PHFI & NHSRS (NIH&FW)

Occupational Health for newly Inducted

‘Medical Officers’

OCCUPATIONAL DISEASES – PRIMARILY PREVENTABLE

Jayaraj.G
Abstract: Occupational Diseases , its recognition, diagnosis, control and treatment continue to
be ambiguous as the awareness among practicing Medical Officers is practically nil.
Occupational Health as a multidiscipline under Public Health , wedded to industries healthcare
management is not given importance in the curriculum teaching during medical schooling.
Limited training and opportunities to learn this subject remains to be stumbling block. The PHFI
and NHSRS initiatives augurs well in starting training programs on Occupational Health is to
standardized the training content and delivery to empower the newly recruited Medical
Officers with requisite administrative, behavioural and programmatic skills and to enable them
to perform their job responsibilities to the best of their abilities. Importance of Occupational
Disease, its prevalence, diagnosis, interventions, preventions, management tool kits , Basic
Occupational Health Service planned under National Program for Climate Change and Human
Health (NPCCHH) are dealt with in a nutshell. The recent initiative by the Government to reform
the existing hundreds of complex labour legislations into simplified Fours New Labour Codes-
2020 and its implementation through voluntary participation of all State is awaited to be seen
for inclusive success to cover 500 million workforce of India, with new structure of wages,
industrial relations, social security system, occupational safety and health. First time the major
chunks of unorganised 90 percent of India’s workforce would benefit from the reformed Labour
codes-2020.
Key words: PHFI- Public Health Foundation-India, NHSRS- National Health Systems Resource
Centre , NIH& FW- National Institute of Health &Family Welfare, NPCCHH- National Program for
Climate Change and Human Health, NIOH- National Institute of Occupational Health (ICMR-
Indian Council of Medical Research) ILO- International Labour Organization, WHO-World Health
Organization, ICOH-International Commission of Occupational Health, OSH-Occupational Safety
and Health , NIOSH- National Institute of Occupational Safety and Health (USA), PtD-
Prevention through Design, PPE- Personal Protective Equipment , OHSMS -Occupational Health
and Safety Management System, BOHS- Basic Occupational Health Services
--0—

Introduction

The Public Health Foundation -India , structured as an independent foundation in 2006, adopts
a broad , integrative approach to Public Health , tailoring it endeavours to newly evolving
environmental conditions and related health issues. Focusing on the broad dimensions of
public health that encompasses promotive, preventive, curative that are frequently lost sight of
policy planning as well as popular understanding, the PHFI engages and closely work with, a
wide array of stakeholders, governments, international bodies, civil society, academic -research
institutions, and the communities.

The National Health Systems Resource Centre (NHSRC) set up in the same year 2006, under
the National Rural Health Mission (NRHM) of Government of India to serve as an apex body for
technical assistance , to assist in policy and strategy development in the provision and
mobilization of technical assistance to the states and in capacity building for the Ministry of
Health and Family Welfare (MoHFW) at the centre and in the states.

Jointly organised by the PHFI and NHSRC, the aim of this training program is to standardized the
training content and delivery to empower the newly recruited Medical Officers with requisite
administrative, behavioural and programmatic skills and to enable them to perform their job
responsibilities to the best of their abilities. Few of topics to be covered during the induction
training program are Communication Skills and Behavioural Standards, Leadership Skills,
Understanding health indicators, Code of conduct and Medical Ethics, national programs
overview, occupational diseases, disaster management etc.

Awareness on the Basic Occupational Health Service (BOHS) related to the National Program
for Climate Change and Human Health (NPCCHH), is to bring to the notice of the t growing
industries, its impact on the health of population who are directly involved operating industries
and people as a whole facing the wrath of climate changes due to fast industrialisation and
technologies, resulting numerous new diseases / disorders. Occupational Diseases hitherto
ignored in the atlas of medicine is to advocate the upcoming generation of Medical Officer all
over the country, to enable them to be inclusive in diagnosing, treating, controlling and
preventing diseases of new order due to Climate Changes, where occupational diseases is one
discipline, being neglected both by the industries and the medical profession.

1. Brief overview of locally prevalent occupational diseases and their diagnosis

The predominance of occupational diseases has been changing due to transformations in the
structure of industry, use of untested chemicals, technologies on the livings and changing
hazardous working conditions all over the world, specially among developing countries. Now
we are towards 5th and 6th Industrial revolution , the first one started in mid 1770s with steam
power, now embrace robotics . So much of development had taken place in the technology
which are currently moving to acquire Artificial Intelligence, Machine Learning, IoT, Data
Sciences, nano-technology , 5G to 6 G etc, creating new list of health hazards and
diseases/disorders.

An “occupational disease” is any disease contracted primarily as a result of an exposure to

risk factors arising from work activity. “Work-related diseases” have multiple causes, where
 factors in the work environment may play a role, together with other risk factors, in the
development of such diseases…. (WHO)

Most of them falling under the list of non-communicable diseases, which are exclusively
contracted due to several health hazards at workplaces related to physical ,chemical, biological,
psychological, ergonomic factors. They are primarily preventable.

Occupational health, a sub-sect of Public Health, deals with all aspects of health and safety at
the workplace with special emphasis on primary prevention of hazards , where the curative
solutions are limited. The health of the workers has several determinants, including risk factors
at the workplace leading to accidents, musculoskeletal diseases, respiratory diseases, hearing
loss, circulatory diseases, stress related disorders, communicable diseases , cancers and others. 

Safety and health of workers has a positive impact on productivity and economic and social
development. To ensure sustainable and fair economic growth, having the highest standards of
safety and health standard are just as  important as business performance, profits and bottom
line.

The causes of Climate Changes are found in the multiple consequences of industrialization.
Emissions pollution, overpopulation and deforestation are double-duty issues , while they are
the negative effects of industrialization, are also the main causes of global warming.

Recognising that occupational health is closely linked to public health and health systems , the
PHFI ,ILO, WHO , ICHO addressing all determinants of workers' health, including risks for
disease and injury in the occupational environment, social and individual factors, and access to
health services. The ILO working since 1919 on labour issues , through Conventions 155, 161 on
Occupational Safety and Health and the WHO’s work on occupational health is governed by the
Global Plan of Action on Workers’ Health 2008-2017, advocate protection of working
population form innumerable health hazards faced at workplaces. But the figures in the Table.1
given below reveals gross variation in the occupational health issues data , indicating how
difficult it is to collect and collate the work-related accidents and diseases data are, and how
complex the health issues are to be handled.

Table 1: Comparative Facts and figures of Occupational Diseases and Disorders(2012)

International Labour Organization(ILO) World Health Organisation (WHO)
 2.02 million die each year from work-related 0.7 million death due to occupational
diseases diseases (India contribute 17%)
 321,000 die from occupational accidents  11 million occupational diseases (1.9 million
 160 million non-fatal work-related diseases in India
 317 million non-fatal occupational accidents  100 million occupational injuries
 Every 15 seconds one worker die from work- 45,000 fatal injuries
related accidents  17 millions non-fatal accidents
 Every 15 seconds 151 workers sustain work-
 related accidents

Each national occupational diseases list, usually presented as a schedule in the labour
legislations, presents a large variety of concepts for covering occupational diseases within the
system, reflecting the social, cultural, and technological background and environment of the
system .

Based on ILO’s Recommendation No. 194 (R194), the ILO List of Occupational Diseases was
modified to emphasize prevention and reporting more than compensation 1 .
Table.2: ILO List of Occupational Diseases 2010

I. Occupational diseases caused by exposure to agents arising from work activities Nos
1. 1.1.Occupational diseases caused by exposure to agents arising from work
activities 1.1. Diseases caused by chemical agents-………………………………………… 41
2. 1.2. Diseases caused by physical agents-………………………………………………………… 07
3. 1.3. Biological agents and infectious or parasitic diseases………………………………… 09

I. Occupational diseases caused by exposure to agents arising from work activities

1. 1.2. Diseases caused by physical agents-………………………………………………………… 07
2. 1.3. Biological agents and infectious or parasitic diseases-……………………………… 09

III. 3. Occupational cancer………………………………………………………………………………………… 21

IV. 4. Other diseases………………………………………………………………………………………………… 02

Under the New Labour ( Occupational Safety, Health & Working conditions) Code-2020, the
Ministry of Law and Justice ,Govt. of India , enlisted 29 notifiable disease under the Third
Schedule of the Labour (OSH) Code-2020 2 .
2.Mechanisms for safeguarding Occupational Health (Emergency Safety
Interventions - ESIC/ FA)

Industrial Hygiene , more of science discipline of applied physics, chemistry, biology,

psychology, is generally defined as the the Anticipation, Recognition, Evaluation and Control of
hazards (AREC) arising in or from the workplace that could impair the health and well-being of
workers, taking into account the possible impact on the surrounding communities and the
general environment. Industrial Hygiene domain is necessarily vast, encompassing a large
number of disciplines and numerous workplace and environmental hazards. A wide range of
structures, skills, knowledge and analytical capacities are needed to coordinate and implement
all of the “building blocks” that make up national Occupational Safety and Health (OSH) systems
so that protection is extended to both workers and the environment 3

Work-related health problems result in an economic loss of 4–6% of GDP for most countries.
Above 70% of workers do not have any insurance to compensate them in case of occupational
diseases and injuries. Universal health coverage combines access to services needed to achieve
good health viz., providing health promotion, prevention, treatment and rehabilitation,
including those that address health determinants, with the financial protection that prevents ill
health leading to poverty. There are effective interventions to prevent occupational diseases,
but are generally ignored, keeping productive in industries as prime . For example
encapsulation of pollution sources, ventilation, noise control, substitution of dangerous
chemicals, waste management, improvement of workplace house-keeping, and the
organization of work etc , are Industrial hygiene measures.

Currently, specialized occupational health services are available only for 15% of workers across
the world, primarily in big companies that offer health insurance and employment injury
benefits, in India only around 8% of working population gets this coverage. With the ongoing
global job crisis, more and more people seek labour in the informal sector without any
insurance cover and no occupational health services. Many such workers often also work in
hazardous conditions and suffer work-related diseases, injuries and disabilities. In many
communities, when the breadwinner falls sick the entire family suffers as there is no social
protection4

Hierarchy of Hazards Controls: Controlling exposures to occupational hazards is the

fundamental method of protecting workers. Traditionally, a hierarchy of controls has been used
as a means of determining how to implement feasible and effective control solutions 5. The idea
behind this hierarchy is that the control methods at the top of graphic are potentially more
effective and protective than those at the bottom. Following this hierarchy normally leads to
the implementation of inherently safer systems, where the risk of illness or injury has been
substantially reduced. NIOSH leads a national initiative called Prevention through Design (PtD)
to prevent or reduce occupational injuries, illnesses, and fatalities through the inclusion of
prevention considerations in all designs that impact workers. Hierarchy of controls is a PtD
strategy.

a. Elimination and Substitution: Elimination and substitution, while most effective at

reducing hazards, also tend to be the most difficult to implement in an existing process.
If the process is still at the design or development stage, elimination and substitution of
hazards may be inexpensive and simple to implement. For an existing process, major
changes in equipment and procedures may be required to eliminate or substitute for a
hazard.

b. Engineering Controls: Engineering controls are favoured over administrative and

personal protective equipment (PPE) for controlling existing worker exposures in the
workplace because they are designed to remove the hazard at the source, before it
comes in contact with the worker. Well-designed engineering controls can be highly
effective in protecting workers and will typically be independent of worker interactions
to provide this high level of protection. The initial cost of engineering controls can be
higher than the cost of administrative controls or PPE, but over the longer term,
operating costs are frequently lower, and in some instances, can provide a cost savings
in other areas of the process.

c. Administrative Controls and Personal Protective Equipment (PPE):Administrative

controls and PPE are frequently used with existing processes where hazards are not
particularly well controlled. Administrative controls and PPE programs may be relatively
inexpensive to establish but, over the long term, can be very costly to sustain. These
methods for protecting workers have also proven to be less effective than other
measures, requiring significant effort by the affected
 3.Role of Medical Officers in prevention and control of Occupational Diseases.

To assess the role of Occupational Medicine in the promotion of workers' health from a
clinical-diagnostic approach to the current emphasis on prevention, this training would offer
good opening. In Occupational Medicine even preventive measures are based on clinical
methodology, as for example in health surveillance, where the main tasks are the identification
of individual hyper-susceptibility and the assessment of early and reversible health effects due
to occupational risks. Moreover, the traditional clinical-diagnostic approach is still of utmost
importance. In fact, the classical occupational diseases do not present with the specific clinical
features of the recent past. Instead, it is necessary to evaluate whether occupational risk
factors play a concomitant role in the origin of diseases that affect the general population.
Moreover, new occupational diseases are emerging, due to the continuous changes in
manufacturing processes and work organization. However doctors face new problems that
impose a continuous updating process, not only on medical topics but also on the development
of technological processes. The laws and the recommendations of the most prestigious national
and international organizations and the principles of the ICOH Code of Ethics, ILO Conventions,
WHO guidelines should guide Physicians in their profession and their actions must imply full
professional independence. They must acquire and maintain the necessary competence in
occupational health for their duties and adequate conditions to carry out their tasks according
to good practice and professional ethics6.

Physician’s Roles in providing Occupational Health Services : The primary concerns of

occupational health services remain those specified by the ILO/WHO in 1950, although work-related
diseases are now considered as well as purely occupational diseases. The actual services offered are
essentially preventive in nature and are summarized below.
a. Pre-Employment Medical Examination: People with certain pre-existing medical
conditions may be at a disadvantage in some jobs. A preemployment health
questionnaire or medical examination can be of great value in such cases by
determining job unsuitability before training time and expense have been incurred. Job
suitability may also need to be regularly monitored in order to assure employee health
and ability. The health service can also give valuable advice with regard
to alternative employment when a worker is found to be unfit for a particular job.

b. Occupational Safety Practices: An occupational health service has a responsibility to

keep all employees informed about hazards in the workplace. The measures taken to
protect employee health should be thoroughly explained so that workers understand
the necessity of complying with such irksome or unpleasant restrictions as the wearing
of protective clothing and face masks. First aid facilities should be organized and
employees instructed about first aid procedures in case of accidental injuries or other
emergencies.

c. High-Risk workforce Surveillance: Workers engaged in Hazardous jobs need continuous

monitoring both at shop-floor level hazards recording and simultaneous health
 screening. Examples: Silica exposure leading to silicosis, Noise exposure to Noise
induced hearing loss, Heat exposure to heat stress disorders etc. Exposure levels
considered safe for a young male worker may be hazardous for a pregnant woman.
Pregnant women, as well as such other vulnerable groups as the very young, the elderly,
and the disabled, therefore require appropriate medical surveillance and advice about
specific precautionary measures they can take.

d. Hazards control at workplaces: A complex system of Industrial Hygiene environmental

and biological monitoring has been developed for the control of known hazards at work.
Occupational health practice is concerned with monitoring the concentration of toxic
substances in the environment, determining safe exposure levels, suggesting procedures
to limit worker exposure, and monitoring workers for signs of overexposure.
Occupational health specialists can also contribute to the prevention of health risks by
assisting in the planning and design of new equipment and factories.

e. Recognize the hazards and health disorders: Occupational health services can play a
major role in the detection of new health hazards of all types. Clinical observation and
study may reveal a causal relationship between patterns of sickness or mortality in
groups of workers and their occupational exposure. Examples of hazards identified in
this manner include lung and nasal cancer among nickel workers, lung
cancer in asbestos workers, and coronary heart disease among workers exposed
to carbon disulfide (used in the manufacture of rayon).

f. Clinical management : Occupational Diseases and disorders are preventable and very
rare that any treatment be given. Quick, on-site treatment of work injuries and
poisonings can prevent complications and aid recovery. Such treatment can also be
economically beneficial by saving traveling and waiting time. Furthermore, physicians
who are unfamiliar with their patients’ working conditions may keep workers with minor
injuries away from work longer than necessary. An occupational treatment service
offers opportunities for specialized counselling and health education.

Occupational Health and Safety Management System (OHSMS): The purpose of an

Occupational Health and Safety (OH&S) management system is to provide a framework for
managing workplace risks. The intended are to prevent work-related injury and ill health to
workers and to provide safe and healthy workplaces. When these measures are applied by the
organization, they improve its OH&S performance. An OH&S management system can be more
effective and efficient when taking early action to address opportunities for improvement of
OH&S performance. The recent OHSMS ISO 45000:2018 provides steps for such protection and
promotion 7.

 Hazard Identification, Assessment of risks and opportunities.

 Managing OH & S risks
  Legal and Other Requirements
 OHS Objectives and planning to achieve them
 Resources, Roles, Responsibility, Accountability and Authority
 Competence, Training and Awareness
 Communication, Participation and Consultation
 Operational planning and Control
 Emergency Preparedness and Response
 Monitoring, Measurement, analysis and Performance evaluation
Improvement.
The benefits derived from ISO 45000 application would be to promotes a safe and healthy
working environment by providing a framework that allows organizations to consistently
identify and control their health and safety risks, reduce the potential for accidents, aid
legislative compliance and improve overall performance (Prevent work-related injury and ill
health to workers and to provide safe and healthy workplaces)
 Improves the efficiency of internal operations
 Improved employee safety and the quality of the working environment
 Compliance with applicable legal requirements
 Demonstrate high levels of occupational health and safety when bidding for
international contracts
 Improves the reliability of your internal operations to meet customer requirements
and overall performance
 Gain significant improvement in staff motivation and commitment and understanding
of their responsibility in helping ensure workplace safety

The Employees' State Insurance Act, 1948 applies to non-seasonal factories employing 10 or
more persons, which does not apply to the unorganised sector till the recent announcement by
the government . All 380 million unorgansied sector workers may get treatment at Employees’
State Insurance Corporation (ESIC)-run healthcare facilities. Unorganised sector workers like
domestic and household workers, construction workers and those engaged as private security,
among millions of others, and are not members of either the EPFO or the ESIC at present, to
make a paltry contribution to the social security fund, proposed in the social security code, to
avail medical benefits under the scheme. For the first time, the government has taken the
initiative to identify such workers by registering them in the e-shram portal. Around 280 million
out of an estimated 380 million of them have already been registered on the portal. Employees
above 40 years and insured under Employees' State Insurance Corporation's (ESIC) will be able
to undergo free annual health check-ups at the government facilities spread across the country,
at a time non-communicable diseases are on the rise.

The Laour (OSH) Code-2020: The Government has taken to reform labour laws by merging various
laws into 4 codes. The four codes are 1.Wages, 2.Industrial relations, 3.Social security, and 4.
Occupational safety, health & working conditions. The newly evolved Labour Codes in 2020, open ways
and means for inclusive faster development and at the same time protecting the Labour wages, welfare,
social security, occupational health and safety. The hitherto much neglected 90 percent of unorganised
8
force now to breath fresh benefits under the new Labour Cods legislations
India: Gig Workers And Platform Workers: The Code On Social Security 2020: The new Code
on Social Security Code-2020 . The Code will replace nine legislations which provided social
security to the employees like Maternity Benefit Act, Employees' Provident Fund Act,
Employees' Pension Scheme, Employees' Compensation Act, among others. The term gig
worker is a newly introduced concept in India. In general the term gig worker means someone
who takes on hourly or part-time jobs in everything from catering events to software
development. The work is usually temporary and completed during a specified time under a
nonstandard work arrangement. The Code defines the term gig worker as, “a person who
performs work or participates in a work arrangement and earns from such activities outside of
traditional employer-employee relationships”. The Code also mandates for compulsory
registration of both gig workers as well as platform workers on an online portal to avail benefits
under the Code which shall be specified by the Central Government 9.

4.Basic Occupational Health Service planned under National Program for

Climate Change and Human Health (NPCCHH).

Basic Occupational Health Services (BOHS) :An effort was launched by the International
Commission on Occupational Health (ICOH) to develop Basic Occupational Health Services,
since occupational health services are available to only 10-15% of workers worldwide. Even
where services are available, their quality and relevance may be low. Basic Occupational Health
Services are most needed for countries and sectors that do not have services at all or which are
seriously underserved. The BOHS are an application of the primary health care principles in the
sector of occupational health. Primary health care definition can be found in the World Health
Organization Alma Ata declaration from the year 1978 as the “essential health care based on
practical scientifically sound and socially accepted methods. The objective is to provide
occupational health services for all working people in the world, regardless of mode of
employment, size of workplace or geographic location, that is, according to the principle of
universal services provision 10. The main functions being:
 Surveillance of work environment and risk assessment
 Health surveillance and health examinations
 Advice on preventive and control measures
 Health education and health promotion, and promotion of work ability
 Maintaining preparedness for first aid and participation in emergency preparedness
 Diagnosis of occupational diseases
 Health Record keeping

The Ministry of Health & Family Welfare launched the National Program for Climate Change
and Human Health (NPCCHH) in 2019. The objectives with some initially identified key actions
are 11:
  To create awareness among general population (vulnerable community), health-care
providers and Policy makers regarding impacts of climate change on human health.
 To strengthen capacity of healthcare system to reduce illnesses/ diseases due to
variability in climate
 To strengthen health preparedness and response by performing situational analysis at
national/ state/ district/ below district levels.
 To develop partnerships and create synchrony/ synergy with other missions and ensure
that health is adequately represented in the climate change agenda in the country
 To strengthen research capacity to fill the evidence gap on climate change impact on
human health

Key activities: Development of IEC material on health impacts of Climate variability & change;
Advocacy on health impacts of Climate variability & change; Strengthening of health care
system in context of climate change; Capacity building for vulnerability assessment at various
levels and liaison with centre ; Develop/ strengthen the monitoring and surveillance systems for
climate sensitive diseases; Develop mechanisms for EWS/ alerts and responses at state, district
and below district level; Develop joint action plan with other dept./ organizations In view of
their capabilities and complementarities; Integrate, adopt and implement environment friendly
measures suggested in other missions on climate change; Strengthening  of healthcare services
based on researches on climate variables and impact on human health 

Expected Output: Awareness & Behaviour modification of general population for impact,
illnesses, prevention and adaptive measures for climate sensitive illnesses ; Increase in trained
healthcare personnel and equipped institutes/ organization towards achievement of climate
resilient healthcare services and infrastructure at district level in each state; Integrated
monitoring system for collection and analysis of health related data with meteorological
parameters, environmental, socio-economic and occupational factors; regulation on key
environmental determinants of health: air quality, water quality, food, waste management,
agriculture, transport; Evidence–based support to policy makers, programme planners and
related stakeholders

Occupational Health Research in India: India being a developing nation is faced with traditional
public health problems like communicable diseases, malnutrition, poor environmental
sanitation and inadequate medical care. However, globalization and rapid industrial growth in
the last few years has resulted in emergence of occupational health related issues. Agriculture
(cultivators i.e. land owners + agriculture labourers) is the main occupation in India giving
employment to about 58% of the people. The major occupational diseases/morbidity of
concern in India are silicosis, musculo-skeletal injuries, coal workers' pneumoconiosis, chronic
obstructive lung diseases, asbestosis, byssinosis, pesticide poisoning and noise induced hearing
loss. There are many agencies like National Institute of Occupational Health, Industrial
Toxicology Research Centre, Central Labour Institute, etc. are working on researchable issues
like Asbestos and asbestos related diseases, Pesticide poisoning, Silica related diseases other
than silicosis and Musculoskeletal disorders. Still much more is to be done for improving the
occupational health research. The measures such as creation of advanced research facilities,
human resources development, creation of environmental and occupational health cells and
development of database and information system should be taken 12.

NIOH-ICMR is conducting research to try to identify a possible biological marker (biomarker) that
could be used to detect the possible early signs of silicosis among workers exposed to silica dust. A
rapid point of care CC16 kit for screening of occupational silica dust exposed workers for early
detection of silicosis/silico-tuberculosis has been developed . A diagnostic test that highlights the
presence of a biomarker in an individual may indicate that the person is at risk of developing a
specific disease. 13

Conclusion: What is the mission of training Medical Officers in occupational health and safety ? In
answer to this question , a comprehensive occupational health and safety program is outlined linking
services for all job-related illnesses, injuries and hazards to other arrangements providing health care for
the worker and his or her family. The significance of this problem makes it a matter of major concern to
public health. The mission of occupational health and safety has long been acknowledged to be the
"prevention" of job-related illnesses and injuries.

Medicine is an ethical profession with dedicated commitments to the patient, the community, and itself,
but the impact on the community, of which we as physicians also are a product, has fragmented our
ethics and separated us from those in need of our skills and learning. The practice of medicine continue
to be curative in spite of several preventable pandemic, epidemics, endemics faced in the history.
Occupational medicine is an alien for day to day practice by general physicians. It’s time the curative
oriented Medical Officers are to be involved in the practice of Holistic Public Health issues .

The main aim this awareness mission on Climate Changes to health issues , however, has cloaked the
doctors with an aura of greater concern for the on-the-job health of the worker inclusive of his total
health and well-being. This has been reinforced by the apparent isolation of the experts, individually and
collectively, from professional colleagues in both medicine and public health. Trained doctors shortage
in occupational health preclude the continuance of traditional patterns of delivering services as purely
curative . The worker is the consumer of these services and he has rapidly become aware of their need
and importance prevention from workplace hazards. He is also equally aware that these services must
be provided in a manner which fully protects his total health and continued employment without adding
to his insecurity. New developments are providing the catalytic force for a broadened concept of
occupational health , a merging of the forces of all parties interested in promoting the comprehensive
health and safety of workers and their families 14.

The interest of focus on Occupational Health and Safety is a new initiative jointly by the Public Health
Foundation India (PHFI) and the National Health Systems Resource Centre (NHSRC) a technical
support unit of Ministry of Health & Family Welfare (MoHFW). The Health and Labour are
under the different Ministries , run parallel at no meeting point. Occupational health is alien to
both. The efforts taken by the PHFI and NHSRC need all out appreciation to help these
Ministries to meet at point , especially when health-safety-welfare-work environment of huge
the nation’s work force of 500 million , of India population is concerned .

References:
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3. Fundamental Principles of Occupational Health and Safety-ILO, Benjamin O, Alli,

https://www.ilo.org/wcmsp5/groups/public/@dgreports/@dcomm/@publ/documents/
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4. Protecting workers -WHO,

https://www.who.int/news-room/fact-sheets/detail/protecting-workers'-health)

5. Center for Disease Control and Prevention, NIOSH Hierarchy of hazards control,
https://www.cdc.gov/niosh/topics/hierarchy/default.html) .

6. International code of ethics for occupational health professionals, Third Edition, *ICOH:
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7. ISO/IEC 45001:2018 OCCUPATIONAL HEALTH AND SAFETY MANAGEMENT

SYSTEMS https://www.kebs.org/index.php?
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8. The New Labour Code New India ,Biggest Labour Reforms in Independent India ,
https://labour.gov.in/sites/default/files/Labour_Code_Eng.pdf

9. India: Gig Workers And Platform Workers: The Code On Social Security 2020, 11
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workers-and-platform-workers-the-code-on-social-security-2020

10. Basic Occupational Health Services: Strategy, Structures, Activities, Resources.

Rantanen, J. Helsinki, 2005.
BOHS,https://en.wikipedia.org/wiki/Basic_Occupational_Health_Services

11. Source : National Centre for Disease Control:

https://vikaspedia.in/health/nrhm/national-health-programmes-1/national-programme-
on-climate-change-human-health#:~:text=NPCCHH)%20in%202019.-,Objectives,climate
%20change%20on%20human%20health
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Institute for Research in Environment,
https://www.researchgate.net/publication/8577769_Occupational_Health_Research_in
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13. Preventing Occupational Disease in India , Dr. Kamalesh Sarkar ,Director-NIOH, 2019,
https://www.britsafe.in/publications-and-blogs/safety-management-magazine/safety-
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14. Occupational Health A Discipline in Search Of A Mission, Lorin E. Kerr, M.D., M.P.H.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1775163/pdf/amjph00818-0007.pdf