed to
conditions that would lead them to work
related injuries or illnesses.
• Accidents that occur in factories are
expected to be reported to the Department
of Factory Inspectorate but Companies
hardly report such events to the
inspectorate for investigation and
correction.
 Agencies
• Road Safety Commission
• The Minerals Commission, Mining Regulations 1970
• Radiation Protection Board of the Ghana Atomic Energy Commission
• Environmental Protection Agency
• Ghana Health Service
• MOH
• Ghana standard board
• Food and drug board
• Labour commission
• Ambulance services
• Ges
• Food and drug Authority
• Legal issues
• Security services
 Occupational hazards

• The work environment contains a wide range

of potential environmental exposure grouped
as:
- Chemical (e.g. solvents, poisons)
- Physical (e.g. radiation, noise)
- Biological (e.g. blood products, viruses)
- Mechanical and ergonomic (e.g. repetitive
strains, awkward posture)
- Psychosocial (e.g. stress, isolation)
 Occupational hazards
• Hazard is the potential to cause harm.
PHYSICAL
• Non-ionising radiation e.g. microwaves, infra
red, visible and ultra-violet light
• Ionising radiation e.g. X-rays, gamma rays,
beta particles, alpha particles from radon
daughters
• Noise (usually measured in decibels dB) and
vibration;
• Temperature, humidity etc.
ERGONOMIC
• Posture, movement (e.g. keyboard
operation), load bearing (e.g. patient
handling)
Chemical
• Inorganic - e.g. lead, arsenic, silica,
• Organic - e.g. solvents, resins, glues,
fluxes
 Occupational hazards
Biological
• Allergens of biological origin:- laboratory
animals, insects, mites, wood and other plant
material, fungal spores.
• Infections: Bacteria: Tuberculosis, Brucella,
etc.
• Viruses: e.g. Hepatitis B from needlestick
injuries.
Psychological
• Various aspects of work organisation may be
stressors.
 Control of Hazards

• Once the hazard is known and the risk of it

causing injury or disease is determined,
then control measures should be applied
in a hierarchical fashion.
• In taking action, the issues to address are:
a. Can I get rid of the hazard altogether?
b. If not, how can I control the risks so that
harm is unlikely?
The principles below should then be applied
as far as possible in the order in which they
are listed:
• Try a less risky option
• Prevent / limit access to the hazard (e.g. to
isolation ward, radiation exposed areas,
guarding of beds with side rails to limit falls
etc)
• Organize work to reduce exposure to the
hazard
• Issue and ensure the use of personal
protective equipment
• Provide welfare facilities (e.g. washing
facilities for removal of contamination and
first aid).
 Occupational related disease
- Cancers,
- Reproductive problems in men and women
- Accidents,
- Musculoskeletal diseases,
- Respiratory diseases,
- Noise-induced hearing loss,
- Circulatory diseases,
- Stress related disorders
- Communicable diseases
- Skin disorders
 OCCUPATIONAL HEALTH
TEAM
• occupational health nurses
• occupational health physicians
• industrial hygienists
• safety engineers
• work organization specialists
• psychologists
• counsellors
• physiotherapists.
• ergonomists
• health economists
• academic researchers and others.
 Benefits
• 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
 Benefits - cont
• 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.
 The role of the Nurse in OH
• contributing to accident follow up;
• maintaining employee health records;
• monitoring employee exposure to
hazardous chemicals and undertaking
statutory and non-statutory health
surveillance;
• undertaking a role in attendance
management;
• advising on disability issues in the
workplace;
 The role of the Nurse in OH
• developing return to work strategies
following serious injury or a period of
prolonged ill-health;
• advising employers on how they can
achieve compliance with health and safety
and employment legislation;
• keeping up to date with legal and
professional changes associated with
public health and occupational health and
safety.