TUTORIAL BATCH 30

OCCUPATIONAL HEALTH
2022.06.30, 10.45 am – 11.45 am (Prof. ARW/Dr.KMNP/Dr.LA/Dr.TP)

1. Distinguish the difference between Occupational Disease and Work-Related Disease

giving examples.

Work related diseases Occupational diseases Occurs largely in the community Occurs
mainly among working populations Multifactorial in origin Cause specific Exposure at
workplace may be a factor Exposure at workplace is essential May be notifiable and
compensable Notifiable and compensable

Work related diseases Occupational diseases

Diseases caused by work or work Diseases initiated, hampered or easy to
environment get by work
Occurs largely in the community Occurs mainly among working
populations
Multifactorial in origin Cause specific
Exposure at workplace may be a factor Exposure at workplace is essential
May be notifiable and compensable Notifiable and compensable
2. What is described as the Healthy Worker Effect and describe its implications.

The consistent tendency of the actively employed to have a more favourable mortality
experience than the population at large.

Generally healthy people can work and are recruited compared to the people with health
problems. Employers prefer healthy workers as they are more productive, which will help to
run a successful business. Healthy people will continue to work, so that the working
population (where majority are healthy) healthier than the general population. This is
observed as comparatively low mortality rates seen in working population, compared to the
public. This could interfere with occupational cohort studies as a selection bias.

3. Describe the different methods of assessing employee’s health.

 Pre-assignment (pre-employment) health examinations
o conducted before recruitment to the job to assess employability of the
worker
 o no job offer If the prospective employee is found to have physical
limitations that affect safe and effective performance of the job
o Pre-placement medical examination (PPME)/ Post offer medical
examination –
 To decide on work suitability after employment.
 To place the worker in a job that suits his capabilities and status of
health and not to screen them out

 Periodic health examinations

 Return to work health examinations
 General health examinations
 Post assignment health examinations

4. Describe the Inverted pyramid of Control of Hazards.

 Elimination
o If there is a hazard – Remove the hazard
o Replace machinery
o Re-design
o Remove contaminant
 Substitution
o Substitution of toxic chemicals with non-toxic or less toxic substances –e.g.
replacement of benzene with xylene or toluene
o Re-design of equipment and machinery to minimize hazards – e.g. to reduce
noise replacing tooth-wheel transmission in machinery with pulley systems
 Isolation
o Total enclosure: Complete protection of workers from chemical and physical
hazards – e.g. mechanized or automated handling of asbestos, benzene,
pesticides
o Isolate hazardous processes to have minimum contact with workers
 Engineering Controls
o Re-design of equipment and machinery to minimize hazards – e.g.
mechanized or automated handling of asbestos, benzene, pesticides
o Total enclosure: Complete protection of workers from chemical and physical
hazards
o Ventilation - applying exhaust ventilation at point of emission e.g. dust,
fumes and vapours
o Chimneys to remove smoke and other pollutants generated in burning
o Shielding: Partial protection of workers from ionizing radiation, microwave or
noise to avoid excessive exposure – e.g. to reduce noise replacing tooth-
wheel transmission in machinery with pulley systems
 Administrative controls
o Standard operating procedures (SOPs)
o Signage
o Limit exposure time / work shifts
o Prohibition of smoking, eating and drinking in work area
o Washing facilities for decontamination
o Cleanliness of work area
o Proper storage of material
 Personal Protection Equipment (PPE)
o The last line of defence
o Better to use in combination with other methods – Goggles – Ear plugs, ear
muffs – Helmets – Masks – Gloves – Aprons – Special boots with
strengthened toe caps
 Monitoring
o Regular environmental monitoring to ensure safe levels are maintained
 o Periodic medical examination of workers to assess exposure and its effects
and susceptibility of individuals
o Supervision of control measures
o Use of Threshold Limit Values (TLVs) to limit exposure to a level that will not
have a serious health risk for lifetime exposure

5. Describe the psychosocial hazards that working population face today.

Work demands

Substantial and/or excessive physical, mental and emotional efforts required to do the job        

Tasks or jobs that involve:

 fast work-pace and time pressure
 excessive workload
 repetitive or monotonous tasks
 sustained concentration
 high mental workload
 extended work hours
 large number of consecutive days worked
 roster length
 shift rotation
 exposure to emotionally distressing situations (e.g. first responders including
emergency and medical call outs)

Low levels of control 

Lack of control over aspects of the work, including how and when a job is done (i.e. autonomy)

 workers have little say in the way they do their work, when they can take breaks or
change tasks
 workers are not involved in decision making about work that affects them or their
clients
 workers are unable to refuse working with aggressive individuals

Lack of control over aspects of accommodation arrangements         

There may be limited options to allow for:

 personal scheduling of activities of daily living (e.g. meal times, showering)
 varying sleep schedules
  different accommodation preferences (e.g. privacy)

Inadequate support from supervisors and/ or co-workers

Lack of support in the form of constructive feedback, problem solving, practical assistance,
provision of information and resources

The workers have insufficient or inappropriate:

 support from supervisor or co-workers
 information or training to support their performance
 equipment and resources to do the job

Lack of role clarity

Unclear or constantly changing management expectations about the responsibilities of the job

 Incompatible expectations or demands placed on workers by different workplace

stakeholders
o conflicting job roles, responsibilities or expectations
o Poor organisational change management

Inadequate communication

 and consultation with workers about the changes

Low recognition and reward

Lack of positive feedback on job and task performance, and inadequate skills development and
utilisation

6. This CXR is from a person who has

been diagnosed with pneumoconiosis.
 ii. State the management of this patient.

 Broncho dilators/nebulization
 Oxygen therapy
 Physiotherapy

7. A 32-year-old construction worker falls from the 11 th floor of the building and dies.
Outline the steps that must be taken by factory management and relevant labour
authorities following the death of the worker.
 Written notice of the accident should be sent to District Factory Inspecting
Engineer.
 Office of Commissioner of Workmen’s Compensation members (The
Commissioner, Additional Commissioner, and the Deputy Commissioner) should,
o Receipt of complaints claiming workmen’s compensation
o Conducting inquiries into the accepted applications for compensation and
settlement of the problem
o Collection of compensatory payments from employers
o Obtain compensation from employers to dependents of the workman