ENVIRONMENTAL

HEALTH AND SAFETY

ANANDU V G
Assistant Professor
Dept. of Civil Engineering
TKMCE, Kollam
 MODULE 1
Introduction to Occupational Health and Toxicology: safety at work-
socio-Economic reasons. Introduction to health and safety at
various industries. Occupational related diseases – Musculoskeletal
disorders. Hearing impairment, carcinogens, silicosis, asbestosis,
pneumoconiosis-toxic materials and substances used in work,
exposure limits ,toxicological investigation, Industrial Hygiene.
Arrangements by organisations to protect the workers.
 Occupational (or Industrial) health
As per WHO/ILO

“ Occupational health aim at; the promotion and maintenance of highest

degree of physical, mental, and social well-being of workers in all
occupation”

Occupational health is a multidisciplinary activity aimed at:

The protection and promotion of the health of workers by preventing and

controlling occupational diseases and accidents and by eliminating
occupational factors and conditions hazardous to health and safety at work.
 Health, workplace, economy and sustainable
development
• Workplaces designed according to good principles of occupational
health, safety and ergonomics are also the most sustainable and
productive.

• A healthy economy, high quality of products or services and long-

term productivity are difficult to achieve in poor working
conditions where workers are exposed to health and safety hazards
 Occupational toxicology
• A toxin is a chemical substance which damages an organism.

• In the study of Toxicology, the central motto is that, “all substances are toxic, it is
only the dose which matters.”

• Toxicity- The capacity of a substance to induce damage to living tissue

Occupational (or Industrial) toxicology is the application of the

principles and methodology of toxicology to understanding and managing chemical
and biological hazards encountered at work
 OCCUPATIONAL DISEASES
Adverse health conditions in the human being, the occurrence or
severity of which is related to exposure to factors on the job or in
the work environment.

Such factors can be:

• Physical: e.g. heat, noise, radiation

• Chemical: e.g. solvents, pesticides, heavy metals, dust

• Biological: e.g. tuberculosis, hepatitis B virus, HIV

 OCCUPATIONAL DISEASES(Cont.)

• Ergonomic: e.g. improperly designed tools or work areas,

repetitive motions

• Psychosocial stressors: e.g. lack of control over work,

inadequate personal support

• Mechanical: these mainly cause work accident and injuries

rather than occupational diseases
 Prevention of occupational diseases
1. Primary : done by reducing the risk of disease by reducing the
magnitude of exposure to hazardous substances
• Industrial hygiene personnel
• changes in production process or associated infrastructure, e.g. the
substitution of a hazardous substance with a safer one, or enclosure or
special ventilation of equipment or processes that liberate airborne
hazards. These are known as Engineering controls
• use of personal protective equipment and rotation of workers through
areas in which hazards are present to reduce the dose to each worker
2. Secondary :done by identifying health problems before they
become clinically apparent (i.e. before workers report feeling ill)
and intervening to limit the adverse effects of the problem. This is
also known as occupational disease surveillance.

•An example of secondary prevention is the measurement of blood

lead levels in workers exposed to lead. Corrective action would be
to improve the primary prevention activities listed above.
•3. Tertiary : accomplished by minimizing the adverse clinical
effects on health of a disease or exposure. Typically this is
thought of as clinical occupational medicine.

•An example of tertiary prevention is the treatment of lead

poisoning by administration. The goal is to limit symptoms or
discomfort, minimize injury to the body and maximize functional
capacity.
 Musculoskeletal disorders(MSD)
• Musculoskeletal Disorders- Injuries and conditions that affect the
movement of the human body or the musculoskeletal system
comprising of bones, tendons, ligaments, muscles, discs, blood
vessels, nerves, etc.

• The work environment and performance of work contribute

significantly to the condition. The condition is made worse or persists
longer due to work conditions

Eg; Sprains, strains , Back pain, Carpal tunnel syndrome

 Musculoskeletal disorders(Cont.)
CAUSES
ERGONOMIC
• The design of a workplace plays a crucial role in the
development of MSD. A musculoskeletal disorder is imminent
due to ergonomic risk factors.

• Work-related risk factors are further divided into high task

repetition, forceful exertions, and awkward postures. These are
considered as primary culprits of MSDs.
Musculoskeletal disorders(Cont.)
REPETITION OF TASKS

• Controlled frequently by the daily and hourly production targets

and work processes, tasks and work cycles can be highly
repetitive.

• When combined with other risk factors, awkward postures

including high force activities, and repetition of tasks can
contribute to the advent of MSD.
Musculoskeletal disorders(Cont.)
EXERTION WITH FORCE
• Several work tasks involve high levels of muscle response, which
lead to force loads on the human body. This increases fatigue,
leading to MSD.

POSTURES
• awkward postures can be detrimental.

• These impose excessive force on the joints and tend to overload the
muscles and tendons.
Musculoskeletal disorders(Cont.)
• Joint efficiency depends primarily upon its closest mid-range
motion. When these are worked outside of the mid-range
repetitively without providing it adequate recovery time,
it leads to an increased risk of MSD.

• Workers exposed to such forceful exertions, repetitive tasks and

prolonged awkward postures, experience fatigue, and the body
is beyond its ability to recover. The resultant musculoskeletal
imbalance ultimately leads to MSD.
Musculoskeletal disorders(Cont.)
Musculoskeletal disorders(Cont.)
Hearing Impairment
➢Noise exposure is the primary cause of hearing loss at workplaces.

➢ Continuous exposure to loud noises may affect your hearing

capabilities leading to hearing loss.

➢This occurs when one is exposed to loud noises that either last too

long or are too loud. The loud noise damages the sensory hair cells

in the ear that aid hearing.

Hearing Impairment(Cont.)
Preventive measures

➢Employers should install acoustic barriers to prevent loud noise

from damaging the ears of their employees.

➢They should also offer prevention programs and training to

workers, including hearing loss education, assessments, and

appropriate equipment use to their workers.

Hearing Impairment(Cont.)

➢Employees should wear protective equipment like ear muffs

or earplugs when exposed to unsafe noise levels.

➢Also, they should not spend much time working in

environments with loud noises.
PNEUMOCONIOSIS
 Contents
• Definitions

• Pathogenesis

• Types

• Individual diseases
• Silicosis
• Asbestosis
• Anthracosis

• Preventive measures
 Definitions
• The term pneumoconiosis derives its meaning from the Greek
words: pneuma = air and konis = dust.

• The International Labour Organisation (ILO) defines pneumoconiosis

as “the accumulation of dust in the lungs and the tissue reactions to
its presence”.

• Not included in the definition of pneumoconiosis are conditions

such as asthma, chronic obstructive pulmonary disease (COPD),
and hypersensitivity pneumonitis, in which there is no requirement
for dust to accumulate in the lungs in the long term.
 Pathogenesis
For clinical pneumoconiosis to develop, 3 essential factors are
required:

• Exposure to specific substance: coal, appear relatively inert and

may accumulate in considerable amounts with minimal tissue
response; while silica and asbestos, have potent biologic effects.

• Particles of appropriate size to be retained in lung (1-5μm)

• Exposure for a sufficient length of time (usually around 10 years)

 Pathogenesis(Cont.)
From an occupational health point of view, dust is classified by size into
following categories:

• Inhalable Dust: is the one which enters the body, but is trapped in
the nose, throat, and upper respiratory tract. Particle size is usually 6-
25μm.

• Respirable Dust: particles that are small enough to penetrate the

nose and upper respiratory system beyond the body’s natural
clearance mechanisms of cilia and mucous and are more likely to
be retained in the lungs. Particle size is usually 1-5μm.
 Types
• – Silicosis – from silica dust

• – Asbestosis – from asbestos dust

• – Coal Workers Pneumoconiosis (Anthracosis) – from coal dust

• – Byssinosis – from cotton dust

• – Bagassosis – from sugarcane dust

• – Farmers Lung – from hay dust or spores or other agricultural products.

• – Berylliosis – from beryllium

 Types(Cont.)
• – Siderosis – from iron oxide

• – Stanosis – from tin oxide

• – Talcosis – from talc (hydrated magnesium silicate)

• – Bauxite fibrosis – from bauxite dust

• – Mixed dust pneumoconiosis – from a mixture of dusts

• – Hard metal pneumoconiosis – from certain metals like cobalt

 Types (Cont.)
• Pneumoconiosis is usually divided into three groups:

– Major pneumoconiosis
“ Fibrotic Pneumoconiosis”
– Minor pneumoconiosis

– Benign pneumoconiosis
 Types(Cont.)
• Major Pneumoconiosis: Inhalation of some dusts results
in “major fibrosis” of the lungs

• Examples are:
– Silica :silicosis
– Asbestos :asbestosis
– Coal :anthracosis
Healthy lung Silicotic lung
 Types (Cont.)
• Minor Pneumoconiosis: Inhalation of some dusts results in
“minor fibrosis” of the lungs
• There is minimal fibrosis of the lungs

• These dusts include:

– Mica pneumoconiosis
– Kaolin (china clay) pneumoconiosis
 Types (Cont.)
Benign Pneumoconiosis: There isn't any reaction in the lungs, but
dust deposition casts a shadow in x-ray of the lung. There is no
fibrosis and no disturbance of lung functions
• It can result from the inhalation of:
– Iron dust- Siderosis
– Tin dust- Stannosis
– Calcium dust- Chalcosis
Deposit in lungs get disappeared when exposure is
discontinued.
 ASBESTOSIS
• Asbestosis is diffuse interstitial pulmonary fibrosis that occurs
secondary to the inhalation of asbestos fibers.

Complications

• Pleural disease – thickening of the lining covering the lungs (pleura)

• Mesothelioma – cancer that affects the lining of the lungs,

tummy, heart or testicles

• Asbestosis –classified into serpentine and amphibole

 ASBESTOSIS(Cont.)

Serpentine Amphibole
(93% of commercial use) (7% of commercial use)
Actinolite, Amosite, Anthophyllite,
Chrysolite Crocidolite, Richterite, Tremolite
 ASBESTOSIS(Cont.)
• Significant occupational exposure to asbestos occurs mainly in

– Asbestos cement factories

– Asbestos textile industry
– Asbestos mining and milling.
Asbestos cement factories

Asbestos textile industry Asbestos mining

 ASBESTOSIS(Cont.)
• Symptoms
– Average latency period is 20-30 years
– Dyspnoea
– Cough
– Chest pain
– In advanced cases, clubbing of fingers
• Diagnosis ( X-ray or CT Scan)
In histopathologic
. analysis, asbestos bodies, which may
consists of a single asbestos fiber surrounded by a segmented
protein-iron coat can be identified in intra-alveolar macrophages.
 ASBESTOSIS(Cont.)
• Treatment Strategy:
– Stopping additional exposure
– Careful monitoring to facilitate early diagnosis
– Smoking cessation
– Regular influenza and pneumococcal vaccines
– Disability assessment
– Pulmonary rehabilitation as needed
– Aggressive treatment of respiratory infections
– Health education to patient
 ANTHRACOSIS
• Anthracosis/ Coal Worker's Pneumoconiosis (CWP) / Black
lung disease:
– Accumulation of coal dust in the lungs and the tissues
– Associated with coal mining industry
– Takes one or two decades to cause symptoms
– The disease is divided into 2 categories:
• Simple CWP and
• Complicated CWP or Progressive Massive Fibrosis (PMF).
 ANTHRACOSIS(Cont.)
• Simple Coal Worker's Pneumoconiosis

– Benign disease if no complications.

– Common symptoms: cough, expectoration (black in color) and

dyspnoea.

• Complicated Coal Worker's Pneumoconiosis

– Pathologically it is characterized by large masses of black

colored fibrous tissue. Symptoms are similar but more severe.

– Recurrent pulmonary infection

ANTHRACOSIS(Cont.)

On histopathological examination
SILICOSIS
 What is Silicosis??
A form of occupational lung disease caused by the inhalation of crystalline
silica dust, causing inflammation in the lungs.

Presence of silica dust in the lungs - causes scar tissue to form and build up
over time
• Silicon dioxide, or silica, is the earth’s most abundant mineral.
• Silicosis occur when workers are consistently exposed to silica particles of
respirable size (0.5–5.0 μm in diameter) at levels exceeding those recognized
to be safe.
 Crystalline form-Crystalline form silica are
different in their structure, fibrogenicity, and
biologic activity.

SILICA

Amorphous form- Amorphous silica is

relatively less fibrogenic and does not
cause lung fibrosis.
Silicosis-history -Known as “disease of workers”
Variety of occupations
• Mining industries
• Pottery and ceramic industries
• Iron and steel industries
• Metal grinding
• Sand blasting
• Building and construction workers
• Glass manufacture etc…
Small silica dust particles when inhaled:
➢ Can embed themselves deeply into the tiny alveolar sacs and ducts in the
lungs, where oxygen and carbon dioxide gases are exchanged.
➢ lungs cannot clear out the dust by mucous or coughing.
 Symptoms
Continued exposure:-
• Irritated cough
• Dyspnoea
• Fever
• Bluish skin at earlobes or lips
As disease progresses:-
• Chest pain
• Fatigue
• Extreme shortness of breath
• Loss of appetite
• Respiratory Failure
 Investigation

• Chest X-ray: Fine

nodularity in the upper
zones of the lung
• Pulmonary function
test(PFTs)
• Test for tuberculosis
 Medical Treatment
• NONE

• End result of silicosis is death

• Those with silicosis are also more susceptible to:

– Tuberculosis

– Lung cancer

– Heart attacks

– Connective tissue diseases

 Types of silicosis
• Chronic silicosis

• Accelerated silicosis

• Acute silicosis
 Chronic/Accelerated/Acute
• Chronic silicosis: the most common
• Long-term exposure (10-20 years or longer)
• Present as a disease entity in lungs 5-10 years - before
symptoms lead to diagnosis

• Accelerated silicosis
• Rapidly progressive symptoms after 5-10 years of exposure

• Acute silicosis
• Occurs after exposure to high concentrations of silica dust.
Symptoms show within weeks to months of exposure
❖OSHA permissible exposure limit (PEL)
is 100 μg/m3 for an 8-hour work exposure.

❖Bronchitis, a well-recognized effect of chronic dust

inhalation, can occur with silica dust inhalation.

❖Silica exposure can be associated with:

1.Autoimmune diseases

2.Nephropathy
3.Tuberculosis
4.lung cancer
 Prevention & Management
• To identify silica through dry air filtering.
• To eliminate or control the dust in workplace.
• Water spray is often used where dust emanates.
• Product substitution of silica with less toxic particles in abrasive blasting.
• Appropriate use of respiratory protective devices.
• Medical screening of silica-exposed workers is generally recommended,
using chest X-rays and spirometry
• Once a diagnosis of silicosis is made the worker should be removed from
further silica exposure.
 CARCINOGENS
• Any substance that is capable of causing or aggravating cancer in humans or animals is
labelled a carcinogen.

• Some of these substances are inhaled, others enter through the skin or mucous
membranes.

• Carcinogenic substances cause cancer by directly damaging the DNA of cells or by

causing cells to divide at a faster rate than normal, and thereby increasing the chances
that DNA changes and mutations will occur.

• Not every exposure to a carcinogenic substance inevitably leads to cancer. Many factors,
including the extent and duration of the exposure, as well as the individual’s genetic
background, can influence whether an individual exposed to a carcinogen will develop
cancer at some stage in their lifetime.
Preventative Measures Against Carcinogenic
Exposure
• Elimination is the most effective measure and can be achieved by making

changes to the technology used or by adjusting the characteristics of the

final product in order to remove carcinogens from the workplace entirely.

• Where elimination is not technically possible, substitution is the most

desirable means of prevention. Employers can reduce the risk of exposure

to workers by replacing a dangerous carcinogen with a safer substance,

product or process, providing that this does not lead to other hazards with

higher levels of risk.

Preventative Measures Against Carcinogenic
Exposure(Cont.)

• Where substitution is not possible, the employer should operate using a

closed system that does not expose any carcinogens to the external
environment.

• Where a closed system is not possible, the employer should reduce

exposure to a minimum.

• If there remains a level of risk to worker ’ s health, specified areas should

only be accessible to workers who are required to enter them.
 How To Assess the Risk of Exposure to
Carcinogens in the Workplace?
▪ Employers must assess the risk of exposure to carcinogens in the workplace in the form of a risk assessment

▪ Set preventive measures that take into account all possible means of exposure, including the storage of
chemicals and waste.

▪ Safety data sheets and labels describe the hazards associated with substances, and provide information on
storage, handling, emergency measures and risk management processes.

▪ Employers are required to adjust the recommended measures to the specific conditions of their workplace, and
to provide appropriate instructions and relevant training to workers regarding the potential risks to health and
safety.

▪ Training needs to also raise awareness of risks that are not visible and effects that may only materialise after an
extended period of time.

▪ The risk assessment requires regular revision, particularly when a change in the workplace has occurred, as this
has the potential to introduce new carcinogens into the environment.
• The toxicity of any new product must be
checked before it is introduced and any
changes to working procedures or methods
must be carefully assessed.
• It is important to remember that a substance
currently regarded as acceptable may later be
recognised as carcinogenic following new
research.
• Although carrying out a risk assessment is the
responsibility of the employer, it is always
advisable to consult an occupational hygienist,
such as ourselves, as best practise.
 Effects of toxic substances
Toxic substances can cause four types of effects on the body:

• Local
• Systemic
• Acute
• Chronic
 Local effects
• Some substances have only a localized effect on one part of the
body - where the hazardous agent comes into contact with or
enters the body.

• For example, the local effect can be on the skin, such as an acid
burn, or in the digestive tract when a hazardous agent is
ingested.

• Some substances like ammonia, chlorine, welding fumes and

exhaust fumes can cause local irritation to the lungs when they
are inhaled.
 Systemic Effects
• Systemic effects are effects occurring in tissues distant from the
site of contact between the body and the hazardous material

• Systemic effects can occur in the blood when the substance is

absorbed into the bloodstream, and in the organs that either store
the toxic material (such as the bones and the brain), neutralize it
(such as the liver), or remove it from the body (such as the kidney
and bladder).
 Systemic Effects(Cont.)
• A typical systemic effect in the blood is anaemia (a shortage of red
blood cells) which can be caused by a number of chemicals, including:
lead, beryllium, cadmium, mercury compounds and benzene.

• Benzene can damage the cells that form blood, leading to leukaemia.

• Some chemicals known to damage the liver are: benzene, DDT,

dioxane, phenol and trichloroethylene.

• Vinyl chloride monomer, used in the plastics industry, is known to

cause a rare form of liver cancer.
 Acute Effects
• Exposure to many occupational hazards causes the body to
produce an immediate obvious response, called an acute effect.

• Disappear soon after the exposure stops

• An example : nausea, headache or vomiting a worker might

experience after using a solvent to clean auto parts.

• Acute effects can be localized to one part of the body (such as a

skin reaction from a chemical), but they can also be systemic (if,
for example, that chemical also gets absorbed into the
bloodstream, there can be effects on target organs).
 Chronic Effects
• Some hazardous substances cause chronic effects, which usually
appear a long time after the exposure occurred and persist over
time.

• Only appears after a long time because of the disease's latency

period (the period of time between the exposure and the first sign
of disease).

• Chronic conditions, such as many occupational cancers, may take

20 or 30 years to develop.
 Chronic Effects(Cont.)

• Some chronic conditions develop after just a short exposure,

whereas other chronic conditions only develop after repeated
contact with a substance or work process.

• Like acute effects, chronic effects can be localized to one part of the
body (such as chronic lung disease which develops over years), but
they can also be systemic.
• Local, systemic, acute and chronic health effects can all result from
exposure to one substance.

• For example, if a worker drinks too much alcohol, these are the
possible effects that can result:

• Local effects - stomach irritation and stomach upset.

• Systemic effects - an increase in the blood alcohol level, which can

cause damage to brain cells.

• Acute effects - drunkenness, headache and a hangover.

• Chronic effects - permanent liver damage, which can have a

latency period of many years.
Temporary and Cumulative effects
Reversible or Temporary Toxicity

• It is the toxicity or harmful effect that remains for short duration

of time.

e.g., narcosis

• Cumulative Effects

• It is progressive toxicity or harmful effect produced by summation

of incremental injury resulting from successive exposures.
e.g. liver fibrosis produced by ethanol
What Is Industrial Hygiene???
• Industrial hygiene is the science of protecting the health and safety of people in

the workplace.

• The term industrial hygiene emerged in the early 1900s with the launch of the

Industrial Hygiene arm of the American Public Health Association (APHA).

• Today, the Occupational Safety and Health Administration (OSHA) requires

companies to uphold certain industrial hygiene regulations and occupational

health standards.
Industrial hygiene aims to reduce or remove work hazard
exposure by implementing a series of controls and programs
toward keeping the workplace clean, free from environmental
stressors, and hygienic.
The Industrial Hygienist or IH
It is the individual hired by OSHA who will monitor the environment
and draw analytical data
- to determine if there are potential health hazards to your employees.
- Through OSHA, the Industrial Hygienist ensures that standards are
being met,
- will assist you with controlling or eliminating any hazardous issues
that may be exposed in the evaluation process.
Industrial Hygiene is the art and
science of the anticipation,
recognition, evaluation,
control and confirmation of
environmental health
hazards arising in or from the
workplace.
Anticipation
• Thorough documentation of the workplace design, operations, processes, specific work tasks,
materials, and worker population. One notable example of anticipating industrial hygiene hazards is
the use of Safety Data Sheets (SDS)
• SDSs include important information on the properties of each chemical, the various hazards,
protective measures, and safety precautions for proper handling, storing, and transporting of the
chemical.
• Employers must ensure SDSs are readily available to all workers to serve as their guide on how to
handle hazardous chemicals in the workplace.
• This step also covers the importance of identifying any potential exposure issues caused by
workplace hazards. In this phase, using a hazard identification checklist would be useful.
Recognition
• Having a system on surveying each worker about how they get their work
done is a key part of recognizing hazards.
• Employers must consider the layout of the workplace as employees working
close to each other, also called as simultaneous operations, can affect their
hazard exposures.
Evaluation
• This is where the exposure assessment comes in.
• Strictly done by qualified professionals such as industrial hygienists, the
process involves evaluating the exposure risk and determining the who, what,
where, when, and how, based on the work environment and industrial hygiene
instruments necessary.
Control
According to OSHA, there are 3 main ways on how to reduce employee exposure to
occupational hazards:
•Engineering controls – These aim to reduce or remove the hazard at its source or
isolate the worker from the hazard itself.
Such controls include
-confining work operations,
-installing general and local ventilation systems,
- eliminating toxic chemicals and replacing them with non-toxic ones.
•Work practice controls
– Such practices alter the way tasks are performed for the purposes of mandating
safe work practices and asking workers to follow the proper procedures to
minimize exposures.
-Some examples include implementing workplace housekeeping practices and
providing good supervision guidelines.
•Administrative controls
– Setting production and task schedules is key to controlling employees’ hazard
exposure.
--For instance, employers may schedule high-exposure productions during a period
when only a few employees are present.
Confirmation
• Once measures and controls have been established, the last step is to check the
performance of what was implemented.
• Proactive confirmation also involves investigating issues, both present and
potential, and employing corrective actions that complement your industrial
hygiene program initiatives.
 FUNDAMENTALS OF INDUSTRIAL HYGIENE

Chemical agents Physical agents

• noise & vibration
• gases & vapors
• IR & NIR
• dust = API & IPI
• climate

Biological agents
(Ergonomics) • bio hazards
• repetition • fungi
• posture • allergens
• workforce • toxins

87
 INDUSTRIAL HYGIENE SERVICES

• Advice on the toxicity of materials and on substitution of less

toxic substances
• Evaluation of potential health hazards in the facilities
and laboratories by analysis of air and physical samples,
detection of lead, arsenic, asbestos, organic solvents, metals,
and other materials
• Review of ventilation hoods and other exposure control
measures
• Measurement of exposure to noise levels and heat with
recommendations for control measures
• Evaluation of indoor air quality concerns, including
measurements of carbon dioxide, relative humidity and
detectable trace contaminants 88
• Lectures and training sessions on occupational and environmental health
issues

• Review of research protocols for the safe use of hazardous materials

• Services to control hazards during renovations and maintenance, such

as asbestos fibers, lead dust, noise and odors

• Information, training, and support for compliance with the Department of

labor occupational safety and health administration laboratory standard
(chemical hygiene plans)

• Fit testing of proper respiratory protective equipment

• Information on proper personal protective equipment for spill clean-up and

decontamination procedures 89